February 3, 2017

Hashimoto’s disease is a condition caused by chronic inflammation of the thyroid gland. The resulting inflammation often leads to hypothyroidism, an underactive thyroid gland. The condition is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. The most common cause of hypothyroidism is Hashimoto’s disease.

The thyroid gland, located in front of your neck just below the voice box (larynx) produces two hormones namely thyroxine (T4) and triiodothyronine (T3) that regulate body metabolism.

The thyroid is a small, butterfly-shaped gland located in the front of the neck that produces hormones, notably thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes in every part of the body. These thyroid hormones have a major impact on the following functions –

  • Growth
  • Use of energy and oxygen
  • Heat production
  • Fertility
  • The use of vitamins, proteins, carbohydrates, fats, electrolytes, and water
  • Immune regulation in the intestine

These hormones can also alter the actions of other hormones and drugs.

With Hashimoto’s disease, the immune system makes antibodies that damage thyroid cells and interfere with their ability to make thyroid hormone. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism (heye-poh-THEYE-royd-ism). An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy. Hashimoto’s disease is the most common cause of an underactive thyroid. It is closely related to Graves’ disease, another autoimmune disease affecting the thyroid.

Who’s at Risk?

Genes – Some people are prone to Hashimoto’s disease because of their genes. Researchers are working to find the gene or genes involved.

Gender – Sex hormones also might play a role. This may help to explain why Hashimoto’s disease affects more women than men.

Pregnancy – Pregnancy affects the thyroid. Some women have thyroid problems after having a baby, which usually go away. But about 20 percent of these women develop Hashimoto’s disease in later years. This suggests that pregnancy might trigger thyroid disease in some women.

Too much iodine and some drugs may trigger the onset of thyroid disease in people prone to getting it.

Radiation exposure has been shown to bring on autoimmune thyroid disease. This includes radiation from the atomic bomb in Japan, the nuclear accident at Chernobyl, and radiation treatment of Hodgkin’s disease (a type of blood cancer).

Causes

Hashimoto’s thyroiditis is an autoimmune disease. The patient’s own immune system creates antibodies that attack and damage the thyroid gland.

Our immune system is designed to protect us against harmful invaders, such as viruses, bacteria, parasites and fungi. In patents with Hashimoto’s thyroiditis, their immune system mistakenly recognizes normal thyroid gland cells as harmful, foreign tissue and attacks them.

Experts are not sure why the immune system becomes activated in such a way. Some suggest that perhaps a virus or bacterium may play or role, maybe a genetic fault, or possibly a combination. So far, none of these environmental or genetic factors have been compellingly proven to be the cause of Hashimoto’s thyroiditis.

Symptoms

Many people with Hashimoto’s disease have no symptoms for years. An enlarged thyroid, called a goiter, is often the first sign of disease. The goiter may cause the front of the neck to look swollen. You or your doctor may notice the goiter. If large, it may cause a feeling of fullness in the throat or make it hard to swallow. It rarely causes pain.

Many people with Hashimoto’s disease develop an underactive thyroid. They may have mild or no symptoms at first. But symptoms tend to worsen over time. Symptoms of an underactive thyroid include –

  • Fatigue
  • Weight gain
  • Pale, puffy face
  • Feeling cold
  • Joint and muscle pain
  • Constipation
  • Dry, thinning hair
  • Heavy menstrual flow or irregular periods
  • Depression
  • A slowed heart rate
  • Problems getting pregnant

Treatment

Medication – Some medications and supplements may interfere with levothyroxine absorption. Some foods may affect absorption as well, including soy products or very high fiber foods.

 

The following medications and supplements may interfere with proper levothyroxine absorption –

  • Blood thinners, such as warfarin
  • Estrogen-containing medications, such as birth control pills
  • Sodium polystyrene sulfonate
  • Antacids that contain aluminum hydroxide
  • Calcium supplements
  • Iron supplements (many multivitamins contain iron)
  • Some cholesterol-lowering drugs, such as cholestyramine

Synthetic hormone treatment – For patients with goiter or hypothyroidism, thyroid hormone therapy is required. The patient needs to take one tablet of levothyroxine each day. People with an underlying heart disease or severe hypothyroidism start off on a low dose which is gradually increased.

The treatment may take a few months before any improvements in symptoms are noticed. There may be some hair loss during the first few months of treatment. This effect is temporary.

 

Alternative Treatment

Lithium – Prescription lithium carbonate is well known to cause hypothyroidism. Small studies have shown that lithium carbonate is also effective at controlling symptoms of hyperthyroidism. There are also case reports where patients who were prescribed lithium for other reasons and went on to develop Hashimoto’s disease remained asymptomatic while on lithium

Selenium – A dose of slenium may show effective in reducing symptoms of Hashimoto’s disease, including ophthalmopathy.

Carnitine – L-carnitine helps to improve symptoms of hyperthyroidism.

Probiotics like acidophilus – These can help the immune system as well.

Omega-3 Fatty Acids – Omega-3s such as those that are found in fish oil decrease inflammation and improve immunity.

Iodine – Iodine is a vital nutrient in the body and essential to thyroid function; thyroid hormones are comprised of iodine. While autoimmune disease is the primary cause of thyroid dysfunction in the United States, iodine deficiency is the main cause worldwide.

Vitamin D – Hyperthyroidism, particularly Graves’ disease and Hashimoto’s disease, is known to cause bone loss, which is compounded by the vitamin D deficiency commonly found in people with hyperthyroidism. This bone mass can be regained with treatment for hyperthyroidism, and experts suggest that adequate bone-building nutrients, such as vitamin D, are particularly important during and after treatment.

  • Goitrogens – Cruciferous vegetables such as broccoli, cauliflower, and cabbage naturally release a compound called goitrin when they’re hydrolyzed, or broken down. Goitrin can interfere with the synthesis of thyroid hormones. Soy is another potential goitrogen

Reference –

http://www.medicalnewstoday.com/articles/266780.php

http://womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html

http://www.thyroidawareness.com/hashimotos

http://www.healthline.com/health/chronic-thyroiditis-hashimotos-disease#Overview1

http://www.nytimes.com/health/guides/disease/chronic-thyroiditis-hashimotos-disease/print.html

http://emedicine.medscape.com/article/120937-overview

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/thyroid-hashimotos-disease

https://www.aace.com/files/hashimotos.pdf

February 2, 2017

Postherpetic neuralgia (PHN) can be an unfortunate result of herpes zoster infection (shingles). It is defined broadly as any pain that remains after healing of herpes zoster lesions or rash, usually after a three month period.

Shingles (also known as herpes zoster) is a skin rash that can be very painful. It is a viral infection of the nerves, and the nerves affected by shingles can occasionally continue to cause severe pain after the shingles have cleared. Shingles appear as a rash, patch, or a line of painful blisters which arise on the skin over a nerve in the shape of a band. This band follows the distribution of a specific nerve where the virus has been living before its spread to the skin. Shingles affects both men and women equally. This disease is caused by the same virus that causes chicken pox (varicella zoster). Chicken pox usually affects young children, and its symptoms involve itchy blisters all over the body. Once these symptoms go away, the varicella zoster virus stays in the nerves near the spine. It is almost as if the virus “goes to sleep”. It will “wake up”, however, when the body’s immune system is

If the pain caused by shingles continues after the shingles is over – within two to four weeks – it is known as post-herpetic neuralgia. It is estimated that about one-in-five patients with shingles will go on to have post-herpetic neuralgia. Post-herpetic neuralgia (PHN) is more common as people get older – it is uncommon in children weakened. The virus then grows in the nerves, causing pain. When the virus reaches the skin, it causes the shingles rash.

