Tourette’s syndrome is a neurological disorder that effects certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells.The disorder is named for Dr. Georges Gilles de la Tourette, the neurologist who in 1885 first described the condition in an 86-year-old woman. He summarized it as a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics.The exact cause of Tourette’s is unknown, but it is well known that both genetic and environmental factors are involved. Genetic epidemiology studies have shown that the majority of cases of Tourette’s are inherited, although the exact mode of inheritance is not yet known as no gene has been identified. In other cases, tics are associated with disorders other than Tourette’s, a phenomenon known as tourettism, such as OCD (obsessive Compulsive Disorder) and ADHD (Attention Defeicit Hyperactive Disorder).

Signs and symptoms of Tourette syndrome typically show up between ages 2 and 12. Males are about three to four times more likely than females to develop Tourette syndrome.It involves unusual repetitive movements or unwanted sounds that can’t be controlled (tics). You may repeatedly blink your eyes, shrug your shoulders or jerk your head, or you might unintentionally blurt out offensive words.

You can live a normal life span with Tourette’s syndrome, and many people don’t need treatment when symptoms aren’t troublesome. Symptoms often lessen or become quiet and controlled after the teen years.

While there is no known cure for Tourette’s Syndrome here at COEM we treat using multiple techniques.

1. Reduce the allergic load
2. Look for mineral depletion
3. Eradicate over growth of yeast from the body
4. Look for a bacterial infection or over growth

To prepare for your appointment you will want to come off any antihistamines 48 hours before your visit, to allow for accurate allergy testing. Also make sure to bring with you copies of any recent tests and bloodwork performed, along with your new patient packet.

 

References

www.tsa-usa.org

National Institute of Neurological Disorders and Stroke. www.ninds.nih.gov

Scleroderma, also known as systematic sclerosis, is a chronic auto immune rheumatic disease. It affects skin and connective tissues of the body, which means that it is a condition where the body’s immune system acts abnormally. Hardening of the skin is one of the most visible effect of the disease. It also involves inflammation and scarring of many body parts, leading to problems in the lungs, kidneys, heart, intestinal system and other areas. Scleroderma is not contagious, infectious, cancerous or malignant.

The word “scleroderma” comes from two Greek words: “sclero” meaning hard, and “derma” meaning skin. The disease has been called “progressive systemic sclerosis,” but the use of that term has been discouraged as it has been found that scleroderma is not necessarily progressive. The disease varies from patient-to-patient.

Scleroderma is a rare disease. It is more common in women than men. Anyone can get it, even children. About 75,000 to 100,000 people in the U.S. have this disease.

Types of Scleroderma

There are two types of Sclerodera and each are sub classified.

Localized Scleroderma

The changes, which occur in localized scleroderma, are usually found in only a few places on the skin or muscles, and rarely spread elsewhere. It is relatively mild in nature. The internal organs are usually not affected, and persons with localized scleroderma rarely develop systemic scleroderma. It is classified in two types :

• Morphea

Morphea is a form of localized scleroderma characterized by waxy patches on the skin of varying sizes, shapes and color. The skin under the patches may thicken. The patches may enlarge or shrink, and often may disappear spontaneously. It mostly occurs between the ages of 20 and 50, but is often seen in young children.

• Linear scleroderma

It is a form of localized scleroderma which frequently starts as a streak or line of hardened, waxy skin on an arm or leg or on the forehead. Sometimes it forms a long crease on the head or neck, referred to as en coup de sabre because it resembles a saber or sword wound. This type tends to involve deeper layers of the skin as well as the surface layers, and sometimes affects the motion of the joints, which lie underneath and usually develops in childhood.

 

Systemic scleroderma (systemic sclerosis)

The changes occurring in systemic scleroderma may affect the connective tissue in many parts of the body. Systemic scleroderma can involve the skin, esophagus, gastrointestinal tract (stomach and bowels), lungs, kidneys, heart and other internal organs. It can also affect blood vessels, muscles and joints. It involve –

• Limited Scleroderma – CREST Syndrome

Limited scleroderma means only limited areas of skin are thick; usually just the fingers and/or face. Limited scleroderma is the milder form of scleroderma. The CREST syndrome is a type of limited scleroderma. CREST stands for the following:

• C – is for the calcium deposits under the skin and in tissues (calcinosis)
• R – for Raynaud’s phenomenon.
• E – esophageal dysmotility. This causes heartburn, which is often experienced by CREST patients.
• S – is for sclerodactyly; that means thick skin on the fingers.
• T – is for telangiectasias, which are enlarged blood vessels. These appear as red spots on the face and other areas.

Limited scleroderma causes less involvement of body organs than the more severe form. Some patients can develop lung and heart disease.

• Diffuse Scleroderma

This type of scleroderma is called diffuse scleroderma. It means that more areas of the skin are involved and thickened, but there is a high degree of variability among patients. Skin of the arms, legs, and trunk are more likely to be involved. The tightened skin makes it difficult to bend fingers, hands, and other joints. There is sometimes inflammation of the joints, tendons and muscles. Tight skin on the face can reduce the size of a person’s mouth and make good dental care very important.

Diffuse scleroderma can have associated involvement of internal organs such as the gastrointestinal tract, heart, lungs, or kidneys. The degree of organ involvement is highly variable – some get none at all and other patients organs may be badly affected.

Causes

The cause of scleroderma is not known. We don’t yet know why people’s immune system becomes overactive and initiates excessive production of collagen or the reason for blood vessel abnormalities; but it is thought to be a combination of genetic and environmental factors.

Environmental Factors –

• Toxic Exposure – Exposure to cadmium, mercury (dental amalgam), solvents (such as paint thinners), radiation, and silica as either known or suspected causes of autoimmune diseases or scleroderma.
• Artificial Joints and Silicon Implants – Some cases of connective tissue disease, such as scleroderma, related to artificial joints or silicone breast implants.
• Asbestos – Asbestos is relatively harmless. However, when asbestos is become dry and brittle or is ground or broken up, the fibers become airborne and can be ingested through the mouth or inhaled through the lungs. As a result, once inhaled or ingested, asbestos fibers often remain in the body and can cause a multitude of medical problems like Scleroderma, lung cancer etc.
• Air Pollution – Diseases such as scleroderma may be triggered by the inhalation of chemical solvents, herbicides and silica.
• Drugs & Medications – Some medications and street drugs are known or thought to induce scleroderma or Raynaud’s, such as Bleomycin, Cocaine, Marijuana, and Paclitaxel (Taxanes).

Genetic Factors

Research has demonstrated that systemic sclerosis is a polygenic (involving more than one gene) autoimmune (involving the immune system response) disease. Several genes and gene-gene interactions have been identified as playing a role in systemic sclerosis.

Inflammatory Response and Autoimmunity

The disease cause leading to scleroderma seems to occur as an autoimmune response, in which an abnormal immune system attacks the body itself. In scleroderma, this response produces swelling (inflammation) and too much production of collagen. Collagen is the tough protein that helps build connective tissues such as tendons, bones, and ligaments. Collagen also helps scar tissue form. When normal tissue from skin, lungs, the esophagus, blood vessels, and other organs is replaced by this type of abnormal tissue, none of these body parts work as well, and many of the symptoms previously described occur.

Other Factors

• Proteins – Increased amount of S100A8 (calcium- and zinc-binding protein) and S100A9 (Calcium Binding Protein) in patients with diffuse coetaneous systemic sclerosis. A correlation with organ involvement and immunological abnormalities. These two proteins may play important roles in the development of systemic sclerosis.
• Oxidative Stress- Lipid Peroxidation – Oxidative Stress is an imbalance between pro-oxidants and antioxidants that can result in cellular degeneration.
• Gluten – Studies suggest, of several rheumatological disorders , including Raynaud’s phenomenon in people with celiac disease, but this seems to be the first report of extensive microvascular damage, similar to capillary changes in scelroderma, documented by nailfold capillaroscopy in a patient with celiac disease.
• Thyroid – It is common for people with systemic scleroderma to also have other health problems, and thyroid disease can often be associated with it. However, thyroid disease is very common in the general population, whereas systemic scleroderma is very rare, and thyroid disease is not considered to be a symptom of any type of scleroderma.
• B and T Cells – B and T cells are white blood cells that help stimulate an immune response to infections. In the thymus gland, lympohocytes are matured into these cells. Sometimes these cells become overactive, which is suspected as being part of the process that leads to autoimmune diseases like Scleroderma.

Symptoms

Symptoms vary greatly from person to person depending on what part of the body is involved.

For some people, following symptoms are among the early signs of scleroderma:

• Raynaud’s phenomenon – The fingers or toes turn white, then blue in the cold, and then red as blood flow returns. This is caused by narrowing of the blood vessels. It is possible to have Raynaud’s without having scleroderma, but most people with scleroderma will have symptoms of Raynaud’s at some time and it’s often one of the first symptoms to appear.
• Thickening and hardening of the skin on the hands, arms and face
• Stiffness and pain in the muscles and/or joints
• Swelling of hands and feet, especially in the morning
• Thinning of the pads at the finger tips
• Small white chalky lumps (calcium deposits) under the skin
• Indigestion or heartburn
• Diarrhoea or constipation
• Shortness of breath or reduced ability to exercise
• Kidney problems and high blood pressure
• Gut Problems – The gastrointestinal (GI) tract is primarily responsible for the processes of digestion and excretion, and is frequently affected by manifestations of Scleroderma.
• Dryness – It is characterized by a decrease in secretions of the tear glands and the salivary glands, which provide lubrication for the eyes and mouth. The unusual dryness of the eyes resulting from this condition can lead to serious irritation and inflammation. Excessive dryness of the mouth may lead to difficulties in swallowing and speaking, a pronounced increase in tooth decay and cavities, and a reduced sense of taste. Dryness may also involve vagina and other areas of the body.

Related Complications

• Digestive Systems – Digestive problems associated with scleroderma can lead to acid reflux and difficulty swallowing — some describe feeling as if food gets stuck midway down the esophagus.
• Heart – Scarring of heart tissue increases the risk of abnormal heartbeats (arrhythmias) and congestive heart failure, and can cause inflammation of the membranous sac surrounding the heart (pericarditis). Scleroderma also can raise the pressure on the right side of the heart and cause it to wear out.
• Teeth – Severe tightening of facial skin can cause the mouth to become smaller and narrower, which may make it hard to brush teeth or to even have them professionally cleaned.
• Kidneys – When scleroderma affects the kidneys, it can develop an elevated blood pressure and an increased level of protein in the urine.
• Lungs – Scarring of lung tissue (pulmonary fibrosis) can result in reduced lung function, reduced ability to breathe and reduced tolerance for exercise.
• Sexual function – Men who have scleroderma often experience erectile dysfunction. Scleroderma may also affect the sexual function of women, by decreasing sexual lubrication and constricting the vaginal opening.
• Gut – Evidence suggests that the involuntary muscle of the gastrointestinal tract (smooth muscle) can be affected in scleroderma. When this muscle is involved, abnormal motor function of the esophagus, stomach, small or large bowel results.

 

Treatment

• Medications

Calcium-channel blockers are the standard drugs to open the blood vessels, and may be used for pulmonary artery hypertension and Raynaud’s phenomenon. This may involve – diltiazem (Cardizem, Dilacor), dihydropyridine medications (felodipine, amlodipine, and isradipine).

Side effects may include fluid buildup in the feet, constipation, fatigue, gingivitis, erectile dysfunction, flushing, and allergic symptoms.

• ACE Inhibitors –

Many medications are available for controlling blood pressure, but ACE inhibitors appear to be the most effective for scleroderma patients because of their protective actions in the kidney. This includes – captopril (Capoten), enalapril (Vasotec), quinapril (Accupril), benazepril, and lisinopril (Prinivil, Zestril). Side effects may include irritating cough, large drops in blood pressure, and allergic reactions.

