February 8, 2017

Hypercalcemia is an elevated calcium level in the blood. Hypercalcemia can be asymptomatic in laboratory results, but high calcium levels are often an indicator of multiple myeloma. Hypercalcemia related to multiple myeloma is caused by the breakdown of bone which leads to the release of calcium into the blood. This can be a serious problem if appropriate treatment is not given immediately. Severe hypercalcemia can result in coma or cardiac arrest.

Hypercalcemia develops in 10%–20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM)

Calcium enters the blood in different ways. The level of calcium in the blood is controlled by hormones and the kidneys.

Calcitriol is a hormone form of vitamin D. It helps the intestines take up calcium from foods and drinks. The intestines then release calcium into the blood. Parathyroid hormone (PTH) helps control the level of calcium in the blood. When blood calcium levels are low, the parathyroid gland releases PTH. PTH stimulates cells in the bones to break bone down and release calcium into the blood. It also tells the kidneys and intestines to absorb more calcium. The kidneys help control the amount of calcium in the body. They can remove large amounts of calcium from the blood and pass it into the urine.

Severe hypercalcemia can have serious consequences, including kidney damage, dementia, and coma. Treating the underlying disorder is often sufficient to restore blood levels of calcium to normal. However, some of the problems associated with severe hypercalcemia are irreversible.

Causes

Calcium is important to many body functions, including –

  • Bone formation
  • Hormone release
  • Muscle contraction
  • Nerve and brain function

Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands, which are four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as –

  • Egg yolks
  • Fish
  • Fortified cereals
  • Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth on one of the glands. (Most of the time, these growths are not cancerous).

Other conditions can also cause hypercalcemia –

  • An inherited condition that affects the body’s ability to regulate calcium (familial hypocalciuric hypercalcemia)
  • Being bed-bound (or not being able to move) for a long period of time (this occurs most often in young people)
  • Calcium excess in the diet. This is called milk-alkali syndrome. It is most often due to at least 2,000 milligrams of calcium per day. Taking too much vitamin D may add to the problem.
  • Hyperthyroidism
  • Kidney failure
  • Medications such as lithium and thiazide diuretics (water pills)
  • Some cancerous tumors (for example, lung cancers, breast cancer)
  • Some infectious and inflammatory diseases such as tuberculosis, Paget’s disease and sarcoidosis

Women in their 50s are the population at highest risk of overactive parathyroid glands.

Symptoms

The symptoms of hypercalcemia often develop slowly and may be similar to the symptoms of cancer or cancer treatment. How serious a person’s symptoms are is not related to the calcium level in the blood. Many patients have no symptoms. And, older patients usually experience more symptoms than younger patients.

People with hypercalcemia may experience the following symptoms –

  • Loss of appetite
  • Nausea and vomiting
  • Constipation and abdominal pain
  • Increased thirst and frequent urination
  • Fatigue, weakness, and muscle pain
  • Confusion, disorientation, and difficulty thinking
  • Headaches
  • Depression

Symptoms of severe hypercalcemia may include –

  • Kidney stones, a painful condition in which salt and minerals form solid masses called stones in the kidneys or urinary tract
  • Irregular heartbeat
  • Heart attack
  • Loss of consciousness
  • Coma

Patients and their families should be familiar with the symptoms on this list. Relieving side effects is an important part of cancer care and treatment. This is called palliative care. Talk with your health care team about any symptoms or side effects you may experience. This includes any new symptoms or a change in symptoms.

Complications

  • Pancreatitis
  • Peptic ulcer disease
  • Calcium deposits in the kidney (nephrocalcinosis)
  • Dehydration
  • High blood pressure
  • Kidney failure
  • Kidney stones
  • Depression
  • Difficulty concentrating or thinking
  • Bone cysts
  • Fractures
  • Osteoporosis

These complications of long-term hypercalcemia are uncommon today.

Treatment

Removal of the abnormal and hyperfunctioning parathyroid tissue results in a long-term cure of HPT in 96% of patients and significant improvement in associated symptoms. The following criteria were proposed as indications for parathyroidectomy based on a National Institutes of Health–sponsored panel and endocrine specialty societies –

  • Serum Ca level more than 1 mg/dL above the upper limit of normal
  • Marked hypercalciuria higher than 400 mg/day
  • Creatinine clearance reduced more than 30% compared with age-matched controls
  • Reduction in bone mineral density of the femoral neck, lumbar spine, or distal radius of more than 2.5 standard deviations below peak bone mass (T score lower than -2.5)
  • Age younger than 50 years
  • Patients for whom medical surveillance is not desirable or possible
  • Presence of any complications (e.g., nephrolithiasis, overt bone disease)
  • An episode of hypercalcemic crisis

Medications – In some cases, the doctor may recommend:

Calcimimetics – This type of drug mimics calcium circulating in the blood, so it can help control overactive parathyroid glands.

Bisphosphonates – Intravenous osteoporosis drugs can help rebuild bone weakened by hypercalcemia. Risks associated with this treatment include osteonecrosis of the jaw and certain types of thigh fractures.

Prednisone – If the hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone might be helpful.

IV fluids and diuretics – Extremely high calcium levels can be a medical emergency. Hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level may be needed to prevent heart rhythm problems or damage to the nervous system.

Dialysis – If the kidneys fail due to cancer or its treatment, you may need dialysis. Dialysis removes wastes from the blood when the kidneys don’t work properly.

Alternative Treatment

  • Probiotics – Vitamin K2 (menaquinone) is one of many vitamins that probiotic microbes make in the digestive tract. If the bacteria in the gut are out of balance, people may be deficient in K2 and several other B vitamins. A deficiency of vitamin K2 causes deposition of calcium on the artery walls and atherosclerosis.
  • Drink plenty of fluids, especially water – Drinking fluids can help keep the person from dehydration and help prevent kidney stones from forming.
  • Exercise – Once the calcium levels return to normal, and if the person is otherwise healthy, it’s important to remain active to help maintain bone density. Try to combine strength training with weight-bearing exercises.
  • Don’t smoke – Smoking has been shown to increase bone loss as well as dramatically increase the risk of a number of serious health problems.

 

Reference –

http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/managing-side-effects/increased-intracranial-pressure-icp/?region=on

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.692&rep=rep1&type=pdf\

http://www.mayoclinic.org/diseases-conditions/hypercalcemia/basics/treatment/con-20031513

http://www.globalhealingcenter.com/natural-health/what-is-calcium-toxicity-and-hypercalcemia/

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.692&rep=rep1&type=pdf\

http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0009/36945/aaa_Hypercalcaemia_FINAL_021111.pdf

https://www.endocrinology.org/policy/docs/13-02_EmergencyGuidance-AcuteHypercalcaemia.pdf

http://www.healthcommunities.com/blood-disorders/what-is-hypercalcemia.shtml

https://umm.edu/health/medical/ency/articles/hypercalcemia

http://www.merriam-webster.com/dictionary/hypercalcemia

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2967024/

 

February 8, 2017

Hormones are incredible chemical messengers in the body that affect the brain, heart, bones, muscles, and reproductive organs and are an essential part of the workings of every cell in the human body. Hormones work best when balanced. However, hormones can become imbalanced.

Hormone imbalances are caused by –

  • Higher than average levels of stress
  • Poor food choices
  • Inadequate sleep
  • Taking synthetic hormones
  • Sedentary lifestyle (lack of movement or exercise)

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones work slowly, over time, and affect many different processes, including –

  • Growth and development
  • Metabolism – how your body gets energy from the foods you eat
  • Sexual function
  • Reproduction
  • Mood

Symptoms

Symptoms of hormone imbalance are experienced during puberty, menstruation, pregnancy and post-partum, premenopausal and menopause. That makes up a sizeable portion of a woman’s life.

The common hormone imbalance symptoms include –

  • Premenstrual syndrome
  • Acne or skin breakouts
  • Urinary tract infections
  • Temperature changes
  • Anxiety and irritability
  • Headache/migraines
  • Cravings for sweets
  • Excess hair growth

Other symptoms include

  • Allergy symptoms
  • Problem sleeping
  • Irregular periods
  • Feeling fatigued
  • Water retention
  • Oily or dry skin
  • Endometriosis
  • Mood swings
  • Weight gain
  • Depression

Natural or Bio-identical Hormone Balancing

Bioidentical hormones – or bio identical hormones – are derived from naturally occurring sources, such as yams and soy, and are designed to replicate the same chemical structure as the hormones that are produced naturally by our bodies. Based on your hormone levels, a specialized compounding pharmacy can individually tailor a bioidentical hormone regimen specifically designed for you.

These include –

Estrogen – Bi-estrogen (Bi-Est), a combination of estriol and estradiol. From 50% to 80% of Bi-Est is estriol, which has been shown to protect against breast cancer in animal studies. Estriol causes little or no stimulation to the uterine lining and is clinically effective for the treatment of symptoms caused by estrogen deficiency, such as vaginal dryness and atrophy, painful intercourse, and urinary tract disorders (incontinence, frequent urinary tract infections). Estradiol relieves symptoms such as vaginal thinning and dryness. It decreases hot flashes and night sweats; improves mood, energy level, sleep patterns, memory, and cognitive function; and reduces bone loss and the risk of developing type 2 diabetes. It also helps to lower blood pressure.

Tri-estrogen (Tri-Est) a combination of 80% estriol, 10% estradiol, and 10% estrone. Only a few women may need supplemental estrone, which is the primary estrogen produced after menopause.

Progesterone is a hormone commonly prescribed for women with too much estrogen relative to the level of progesterone produced by the body. Progesterone minimizes the stimulating effects of estrogen on coronary arteries, and when given alone or combined with estrogen, it may improve bone mineral density. Progesterone improves sleep, may increase libido, acts as a diuretic, lowers blood pressure, and improves the insulin-glucose balance to facilitate blood glucose control.

Dehydroepiandrosterone (DHEA) is prescribed for women whose hormone profile as determined by saliva, blood or urine testing indicates a low level of DHEA. DHEA enhances libido, helps to build bone mass, lowers the levels of cholesterol and triglycerides, improves the sense of well-being, and increases alertness.

Testosterone is prescribed for women deficient in that hormone. It can help to improve libido, help to build bone mass, improve mood and the sense of well-being, increase muscle mass and strength, lower levels of cholesterol and triglycerides, normalize blood glucose levels, and decrease body fat.