Each year approximately 1,000,000 people in the U.S. develop shingles or herpes zoster. Of these, it is estimated approximately 10-20% (about 200,000) will go on to develop PHN.

The risk of developing PHN increases with age and can affect at least 40% of all herpes zoster patients over age 50 and 75% of herpes zoster patients over age 75. PHN is the single most common neurologic condition in elderly patients

Causes

The nerve damage caused by shingles disrupts the proper functioning of the nerve. The faulty nerve becomes confused and sends random, chaotic (uncontrolled) pain signals to the brain, which the patient feels as a throbbing, burning pain along the nerve.

Experts believe that shingles results in scar tissue forming next to nerves and pressing on them, causing them to send inaccurate signals, many of which are pain signals to the brain. However, nobody is really sure why some shingles patients go on to develop postherpetic neuralgia.

Symptoms

Symptoms are usually limited to the area of skin where the shingles outbreak first occurred. Symptoms may include:

  • Occasional sharp burning, shooting, jabbing pain
  • Constant burning, throbbing, or aching pain
  • Extreme sensitivity to touch
  • Extreme sensitivity to temperature change
  • Itching
  • Numbness
  • Headaches

In rare cases, if the nerve also controls muscle movement, the patient may experience muscle weakness or paralysis.

Some patients may find the symptoms interfere with their ability to carry out some daily activities, such as bathing or dressing. Postherpetic neuralgia may also cause fatigue and sleeping difficulties.

Treatment

Treatment will depend on the type of pain, as well as some aspects of the patient’s physical, neurological and mental health.

Antidepressants – These help patients with postherpetic neuralgia not because the patient is depressed, but because they affect key brain chemicals, such as serotonin and norepinephrine, which influence not only depression, but also how the body interprets pain. Dosages for postherpetic neuralgia will tend to be lower than for depression, unless the patient has both depression and postherpetic neuralgia. Examples of drugs that inhibit the reuptake of serotonin or norepinephrine are tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), nortriptyline (Pamelor) and duloxetine (Cymbalta). They will not get rid of the pain, but are said to make it more bearable.

Anticonvulsants – As with trigeminal neuralgia pain, postherpetic pain can be lessened with anticonvulsants, because they are effective calming down nerve impulses and stabilize abnormal electrical activity in the nervous system caused by injured nerves. Gabapentin (Neurontin), pregabalin (Lyrica) are examples of commonly prescribed anticonvulsants for this type of pain.

Steroids – A corticosteroid medication is injected into the area around the spinal cord. Injected steroids are effective for postherpetic neuralgia patients with chronic pain (persistent long-term pain). The patient should not receive this medication until the shingles pustular skin rash has completely disappeared.

Painkillers – This may include tramadol (Ultram) or oxycodone (OxyContin). There is a small risk of dependency.

TENS (transcutaneous electrical nerve stimulation) – Electrodes are placed over the areas where pain occurs. Small electrical impulses are emitted. The patient turns the TENS device on and off as required. Some patients obtain significant pain relief from TENS, while others don’t. Experts are not sure why the electrical impulses relieve pain. Some say that TENS stimulates endorphin release – endorphins are the body’s natural painkillers; some people call them natural “feel good” chemicals.

Spinal cord or peripheral nerve stimulation – Similar to TENS, but here the devices are implanted under the skin, along the course of peripheral nerves. These devices are a safe, efficient, and effective way to relieve many types of neuropathic pain conditions, including trigeminal neuralgia.

Alternative Treatment

Proteolytic Enzymes – Proteolytic enzymes are enzymes that are produced naturally by the pancreas to help digest protein we eat. They help in pain relief and skin improvement.

Capsaicin Cream – Although people may not have heard of capsaicin before, if you’ve ever eaten a chili pepper and felt the mouth burn. Capsaicin is the active ingredient in chili peppers and is sometimes used for postherpetic neuralgia.

Colloidal silver is an extremely effective pathogen destroyer which can be taken internally as well as applied topically. Colloidal silver attaches itself to viruses and prevents them from replicating and there are specific silver receptors on human nerve tissue – the location where the shingles virus “hides out”.

 

 

Reference –

http://www.centerforhomeopathy.com/shingles-post-herpetic-neuralgia/

http://emedicine.medscape.com/article/1143066-treatment

http://www.nhs.uk/Conditions/postherpetic-neuralgia/Pages/Treatment.aspx

http://www.healingchronicpain.org/neuralgia/frequency

http://www.med.or.jp/english/pdf/2004_11/529_536.pdf

http://patient.info/health/postherpetic-neuralgia-leaflet

http://www.medicalnewstoday.com/articles/160253.php

http://www.nhs.uk/conditions/postherpetic-neuralgia/Pages/Introduction.aspx

http://emedicine.medscape.com/article/1143066-overview

1 February 2, 2017

Hashimoto’s disease is a condition caused by chronic inflammation of the thyroid gland. The resulting inflammation often leads to hypothyroidism, an underactive thyroid gland. The condition is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. The most common cause of hypothyroidism is Hashimoto’s disease.

The thyroid gland, located in front of your neck just below the voice box (larynx) produces two hormones namely thyroxine (T4) and triiodothyronine (T3) that regulate body metabolism.

The thyroid is a small, butterfly-shaped gland located in the front of the neck that produces hormones, notably thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes in every part of the body. These thyroid hormones have a major impact on the following functions –

  • Growth
  • Use of energy and oxygen
  • Heat production
  • Fertility
  • The use of vitamins, proteins, carbohydrates, fats, electrolytes, and water
  • Immune regulation in the intestine

These hormones can also alter the actions of other hormones and drugs.

With Hashimoto’s disease, the immune system makes antibodies that damage thyroid cells and interfere with their ability to make thyroid hormone. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism (heye-poh-THEYE-royd-ism). An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy. Hashimoto’s disease is the most common cause of an underactive thyroid. It is closely related to Graves’ disease, another autoimmune disease affecting the thyroid.

Who’s at Risk?

Genes – Some people are prone to Hashimoto’s disease because of their genes. Researchers are working to find the gene or genes involved.

Gender – Sex hormones also might play a role. This may help to explain why Hashimoto’s disease affects more women than men.

Pregnancy – Pregnancy affects the thyroid. Some women have thyroid problems after having a baby, which usually go away. But about 20 percent of these women develop Hashimoto’s disease in later years. This suggests that pregnancy might trigger thyroid disease in some women.

Too much iodine and some drugs may trigger the onset of thyroid disease in people prone to getting it.

Radiation exposure has been shown to bring on autoimmune thyroid disease. This includes radiation from the atomic bomb in Japan, the nuclear accident at Chernobyl, and radiation treatment of Hodgkin’s disease (a type of blood cancer).

Causes

Hashimoto’s thyroiditis is an autoimmune disease. The patient’s own immune system creates antibodies that attack and damage the thyroid gland.

Our immune system is designed to protect us against harmful invaders, such as viruses, bacteria, parasites and fungi. In patents with Hashimoto’s thyroiditis, their immune system mistakenly recognizes normal thyroid gland cells as harmful, foreign tissue and attacks them.

Experts are not sure why the immune system becomes activated in such a way. Some suggest that perhaps a virus or bacterium may play or role, maybe a genetic fault, or possibly a combination. So far, none of these environmental or genetic factors have been compellingly proven to be the cause of Hashimoto’s thyroiditis.

