Category: Health

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Health

What causes hypothyroidism?

What causes hypothyroidism? Why is hypothyroidism more common in women than men? Several hours of research into these questions did not yield all the answers I was looking for, but here is some interesting information I found about possible causes for this all too common condition.

  • Autoimmune disease, where the body’s immune system mistakenly attacks the thyroid gland, is cited as the most common cause of hypothyroidism, a decreased production of the essential thyroid hormone. Hashimoto’s Thyroiditis, the most common type of autoimmune thyroiditis, was discussed in an earlier blog. Click here to read this article.

  • Surgery, removing part or all of the thyroid, (for example, to remove thyroid nodules or cancer), can leave the thyroid with reduced ability to produce hormone, depending on the amount of gland removed.

  • Radiation of the head, neck or upper chest to treat cancer or overactive thyroid can cause loss of part or all thyroid function.

  • Thyroiditis, inflammation of the thyroid gland, is usually caused by an autoimmune attack or viral infection. The inflamed thyroid can release stored thyroid hormone initially, causing temporary hyperthyroidism, followed by reduced function and hypothyroidism.

  • Medications, for example, lithium (to treat bipolar illness), amiodarone (for heart arrhythmias), interferon alpha and interleukin-2, can prevent the thyroid gland from being able to make hormone normally. Medications are more likely to trigger hypothyroidism in those with a genetic tendency.

  • Iodine deficiency or excess – The thyroid needs iodine to make thyroid hormone, but too much can worsen hypothyroidism. The recommended daily intake is 150 mcg in adults but amounts greater than this are generally well tolerated. Authorities recommend a maximum of 1,100 mcg daily but there is controversy around this, with amounts as high as 40 mg daily being used to treat iodine deficiency in some countries.

    • Iodine is contained in various foods, such as seafood, eggs, dairy products, sea weed/sea vegetables (kelp and dulse, for example), and it is added to regular table salt. The amount of iodine in vegetables will vary, depending on how much iodine was in the soil they where they were grown.

    • Because low iodine can be a cause of severe mental retardation, as well as thyroid dysfunction, the mineral is added to table salt. However, for those with salt restricted diets, of course I this is no longer a source.

  • Genetic factors may play a role; if close family members have developed hypothyroidism, you are likely at greater risk of developing it also.

  • Pregnancy – The increase in risk is thought to be due to increased antibody production during pregnancy. Often, thyroid problems during pregnancy resolve after the birth, but the mother remains at increased of developing hypothyroidism again later in life. Note that low thyroid during pregnancy can increase the risk of miscarriage and birth defects.

Some, more controversial causes have been suggested, as researchers look for explanations for increases in occurrence of thyroid diseases:

  • Increased exposure to chlorine and fluorine (fluoride)

    • Chlorine, fluorine and iodine are in the same family of elements, and are prone to react in a similar manner. Some have suggested that ingesting chlorinated/fluorinated water might prevent iodine absorption or proper function. Sounds like the idea might hold water, but I didn’t find any studies to support this theory. I expect other factors would also need to be present to see this effect.

  • Stress may exacerbate an underlying thyroid condition (EndocrineWeb.com; Pharmacy conference)

    • Stress causes an increase in release of the stress hormone, cortisol.

      • Cortisol interferes with thyroid hormone production.

    • Production of reverse-T3 thyroid (which is inactive) rather than active T3 as a genetic response to stress is theorized to occur in dependants of populations who survived famine. This mechanism would have enabled increased chance of famine survival by slowing the metabolism and reducing need for food.

      • Today’s stresses rarely involve a lack of food, but those with this genetic trait are thought to react to modern stress as their ancestors did to the stress of famine.

    • When stressed, humans are considered more vulnerable to autoimmune disease (e.g. Hashimoto’s Thyroiditis)

    • Treating stress may help improve thyroid function, according to EndocrineWeb.com:

      • Mind/body techniques (relaxation, medication, yoga)

      • Exercise (helps reduce the effects of cortisol)

      • Sleep (helps cope with stress)

  • X-rays – If radiation treatment damages the thyroid, can low-level radiation used in x-rays cause damage over time?

    • Experts say, probably not: most radiation goes where intended. The rest of the body is exposed only to “scatter radiation”. One study (Mayo Clinic.org) estimated scatter radiation to the thyroid from a standard mammogram to be equivalent to 30 minutes of natural background radiation in the environment.

    • Repeated dental x-rays performed before 1970, when higher levels of radiation were emitted, increased risk for thyroid cancer later in life (risk of hypothyroidism was not mentioned). X-rays are safer now but the American Dental Association still stresses the need to shield the thyroid during dental x-ray examination.

    • Most mammogram clinics have thyroid guards but, generally, you need to ask for this protection. Mayoclinic.org states that thyroid guards can sometimes interfere with getting good images, so discuss this option with your doctor and/or x-ray technician.

So, what are the risk factors for developing hypothyroidism?

