Fibromyalgia

Introduction

Fibromyalgia affects an estimated 2% to 4% of the population, most of which are female.

The main sensation is one of hurting all over, feeling exhausted constantly. Even after numerous tests, your doctor can't find anything specifically wrong with you. If this sounds familiar, you may have fibromyalgia.

Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain. Fibromyalgia is more common in women than in men. Previously, fibromyalgia was known by other names such as fibrositis, chronic muscle pain syndrome, psychogenic rheumatism and tension myalgias.

While it may be reassuring to know that fibromyalgia isn't progressive or life-threatening it can and probably will be very annoying to you and your lifestyle. Treatments and self-care steps can improve fibromyalgia symptoms and your general health.

Signs and symptoms

Signs and symptoms of fibromyalgia can vary, depending on the weather, stress, physical activity or even the time of day. Common signs and symptoms include:

1. Widespread pain. Fibromyalgia is characterized by pain in specific areas of your body when pressure is applied, including the back of your head, upper back and neck, upper chest, elbows, hips and knees. The pain generally persists for months at a time and is often accompanied by stiffness.

2. Fatigue and sleep disturbances. People with fibromyalgia often wake up tired and unrefreshed even though they seem to get plenty of sleep. Some studies suggest that this sleep problem is the result of a sleep disorder called alpha wave interrupted sleep pattern, a condition in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness. So people with fibromyalgia miss the deep restorative stage of sleep. Nighttime muscle spasms in your legs and restless legs syndrome also may be associated with fibromyalgia.

3. Irritable bowel syndrome (IBS). The constipation, diarrhea, abdominal pain and bloating associated with IBS are common in people with fibromyalgia.

4. Headaches and facial pain. Many people who have fibromyalgia also have headaches and facial pain that may be related to tenderness or stiffness in their neck and shoulders. Temporomandibular joint (TMJ) dysfunction, which affects the jaw joints and surrounding muscles, also is common in people with fibromyalgia.

5. Heightened sensitivity. It's common for people with fibromyalgia to report being sensitive to odors, noises, bright lights and touch.

Other common signs and symptoms include: Depression, numbness or tingling sensations in the hands and feet (paresthesia, mood changes, chest pain, dry eyes, skin and mouth, painful menstrual periods, dizziness and anxiety.

Causes

There are no causes identified yet. A theory for fibromyalgia is that people with it have a lower threshold for pain because of increased sensitivity in the brain to pain signals. But what initiates this process of central sensitization isn't known.
It's likely that a number of factors contribute to the development of fibromyalgia. Other theories as to the cause of fibromyalgia include:

1. Sleep disturbances. Some researchers theorize that disturbed sleep patterns may be a cause rather than just a symptom of fibromyalgia.

2. Injury. An injury or trauma, particularly in the upper spinal region, may trigger the development of fibromyalgia in some people.

3. Infection. Some researchers believe that a viral or bacterial infection may trigger fibromyalgia.

4. Abnormalities of the autonomic (sympathetic) nervous system. Part of your autonomic nervous system — the sympathetic, or involuntary, system — controls bodily functions that you don't consciously control, such as heart rate, blood vessel contraction, sweating, salivary flow and intestinal movements.

5. Changes in muscle metabolism. For example, deconditioning and decreased blood flow to muscles may contribute to decreased strength and fatigue. Differences in metabolism and abnormalities in the hormonal substance that influences the activity of nerves may play a role.

Psychological stress and hormonal changes also may be possible causes of fibromyalgia.

Risk factors

Risk factors for fibromyalgia include:

Sex: Fibromyalgia occurs more often in women than in men.

Age:Fibromyalgia tends to develop during early and middle adulthood. But it can also occur in children and older adults.

Disturbed sleep patterns:It's unclear whether sleeping difficulties are a cause or a result of fibromyalgia — but people with sleep disorders, such as nighttime muscle spasms in the legs, restless legs syndrome or sleep apnea, can also develop fibromyalgia.

Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.

Rheumatic disease. If you have a rheumatic disease, such as rheumatoid arthritis, lupus or ankylosing spondylitis, you may be more likely to have fibromyalgia.

When to seek medical advice

See your doctor if you experience general aching or widespread pain that lasts several months and is accompanied by fatigue. Many of the symptoms of fibromyalgia mimic those of other diseases, such as low thyroid hormone production (hypothyroidism), polymyalgia rheumatica, neuropathies, lupus, multiple sclerosis and rheumatoid arthritis. Your doctor can help determine if one of these other conditions may be causing your symptoms.

Diagnosis

Diagnosing fibromyalgia is difficult because there isn't a single, specific diagnostic laboratory test. In fact, before receiving a diagnosis of fibromyalgia, your doctor may order several medical tests, such as blood tests and X-rays, only to rule out other conditions, such as rheumatoid arthritis, lupus and multiple sclerosis, but they will not confirm fibromyalgia, which by definition is a diagnosis of exclusion.

The American College of Rheumatology has established general classification guidelines for fibromyalgia, to help in the assessment and study of the condition. According to these guidelines, to be diagnosed with fibromyalgia you must have experienced widespread aching pain for at least three months and have a minimum of 11 locations on your body that are abnormally tender under relatively mild, firm pressure.

In addition to taking your medical history, a doctor checking for fibromyalgia will likely press firmly on specific points on your head, upper body and certain joints so that you can confirm which cause pain.

Treatment

In general, treatment for fibromyalgia includes both medication and self-care. The emphasis is on minimizing symptoms and improving general health.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

1. Analgesics. Acetaminophen (Tylenol, others) may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies and is not usually good nor has proven in research to be useful to fibromyalgia patients.. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without acetaminophen. Other medications include nonsteroidal anti-inflammatory drugs (NSAIDs) — such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Anaprox, Aleve).