Symptoms

Many people with Hashimoto’s disease have no symptoms for years. An enlarged thyroid, called a goiter, is often the first sign of disease. The goiter may cause the front of the neck to look swollen. You or your doctor may notice the goiter. If large, it may cause a feeling of fullness in the throat or make it hard to swallow. It rarely causes pain.

Many people with Hashimoto’s disease develop an underactive thyroid. They may have mild or no symptoms at first. But symptoms tend to worsen over time. Symptoms of an underactive thyroid include –

  • Fatigue
  • Weight gain
  • Pale, puffy face
  • Feeling cold
  • Joint and muscle pain
  • Constipation
  • Dry, thinning hair
  • Heavy menstrual flow or irregular periods
  • Depression
  • A slowed heart rate
  • Problems getting pregnant

Treatment

Medication – Some medications and supplements may interfere with levothyroxine absorption. Some foods may affect absorption as well, including soy products or very high fiber foods.

 

The following medications and supplements may interfere with proper levothyroxine absorption –

  • Blood thinners, such as warfarin
  • Estrogen-containing medications, such as birth control pills
  • Sodium polystyrene sulfonate
  • Antacids that contain aluminum hydroxide
  • Calcium supplements
  • Iron supplements (many multivitamins contain iron)
  • Some cholesterol-lowering drugs, such as cholestyramine

Synthetic hormone treatment – For patients with goiter or hypothyroidism, thyroid hormone therapy is required. The patient needs to take one tablet of levothyroxine each day. People with an underlying heart disease or severe hypothyroidism start off on a low dose which is gradually increased.

The treatment may take a few months before any improvements in symptoms are noticed. There may be some hair loss during the first few months of treatment. This effect is temporary.

 

Alternative Treatment

Lithium – Prescription lithium carbonate is well known to cause hypothyroidism. Small studies have shown that lithium carbonate is also effective at controlling symptoms of hyperthyroidism. There are also case reports where patients who were prescribed lithium for other reasons and went on to develop Hashimoto’s disease remained asymptomatic while on lithium

Selenium – A dose of slenium may show effective in reducing symptoms of Hashimoto’s disease, including ophthalmopathy.

Carnitine – L-carnitine helps to improve symptoms of hyperthyroidism.

Probiotics like acidophilus – These can help the immune system as well.

Omega-3 Fatty Acids – Omega-3s such as those that are found in fish oil decrease inflammation and improve immunity.

Iodine – Iodine is a vital nutrient in the body and essential to thyroid function; thyroid hormones are comprised of iodine. While autoimmune disease is the primary cause of thyroid dysfunction in the United States, iodine deficiency is the main cause worldwide.

Vitamin D – Hyperthyroidism, particularly Graves’ disease and Hashimoto’s disease, is known to cause bone loss, which is compounded by the vitamin D deficiency commonly found in people with hyperthyroidism. This bone mass can be regained with treatment for hyperthyroidism, and experts suggest that adequate bone-building nutrients, such as vitamin D, are particularly important during and after treatment.

  • Goitrogens – Cruciferous vegetables such as broccoli, cauliflower, and cabbage naturally release a compound called goitrin when they’re hydrolyzed, or broken down. Goitrin can interfere with the synthesis of thyroid hormones. Soy is another potential goitrogen

Reference –

http://www.medicalnewstoday.com/articles/266780.php

http://womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html

http://www.thyroidawareness.com/hashimotos

http://www.healthline.com/health/chronic-thyroiditis-hashimotos-disease#Overview1

http://www.nytimes.com/health/guides/disease/chronic-thyroiditis-hashimotos-disease/print.html

http://emedicine.medscape.com/article/120937-overview

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/thyroid-hashimotos-disease

https://www.aace.com/files/hashimotos.pdf

February 1, 2017

Cryotherapy is the local or general use of low temperatures in medical therapy. The term “cryotherapy” comes from the Greek cryo meaning cold, and therapy meaning cure. Cryotherapy has been used as early as the seventeenth century.

Cryotherapy is a pain treatment that uses a method of localized freezing temperatures to deaden an irritated nerve. Cryotherapy is also used as a method of treating localized areas of some cancers (called cryosurgery), such as prostate cancer and to treat abnormal skin cells by dermatologists. In this article we only discuss its use in nerve conditions.

In cryotherapy, a probe is inserted into the tissue next to the affected nerve. The temperature of the probe drops to then effectively freeze the nerve. The freezing inactivates the nerve and, as a result, painful nerve irritation is relieved. Cryotherapy is a relatively safe and effective means of treating localized nerve irritation. During cryotherapy, liquid nitrogen or argon gas flows into a needle-like applicator (a cryoprobe) creating intense cold that is placed in contact to diseased tissue. Physicians use image-guidance techniques such as ultrasound, computed tomography (CT) or magnetic resonance (MR) to help guide the cryoprobes to treatment sites located inside the body.

Cryotherapy has historically been used to provide pain relief, reduce fever, slow the damage of thermal burns, control bleeding, and prevent or reduce edema caused by soft tissue trauma.   Cryotherapy has also been shown to be useful for the reduction of extrafusal and intrafusal muscle spasm, neuromuscular hypertonicity, and spasticity.  Cryotherapy may additionally be used to elevate the pain threshold and slow destructive enzyme action that occurs in some joint diseases.

The cooling of bodily tissue is governed by two basic physiological principles –

  • The cooling effect on the soft tissue by an ice massage or ice pack will decrease as the depth of the tissue increases.
  • The time required for cooling to be effective will vary according to the type of tissue being cooled (the speed of cooling underlying tissues will decrease as the amount of insulating fat increases).

Uses of Cryotherapy

Cryotherapy can be applied topically (on the skin surface), percutaneously, or surgically. Topical cryotherapy is used typically in the case of skin and eye lesions. When the lesion is situated below the skin surface, a needle-like therapy probe or applicator needs to be placed through the skin. Occasionally, a surgical incision is required.

Cryotherapy is used to treat –

  • Skin tumors.
  • Pre-cancerous skin moles.
  • Skin tags.
  • Unsightly freckles.
  • Retinoblastomas, a childhood cancer of the retina.
  • Prostate, liver, and cervical cancers, especially if surgical resection is not possible.

Cryotherapy is also being used to treat tumors in other parts of the body, such as the kidneys, bones (including the spine), lungs, and breasts (including benign breast lumps called fibroadenomas). Although further research is needed to determine its long term effectiveness, cryotherapy has been shown to be effective in selected patients.

Side Effects

Cryotherapy risks include –

  • Blisters and ulcers, leading to pain and infection
  • Scarring, especially if the freezing was prolonged or deeper areas of the skin were affected
  • Changes in skin color (skin turns white)

Components

  • Liquid nitrogen – Cryotherapy using liquid nitrogen (temperature –196C) involves the use of a cryospray, cryoprobe or a cotton-tipped applicator. The nitrogen is applied to the skin lesion for a few seconds, depending on the desired diameter and depth of freeze. The treatment is repeated in some cases, once thawing has completed. This is known as a ‘double freeze-thaw’ and is usually reserved for skin cancers or resistant viral warts.
  • Carbon dioxide snow – Carbon dioxide cryotherapy involves making a cylinder of frozen carbon dioxide snow (–78.5C) or a slush combined with acetone. It is applied directly to the skin lesion.
  • DMEP – DMEP works at a temperature of –57C. It comes in an aerosol can available over the counter. It is used to treat warts using a foam applicator pushed onto the skin lesion for between 10 and 40 seconds, depending on its size and site.
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February 1, 2017

Chronic Kidney Disease (CKD) is a long-term condition characterized by a gradual loss of kidney function over time. CKD is a worldwide public health problem. There are a rising incidence and prevalence of kidney failure, with poor outcomes and high cost in the United States.