Bioidentical hormones are more appealing to the masses when dealing with menopause or andropause because they are derived naturally and our bodies can metabolize them properly. Another advantage of using bioidentical hormones is that they are specifically designed to match your individual hormonal needs – unlike synthetic hormones, which use a one-size-fits-all approach to symptom relief.

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February 8, 2017

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

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

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

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

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

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

Who’s at Risk?

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

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

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

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

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

Causes

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

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

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

Symptoms

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

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

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

Treatment

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

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

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

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

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

Alternative Treatment

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

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

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

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

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

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

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

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

 

Reference –

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

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

http://www.thyroidawareness.com/hashimotos

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

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

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

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

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

 

February 8, 2017

Grave’s Disease also known as ‘Diffuse toxic goitre’ is characterized by hyperthyroidism and diffuse goiter. Graves’ disease is an autoimmune disorder where misplaced attacks from the immune system cause the thyroid gland to become overactive. It is caused by a generalized overactivity of the entire thyroid gland (hyperthyroidism). It is named for Robert Graves, an Irish physician, who described this form of hyperthyroidism about 150 years ago.

Graves’ disease is very common and affects about 1 in 200 people and is the most common cause of hyperthyroidism in the United States. Graves’ disease it is most often seen in women ages 20 to 40.

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

With Graves’ disease, the immune system makes antibodies that act like thyroid stimulating hormone (TSH), causing the thyroid to make more thyroid hormone than your body needs. This is called an overactive thyroid or hyperthyroidism. An overactive thyroid causes every function of the body to speed up, such as heart rate and the rate your body turns food into energy. Graves’ disease is one cause of overactive thyroid. It is closely related to Hashimoto’s disease, another autoimmune disease affecting the thyroid.

Who gets Grave’s Disease?

Both men and women can get Graves’ disease. But it affects women 10 times more often than men. Graves’ disease occurs in people of all ages, but most often starts in the 20s and 30s. People who get Graves’ disease often have family members who have thyroid or other autoimmune diseases. People who get Graves’ disease sometimes have other autoimmune diseases, such as:

  • Vitiligo — A disease that destroys the cells that give the skin its color
  • Rheumatoid arthritis — A disease that affects the lining of the joints throughout the body
  • Addison’s disease — A disease that affects the adrenal glands, which make hormones that help the body respond to stress and regulate the blood pressure and water and salt balance
  • Type 1 diabetes — A disease that causes blood sugar levels to be too high
  • Pernicious anemia — A disease that keeps the body from absorbing vitamin B12 and making enough healthy red blood cells
  • Lupus — A disease that can damage many parts of the body, such as the joints, skin, blood vessels, and other organs

Causes

Genetic factors – High prevalence of Graves’ disease in family members and relatives of Graves’ disease and Hashimoto’s thyroiditis support that genetic factors are involved in causation of Graves’ disease. There is also evidence that occurrence rate of Graves’ disease is higher in monozygotic twins than dizygotic twins. The concordance rate in monozygotic twins is only 17-35% which indicate low penentrance of genes.

Environmental Factors – From very early it has been suggested that Graves’ disease is associated with infectious agents, but this hypothesis has not been confirmed. Incidence of viral infections is high in patients with Graves’ disease. The association of Graves’ disease with infectious agents can be explained by molecular mimicry. Infection might play a role in the onset of Graves’ disease, but no studies have shown infection to directly cause Graves’ disease.

Stress – Severe emotional and physical stress, like separation from the loved one or following road traffic accident, cause release of cortisol ad corticotrophin releasing hormone. So, stress is a relatively immune suppression state. Immune system overcompensates once stress is over which can precipitate disease similar to postpartum period. In conclusion there is limited but significant evidence that stressful life events can precipitate the onset of Graves’ disease in genetically susceptible individuals.

Gender – Typically Graves’ disease is more prevalent in females than males. It is about 5-10 times more common in females at any age. But Graves’ disease also occurs in men and postmenopausal women. These observations have suggested that it is the X-chromosome, not the sex steroids, which is responsible. But most of the x-linked disorders are only present in man, it has been thought that a gene with dose dependent effect on X-chromosome is responsible.

Pregnancy – Postpartum period is an important risk factor for both the onset and relapse of Graves’ disease. Postpartum period is associated with a fourfold to eightfold increased risk for the onset of Graves’ disease. However in women with Graves’ disease who became pregnant, successful pregnancy outcome is low because Graves’ disease causes increased pregnancy loss and its complications.

Smoking – Smoking is a minor risk factor for Graves’ disease; however it is a major risk factor for Graves’ ophthalmopathy. There are number of studies showing relationship between Graves’ disease, Graves’ ophthalmopathy and smoking.

Other Factors – Direct trauma to the thyroid gland, ethanol injection for the treatment of autonomously functioning thyroid nodules, or thyroid injury following radio-iodine treatment for toxic adenoma or toxic multinodular goiter are associated with an increased risk of Graves’ disease. Radio-iodine treatment may also cause onset or worsening of ophthalmopathy. Possible explanation is that thyroid injury by any means cause massive release of thyroid antigens, which in turn stimulate an autoimmune reaction to TSHR in susceptible individuals.

Symptoms

The overproduction of thyroid hormones can have a variety of effects on the body due to the important role these hormones play to regulate a person’s metabolism.

The onset of Graves’ disease can have a number of effects on the body.

The influx of thyroid hormones can increase these processes, symptoms of this include –

  • Increased sweating
  • Weight loss
  • Nervousness
  • Hand tremors
  • Anxiety
  • An irregular or rapid heartbeat
  • Enlargement of the thyroid gland (goiter).

One distinct feature of Graves’ disease, compared with other causes of hyperthyroidism, is its effects on the eyes. Graves’ disease is the only type of hyperthyroidism that is associated with the swelling and inflammation of the eye tissue.

Graves’ eye disease is also known as ophthalmopathy (exophthalmos) and is a common symptom of patients with Graves’s disease with 30% of patients suffering from the condition. In this instance, the eyes become painful, red and watery. Patients may also experience extreme sensitivity to sunlight and blurred vision.

Treatment

Conventional Treatment – People with Graves’ disease have three conventional treatment options – radioiodine therapy, medications, and thyroid surgery.  Radioiodine therapy is the most common treatment for Graves’ disease in the United States.  Graves’ disease is often diagnosed and treated by an endocrinologist—a doctor who specializes in the body’s hormone- secreting glands.

  • Radioactive iodine therapy – Radioactive iodine is taken orally and directly targets the thyroid gland. Iodine is required to produce the thyroid hormones. When medication is taken, the radioactive iodine soon accumulates in the thyroid gland and slowly destroys any overactive thyroid cells. This results in the reduction of the thyroid gland and fewer thyroid hormones being produced. Although there have been concerns regarding the relationship between head and neck irradiation and the increased risk of thyroid cancer, so far no study has revealed any relation.
  • Medications
    • Beta blockers.Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. But beta blockers do not stop thyroid hormone production.
    • Anti-thyroid medications.Health care providers sometimes prescribe anti-thyroid medications as the only treatment for Graves’ disease.  Anti-thyroid medications interfere with thyroid hormone production but don’t usually have permanent results.  Use of these medications requires frequent monitoring by a health care provider.  More often, anti-thyroid medications are used to pretreat patients before surgery or radioiodine therapy, or they are used as supplemental treatment after radioiodine therapy
  • Thyroid Surgery – Surgery is the least-used option for treating Graves’ disease. Sometimes surgery may be used to treat
    • pregnant women who cannot tolerate anti-thyroid medications
    • people suspected of having thyroid cancer, though Graves’ disease does not cause cancer
    • people for whom other forms of treatment are not successful

Alternative Treatment 

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

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

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

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

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

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

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

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

 

Reference –

http://www.niddk.nih.gov/health-information/health-topics/endocrine/graves-disease/Pages/fact-sheet.aspx#treatment

http://www.medicalnewstoday.com/articles/170005.php#what_is_graves_disease

http://elaine-moore.com/Articles/Graves%E2%80%99Disease/AlternativeMedicine/tabid/70/Default.aspx

http://www.mayoclinic.org/diseases-conditions/graves-disease/basics/risk-factors/con-20025811

http://cdn.intechopen.com/pdfs-wm/37914.pdf

http://cdn.intechopen.com/pdfs-wm/37914.pdf

http://www.thyroidmanager.org/wp-content/uploads/chapters/graves-disease-and-the-manifestations-of-thyrotoxicosis.pdf

http://www.livescience.com/34730-graves-disease-overactive-thyroid.html

http://www.kellogg.umich.edu/patientcare/conditions/graves.disease.html

https://www.womenshealth.gov/publications/our-publications/fact-sheet/graves-disease.html

 

 

February 8, 2017

Fibrocystic breast disease (FBD), or fibrocystic breast condition or changes, is described as common, benign changes involving the tissues of the breasts. Common breast symptoms are swelling and tenderness, nodularity, palpable lumps, nipple discharge, and inflammation. These changes are typically accompanied by breast pain. The discomfort associated with fibrocystic breast disease is often in the upper outer quadrant, is diffuse, and may radiate to the axilla or upper arm. The incidence of fibrocystic breast disease is estimated to be up to 70% of all women. It can occur in women aged 18 or older, but is most common in women between the ages of 30 and 50, and rare in postmenopausal women.

Fibrocystic changes occur during ovulation and just before menstruation. During these times, hormone level changes often cause the breast cells to retain fluid and develop into nodules or cysts (sacs filled with fluid), which feel like a lump when touched. The nodules or cysts can spread throughout the breast, may be located in one general area or simply appear as one or more large cysts. If the lump is not filled with fluid, it is called a fibroadenoma. A fibroadenoma is a solitary, firm distinct lump, composed of a mass or lump of fibrous tissue.

Having fibrocystic breasts does not place women at a higher or lower risk of developing breast cancer. This generalized breast lumpiness is known by several names, including fibrocystic breast condition, fibrous breasts, fibrocystic breast disease, fibrocystic changes and benign breast disease. There even exist several types of fibrocystic breast condition.

Unfortunately, many women and even doctors think that fibrocystic breast disease is a “normal” condition for women. However, large, palpable cysts have been linked to an increased risk of breast cancer, not to mention the pain the women experience, so women need to be concerned about pain and cysts in their breasts and not let it go on thinking it is “normal”.

Causes

Fibrocystic breasts occur from changes in the glandular and stromal (connective) tissues of the breast. These changes are related to a woman’s menstrual cycle and the hormones, estrogen and progesterone. Women with fibrocystic breasts often have bilateral cyclic breast pain or tenderness that coincides with their menstrual cycles.