2. Antidepressants. Your doctor may prescribe antidepressant medications such as amitriptyline, nortriptyline (Pamelor) or doxepin (Sinequan) to help promote sleep. Fluoxetine (Prozac) in combination with amitriptyline has also been found effective. Sertraline (Zoloft) and paroxetine (Paxil) may help if you're experiencing depression.
Studies have found that duloxetine (Cymbalta) may help control pain better than placebo in people with fibromyalgia.

3. Muscle relaxants. Taking the medication cyclobenzaprine (Flexeril) at bedtime may help treat muscle pain and spasms. Muscle relaxants are generally limited to short-term use and may cause drowsiness.

4. Pregabalin (Lyrica). Pregabalin may reduce pain and improve function in people with fibromyalgia. It is the first drug approved by the Food and Drug Administration to treat fibromyalgia. Studies show pregabalin reduced signs and symptoms of fibromyalgia in some people. In one study, about half of the participants taking the highest doses of the drug reported at least a 30 percent improvement. Lyrica is not without side effects that include dizziness, sleepiness, difficulty concentrating, blurred vision, weight gain, dry mouth, and swelling in the hands and feet.

Prescription sleeping pills, such as zolpidem (Ambien), may provide short-term benefits for some people with fibromyalgia, but doctors usually advise against long-term use of these drugs.

Benzodiazepines may help relax muscles and promote sleep in the short term, but do not expect your doctor to continue these medications for long as benzodiazepines can become habit-forming, and they haven't been shown to provide long-term benefits.

Doctors don't usually recommend narcotics for treating fibromyalgia because of the potential for dependence and addiction. Corticosteroids, such as prednisone, haven't been shown to be effective in treating fibromyalgia.

Cognitive behavioral therapy

Cognitive behavior therapy seeks to strengthen your belief in your abilities and teaches you methods for dealing with stressful situations. Therapy is provided through individual counseling, classes, and with tapes, CDs or DVDs, and may help you manage your fibromyalgia.

Treatment programs

Programs that combine a variety of treatments may be effective in improving your symptoms, including relieving pain. These interdisciplinary programs can combine relaxation techniques, biofeedback and receiving information about chronic pain. There isn't one combination that works best for everybody. Your doctor can create a program based on what works best for you.

Self-care

Self-care is critical in the management of fibromyalgia. The patient needs to become actively involved in their own care.

1. Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt. But try not to change your routine completely. People who quit work or drop all activity tend to do worse than those who remain active. Try stress management techniques, such as deep-breathing exercises or meditation.

2. Get enough sleep. Because fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping.

3. Exercise regularly. At first, exercise may increase your pain. But doing it regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises also are helpful.

4. Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days.

5. Get rid of ANGER and Traumas. Get yourself a friend and try to talk out your emotional issues. Let lose of them and try living a peaceful life.

Complementary and alternative medicine

Several of these treatments do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. Some of the more common complementary and alternative treatments promoted for pain management include:

1. Acupuncture. Acupuncture is a Chinese medical system based on restoring normal balance of life forces by inserting very fine needles through the skin to various depths. According to Western theories of acupuncture, the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord. In a 2006 Mayo Clinic study, acupuncture significantly improved symptoms of fibromyalgia.

2. Massage therapy. This is one of the oldest methods of health care still in practice. It involves use of different manipulative techniques to move your body's muscles and soft tissues. The therapy aims to improve blood circulation in the muscle, increasing the flow of nutrients and eliminating waste products.

3. Osteopathy. Doctors of osteopathy go through rigorous and lengthy training in academic and clinical settings, equivalent to medical doctors. They're licensed to perform many of the same therapies and procedures as conventional doctors. One area where osteopathy differs from conventional medicine — but is similar to chiropractic medicine — is in the use of manipulation to address joint and spinal problems, doing it much more effectively and gently than chiropractors.

4. Herbal Medicine. Can certainly help to reduce inflammation. Use herbs such as magnesium, malic acid, 5-hydroxytryptophan, MSM at high doses, SAM-e, Vitamin B12, high dose fish oil, etc.

5. Chinese Assesment and Herbs: By balancing meridians you can certainly help to improve and optimize the body’s function.

6. Diet. Avoid canned and heavily processed food. The patient will need to eat raw and unprocessed foods, drink plenty of water, lean protein. Avoid caffeine, dairy products and wheat. Avoid sugar and artificial sweeteners.

This is a video from a patient's perspective of Fibromyalgia

Diabetes type 2 Part II Treatment

Treatment



Diabetes mellitus type 2 is a chronic, progressive disease that has no clearly established cure. There are two main goals of treatment of the disease:


1. Reduction of mortality and concomitant morbidity (from assorted diabetic complications)



2. Preservation of quality of life


The first goal can be achieved through close glycemic control (i.e., blood glucose levels); the reduction effect in diabetic complications has been well demonstrated in several large clinical trials and is well established beyond controversy.


The second goal is often addressed (in developed countries) by support and care from teams of diabetic health workers (physician, PA, nurse, dietitian or a certified diabetic educator). Endocrinologists, family practitioners, and general internists are the types of physicians most likely to treat people with diabetes. Knowledgeable patient participation is vital and so patient education is a crucial aspect of this effort.


Type 2 is initially treated by adjustment in diet and exercise, and by weight loss, especially in obese patients. The amount of weight loss which improves the clinical picture is sometimes modest (2-5 kg or 4.4-11 lb); this is almost certainly due to currently poorly understood aspects of fat tissue activity, for instance chemical signaling (especially in visceral fat tissue in and around abdominal organs). In many cases, such initial efforts can substantially restore insulin sensitivity.


Treatment goals


Treatment goals for diabetic patients are related to effective control of blood glucose ( less than 126 fasting and less than 200 mg/dl after meals ), blood pressure ( less than 130/80 mmHg )and lipids ( LDL score less than 100, for others less than 70 ) to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies.


The targets are:


HbA1c ( Glycosilated Hemoglobin, a compount that let us know about glucose control in the past 3 months ) of 6% to 7.0%. Preprandial blood glucose: 100-120 mg/dl and postprandial blood glucose: 160 - 190 mg/dl.