There is an even higher prevalence of earlier stages of chronic kidney disease. The outcomes of CKD are adverse, and include, s kidney failure, cardiovascular disease, and premature death, and to prevent these outcomes, it becomes necessary to understand the function of the Kidney and Chronic Kidney Disease.

How does our Kidney function?

The function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through the urine. The production of urine involves highly complex steps of excretion and re-absorption. This process is necessary to maintain a stable balance of body chemicals. The critical regulation of the body’s salt, potassium and acid content is performed by the kidneys.

The kidneys also produce hormones that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. Other hormones produced by the kidneys help regulate blood pressure and control calcium metabolism. The kidney also helps to produce a substance called erythropoietin, which stimulates the production of red blood cells.

The kidneys are powerful chemical factories that perform the following functions:

  • remove waste products from the body
  • remove drugs from the body
  • balance the body’s fluids
  • release hormones that regulate blood pressure
  • produce an active form of vitamin D that promotes strong, healthy bones
  • control the production of red blood cells

What is Chronic Kidney Disease (CKD)?

Chronic kidney disease includes conditions that damage the kidney and decrease its ability to keep the body healthy by doing its usual job. CKD is usually asymptomatic, but it is detectable, and tests for CKD are simple and freely available. When the kidneys do not work properly, they leave behind waste in the blood. The waste can build up and make the person feel sick. It can cause problems with the heart and can increase the risk of bone loss, broken bones, anemia (a low number of red blood cells, which carry oxygen throughout the body), complete kidney failure, and other serious problems. It can also lead to death. Chronic kidney disease is also called a chronic renal failure or chronic renal insufficiency.

One way to measure how well the kidneys are working is to figure out the glomerular filtration rate (GFR). The GFR is usually calculated using results from the blood creatinine test. Then the stage of kidney disease is figured out using the GFR. There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.

How is GFR calculated?

The doctor can estimate the GFR from the results of a simple blood test for creatinine. Creatinine is a waste product of the body’s muscle activity. Kidneys usually keep the level of creatinine just right. The creatinine result is used in a math formula with age, race, and gender to determine your GFR.

A GFR of 90 or above is considered normal. Even with a normal GFR, you may be at increased risk for developing CKD if you have diabetes, high blood pressure, or a family history of kidney disease. The risk increases with age: People over 65 are more than twice as likely to develop CKD as people between the ages of 45 and 65.

Chronic Kidney Disease Stages

The 5 stages of chronic kidney disease stages are:

StageGFRDescription
 

1

 

90+

Normal kidney function but urine findings or structural abnormalities or genetic trait point to kidney disease.
 

2

 

60-89

Mildly reduced kidney function, and symptoms as stage 1
345-59

30-44

Moderately reduced kidney function
415-29Severely reduced kidney function
 

5

 

<15 or on dialysis

Very severe, or end-stage kidney failure (sometimes call established renal failure

Causes of Chronic Kidney Disease

CKD is usually caused by conditions that put a strain on the kidneys. The two main causes are:

  • Diabetes – Diabetes is a condition in which the body produces no – or too little – insulin (type 1 diabetes) or has become unable to make effective use of insulin (type 2 diabetes). If diabetes is poorly controlled, too much glucose can build up in your blood. The glucose can damage the tiny filters in the kidneys, which affects the ability of your kidneys to filter out waste products and fluids. The first sign of diabetic kidney disease is the appearance of low levels of protein in the urine.
  • High Blood Pressure – High blood pressure puts more stress on blood vessels throughout the body, including the kidneys filters called the nephrons. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes, and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

Other Causes of Chronic Kidney Disease are:

  • Overuse of pain killers and allergic reactions to antibiotics – Heavy use of painkillers containing ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol) have been linked to interstitial nephritis, a kidney inflammation that can lead to kidney failure. Allergic reactions to or side effects of antibiotics like penicillin and vancomycin may also result in CKD.
  • Drug Abuse – Use of certain non-prescribed drugs, such as heroin or cocaine, can damage the kidney.
  • Inflammation – Glomerulonephritis, a group of diseases that cause inflammation and causes damage to the kidney’s filtering units. Some glomerulonephritis is inherited, and some may be an immune response to infections like strep throat. Sometimes, these are enough to cause CKD.
  • Environmental Toxins – Exposure to various toxic agents and conditions in the natural and occupational environment such as heavy metals, industrial chemicals, elevated ambient temperatures, and infections can lead to CKD. Various toxins are derived from gut microbiota, and an imbalance of gut microbiota or dysbiosis is related to renal failure. However, the pathophysiologic mechanisms underlying the relationship between gut microbiota and renal failure are still obscure. Toxics include –
    • Cadmium
    • Fluoride in drinking water
    • Combination of fluoride in drinking water and aluminum vessel
    • Arsenic
    • Hard Water
    • Cyanobacterial toxins
    • Bioaccumulation – pesticide residues, heavy metals and toxins in the plants and aquatic animals
    • Liquor – Illicit liquor is another probable cause
    • Pesticides
    • Lead
  • Blockages – Infections or a malformed lower urinary tract system (birth defect) can force urine to back up into the kidney and damage it. Blood clots or plaques of cholesterol that block the kidney’s blood vessels can reduce blood flow to the kidney and cause damage. Repeated kidney stones can block the flow of urine from the kidney and are another kind of obstruction that can damage the kidneys.
  • Family History – The person having one or more family members with CKD or on dialysis or kidney transplant may be at high risk of getting this condition. One inherited disease, polycystic kidney disease, causes large, fluid-filled cysts that eventually crowd out normal kidney tissue. Diabetes and high blood pressure can also run in families.
  • Premature Birth – About one in five very premature infants (less than 32 weeks gestation) may have calcium deposits in parts of the kidney called nephrons. This is termed nephrocacinosis. Sometimes, individuals with this condition may go on to develop kidney problems later in life.
  • Certain Diseases – Having certain diseases puts people at higher risk for kidney disease. These diseases include systemic lupus erythematosus (a connective tissue disease), sickle cell anemia, cancer, AIDS, hepatitis C, and congestive heart failure.

Chronic Kidney Disease: Symptoms

Many people who have chronic kidney disease don’t know it, because the early signs can be very subtle. It can take many years to go from chronic kidney disease (CKD) to kidney failure. Some people with CKD live out their lives without ever reaching kidney failure.

Symptoms include –

  • Change in urination – Kidneys are responsible for making urine, hence, the when kidneys fail to function properly, the urine may change (color, difficulty in urinating, urine may be foamy or bubbly, increased need to urinate, especially at night)
  • Swelling in the legs, ankles, feet, face and/or hands – Failing kidneys don’t remove extra fluid, which builds up in the body.
  • Fatigue – Healthy kidneys make a hormone called erythropoietin that tells the body to make oxygen-carrying red blood cells. As the kidneys fail, they make less erythropoietin. With fewer red blood cells to carry oxygen, the muscles and brain become tired very quickly. This condition is called anemia, and it can be treated.
  • Skin Rash – Kidney cleans the body by removing wastes from the body. When it fails in performing its functions, the waste called uremia accumulates in the blood and causes severe itching.
  • Ammonia Breath – The accumulation of waste in the blood can make the food taste different and cause foul breath.
  • Nausea & Vomiting – A severe build-up of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
  • Shortness of breath – Due to extra fluid in the body and anemia
  • Feeling Cold – Due to anemia