During each menstrual cycle, normal hormonal stimulation causes the breasts’ milk glands and ducts to enlarge, and in turn, the breasts may retain water. Before or during menstruation, the breasts may feel swollen, painful, tender, or lumpy. The severity of these symptoms varies significantly from woman to woman. Some women only experience mild breast swelling during menstruation, while others experience constant breast tenderness. Because the condition is hormone-related, it will usually affect both breasts (bilaterally). Symptoms of fibrocystic breasts usually stop after menopause but may be prolonged if a woman takes hormone replacement therapy.

Risk Factors

Women who have a family history of benign breast disorders, particularly in a mother or sister, are most likely to develop FCBD. It is also more common among women who have not had children, who are Jewish or Caucasian, or who have experienced severe PMS.

Symptoms

Symptoms usually get better after women go through menopause. If some take birth control pills, they may have fewer symptoms. If the patient is on hormone therapy, you may have more symptoms.

Symptoms are usually worse right before the menstrual period and improve after the period starts.

Symptoms can include –

  • Pain or discomfort in both breasts
  • The pain commonly comes and goes with the period, but can last through the whole month
  • Breasts that feel full, swollen, and heavy
  • Pain or discomfort under the arms
  • Thick or lumpy breasts

Women may have a lump in the same area of the breast that becomes larger before each period and shrinks afterward. This type of lump moves when it is pushed with the fingers. It does not feel stuck or fixed to the tissue around it. This lump is common with fibrocystic breasts.

Some may have discharge from the nipple. If the discharge is clear, red, or bloody, talk to the health care provider right away.

Treatment

Supportive therapy treats the symptoms caused by fibrocystic breast changes, but it does not treat the underlying cause of the breast condition. Supportive care options for fibrocystic breast changes may include –

  • Wearing a fitted, supportive bra
  • Over-the-counter pain medicines
  • Ibuprofen (Advil, Motrin)
  • Acetaminophen (Tylenol)
  • Diclofenac cream (Voltaren)
  • Fine needle aspiration to relieve pain from a breast cyst
  • Adding ground flaxseed to the diet

If supportive care measures do not reduce the symptoms, or if the symptoms are severe, other treatment options may be offered.

Oral contraceptives (birth control pills)

Surgery – Sometimes done to remove a lump

Drug treatment – Rarely offered for fibrocystic breast changes due to concerns about side effects

  • Danazol (Cyclomen, Danocrine) – decreases the production of estrogen
  • Tamoxifen (Nolvadex, Tamofen) – blocks the effects of estrogen

Alternative Treatment

Vitamin E has been used for managing fibrocystic breast disease for more than 35 years. Vitamin E reduces pain, relieves tenderness, and limits the development of nodules.

Evening Primrose Oil – The pain and tenderness of benign breast disease associated with “cyclic mastalgia” have been alleviated with evening primrose oil, the only one of the fatty acids to be scientifically studied in relation to fibrocystic breasts.

Chasteberry, also called vitex, adjusts imbalances between the menstrual hormones estrogen and progesterone and can stop excess production of prolactin, thereby reducing discomfort. It helps with painful bloating and may clear up PMS-related complaints, such as irritability and depression, in the process.

Essential fatty acids (EFAs) have an anti-inflammatory action that soothes breast pain and also helps the body absorb iodine. An iodine deficit is associated with fibrocystic breast changes. Good sources of EFAs are evening primrose oil, flaxseed oil, and borage oil

Magnesium is a versatile mineral that appears to reduce the pain and inflammation of fibrocystic breast changes and may also help with PMS and menstrual cramps. It’s less likely to upset the stomach if taken with food; cut the dose if diarrhea develops.

Vitamin B6 helps the liver process any extra estrogen and, like some of the supplements above, also can relieve PMS symptoms. Though this vitamin is essential to nerve health, it can cause nerve damage when taken in very high doses (over 500 mg a day) for a long period of time. Vitamin B6; will be most effective for this condition if used during the two weeks before your menstrual period.

A coenzyme Q10 deficiency has been reported in some cases of both breast cancer and fibrocystic breast changes. Supplementing with this high-potency antioxidant may be helpful in the prevention and treatment of these and other disorders in the body.

Herbal therapies for addressing the symptoms of breast pain, swelling, and cystic nodules in the breast are largely arrived at from traditional uses of herbal medicines and from observational empirical evidence in clinical practice. Herbal diuretics can be useful in decreasing breast swelling and the discomfort associated with it. The most effective of these is dandelion leaf (Taraxacum officinale). Other diuretics to consider are cleavers (Galium aparine), yarrow (Achillea millefolium) and uva ursi (Arctostaphylos uva ursi).

Lifestyle Advice – Start and maintain an exercise program that addresses three key components of health: duration (aerobics), strength (weight resistance), and flexibility (stretching). A moderate daily exercise routine will promote weight loss and hormonal balance, stabilizing your mood and the overall feeling of well being.

 

Reference –

http://www.cancer.ca/en/cancer-information/cancer-type/breast/breast-cancer/benign-conditions/fibrocystic-changes/?region=mb

http://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/basics/definition/con-20034681

http://www.healthline.com/health/fibrocystic-breast-disease

http://www.cancer.org/healthy/findcancerearly/womenshealth/non-cancerousbreastconditions/non-cancerous-breast-conditions-fibrocystic-changes

http://www.007b.com/fibrocystic_breast_pain.php

http://www.msdmanuals.com/home/women’s-health-issues/breast-disorders/fibrocystic-changes

http://womenshealth.about.com/cs/cysticbreasts/a/fibcysbrlubupan.htm

https://umm.edu/health/medical/ency/articles/fibrocystic-breast-changes

http://www.whg-pc.com/webdocuments/Breast-health/Breast-Fibrocystic.pdf

http://www.sphcs.org/fibrocysticbreasts

https://my.clevelandclinic.org/health/diseases_conditions/hic-fibrocystic-breast-changes

http://www.healthywomen.org/content/ask-expert/1290/fibrocystic-disease-hiding-breast-cancer

http://goodbreasthealth.com/breast_pain/fibrocystic_breast_disease/

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

 

February 8, 2017

Female sexual dysfunction is a complex and poorly understood condition that affects women of all ages. Sexual dysfunction is defined as a disturbance in, or pain during, the sexual response. This problem is more difficult to diagnose and treat in women than it is in men because of the intricacy of the female sexual response. A woman has female sexual dysfunction, also called FSD, when she is upset or unhappy about her sexual health.

Sexual activity includes a wide variety of intimate activities, such as fondling, self-stimulation, oral sex, vaginal penetration and intercourse. Every woman differs in her sexual interest, response and expression. A woman’s feelings about sexuality can change according to the circumstances and stages of her life. Women also can experience a variety of sexual problems, such as lack of desire, difficulty becoming aroused, difficulty having an orgasm or pain during sex. When a physical or emotional problem associated with sex persists, it’s time to contact a health care professional.

Sexual Dysfunction can be described as –

  • Low Sexual Desire – Diminished libido, or lack of sex drive.
  • Sexual Arousal Disorder – The desire for sex might be intact, but may have difficulty or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic Disorder – Women may have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual Pain Disorder – Women may have pain associated with sexual stimulation or vaginal contact.
  • Low Libido Associated with Menopause 

A woman’s sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships and her self-esteem. Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients. Instead, women may needlessly suffer in silence when their problems could be treated.

A woman might have more than one of these issues, which are often related to each other.  Sexual dysfunction can be lifelong or temporary.  It can happen all the time, only with a certain partner, or only at certain times, such as after pregnancy. A healthy sex life depends on a complex mix of many factors.  The same is true for a troubled sex life. Health issues, certain prescription medicines, changes in hormone levels, partner or family issues, and psychological concerns can all contribute to FSD.

Types of Sexual Dysfunctions

Hypoactive Sexual Desire Disorder – When sexual fantasies or thoughts and desire for sexual activity are persistently reduced or absent causing distress or relationship difficulties, the problem is known as hypoactive sexual desire disorder, or inhibited sexual desire disorder. The Merck Manual estimates hypoactive sexual desire disorder occurs in about 20 percent of women.

Sexual aversion disorder: Diagnosed when a women avoids all or almost all genital sexual contact with a sexual partner to the point that it causes personal distress and relationship difficulties. This condition may affect women who have experienced some type of sexual abuse or who grew up in a rigid atmosphere in which sex was taboo.

Sexual arousal disorder – The persistent or recurrent inability to reach or sustain the lubrication and swelling reaction in the arousal phase of the sexual response to the point that it causes personal distress. It is the second most common sexual problem among women, affecting an estimated 20 percent of women, and most frequently occurs in postmenopausal women. Low estrogen levels after menopause can make vaginal tissue dry and thin and reduce blood flow to genitals.

Female orgasmic disorder – The persistent absence or recurrent delay in orgasm after sufficient stimulation and arousal, causing personal distress. According to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. Most women are biologically able to experience orgasm. Never having an orgasm, or not having one in certain situations, are problems that can often be resolved by learning how the female body responds, how to ensure adequate stimulation and/or how to overcome inhibitions or anxieties.

Causes

Once thought to be purely psychological, doctors now know the causes of female sexual dysfunction can be physical, psychological or both. It’s important to rule out physical causes in order to properly address hormonal causes, psychological causes and social causes.

These are some of the possible physical causes of female sexual dysfunction –

  • Nerve damage caused by trauma or surgery
  • Infection in the pelvis
  • Gynecological disease
  • Lubrication insufficiency
  • Fatigue
  • Heart disease
  • Diabetes
  • Hormone causes and imbalances
  • Menopause hormonal changes
  • Insufficient stimulation
  • Medications that decrease sex drive

Psychological causes and social causes of female sexual dysfunction include the following –

  • Anxiety about sexual intercourse or anxiety disorders
  • Partner-to-partner communication problems
  • Fear of pain, pregnancy or infection caused by sexual intercourse
  • Feeling guilty or shameful
  • Stress
  • Fatigue
  • Depression
  • Marriage/relationship problems

Interpersonal relationship causes may include –

  • Partner performance and technique
  • Lack of a partner
  • Relationship quality and conflict
  • Lack of privacy

Sociocultural influence causes may include –

  • Inadequate education
  • Conflict with religious, personal, or family values
  • Societal taboos

While periodic female sexual dysfunction can be normal, a physician should examine lasting symptoms. Some females are at a higher risk for developing dysfunction. Risk factors include past sexual abuse, including rape.