Dietary Management



Modifying the diet is known to help control glucose (or glucose equivalent, eg starches) intake, and in consequence, blood glucose levels. Additionally, weight loss is often recommended in persons suffering from type 2 diabetes for the reasons discussed above.
Please be aware about a recognized way of dealing with bad carbs or "not that bad" carbs ( if you eat sufficient quantities, no matter how good a carb is, it will lead to too much glucose in your blood ). It is called glycemic index.

Glycemic index (also glycaemic index, GI) is a ranking system for carbohydrates based on their effect on blood glucose levels. It compares available carbohydrates gram for gram in individual foods, providing a numerical, evidence-based index of postprandial (post-meal) glycemia. The concept was invented by Dr. David J. Jenkins and colleagues in 1981 at the University of Toronto.


Carbohydrates that break down rapidly during digestion have the highest glycemic indices. Carbohydrates that break down slowly, releasing glucose gradually into the blood stream, have a low glycemic index. A lower glycemic index suggests slower rates of digestion and absorption of the sugars and starches in the foods and may also indicate greater extraction from the liver and periphery of the products of carbohydrate digestion. A lower glycemic response is often thought to equate to a lower insulin demand, better long-term blood glucose control and a reduction in blood lipids. The insulin index may therefore also be useful as it provides a direct measure of the insulin response to a food.


Some examples of glycemic index



Low GI: 55 or less such as most fruit and vegetables (except potatoes, watermelon and sweet corn), wholegrains, pasta, beans, lentils )Medium GI : 56 - 69 croissant, basmati rice, brown riceHigh GI: 70 or more corn flakes, baked potato, some white rices (e.g. jasmine), white bread, candy bar


Exercise


In September 2007, a joint randomized controlled trial by the University of Calgary and the University of Ottawa found that "Either aerobic or resistance training alone improves glycemic control in type 2 diabetes, but the improvements are greatest with combined aerobic and resistance training than either alone." The combined program reduced the HbA1c by 0.5 percentage point. Other studies have established that the amount of exercise needed is not excessive, but must be consistent and continuing. Examples might include a brisk 45 minute walk every other day.


Video to control Diabetes type 2 through diet



If you go to a doctor there are several medications he can put you on. Bear in mind that some of the medications you might be started on might not even be to control your blood glucose but could be directed to control problems that diabetes is related to.



Antidiabetic therapy with herbs



There are several herbs hat can help you manage your blood glucose:

Chromium 200-1000mg per day improves glucose tolerance

Gymnema sylvestre 400mg daily improves glucose tolerance

Fish Oil: High doses of DHA and EPA: 2000mg at least, support nerve function and decreases inflammation

Alpha lipoic acid: 300mg-1200mg a day, decreases insulin resistance

High dose Vitamin C: 2000mg and up: decreases glycosilation of proteins

Cinnamon extract: 500mg twice daily ( may double for severe cases )

Biotin: 1000 mg

Yacon: a Peruvian herb may help increasing insulin release from the pancreas.

If you are going to be started on a statin for cholesterol, you do need to supplement with Coenzime Q10 at least 200mg.



If you are looking for just one multi pill against diabetes, try Jarrow's Formula: Glucose Optimizer




Antidiabetic therapy with medications



The best research availiable, besides losing weight, diet and excercise is with metformin. This medication works by making sure that the liver stops making even more glucose in response to the cells chemical mediators ( cells need glucose, but with insulin resistance present very little of the glucose that is in the blood goes into the cells... thus the cells starve and ask the liver to make glucose from it's reserves ). Metformin blocks it.



Another kind of antidiabetics are sulfonylureas such as glyburide and glipizide. These are old types of medications that increase the pancreas production of insulin. This helps glucose control in the short run. In the long run, ends up worsening the problem. The patient will gain weight and become more and more insulin resistant.



A similar kind, but shorter acting, of medications are Starlix and Prandin. These increase insulin for meals only, and have small half lives.



Then, you get to the TZD's which are ACTOS and AVANDIA. These help by increasing insulin sensitivity in muscles and fat tissue. They have got bad press lately due to an increase in cardiovascular mortality. They also cause weight gain which certainly in the long run will make you more insulin resistant.



Then other treatments include insulin. I will not get into these treatments. Insulin for ER treatment and other emergencies is good but in the long run, for diabetes type 2, willnot solve any problem.



Newer treatments include Byetta and Januvia, that at last, do not cause weight gain.

Other drugs that "come with" the diagnosis of diabetes include:

1. Ace inhibitors: Will not only work for blood pressure but they also help avoid complications of diabetes such as kidney diease.
2. Statins or cholesterol lowering drugs: Usually diabetes patients will have elevated cholesterol that your doctor might want to treat with statins.
3. Aspirin: Usually 81mg, for cardiovascular health


Some surgeons are advocating treating Diabetes with gastric bypass and band surgeries. And certainly yes, if you get this surgery and lose a lot of pounds you will get rid of diabetes, but a surgery is not without significant risks. Please make sure you will be willing to endure being fed with shakes for prolonged periods of time if you wish to proceed with surgery. It might be a last resource though, against diabetes.



Until next time!

Diabetes Type 2 Part I

Diabetes mellitus type 2 or Type 2 Diabetes is a metabolic disorder that is usually characterized by insulin resistance, relative insulin deficiency and hyperglycemia and weight gain.