 Chronic Kidney Disease Treatment

 Conventional Medicines

  • Angiotensin receptor blockers (ARBs) – ARBs are drugs that block the action of angiotensin 2 on its receptors. These drugs, like ACE-I, have a protective effect on the kidneys and slow the progression of kidney failure. Drugs included in this category include losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand) and olmesartan (Benicar).
  • Angiotensin converting enzyme inhibitors (ACE-Is) – ACE-Is are drugs commonly used in the treatment of hypertension. The drugs include captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril, Prinivil), ramipril (Altace), quinapril (Accupril), benazepril (Lotensin) and trandolapril (Mavik). These drugs decrease blood pressure by reducing production of angiotensin-II (a hormone that causes blood vessels to constrict) and aldosterone (a hormone that causes sodium retention).
  • Diuretics – The doctor may prescribe diuretics (water pills) to control edema (swelling), blood pressure and/or potassium levels. There are several classes of diuretics, including loop diuretics (furosemide, ethacrynic acid, bumetanide, torsemide), thiazides (hydrochlorothiazide, chlorthalidone, indapamide), and potassium-sparing diuretics (spironolactone, eplerenone, amiloride, triamterene). Diuretics differ in their potential to eliminate salt and water.
  • Erythropoiesis-stimulating agents (ESAs) – Patients with chronic kidney disease often develop anemia due to a lack of erythropoietin produced by the kidneys. Anemia is a condition with too few red cells and is characterized by fatigue and tiredness. After excluding other causes of anemia, the doctor may prescribe erythropoiesis-stimulating agents (ESAs). This includes Procrit (erythropoietin), Aranesp (darbepoetin), or Omontys (peginesatide). ESAs also stimulate the bone marrow to produce red cells and reduce the need for blood transfusions.
  • Phosphate binders – Binders are divided into large classes, including calcium-based binders such as Tums (calcium carbonate) and PhosLo (calcium acetate) and non-calcium based binders like Fosrenol (lanthanum carbonate), Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).
  • Vitamin D -Vitamin D deficiency is very common in patients with chronic kidney disease. The first step in treating metabolic bone disease is to ensure that there are adequate reserves of vitamin D in the body.

Others Treatment for Chronic Kidney Disease

  • Dialysis – removes Dialysis helps to maintain your body’s balance by removing waste and extra fluid from the blood, keeping the blood’s chemical balance at a safe level and assisting with blood pressure control. Dialysis is a useful and important treatment.
    • Haemodialysis – Uses machine acting as an artificial kidney cleans the blood. Requires good access to your bloodstream, which may be an issue if you have diabetes. If you have heart problems, changes in blood pressure and waste levels associated with haemodialysis can cause problems.
    • Peritoneal Dialysis – Allows the blood to be cleaned inside the body and is usually done at home. PD may not be possible if you’ve had major abdominal surgery causing scarring. It may also be difficult to obtain the right amount of dialysis with PD if you are tall and muscular, or overweight.
  • Transplantation – If you start dialysis you will also be assessed for your suitability for transplantation. Health issues may prevent this option.
  • Conservative or Supportive Care – If you decide that dialysis or transplant is not for you, then your health-care team will support you to stay as healthy as possible without dialysis. Your life-span however will be limited.

Alternative Medicine

Environmental Medicine focuses on finding the causes of an illness rather than just treating the effects.

  • Biodetoxification Program – Safe, intensive treatment for the reduction of the body’s burden of toxic chemicals. Biodetoxification Program utilizes clinical procedures that safely reduce the body’s burden of toxic chemicals, including chemicals stored following occupational, accidental, and/or chronic airborne exposures. Chemicals bind to human tissues on the basis of their lipophilic properties — meaning literally “attracted to fats.” When our bodies absorb lipophilic toxins, they are deposited in the fat stores and released whenever those fatty tissues are broken down to provide energy. Thus, although a patient may initially be poisoned by an extrinsic (outside) source of toxicants, the patient may continue to be poisoned over a prolonged period of time by our own intrinsic (inside) body stores of those poisons.
  • Fish Oils – Fish oils affect the progression of CKD. In one meta-analysis some studies indicate a negative effect on the progression of CKD
  • Vitamin and mineral supplements – Replacement of certain vitamins and minerals that the patient does not get in the diet or that are lost during dialysis.
  • Avoiding IV Dye – Avoiding X-ray tests that require IV dye (contrast material), such as an angiogram, an intravenous pyelogram (IVP), and some CT scans. IV dye can cause more kidney damage.
  • Diet – This may include – Avoid products with added salt, lower potassium foods, a limited amount of protein in the diet.
  • Chinese Herbal Medicine – Acupuncture, Lei Gong Teng, Micro-Chinese Medicine Osmotherapy are the natural alternative treatments for kidney failure which is used externally.
  • Ayurveda – Gokshura and Mutrakrichantak Churna which contains herbs like Punarnava, Varuna, Shigru, Apamarg, etc. maintain effective kidney functioning by promoting proper urination, reducing kidney discomforts and removing stones and helps to reduce accompanying fluid accumulation and kidney tissue inflammation.
  • Herbal treatment – Cornsilk, dandelion, astragalus, basil, etc. helps to cleanse and strengthen the kidney.

chronic kidney disease

February 1, 2017

Breast cancer is the second leading cause of death among women, behind lung cancer. According to the American Cancer Association, in 2007 an estimated 178,480 new cases of invasive breast cancer will be diagnosed among women, as well as an estimated 62,030 additional cases of in situ breast cancer. In addition, approximately 40,460 women are expected to have died from breast cancer in 2007. Given these circumstances, early detection of breast cancer is considered an important prognostic factor

Breast thermography, also known as thermal breast imaging, is a technique that takes thermal images of the breasts and surrounding areas to aid in the early detection of breast cancer. Thermography assesses function rather than anatomically.

It is based on the principle that metabolic activity and vascular circulation in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in normal breast tissue. In an ever-increasing need for nutrients, cancerous tumors increase circulation to their cells by holding open existing blood vessels, opening dormant vessels, and creating new ones (neoangiogenesis). This process frequently results in an increase in regional surface temperatures of the breast. Breast thermography uses ultra-sensitive medical infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution images of these temperature variations. Because of this technique’s extreme sensitivity, these temperature variations may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast.

Heat is an indication that inflammation exists, and typically inflammation is present in precancerous and cancerous cells. It’s also present in torn muscles and ligaments as well as arthritic joints, which thermography can also detect. Breast thermography does not involve the compression of the breast or exposure to radiation. While thermography can localize an abnormal area, it is unable to pinpoint the actual depth, location, and size of a tumor.

Thermography as a breast cancer risk assessment tool in the US has been approved by the FDA since 1982, and as a screening tool for breast cancer, thermography was first introduced in 1956 and was accepted widely by medical professionals at that time.

Process of Breast Thermography

Breast thermography uses ultra-sensitive infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution diagnostic images of these temperature and vascular changes. The procedure is both comfortable and safe using no radiation or compression. By carefully examining changes in the temperature and blood vessels of the breasts, signs of possible cancer or pre-cancerous cell growth may be detected up to 10 years prior to being discovered using any other procedure. This provides for the earliest detection of cancer possible. Because of breast thermography’s extreme sensitivity, these temperature variations and vascular changes may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast.

The procedure involves the use of an infrared high-resolution camera that takes images of each breast. The data collected from the images are then analyzed by computer algorithms that compare infrared patterns. The procedure takes approximately 15 to 20 minutes. Breast thermography does not involve the compression of the breast or exposure to radiation. While thermography can localize an abnormal area, it is unable to pinpoint the actual depth, location, and size of a tumour.