• Angiotensin Receptors – This involves losartan, candesartan cilexetil, and valsartan. They have positive effects on blood vessels. Small studies showing improvement in Raynaud’s phenomenon warrant further research.
• Nitrates – Nitrates relax smooth muscles and open arteries, and are therefore sometimes used for the short-term management of Raynaud’s phenomenon. Side effects of nitrates include headaches, dizziness, nausea, blurred vision, fast heartbeat, and sweating.
• Cyclophosphamide (Cytoxan) – Cyclophosphamide is the most important immunosuppressant currently used for scleroderma. It blocks some of the destructive actions of scleroderma in the lungs. Intravenous cyclophosphamide can be life-saving for patients with pneumonia caused by interstitial lung disease. Side effects may include – hair loss, infection, and bleeding into the urinary tract.
• Other Drugs – D-penicillamine (which may be useful for skin symptoms), methotrexate (Rheumatrex), sirolimus (rapamycin), antithymocyte globulin (ATG), corticosteroids, cyclosporine A, and chlorambucil (Leukeran). All of these drugs have potentially severe side effects.

Surgeries

• Sympathectomy and Hand Surgeries – This uses procedures that block or remove the nerve responsible for narrowing blood vessels in the hand. The result is increased blood flow in the hand.
• Other Surgeries – Disabling deformity of the hand is a common feature of scleroderma. Various surgical procedures can relieve pain, prevent tissue loss, protect hand function, and improve the appearance of the hands.

Alternative Treatment

Environmental Medicine is a branch of medicine whose domain is not limited by anatomical boundaries but, rather, is concerned with the whole person and the way that a person reacts to his/her total environment. At our center we first carry out Comprehensive Approach of studying the patient’s medical history, where we are able to get hold of the root cause and treat accordingly.

• Bio-detoxification Programme – The Center’s Bio-detoxification 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.
• Alka Vita Supplements – This has the tremendous advantage that it alkalises, therefore increases oxygenation, counteracts free radical attack and damage and therefore undermines the basis of disease. It is also directly ‘anti-septic’ against fungal infections, including Candida and possibly all harmful micro-organisms and parasites, although there is not enough information on this, we do know that all anaerobic infections (the harmful ones) are attacked by free electrons that Alka- vita supplies and are eventually destroyed or severely limited by an alkaline environment.
• AA and DHA – The essentiality of arachidonic acid (AA) and docosahexaenoic acid (DHA), when dosed appropriately, fish oil-based lipid emulsions contain sufficient essential fatty acid (EFAs) to prevent essential fatty acid deficiency.
• Curcumin (Tuermeric) – The varied biological properties of curcumin and lack of toxicity even when administered at higher doses makes it attractive to explore its use in various disorders like tumors of skin, colon, duodenum, pancreas, breast and other skin diseases.
• Vitamin B – A growing body of research is drawing a link between low B12 and early cognitive decline, a condition that often leads to auto immune disease.
• Probiotics – Yogurt may be helpful for combatting bowel involvement with systemic scleroderma, especially small bowel bacterial overgrowth. It may also be particularly helpful when taking antibiotics.
• Lipioc acid – Dihydrolipoic acid (DHLA) not only acts as an antioxidant but also an antifibrotic since it has the ability to reverse the profibrotic phenotype of Sclerodermal fibroblasts.
• Vitamins & Minerals – Different Vitamins are essential to aid the immune system and many biochemical processes including the utilisation of calcium and magnesium. Its deficiency is almost universal in northern climates and even more so since the introduction of sun screen. Its deficiency has been linked strongly to auto-immune diseases. Zinc has critical effect in homeostasis, immune function, oxidative stress, apoptosis, aging and in chronic diseases, including atherosclerosis, several malignancies, neurological disorders, autoimmune diseases. Vitamin D is essential for promoting calcium absorption in the gut, build and preserve bone, helps prevent osteoporosis and helps decrease fracture risk.
• Herbs – Herbs such as Cleavers and Red Clover help to cleanse toxins from the lymphatic system and to purify the blood, allowing much needed nutrients to reach the skin and tissues.

Referneces –

www.sclero.org

www.medicinenet.com

www.hopkinsscleroderma.org

www.mayoclinic.org

www.raynauds.org.uk

www.rheumatology.oxfordjournals.org

www.arthritis-research.com

www.todaysdietitian.com

www.scleroderma.ca

www.aarda.org

www.niams.nih.gov

Rheumatoid Arthritis is a chronic disease whereby various joints in the body are inflamed, leading to stiffness, pain, swelling and the possible loss of function. It usually affects the joints symmetrically i.e. on both the sides equally and may initially begin in couple of joints only and most frequently attacks knees, ankles, shoulders, wrists and hands.
Rheumatoid Arthritis is an autoimmune disease in which the body’s immune system – which generally protects its health by attacking foreign substances like viruses and bacteria – mistakenly attack the joints and other tissues causing chronic inflammation. The immune system contains complex organization of cells and anti bodies designed normally to find and destroy the invaders of our system, particularly infections. Though inflammation of the tissue around the joints and inflammatory arthritis are characteristics of rheumatoid arthritis, the disease also causes inflammation and injury to other organs of the body. As it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic (body-wide) illness and sometimes is also known as rheumatoid disease. Rheumatoid arthritis that affects children under 16 years of age is referred as juvenile idiopathic arthritis.

• The process of disease leading to rheumatoid arthritis begins with synovium – the tissues that lines the inside of joints and around the joins that makes a fluid that lubricates joints making them move smoothly creating a protective sac.
• In addition of lubrication of joints, this fluid also supplies nutrients and oxygen to cartilage, a slippery tissue that coats the ends of bones; it composes of collagen – the structural protein in the body that forms a network to give support and flexibility to joints.
• In rheumatoid arthritis, an affected immune system produces destructive molecules that cause continuous and harmful inflammation of synovium. Gradually, the collagen is destroyed, hence narrowing the joint space and eventually damaging bone.
• If the disease develops into a form called progressive rheumatoid arthritis, the destruction process accelerates.
• Fluid and immune system cells gathers in synovium, producing a pannus – a growth composed of thickened synovial tissues. With the development of the disease, the pannus produces more enzymes that destroy nearby cartilage, aggravating the area and attracting more inflammatory white cells, thereby perpetuating the process.

Causes

The exact causes of Rheumatoid arthritis are still not known, but this condition is most likely triggered by a combination of factors such as abnormal autoimmune response, inflammatory process, genetic factors and at times environmental or biological factors like viral infections and/or hormonal changes.

• Abnormal Autoimmune Response & Inflammatory Process
  The immune system helps the body to fight and respond to the foreign substance and antigens – a substance that induces the formation of antibodies, since it is recognized as a threat by our immune system – like toxins and viruses. It helps the body fight these infections and accelerates the healing of wounds and injuries. The inflammatory process is an outgrowth of the immune system. There are two main components of the immune system that are associated with rheumatoid arthritis, namely, B cells and T cells, both belonging to a group of immune cells called lymphocytes – a type of white blood cell.
  If the T cell recognizes an antigen as “non self”, it will result in producing chemicals (cytokines) which in turn causes B cell too multiply and release many antibodies (immune proteins). These antibodies spread in the bloodstream, and help identifying foreign substances and ultimately causing inflammation in order to get rid of these invaders of the body.
  For unknown reasons, these T cells and B cells become over active in patients with Rheumatoid Arthritis.
• Genetic Factors
  Genetic Factors may play a significant role in either increasing the chances of developing RA condition or by worsening the process of the disease. The key genetic marker of RA is Human Leukocyte Antigen (HLA). HLA is not responsible is the development of Rheumatoid arthritis, but they can worsen the condition once developed. Other than that, STAT4 – a gene that plays an important role in the regulation and activation of immune system; TRAF1 and C5 – genes relevant to chronic inflammation; and PTPN22 – gene associated with both development and progression of RA, are connected to Rheumatoid Arthritis. Yet not all people with these genes develop RA and not all RA patients have these genes.
• Environmental Factors
  These factors include infectious agents like bacteria and viruses which may trigger the development of the disease in a person who is more likely to get RA. Research shows that factors like obesity, physical or emotional stress, exposure to cigarette smoke, air pollution, harmful chemicals, occupational exposure to mineral oil, silica etc.

Symptoms

Researchers have proven that about 1.3 million Americans e affected by Rheumatoid Arthritis. Although RA can develop in any age from childhood to old
age, it normally begins between the ages of 30 – 50 years. Women are more likely to develop this condition than men.
The symptoms of Rheumatoid Arthritis are:

• Swelling And Pain
  Te inflamed joints are usually swollen and are often warm and spongy when touched. The pain occurs on both sides of the body and may be more severe on either side.
• Building up of certain
  Fluid may get accumulated in joints. The fluid gathered in the joint sac behind the knee forming a tumor like substance called Baker’s Cyst. This cyst sometimes extends down the back of the calf and causes severe pain.
• Nodules
  In some cases of RA, inflammation of small blood vessels may cause nodules or lumps, under the skin. These nodules are often situated near the elbow (it can show up at other places too) and are about the size of pea or slightly larger than that. These nodules can become sore and infected, particularly if their location is where stress occurs, for e.g. Ankles.
• Specific Joint Pain
  Although RA mostly develops in the wrists and knuckles, the balls of the foot and knees are often affected too. Joints like those in the cervical spine, shoulders, jaw, elbows and even the joints between the inner ear, gets eventually affected.
• Flu like Symptoms
  Fatigue, loss of weight and fever are also few symptoms.

Complications Involved

• Anemia – RA patients tend to develop anemia i.e. decrease in the number of red blood cells.
• Eye Problems – Inflammations of the blood vessels in the eyes, like scleritis and episcliritis that can result in corneal damage. Symptoms include redness of the eye and gritty sensation.
• Skin Problems – Skin problems are common in RA patients, usually on the fingers and under the nails.
• Infections – RA patients are at a higher risk of being affected by infections, because of the disease itself and also due the immune suppressing drugs used in the treatment.
• Peripheral Neuropathy – RA condition affects the nerves, most often n hands and feet.
• Joint Deterioration and Pain – Affected joints become deformed due to the disease.
• Osteoporosis – Loss of bone density, is more common than average in postmenopausal women with RA. The hip is particularly affected. The risk for osteoporosis also appears to be higher in men with RA who are over 60 years old.
• Lung Diseases – Chronic lung diseases like interstitial fibrosis, pulmonary hypertension etc. are also caused in RA condition.
• Pregnancy Complications – Women with RA are more prone to premature delivery. They are also at higher risk of developing high blood pressure than in normal cases.
• Kidney and Liver Problems
• Heart Problems

Treatment

The primary goal of treating RA is:

• Stop inflammation
• Prevent joint and organ damage
• Relieve Symptoms
• Improve physical functions
• Reducing long term complications

The treatment is of different types:

Medications

Different drugs are used in the treatment of Rheumatoid Arthritis. Some are to ease the symptoms of RA, others to slower and eventually stop the different activities of RA.
Drugs used to ease the symptoms – Non-steroidal anti-inflammatory drug (NSAIDs) are used to ease the pain and inflammation involved in the condition of RA. These drugs include ibuprofen, ketoprofen and naproxen sodium. Patients with stomach ulcers are prescribed to take celecoxib, also known as COX-2 inhibitor, which is proven to be safer for stomach. These drugs can be taken by mouth or also can be applied to the skin.