  • Being a woman and over age 60

    • One site suggested that women’s endocrine systems were “more sensitive”. This was the best explanation I found for why women developed hypothyroidism more often than men (doesn’t really explain much!)

  • Any autoimmune disease (for example, rheumatoid arthritis, inflammatory bowel disease)

  • Having a family history of thyroid problems

  • Treatment with radioactive iodine or anti-thyroid medications (for overactive thyroid)

  • Radiation treatment to the head, neck or upper chest

  • Thyroid surgery with partial or complete thyroid removal (amount of function will depend on how much gland was removed)

  • Pregnancy or birth within the past 6 months

How do you know if your thyroid is under performing? Here are some symptoms of hypothyroidism:

  • Fatigue

  • Dry skin

  • Constipation

  • Weight gain

  • Decreased body temperature

  • Intolerance to cold

If you have these symptoms, talk to your doctor. S/he will likely order a blood test to check your thyroid function:

  • Thyroid hormone (levothyroxine or T4) – will be below normal

  • Thyroid Stimulating Hormone (TSH) – will be elevated

    • This is the hormone that tells your thyroid to make more hormone so it increases when thyroid is low, trying to stimulate the gland to make more.

    • If too much thyroid, TSH production will be low. Tests for TSH are also used to check whether you are taking the correct dose of thyroid replacement.

    • “Normal” TSH values vary in different countries:

      • USA – 0.3 to 3.0

      • Canada – 0.5 to 4.5 or 5

      • Some authorities suggest we feel best when TSH is around 1 but in many areas anything in the “normal” range is considered fine.

      • Since excess thyroid hormone can create risk for heart disease and osteoporosis, some doctors intentionally undertreat hypothyroidism slightly.

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Health

Skin tags

Skin tags are very common small, soft, skin growths that usually occur in a fold of skin. They are harmless but some people find them unsightly and annoying. These growths are most commonly found on the neck, underarms, groin, eyelids, or under breasts – any area where skin rubs against itself or clothing.

They are thought to be caused by friction, and are more common in obese and middle age or older adults. However even babies can develop them… Up to 60% of people will develop skin tags at some point in their lives.

Skin tags can be the same color as skin or slightly darker. They are usually 2 to 5 millimeters in diameter (roughly the size of an apple seed) but are occasionally as large as 1 cm (0.5 inch) or even 5 cm (2 inches). They are generally attached to underlying skin by a small band of tissue called a stalk or “peduncle” that is narrower than the body of the tag.

Skin tags do not actually require any treatment, unless irritation is occurring. Removal will not cause more to grow. They do not become cancerous if left untreated.

Treatment

Treatment is by removal. Keep in mind most skin tags do not need to be treated. Most doctors only recommend removal if they become irritated from rubbing or catching in clothing, jewelry or seat belts but most removals are for cosmetic reasons.

Skin tags can be removed by freezing, burning, or cutting them off. Currently, no creams are approved as treatment, and using products designed for other uses may cause irritation of the area and possibly secondary complications, such as infection.

Your doctor will usually numb the area (by injection or by applying an anesthetic cream), especially if the skin tag is large, then cut the stalk with sterilized scissors.

Alternatively, the stalk will be tied with thread or dental floss to block blood circulation to the tag, causing it to drop off after a few days.

Your doctor may choose to burn the tag using medical electrical cautery, which passes electrical current through it with a special device.

Skin tags can also be removed by freezing with liquid nitrogen. This can be done by your doctor or kits are sold at pharmacies to do yourself this at home. Usually this skin tag will drop off 7 to 10 days after treatment.

These procedures can be performed by a family doctor or dermatologist. You may need to see an eye specialist for removal of tags near the eye. Skin tags may drop off spontaneously if they become twisted, blocking off blood supply.

Occasionally, your doctor will have the removed tissue examined to confirm the diagnosis, especially if the tag has bled, grown noticeably, or is multicolored… symptoms that could suggest presence of skin cancer. However, it is generally rare for a skin cancer to resemble a skin tag.

Risk factors

  • Obesity – more skin folds creating increased friction

  • Pregnancy or hormone imbalance – higher levels of estrogen and progesterone

  • Infection with HPV-6 (a strain of human papilloma virus)

  • Individuals with diabetes (if increased insulin levels due to insulin resistance)

    • Note that people who are overweight also may have higher insulin levels due to insulin resistance

  • Possible association with high cholesterol, high blood pressure, and elevated CRP (C-Reactive Protein, a marker of inflammation)

  • Possible genetic factor – people with close family members may be more likely to develop skin tags

Prevention

Based on the understanding that skin tags are likely caused by friction, preventing clothing from continually rubbing on the same area of skin or reducing rubbing of surfaces in skin folds (for example, by using powder) may possibly reduce the formation of these small harmless tumors. Treating underlying modifiable risk factors theoretically could also be helpful. However, I could not find evidence of any studies that had examined the effectiveness of these strategies.

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Health

Fungi are not “Fun guys”!

