Wednesday, December 31, 2008
Hot flushes are most common in women in the period of life called perimenopause, the two to seven years before full-blown menopause when the menstrual period becomes irregular. For instance, there could be a period lasting three weeks in perimenopause, or a period lasting five. They also occur in women of any age who have had their ovaries surgically removed.
Most women sense a flash coming on before it actually happens. There can be a feeling of veins popping in the face and neck as they actually do open up to admit greater blood flow to the head. Waves of heat strike the head and then radiate out to the torso and arms. The heat is wavelike and can last for a few minutes up to an hour. There can be dizziness, nausea, headache, or mood disturbance during the flash. The difference between hot flashes and flushing is that hot flashes include any, many, or all of the aforementioned symptoms, but flushing only involves redness spreading up the face.
Hot flashes strike women of all races, but for reasons scientists do not entirely understand, they tend to be more problematic for women of African descent. A study in the Journal of the American Medical Association found that they affect 53 per cent of African-American women but only 29 per cent of white women.
Flashes also strike women of all ages, but they are most common between the ages of 40 and 56. And men can get them too, but for entirely different reasons.
If there is any doubt as to whether a hot flash is a symptom of menopause, the doctor can run a test for a hormone called follicle stimulating hormone (FSH). There are non-hormonal causes of night sweats and hot flashes. Other kinds of hot flashes are also distinguished by the timing.
The flushing that men and women can get due to diabetes occurs usually during eating or up to 30 minutes after, especially when the food is high in carbohydrate. Tidal fevers of malaria occur approximately the same time every day, while periodic flashes due to hormones occur at random intervals. And hot flashes can be triggered by eating spicy foods. The corresponding symptom of diabetes and malaria is not.
Recent reader questions:
Q. Is there a way to make your period start naturally? Will this relieve hot flashes?
A. Herbalists have used feverfew, ginger, parsley, rosemary, sage, thuja, and wild carrot seed as mild emmenagogues to induce menstruation. They aren't strong enough to interfere with pregnancy, but they are enough, in some cases to restore menstruation. There are stronger herbs, but they have potentially dangerous side effects.
And these herbs won't relieve hot flashes. For that, black cohosh is best.
Q. What about young people with hot flashes?
A. Although menopause may be surgically induced in young men, hot flashes in the young usually are an early warning sign of diabetes, especially if they occur during or within 30 minutes of eating.
Q. Can hot flashes just be chills?
A. Do you mean, can you have a hot flash without getting hot? Yes, but it would have the other characteristics of hot flashes listed above: irregular occurrence, feeling of spreading from the neck up and out, and other symptoms, like dizziness.
There are a lot of reasons to avoid ERT. A paper in a 2002 edition of the Journal of the American Medical Association reported the results of a study that tracked 16,608 women for five years. The study found that taking estrogen increased the risk of breast cancer by 26 per cent and upped the rate of stroke by 41 per cent. ERT doubled the rate of pulmonary embolism and tripled the rate of ovarian cancer.
Estrogen replacement does get quick results. Many women know the risks and take it anyway. But women who can stand their flashes for just a few weeks often get lasting results from herbs.
The best known herb for hot flashes is dong quai, usually considered one of the best Chinese herbs for hot flashes. It contains a compound that keeps blood vessels in the face from opening up to rush blood to the head. A study at the Kaiser Permanent Foundation in California found that the herb does not help women who are already on ERT, but other women report good results.
Also used for hot flashes is black cohosh, found in products such as Remifemin. There have been clinical studies that find that black cohosh is actually more effective than estrogen replacement therapy for stopping hot flashes, but there is one significant drawback. Black cohosh make take six months to begin to work. A few women experience mild stomach upset when taking this herb.
Hot flashes in women taking estrogen sequestering agents after breast cancer are problematic. There is a Japanese herbal formula called kami-shoyo-san that often works. It's a standardized, quality-tested, shelf-stable combination of combination of angelica, bupleurum, Cornelian cherry, ginger, licorice, mint, moutan, peony, poria mushroom, and white atractylodis root.
Honso USA sells this formula under the somewhat odd trade name of Kampo4WomenMindEase in North America. It's also sometimes called Augmented Rambling Powder (referring to a Chinese poem written centuries ago that herbalists thought captured the results of treatment, giving women freedom from hot flashes). This combination of herbs does not interfere with tamoxifen (Nolvadex) and side effects are not reported.
Many women take soy to relieve hot flashes, but tofu is not what works. The best results come with eating miso and using shoyu or tamari soy sauce. Even better results come with taking soy isoflavones (daidzein + genistein), 100 milligrams a day.