Drugs that slower the RA activity– Corticosteroids medications like prednisolone, prednisone and methylprednisolone are some of the fast acting anti-inflammatory medications used in the treatment.
Disease Modifying Anti-Rheumatic Drugs (DMARDs) are the standard medical treatment for RA. Their ability is to slow down the progression of RA. These include- Methotrexate, leflunomide, hydroxychloroqune, minocycline and sulfasalazine. Unfortunately, all DMARDs tend to lose effectiveness over time and may also produce stomach and intestinal side effects.
Biological DMARDs – drugs made out of living cells are also used in the treatment. They are subsets of DMARDs. They target specific components of the immune system that contribute to the various attributes of rheumatoid arthritis. They include abatacept, adalimumab, anakinra, certolizumab pegol, etanercept, infliximab, golimumab and rituximab.

Surgery

Some people with RA are benefitted by joint surgeries. It can help in relieved joint pains and correcting deformities and at times it modestly improves joint function.

Joint Replacement

Joint replacement (arthroplasty) is usually done for people over age 50 or those whose joint damage is rapidly progressing. The joint replacement can last for 20 years or more.

Exercise

Its’ advisable for RA patients to maintain balance between rest and moderate exercise. Studies suggest that even little physical therapy can help the patients and that these benefits are sustained.

Natural Treatment

Natural Supplements

• Boswellia Serate (Indian Frankincense) – contains anti-inflammatory and pain relieving properties.
• Capsicum Fruitescens – reduces substance P, a pain transmitter. Research suggest that it helps in 50 percent reduction of joint pain. It’s available in the form of topical cream, gel etc.
• Fish Oil Capsules (EPA & DHA) – Omega-3 blocks inflammatory cytokines and prostaglandins, and are converted into effective anti-inflammatory chemicals. EPA and DHA are very effective for treating RA and other inflammatory conditions. Studies prove that fish oil significantly decreases joint tenderness and stiffness in RA patients, helping in reduction or elimination of NSAIDs.
• Gamma Linolenic Acid (GLA) – GLA is an Omega-6 fatty acid that the body converts into anti-inflammatory chemicals. Its intake shows significant improvement in joint pain, stiffness and grip strength. Studies show that a combination of fish oil and GLA reduces the need for conventional pain relievers.
• Ginger – Ginger has the properties of anti-inflammatory components similar to ibuprofen and COX-2inhibitors, without any side effects. Its intake reduces osteoarthritis pain in the knee and other joints. It also reduces inflammatory reactions of RA.
• Pine bark extract, rosehips, green-lipped mussel, devil’s claw, borage seed oil etc. also help in the treatment.
• Change in Diet

Restless legs syndrome is a condition that causes an overwhelming urge to move your legs. It is also known as Willis-Ekbom disease.It is experienced by more women than men in the general population and can be a common problem for people who have Parkinson’s. Symptoms can start at any age, but it is more common as you get older.

Restless legs syndrome can be mild, moderate, severe or very severe based on the strength of the symptoms, how often the person may experience them and if they affect the ability to carry out daily tasks. Most people’s symptoms are not severe or frequent enough to need medical treatment. When it happens can vary from person to person. Some people experience it occasionally, while for others it happens every day. It happens most often when you are resting – for example, when you are sitting watching the TV or lying in bed.

People with RLS often have periodic limb movements, a closely related sleep disorder that occurs when muscles

involuntarily tighten, twitch or flex while you are still. Periodic limb movements in sleep occur in 80 percent to 90 percent of people who have RLS.RLS is found in 2 to 5% of people (both men and women). The risk of it goes up as you grow older, and it tends to be more serious in the elderly. But it can start at any age. It can be associated with pregnancy.

Restless Legs Syndrome affects approximately 10% of adults in the U.S. Researchers believe that RLS is commonly unrecognized or misdiagnosed as insomnia or other neurological, muscular or orthopedic condition.RLS also affects about 2% of children, according to a study of more than 10,000 families in the U.S. There is also evidence suggesting that children with attention deficit hyperactivity disorder (ADHD) and a family history of RLS are at risk for more severe ADHD.

Features of RLS

There are four primary features of RLS –

• Uncomfortable sensation in the legs with a clear need or urge to move the legs
• The symptoms are worse at night
• The symptoms come on with rest
• The symptoms are relieved with movement

Types of RLS

• Early-onset RLS starts before the age of 45 years, producing symptoms that progress gradually. The daily occurrence of symptoms usually is not present until the age of 40 to 65 years.
• Late-onset RLS advances more quickly and occurs more often. Symptoms may appear daily from the time that they begin, or they may progress rapidly over a period of about five years until they occur with regularity.
• Primary RLS occurs independently of other disorders but may be exacerbated or triggered by other factors.
• Secondary RLS is precipitated by other disorders and resolves when the other disorders are treated.

Causes

Genetic Factor– The simplest concept is when a specific gene is damaged, for example, hemophilia or sickle cell disease. In these diseases, the damaged gene results in an abnormal protein being made or in no protein at all being made. When we talk about how genes are related to blood pressure, heart disease, Alzheimer’s disease, or RLS then the role of the gene is more difficult to understand because usually these common disorders do not result from one damaged gene but rather from interaction of several genes under certain environmental conditions.More than 50 percent of people with primary RLS report a pattern of the disorder in their family. First-degree relatives of a person with RLS are three times to six times more likely to have it.

Most of the people are born with normal hearts but over time, because of the interaction between environmental factors (aging, high cholesterol, smoking, increased blood pressure, diabetes, etc) and genes, some people will progress to having a bad heart. RLS is also related to environmental factors and genes. The single largest know environmental factors is low iron levels. Low iron may occur before birth, during infancy, as a child, during pregnancy or later in adult life. The low iron may resolve long before one even develops RLS symptoms, but the low iron condition may set into motion set of conditions that eventually lead to getting RLS.

Underlying Health Condition – Restless legs syndrome can sometimes occur as a complication of another health condition, or it can be the result of another health-related factor. This is known as secondary restless legs syndrome.

• Iron deficiency anaemia – low levels of iron in the blood can lead to a fall in dopamine, triggering restless legs syndrome
• A long-term health condition – such as chronic kidney disease, diabetes, Parkinson’s disease, rheumatoid arthritis, an underactive thyroid gland, or fibromyalgia
• Pregnancy – particularly from week 27 until birth; in most cases the symptoms disappear within four weeks of giving birth

Dopamine – Because of the marked improvement in RLS symptoms seen with drugs that stimulate the dopamine system and because of the RLS-like symptoms produced with drug that block the dopamine system, the dopamine system has been implicated RLS. CSF has also been used to evaluate dopamine system, and although this is a crude method for assessing the dopamine system in the brain, the data indicated possible increase in brain dopamine production. Imaging studies using special radioactive chemicals have found reduced receptor and transporter function in the brain of more severely affected RLS patients.

Triggers – There are a number of triggers that don’t cause restless legs syndrome, but can make symptoms worse. These include medications such as –

• Some antidepressants
• Antipsychotics
• Lithium – used in the treatment of bipolar disorder
• Calcium channel blockers – used in the treatment of high blood pressure
• Some antihistamines
• Metoclopramide – used to relieve nausea

Other possible triggers include –

• Excessive smoking, caffeine or alcohol
• Being overweight or obese
• Stress
• Lack of exercise

Alcohol and sleep deprivation also may aggravate or trigger symptoms in some individuals. Reducing or completely eliminating these factors may relieve symptoms, but it is unclear if this can prevent RLS symptoms from occurring at all.

Symptoms

Not only are the signs and symptoms of restless legs syndrome different from person to person, but also they can be tricky to explain. Some describe the leg sensations as “creeping,” “prickling,” “burning,” “tingling,” or “tugging.” Others say it feels as if bugs are crawling up their legs, a fizzy soda is bubbling through their veins, or they have a “deep bone itch.”

The symptoms of RLS can range from mildly annoying to severely disabling. You may experience the symptoms only once in a while, such as when you’re under a lot of stress, or they may plague you every night.

Here are some signs and symptoms of RLS –

Leg discomfort and strong urge to move – Uncomfortable sensations deep within the legs, accompanied by a strong, often irresistible urge to move them. Many describe the sensations as tingling, jitteriness, a “creepy crawly” feeling, itching, or pulling.

Rest triggers the symptoms – Leg pain is normally trigged by activity and relieved by rest, but with restless legs syndrome, the reverse is true. Restless leg symptoms start or become worse when you’re sitting, relaxing, or trying to rest.

Symptoms get worse night – RLS typically flares up at night, especially when you’re lying down. In more severe cases, the symptoms may begin earlier in the day, but they become much more intense at bedtime.

Symptoms improve when you walk or move your legs – The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs. The relief continues as long as you keep moving.

Nighttime leg twitching – Many people with restless legs syndrome also have periodic limb movement disorder (PLMD), a sleep disorder that involves repetitive cramping or jerking of the legs during sleep. These leg movements further disrupt your sleep.

Treatment

Dopamine-Related Medications – Dopamine is a chemical that is produced by certain cells in the brain and this group of drugs functions to either increase the amount of dopamine made by the cell (levodopa) or increase the dopamine signal to other surrounding cells by mimicking dopamine in the brain. The dopamine-related drugs include levodopa, pramipexole, ropinirole and rotigotine. These drugs are also used for Parkinson’s Disease. However, there is no indication that RLS is related to, or is a precursor of, Parkinson’s Disease. These medications are likely to be effective in reducing symptoms in 90% of patients with restless legs syndrome.

Excessive sleepiness, increased compulsive behavior and more commonly, paradoxical worsening of symptoms, referred to as “augmentation”, may occur with these medications after extended use.

Opiates – This category of medications includes codeine, hydrocodone, oxycodone, morphine, hydromorphone, methadone, buprenorphine and pentazocine. It is estimated that 85-90% of patients with RLS will respond very well to opiates.

Benzodiazepines Receptor Agonist (BRA) – This group of drugs is also known as sleeping pills and has valium-like effects. The structure of the parent compound was designated as a “benzodiazepine”. Later research identified the specific target of the benzodiazepine drugs and designated it as the “benzodiazepine receptor”.

Alpha-2 delta Drugs – These drugs have their affect by interacting with one of the calcium channel proteins, alpha-2 delta protein. Calcium channels allow the charged calcium ion to move into the nerve cell and are therefore important in activating, in deactivating and in stabilizing the electrical activity of the nerve cell. The alpha-2 delta drugs are also used to treat patients with nerve-damage related pain even in those without RLS.

Vein Treatment -98% of patients affected by RLS in a recent study found symptom relief after treating varicose veins in their legs with non-surgical sclerotherapy*. Many physicians believe that it is the underlying vein problems that are causing the Restless Leg Syndrome, and by treating this with an outpatient procedure, patients can get relief.

Alternative Treatment

Iron Supplements – Iron supplements may reduce symptoms in people with restless legs syndrome who are also iron deficient. Patients should use them only when dietary measures have failed. Iron supplements do not appear to be useful for RLS patients with normal or above normal iron levels.

Magnesium mineral supplement – Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study.Periodic limb movements during sleep (PLMS), with or without symptoms of a restless legs syndrome (RLS), may cause sleep disturbances. Anecdotal observations have shown that oral magnesium therapy may ameliorate symptoms in patients with moderate RLS.

5-HTP – If the iron levels are normal, then 5-HTP supplementation may significantly improve, or even eliminate, restless legs and myoclonus.

Folic Acid – If there is a family history of restless-legs syndrome (about one-third of all patients with this syndrome have a family history), high- dosage folic acid (35 to 60 mg daily) therapy can be helpful.

Vitamin E – Vitamin E supplements of 400 IU two or three times a day are extremely effective in alleviating RLS.

Chamomile– Studies show the herb chamomile has mild calmative effects (it has a calming effect on the whole body.

Ginkgo biloba – Studies show that the herb ginkgo biloba, which has been used in Chinese medicine for centuries, has beneficial effects on peripheral circulation and may help to improve symptoms.

Valerian – Studies show that the herb valerian is effective in inducing sleep as it has sedative effects that help to improve the quality of sleep. Valerian is often used in herbal preparations for insomnia.