A reader asked if I could also talk about fungal infections of the skin… Like fungal nail infections, these are also very common, quite unpleasant and sometimes misdiagnosed…

Fungal skin infections, also called “tinea corporis”, include infections such as Athlete’s Foot, Jock Itch, and Ringworm (caused by fungus, not worms!). The scalp can also become infected with fungus and this is a common cause of itchy dandruff.

Fungal skin infections often grow as a red circular rash that is brighter red and slightly raised at the borders as the fungus grows into healthy skin. The rash is usually itchy but not painful, and can spread into new skin as round red “dots”. Sometimes the red border is not visible, leaving only itchiness and rough skin, making diagnosis more difficult.

Along with their related personal history (How long have you had the rash? How did it start? etc.), I often consider the characteristics of 3 basic types of infectious skin rashes when helping a client decide what non-prescription treatment to try. These are the criteria I use to base my treatment recommendations:

  • Bacteria – usually painful, red, and form pus and scabs as the infection advances.

  • Virus – less common (cold sores are an example), painful, usually see water-filled “bubbles” or vesicles on the surface of the skin in the early stages.

  • Fungus – itchy, not usually painful, often a circular rash, tends to spread in “dots”

All of these infections are contagious. They can be spread through direct skin contact with an infected person or animal, or via objects recently touched by an infected person or animal. Fungal infections are fairly common in dogs, cats and cows (if you have one of those!). Occasionally an infection can develop from prolonged contact with contaminated soil.

Skin fungal infections

Skin fungus often starts with a flat scaly area that is red and itchy, spreading outward forming a raised red “ring” that is roughly circular. The infection is more active as it moves into uninfected skin, creating the raised red border that is characteristic of this type of infection. The center may look clear, scaly or have scattered red bumps.

The infection affects only the outer layer of skin in most cases. Rarely it will invade lower skin layers, but usually only in people with a compromised immune system.

Risk factors

  • Living in a warm climate and wearing tight clothing or shoes that don’t breathe (trapping moisture). Fungi like to grow in warm moist environments.

  • A weakened immune system

  • Close contact with an infected person or animal, or sharing clothing, bedding, towels, etc.

  • Skin-to-skin sports (e.g. wrestling). If sports equipment becomes contaminated and is packed away while still damp (e.g. hockey gear), it can become a source of fungal skin infection.

Diagnosis

If the outer “ring” is not visible, it is easier to misdiagnose a fungal skin infection. Examining skin scrapings with a microscope can confirm the diagnosis of a skin infection, but often a “trial and error” approach is used – if the rash hasn’t improved after using an antibacterial cream or corticosteroid cream (helpful for rashes caused by irritation or eczema), then it is logical to try an antifungal cream, especially if itching is present.

Some doctors will take a “multi” approach if unsure of the infection type, prescribing a cream containing an antifungal, antibacterial and a corticosteroid to cover several causes at once.

Treatment

  • Treating an infection early gives a better chance of success with creams. If a large area is involved or the person has a weakened immune system, they may need to take an antifungal medication by mouth. However, as you will recall from last week’s blog, these have significant side effects.

  • Apply the cream to the rash area and into the uninfected skin in the surrounding area also to prevent spread. Follow any instructions on the label. Continue to use the cream for 2 weeks, or for several days after the visible rash is gone to ensure all the fungus is destroyed. If the rash has not cleared in 2 weeks, see your doctor. Be sure to tell him/her what treatment you have used.

  • Keep the area as dry as possible – fungus likes a moist environment. If the infection is on your foot, treat your shoes with an antifungal spray and let dry well between uses to prevent reinfection.

  • Change towels/wash cloths used on the infected area often to prevent reinfection.

  • If the infection is very itchy, you can alternate antifungal cream with a corticosteroid cream (such as hydrocortisone 0.5 to 1%) to reduce itchiness. Scratching can worsen or spread the infection. Depending on the rules in your state or province, you may be able to ask your pharmacists to make a cream with both ingredients (adding hydrocortisone powder to an antifungal cream) for convenience.

  • Ask your vet to check your pet for infection and treat if present.

  • Don’t share personal items if you have an infection to avoid infecting others.

  • If you have a chronically itchy scalp with dandruff, try an antifungal shampoo. If severe or long-standing, I would suggest a higher strength antifungal shampoo, such as Selsun Regular (stronger than Selsun Blue) or Nizoral shampoo. Your pharmacist can also make cetrimide 1% with hydrocortisone 0.5% in water for you. This is used by applying drops to wet hair after shampooing, rubbing into the scalp (it will foam), and leaving in. This has the advantage of longer treatment contact than a shampoo could provide, and is not visible on the hair once it dries. Again, keep in mind that some states (strangely) do not allow compounding without a prescription.

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FUNGAL NAIL INFECTIONS

Fungal nail infections can be embarassing, and very difficult to treat. Even the best treatments don’t always work and some have nasty side effects. This encourages sufferers to look for alternatives, but some offerings are overpriced and questionably effective!