Let's clarify our terms before we go any further. When you eat any sweets ( candies, sodas, juices ) or any starches ( anything that contains grains such as bread, rice, potatoes,pasta, pastries, cookies and crakers ) or even fruits and some veggies, what you are actually eating is a carbohydrate that will break down in the end to a sugar called glucose. Glucose gets absorbed to your blood. Part of the glucose load can get easily to inside your cells ( cells need glucose to make energy ), but most of it cannot get inside. It needs a hormone made by your pancreas called insulin, which binds to cell receptos "telling " the receptors to "make it easy" for the glucose to come into the cell. On a normal person, pancreas makes sufficient insulin so that glucose can get efficiently inside the cell. When people gain weight, becoming obese, they become insulin resistant. This means that with the same amount of insulin, they cannot make sufficient glucose to go into the cells. At some point, the pancreas beggins to make more insulin to "make up" for this resistance... the problem then is temporarily solved as the same amount of glucose goes into the cell... except you need more and more insulin for your body to be able to do it... so the problem grows bigger and bigger and you grow more and more resistant to insulin.

Video that illustrates the normal role of insulin




Diabetes Mellitus type 2 is often managed by engaging in exercise and modifying one's diet ( excersice will make the glucose to go into the muscles with ease, modifying diet means eating less carbohydrates, so less glucose, thus reducing the insulin amount required, and decreasing insulin resistance ). It is rapidly increasing in the developed world, and there is some evidence that this pattern will be followed in much of the rest of the world in coming years. The CDC has characterized the increase as an epidemic in the USA. In addition, whereas this disease used to be seen primarily in adults over age 40 it is now increasingly seen in children and adolescents, an increase thought to be linked to rising rates of obesity in this age group.


Pathophysiology

Insulin resistance means that body cells do not respond appropriately when insulin is present.

Other important contributing factors are the following:

Increased hepatic glucose production (e.g., from glycogen degradation), especially at inappropriate times ... How come? Well, when glucose cannot get into the cells due to resistance to insulin, cells start starving... they make chemicals that travel to the liver and tell the liver that it needs to make more glucose ( the cells do not sense that outside, in the blood, they have got a lot of glucose... for them there is none ). t his certainly worsens the problem.

Decreased insulin-mediated glucose transport in (primarily) muscle and adipose tissues (receptor and post-receptor defects)... meaning that glucose is unable to get into muscles and fat.

Impaired beta-cell function—loss of early phase of insulin release. This is due to the massive amounts of glucose that come into the body.

Video that shows what happens in diabetes. It however, neglects to mention that for years and years of poor eating, your insulin levels get impressively high before your pancreas stops making enough of it




Type 2 diabetes may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder and can be sporadic. However, severe complications can result from improperly managed Type 2 diabetes, including renal failure, blindness, wounds that are slow to heal (including surgical incision), and arterial disease ( may lead to limb amputation ), including coronary artery disease ( and heart attacks ). The onset of Type 2 is most common in middle age and later life, although is being more frequently seen in adolescents and young adults due to the increasing prevalence of obesity in these groups.

About 90–95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 has diabetes mellitus type 2. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons, though these are not known in detail. Diabetes affects over 150 million people worldwide and this number is expected to double by 2025. About 55 percent of type 2 are obese —chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of several chemical signals to other tissues (hormones and cytokines). Other research shows that type 2 diabetes causes obesity.

Diabetes mellitus type 2 is often associated with obesity, hypertension, elevated cholesterol (combined hyperlipidemia), and with the condition often termed Metabolic syndrome (it is also known as Syndrome X, Reavan's syndrome, or CHAOS). Additional factors found to increase risk of type 2 diabetes include again, high-fat diets and a less active lifestyle.


Symptoms of Diabetes



Are polyuria ( increased urination ), polydypsia ( increased thirst ) and polyphagia ( increased appetite ), plus at times others such as blurred vision, fatigue. the real danger, however is that some times, when the blood glucose values increase slowly, the disease may present with no symptoms.







Diagnosis

The World Health Organization definition of diabetes is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either:

Fasting plasma glucose ≥ 126 mg/dl
or
With a Glucose tolerance test, two hours after the oral dose a plasma glucose ≥ 200 mg/dl


Screening and prevention

Interest has arisen in preventing diabetes due to research on the benefits of treating patients before overt diabetes. The U.S. Preventive Services Task Force (USPSTF) USPSTF does recommend screening for diabetics in adults with hypertension or hyperlipidemia (grade B recommendation).

In 2005, an evidence report by the Agency for Healthcare Research and Quality concluded that "there is evidence that combined diet and exercise, as well as drug therapy (metformin, acarbose), may be effective at preventing progression to DM in IGT subjects".


Accuracy of tests for early detection

If a 2-hour postload glucose level of at least ≥ 200 mg/dL is used as the reference standard, the fasting plasma glucose >126 mg/dL diagnoses current diabetes with:

sensitivity about 50%
specificity greater than 95%

Sorethroats

Again another easy topic, but amazingly common is the sorethroat. This is a symptom, not a disease in itself becuase it can be caused by many conditions.

The first condition that comes to mind is a viral infection... please DO NOT GO TO YOUR DOCTOR asking for antibiotics for this one. Most sorethroats that last less than 1 week are viral. They will go away on their own as soon as the virus is gone.

When weeks pass by and the sorethroat continues, then it might be a good idea to visit your doctor because it might have become overinfected with bacteria.

Other causes for sorethroats are medications ( one of the typical medications that can give you coughing are the ACE inhibitors such as enalapril captopril and lisinopril ), post nasal drip ( from sinusitis ), reflux disease, etc.

For treatment, let's get rid of a myth. DO NOT USE cough drops, cough sprays, halls, or any pill that COOLS off your throat ( including iced drinks and popsicles ). What you will cause is physical ( temperature ) irritation of the pharynx ( throat ).

You need to drink plenty of fluids that need to be lukewarm or warm and gargle with salt water. For coughing, use honey to sweeten your drinks instead of sugar. Eliminate sweets and dairy for the time of the sorethroat. Try to eat light during those days too as a way to help the body concentrate on dealing with the infection. Some supplements that might work include high dose vitamin C, Zinc ( Zicam ), and a combination of goldenseal and echinacea.