Blood is the main heat exchanging fluid in the body; therefore pathologies identified by thermography are generally associated with changes in blood perfusion. Studies suggest that in normal breast tissue there is a constant positive curve of thermal conductivity, where temperature gradually increases from skin to deep tissue, whereas in breasts with a cancerous lesion, the thermal conductivity resembled a bell-shaped curve. The evidence of a discrepant temperature profile implies that there is something in the middle of this breast type of tissue that releases large amounts of heat.

What does the test reveal ?

The personalized full thermography report comes in color including the images taken during the scan. This report includes a reporting system called the Marseille System of Classification, which provides strict criteria for rating Breast Thermography scans. The Marseille System of Classification is internationally used. The scans are reported on a scale of TH-1 to TH-5 –

  • TH-1 – Normal tissue
  • TH-2 – Some changes in tissue i.e. fibrocystic, but normal response to cold challenge
  • TH-3 – Suspicious tissue activity with areas not responding to the cold challenge and maintaining higher heat areas
  • TH-4 – Abnormal tissue activity with areas not responding to the cold challenge and maintaining higher heat areas
  • TH-5 – severely abnormal tissue activity with areas not responding to the cold challenge and maintaining higher heat areas.

Follow-up thermography scans are dependent on your individual clinical history and thermography results –

  • Level TH-1 – Provides reassurance the tissue activity is normal. The appropriate follow-up is screening by thermography in one year.
  • Level Th-2 – Suggests that tissue did respond normally to the cold challenge and tissue health can be improved through preventive therapies. Suitable follow-up screening recommended within 9-12 months.
  • Level TH-3 – Indicates that close monitoring through ultrasound and professional examination are advised and preventive therapies are needed. Suitable follow-up screening recommended within 6-9 months.
  • Levels TH-4 & TH-5 – Warrants immediate referral for extra testing on the areas specifically located by the Breast Thermography alongside a professional examination and other screening methods as indicated and appropriate preventive therapies. Suitable follow-up screening recommended within 1-3 months.

What else besides breast examinations is thermography useful for?

  • Nervous System Disorders
  • Metabolic Disorders
  • Repetitive Strain Injuries
  • Headaches, Neck and Back Problems
  • TMJ Conditions
  • Pain Syndromes such as Fibromyalgia, myositis
  • Arthritis
  • Vascular Disorders (Raynoud’s disease, etc.)
  • Soft Tissue Injuries

In addition, there are patterns detectable by thermograms that suggest stroke risk, etc. Any condition for which there is an alteration of blood flow or circulation. Other physiological occurrences detected through thermal fluctuations include complex soft tissue injury, diabetes, peripheral vascular disease, osteo-arthritis, neo-natal activity, dental infection, intra-operative surgical fluctuations, breast implant rupture, and melanoma. Many other applications are currently undergoing study.

Breast thermography offers women information that no other procedure can provide. However, breast thermography is not a replacement for or alternative to mammography or any other form of breast imaging. Breast thermography is a risk assessment tool that is meant to be used in addition to mammography and other tests or procedures. Breast thermography and mammography are complementary procedures, one test does not replace the other. All thermography reports are meant to identify thermal emissions that suggest potential risk markers only and do not in any way suggest diagnosis and/or treatment. Studies show that the earliest detection is realized when multiple tests are used together. This multimodal approach includes breast self-examinations, physical breast exams by a doctor, mammography, ultrasound, MRI, thermography, and other tests that may be ordered by the doctor.

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February 1, 2017

Anxiety Disorder

Everyone has feelings of anxiety at some point in life, whether it is about preparing for a job interview, meeting a partner’s family for the first time, or the thought of parenthood. While many, associate anxiety with alterations to the mental state, experienced as worry or apprehension perhaps, and physical symptoms such as raised heart rate and adrenaline, it is also understood that it is likely to affect a person only temporarily until the source of the anxiety has passed or the person has learnt to cope with it. Without anxiety, we would have no way of anticipating difficulties ahead and preparing for them.

Anxiety becomes a disorder when the symptoms become chronic and interfere with our daily lives and our ability to function. An anxiety disorder is a serious mental illness. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling. People suffering from chronic anxiety often report the following symptoms –

  • Muscle tension
  • Physical weakness
  • Poor memory
  • Sweaty hands
  • Fear or confusion
  • Inability to relax
  • Constant worry
  • Shortness of breath
  • Palpitations
  • Upset stomach
  • Poor concentration

These symptoms are severe enough to make individuals feel extremely uncomfortable, out of control and helpless.

Types of Anxiety Disorders

The term “anxiety disorders” describes this group of conditions –

  • Generalized Anxiety Disorder (GAD) – persistent, excessive, and unrealistic worry about everyday things
  • Obsessive-Compulsive Disorder (OCD) – unwanted and intrusive thoughts (obsessions) and ritualistic behaviors and routines (compulsions) conducted to ease anxiety
  • Panic Disorder – spontaneous, seemingly out-of-the-blue panic or “anxiety” attacks and the preoccupation with the fear of a recurring attack
  • Posttraumatic Stress Disorder (PTSD) – an anxiety disorder triggered by an extremely traumatic event in which grave physical harm occurred or was threatened or witnessed
  • Social Anxiety Disorder (social phobia) – an intense fear of being scrutinized and negatively evaluated by others in social or performance situations
  • Specific Phobias – seemingly excessive and unreasonable fears in the presence of or in anticipation of a specific object, place, or situation

Each of these anxiety disorders is distinct in some ways, but they all share the same hallmark features –

  • Irrational and excessive fear
  • Apprehensive and tense feelings
  • Difficulty managing daily tasks and/or distress related to these tasks

 

More than 40 million adults in the United States over the age of 18 suffer from at least one anxiety disorder, and anxiety disorders are the most common mental health illness in children. Researchers are learning that anxiety disorders run in families, and that they have a biological basis, much like allergies or diabetes and other illnesses. Anxiety is the main symptom of several conditions, including panic disorder, phobias, post-traumatic stress disorder and social anxiety disorder (social phobia).

Symptoms

The following examples of anxiety symptoms may indicate an anxiety disorder:

Cognitive – Anxious thoughts (e.g., “I’m losing control”), anxious predictions (e.g., “I’m going to fumble my words and humiliate myself”) and anxious beliefs (e.g., “Only weak people get anxious”).

Physical – Excessive physical reactions relative to the context (e.g., heart racing and feeling short of breath in response to being at the mall). The physical symptoms of anxiety may be mistaken for symptoms of a physical illness, such as a heart attack.

Behavioural – Avoidance of feared situations (e.g., driving), avoidance of activities that elicit sensations similar to those experienced when anxious (e.g., exercise), subtle avoidances (behaviours that aim to distract the person, e.g., talking more during periods of anxiety) and safety behaviours (habits to minimize anxiety and feel “safer,” e.g., always having a cell phone on hand to call for help).

Symptoms vary depending on the type of anxiety disorder, but general symptoms include –

  • Feelings of panic, fear, and uneasiness
  • Problems sleeping
  • Cold or sweaty hands and/or feet
  • Shortness of breath
  • Heart palpitations
  • An inability to be still and calm
  • Dry mouth
  • Numbness or tingling in the hands or feet
  • Nausea
  • Muscle tension
  • Dizziness

 

 

 

Causes

Like most mental health problems, anxiety disorders appear to be caused by a combination of biological factors, psychological factors and challenging life experiences, including:

  • stressful or traumatic life events
  • a family history of anxiety disorders
  • childhood development issues
  • alcohol, medications or illicit substances
  • other medical or psychiatric problems

Biological Factors – The biological causes and effects of anxiety disorders include problems with brain chemistry and brain activity; genetics; and medical, psychiatric and substance use issues. Three major neurotransmitters are involved in anxiety – serotonin, norepinephrine

  • Serotonim – Plays a role in the regulation of mood, aggression, impulses, sleep, appetite, body temperature and pain.
  • Norepinephrine – It involved in the fight or flight response and in the regulation of sleep, mood and blood pressure. Acute stress increases the release of norepinephrine. In people with anxiety disorders, especially those with panic disorder, the system controlling the release of norepinephrine appears to be poorly regulated.