Risk Factors

Risk may increase if the women –

  • Single, divorced, widowed or separated
  • Not a high school graduate
  • Experiencing emotional or stress-related problems
  • Experiencing a decline in the economic position
  • Feeling unhappy, or physically and emotionally unsatisfied
  • A victim of sexual abuse or forced sexual contact

Symptoms

Up to 70% of couples have a problem with sex at some time in their relationships. Most women will have sex that doesn’t feel good at some point in her life. This doesn’t necessarily mean the women has a sexual problem.

Inhibited sexual desire — This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes, medical conditions and treatments (for example cancer and chemotherapy), depression, pregnancy, stress and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.

Inability to become aroused — For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. The inability to become aroused also may be related to anxiety or inadequate stimulation. In addition, researchers are investigating how blood flow disorders affecting the vagina and clitoris may contribute to arousal problems.

Lack of orgasm (anorgasmia) — This is the delay or absence of sexual climax (orgasm). It can be caused by sexual inhibition, inexperience, lack of knowledge and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to anorgasmia include insufficient stimulation, certain medications and chronic diseases.

Painful intercourse — Pain during intercourse (dyspareunia) can be caused by a number of problems, including endometriosis, pelvic mass, ovarian cysts, inflammation of the vagina (vaginitis), poor lubrication, the presence of scar tissue from surgery and a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.

Treatment

Providing education — Education about human anatomy, sexual function and the normal changes associated with aging, as well as sexual behaviors and responses, may help a woman overcome her anxieties about sexual function and performance.

Enhancing stimulation — This may include the use of erotic materials (videos or books), masturbation and changes to sexual routines.

Providing distraction techniques — Erotic or non-erotic fantasies; exercises with intercourse; music, videos or television can be used to increase relaxation and eliminate anxiety.

Encouraging non-coital behaviors — Non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage, can be used to promote comfort and increase communication between partners.

Minimizing pain — Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. The use of vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

Hormonal treatment

  • Estrogen therapy – Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
  • Androgen therapy – Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower amounts of testosterone.

Other medicines

  • Non-prescription treatments, which are hormone-free and have few side effects, can help. They include moisturizers applied to the vagina several times a week or lubricants for the vagina, used just before intercourse.
  • Testosterone, when used short-term (a year or two), may increase sex drive in some women. Testosterone products for women are approved in some countries but not in the U.S.  The long-term safety of testosterone for women has not been proven and is being studied.

Devices – A prescription device called the Eros can help with arousal by increasing blood flow to the genital area and enhancing sensation.

Complementary & Alternative Treatment

Vitamin C may help both men and women, as it increases blood flow. One study suggests vitamin C may increase libido in women.

Essential fatty acids, found in evening primrose oil, fish oil, and borage oil, help improve blood flow.

Dehydroepiandrosterone (DHEA), a hormone made by the body’s adrenal glands, has been studied for both men and women. DHEA levels get lower as women grow older.

L-arginine is an amino acid that has numerous functions in the body. It is needed by the body to make nitric oxide, a compound that helps to relax blood vessels and allow blood to flow through arteries.

Ginkgo biloba is a herb used for centuries in traditional Chinese medicine as a folk remedy for respiratory conditions, cognitive impairment, and circulatory disorders.

Yohimbe – The bark of the herb yohimbe (Pausinystalia yohimbe) was historically used as a folk remedy for sexual dysfunction. The active constituent in the bark is called yohimbine.

Damiana (Turnera diffusa) is a herb used traditionally by the Mayan people of Central America to enhance sexual function in men and women. It is reported to be an aphrodisiac, stimulant, mood enhancer, and a tonic.

Tribulus terrestris – Studies of women who use this herb report greater desire, increased arousal, lubrication, more intense orgasms, and satisfaction.

Suma root – Sometimes called Brazilian Ginseng, this herb is extremely popular with the native population in South America for the way it aids female hormonal balance and excites libido. Science has confirmed suma root increases levels of estradiol-17beta, the primary estrogen hormone during a woman’s reproductive years.

Avena sativa – Generations of women stand by oats (Avena sativa) for its aphrodisiac and libido-stimulating qualities.

Acupuncture is the practice of inserting tiny needles into pressure points all over the body. In traditional Chinese theory, the purpose of acupuncture is to rebalance the energy flow of the body. Many women have claimed that acupuncture has helped decrease sexual pain during intercourse.

Meditation is another way in which women can feel more in touch with themselves and their bodies. Practicing controlled breathing and experiencing the ability to “just be” without life stressors or external judgment has shown to have positive results with their sexuality.

 

Reference –

http://www.hormone.org/questions-and-answers/2012/female-sexual-dysfunction

http://www.healthywomen.org/condition/sexual-dysfunction

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/womens-health/female-sexual-dysfunction/

http://www.everydayhealth.com/sexual-health/sexual-dysfunction.aspx

http://www.medscape.com/viewarticle/849867

https://www.nlm.nih.gov/medlineplus/sexualproblemsinwomen.html

http://www.nhs.uk/Livewell/Goodsex/Pages/Femalesexualdysfunction.aspx

http://www.aafp.org/afp/2000/0701/p127.html

http://www.livestrong.org/we-can-help/just-diagnosed/female-fertility-preservation/

http://www.earthclinic.com/cures/female-sexual-dysfunction.html

http://www.raysahelian.com/femalesexualdysfunction.html

http://altmedicine.about.com/od/sexualhealth/a/TreatFemaleSexu.htm

February 8, 2017

Childbearing and raising of children are extremely important events in every human’s life and are strongly associated with the ultimate goals of completeness, happiness and family integration. It is widely accepted that human existence reaches completeness through a child and fulfils the individual’s need for reproduction. Human fertility, compared with other species of animal kingdom, is unfortunately low.

Female Infertility is defined as the inability of getting pregnant after trying for at least 6 months or one year, for women over 35 years old, without use of birth control means and while having normal sexual intercourse. Infertility may also be referred to as the inability to carry a pregnancy to the delivery of a live baby.

More than 1 out of 10 couples experience infertility. Infertility isn’t just a woman’s problem. Men can have fertility problems, too. When a couple is having a hard time getting pregnant, it is just as likely to be caused by a problem with a man’s fertility as it is with a woman’s fertility.

Natural conception occurs when sperm cells, after sexual intercourse, migrate up through the cervix and uterus and into the fallopian tubes. Somewhere along the fallopian tube the sperm will meet the egg and a single sperm will penetrate the egg and fertilize it. The fertilized egg (called a zygote) continuously divides to form a ball of cells as it travels down the fallopian tube. By the time the fertilised egg has reached the uterus it has developed into a blastocyst.

A blastocyte has an inner group of cells that will become the embryo, and an outer group of cells that will attach the blastocyst to the uterus wall to form the placenta. The placenta carries oxygen and nutrients from the mother to the foetus and waste materials from the foetus to the mother. The blastocyst attaches to the lining of the uterus, where is starts to receive nourishment from the mother’s bloodstream. The implantation of the blastocyst to the uterus lining usually occurs about 10 days after the sperm first penetrated the egg in the fallopian tube. Natural conception is a complex process that relies on a number of factors in order to be successful. These factors include:

  • The production of healthy sperm by the man
  • The production of healthy eggs by the woman
  • Unblocked fallopian tubes to allow the sperm to reach the egg
  • The ability of the sperm to fertilise the egg when they meet in the fallopian tube
  • The ability of the egg to move into the woman’s uterus and become implanted in the uterus wall
  • A good quality embryo
  • Suitable hormonal environment in the woman

When a couple has a problem achieving pregnancy, it’s estimated that about –

  • 1 out of 3 times it’s due to a problem with the man’s fertility
  • 1 out of 3 times it’s due to a problem with the woman’s fertility
  • 1 out of 3 times it’s due to a problem with both the woman’s and the man’s fertility, or a cause cannot be found for the problem

That’s why both the woman and the man usually get tested for fertility problems when a couple is having infertility problems.

Causes

Ovulation disorders

Problems with ovulation are the most common cause of infertility in women, experts say. Ovulation is the monthly release of an egg. In some cases the woman never releases eggs, while in others the woman does not release eggs during come cycles.

Ovulation disorders can be due to:

  • Premature ovarian failure – the woman’s ovaries stop working before she is 40.
  • PCOS (polycystic ovary syndrome) – the woman’s ovaries function abnormally. She also has abnormally high levels of androgen. About 5% to 10% of women of reproductive age are affected to some degree. Also called Stein-Leventhal syndrome.
  • Hyperprolactinemia – if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality – eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk.
  • Overactive thyroid gland
  • Underactive thyroid gland
  • Some chronic conditions, such as AIDS or cancer.

Poorly Functioning Fallopian Tubes

Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage.  Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall, with certain procedures having success rates up to 65%.  The main causes of tubal damage include –

  • Infection – Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at both ends and fluid collects in the tube.
  • Abdominal Diseases – The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the fallopian tubes and lead to scarring and blockage.
  • Previous Surgeries -This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the tubes in such a way that eggs cannot travel through them.
  • Ectopic Pregnancy – This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage and is a potentially life-threatening condition.
  • Congenital Defects – In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.

Problems in the uterus or fallopian tubes

The egg travels from the ovary to the uterus (womb) where the fertilized egg grows. If there is something wrong in the uterus or the fallopian tubes the woman may not be able to conceive naturally. This may be due to –

  • Surgery – pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids – benign or non-cancerous tumors found in the muscular wall of the uterus, occurring in 30% to 40% of women of childbearing age. They may interfere with implantation. They can also block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis – cells that are normally found within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment – if a woman chose to have her fallopian tubes blocked. It is possible to reverse this process, but the chances of becoming fertile again are not high. However, an eight-year study showed tubal reversal surgery results in higher pregnancy and live birth rates and is less costly than IVF.

Medications

Some drugs can affect the fertility of a woman. These include:

  • NSAIDs (non-steroidal anti-inflammatory drugs) – women who take aspirin or ibuprofen long-term may find it harder to conceive.
  • Chemotherapy – some medications used in chemotherapy can result in ovarian failure. In some cases, this side effect of chemotherapy may be permanent.

Behavioral Factors

It is well-known that certain personal habits and lifestyle factors impact health; many of these same factors may limit a couple’s ability to conceive.  Fortunately, however, many of these variables can be regulated to increase not only the chances of conceiving but also one’s overall health.