If you do go to a doctor, you might receive medications to supress the cough, use it wisely because the cough is not just a useless reflex, it also helps the body to get rid of phlegm. The doctor might also prescribe a medication called guaifenesin to help your secretions become more fluid... please be sure to increase your fluid intake when you take this medication. Finally he could put you on an antibiotic.

As always, take care and until next time!

Hypertension

This is one of mankind's "modern"diseases. Due to health policies, the ranges of what has been considered normal and high have gotten more and more demanding.

Hypertension isn't called a silent killer for nothing. High blood pressure is a significant risk factor for developing coronary artery disease (CAD), the leading cause of death in the United States, and it's considered a significant risk for stroke, heart failure, and kidney failure. Most of the times, though, it doesn't give any symptom to the patient ( so they think they are OK ). Anyone with poorly treated hypertension at least doubles his or her risk of developing all of these conditions. And remember, the higher the blood pressure, the higher the danger.

Most of high blood pressure patients have got no apparent reason to have it elevated. This is called idiopathic hypertension and accounts for about 90 to 95% of the causes.

Other factors that contribute to hypertension are the following:

Salt intake: Population studies show that societies in which people consume large amounts of salt (such as the United States) have a correspondingly high incidence of high blood pressure . Similarly, in cultures where salt intake is low, the incidence of high blood pressure is extremely low. Other studies show that for most people with hypertension, restricting salt intake helps lower high blood pressure.

Inherited predisposition: Hypertension also appears to have a genetic component. Some people may be genetically predisposed to have high blood pressure. However, shared lifestyles can certainly contribute to keep the blood pressure elevated.

Doctors certainly know that lifestyle factors, such as obesity (and abdominal obesity, in particular), inactivity, cigarette smoking, and high alcohol consumption all are associated with increased risk of hypertension.

Secondary hypertension is the name for whenever blood pressure has got a known cause, meaning it's a secondary result of a separate primary condition. If the underlying condition can be treated and corrected, then secondary hypertension usually is corrected, too. Conditions known to cause secondary high blood pressure include:

• Narrowing of the arteries that supply the kidneys
• Other kidney diseases
• Abnormalities in the endocrine system, such as overactive adrenal glands
• Certain medications that can increase the risk of high blood pressure, such as oral contraceptives or estrogen replacement therapy following menopause

If you're diagnosed with high blood pressure, your doctor will explore any of these potential underlying causes for hypertension prior to making the diagnosis.

Although medical science may not know the exact mechanisms that cause essential hypertension, a number of conditions are strongly associated with increases in high blood pressure. Your doctor might look for these factors in order to lower blood pressure. For many people, controlling these conditions actually returns their blood pressure to normal levels. these factors are as follows:

Obesity: Hypertension is most clearly associated with obesity (weighing more than 20 percent above your desirable body weight). Obesity contributes to an estimated 40 percent or more of all high blood pressure cases in the United States. Although not everyone who is overweight has high blood pressure, the association remains clear.

Cigarette smoking: Cigarette smoking and the use of other tobacco products increase blood pressure, both in the short term while you're smoking or chewing and in the long term, because components in the smoke or chewing tobacco, such as nicotine, cause your arteries to constrict.

Alcohol intake: Drinking small to moderate amounts of alcohol (fewer than two beers, two glasses of wine, or one shot of distilled spirits) per day has been shown in a number of studies to reduce mortality from CAD. Higher consumption of alcohol (three or more alcoholic drinks per day), however, clearly is associated with increased blood pressure, not to mention an increased risk of dying from heart disease.

Physical inactivity: People who are physically inactive increase their likelihood of developing high blood pressure. In one large study of more than 16,000 individuals, inactive people were 35 percent more likely to develop hypertension than were active people, regardless of whether they had a family history of high blood pressure or a personal history of being overweight.

Now you know a little more of blood pressure, let's look at some numbers:

Normal blood pressure would be defined as systolic: 120 or less and diastolic: 80 or less ( systolic is the blood pressure your heart gives at its maximum contraction, diastolic will be the blood pressure your heart gives with rest )
Pre Hypertension: systolic: 139 or less, diastolic: 89 or less
Hypertension I: systolic: 140 or over, diastolic 90 and over
Hypertension II: systolic: 159 or over, diastolic 109 or over

If you have high blood pressure you might want to go and purchase a blood pressure cuff and measure blood pressure regularly.

What do we do for it?

The first change is to drop the salt. Look at all labels of the food you buy to realize how much salt you eat passively... you need to understand that for you to eat excess salt, you do not need to add salt to your food... it is sufficient with the salt you already have in the food you eat. Ketchup has got a lot of salt even though it tastes sweet. The DASH diet has shown, on latest studies to decrease mortality, hypertension and stroke rates with a dietary approach.

Then you will need to decrease stress. Drop the coffee and the sodas. Replace them with chamomille, mint and/or valerian teas.

The next step is to start exercising, even walking 30 minutes a day is good... if you can run, swim or do any low impact exercise, even better.

A good lifestlyle that will increase your exercise ( buy a pedometer to measure your stes, 10,000 steps a day are recommended ) and lower down your calorie intake would be beneficial. Weight loss is always recommended.

There are several approaches on the natural herbs and homeopathy for hypertension such as Hawthorne, calcium and magnesium and garlic. Carditone is a great ayurvedic product to lower down your blood pressure naturally. Acupuncture has shown to decrease blood pressure, but evidence states the effect will "wear off" in 2-3 months. Dark chocolate and Soy protein have also been shown to decrease hypertension naturally.

Another great option to lower down blood pressure is a machine called RESPERATE, that uses your own breathing to generate relaxation and thus the decrease in blood pressure ( without use of pills ). Follow this link to their WEBPAGE: http://www.resperate.com/ and watch this video:



Do follow up with your regular docror to be checked out for other medical problems such as increased lipids and diabetes. He can help you with medications for blood pressure and to rule out other cases of disease.