Any treatment is more effective when the infection is less severe. Since nail infections are not painful, however, sometimes they are ignored until they become well established and disfiguring. Once an infection becomes extensive, involving the full nail bed, it is more difficult to treat, so best to treat at the first sign of an infection.

The appearance of a fungal nail infection can vary from pitting or flaky white patches in the surface of the nail, to yellow or white streaks in the nail bed, and even to complete nail destruction. Scaling and debris can collect under the nail, causing it to lift and separate from the nail bed. Infections can be caused by several different fungal, yeast or mould agents, but the most common is a fungal dermatophyte infection. Check with your doctor for a proper diagnosis. Clippings of the nail may be taken to confirm the type of infection.

Here are some of the available treatments you may consider…

  • Anti-fungal tablets and capsules (Lamisil, Sporanox) – Prescription only.

    • These are the most effective type of treatment. They need to be taken until the nail completely grows out – usually 6 weeks for fingernails and 12 weeks for toenails, which grow more slowly.

    • Side effects, however, can be serious: liver damage, severe rashes, and effects on blood cell production and pancreas, as well as less serious effects like headache, diarrhea, nausea/vomiting, sun sensitivity and taste or vision changes. Some doctors hesitate to prescribe these medications for what is sometimes considered a cosmetic problem, and many people can’t tolerate the side effects.

  • Anti-fungal creams and solutions – Prescription and non-prescription

    • These work well for fungal skin infections, like Athlete’s Foot, but can’t penetrate the nail. This means they may help for a surface nail infection at an early stage or to prevent an infection between the toes from spreading to the nail, but they can’t treat an infection that is growing under the nail.

    • Creams can be helpful to reduce the chance of reinfection.

  • Nail paints and polishes – Prescription and non-prescription

    • There are two basic types: antifungal and acid containing (acidity inhibits fungus growth). A few products contain both types of ingredients.

    • Some also contain penetration-enhancing ingredients, such as menthol, DMSO, propylene glycol or others to increase penetration into the nail.

    • Strangely, pricing seems to have no relationship to the cost of the ingredients, with prices from under $10 up to $90 for prescription lacquers.

    • Success with this types of product requires perseverance and consistency. Use precisely as directed every day until the infected nail has completely grown out. It will take months of treatment for success.

  • Laser therapy – Does not require a prescription

    • Lasers are thought to kill fungi by producing heat. One to 3 treatments are recommended. Success has been reported in small numbers of patients, but no large studies have yet been completed.

    • Each laser treatment can cost upwards of $1000 and, given this cost plus lack of solid proof of effectiveness, this treatment is not highly recommended. However, I did see a small unit on Amazon for under $300 (still expensive!) that might be worth investigating if you wanted to try this therapy.

  • Surgery and non-surgical nail removal

    • Surgically removing the nail, to allow anti-fungal creams to reach the infected nail bed, is a more extreme treatment. However, it is sometimes considered in more severe infections that have not responded to less invasive treatment.

    • An infected nail can also be removed non-surgically by applying 30-40% Urea cream (commercially available or prepared by a pharmacist). This preparation softens the nail over multiple applications, gradually destroying the integrity of the nail and allowing anti-fungal agents to penetrate. Sometimes the nail falls completely out, and antifungal cream should be applied while the new nail grows in.

  • Home remedies – Non-prescription

    • Tea tree oil

      • Antifungal and antibacterial actions.

    • Menthol/eucalyptus (Vicks Vaporub or can be compounded)

      • These have antifungal activity, plus menthol enhances penetration.

    • Vinegar (acetic acid) 25% (1 part vinegar mixed with 3 parts water)

      • An idea to incorporate all 3 of these approaches: Vicks Vaporub (or generic) with perhaps 10% tea tree oil plus a vinegar soak before application.

      • Your neighbourhood pharmacist could likely prepare something along these lines for you…he may even be able to add 1% clotrimazole antifungal powder too!

  • Prevention – Prevent reinfection or avoid getting it in the first place!

    • Keep feet dry. Fungus grows more easily in a moist environment.

    • Wear socks – look for ones with a moisture-wicking fiber. Change when damp.

    • Wear open shoes whenever possible.

    • Wear shower sandals at public pools or showers. Let dry between uses.

    • Don’t share shoes, socks, nail clippers or files. Clean clippers and files regularly with alcohol.

    • Avoid nail injury, for example, clipping nails too short.

    • Ensure any nail salon you use sterilizes all instruments.

    • If you have diabetes, you could be more susceptible due to poorer circulation. Learn proper daily foot care for people with diabetes.

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Health

Can’t Sleep?

Ideal sleep for an average adult means falling asleep within 30 minutes, not waking more than once, and taking less than 20 minutes to return to sleep when you do wake at night. Is your sleep less than ideal? Read on!

Here are some tips to help get the rest you need!

  1. Turn off electronics. Phones, tablets and computers bleep and flash and these noises can disturb your sleep. Don’t charge your electronics in your bedroom!