  • Diet and Exercise – Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty becoming pregnant.
  • Smoking – Cigarette smoking has been shown to lower sperm counts in men and increases the risk of miscarriage, premature birth, and low-birth-weight babies for women. Smoking by either partner reduces the chance of conceiving with each cycle, either naturally or by IVF, by one-third.
  • Alcohol – Alcohol intake greatly increases the risk of birth defects for women and, if in high enough levels in the motherís blood, may cause Fetal Alcohol Syndrome. Alcohol also affects sperm counts in men.
  • Drugs – Drugs, such as marijuana and anabolic steroids, may impact sperm counts in men. Cocaine use in pregnant women may cause severe retardations and kidney problems in the baby and is perhaps the worst possible drug to abuse while pregnant. Recreational drug use should be avoided, both when trying to conceive and when pregnant.
  • Stress – Excessive physical or emotional stress that results in amenorrhea (absent periods).

Environmental Factors

The ability to conceive may be affected by exposure to various toxins or chemicals in the workplace or the surrounding environment.  Substances that can cause mutations, birth defects, abortions, infertility or sterility are called reproductive toxins.  Disorders of infertility, reproduction, spontaneous abortion, and teratogenesis are among the top ten work-related diseases and injuries in the U.S. today.  Despite the fact that considerable controversy exists regarding the impacts of toxins on fertility, four chemicals are now being regulated based on their documented infringements on conception.

  • Lead – Exposure to lead sources has been proven to negatively impact fertility in humans. Lead can produce teratospermias (abnormal sperm) and is thought to be an abortifacient, or substance that causes artificial abortion.
  • Medical Treatments and Materials – Repeated exposure to radiation, ranging from simple x-rays to chemotherapy, has been shown to alter sperm production, as well as contribute to a wide array of ovarian problems.
  • Ethylene Oxide – A chemical used both in the sterilization of surgical instruments and in the manufacturing of certain pesticides, ethylene oxide may cause birth defects in early pregnancy and has the potential to provoke early miscarriage.
  • Dibromochloropropane (DBCP) – Handling the chemicals found in pesticides, such as DBCP, can cause ovarian problems, leading to a variety of health conditions, like early menopause, that may directly impact fertility.

Risk Factors

  • Age – With increasing age, the quality and quantity of a woman’s eggs begin to decline. In the mid-30s, the rate of follicle loss accelerates, resulting in fewer and poorer quality eggs, making conception more challenging and increasing the risk of miscarriage.
  • Weight – If a women is overweight or significantly underweight, it may hinder normal ovulation. Getting to a healthy body mass index (BMI) has been shown to increase the frequency of ovulation and likelihood of pregnancy.
  • Sexual history – Sexually transmitted infections such as chlamydia and gonorrhea can cause fallopian tube damage. Having unprotected intercourse with multiple partners increases the chances of contracting a sexually transmitted disease (STD) that may cause fertility problems later.

Symptoms

The signs and symptoms of infertility in women depend on the underlying condition causing the infertility.  In women with regular menstrual cycles (periods), 95% of the time one egg is released in each cycle (each month). Women who have problems in releasing eggs are likely to experience infrequent or absent periods (amenorrhea).

Polycystic ovary syndrome is the most common hormone disturbance for women with infertility which results in irregular periods. With this condition some women will experience unwanted hair growth on the face and body, patchy hair loss from the scalp (alopecia) and too much weight gain.

Women with endometriosis are likely to have painful and heavy periods, lower abdominal pain, painful sexual intercourse or a combination of these symptoms.

Treatment

Medications for Ovulation disorders – If the woman has an ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation. These include –

  • Clomifene (Clomid, Serophene)
  • Metformin (Glucophage)
  • Human menopausal gonadotropin, or hMG, (Repronex)
  • Follicle-stimulating hormone (Gonal-F, Bravelle)
  • Human chorionic gonadotropin (Ovidrel, Pregnyl)
  • Gn-RH (gonadotropin-releasing hormone) analogs
  • Bromocriptine (Parlodel)

Surgery

  • Fallopian tube surgery – if the fallopian tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through them.
  • Laparoscopic surgery – a small incision is made in the woman’s abdomen. A thin, flexible microscope with a light at the end (laparoscope) is inserted through the incision. The doctor can then look at internal organs, take samples and perform small operations. For women with endometriosis, laparoscopy removes implants and scar tissue, reducing pain and often aiding fertility.

IVF (in vitro fertilization) – Sperm are placed with unfertilized eggs in a Petri dish; the aim is fertilization of the eggs. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use (cryopreserved).

Intrauterine Insemination (IUI) — Semen is collected from a man. A procedure called “sperm washing” is done to separate the healthy sperm from the rest of the semen. A health care provider puts the sperm directly into the uterus. This puts the sperm closer to the egg. It cuts down the time and distance sperm have to travel to reach an egg. IUI is often referred to as donor insemination, alternative insemination, or artificial insemination.

Assisted hatching -This improves the chances of the embryo’s implantation; attaching to the wall of the uterus. The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to leave its shell and implant into the uterine lining. Patients who benefit from assistant hatching include women with previous IVF failure, poor embryo growth rate, and older women. In some women, particularly older women, the membrane is hardened, making it difficult for the embryo to hatch and implant.

Embryo Transfer – One to three days after the eggs are retrieved, up to four healthy embryos are inserted into the uterus with a thin plastic tube that is passed through the cervix.

  • Gamete Intrafallopian Transfer (GIFT) is a more sophisticated variation of the basic IVF procedure and usually produces a slightly higher pregnancy rate.
  • Zygote Intrafallopian Transfer (ZIFT) is the latest variation on the IVF-GIFT technique. The freshly fertilized eggs (zygotes) are placed into the fallopian tubes during a laparoscopy after they have reached the embryo stage.

Lifestyle Changes – Although there are no dietary or nutritional cures for infertility, a healthy lifestyle is important. Some ovulatory problems may be reversible by changing behavioral patterns. Some tips include –

  • Maintain a healthy weight. Women who are either over- or underweight are at risk for fertility failure, including a lower chance for achieving success with fertility procedures.
  • Stop smoking. Smoking may increase the risk for infertility in both men and women. Everyone should quit.
  • Avoid excessive exercise if it causes menstrual irregularity. However, moderate and regular exercise is essential for good health.
  • Avoid or limit caffeine and alcohol.
  • Avoid any unnecessary medications.

Alternative Treatment

Supplements

Vitamin D- Vitamin D deficiency is very common in America, especially during the winter, and can be very detrimental to overall health. Recent studies link inadequate vitamin D with infertility and miscarriage.

Vitamin C– A potent antioxidant, vitamin C is good for both male and female infertility.

Folic Acid– Folic acid is well known as a necessary vitamin in early pregnancy to prevent complications, but it is most beneficial when taken for several month before the pregnancy as well as during. It helps cell division and promotes ovulation.

Zinc– It is very important for cell division including sperm production and ovulation.

Selenium– Helps protect the body from free radicals and protects sperm and egg.

B-Vitamins– Deficiency of b-vitamins is common in anyone who consumes large amounts of processed foods, grains or sugars. Optimizing b vitamin levels can increase lutenizing hormone and follicle stimulating hormone to improve fertility.

Bioflavonoids – Helps strengthen the uterus by promoting healthy blood vessels.

Flaxseed oil – A healthy fat that can help normalize hormones and is essential to health.

Herbs

Black cohosh (Cimicifuga racemosa)—Balances hormones.

Chaste tree (Vitex castus)—Raises progesterone levels, lowers estrogen levels, and helps correct ovarian dysfunction.

Dong quai (Angelica sinensis)—Nourishes and balances the female reproductive system.

False unicorn (Helonias dioica)—Has a reputation for promoting fertility, is recommended for ovarian dysfunction and as a uterine tonic.

Licorice (Glycyrrhiza glabra)—Balances hormones and is anti-inflammatory and sweet tasting (good flavoring for teas).

Red raspberry (Rubus strigosus)—Nourishes and strengthens the female reproductive system.

Squaw vine (Mitchella repens)—Also known as partridge berry. Recommended for fertility as a uterine tonic.

Wild yam (Dioscorea villosa)—Has a reputation for promoting fertility.

To Avoid –

Avoid Estrogen – Estrogen can have a negative effect on the development of the female reproductive tract. Therefore, it is important to reduce or eliminate excess estrogen or estrogen-like chemicals in your body. Avoid all dairy products where cows have been fed hormones. The drop in sperm counts since the 1940s parallels a rise in the consumption of dairy products.

Chemicals, such as PCBs, dioxin, etc. are weakly estrogenic and degenerate very slowly, they hang around for years in our environment. Avoid the use of toxic substances such as fertilizers, cleaners. Also avoid all fatty animal products where chemicals may be stored up without being degraded.

Avoid Heavy Metals – Sperm are affected by lead, cadmium, arsenic, and mercury. There are many sources of exposure to these heavy metals such as deep-sea fish, cigarette smoke, and water from old pipes. Just as with men, lead, cadmium, or mercury can impair fertility by affecting sex hormones.

Avoid free radicals – We have all heard that free radicals (the hungry and unstable oxygen in our bodies) can cause cancer, heart disease, and increase the aging process. Like –

  • Cigarette smoke
  • Sunlight
  • Unsaturated oils (corn oil may be the worst)
  • Heating oils to too high a temperature when cooking
  • Foods left out of the refrigerator (oxidation causes butter to turn a slight yellow and cut apples to turn brown)

Caffeine and Alcohol – Both can impair female fertility. Excessive alcohol causes prolactin to rise and too much or too little prolactin is associated with infertility. Caffeine causes a decrease in serum prolactin. Caffeinated soft drinks may also reduce the chance of conception.