Vitamin B1 (thiamin) – This vitamin assists the nervous tissue to perform correctly and reduces incidence of symptoms. Vitamin B1 (thiamin) may be more useful for reducing symptoms in combination with the rest of the B vitamins.

Vitamin B5 (pantothenic acid) – This vitamin helps the nervous system tissues perform properly and reduces incidence of symptoms. Vitamin B5 (pantothenic acid) may be more useful for reducing symptoms in combination with the rest of the B vitamins.

Vitamin B12 (cyanocobalamin) – A deficiency of vitamin B12 (cyanocobalamin) is known to cause secondary restless legs syndrome, so this vitamin is very important to help reduce symptoms.

Vitamin C – The antioxidant vitamin C helps to strengthen the capillary and other blood vessel walls, so it may help with those people that have peripheral neuropathy symptoms as the underlying reason for the restless legs syndrome.

Vitamin E – Studies show that the antioxidant vitamin E may help to reduce symptoms in people with peripheral neuropathy, as it helps to ensure there is proper circulation in the peripherals (legs/arms) and the blood in the veins and arteries is circulating properly.

Calcium – The mineral calcium is necessary to enable proper muscles contraction and to ensure the muscles work effectively, so it may assist with reduction of symptoms (in conjunction with other nutrients).

Potassium – The mineral potassium is also necessary for proper muscles contraction and ensuring the muscles work properly, so may assist with reduction of symptoms (especially in conjunction with the other nutrients).

Essential fatty acids – The omega 3 essential fatty acids are needed by the body to help reduce inflammation, especially in the muscles, tendons and nerves. The essential fatty acids may be especially useful in reducing severity of symptoms.

GABA – The amino acid GABA is also one of the neurotransmitters which helps the body to relax. GABA is also required to help make the important other neurotransmitter dopamine, which may not be functioning properly in people with restless legs syndrome.

Tryptophan – Studies show there is a link between low levels of the amino acid tryptophan and increased incidence of restless legs syndrome and this is most likely because tryptophan and vitamin B3 (niacin) are closely related and vitamin B3 (niacin) may be especially required to relieve restless legs syndrome symptoms.

 

Reference –

http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/

http://www.aasmnet.org/resources/factsheets/rls.pdf

http://sleephealthfoundation.org.au/pdfs/Restless-Legs.pdf

https://sleepfoundation.org/sleep-disorders-problems/restless-legs-syndrome/symptoms

http://www.helpguide.org/articles/sleep/restless-leg-syndrome-rls.htm#treatment

http://www.medicinenet.com/restless_leg_syndrome/article.htm

http://patient.info/health/restless-legs-syndrome-leaflet

http://www.besthealthmag.ca/best-you/home-remedies/natural-home-remedies-restless-legs-syndrome

http://www.mommypotamus.com/natural-remedies-for-restless-leg-syndrome/

http://www.nytimes.com/health/guides/disease/restless-leg-syndrome/treatment.html

Raynaud’s Disease, also known as Raynaud’s Phenomenon (RP), refers to reversible spasm of peripheral arterioles in response to cold or stress. It is a disorder characterized by one or more fingers becoming blanched, cyanotic, and red (often in that order), upon an individual’s exposure to cold stimuli or emotional stress. These color changes are attributable to several factors; however, they mainly result from vasospasms of the digital arteries.

RP is named after the French physician, Maurice Raynaud, who first described it. Although the fingers of healthy individuals may become pale in response to severe cold, the effect is exaggerated in individuals with Raynaud’s symptoms. Even mild cold exposures can cause significant symptoms. 8 percent of the sufferers are women, and as many 5 percent population of the U.S. are affected by RP.

The disease mostly affects the fingers, toes, tip of the nose and the ears. The problem is in the blood vessels that supply the skin. Smaller arteries narrow and limit blood circulation to affected areas. Areas of the body subsequently become cold and very pale. Patients typically feel pins and needles, numbness, and even burning. The sensation can be unpleasant and painful.

The disease is classified as following –

• Primary Raynaud’s – This is the most common form, there is no apparent cause (idiopathic). It is possible for the primary form to move to the secondary form.
• Secondary Raynaud’s – It is associated with an underlying disease, such as rheumatoid arthritis. In extreme cases this form can progress to necrosis or gangrene of the fingertips.

Raynaud’s phenomenon doesn’t usually cause permanent damage. However, it can be a symptom of more serious underlying illnesses, so it is important to see the doctor if anyone experiences it.

Causes

• Blood vessels in spasm – With Raynaud’s, arteries to the fingers and toes go into vasospasm when exposed to cold or stress, narrowing the vessels and temporarily limiting blood supply. Over time, these small arteries may thicken slightly, further limiting blood flow. Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting the hands in cold water, taking something from a freezer or encountering cold air, is the most likely trigger. For some people, emotional stress can cause an episode of Raynaud’s.
• Connective tissue diseases – Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud’s. Other diseases that increase the risk of Raynaud’s include lupus, rheumatoid arthritis and Sjogren’s syndrome.
• Diseases of the arteries – Raynaud’s phenomenon can be associated with various diseases that affect arteries, such as the buildup of plaques in blood vessels that feed the heart (atherosclerosis) or a disorder in which the blood vessels of the hands and feet become inflamed (Buerger’s disease). A type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension) can be linked to Raynaud’s.
• Carpal tunnel syndrome – This condition involves pressure on a major nerve to the hand (median nerve) producing numbness and pain in the affected hand. The hand may become more susceptible to cold temperatures and episodes of Raynaud’s.
• Repetitive action or vibration – Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can increase the risk of developing Raynaud’s.
• Smoking – Smoking constricts blood vessels and is a potential cause of Raynaud’s.
• Injuries – Injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud’s phenomenon.
• Certain medications – Some drugs — including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications — have been linked to Raynaud’s.
• Cancers – Some types of cancer can cause secondary Raynaud’s. These are usually cancers that develop inside the blood, bone marrow or immune system, such as –
  • Acute lymphoblastic leukaemia – a cancer of the white blood cells that mainly affects children
  • Lymphoma – a cancer that develops inside one or more of the glands that are part of the immune system
  • Multiple myeloma – a cancer that develops inside bone marrow

 

Risk Factors

Risk factors for primary Raynaud’s include –

• Sex – Primary Raynaud’s affects women more than men.
• Age – Although anyone can develop the condition, primary Raynaud’s often begins between the ages of 15 and 30.
• Climate – The disorder is also more common in people who live in colder climates.
• Family history – A family history appears to increase the risk of primary Raynaud’s. About one-third of people with primary Raynaud’s have a first-degree relative — a parent, sibling or child — with the disorder.

Risk factors for secondary Raynaud’s include –

• Associated diseases – These include conditions such as scleroderma and lupus.
• Certain occupations – People in occupations that cause repetitive trauma, such as operating tools that vibrate, may be more vulnerable to secondary Raynaud’s.
• Exposure to certain substances – Smoking, medications that affect the blood vessels, and exposure to certain chemicals, such as vinyl chloride, are associated with an increased risk of Raynaud’s.

Symptoms

Generally, primary Reynaud’s disease symptoms are mild, while the secondary form’s may be more severe. In the primary form both hands are affected simultaneously, usually all fingers at the same time. In the secondary form the development and appearance of symptoms is more patchy, with perhaps a couple of fingers on one side being affected.

The affected areas will become very pale (pallor), and then take on a bluish color (cyanosis) due to hypoxia (lack of oxygen to that area). They will feel very cold and numb. If all fingers are affected, trying to rummage in your pockets for specific coins becomes much more difficult. This can sometimes be distressing.

• Cold fingers and toes
• Color changes in your skin in response to cold or stress
• Numbness or tingling in the fingers and toes (can be on the ears or nose)
• Stinging or throbbing pain upon warming or stress relief
• Ulcers in the tips of fingers and/or toes
• Raynaud’s-type symptoms may occur during breastfeeding; the nipples will turn white and become extremely painful.

Treatment

Conventional Treatment

Calcium channel blockers – These are prescription medications that help to dilate or enlarge the blood vessels, thereby increasing circulation to the extremities. These medications are helpful in reducing the severity and frequency of attacks. Some medications used are – nifedipine and diltiazem.

Vasodilators – Topical prescription medications like nitroglycerin which relax the walls of the blood vessels can provide relief. This type of drug can be used to help heal painful skin ulcers caused by the condition of Raynaud’s. Vasodilators that are typically used to treat other conditions are also prescribed to those with Raynaud’s. Such drugs as: Cozaar (used for treatment of high blood pressure), antidepressants like Prozac and Sarafem, and as odd as it may sound, Viagra (sildenafil) is also prescribed for Raynaud’s.

Alpha Blockers – These drugs typically counteract the actions of the hormone that constricts the blood vessels, norepinephrine. Some examples of this type of medication are Minipress (prasolin) and Cardura (doxazosin).

Surgeries or medical procedures – Nerve surgery to cut the sympathetic nerves in your hands and feet can help to interrupt their exaggerated response to temperature shifts, etc. This surgery is called a sympathectomy and may reduce the frequency or severity of attacks, but has not always been successful.

Chemical Injections – Physicians use chemicals injected into the sympathetic nerves to block the nerves. This procedure needs to be repeated if symptoms persist.

Surgical intervention – In very rare cases where the blood flow has been completely blocked, gangrene can set in, requiring amputation of the affected tissue.

Alternative Treatment

Omega-3 fatty acids, found in fish oil, may reduce symptoms in people with primary Raynaud’s, according to one study. High doses of fish oil can increase your risk of bleeding.

Evening primrose oil contains a different type of fatty acid that stops the body from making chemicals that narrow blood vessels. In one study, people with Raynaud’s who took EPO had fewer and less severe attacks compared to those who took placebo. More research is needed, however. People who have a history of seizures should not take EPO. EPO can increase your risk of bleeding.

Inositol hexaniacinate, a form of vitamin B3 or niacin, may reduce frequency of Raynaud’s attacks. In studies, people took high doses of inositol hexaniacinate, which can be dangerous if not monitored by a doctor.

Magnesium opens up blood vessels. Some doctors suggest taking a magnesium supplement, although there are no scientific studies to show it works. Magnesium can interact with a number of medications, including antibiotics, drugs used to treat high blood pressure, and drugs used to treat osteoporosis.

Alpha Lipoic Acid to ease the circulatory issues with Raynaud’s.

Vitamin E enhances blood flow. Vitamin E may potentiate the effect of anticoagulant drugs

Ginkgo (Ginkgo biloba) can open up blood vessels and increase circulation in the fingers. One preliminary study found that people with Raynaud’s who took 160 mg of ginkgo per day had less pain.

Flavonoids are found in a variety of herbs and produce. Vegetable juice and eating a variety of fruits is an option. Flavonoids help dilate blood vessels.

 

Reference

https://umm.edu/health/medical/altmed/condition/raynauds-phenomenon

http://www.medicinenet.com/raynauds_phenomenon/article.htm

http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/risk-factors/con-20022916

http://www.nhs.uk/Conditions/Raynauds-phenomenon/Pages/Causes.aspx

http://www.thelancet.com/pdfs/journals/lancet/PIIS014067360313646X.pdf

http://www.turner-white.com/pdf/hp_sep01_raynaud.pdf

http://www.medicalnewstoday.com/articles/176713.php

Primary biliary cirrhosis (PBC) is an inflammation with chronic and slowly progressive scarring of bile ducts in the liver. If left untreated, or if a patient does not adequately respond to treatment, chronic inflammation and fibrosis can advance to cirrhosis.

The bile ducts carry a fluid called bile from the liver to the gallbladder, where it is stored. When food enters the stomach after a meal, the gallbladder contracts, and the bile ducts carry bile to the duodenum, the first part of the small intestine, for use in digestion. The liver makes bile, which is made up of bile acids, cholesterol, fats, and fluids. Bile helps the body absorb fats, cholesterol, and fat-soluble vitamins. Bile also carries cholesterol, toxins, and waste products to the intestines, where the body removes them. When chronic inflammation, or swelling, damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue. This damage to the liver tissue can lead to cirrhosis, a condition in which the liver slowly deteriorates and is unable to function normally. In cirrhosis, scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.