  2. Daytime naps? While short naps can recharge and improve productivity, longer ones can leave you groggy and make it more difficult to get a good night’s sleep. Limit daytime naps to 20 mins or less.

  3. Watching the clock? Some find they check the time frequently when they wake at night, getting upset about being unable to get back to sleep quickly. For some, turning the clock away from view or putting it in a drawer can mean a better night’s sleep.

  4. Get comfy… A relaxing bath with Epsom salts can relieve muscle and joint pain and set you up for a good rest. If your bed is not comfortable, consider a new mattress or memory foam topper. Your pillow needs to be the right depth to support the natural curve of your neck and a second pillow for between or under knees may make you more comfortable, especially if issues with back pain. A dark, relatively cool room also helps sleep.

  5. Allergies? If you get stuffy at night, you may be allergic to dust mites, one of the most common allergies. These are microscopic creatures that live off dead skin cells in our mattresses. Dust mite proof or plastic mattress covers that are wiped down or vacuumed regularly plus washing bedding (including pillows) in hot water reduces mite counts and can eliminate or greatly reduce this problem.

  6. Stick to sleep and sex… Working, watching TV or surfing the internet in bed trains your brain to be alert in the bedroom. Keep your sleep environment relaxing by saving it for only sleep and sex.

  7. Wake/sleep cycle… Establish routine bed and wake times. This can help people of any age fall asleep more quickly and sleep more soundly. Lowering lights in the evening also helps set up for sleep and bright light for 5 to 30 minutes when you wake up helps get you going in the morning too.

  8. Avoid caffeine. Some people who don’t metabolize caffeine well may find that any caffeine results in a poor night’s sleep. For most, avoiding caffeine after noontime is usually sufficient. Watch for hidden caffeine in chocolate and some “herbal” teas, pain relievers and weight loss pills.

  9. Exercise can help or hinder. Regular exercise can improve sleep, but some experience a post-workout increase in energy that could keep you awake. Try scheduling exercise to finish 3 to 4 hours before bedtime. Relaxing exercise, like yoga or tai chi, however, can help sleep when done just before bed.

  10. Alcohol. Alcohol can make you drowsy but, when the effect wears off, you may find yourself waking up more often. Mid-life women may actually experience increased hormone swings several hours after consuming alcohol. Try non-caffeine herbal tea instead if you notice this connection.

  11. Getting up to pee? Try avoiding liquids for 2 hours before bed.

  12. Noises at night? Use earplugs or try a white noise machine or fan to drown out traffic, a dripping faucet, hubby’s snoring or the neighbour’s barking dog.

  13. Still smoking? Nicotine is a stimulant that can make insomnia worse…yet another good reason to quit!

  14. And doggie makes three… You love your pet but he can be the cause of nighttime wakening as well as allergies. Ask your vet or pet school how to train your pet to sleep in his own bed. Same goes for toddlers – but talk to a sleep specialist or your doctor instead of the vet…

  15. Consider meditation. Meditation trains you to put active thoughts out of your mind. Clearing your thoughts for even 10 mins before bed can help you fall asleep. Avoiding work or complex discussions for 2 to 3 hours before you retire is also advised for best sleep.

  16. Careful with sleeping pills. Many prescription sleeping medications are habit forming and only recommended for up to 7 days of continuous use. Rebound insomnia can occur with guaranteed poor sleep for up to several weeks on discontinuation. Some also have side effects such as memory impairment and use in elderly is associated with falls that can cause bone fractures.

  17. Non-prescription supplements?

    1. A magnesium supplement taken at bedtime relaxes muscles and can help sleep. Magnesium is important for bone health too, so you may benefit from it in more than one way…

    2. Chamomile tea or valerian in pill or tea form can help sleep and are non-addicting. Valerian smells somewhat like “dirty socks”, though, so I’d suggest the pill form!

    3. Vitamin B5 (pantothenic acid) can help reduce production of the stress hormone, cortisol, that is sometimes inappropriately produced at night in stressed people, causing them to wake at night feeling “tired but wired”. B5 is a common ingredient in vitamin B-based stress formulas available without prescription.

    4. Antihistamines, like Gravol (dimenhydrinate) or Benadryl (diphenhydramine, also used in several non-prescription sleep aids), are not recommended for nightly use. Both have been reported to be habit forming and tolerance develops to the drowsy effect within a few days, leading some to increase the dose inappropriately. Withdrawal effects can be noted with the drug is stopped.

  18. Look for a possible cause. Ask your doctor if a health condition like acid reflux, arthritis, asthma, depression or hormone imbalance could be causing the problem. Get your pharmacist to check if a medication you are taking could be contributing to insomnia. Try keeping a sleep diary to determine what factors might be interfering with your sleep. Ask about the possibility of treatment at a sleep clinic.

Lastly, until you find the solution to your problem, avoid tossing and turning in bed. Get up and do something calming, like reading for 10 or 15 minutes. Chances are you’ll fall asleep more easily when you return to bed!