 

Genetic Factors – Studies suggest that genetic factors play a role in the development of anxiety disorders. People are more likely to have an anxiety disorder if they have a relative who also has an anxiety disorder. The incidence is highest in families of people with panic disorder, where almost half have at least one relative who also has the disorder.

Medical Factors – Alcohol, medications and illicit substances use may induce anxiety symptoms, either while the person is intoxicated or when the person is in withdrawal. The substances most often associated with generalized anxiety or panic symptoms are stimulants, including caffeine, illicit drugs such as cocaine, and prescription drugs such as methylphenidate (e.g., Ritalin).

Other factors – Studies show that people who are anxious tend to have an irregular pattern of breathing, alternating from hyperventilation to holding their breath. This pattern of breathing contributes to further symptoms (e.g., lightheadedness, dizziness and possibly fainting) and increases the feelings of anxiety. Breathing retraining techniques can help these people cope or manage anxiety symptoms.

 

Treatment

Therapies – Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past.

  • Cognitive-behavior therapy focuses on thoughts—or cognitions—in addition to behaviors. In anxiety disorder treatment, cognitive-behavioral therapy helps to identify and challenge the negative thinking patterns and irrational beliefs that fuel anxiety.
  • Exposure therapy for anxiety disorder treatment encourages confronting the fears in a safe, controlled environment. Through repeated exposures to the feared object or situation, either in the imagination or in reality, a person may gain a greater sense of control. As he/she face fear without being harmed, hence anxiety gradually diminishes.

Medications – Medical treatments for anxiety utilize several types of drugs. If the cause of the anxiety is a physical ailment, treatment will be designed to eliminate the particular ailment. This might involve surgery or other medication to regulate a physical anxiety trigger. Often, however, medicines such as antidepressants, benzodiazepines, tricyclics, and beta-blockers are used to control some of the physical and mental symptoms.

Benzodiazepines – Anxiety historically has been treated with a class of drugs called benzodiazepines. Their use has declined, however, due to their addictive nature. These drugs tend to have few side-effects except for drowsiness and possible dependency. Some common benzodiazepines include –

  • Diazepam (Valium)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Clonazepam (Klonopin)

Anti-depressants – those in the class of serotonin reuptake inhibitors (SSRI) – are also commonly used to treat anxiety even though they were designed to treat depression. SSRIs have fewer side effects than older anti-depressants, but they are still likely to cause jitters, nausea, and sexual dysfunction when treatment begins. Some anti-depressants include –

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Escitalopram (Lexapro)
  • Citalopram (Celexa)
  • Venlafaxine (Effexor)

Tricyclics are a class of drugs that are older than SSRIs and have been shown to work well for most anxiety disorders other than obsessive-compulsive disorder. These drugs are known to cause side-effects such as dizziness, drowsiness, dry mouth, and weight gain. Two types of tricyclics include –

  • Imipramine (Tofranil)
  • Clomipramine (Anafranil)

Additional drugs used to treat anxiety include monoamine oxidase inhibitors (MAOIs), beta-blockers, and buspirone. MAOIs, such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan), are an older type of anti-depressant that is used to treat some anxiety disorders.

Alternative Treatment

Chromium – Chromium may also have a direct effect on brain receptors for serotonin.. Chromium may help free up serotonin receptors. It is already popular as a dietary supplement. It’s marketed to athletes as a muscle-builder and touted as a treatment for weight loss and diabetes.

DHEA (5-Dehydroepiandrosterone) is a natural steroid produced in the adrenal glands, the gonads and the brain. It is the most abundant circulating steroid in humans. DHEA supplementation may help with depression. DHEA levels in the blood correlate with mood, memory and functional abilities

Omega 3 – Studies suggest that there is promising evidence for omega-3s in the treatment of depression. The prevalence of depression in a society is inversely related to that society’s consumption of fish – the more that people eat fish, the healthier the population, both physically and mentally. It has been theorized that omega-3 essential fatty acids may reduce the development of depression, since anxiety and depression patients show significant depletion of omega-3s.

Magnesium is another important nutrient that helps the body to relax. It’s also commonly deficient and depleted by chronic stress, as is vitamin C. Magnesium not only relaxes the mind, it relaxes the muscles. Symptoms of deficiency therefore include muscle aches, cramps and spasms, as well as anxiety and insomnia. Low levels are commonly found in anxious people and supplementation can often help.

Supplement GABA and Taurine –

GABA (gamma-amino-butyric acid) is the main inhibitory or calming neurotransmitter. It not only switches off stress hormones, it also affects serotonin, thereby affecting the mood. For these reasons, having enough GABA in the brain is associated with being relaxed and happy, while having too little is associated with anxiety, tension, depression and insomnia. GABA is not only a neurotransmitter, it’s also an amino acid. This means it’s a nutrient and, by supplementing it, you can help to promote normal healthy levels of GABA in the brain.

Taurine is another relaxing amino acid, similar in structure and effect to GABA. Many people think taurine is a stimulant because it is used in so-called ‘energy drinks’, but it is not. It helps to relax and unwind from high levels of adrenalin, much like GABA.

B-Complex Vitamins also help even out the blood sugar. In addition, the metabolism of just about everything to digest hinges on one or more of this group of B-vitamins. Taken together, they are especially safe and effective.

Niacin – Vitamin B-3 is so effective against actual psychoses that half of all mental ward inmates in the South were able to be released once a depression-era deficiency of this vitamin was corrected. Niacin in appropriate doses acts as a natural tranquilizer and induces relaxation or sleep. It is non-addictive, cheap, and safer than any pharmaceutical product. Dosage varies with condition.

Lecithin – A food supplement that is high in phosphatidyl choline. The body is able to make acetylcholine, a neurotransmitter, out of this. This has a sedating effect. It is interesting to note that one third of your brain, by dry weight, is lecithin.

Relaxing herbs – valerian, hops and passion flower –

  • Valerian is an excellent anti-anxiety herb (Valeriana officinalis). As a natural relaxant it is useful for several disorders such as restlessness, nervousness, insomnia and hysteria, and it has also been used as a sedative for ‘nervous’ stomach. Valerian acts on the brain’s GABA receptors, enhancing their activity and thus offering a similar tranquillising action as the Valium-type drugs but without the same side-effects.
  • Hops (Humulus lupulus) are an ancient remedy for a good night’s sleep and probably included in beer for that reason. Hops help to calm nerves by acting directly on the central nervous system, rather than affecting GABA receptors.
  • Passion flower (Passiflora incarnata) was a favourite of the Aztecs, who used it to make relaxing drinks. It has a mild sedative effect and promotes sleep much like hops, with no known side-effects at normal doses. Passion flower can also be helpful for hyperactive kids.
  • Kava – Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage even with short-term use caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States.

Herbs such as chamomile and catnip make a soothing tea.