The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells.

Causes

Autoimmune System – Most research suggests the disease is an autoimmune condition. The immune system usually protects the body from harmful substances such as bacteria and viruses by attacking and destroying them. In autoimmune diseases, the immune system instead attacks the body’s own tissues. In primary biliary cirrhosis, the immune system attacks the bile ducts.

Genetic Factor – Genetic factors may make a person prone to develop primary biliary cirrhosis. Primary biliary cirrhosis is more common in people who have a parent or sibling-particularly an identical twin-with the disease. Genetic factors may also make some people prone to develop other autoimmune diseases. People with primary biliary cirrhosis may have other autoimmune conditions such as rheumatoid arthritis or autoimmune thyroiditis. A person who has genetic factors for primary biliary cirrhosis may be more likely to develop the disease after exposure to chemicals or infections, such as urinary tract infections.

Environmental Factors – Environmental factors may have a potential causative role – infection, chemicals, smoking. It may trigger or worsen the disease.

Risk Factors

PBC is most commonly diagnosed after the age of 40 years. Of patients with PBC, 90% are women. The prevalence is higher in northern European population groups and lower in Japan. Disease prevalence estimates have ranged from 40 to 400 cases per 1,000,000 population, with an incidence between 4 and 30 cases per 1,000,000 per year. In particular the following women are most at risk –

• Women who are middle aged or older
• Women who have a family history of PBC.

Symptoms

Some people with PBC will never get any symptoms of the disease. Clear symptoms of PBC are constant tiredness (for some people this can be severe) and intense itching in any part of the body. Itching, also known as pruritus, may be a result of your liver’s inability to process bile. It is thought that bile acids are not the cause of the itching but rather other chemicals that are retained in the body. As with tiredness, the severity of the itching will vary from person to person. Severity is not an indication of the amount of liver damage.

Other symptoms that may develop usually include the following –

• Dry eyes and/or dry mouth
• Constant or variable ache or discomfort in the upper right hand side, below your ribs
• Indigestion, nausea or poor appetite
• Arthritis (inflammation of the joints)
• Pain in the bones
• Mottled palms with red or pink blotches
• Diarrhoea
• Dark urine and/or stools
• Jaundice – yellowing of the skin and whites of the eyes.

Tiredness and itching are generally the first symptoms to appear while jaundice is usually associated with the later stages of the disease.

Complications

Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis. In some cases, portal hypertension and esophageal varices may develop before cirrhosis.

• Edema and Ascites
• Portal Hypertension
• Varices
• Splenomegaly
• Hepatic encephalopathy
• Gallstones and bile duct stones
• Metabolic bone diseases
• Liver cancer
• Steatorrhea

Treatment

Medications – Stuies suggest ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Ursodiol is a nontoxic bile acid that people can take orally. Ursodiol replaces the bile acids that are normally produced by the liver, which are more toxic and can harm the liver. Treatment with ursodiol can reduce levels of bilirubin and liver enzymes in the blood. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival. Researchers continue to explore other drugs for treating primary biliary cirrhosis. Immunosuppressant drugs, in particular methotrexate (Trexall, Rheumatrex) and colchicine (Colcrys), have been widely used, but their effectiveness remains unproved.

Surgery – A health care provider may consider a liver transplant when cirrhosis leads to liver failure or treatment for complications is ineffective. Liver transplantation is surgery to remove a diseased or an injured liver and replace it with a healthy liver or part of a liver from another person, called a donor.

Lifestyle Changes – People with cirrhosis should not drink any alcohol or take any illegal substances, as both will cause more liver damage. People with cirrhosis should avoid complementary and alternative medications, such as herbs. People with cirrhosis should be careful about starting new medications and should consult a health care provider before taking prescription medications, over-the-counter medications, or vitamins. Many vitamins and prescription and over-the-counter medications can affect liver function.

Alternative Treatment

Vitamin B complex is a group of vitamins (B1, thiamine; B2, riboflavin; B3, niacin; B5, pantothenic acid; B6, pyridoxine; folic acid; betaine; inositol; and B12, cyanocobalamin) that differ from each other in structure and the effect they have on the human body. The B vitamins (thiamine, riboflavin, niacin, pantothenic acid, pyridoxine) play a vital role in numerous metabolic functions including enzyme activities.

Folic acid (vitamin B4) is an important member of the B complex family, known for reducing harmful levels of homocysteine (a sulfur-containing amino acid) known to be a major culprit in heart disease. At normal levels, homocysteine plays a vital role in the biosynthesis of cysteine, which assists glutathione in the liver to detoxify carcinogens and other toxins, but without adequate methylation, which is provided by folic acid and other B vitamins, biochemical reactions generated from beneficial byproducts of homocysteine cannot occur.

Choline is another of the B complex vitamins, essential for the use of fats in the body.

Selenium is a trace element that acts by several mechanisms, including detoxifying liver enzymes, exerting anti-inflammatory effects, and providing antioxidant defense.

Zinc is used in numerous drugs and preparations that are protective: zinc oxide in skin ointments; zinc stearate in acne and eczema preparations; and zinc permanganate to treat bladder inflammation. Zinc deficiency features weakness, decreased taste and appetite, lengthy wound healing, and risk of infection. Zinc levels that are low have also been related to the progression of cirrhosis to hepatic encephalopathy.

Coenzyme Q10 (CoQ10) is an excellent antioxidant that is protective for a liver that has been damaged by ischemia (reduced blood flow). CoQ10 is also an important component of healthy metabolism.

N-acetyl-cysteine (NAC) is a substance that acts as an antioxidant or free-radical scavenger. Most scientific articles related to liver protection with NAC emphasize this effect.

S-Adenosyl Methionine (SAMe) is a methylation agent (a methyl group donor) and is necessary for the synthesis of glutathione, necessary for liver health.

Polyenylphosphatidylcholine (PC) is one of the most important substances for liver protection and health and is a primary constituent of the cell membrane. As such, PC is necessary for integrity of liver cells.

Alpha-lipoic acid is an antioxidant that has been shown to decrease the amount of hepatic fibrosis associated with liver injury. Both of these mechanisms suggest it has promise for cirrhosis.

Acetyl-L-carnitine is the biologically active form of the amino acid L-carnitine that has been shown to protect cells throughout the body from age-related degeneration. By facilitating the youthful transport of fatty acids into the cell mitochondria, acetyl-L-carnitine facilitates conversion of dietary fats to energy and muscle.

Taurine is a conditionally essential amino acid produced from cysteine by the body. It is abundantly found in the body, particularly the central nervous system where it is thought to have a regulating influence. Taurine is a crystallized acid that comes from bile, which is produced by the liver.

L-glutamine is a nonessential amino acid that has benefits for the liver and intestines, particularly for those who use NSAIDs (nonsteroidal anti-inflammatory drugs). L-glutamine may also be useful in neutralizing the effects of alcohol and strengthening the immune system.

L-arginine is an essential amino acid. L-arginine is also a key building block for repair of damaged tissue.

Branched-Chain Amino Acids are considered to be essential amino acids because humans cannot survive unless these amino acids are present in the diet. BCAAs are needed for the maintenance of muscle tissue and appear to preserve muscle stores of glycogen (stored form of carbohydrates that can be converted into energy).

Silymarin (also known as milk thistle or Silybum marinum) is a member of the aster family (Asteraceae) that has been used as a medicinal plant since ancient times and is widely used in traditional European medicine.

 

Reference –

http://patient.info/doctor/primary-biliary-cirrhosis-pro

https://www.aasld.org/sites/default/files/guideline_documents/PrimaryBillaryCirrhosis2009.pdf

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/cirrhosis-cholangitis-other-cholestatic-liver-disease/

https://www.interceptpharma.com/research-development/therapeutic-areas/primary-biliary-cirrhosis/

http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=186

http://www.liver.ca/liver-disease/types/primary-biliary-cirrhosis.aspx

http://www.nhs.uk/conditions/Primary-biliary-cirrhosis/Pages/Introduction.aspx

http://www.mayoclinic.org/diseases-conditions/primary-biliary-cirrhosis/basics/definition/con-20029377

http://www.niddk.nih.gov/health-information/health-topics/liver-disease/primary-biliary-cirrhosis/Pages/facts.aspx

http://emedicine.medscape.com/article/171117-overview

http://www.pbcfoundation.org.uk/about-us/services

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00154-3/fulltext?rss%3Dyes

http://www.surgery.ucsf.edu/conditions–procedures/primary-biliary-cirrhosis.aspx

Obesity is defined as an excessively high amount of body fat (adipose tissue) in relation to lean body mass. There is evidence that obese children and adults are at greater risk of short-term and long-term health consequences.

An obese person has accumulated so much body fat that it might have a negative effect on their health. If a person’s bodyweight is at least 20% higher than it should be, he or she is considered obese. If your Body Mass Index (BMI) is between 25 and 29.9 you are considered overweight. If your BMI is 30 or over you are considered obese.

Obesity causes or exacerbates many health problems, both independently and in association with other diseases. In particular, it is associated with the development of type 2 diabetes mellitus, coronary heart disease (CHD), an increased incidence of certain forms of cancer, respiratory complications (obstructive sleep apnoea) and osteoarthritis of large and small joints.

Obesity has reached epidemic proportions in the United States. Over two-thirds of adults are overweight or obese, and one in three Americans is obese. The prevalence of obesity in children has increased markedly. Obesity has also been increasing rapidly throughout the world, and the incidence of obesity nearly doubled from 1991 to 1998.

Who is at Risk?

• In women, overweight and obesity are highest among non-Hispanic Black women (about 82 percent), compared with about 76 percent for Hispanic women and 64 percent for non-Hispanic White women.
• In men, overweight and obesity are highest among Hispanic men (about 82 percent), compared with about 74 percent for non-Hispanic White men and about 70 percent for non-Hispanic Black men.
• Children also have become heavier. In the past 30 years, obesity has tripled among school-aged children and teens. About 1 in 6 American children ages 2–19 are obese. The survey also suggests that overweight and obesity are having a greater effect on minority groups, including Blacks and Hispanics.

Causes

Lifestyle and Behavior Factor – Healthy behaviors include a healthy diet pattern and regular physical activity. Energy balance of the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain.

Other reasons for not being active include: relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education classes in schools.

People who are inactive are more likely to gain weight because they don’t burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems.

Environmental Factor – People and families may make decisions based on their environment or community. For example, a person may choose not to walk or bike to the store or to work because of a lack of sidewalks or safe bike trails. Community, home, child care, school, health care, and workplace settings can all influence people’s daily behaviors. Therefore, it is important to create environments in these locations that make it easier to engage in physical activity and eat a healthy diet.

Lack of Sleep – People who do not sleep enough are at a higher risk of becoming obese, according to a research. The ‘epidemic’ of obesity is paralleled by a ‘silent epidemic’ of reduced sleep duration with short sleep duration linked to increased risk of obesity both in adults and in children. These trends are detectable in adults as well as in children as young as 5 years

Genetic Factor – Genetic changes in human populations occur too slowly to be responsible for the obesity epidemic. Nevertheless, the variation in how people respond to the environment that promotes physical inactivity and intake of high-calorie foods suggests that genes do play a role in the development of obesity.

Other Factors – Some illnesses may lead to obesity or weight gain. These may include Cushing’s disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain. The science continues to emerge on the role of other factors in energy balance and weight gain such as chemical exposures and the role of the microbiome.

A health care provider can help you learn more about your health habits and history in order to tell you whether behaviors, illnesses, medications, and/or psychological factors are contributing to weight gain or making weight loss hard.