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Health

Gut Bacteria Have Many Roles

The Mayo Clinic reported on some interesting research this week. A study conducted in mice has shown a link between the presence of a particular bacteria in the gut, called Collinsella, and increased risk of developing rheumatoid arthritis. This bacteria is not usually found in the intestines but was found in significant numbers in people with rheumatoid arthritis, inspiring researchers to run a test in mice.

Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system mistakenly attacks itself, causing damage to joints with swelling and pain. It can also cause damage to other parts of the body, including the skin, eyes, heart, lung and blood vessels. To date, no cause or cures have been identified, and treatments focus on relieving pain and swelling, and slowing the progression of the disease.

Researchers treated the mice by introducing a specific good bacterial flora to compete with the unwanted bacteria. This resulted in decreased symptoms and fewer inflammatory indicators associated with rheumatoid arthritis in the treated mice.

Since mice’s immune systems and arthritis processes are similar to those in humans, this suggests that a similar treatment could give people relief from this difficult to treat disease. Further, it suggest that examining intestinal bacteria may provide a way to detect who is at risk of developing arthritis and even the possibility of preventing it from occurring. It is expected that, like the mice, humans will be unlikely to experience side effects from this treatment.

The Mayo Clinic is also researching other autoimmune and infection problems that might possibly be related to improper bacteria in our digestive systems. These include conditions such as:

  • Gluten sensitivity

  • Irritable bowel syndrome

  • C. Difficile gut infection

  • Colon cancer

  • Bacterial vaginosis and reproductive health problems

While it will be interesting to see results of human trials using treatment of RA with good bacteria, there is no reason not to try this therapy on yourself if you are suffering with one of these diseases. Discuss this possibility with your physician! There are many good quality probiotics available without prescription that might give similar results to the product used in the mice experiment in arthritis.

This ties in closely with my earlier book review blog post, Bacteria for Breakfast, http://jeanniebeaudin.wixsite.com/author/single-post/2016/07/22/Bacteria-for-Breakfast-Probiotics-for-Good-Health-%E2%80%93-A-book-review that discusses how gut bacteria can influence the function of the immune system. Click here if you missed it!

Reference: Mayo Clinic Microbiome Program and https://www.ScienceDaily.com/releases/2016/07/160711151315.htm

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Infrared sauna..health effects?

This question from a reader prompted me to investigate use of infrared as a treatment for inflammation, pain and autoimmune diseases.

Here’s what I found…

Mayo Clinic describes infrared saunas as being similar in function to heat saunas: regular heat saunas warm the body by producing heat in the air around the body; infrared saunas produce warmth directly, generating heat in the tissues (similar to the way longer wavelength microwaves heat food). They report these treatments are considered safe, with no reports of adverse effects.

While we are all familiar with light emitting diodes (or LEDs) in our TVs and lightbulbs, infrared-LEDs (or IR-LEDs) emit light in a specific wavelength that is longer than visible red light – somewhere in the range of 800-1000 nanometers (nm). Infrared rays are invisible to humans but sometimes appear red due to a small amount of red or orange wavelength light being also emitted.

Infrared light waves can penetrate the skin up to 3 – 4 cm, depending on the wavelength and power intensity of the LED. While the IR-LED does not feel warm on the skin (or only slightly warm), it generates heat in and below the surface of the skin. Users will usually describe sweating during use.

In addition to generating heat, studies have found that IR-LEDs reduce “mediators of inflammation”, substances that the body produces to create and sustain the inflammatory process. Infrared LEDs also dilate blood vessels. They are used in medicine to reduce edema (swelling caused by increased fluid in the tissues), reduce production and movement of inflammatory substances, and to accelerate skin and connective tissue healing.

Studies have demonstrated increased healing rates of 25-35% post-surgery and similar rates of improvement in soft tissue injury, such as sprains. IR-LEDs have also been shown to decrease pain and increase range of movement in injuries with no bone involvement, such as tennis elbow.

Many diseases of aging, for example rheumatoid arthritis, involve production of inflammatory substances that have been shown to be reduced by IR-LED irradiation, suggesting a potential use in these diseases. Animal studies suggest IR-LED may also improve healing of nerve lesions but, as of the publication of the articles I found, additional study was still needed.

Infrared-LEDs are available as small portable units as well as complete saunas. The technology is considered very safe to use, with the exception of early pregnancy when no saunas of any type are recommended (increased body temperature can be harmful to the baby). I would expect heat therapy would be safe for small area treatment, such as a joint, with a hand-held unit but best, as always, to check with your doctor first.

Regarding IR-LED use in autoimmune diseases, the focus of the question I received, there didn’t seem to be as much research available. Infrared-LED seems to be primarily recommended for inflammatory diseases: cardiovascular disease, diabetes, rheumatoid arthritis, Chronic Fatigue Syndrome, chronic muscle and joint pain, poor digestion and anger/depression (although no mechanism was given for these last two actions). Infrared saunas are recommended for those with increased blood pressure who wish to use a sauna. They cause a temporary reduction in pressure due to dilation of blood vessels, as compared to heat saunas that raise blood pressure when used.