Others

  • Flower Essences – The flowers of plants may be prepared in a similar way to homeopathic remedies so that the “essence” of the plant is harnessed in a medicinal way. An example is Pomegranate. Its use is described as a treatment for imbalance, i.e., women who are ambivalent or confused about the focus of feminine creativity, home or career, creative or procreative, those who attempt to balance both possibilities may feel drained and the psychological tension may be profound resulting in physical illness especially in the female organs.
  • Stress Reduction/Relaxation Therapies
  • Diaphragmatic Breathing Exercise

 

Reference –

http://www.mayoclinic.org/diseases-conditions/female-infertility/basics/risk-factors/con-20033618

http://www.yourhormones.info/endocrine_conditions/female_infertility.aspx

http://www.drugs.com/health-guide/female-infertility.html

http://www.health.harvard.edu/womens-health/female-infertility

https://www.mivf.com.au/fertility-treatment/female-infertility-tests

http://www.healthcentral.com/encyclopedia/hc/female-infertility-3168698/

http://www.advancedfertility.com/age.htm

http://www.nytimes.com/health/guides/disease/infertility-in-women/overview.html

http://www.babycenter.com/0_common-causes-of-fertility-problems-in-women_1228906.bc

http://www.ivf.com.au/fertility-treatment/female-infertility-tests

https://www.plannedparenthood.org/learn/womens-health/female-infertility

https://umm.edu/health/medical/reports/articles/infertility-in-women

http://www.cdc.gov/reproductivehealth/infertility/

http://www.hfea.gov.uk/infertility.html

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/infertility-in-women

https://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/Causefem.htm

https://www.nlm.nih.gov/medlineplus/femaleinfertility.html

http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html

http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html

 

 

 

 

February 8, 2017

Endometriosis is a medical condition that occurs when the lining of the uterus, called the endometrium, grows in other places, such as the fallopian tubes, ovaries or along the pelvis. Women with endometriosis may experience infertility, pelvic pain, or both.

Every month a woman’s body goes through hormonal changes. Hormones are naturally released which cause the lining of the womb to increase in preparation for a fertilized egg.  If pregnancy does not occur, this lining will break down and bleed – this is then released from the body as a period.

In endometriosis, cells like the ones in the lining of the womb grow elsewhere in the body. These cells react to the menstrual cycle each month and also bleed. However, there is no way for this blood to leave the body. This can cause inflammation, pain and the formation of scar tissue.

Areas of endometrial tissue often called implants, occur in the following places –

  • Peritoneum
  • Ovaries
  • Fallopian tubes
  • Outer surface of the uterus, bladder, ureters, intestines and rectum
  • Cul-de-sac (the space behind the uterus

About 5 million women in the United States have endometriosis, but the true number of cases may be much higher, because not all women with the condition have symptoms. Endometrosis occurs in about one in ten women of reproductive age. It is most often diagnosed in women in their 30s and 40s.

However, with the right endometriosis treatment, many of these issues can be addressed, and the symptoms of endometriosis made more manageable.

Causes

The actual cause of endometriosis is unknown. There are several theories about the cause of endometriosis, but none fully explains why endometriosis occurs. It is possible that a combination of the following factors could be causing endometriosis to develop in some women –

Retrograde menstruation – When women have periods, some of the endometrium (womb lining) flows backwards, out through the fallopian tubes and into the abdomen. This tissue then implants itself on organs in the pelvis and grows. It has been suggested that most women experience some form of retrograde menstruation, but their bodies are able to clear this tissue and it does not deposit on the organs. This theory does not explain why endometriosis has developed in some women after hysterectomy, or why, in rare cases, endometriosis has been discovered in some men when they have been exposed to oestrogen through drug treatments.

Lymphatic or circulatory spread – Endometriosis tissue particles are thought to somehow travel round the body through the lymphatic system or in the bloodstream. This could explain why it has been found in areas such as the eyes and brain.

Genetic Factors – Some research suggests that endometriosis can be passed down to new generations through the genes of family members. Some families may be more susceptible to endometriosis but the causes of this are unclear.

Immune dysfunction – It is thought that, for some women, their immune system is not able to fight off endometriosis. Many women with endometriosis appear to have reduced immunity to other conditions. It is not known whether this contributes to endometriosis or whether it is as a result of endometriosis.

Environmental causes – This theory suggests that certain toxins in our environment, such as dioxin, can affect the body, the immune system and reproductive system and cause endometriosis. Research studies have shown that when animals were exposed to high levels of dioxin they developed endometriosis. This theory has not yet been proven for humans.

Metaplasia – Metaplasia is the process where one type of cell changes or morphs into a different kind of cell.  Metaplasia usually occurs in response to inflammation and enables cells to change to their surrounding circumstances to better adapt to their environment. In the case of endometriosis, metaplasia would explain how the endometriosis cells appear spontaneously inside the body – and how they appear in areas such as the lung and skin. It would also explain the appearance of endometriosis cells in women with no womb – or in men who have taken hormone treatments.

Risk Factors

Endometriosis can happen in any girl or woman who has menstrual periods, but it is more common in women in their 30s and 40s. The risk factors include –

  • Never had children
  • Menstrual periods that last more than seven days
  • Short menstrual cycles (27 days or fewer)
  • A family member (mother, aunt, sister) with endometriosis
  • A health problem that blocks the normal flow of menstrual blood from the body during periods

Symptoms

Symptoms of endometriosis can include:

  • Pain – This is the most common symptom. Women with endometriosis may have many different kinds of pain. These include:
  • Very painful menstrual cramps – The pain may get worse over time.
  • Chronic (long-term) pain in the lower back and pelvis
  • Pain during or after sex – This is usually described as a “deep” pain and is different from pain felt at the entrance to the vagina when penetration begins.
  • Intestinal pain
  • Painful bowel movements or pain when urinating during menstrual periods – In rare cases, you may also find blood in your stool or urine.
  • Bleeding or spotting between menstrual periods – This can be caused by something other than endometriosis. If it happens often, you should see your doctor.
  • Infertility, or not being able to get pregnant.
  • Stomach (digestive) problems – These include diarrhea, constipation, bloating, or nausea, especially during menstrual periods.

Complications

Infertility – The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.

Ovarian cancer does occur at higher than expected rates in women with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some studies suggest that endometriosis increases that risk, but it’s still relatively low.

Treatment

Pain Medication – Some over-the-counter pain medications such as aspirin, acetaminophen, and ibuprofen may lessen the discomfort for women when dealing with endometriosis. Prescription medication may be needed if the pain does not respond to over-the-counter drugs.

Hormonal Drug Therapy – Hormonal drugs are given to try to stop ovulation for as long as possible in order to keep the implants or lesions from being aggravated. These can include oral contraceptives, progesterone drugs, and GnRH agonists.

Surgery – Conservative surgery is used to diagnose, remove growths, relieve pain, and increase the chances of pregnancy. Conservative surgery is usually done through a laparoscopy or a laparotomy. In some cases, a more radical surgery such as a hysterectomy is recommended for treating endometriosis.

Birth Control Pills simulate a pregnancy state in the body. They reduce menstrual bleeding by thinning the endometrial lining, thereby shortening and lightening the period. These pills must be taken for a minimum of six months.

Danazol – This drug suppresses estrogen levels and increases the amount of testosterone circulation. This form of medical therapy stops patients from ovulating and menstruating. It also shrinks the uterine lining and prevents new tissue implants from forming. However, side effects may occur, such as –

  • Fluid retention
  • Acne
  • Hot flashes
  • Dry vaginal wall (atrophic vaginitis)
  • Increased hair growth

Alternative Treatment

Omega-3 fatty acids are found in fish such as salmon, mackerel, sardines, and anchovies. They are also available in fish oil capsules, which may be the preferable form because good brands contain minimal amounts of PCBs and dioxins.

All of the B vitamins strengthen the liver, and directly assist the body in disposing of excess estrogen.

Licorice is one of the most commonly used herbs in China, and it is well known for its beneficial effect on the liver.

Dandelion strengthens the liver and kidneys.

Milk thistle is renowned for strengthening the liver.

Selenium has been historically given to cows by farmers to prevent endometriosis. Endometriosis hinders fertility, so farmers work hard to prevent a disease that results in fewer calves. The best single source of selenium is Brazil nuts, followed by tuna, cod, and meats. It can also be purchased in supplement form.

Vitamin E is known to ensure that animals have healthy uterine linings, and it has been used by farmers since the 1930’s. Vitamin E and selenium are believed to work together to prevent damage to cell membranes, and protect against oxidation. Do not take blood thinners like vitamin E during the menstrual period, because they will increase bleeding.

Chlorophyll  – Due to the link between endometriosis and dioxins, it would be wise to supplement with chlorophyll. Chlorophyll can remove dioxins from the body, and it can be purchased as a liquid concentrate.

Folate or folic acid – Folate is necessary for the body to make heme (the iron-containing, non-protein part of hemoglobin) for the red blood cells. Too little folate can cause nutritional megoblastic anemia (large red blood cells that cannot transport oxygen well). It is known to help regulate and balance the hormones. Folic acid assists in the chelation of lead, and helps the body to properly utilize zinc. There is a strong connection between folate and the liver, because liver disease increases the loss of folate.

Radishes were used in Traditional Chinese Medicine to cure endometriosis, and to fix liver problems, including jaundice. It would be wise to include them in the diet.

Flaxseeds are high in lignans and fiber, which have been found to be beneficial for estrogen-related conditions.

Hydrotherapy – A contrast sitz bath is often recommended by alternative practitioners for endometriosis. It is a home remedy and has not been studied.

Acupuncture – The insertion of thin needles at various points in the skin is said to bring relief to women suffering from Endo pain, menstrual cramping, and post-operative pain as well.

Exercise is a demonstrated stress reliever, pain reducer, and depression fighter. It also provides obvious benefits such as weight control and improved cardiovascular health.

Biofeedback – This involves the altering of body processes such as heart rate, muscle activity, skin temperature, and brain wave activity. This is done through the use of electrodes attached to the skin which convert minute physiological, chemical or electrical changes into auditory or visual signals.

Chiropractic treatment – This differs from osteopathic treatment in that Chiropractors believe the disease can be relieved by correcting dislocations (subluxations) in the musculoskeletal system alone.

 

Reference –

http://www.livescience.com/34722-endometriosis-causes-symptoms-treatments.html

http://emedicine.medscape.com/article/271899-overview

https://www.endometriosis-uk.org/understanding-endometriosis

http://www.alternativesurgery.com/education/endometriosis/

http://www.endofound.org/endometriosis

http://www.medicalnewstoday.com/articles/149109.php

http://patient.info/health/endometriosis-leaflet

https://my.clevelandclinic.org/health/diseases_conditions/hic_Endometriosis

https://jeanhailes.org.au/health-a-z/endometriosis

http://endometriosis.org/

http://www.endometriosisassn.org/endo.html

http://www.healthline.com/health/endometriosis

https://healthunlocked.com/endometriosis-uk

https://www.womentowomen.com/sex-fertility/endometriosis-start-with-a-natural-approach/

 

 

February 8, 2017

Diabetic neuropathies are a family of nerve disorders caused by diabetes. It has been defined as presence of symptoms and/or signs of peripheral nerve dysfunction in diabetics after exclusion of other causes, which may range from hereditary, traumatic, compressive, metabolic, toxic, nutritional, infectious, immune mediated, neoplastic, and secondary to other systemic illnesses.