Endocrine disruptors, such as some foods that interfere with lipid metabolism. The molecular mechanism through which fructose (a type of sugar) in beverages may alter lipid energy metabolism and cause fatty liver and metabolic syndrome.

Symptoms

Weight gain usually happens over time. Most people know when they’ve gained weight. Some of the signs of overweight or obesity include –

• Clothes feeling tight and needing a larger size.
• The scale showing that you’ve gained weight.
• Having extra fat around the waist.
• A higher than normal body mass index and waist circumference

The BMI is a statistical measurement derived from your height and weight. Although it is considered to be a useful way to estimate healthy body weight, it does not measure the percentage of body fat. The BMI measurement can sometimes be misleading – a muscleman may have a high BMI but have much less fat than an unfit person whose BMI is lower. However, in general, the BMI measurement can be a useful indicator for the ‘average person’.

Complications

• Diabetes
• Heart Disease
• Hypertension

Other risks

In addition to diabetes, heart disease and hypertension, obesity is related to dozens of serious health problems. For instance –

• A growing body of evidence shows links between maternal health conditions -— including obesity, chronic diseases — and increased risks before, during and after childbirth.
• Approximately 20 percent of cancer in women and 15 percent of cancer in men is attributable to obesity.
• An estimated 24.2 percent of kidney disease cases among men and 33.9 percent of cases among women are related to overweight and obesity.
• Almost 70 percent of individuals diagnosed with arthritis are overweight or obese.
• Both overweight and obesity at midlife independently increase the risk of dementia, Alzheimer’s disease and vascular dementia.
• Other mental health conditions.

Treatment

• Diet, exercise, and behavioral modification should be included in all obesity management approaches for body mass index (BMI) of 25 kg/m 2 or higher.

 

Medications – A variety of over-the-counter and prescription weight loss drugs are available. Some people find these drugs help curb their appetites. Studies show that patients on drug therapy lose around 10 percent of their excess weight, and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs. Weight loss drugs, approved by the U.S. Food and Drug Administration (FDA) for treating obesity, include:

• Beta-methyl-phenylethylamine (Fastin) — This is a stimulant that increases fat metabolism.

• Orlistat (Xenical) — This drug works by blocking about 30 percent of dietary fat from being absorbed. Alli is a lower-dose, over-the-counter formula of the same medication.

• Phentermine — Phentermine, an appetite suppressant, has been available for many years. It is half of the “fen-phen” combination that remains available for use. The use of phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination.

• Sibutramine (Meridia) — This is an appetite suppressant approved for long-term use.

Surgeries – In patients with morbid obesity associated with comorbidities, bariatric surgery is the only available therapeutic modality associated with clinically significant and relatively sustained weight loss. Well-performed bariatric surgery, in carefully selected patients and with a good multidisciplinary support team, substantially ameliorates the morbidities associated with severe obesity.

• Roux-en-Y procedure (gastric bypass) – Permanently reduces the size of the stomach; vomiting is the most common side effect.
• Gastric banding – An adjustable silicone band is placed around the stomach, decreasing the amount of food that can be eaten. The band can be adjusted or removed.
• Laparoscopic vertical sleeve gastrectomy – The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. The stomach that remains is shaped like a very thin banana.

Behavior Modification – The goal of behavior modification therapy is to change your eating and exercise habits to promote weight loss. Examples include:

• Setting realistic weight loss goals — short term and long term.
• Recording your diet and exercise patterns in a diary.
• Identifying high-risk situations and avoiding them.
• Rewarding specific actions, such as exercising for a longer time or eating less of a certain type of food.
• Adopting realistic beliefs about weight loss and body image.
• Developing a support network, including family, friends and co-workers, or joining a support group that can help you focus on your goal.

Alternative Treatment

5-Hydroxytryptophan (5-HTP) – 5-HTP is thought to reduce hunger cravings by boosting serotonin levels in the central nervous system, which may reduce appetite and lessen food cravings.

Fiber – Fiber may help lower insulin levels (insulin controls the amount of sugar in the blood) and help you feel fuller.

Calcium – Calcium may play an important role in fat burning. Population studies show that higher dietary calcium levels are associated with lower BMIs.

Zinc – Zinc may increase lean body mass and reduce or stabilize the amount of fat. The reason may be that zinc increases levels of leptin, a hormone in the body that helps you feel full. Zinc can interact with certain medications, including Cisplatin, and some antibiotics.

Pyruvate – Pyruvate is a substance that occurs naturally in the body, where it is converted to lactic acid. There is some evidence that it may help reduce body fat, possibly by increasing the body’s metabolic rate.

Vitamin D and Calcium – Studies found that in postmenopausal women, those who took calcium and vitamin D supplements were less likely to gain small to moderate amounts of weight than those who took placebo. Calcium can interfere with certain medications, including some antibiotics and thyroid medications. Calcium must be in balance with other minerals and electrolytes in the body, such as magnesium and phosphate.

Hydroxycitric acid (HCA) – This substance, extracted from the fruit Garcinia cambogia, is similar to citric acid (found in oranges and citrus fruits). HCA stops carbohydrates from being stored as fat, and some animal tests indicate HCA can suppress appetite.

Chitosan – Chitosan is a fiber-like supplement made from the shells of crustaceans, such as shrimp and crab. While some studies show that chitosan (in addition to a low-calorie diet) reduces weight, it is unclear whether the supplement itself, the low-calorie diet, or a combination of both led to the weight loss. Other studies show mixed results. Chitosan may have a blood-thinning effect, and therefore can interact with blood-thinning medications, such as warfarin (Coumadin) and aspirin.

Glucomannan – Glucomannan is a kind of insoluble fiber that appears to reduce blood sugar levels and may help promote weight loss. People with diabetes should not take glucomannan without their doctor’s supervision. Glucomannan may interfere with the absorption of several medications.

Psyllium – Psyllium, a kind of soluble fiber, may reduce hunger cravings by making you feel full. Adding psyllium and other sources of fiber into your diet may aid weight loss.

Guggul – A common ingredient in several Ayurvedic medicines used to treat obesity. Studies suggest that overweight people who take these Ayurvedic remedies lose slightly more weight compared to those who do not take them. Guggul can cause mild diarrhea and nausea, and may interact with the following medications: blood-thinning drugs (anticoagulants), birth control pills, thyroid hormone, tamoxifen, and estrogens.

Green tea – Green tea extract may boost metabolism and help burn fat.

Cayenne or capsaicin – Preliminary evidence indicates that capsaicin (the substance that makes chili peppers taste hot) may reduce hunger and help the body burn fat, particularly when eating a high-fat diet.

Hoodia – A number of media reports on hoodia have suggested it could be an effective weight loss supplement.

 

Reference –

http://www.nhlbi.nih.gov/health/health-topics/topics/obe/treatment

http://www.cdc.gov/obesity/adult/causes.html

http://www.mayoclinic.org/diseases-conditions/obesity/basics/causes/con-20014834

http://www.nhs.uk/Conditions/Obesity/Pages/Treatment.aspx

http://www.medicinenet.com/obesity_weight_loss/page2.htm

http://www.medindia.net/patients/patientinfo/obesity.htm

http://www.webmd.com/diet/obesity/obesity-treatment-overview

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776037/

http://treatment.hpathy.com/homeo-medicine/homeopathy-obesity/

http://health.howstuffworks.com/wellness/natural-medicine/alternative/alternative-medicines-for-obesity.htm

Molds are present everywhere; indoors and outdoors. Walls, clothes, books, toys- nothing is sacred when it comes to mold growth. Molds can turn our most prized possessions into clammy, moist anguish that only look perfect for the garbage. But for all its hazard effects , the question rises, that to what extent should we be worried about mold and the most important question, that we should ask ourselves is that, if these are the effects that it can have on our possessions, to what extent can these molds affect our bodies ?

It is very important to understand the meaning and the underlying effect of mold on human health.

Mold and Human Health

Mold, fungi and mildew are all terms generally used to describe a specific group of organisms that can be found both indoors and outdoors. Molds grow wherever there is enough surface moisture to keep them alive. These molds are found in every type of environment and in every social and economic condition. They generally grow on a damp surface. Mold and mold spores require moisture and a food source, such as cellulose or decaying food, to grow. As mold spores swell with water and grow, they elongate, forming balloon-like protuberances (hyphae), which secrete digestive enzymes and mycotoxins. The fungi then digest the food source to support their growth. About 100,000 fungal species have already been identified; in fact, fungi are estimated to comprise an astounding 25% of the world’s biomass. Molds are capable of growing on a variety of different surfaces, like, fabric, paper and wood. The most common indoor molds are:

• Alternaria – that are found in damp places indoors, such as showers or under leaky sinks or ceilings.
• Aspergillus – these types of molds are often found growing on dust, powdery food items and building materials like dry walls.
• Penecillium – its found typically on water damaged materials and are , mostly of green and blue color.
• Cladosporium – these are capable of growing in cool areas as well as warm areas.

Mold spores are invisible to naked eyes but still are found everywhere. Open windows, doorways and even ventilation systems are getaways through which these spores enter the houses. These molds will only land somewhere if the conditions are idle for their growth i.e. places with excessive moisture and with a supply of suitable nutrients. Wet cellulose materials act as a great support for mold growth – these includes paper products, cardboard, ceiling tiles and wood products. Wallpaper, insulation materials and upholstery are other typical launch pads for mold growth. Mold growth can be easily notices as it usually is visible and often produces a musty and moist odor.

Exposure to molds causes numerous health diseases. After pollens, molds are the leading cause of outdoor airborne allergies. Molds produce several harmful substances like allergens, irritants and the most harmful of all, mycotoxins – potentially toxic substance. Molds and the toxins they secrete i.e. mycotoxins are increasingly being recognized as a source f illness and wide range of symptoms, ranging from mild to severe, including wheezing, muscle aches, headaches, fatigue, depression, sleep disorders, skin rashes, immune suppression, kidney disease, lung disease, and even cancer.

Mold Toxicity

The term Mold Toxicity refers to the direct injurious effects of mold produced molecules, called mycotoxins – low molecular-weight chemicals produced by molds that are secondary metabolites unnecessary for the primary growth and reproduction of the organisms. Fungus causes mold toxicity by releasing this poison called a mycotoxin, commonly found in wet homes or buildings and some foods such as coffee and peanuts. Water damage is a leading culprit of mold toxicity. Since the odorless mold lives in hidden spots and floorboards, it often lurks quietly and indefinitely. Mold toxicity can affect the mind in the form of intangible issues that are pegged as overarching “depression” or “stress.” Since many people have these problems from time-to-time, it’s simple to chalk it up to a hectic work or family life.Major long-term effects are memory loss, insomnia, anxiety, and depression. Additional symptoms include difficulty focusing or finishing a task, disorganization, feeling disconnected, confused, not feeling like yourself, or losing parts of your personality. These symptoms are described further.