Only one reference I found (blog by physician Amy Myers) referred to autoimmune action. She described many of the benefits of infrared LED as being produced by vasodilation and increased blood circulation to the area. She also described differences in various wavelengths of infrared radiation:

  • Near-infrared (shorter wavelength) – best for wound healing and improving immune function

  • Middle-infrared – ideal for increasing circulation and promoting muscle relaxation

  • Far-infrared (longer wavelength) – mainly for detoxification

I would expect that one would need to use a sauna-style of near infrared LED to expose the entire body to achieve immune effects. A hand-held unit could be used when only a small area needs to be treated for pain or inflammation.

It is recommended to use IR-LED for 5 to 30 minutes, with one source recommending no longer than 20 minutes per session. Sessions can be repeated several times daily, however. The effect is considered useful for temporary relief when used for pain and inflammation.

Bottom line…

For pain and inflammation, infrared-LED can be useful but would be expected to give subtle improvements. There does not yet appear to be a lot of scientific study for its use in autoimmune disease but it is safe and not extremely expensive for those who want to try it. For relaxation or detoxification (produced by sweating), infrared saunas would function similarly to heat saunas.

Healthy Aging Review 2015

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Health

Yin and Yang

I’ve seen the symbol for Yin and Yang many times, but never understood what it represented beyond light and dark, male and female, strength and passivity. I was surprised to find a detailed explanation of Yin and Yang in body functions in a scientific article about chronic inflammation.

During the Yin phase, natural cell death, or apoptosis, is promoted. Growth of various tissues is slowed, inflammation is promoted and potential tumor growth would be blocked.

During the Yang phase healing of wounds is promoted, growth is stimulated, and anti-inflammatory mediators are produced, but there is a tendency toward tumorigenesis, or the growth of new tumors.

As with other Yin and Yang interpretations, the need for balance between the two opposing elements is important.

Acute inflammation, the type that occurs in response to injury or acute illness, is considered a “friend” that protects the body against harmful elements. However, chronic or persistent inflammation becomes a “foe” that eventually destroys tissue integrity and function. The immune system uses inflammation to stimulate its protective actions but this function needs to be self-terminating… stimulating acute Yin inflammation when necessary to kill off foreign invaders such as bacteria and reverting to the Yang anti-inflammatory growth and repair phase when the threat is gone.

The ability of our immune system to protect us from disease is affected by the amount of oxidative stress (quantity of damaging free radicals versus protective antioxidants) in our system, immunosenescence (the gradual deterioration of the immune system that occurs with age) and altered function of various hormones (the stress hormone, cortisol, as well as estrogen, progesterone, androgens, insulin, and thyroid).

Here are some simple ways to address each of these factors:

  • Oxidative stress – increase the amount of colored fruits and vegetables to ensure adequate intake of antioxidants.

    • Brightly coloured foods are known to contain these beneficial substances, and including five different colours on your plate is an easy way to increase intake of antioxidants.

  • Immunosenescence – ensure optimal bacterial flora in the digestive system.

    • Substances that control the amount and type of inflammation in the body are largely produced in the gut, and are controlled by the type of bacteria that resides there. Eating more fermented food, such as yogurt and sauerkraut, or taking a probiotic supplement, introduces good bacteria to the digestive system, and is especially important after taking antibiotics.

  • Altered hormone function – reduce stress, and change response to stress.

    • Stress hormones, Including cortisol, are an important anti-inflammatory factor. However, cortisol also increases blood sugar levels. While this function is important for the “fight or flight” response, with chronic stress cortisol tends to cause unhealthy weight gain around the waist. Increased levels of cortisol can also interfere with the function of reproductive hormones that are similar in structure (estrogen, progesterone and androgens) giving the effect of a lack of hormone even if levels are normal.

    • While it maybe difficult to avoid stress, you can change your response to stress. Simply pausing to do a few deep breaths, and thinking positive thoughts can induce a relaxation response, and reduce chronic production of cortisol.

    • Work to keep a positive outlook – look for the good side of every situation!

Even low-level ongoing inflammation has been associated with many chronic diseases, such as heart disease, arthritis, and dementias. Working to keep your Yin and Yang balanced, and your immune system functioning properly, may be the ideal approach to preventing chronic disease.

Reference: Inflammation, Chronic Diseases and Cancer-Cell and Molecular Biology, Immunology and Clinical Bases, Mahin Khatami. Intechweb.org

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Health

A must-read for coffee lovers!

Many good things have been said about the benefits of drinking tea, but what about coffee? Rally ‘round, coffee lovers…here’s some good news!

An analysis of 9 studies suggested that 1 to 2 cups of coffee daily was associated with a decrease in the occurrence of Alzheimer’s disease, dementia and cognitive decline or impairment. They stated that drinking a moderate 1 to 2 cups daily was found to be more beneficial than no coffee or more than 2 cups daily.