About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

Types of Diabetic Neuropathy

There are different types of diabetic neuropathy. The distinction depends upon which types and location of nerves are affected.

  • Diabetic peripheral neuropathy refers to damage to peripheral nerves, most commonly the nerves of the feet and legs.
  • Diabetic proximal neuropathy affects nerves in the thighs, hips, or buttocks.
  • Diabetic autonomic neuropathy affects the autonomic nervous system, the nerves that control body functions. For example, it can affect nerves of the gastrointestinal, urinary, genital, or vascular systems.
  • Diabetic focal neuropathy affects a specific nerve or area at any site in the body.

Neuropathy is damage to nerves, and diabetic neuropathy is damage to nerves that occurs as a result of diabetes. Diabetes is thought to damage nerves as a result of prolonged elevated levels of blood glucose. Diabetic neuropathy can affect different parts of the body, and symptoms can range from mild to severe. Diabetic neuropathy is the most common complication of diabetes.

Causes

High glucose and lipid (fat) levels in the blood, and the toxic byproducts they generate through their metabolism, are thought to be the major causes of neuropathy associated with diabetes. However, good glucose control in people with type 1 diabetes can reduce neuropathy by 60 per cent.

It’s possible that elevated blood glucose levels damage the tiny blood vessels that lead to the nerves. If the blood vessels are damaged, they don’t bring oxygen and nutrients to the nerves as they should, which eventually can cause nerve damage.

Other factors may include –

  • Age – Diabetic neuropathy takes time to develop, so it’s much more common in older people who have had diabetes for 25 years or more.
  • Genetic factors – Unrelated to diabetes that make some people more susceptible to nerve damage.
  • Lifestyle choices – It seems that alcohol and smoking make the symptoms of neuropathy worse.
  • Nerve injury – Whether the nerves have been damaged through inflammation or through a mechanical injury (such as nerve compression associated with carpal tunnel syndrome), it’s possible the previously-damaged nerves are more susceptible to developing diabetic neuropathy.

Risk Factors

The longer a person has diabetes and the worse the control of their diabetes, the more likely they will develop diabetic neuropathy.

Those people experiencing complications of their diabetes elsewhere in their body (such as in the kidneys, heart or eyes) are also more likely to have or develop neuropathy, as the same factors that cause these problems also contribute to neuropathy. Smoking, high blood pressure and being overweight also make it more likely that people with diabetes will get nerve damage.

Symptoms

The symptoms of diabetic neuropathy depend on what type of neuropathy  the  person has. Symptoms are dependent on which nerves have been damaged. In general, diabetic neuropathy symptoms develop gradually; they may seem like minor and infrequent pains at first, but as the nerves become more damaged, symptoms may grow.

As mild symptoms can indicate the beginning of neuropathy, the following should be noted – pain, numbness, weakness, or tingling—even if it seems insignificant.

Peripheral Neuropathy Symptoms – Peripheral neuropathy affects nerves leading to the extremities—the feet, legs, hands, and arms. The nerves leading to the feet are the longest in the body, so they are the most often affected nerves (simply because there’s more of them to be affected). Peripheral neuropathy is the most common form of diabetic neuropathy. The symptoms include –

  • Pain
  • Numbness (loss of feeling)
  • Tingling
  • Muscle weakness
  • Muscle cramping and/or twitching
  • Insensitivity to pain and/or temperature
  • Extreme sensitivity to even the lightest touch

Symptoms get worse at night.

Proximal Neuropathy Symptoms – Proximal neuropathy affects the buttocks, hips, thighs, and legs. Its symptoms aren’t usually long-term; they may go away after several weeks or months.

Symptoms include –

  • Weakness in the legs
  • Trouble standing up from a seated position without help.

Autonomic Neuropathy Symptoms – The autonomic nervous system is in charge of the “involuntary” functions of the body. It keeps the heart pumping and keeps the digestion healthy.

  • Cardiovascular System
    • Dizziness just after standing
    • Fainting just after standing
    • Irregular heart rate
  • Digestive System
    • Bloating
    • Constipation
    • Diarrhea
    • Nausea
    • Vomiting
  • Eyes
    • Vision trouble at night or during sudden light changes (e.g., when stepping into a dark building from the sunlight)
  • Reproductive System
    • Sexual problems—erectile dysfunction in men; vaginal dryness in women
  • Sweat Glands
    • Profuse sweating, especially at night or when eating particular foods (cheese commonly causes excessive sweating, for example, although that’s not true for every person with diabetic neuropathy)
    • Reduced sweating, especially in the legs and feet
    • Urinary System
    • Bladder dysfunction

Focal Neuropathy Symptoms – This affects the head, torso, or legs. Symptoms include –

  • Head
    • Vision trouble—double vision, ache behind an eye, difficulty focusing
    • Sudden paralysis of one side of the face (Bell’s palsy)
  • Torso
    • Pain in the chest
    • Pain in the stomach
    • Pain on the side
    • Pain in the low back
  • Legs
    • Pain in the front of the thigh
    • Pain on the outside of the shin
    • Pain on the inside of the foot

Treatment

he first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage.x`

Medications – People with severe nerve pain may benefit from a combination of medications or treatments and should consider talking with a health care provider about treatment options.

Medications used to help relieve diabetic nerve pain include – Tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane) and other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa) Anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal), Opioids and opioidlike drugs, such as controlled-release oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant.

Treatments that are applied to the skin—typically to the feet—include capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha-lipoic acid, an antioxidant, and evening primrose oil suggest they may help relieve symptoms and improve nerve function in some patients.

A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials.

Treating gastroparesis – For gastroparesis, in which the stomach is not emptying properly, physicians at Joslin may prescribe metoclopramide (Reglan®), which will help the stomach push food and get it through the rest of the digestive process. These may be used in conjunction with sucralfate (Carafate®), which “helps to sop up extra acid that may be sitting in the stomach,” Dr. Gibbons says.

Treating bladder neuropathy – For those experiencing bladder neuropathy, which results in the bladder never completely emptying, bethanechol (Urecholine®) may be prescribed. “This is a urine propellant that helps to keep the bladder clear,” says Dr. Gibbons. “Because patients with this problem will be more likely to develop frequent urinary tract infections, the physician may also prescribe chronic antibiotic therapy to try and keep the bacterial count in the bladder and urinary tract at a manageable level.”

Treating impotence – Impotence in men that is a result neuropathy or blood vessel damage (versus psychological causes or due to medications such as anti-depressants or blood pressure medication) can be treated using certain drugs that are either inserted into the end of the penis or injected to cause an erection before intercourse. Vacuum devices that enable an erection to be achieved or a surgically implanted prosthesis are also options to be explored with a physician.

Alternative Treatment

  • Alpha lipoic acid is one if the most important nutrients to consider for diabetes. Alpha Lipoic acid has been evaluated for blood sugar control, and it may also be considered in diabetic neuropathy and kidney disease. Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy.
  • Acetyl-L-carnitine is helpful in the treatment of diabetic neuropathy. It improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy.
  • Benfotiamine has been evaluated in diabetic neuropathy with positive results
  • B vitamins could be helpful, perhaps combined with gabapentin (Neurotin). Vitamin B12 is a possible supplement to take for diabetic neuropathy. Vitamin B12 may be more effective than nortriptyline in improving painful diabetic neuropathy. It is more effective than nortriptyline for the treatment of symptomatic painful diabetic neuropathy.
  • Ginkgo biloba herbal extract has the best effect with the combination of folate for diabetic neuropathy.
  • Capsaicin applied to the skin, capsaicin cream can reduce pain sensations in some people. Side effects may include a burning feeling and skin irritation.
  • Vitamin B6 deficiency may be associated with the development of peripheral neuropathy. In addition, in the form of pyridoxine HCl, high doses of B6 have been implicated as a cause of PN.
  • Chromium is an essential mineral, chromium plays an important role in facilitating glucose metabolism.
  • Coenzyme Q10 is a cofactor used in oxidative respiration and is produced endogenously. Supplementation of coenzyme Q10 is especially popular for cardiovascular diseases.
  • Magnesium is an abundant mineral in the human body involved in numerous biochemical processes, including glucose metabolism. It Increases insulin sensitivity.
  • Omega-3 polyunsaturated fatty acids (PUFAs) are one of the most common dietary supplements taken in the United States. Studies indicate reductions in coronary artery disease and sudden cardiac death based on omega-3 PUFA intake. In patients with type 2 diabetes, a meta-analysis of omega-3 PUFA supplementation set of type 2 diabetes.60
  • Vanadium is a mineral with no known biological importance or deficiency-associated disease.

 

February 8, 2017

Diabetes or Diabetes mellitus is defined as a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action, or both. is a defect in the body’s ability to convert glucose (sugar) to energy. Glucose is the main source of fuel for the body.

Foods that affect blood sugars are called carbohydrates. Carbohydrates, when digested, change to glucose. Examples of some carbohydrates are: bread, rice, pasta, potatoes, corn, fruit, and milk products. Individuals with diabetes should eat carbohydrates but must do so in moderation. Glucose is then transferred to the blood and is used by the cells for energy. In order for glucose to be transferred from the blood into the cells, the hormone – insulin is needed. Pancreas—an organ, located between the stomach and spine, that helps with digestion—releases a hormone it makes, called insulin, into the blood. Insulin helps the blood to carry glucose to all the body’s cells. Sometimes the body doesn’t make enough insulin or the insulin doesn’t work the way it should. The blood glucose levels get too high and can cause diabetes or prediabetes.

What is prediabetes?

Prediabetes is when the amount of glucose in the blood is above normal yet not high enough to be called diabetes. With prediabetes, the chances of getting type 2 diabetes, heart disease, and stroke are higher. With some weight loss and moderate physical activity, it can be delayed or prevented.

Over time, diabetes can lead to blindness, kidney failure, and nerve damage. These types of damage are the result of damage to small vessels, referred to as microvascular disease. Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. This is referred to as macrovascular disease. Diabetes affects approximately 26 million people in the United States, while another 79 million have prediabetes. An estimated 7 million people in the United States have diabetes and don’t even know it. Diabetes is the seventh leading cause of death in the United States.