Dr Allan Lieberman, in his paper “Explosion of Mold Cases in Homes, Workplaces and Occupational Medicine Practice”, examined 48 patients who were heavily exposed to molds and stated that the following problems are caused by molds:

• Muscle and joint pain (71%)
• Fatigue and weakness (70%)
• Neurocognitive dysfunction (67%)
• Sinusitis (65%)
• Headache (65%)
• Gastrointestinal problems (58%)
• Shortness of breath (54%)
• Anxiety/depression/irritability (54%)
• Chest tightness (42%)
• Insomnia (40%)
• Dizziness (38%)
• Numbness/tingling (35%)
• Laryngitis (35%)
• Tremors (25%)
• Heart palpitations (21%)

Symptoms

Following are the symptoms of Mold Toxicity in different levels:

Level 1

• Sneezing
• Itching Skin
• Redness and skin irritation
• Watery Eyes
• Itching Eyes
• Headache

Level 2

Symptoms are reported to have become more severe and longer lasting directly in proportion to the length of exposure time to toxic molds. Their reported symptoms are as follows:

• Constant Headaches
• Nose Bleeds
• Feelings of Constant Fatigue
• Breathing Disorders
• Coughing up Blood or Black looking Debris
• Nausea
• Diarrhea
• Vomiting
• Loss of Appetite
• Weight Loss
• Hair loss
• Skin Rashes
• Open Sores on the Skin
• Memory Loss “Short Term”
• Neurological & Nervous Disorders
• Sexual Dysfunction
• Swollen Glands in the Neck Area and under the Armpit
• Sudden Asthma Attacks or Breathing Disorders
• Ear Infections and Pain
• Chronic Sinus Infections
• Chronic Bronchitis
• Pain in the Joints and Muscles

Level 3 – Late Symptoms of Mold Toxicity

The following Mold toxicity symptoms are the most severe and are attributed to high levels of exposure:

• Blindness
• Brain Damage
• Memory Loss “Long term”
• Bleeding Lungs
• Cancer
• Death

 

Diagnosis and Treatment

Urine, blood and sputum testing can be performed to determine the type of mold you have been exposed to. Knowing the type of mold can help the doctor adjust the treatment. Other indicators of mold poisoning include a low white blood cell count poor lung function as measured by a spirometer test and neurological damage associated with exposure to biotoxins, indicated by a visual contrast sensitivity test.

At our center evaluation by an environmental physician, including a comprehensive history and physical examination is a part of the diagnosis. It also includes the following:

• Mold and mycotoxin antibody levels
• Immune markers—T and B cells/natural killer cells
• Vision contrast sensitivity
• SPECT brain scans
• Antimyelin auto-antibodies

Treatment

• Eating fungicidal herb such as garlic – Garlic possesses powerful anti-fungal properties and can kill fungi, molds and yeasts. While garlic is most commonly used to cure Candida yeast infection, this herb may also help you in the days after exposure to mold. Garlic is one of the most powerful anti-fungal herbs available.
• Taking immunity boosting herbs such as Echinacea – Certain herbs, such as echinacea, can be effective in protecting and boosting immune function. echinacea also can help to accelerate healing from viral infections such as flu and cold, in addition to clearing fungal infections. Echinacea stimulates polysaccharides and forms immune stimulators that boost the immune system and help it to manufacture more T cells. Echinacea is comprised of antimicrobial compounds which support the function of the immune system by combating infection and swelling.
• Consumption a detoxifying herb such as dandelion root – Detoxifying herbs can be used to cleanse the organs and bloodstream of harmful substances. Dandelion root, in particular, acts by enhancing the flow of urine, sweat, tears and other body secretions to detoxify the body.
• Herbs that restore brain function, like gingko biloba – Exposure to certain kinds of mold can give rise to nervous system damage or cerebral allergy. Therefore, herbs which safeguard the function of the brain – such as ginkgo biloba – are considered helpful for recovery.
• Taking adaptogens like Siberian ginseng – Adaptogens work to normalize bodily functions and help the body to achieve homeostasis, or a state of balance. Most of these herbs also protect the immune system and can be used for their ability to restore the kidneys, adrenal glands and other organs to their original healthy states.
• Adding artichoke leaf extract in the diet – According to research published in the “Journal of Agricultural Food Chemistry” in 2004, artichoke leaf extract helps to cancel out the effects of many kinds of fungi, including yeasts and molds.
• Consumption of foods that are high in omega-3 fats – These are a mixture of animal and plant sources. Krill oil, salmon and tuna are the best animal-based sources of omega-3, while avocado is a good source of plant-based omega 3.
• Increase of vitamin D intake – According to research, Vitamin D may be useful for preventing mold allergies. Therefore, you should ensure that the levels of vitamin D in your body are optimal.
• Eating foods that contain glutathione – Glutathione is referred to as the “master antioxidant” due to its ability to optimize the activity of every other antioxidant present in the body.

Treatment of mold toxicity is a combined effort of you as patients and we as doctors. Clean environment and clean house is the stepping stone of a successful treatment. We care, hence we cure….

Migraines are a type of recurring severe headache that can cause you to have time off work and need to rest in bed. They are often accompanied by feeling sick, vomiting or an increased sensitivity to light.

It’s estimated that about 36 million Americans suffer from migraine, but only 1 of every 3 people talk with a doctor about their headaches. Of those, only half get the right diagnosis.

Women are roughly three times more likely to get migraines than men. About four in every 20 women get migraines, while only about one in every 20 men do. You can get migraines for the first time at any age, but they commonly start during the teenage years.

In general, a migraine is a very bad headache that tends to come back. It may occur as often as several times a week or only once every few years. It can last anywhere from a few hours to 3 days. The pain usually begins in the morning, on one side of the head. (In fact, the word migraine is derived from a Greek word that means “half-head.”) Less frequently, the entire head is swallowed up by pain.

The amount of pain can vary. Some migraines can be fairly mild, while others seem almost unbearable. Obviously, the worse the pain, the more trouble you have carrying out daily activities, whether it’s going to work or simply getting out of bed. Of course, different people have different abilities to put up with pain. For some people, even a mild migraine can force them to lie down; others are able to work through a more severe migraine.

Two types of migraines

While there are many variations, there are two main types of migraines –

Migraine without aura (previously called common migraine) – Almost 80 percent of migraine sufferers have this type of migraine.

Migraine with aura (previously called classic migraine) – This type of migraine announces itself about a half-hour before the onset of head pain with an aura.

Aura is a term used to describe the visual or sensory symptoms that some people get when their migraine is starting. The following are less common types of migraine –

• Retinal migraines are headaches associated with visual changes in one eye only.
• Abdominal migraines are associated with stomach pains, and happen more often in children.
• Menstrual migraines can happen in women two days before their period starts or finishes.
• Status migrainosus are migraines that can last for a few weeks.

Migraine is a medical condition that can have a big effect on your life and others caring for you. It can affect your daily life and can mean taking time off work or school.

Causes

There are many theories that discuss the causes of migraine. The cortical spreading depression (CSD) theory suggests that migraine is a disease of the brain such as angina is a disease of the heart. Disruption of normal brain functioning is believed to be the underlying cause of the migraine pain and aura. Another theory is the vascular theory which suggests that migraines result from the widening of blood vessels surrounding the brain. The chemical serotonin is also thought to play an important role in migraine development. While the precise cause of migraines remains unknown, a number of potential migraine triggers (habits or conditions associated with the onset of a migraine) have been identified.

Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include –

• Allergies and allergic reactions
• Bright lights, loud noises, flickering lights, smoky rooms, temperature changes, strong smells and certain odors or perfumes
• Physical or emotional stress, tension, anxiety, depression, excitement
• Physical triggers such as tiredness, jet lag, exercise
• Changes in sleep patterns or irregular sleep
• Smoking or exposure to smoke
• Skipping meals or fasting causing low blood sugar
• Dehydration
• Alcohol
• Hormonal triggers such as menstrual cycle fluctuations, birth control pills, menopause
• Tension headaches
• Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs and salami)
• Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products and fermented or pickled foods
• Medication such as sleeping tablets, the contraceptive pill, hormone replacement therapy.
• A higher percentage of obese people have episodic (occasional) migraines compared to individuals with a healthy body weight.
• Sudden weather changes, including a drop in barometric pressure or changes in temperature, humidity, or wind
• Loud noises
• Perfumes or fumes
• Secondhand smoke
• Exposure to glare or flickering lights

Symptoms

Migraine symptoms may begin one to two days before the headache itself. This is known as the migraine’s prodrome stage. Symptoms include –

• Food cravings
• Depression
• Fatigue or low energy
• Frequent yawning
• Hyperactivity
• Irritability
• Neck stiffness

Some people may also experience an aura after the prodrome stage. An aura causes visual, motor, and/or speech disturbances, such as –

• Difficulty speaking clearly
• Feeling a prickling or tingling sensation in the arms and legs
• Flashes of light
• Seeing shapes, light flashes or bright spots
• Transient vision loss

The next phase is known as the attack phase. This is the most acute or severe of the phases when the actual migraine occurs. Attack phase symptoms can last anywhere from four hours to three days. Symptoms of a migraine can vary from person to person. Some symptoms may include –

• Feeling dizzy or faint
• Increased sensitivity to light and sound
• Nausea
• Pain on one side of the head
• Pulsing and/or throbbing pain
• Vomiting

Risk Factors

Family history – You are much more likely to have migraines if one or both of your parents had migraines.

Sex – Women are more likely than men to have migraines.

Age – Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.

Treatment

Medications

Analgesia – Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain.

Anti-emetics – Metoclopramide may also be used to control symptoms such as nausea and vomiting.

Serotonin agonists – Sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications. Antidepressants such as tricyclics – are prescribed to reduce migraine symptoms although they are not approved in all countries for this purpose.

Ergots – Another class of abortive treatments is called ergots, which are usually effective if administered at the first sign of a migraine.

Alternative Treatment

5-hydroxytryptophan – Body makes the amino acid 5-HTP and converts it into serotonin, an important brain chemical. Researchers think abnormal serotonin function in blood vessels may be related to migraines, and some of the drugs used to treat migraines work by affecting serotonin.

Magnesium – People with migraines often have lower levels of magnesium than people who do not have migraines, and several studies suggest that magnesium may reduce the frequency of migraine attacks in people with low levels of magnesium.

Vitamin B2 – A few studies indicate that riboflavin may reduce the frequency and duration of migraines. In one study, people who took riboflavin had more than a 50% decrease in the number of attacks.

Coenzyme Q10 – CoQ10 can interact with several medications including blood thinners such as warfarin (Coumadin), some cancer medications, and medications for high blood pressure.

Melatonin – Melatonin can interact with a number of medications, so ask your doctor before taking it.

Butterbur – A few studies suggest that butterbur may help reduce both the frequency and duration of migraine attacks when taken on a regular basis for up to 4 months. More research is needed to see whether butterbur is really effective at preventing migraines.

Feverfew – Feverfew has been used traditionally to treat headaches, and several well-designed studies have found that it may help prevent and treat migraines.

Acupuncture has been studied as a treatment for migraine headache for more than 20 years. While not all studies have shown it helps, researchers agree that acupuncture appears safe, and may work for some people.

Chiropractic – In another study, people with migraine headaches were randomly assigned to receive spinal manipulation, a daily medication (Elavil), or a combination of both. Spinal manipulation worked as well as Elavil in reducing migraines and had fewer side effects. Combining the 2 therapies didn’t work any better.

Reflexology is a technique that places pressure on specific “reflex points” on the hands and feet that are believed to correspond to areas throughout the body. Some early studies suggest it may relieve pain and allow people with migraines to take less pain medication.

Reference –

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache-migraine

http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/treatment/con-20026358

http://www.medicinenet.com/migraine/article.htm

http://www.migraine.org.uk/get-involved/events

https://www.acponline.org/patients_families/pdfs/health/migraine.pdf

http://familydoctor.org/familydoctor/en/diseases-conditions/migraines.html

http://www.migraines.org/myth/mythreal.htm

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache-migraine

Mercury is a common environmental contaminant, and many of us are unknowingly predisposed to mercury toxicity. It is the most poisonous, non-radioactive, naturally occurring substance on our planet. There is no safe level of mercury because even one atom of it in the body is doing some harm to it.

Mercury exists in three forms: elemental mercury, inorganic mercury compounds (primarily mercuric chloride), and organic mercury compounds (primarily methyl mercury). All forms of mercury are quite toxic, and each form exhibits different health effects. These forms of mercury differ in their degree of toxicity and in their effects on the nervous, digestive and immune systems, and on lungs, kidneys, skin and eyes.