Please check the video to expand our post:

Irritable Bowel Syndrome

Today we will discuss irritable bowel syndrome or IBS. It is called a syndrome because it is an ill defined grouping of sygns and symptoms.

Irritable bowel syndrome (IBS) is defined as chronic or recurrent abdominal pain, altered bowel habits, and bloating, with the absence of structural or biochemical abnormalities to explain these symptoms. IBS is part of a broader group of disorders known as functional gastrointestinal disorders.

It is more common in females than in males, and although it is not life threatening, it does impact significantly the patient's life. Usually it is a disease of young people and adolescents.

The characteristics of abdominal pain vary between patients and even within an individual patient, as it can be dull, achy, colicky, or sharp. Pain can occur anywhere in the abdomen but is commonly located in the below or around the belly button. Stress and food certainly aggravate the pain and it is partially relieved after defecation.

The patient presents with altered bowel habits that include constipation, diarrhea, or alternating constipation with diarrhea.

Sometimes, stools usually are of small volume and pasty in IBS . Even IBS can present with constipation is associated with small, hard, pelletlike stools. Diarrhea characteristically occurs during waking hours and often is precipitated by meals. Mucus can be a component of the stool in as many as 50% of patients with IBS.
In some patients, defecation is associated with a sense of incomplete evacuation that can lead to repeated trips to the bathroom and prolonged straining.
Symptoms of abdominal distension (ie, bloating, increased belching, flatulence) frequently are reported by patients with IBS.

Other gastrointestinal symptoms (ie, heartburn, dyspepsia, nausea, vomiting) are reported in 25-50% of adult patients with IBS. Dyspeptic symptoms are present in as many as 30% of pediatric patients with IBS.

Ok, so now what do we do?


Now several changes need to be addressed. The first one is stress. Please address this issue because stress can definitively worsen any IBS.

The next step is to organize better your life. You need to keep a log of what you eat, when you eat it and the level of stress in your life.

Several foods need to be assessed. IBS can be caused by several types of foods such as: caffeinated drinks ( Soda, coffee ), Chocolate, wheat and dairy. Avoid them, start yourself on a diet to keep away from your triggers. A more professional allergy testing can always be obtained by your doctor.

Next, you can use peppermint oil capsules ( such as Nature's Way Pepogest ). this can give much relief to abdominal bloating, gas and pain. Anise and peppermint/spearmint teas ( lukewarm )are also goog to soothe your intestines.

Getting into the medical areas the Naturopathic doctors are the ones that started with the idea of replenishing the intestines of good bacteria. There are out there several products that have got several strains of lactobacillus. These, it is my opinion , should always be used on and after starting ANY antibiotic regime and should be prescribed by your regular doctor or picked up by you in any healthfood store. Naturopaths also believe that yeast overgrows on the intestines, making the problem larger. There are several protocols to free your intestines from yeast. A treatment that is less popular is colonics.

Going to a doctor is sometimes necessary because some of these symptoms can also be caused by other diseases especially when patients have fever, weight loss, progression in symptoms, arthritis or rectal bleeding. The doctor can prescribe medication to decrease the muscle cramps or help you with diarrhea or constipation, or deal with bacterial overinfections or yeast.

Please take a look at this video that will outline a few tips for patients with IBS:

Muscle spasms and cramps

Hello again.

I would like to treat this apparently simple topic because it is very common. Being muscle tissue abundant on our body, it has the potential to cramp and spasm and produce pain.



I would like to remind you again that we should not see pain as our enemy, but rather as a way that our body tells us that something is wrong. Some examples of this "something is wrong" are muscle cramps ( specially in calves ) due to low potassium or low magnesium in blood. They can also tell us that, for example if we develop back pain, our body position and mechanics could be off ( read about the Alexander techniques that, by improving and overcoming some physical habits, helps on physical illnesses ), or even it could tell us that we have got too much of a curvature in the spine ( scoliosis ) or tell us about a short leg syndrome.

What do we do?

Well, first of all RELAX. You need to release some of that body stiffness you have as a baseline, so breath in deep and RELAX ( take a look at what happens when you purposely relax your neck and shoulder areas and keep them relaxed for at least a minute ). Daily stretches help a lot to prepare the muscles for regular activity.

Next, you can always get a good massage. Applying HOT packs or compresses and pressure to the area is good ( Please remember that ice is great for the first 48 to 72 hours after a crash or trauma or any acute event, but later it NEEDS to be replaced by heat ).

Also, you can use muscle rubs to help relax the area. My personal favorites are the ones that have Arnica, a homeopathic product, and are widely availiable on pharmacies and health food stores. Some of these creams also use Bryonia, another homeopathic product. Arnica is also availiable in homeopathic pillules and is great for muscle pain.

Do consider visiting your local osteopath ( DO ) or your local chiropractor should your pain continues.

Finally, you can always go to the medical doctor for evaluation and assesment. Here the doctor might send you for images ( x rays only "see" fractures, MRI's are very expensive but they might see tendons, ligaments and even muscle tears )and/or might treat you with anti inflammatories, muscle relaxants or narcotic pain medications.

Until next time

Headaches

The pain and duration of the lingering headache may be annoying, but generally not life threatening. Taking productivity and quality of life issues into account, however, many experts believe headaches pose a heavy burden on people. Why do headaches have such a pervasive effect?

Two-thirds of all adult men and greater than 80 percent of women in developed countries suffer from them, according to the World Health Organization (WHO). Their effects are just as destructive to developing nations too, largely because people don't regard headaches as a disease. WHO estimates about half of the people who have headaches never receive any treatment for them either.

People who suffer from chronic daily headaches amount to a staggering 4 to 5 percent of the world's population, surpassing the rate of many other illnesses. Experts believe, in relation to those suffering from disabilities, the number of headache sufferers is about the same.

Medical expenses, lost work time and lower productivity accounts for about $50 billion in losses for American businesses.