 

Complementary Treatment

Stress and Relaxation Techniques – Relaxation techniques may produce modest, short-term reduction of anxiety in people with ongoing health problems such as heart disease or inflammatory bowel disease, and in those who are having breast biopsies, dental treatment, or other medical procedures. These techniques have also been shown to be useful for older adults with anxiety. In people with generalized anxiety disorder, studies indicate that cognitive-behavioral therapy is more effective over the long term than relaxation techniques. For symptoms of depression they may have modest benefit, but they are not as effective as cognitive-behavioral therapy (CBT) or other psychological treatment. Find out more.

Meditation – Moderate evidence suggests that meditation is useful for symptoms of anxiety and depression in adults.

Yoga – Yoga, which combines physical postures, breathing exercises, meditation, and a distinct philosophy, is one of the top ten CAM practices. Studies suggest that practicing yoga (as well as other forms of regular exercise) might confer health benefits such as reducing heart rate and blood pressure, and it may also help alleviate anxiety and depression.

Acupuncture – Evidence for the use of acupuncture – the Chinese practice of inserting needles into the body at specific points to manipulates the body’s flow of energy – to treat anxiety disorders is becoming stronger.

 

 

Reference

http://www.adaa.org/

http://www.nhs.uk/Conditions/Anxiety/Pages/Symptoms.aspx

http://www.health.com/health/gallery/0,,20646990_2,00.html

http://www.healthline.com/health/anxiety/generalized-anxiety-disorder#Overview1

http://www.medicalnewstoday.com/info/anxiety/what-causes-anxiety.php

http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders?page=3

http://www.adaa.org/finding-help/treatment/complementary-alternative-treatment

http://www.health.com/health/gallery/0,,20669377,00.html

http://www.takingcharge.csh.umn.edu/conditions/anxiety-depression

http://www.medscape.com/viewarticle/568309_1

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February 1, 2017

Acid Reflux

Acid reflux, also known as Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach. Reflux is a normal process that occurs in healthy infants, children, and adults. Most episodes are brief and do not cause bothersome symptoms or complications.

Acid reflux is a common condition in which stomach acid flows backward up the esophagus (the tube carries food from the mouth to the stomach), causing acid refulx symptoms such as a burning feeling in the chest (heartburn) and a bitter or sour taste in the mouth. These acid reflux symptoms usually last a few hours after a meal and then go away. Most people experience acid reflux from time to time, usually after eating certain foods. Acid reflux that occurs more than twice a week is called gastroesophageal reflux disease (GERD). This is a more serious condition that, left untreated, can lead to problems such as inflammation of the esophagus (esophagitis) and a precancerous condition called Barrett’s esophagus. GERD can also worsen asthma, chronic cough, insomnia, and pulmonary fibrosis.

Acid reflux is considered very common, and diseases resulting from acid reflux are the most common gut complaint seen by US hospital departments. Studies suggest that over 60 million Americans experience heartburn at least once a month, and at least 15 million as often as daily.

Causes

Gastroesophageal reflux disease is seen in people of all ages, sometimes for unknown reasons (idiopathic). Often the cause is attributable to a lifestyle factor, but it can also be due to causes that cannot always be prevented.

The main cause of acid reflux disease is a problem with the lower esophageal sphincter (LES) muscle. This muscle, which is the “valve” between the stomach and the esophagus, normally closes tightly after food has passed through to the stomach.

The LES does not stay closed in people with acid reflux disease. When this happens, acid and stomach contents may back up (reflux) into the esophagus. This acid backup can sometimes cause the painful, burning sensation known as heartburn or other symptoms.

Other risk factors are more easily controlled and often directly linked to modifiable lifestyle or dietary issues, including –

  • Obesity
  • Smoking (active or passive)
  • High intake of table salt
  • Low dietary fibre intake
  • Low levels of hysical exercise
  • Medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants.

Symptoms

  • Stomach pain (pain in the upper abdomen)
  • Non-burning chest pain
  • Difficulty swallowing (called dysphagia), or food getting stuck
  • Painful swallowing (called odynophagia)
  • Persistent laryngitis/hoarseness
  • Persistent sore throat
  • Chronic cough, new onset asthma, or asthma only at night
  • Regurgitation of foods/fluids; taste of acid in the throat
  • Sense of a lump in the throat
  • Worsening dental disease
  • Recurrent pneumonia
  • Chronic sinusitis
  • Waking up with a choking sensation

The following signs and symptoms may indicate a more serious problem, and should be reported to a healthcare provider immediately –

  • Difficulty or pain with swallowing (feeling that food gets “stuck”)
  • Unexplained weight loss
  • Chest pain
  • Choking
  • Bleeding (vomiting blood or dark-colored stools)

Complications

Ulcers – Ulcers can form in the esophagus as a result of burning from stomach acid.

Lung and throat problems – Some people reflux acid into the throat, causing inflammation of the vocal cords, a sore throat, or a hoarse voice.

Stricture – Damage from acid can cause the esophagus to scar and narrow, causing a blockage (stricture) that can cause food or pills to get stuck in the esophagus.

Barrett’s esophagus – Barrett’s esophagus occurs when the normal cells that line the lower esophagus (squamous cells) are replaced by a different cell type (intestinal cells).

Esophageal cancer – There are two main types of esophageal cancer: adenocarcinoma and squamous cell carcinoma.

Treatment

Antacids – These OTC drugs (Alka-Seltzer, Maalox, Mylanta, Rolaids, Tums) use different combinations of either magnesium, calcium, or aluminum and hydroxide or bicarbonate ions to help neutralize stomach acid and temporarily relieve symptoms. Depending on their ingredients, they may also cause diarrhea or constipation.

H2 Blockers – Available both OTC and by prescription, these drugs (Tagamet, Pepcid, Zantac, Axid) provide short-term relief of GERD by preventing production of stomach acid.

Proton Pump Inhibitors (PPIs) – Available by prescription, PPIs (Prilosec, Prevacid, Protonix, Nexium) block stomach acid production more effectively than H2 blockers. However, they can cause “rebound” reflux: If the patient uses them, then stops taking them, the stomach acid may return worse than before.

Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Fundoplication, usually a specific variation called Nissen fundoplication, is the standard surgical treatment for GERD. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.

Alternative Treatment

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.

Omega-3 fatty acids, such as fish oil, may help decrease inflammation. Omega-3 fatty acids may increase the risk of bleeding.

Probiotic or “friendly” bacteria may help maintain a balance in the digestive system between good and harmful bacteria.

Melatonin is usually thought of as the sleep hormone.

Glutamine is the one that is naturally appearing within the body. Glutamine is found in several dietary sources including milk, fish, parsley, spinach, eggs, and more. Glutamine is yet another thing that many people have had helped their acid reflux.

Herbal licorice can help to coat your belly with a protective layer of gel. Removing the distress from acid reflux disease can be achieved without costly over-the-counter drugs.

Cranberry (Vaccinium macrocarpon) – Preliminary research suggests cranberry may inhibit H. pylori growth in the stomach. Cranberry may increase the length of time that medications, including warfarin (Coumadin), may stay in your body.

Mastic is a traditional treatment for peptic ulcers.

Hypnosis, massage, and other relaxation techniques may help reduce symptoms of GERD. Stress often makes GERD symptoms worse.

 

Reference –

http://www.drweil.com/drw/u/ART02882/acid-reflux.html

https://my.clevelandclinic.org/health/diseases_conditions/hic_gastroesophogeal_reflux_disease_GERD/dd_overview

http://www.besthealthmag.ca/best-you/a-z-index/acid-reflux-gastroesophageal-reflux-disease-heartburn

https://www.tums.com/heartburn-information/acid-reflux-gerd/

http://www.healthline.com/health/gerd/acid-reflux-symptoms

http://patient.info/health/Acid-Reflux-and-Oesophagitis

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