All humans are exposed to some level of mercury. Most people are exposed to low levels of mercury, often through chronic exposure (continuous or intermittent long term contact). However, some people are exposed to high levels of mercury, including acute exposure (exposure occurring over a short period of time, often less than a day). An example of acute exposure would be mercury exposure due to an industrial accident.

Forms of Mercury

• Elemental mercury or metallic mercury is the element in its pure, ‘un-combined’ form. It is a shiny, silver-white metal that is liquid at room temperature, but is rarely found in this form in nature. If not sealed off, mercury slowly evaporates into the air, forming a vapour. The quantity of vapour formed increases as temperatures rise. Elemental mercury is traditionally used in thermometers and some electrical switches.

 

• Inorganic mercury compounds or mercury salts, more commonly found in nature, include mercuric sulphide (HgS), mercuric oxide (HgO) and mercuric chloride (HgCl2). Most of these are white powders or crystals, except for mercuric sulphide which is red and turns black after exposure to light. Some mercury salts, such as mercury chloride, also form vapour, but they stay in the air for a shorter time than elemental mercury because they are more soluble in water and more reactive.

 

• Organic mercury is formed when mercury combines with carbon and other elements. Examples of organic mercury compounds are dimethylmercury, phenylmercuric acetate and methylmercuric chloride. The form most commonly found in the environment is methylmercury.

Sources of Mercury

Mercury can enter the body through the lungs, through food and water, and by direct physical contact.

• Dental Amalgams – Commonly used silver amalgam dental fillings contain about 50 percent mercury. Older dental fillings may contain higher amounts. There is increasing evidence that mercury is leached from dental amalgam and that mercury can vaporize from fillings. Fillings which crack can also be a source of mercury toxicity. Silver amalgam fillings also generate negative electrical potentials in the mouth which can detrimentally affect one’s health status. There are alternatives to silver amalgam fillings, including gold alloys and composite quartz-resin materials.
• Large Fish – The concentration of mercury in fish varies directly with the size of the fish, inasmuch as mercury is more concentrated at each step upward as one goes up the food chain. Tuna and swordfish are the most common fish contaminated with mercury. Most swordfish are kept off the market today for this reason. Albacore tuna has been found to be safer than the larger species of tuna. While fish contain selenium, which helps to neutralize the toxic effects of mercury, we do not recommend eating tuna fish more than twice a week, due to mercury contamination.
• Water Supplies – Mercury in industrial waste is a common water contaminant. Mercury used in fungicides and slimicides easily finds its way into water supplies. Sewage sludge is commonly contaminated with mercury.
• Seeds Treated With Mercurial Fungicides – Mercury is commonly used as a treatment to prevent fungal growth on seeds.
• Medications – Because of its bacteriostatic properties, mercury is a common ingredient in antiseptics (Mercurochrome, Merthiolate) and contact lens solution. Mercury is also found in the thiazide diuretics and in some hemorrhoid medications.
• Congenital Mercury Toxicity – Methylmercury easily crosses the placenta into the growing fetus. Other mercurial compounds pass with less ease. Mercury compounds can also be transferred through breast milk to nursing babies. Levels in breast milk are about five percent of those of blood. It is believed that fetuses are the group most susceptible to mercury toxicity. Infants excrete mercury more slowly than adults.
• Other – Mercury is widely used in industry and in a variety of products, e.g., felt, fungicides, algicides used in swimming pools, adhesives, floor waxes, fabric softeners, slimicides, and in the production of chlorine.

Causes

Mercury toxicity may occur when you are exposed to toxic amounts of mercury due to:

• Breathing airborne mercury vapors
• Eating contaminated food, especially fish or shellfish—Larger and older fish tend to have the highest levels of mercury.
• Drinking water contaminated with mercury (rare)
• Practicing religious or folk medicine rituals that include mercury

Metallic mercury can be found in consumer products, such as fluorescent light bulbs, batteries, thermostats, and old thermometers. Mercury, combined with other elements, is also found in some types of dental fillings. Research has not shown that this type of filling is harmful to people. Although thimerosol is no longer used in vaccines in the United States, the mercury-containing compound is still used in some countries. Research has not shown that it is harmful to people.

Symptoms of Mercury Toxicity

Respiratory System

Up to 80% of inhaled mercury vapour is absorbed through the lungs. From here it travels to all the other tissues and organs of the body in the circulation, but particularly concentrates within the kidney, liver and brain. Effects and symptoms include –

• Asthma
• Bronchitis
• Breathlessness
• Persistent cough and
• Bad breath

Changes in mood

Mercury is also known to have profound effects upon mood including –

• Fears
• Anxieties
• Irritability
• Fits of anger
• Panic attacks
• Mood swings
• Loss of self-confidence
• Withdrawal
• Being easily embarrassed
• Feeling overwhelmed
• Feeling easily discouraged
• A loss of sense of humour and
• Life seems an endless, joyless struggle

Effects on Mental Health

• Hallucinations
• Depression
• A persistent death wish
• Suicide attempts
• Obsessive-Compulsive Disorders
• Manic-Depressive Disorder
• Panic disorders and
• Schizophrenia spectrum disorders

Compromised cognitive function

Mercury is both highly neurophilic (which means that it binds tightly to nerves) and highly lipophilic (which means that it binds tightly to fats). When distributed around the body in the circulation it is absorbed into the nerve endings that regulate all the functions of the body (the autonomic nervous system). From there it slowly tracks up the nerves into the central nervous system, in what is known as retrograde axonal transport. Mercury can produce a host of mental, emotional, and behavioural changes and what are considered ‘psychiatric’ disorders by disrupting neurotransmitters, interfering with endocrine gland function and hormones and causing destruction of nervous pathways.

• Poor memory
• Difficulty multitasking
• Difficulty finding words
• A lack of initiative
• An inability to concentrate
• An inability to make decisions and
• Lack of motivation

Reproductive and sexual function

Mercury is also recognized to collect in the reproductive organs in both men and women where it can cause a variety of disorders including infertility. Symptoms include –

• A low or non-existent libido
• Precocious or late puberty and
• Infertility

In women, the effects of mercury on reproductive function include –

• Heavy, missed or irregular periods
• Severe period pains
• Pre-menstrual tension (PMT)
• Miscarriages and
• Still births

In men, mercury accumulates in the reproductive organs and particularly the testes causing –

• Impotence
• Premature ejaculation and
• Low sperm count, defective sperm and sperm with poor motility

 

Peripheral nervous system symptoms

The profound disruption of nerve structure and function leads to difficulty with motor nerve function including –

• Difficulty articulating words
• Numbness and tingling
• Clumsiness
• Difficulty doing fine tasks such as typing or adding numbers on a calculator
• Tremors
• Ticks and twitches (especially of the face and eyes)
• A loss of coordination and
• Restless legs

The cardiovascular system

In particular, mercury seems to collect in the heart muscle and valves and has been found at 22,000X the levels found in the blood. Mercury is strongly associated with elevated levels of homocysteine and cholesterol and heart attacks.

It also causes red blood cells to rupture and replaces the iron in haemoglobin so that the oxygen carrying capacity of the blood can be reduced by half. Mercury also causes a weakening in the walls of the small blood vessels leading to a reduced blood supply to the organs and tissues. The cardiovascular symptoms of mercury poisoning include –

• Heart palpitations
• An irregular heart beat
• Angina or chest pain
• A racing heart beat
• Either an abnormally slow or rapid heart rate
• Low or high blood pressure
• Frequently feeling faint
• Elevated blood cholesterol and homocysteine levels and
• Easy bleeding and bruising.

Dental Symptoms

Mercury also collects in very high concentrations in the jaw bones and the soft tissues of the mouth. This is a result of it being a heavy metal that literally sinks to the bottom of each body compartment including the jaws and pelvis and the fact that mercury is driven into the tissues of the mouth which act as a cathode to the anode of the amalgam fillings.

Mixing gold and amalgam restorations in the mouth is also recognised to increase the amount of mercury vapour given off several fold and placing gold crowns over amalgam cores particularly drives mercury into the surrounding bone.

• Bleeding gums
• Periodontal (gum) disease
• Mouth ulcers
• A metallic taste
• Excessive salivation
• A loss of the sense of taste
• A burning, red, inflamed mouth
• ‘Bald’ patches on the tongue or cheeks (includes geographical tongue) and
• Dark spots on gums (‘amalgam tattoos’)

Effects on Ears

• Dizziness
• Vertigo
• Poor balance
• Tinnitus (ringing or whining noises in the ears)
• Pain in the ear canals
• Poor hearing and deafness and
• Difficulty interpreting what you hear.

Endocrine System

Symptoms of mercury poisoning in the endocrine system include:

• Hypoglycaemia and dysglycaemia (low and poorly controlled blood sugar respectively)
• Hypothyroidism (an underactive thyroid gland)
• Hypoadrenalism (under-functioning adrenal glands)
• Constant fatigue (adrenal and thyroid gland exhaustion) and
• A poor physiological response to stress.

Skin Hair and Nails

• Cold, clammy skin
• Dry skin
• Peeling or flaking skin on the hands, feet and face
• A puffy face
• Red, flaky skin around the eyes
• Thick, red skin on hands & feet
• Pricking, stabbing, fizzing or crawling sensations in the skin (vermiculation)
• Very itchy rashes
• Eczema and psoriasis
• Excessive perspiration
• An inability to sweat or
• Night sweats
• Loss of axillary, pubic, body or head hair
• Greying of hair
• Dry, thin, wiry, dull hair and
• Weak, flaky nails that split and tear easily

Nose

• Chronic sinusitis
• Poor sense of smell
• Chronic or recurrent rhinitis
• Nasal congestion
• A persistently sore throat and
• Chronic tonsillitis

Eyesight

• Intermittent visual blurring
• Deteriorating peripheral vision or ‘tunnel’ vision
• Bulging eyes
• Sensitivity to light
• Difficulty focussing
• Poor colour vision
• Poor night vision and
• Difficulty moving the eyes

Immune System

• Chronic, recurrent or frequent infections.
• Chronic or recurrent yeast infections – Mercury actively promotes the overgrowth of yeasts such as Candida albicans causing thrush, ‘jock’ itch and athlete’s foot.
• The development of allergies and sensitivities – Mercury alters the ratios of T-helper cells to T-suppressor cells so that the immune response is turned on more readily but not terminated, leading the immune system to over-react to a wide variety of foods and chemicals.
• Autoimmune diseases – Mercury binds to proteins on the surface of the cells of the body (the histocompatibility complex), leading the immune system to identify them as being foreign and initiating one of the 100 or more autoimmune diseases such as multiple sclerosis, scleroderma or Hashimoto thyroiditis.
• Various cancers – The undermining of the immune response and in particular the disabling of the natural killer cells leads to the development of one of the most prevalent immune deficiency disease of all: cancer.
• Water retention (especially of the legs) and
• Swollen lymph nodes (especially in the neck).

Digestive System

• The development of food sensitivities and intolerances
• Abdominal cramps and pain
• Constipation and/or diarrhoea
• Irritable bowel syndrome
• Malabsorption
• Leaky gut
• Gastroenteritis
• Nausea and
• Heartburn

Others

• A profound exhaustion and fatigue (chronic fatigue syndrome and fibromyalgia)
• Low body temperature
• Cold hands and feet
• Unexplained changes in weight
• Changes in appetite
• Excessive thirst
• Headaches and migraines
• Anaemia
• Difficulty getting to sleep
• Early waking
• Insomnia and
• Sleepiness during the day

Complications

• Fibromyalgia
• Chronic fatigue syndrome (CFS)
• Rheumatoid arthritis (RA)
• Multiple sclerosis (MS)
• Parkinson’s disease
• Alzheimer’s disease (AD)
• Colitis
• Crohn’s disease
• Autoimmune diseases
• Attention deficit hyperactivity disorder (ADHD)
• Autism and
• Cancer

Treatment