Classification of headaches is as follows:

Tension headaches (80 percent) that are largely treated with over-the-counter drugs

Vascular headaches (including migraines and cluster headaches ) very painful and incapacitating

Brain tumors, aneurysms or other maladies account for less than 2 percent

What do we do about them?

First we need to get rid of the obvious. No more sodas, wean yourself off coffee ( at first the headaches will increase! ), get rid of all artificial sweeteners ( read our previous blog ).

Other things you can do include is try some allergy testing. Some headaches are related to allergy and these can be tackled this way. The cheap way of doing this is to decrease or eliminate dairy and to reduce your wheat intake considerably.

Other ways to help are to reduce stress ( deep breathing and meditation are key ).

Herbal remedies include forehead application of essential peppermint oil and the use of feverfew orally. Lately research with high dose riboflavin ( a vitamin ) are showing promise to help migraines.

Acupuncture, EFT and massage can also help.

Allopathic medication is good too, but do not forget that the headache pain is a way that your body tells you that there is something wrong, something you need to correct... and you don't want to shut it up.

Watch this video that shows you how to apply massage to reduce headaches

The Obesity Epidemic

Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. It affects virtually all ages and socioeconomic groups.

Increased consumption of more junk food with high levels of sugar and saturated fats, combined with reduced or no physical activity, have led to obesity rates that have risen three times or more since 1980 in some areas of North America, the United Kingdom, Eastern Europe, the Middle East, the Pacific Islands, Australasia and China.The obesity epidemic is not restricted to industrialized societies; this increase is often faster in developing countries than in the developed world.

Obesity and overweight pose a major risk for serious diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. The health consequences range from increased risk of premature death, to serious chronic conditions that reduce the overall quality of life. Of especial concern is the increasing incidence of child obesity.

Childhood obesity is already epidemic in some areas and on the rise in others. An estimated 22 million children under five are estimated to be overweight worldwide. According to the US Surgeon General, in the USA the number of overweight children has doubled and the number of overweight adolescents has trebled since 1980.

The problem is global and increasingly extends into the developing world; for example, in Thailand the prevalence of obesity in 5-to-12 year olds children rose from12.2% to 15-6% in just two years.

Please take a look at the following report that will show you graphically what we are talking about and how obesity is exploding in the USA:


http://health.msn.com/reports/obesity/default.aspx

What can you do about it?

First excercise! Even walking if done constantly ( 30 minutes or more daily ) is good for you. This epidemic has also been helped by the large degree of physical inactivity. If you can get a pedometer ( step counter ) from a store and start counting steps ( over 10,000 a day is recommended ) because it is very easy to kid yourself that you have "walked" for that day. FOr short trips, do not take your car out, try to walk. For long distances, try parking your car not that close to where you need to go ( provided weather is good ).

Then start to eat healthy. The best food is cooked from scratch. It needs to include some source of protein ( eggs, milk, soy, meats, legumes), salads ( with very little or healthy dressings such as vinegar and olive oil ) and fruits.

Carbohydrates ( pasta, rice, potatoes, bread, pastries, cookies, crackers and also cereal such as the so infamous cheerios ) are linked with insulin resistance ( which is linked with diabetes ), so try to use them very sparingly. Certainly if you have to eat them, try whole grains first ( whole grain food will not taste good at first. It will require you to chew better, it will be raspy to your throat, but in the long run good for you ).

Certainly try not to eat the unnecesary junk foods and junk drinks such as fried foods, sodas, juices, excessive alcohol, etc.

Please take a look at this video from Canada. Here in the USA things are even worse.



Until next time!

Depression

Hello again and thank you for reading our blog.

Last time we spoke about artificial sweeteners... now we will focus again on the mind. I will ask you to bear with me because I will try to explain some of the notorious problems with modern life. Have you noticed how angry we get when someone calls us losers? Has Hollywood turned American society into one that tolerates no middle grounds? Either you are a winner ( just one per race, competition, etc ) or you belong where most people will end up. Not everyone will be number one! If you add up family problems, divorce, and just life "not being perfect" to the equation, you have a problem

Notice that you need to realize that THE ONLY THING YOU CAN CONTROL is your own life and YOUR ACTIONS and certainly the WAY YOU FEEL. So, please, GRAB CONTROL OF YOUR LIFE and live it.

I do not believe that neurotransmitters ( the chemicals that connect your brain cells ) are responsible for depression, they are the effect of what years of wrong thoughts have made in your brain. The answer, as simple as it might appear is to change the way you think and even more important, to change the way you feel.

Your job is then, to find out what is wrong... again, get a friend and speak out all your troubles, and then start thinking how to solve them and if you will not be able to solve it, how to change your feelings so that the issue doesn't affect you. Certainly an alternative is to talk to a counselor ( psychologist or LCSW ).

And, yep, if you think you could hurt yourself and/or others, then it is time to visit the doctor, who can certainly help with the most severe depressions with pills at least until you change the way you think and feel.

Other alternatives include the use of herbs such as Saint John's Wort or SAM-e which have shown to work for mild to moderate depression.

See you next time.

Artificial Sweeteners

Beware of all artificial sweeteeners

They are not an alternative to sugar. Please consider the many side effects they have before you try them.

Splenda ( sucralose )

It is a synthetic compound stumbled upon in 1976 by scientists in Britain seeking a new pesticide formulation. Once it gets to the gut, sucralose goes largely unrecognized in the body as food — that’s why it has no calories.. A percentage of sucralose will acumulate in your body and you will not be able to excrete it.With very few studies showing safety in humans, was approved in a rush by FDA, it is 100% synthetic and has got chlorine in it.

Side effects of Splenda are skin rashes/flushing, panic-like agitation, dizziness and numbness, diarrhea, muscle aches, headaches, intestinal cramping, bladder issues, and stomach pain.