Types of Diabetes

Type 1 diabetes occurs most frequently in children and young adults, although it can occur at any age. Type 1 diabetes accounts for 5-10% of all diabetes in the United States. There does appear to be a genetic component to Type 1 diabetes, but the cause has yet to be identified. In type 1 diabetes, the body no longer makes insulin or enough insulin because the body’s immune system, which normally protects the body from infection by getting rid of bacteria, viruses, and other harmful substances, has attacked and destroyed the cells that make insulin.

Type 2 diabetes is much more common and accounts for 90-95% of all diabetes. Type 2 diabetes primarily affects adults, however recently Type 2 has begun developing in children. There is a strong correlation between Type 2 diabetes, physical inactivity and obesity. Type 2 diabetes usually begins with insulin resistance—a condition that occurs when fat, muscle, and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals.

Gestational diabetes affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Overweight or obese women have a higher chance of gestational diabetes. Also, gaining too much weight during pregnancy may increase the likelihood of developing gestational diabetes. Gestational diabetes most often goes away after the baby is born. However, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes.

Causes

Diabetes causes vary depending on your genetic makeup, family history, ethnicity, health and environmental factors. There is no common diabetes cause that fits every type of diabetes.

Type 1

Type 1 diabetes is caused by the immune system destroying the cells in the pancreas that make insulin. This causes diabetes by leaving the body without enough insulin to function normally. This is called an autoimmune reaction, or autoimmune cause, because the body is attacking itself. There is no specific diabetes causes, but the following triggers may be involved:

  • Viral or bacterial infection
  • Chemical toxins within food
  • Unidentified component causing autoimmune reaction

Underlying genetic disposition may also be a type 1 diabetes cause.

Type 2

Type 2 diabetes causes are usually multifactorial – more than one diabetes cause is involved. Often, the most overwhelming factor is a family history of type 2 diabetes. This is the most likely type 2 diabetes cause. There are a variety of risk factors for type 2 diabetes, any or all of which increase the chances of developing the condition. These include:

  • Obesity
  • Living a sedentary lifestyle
  • Increasing age
  • Bad diet

Other type 2 diabetes causes such as pregnancy or illness can be type 2 diabetes risk factors.

Gestational Diabetes

The causes of diabetes in pregnancy also known as gestational diabetes remain unknown. However, there are a number of risk factors that increase the chances of developing this condition –

  • Family history of gestational diabetes
  • Overweight or obese
  • Suffer from polycystic ovary syndrome
  • Have had a large baby weighing over 9lb

Causes of gestational diabetes may also be related to ethnicity – some ethnic groups have a higher risk of gestational diabetes.

Other Causes

  • Pancreatitis or pancreatectomy as a cause of diabetes. Pancreatitis is known to increase the risk of developing diabetes, as is a pancreatectomy.
  • Polycystic Ovary Syndrome (PCOS). One of the root causes of PCOS is obesity-linked insulin resistance, which may also increase the risk of pre-diabetes and type 2 diabetes.
  • Cushing’s syndrome. This syndrome increases production of the cortisol hormone, which serves to increased blood glucose levels. An over-abundance of cortisol can cause diabetes.
  • Patients with glucagonoma may experience diabetes because of a lack of equilibrium between levels of insulin production and glucagon production.
  • Steroid induced diabetes (steroid diabetes) is a rare form of diabetes that occurs due to prolonged use of glucocorticoid therapy.

Medications and Chemical Toxins – Some medications, such as nicotinic acid and certain types of diuretics, anti-seizure drugs, psychiatric drugs, and drugs to treat human immunodeficiency virus (HIV), can impair beta cells or disrupt insulin action. These drugs can increase the risk of pancreatitis, beta cell damage, and diabetes. Also, glucocorticoids—steroid hormones that are chemically similar to naturally produced cortisol—may impair insulin action. Glucocorticoids are used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis.

Many chemical toxins can damage or destroy beta cells in animals, but only a few have been linked to diabetes in humans. For example, dioxin—a contaminant of the herbicide Agent Orange, used during the Vietnam War—may be linked to the development of type 2 diabetes.

Symptoms

Diabetes often goes undiagnosed because many of its symptoms seem harmless or don’t always appear right away. Recent studies show that early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Symptoms of diabetes include:

  • Increased thirst
  • Increased hunger
  • Having to urinate more often – especially at night
  • Feeling very tired
  • Weight loss
  • Blurry vision
  • Sores that do not heal
  • Tingling/numbness in the hands and feet

People who are concerned that they might have diabetes should talk to their doctor or health care provider to find out how to get tested for diabetes.

If blood sugar is consistently high, over time it can affect the heart, eyes, kidneys, nerves, and other parts of the body. These problems are called complications. Sometimes people with diabetes don’t realize that they have the disease until they begin to have other health problems. For example, a doctor or health care provider may detect signs of diabetes damage even though the patient does not know that he/she has the disease.

Other Complications

  • Heart Disease – People with diabetes have a higher risk for heart attack and stroke.
  • Eye Complications – People with diabetes have a higher risk of blindness and other vision problems.
  • Kidney Disease – Diabetes can damage the kidneys and may lead to kidney failure.
  • Nerve Damage (neuropathy) – Diabetes can cause damage to the nerves that run through the body.
  • Foot Problems – Nerve damage, infections of the feet, and problems with blood flow to the feet can be caused by diabetes.
  • Skin Complications – Diabetes can cause skin problems, such as infections, sores, and itching. Skin problems are sometimes a first sign that someone has diabetes.
  • Dental Disease – Diabetes can lead to problems with teeth and gums, called gingivitis and periodontitis.
  • Erectile dysfunction– Male impotence.
  • HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome)– Blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.

Treatment

Insulin Shots

  • Insulin shot – The patients use a needle attached to a syringe—a hollow tube with a plunger—that is filled with a dose of insulin. Some people use an insulin pen, a penlike device with a needle and a cartridge of insulin. Never share insulin needles or insulin pens, even with family.
  • Insulin pump – An insulin pump is a small device filled with insulin that you wear on your belt or keep in your pocket. The pump connects to a small, plastic tube and a small needle.
  • Insulin jet injector – This device sends a fine spray of insulin through the skin with high-pressure air instead of a needle.
  • Insulin injection port – The patient or the doctor inserts a small tube just beneath your skin, where it remains in place for several days.

Medications

  • Metformin is usually the first treatment offered, however, and it is the most widely used oral antihyperglycemic. Metformin is a sensitizer in the class known as biguanides; it works by reducing the amount of glucose released by the liver into the bloodstream and increasing cellular response to insulin.
  • Sulphonylureas are secretagogues that increase pancreatic insulin secretion. There are several drug names in this class, including – Chlorpropamide, Glimepiride, Glipizide, Glyburide.
  • Glitazones (also known as thiazolidinediones) are sensitizers – they increase the effect of insulin in the muscle and fat and reduce glucose production by the liver.
  • Alpha-glucosidase inhibitors are intestinal enzyme inhibitors that block the breakdown of carbohydrates into glucose, reducing the amount absorbed in the gut.
  • Dipeptidyl peptidase-4 (DPP4) inhibitors include alogliptin, linagliptin, saxagliptin and sitagliptin. Also known as gliptins, DPP4 inhibitors have a number of effects, including stimulating pancreatic insulin (by preventing the breakdown of the hormone GLP-1). They may also help with weight loss through an effect on appetite.
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors include canagliflozin and dapagliflozin. They work by inhibiting the reabsorption of glucose in the kidneys, causing glucose to be excreted in the urine (glycosuria).
  • Meglitinides include repaglinide and nateglinide. They stimulate the release of insulin by the pancreas. Meglitinides are associated with a higher chance of hypoglycemia and must be taken with meals three times a day.

The side effects of above drugs include – flatulence, diarrhea and bloating, urinary infection, nausea and vomiting, weight gain or swelling etc.

Alternative Treatment

Alpha-lipoic acid (ALA) – ALA is a chemical compound that is found in food (especially high in spinach, broccoli, and tomatoes), produced endogenously, and sold as a nutritional supplement. As an antioxidant, ALA may mitigate high levels of oxidative stress, which in patients with diabetes contributes to insulin resistance and secondary complications such as diabetic neuropathy.

Chromium – As an essential mineral, chromium plays an important role in facilitating glucose metabolism.

Coenzyme Q10 – Coenzyme Q10 is a cofactor used in oxidative respiration and is produced endogenously. Supplementation of coenzyme Q10 is especially popular for cardiovascular diseases.

Magnesium – Magnesium is an abundant mineral in the human body involved in numerous biochemical processes, including glucose metabolism.

Omega-3 fatty acid – Omega-3 polyunsaturated fatty acids (PUFAs) are one of the most common dietary supplements taken in the United States.3 Major sources of omega-3 PUFAs include fish, marine-derived supplements, and prescription formulations. Based on multiple studies, high omega-3 PUFA intake does not prevent the onset of type 2 diabetes.

Vanadium – Vanadium is a mineral with no known biological importance or deficiency-associated disease. Although three controlled studies of vanadium for type 2 diabetes reported significant decreases in fasting blood glucose levels, small sample sizes and lack of randomization limit these results.

Ginseng –  The panex genus contains multiple species described as ginseng, with two varieties most frequently used and studied: panex ginseng (Asian ginseng, Chinese ginseng, Korean ginseng) and panex quinquefolius (American ginseng). The root of this herb traditionally has been used in Asia and is one of the most popular botanicals in the United States.

Botanical products and Herbs like Allium sativum (garlic), Aloe vera, Coccinia indica (ivy gourd), Gymnema sylvestre (gymnema), Momordica charantia (bitter melon), Opuntia streptacantha (prickly pear cactus, nopal), Trigonella foenum graecum (fenugreek) are very essential for Diabetes.

 

Reference

http://www.medicalnewstoday.com/info/diabetes/

https://www.nlm.nih.gov/medlineplus/diabetes.html

http://www.webmd.com/diabetes/

http://www.diabetes.org/diabetes-basics/type-2/?referrer=https://www.google.co.in/

http://www.diabetes.org/diabetes-basics/type-2/

http://www.who.int/nmh/publications/fact_sheet_diabetes_en.pdf

http://www.diabeteswellness.net/Portals/0/files/DRWFUSdiabetes.pdf

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

https://www.idf.org/sites/default/files/IDF-Guideline-for-Type-2-Diabetes.pdf

http://www.sign.ac.uk/pdf/sign116.pdf

https://www.health.ny.gov/diseases/conditions/diabetes/what_are_the_symptoms.htm

http://www.mayoclinic.org/diseases-conditions/diabetes/basics/symptoms/con-20033091