And herbs are not all that women can do to stop hot flashes. Here are some more tipe:
There are a number of simple, practical, natural therapies that help restore the male sex drive. Here are just a few.
The best way for any man with ED to use homeopathic therapies is to consult a homeopathic physician. The homeopathic physician will work with the man to understand the issues that cause ED and to remove them from his life. The pills you take are secondary. Nonetheless, some men get results from pills alone, and they will not harm you
Try the remedy that matches your symptoms best for 30 days. If it does not work, discontinue it and try something else.
• Agnus castus is recommended when there is a cold sensation in the penis, frequent urination, and disturbed sleep. Homeopathic physicians often recommend this remedy for men who develop ED after many years of frequent sexual activity or, in some cases, excessive masturbation. The homeopathic literature suggests that agnus castus is appropriate for men who are anxious about disease conditions or who have problems with inattention or memory loss.
• Argentum nitricum treats ED occurring after intercourse is initiated. Men who need this remedy usually have cravings for sweets and salt, and may be described as volatile or artistic.
• Caladium remedies the complete absence of erection despite sexual excitement. Men who benefit from this remedy may have nocturnal emissions without dreams. •
• Causticum treats ED occurring with incontinence, especially loss of urine when coughing, laughing, or sneezing, or prostate problems. Homeopathic theory associates this remedy with the need to check things, such as returning home in the middle of a trip to make sure the appliances are turned off, checking bank balances several times a day, and so on.
• Lycopodium treats ED in men who are sexually inexperienced or lacking in self-confidence. Homeopathy teaches that this remedy is appropriate for men who have problems with bloating and flatulence or who have the need for rest or sleep late in the day.
• Selenium metallicum is given to men who develop ED after a serious illness. Loss of body hair or eyebrows is a sign that homeopathic selenium is an appropriate remedy.
• Staphysagria treats ED in men who suffer embarrassment in a sexual context. Homeopathic doctors typically offer this remedy to men from religious backgrounds with strong prohibitions on sexual activity.
Far and away the one most effective treatment for diabetic ED is keeping blood sugars down. Men who manage to keep their blood sugars below 100 mg/dl (5.5 mM) all the time may notice improvement in as little as six weeks without any drug treatment at all. But for diabetic men who cannot control blood glucose readings quite that tightly, there's alpha-lipoic acid, also known as ALA.
ALA is the best-researched and most reliable over-the-counter aid to recovery from any kind of diabetic nerve damage, including ED. Doctors recommend up to 3,000 milligrams a day, although much more than 1,800 milligrams a day is likely to be more than the body can use. ALA depletes the B vitamin biotin, so it's important to take supplemental biotin or to use a brand of ALA that includes biotin in the formula.
Diabetic men who use ALA report that it restores sensation before it restores erection. ALA will enhance the ability of either the conventional prescription drugs Viagra, Cialis, and Levitra or the herbs that contain yohimbine, namely yohimbe and quebracho, to enable damaged nerves to release nitric oxide (NO). The antioxidant NO opens the blood vessels that fill the penis with blood to enable intercourse. ALA may also restore sensation in feet, hands, and other parts of the body.
Many nutritional experts and some holistically oriented doctors recommend supplementing with the amino acid L-arginine for erectile dysfunction. It's a complement to either the "little blue pill" or alpha-lipoic acid. L-arginine provides the raw materials from which nitric oxide, NO, is made. ALA and/or Viagra, Cialis, and Levitra stimulate nerve endings to release it.
Men get L-arginine from food, especially soy and meat, but it's simply not possible (unless you can wolf down a 72-ounce steak every day) to get all the L-arginine that your body can use from food. Take up to 5 grams (that's 5,000 milligrams) of L-arginine daily. L-arginine is not likely to be the complete remedy for erectile dysfunction all by itself, but it will greatly enhance the effects of either prescription medications (that is, those taken by mouth, not the papaverine injection) or ALA.
L-arginine is frequently recommended for ED, and may increase the effectiveness of Viagra, since it provides the chemicals from which NO is made. Clinical studies of L-arginine have used relatively small doses, no more than 3,000 milligrams per day,7,8 and using more than 5,000 milligrams of L-arginine may make ED worse. The herbs damiana, ginseng, and muira puama are also frequently recommended for ED, but their effects are unpredictable and they do not help the majority of men who take them.
This herbal remedy for ED is made from the bark of an African tree. One of the phytochemicals in this bark, yohimbine, was in pre-Viagra days the only medication approved by the FDA for treating erectile problems. This male sexual stimulant compound is also found in a few South American rain forest herbs, igpepo, pamprana, and quebracho.