Equal ( aspartame )

The components of aspartame can lead to a number of health problems. Side effects can occur gradually, can be immediate, or can be acute reactions. According to Lendon Smith, M.D. there is an enormous population suffering from side effects associated with aspartame, yet have no idea why drugs, supplements and herbs don’t relieve their symptoms. Then, there are users who don’t ‘appear’ to suffer immediate reactions at all. Even these individuals are susceptible to the long-term damage caused by excitatory amino acids, phenylalanine, methanol, and DKP.

Has got a huge amount of side effects including pains, headaches and even weight gain ( Were you trying to lose weight in the first place? ).

Please review the list of side effects that aspartame has:


Abdominal Pain
Anxiety attacks
Arthritis
Asthma
Asthmatic Reactions
Bloating, Edema (Fluid Retention)
Blood Sugar Control Problems (Hypoglycemia or Hyperglycemia)
Brain Cancer (Pre-approval studies in animals)
Breathing difficulties
Burning eyes or throat
Burning Urination
Can't think straight
Chest Pains
Chronic cough
Chronic Fatigue
Confusion
Death
Depression
Diarrhea
Dizziness
Excessive Thirst or Hunger
Fatigue
Feel unreal
Flushing of face
Hair Loss (Baldness) or Thinning of Hair
Headaches/Migraines dizziness
Hearing Loss
Heart palpitations
Hives (Urticaria)
Hypertension (High Blood Pressure)
Hysterical pregnancy
Impotency and Sexual Problems
Inability to concentrate
Infection Susceptibility
Insomnia
Irritability
Itching
Joint Pains
Laryngitis
"Like thinking in a fog"
Marked Personality Changes
Memory loss
Menstrual Problems or Changes
Migraines and Severe Headaches (Trigger or Cause From Chronic Intake)
Muscle spasms
Nausea or Vomiting
Numbness or Tingling of Extremities
Other Allergic-Like Reactions
Panic Attacks
Phobias
Poor memory
Rapid Heart Beat
Rashes
Seizures and Convulsions
Slurring of Speech
Swallowing Pain
Tachycardia
Tremors
Tinnitus
Vertigo
Vision Loss
Weight gain In addition, aspartame can mimic symptoms or worsen the following diseases:
Fibromyalgia
Arthritis
Multiple Sclerosis (MS)
Parkinson's Disease
Lupus
Multiple Chemical Sensitivities (MCS)
Diabetes and Diabetic Complications
Epilepsy
Alzheimer's Disease
Birth Defects
Chronic Fatigue Syndrome
Lymphoma
Lyme Disease
Attention Deficit Disorder (ADD)
Panic Disorder
Depression and other Psychological Disorders

Saccharin

Has been associated with bladder cancer in rats.

These products are present in all LOW and NO CALORIE foods, so next time you go to a supermarket, read the label carefully.

High fructose corn syrup

Main sweetener of regular sweetened foods has been linked to the obesity epidemic in America and is a super concentrated form of a mixture of fructose with glucose.

For more information visit http://www.mercola.com/ if you can get over all the products they try to sell you.

The only 2 sweeteners that have a safer profile are Stevia and Xylitol. Still I would recommend not to abuse them.

The next are 2 informative videos that you should watch.

Aspartame Video from FOX



Splenda Video from Mercola

Anxiety Disorders

Hello and welcome again Today we will speak about anxiety. Anxiety disorders are a category of neurotic disorders with anxiety as a prominent or the prominent symptom...

Classification of anxiety

1. Phobic anxiety disorder: Agoraphobia (with or without panic disorder) Social phobias Specific (isolated) phobias

2. Other anxiety disorders include: Panic disorder Generalised anxiety disorder Mixed anxiety and depressive disorder

3. Obsessive compulsive disorder: But exactly what do you feel with Anxiety? You will feel fearfulness and unwanted and distressing physical symptoms. It is a normal and appropriate response to stress ( have you ever been in immediate danger? the normal response is a rapid heart beat, sweating, pupil dilation, etc ) but becomes pathological when it is disproportionate to the severity of the stress, continues after the stressor has gone, or occurs in the absence of any external stressor. Most of anxiety nowadays is very chronic and is pathological.

What to do?

Get a friend! Talk it out! If that doesn't work, you will need professional support... pills? Maybe, counseling? ALWAYS! You need to get into counseling but do not ever think that it will be up to your psychologist or LCSW to make you better. You are the only one that can get better. Acupuncture and massage are great too. Do not forget the power of meditation and deep breathing! Pills for this condition are several and one piece of advise: STAY AWAY from benzodiazepines such as ativan and xanax. They are addictive if taken for prolonged time. Some antidepressants do have anti anxiety properties ( so don't be shocked if your doctor asks you to take one of these pills ), these are way safer than "benzos". A more healthy alternative for anxiety is a medication that is not addictive called BUSPAR. Ok, time to leave... do take care!

Alternative Medicine Herbs for Anxiety

Consider the following options:

1. Start Kava. One of the best Kava is the one sold online by http://www.konakava.com/. Their 83% concentrated capsule delivers thae maximum allowed amount of Kava a day. Take 2 caps a day.

2. Bach Flowers: These are on the homeopathic realm. They need to be away from electric appliances and radiation. There is a list with well over 20 Bach Flower remedies that are case specific for the multiple types of anxiety people have.

Go to http://www.bachcentre.com/centre/remedies.htm or to
http://www.bachremedies.co.uk/?lang=us

These sites should give you the names of the bach flower herbs you need. USe 4 drops below the tongue 3 to 4 times a day of all the ones that apply to you. If you don't wish to go through all the " figuring out", do Rescue Remedy: 4 drops either sublingually or in ½ cup water. Three times a day.

3. Valerian caps at night to sleep or Valerian tea. You might also consider chamomille instead of coffee.

4. Limit coffee, tea, and sodas before sleep.

5. Get the TV out of the room.

6. 5-HTP and GABA supplements if you are not taking an antidepressant.

If you want you can take a look at this video which is a part of a series of informative videos I got from Expert Village of what anxiety is, and how to cope with it.