Coffee can help your circulation by improving the function of small blood vessels. A study, looking at blood flow in the finger, found a 30% increase in blood flow for 75 minutes after a cup of coffee compared to people drinking a cup of decaf. So a cup of hot java really does warm up cold hands and feet! The American Heart Association described this action as “perking up your blood vessels”… The study also noted, however, that caffeinated coffee also slightly raises blood pressure, so don’t have a cup just before checking your pressure, to ensure a true reading.

In people with chronic hepatitis-C liver infection, higher caffeine intake (123-308 mg per day) is linked to a 61% decreased risk for advanced hepatic failure, a possible outcome of hep-C infection. They also noted that the liver enzyme, ALT (an enzyme that is often elevated in liver disease), was lower in people who drank more caffeinated beverages. Two studies suggested increased coffee drinking is associated with decreased liver cancer. However, they did state that more research is needed.

Although previous studies have suggested an association between coffee drinking and lung cancer and favoured black tea as a better choice, a study sponsored by the Canadian Cancer Society and Canadian Institute for Health Research found there is no strong support for this link. Their study of over 2,500 people did not show any significant difference between coffee and black tea when it comes to lung cancer risk, once the numbers were adjusted to take smoking into consideration. Perhaps previous study results were due to people being more likely to have a cigarette with coffee than with tea!

Several compounds in coffee have been found to be protective against colorectal cancer. A 2016 study published in Cancer Epidemiology, Biomarkers & Prevention found that regular coffee consumption was associated with 26% lower chance of developing colorectal cancer. Additionally, the study stated that those who developed this cancer were less likely to be physically active or eat 5 or more servings of vegetables daily and were more likely to report a stronger family history of colorectal cancer.

Caffeine content is affected by the type of coffee bean, roast style, how the coffee is brewed and the cup size. An average cup of coffee is estimated to contain 95mg of caffeine but can range from less than 15mg (decaffeinated) to over 500mg for the largest sizes served at some coffee shops. See this article for more details.

References: Univadis.ca; Medscape.com

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Health

Increase in child inflammatory disease

Recent reports in the news discussed a significant increase in inflammatory bowel disease (IBD) in Canadian children…7.5% each year between 1999 and 2010. IBD most commonly begins around age 20, and in the past has almost never been seen in children less than 5 years old. But now, even babies are being diagnosed with it. So, what is happening?

IBD is a group of diseases that include Crohn’s disease and ulcerative colitis. These are lifelong diseases with no cure… medications only control and reduce the symptoms to a varying extent, depending on the individual patient’s response. Those affected experience recurring bouts of abdominal pain, cramps, diarrhea and severe fatigue.

Almost 250,000 cases have been diagnosed in Canada, and 10,000 new cases are diagnosed each year. The cause is vaguely described as likely being a combination of hereditary and environmental factors that trigger the immune system to malfunction and attack the digestive system. As well as genetics and environment, vitamin D and gut bacteria have been proposed as being involved in the cause.

Lack of vitamin D has been linked to increased inflammation and pain. In northern countries like Canada, insufficient sunshine is available to enable production of adequate vitamin D during the winter months, putting people at increased risk of deficiency.

As well, babies under 6 months are recommended to be kept out of sunlight and to be protected with sunscreens after 6 months of age. Since breast milk does not contain adequate vitamin D and without sun exposure babies are unlikely to produce adequate amounts of their own vitamin D, supplementation of 400iu per day is recommended.

During birth and early life, babies are exposed to their mothers’ bacterial flora. With antibiotic use, however, good bacteria are destroyed along with the infectious bacteria, so mothers do not always have the ideal bacteria to share with their infants.

In my previous blog reviewing the book Bacteria for Breakfast, I discussed how the type of bacteria in our digestive system can influence the function of the immune system. It seems to me that correcting the balance of bacteria in the digestive system should be part of the basic treatment for any autoimmune disease…or a strategy for prevention.

Standard treatments for inflammatory bowel disease, however, tend to ignore the environmental factors that might prevent the disease if avoided or changed…instead they focus on which elements of the immune system can be blocked by drugs to reduce the inflammatory response in the bowel. Since they don’t correct the underlying problem, these drugs are needed lifelong to control symptoms…certainly more lucrative than finding and correcting the underlying cause. Perhaps this is the reason researchers are not addressing the root of the immune malfunction.

However, you don’t need a prescription to replace vitamin D or try probiotics. Both are safe to take, even for young children, as long as recommended daily amounts of vitamin D are used. Specially formulated versions of vitamin D and probiotics are available for children and even for young babies.

With an increase in an inflammatory disease like IBD and other immune dysfunction conditions such as allergies, perhaps gut bacterial health and vitamin D status will be given greater consideration in childcare recommendations, and will become an increased focus of research for possible causes of the increase of inflammatory diseases in children.

The role of inflammation in chronic diseases is an area of current study for me and in upcoming blogs I plan to address this topic further…sign up for my mailing list if you’d like to receive notice of these postings!