Yohimbe is like Cialis, Levitra, and Viagra in that it restores the ability to have erections regardless of the cause of the problem. Like the well-known prescription drugs, this natural impotence remedy acts by stimulating blood flow into the penis. Yohimbine, the chemical in the herb, “unlocks” norepinephrine, a stimulant hormone, in the lining of the blood vessels leading to the male sex organ, in the same way Cialis, Levitra, and Viagra do, by stimulating the release of antioxidant nitric oxide. Blood stays in the penis and erections are sustainable.
The difference between yohimbe and the little blue pill and similar prescriptions is that the herb is also an aphrodisiac. In a dosage of up to 30 milligrams, it is an antidepressant. It increases the brain’s ability to respond to dopamine, the pleasure chemical. It enhances a man’s ability to pay attention to his partner, allowing a smaller dose to get a better result.
So what’s not to like about this herbal miracle? You do want to be sure you are getting the real herb, not a substitute. In my personal experience working with brokers and manufacturers, the smaller, “boutique” manufacturers of herbal products are more likely to give you the real thing. Also, vendors of the South American herbs that work the same way, such as quebracho, tend to be honest and reliable.
Also, yohimbe works best if you let it “take your penis by surprise.” Men who take the herb every day need more and more to get the same result. That’s why some clinical studies found that men who take the herb every day didn’t get relief from ED, while men who took it on special occasions did.
How do you find the dosage that works for you? Patience is required. Start with 5 milligrams at a time and work up to 50 milligrams at a time, each dosage 5 or 10 milligrams higher. Don’t rely on the herb. Skipping a day between doses makes it more effective. It won’t interfere with the little blue pill (or Cialis or Levitra) if you decide to continue taking them.
There are some medications that don’t mix with yohimbine. The antidepressant trazodone (Deseryl, Trialodine) combined with the herb (or with any of the South American ED herbs) sometimes can cause priapism. That’s the “erection lasting more than four hours” (yes, there are erections that last more than four hours in men of all ages) you hear about on the television commercials. Mixing the herb and trazodone can priapism and surgical drainage of the penis may be necessary to prevent permanent damage.
This herb does not work when it is used selegiline, a drug used to stimulate male sexual desire (and to treat Parkinson’s disease). There is only so much dopamine reuptake modulation in the brain can do for your love life, and the combination of drug and herb is redundant. No herb containing yohimbine should be taken at the same time as butyl nitrate (“poppers”), and the blood pressure medication clonidine wipes out any stimulant effect of the herb. Clonidine is also the antidote for overdoses of the herb.
One other word of caution. Many men find it difficult to sleep for up to 24 hours after taking yohimbe. One should be prepared to enjoy the benefits the herb confers before taking it. It is best used in the context of a stable sexual relationship. Tranquilizers will not relieve insomnia caused by taking the herb. Only sexual activity does.
Recent reader questions:
Q. Does yohimbe help you have multiple erections? Does Viagra help you have multiple erections?
A. If you are a man otherwise healthy capable of multiple erections, yohimbe will keep you "turned on," since it is an aphrodisiac. Viagra is not an aphrodisiac, and its effects are at the "plumbing" level.
Q. Does yohimbe help you deal with anxiety medication side effects?
A. To the extent the anxiety medication causes absence of desire. If the anxiety medication causing low blood pressure, yohimbe doesn't work on the same nerve receptors and won't power blood flow into the penis.
In ancient times women were plied with gifts of sandalwood to get them in touch with their physical side. For centuries men have brought roses to open their loves and themselves to emotion. Cultures around the world have used bouquets of jasmine to inspire tranquility.
What about the conventional wisdom that a man’s sweat turns a woman on? The scientific evidence is that a single component in male perspiration, androstadienone, really does cause a physical reaction in women. The complication is that smelling male sweat causes an increase in women’s cortisol levels. Cortisol is the fight-or-flight hormone, not a pure sexual stimulation hormone.
Moreover, this kind of hormonal stimulation in women has a greater effect on mood than behavior. Whether stimulation of fight-or-flight leads to sex is a matter far more complicated than a simple turn-on or turn-off, but, on the whole, sweaty men are not walking aphrodisiacs for the human female. And laboratory testing confirms that the hormone reactions triggered by male sweat definitely do not transform a couch potato into an Adonis. Facial preference, measured in female test volunteers, is not changed by androstadienone.
What about women’s sexual activation by pheromone sprays? In a study of post-menopausal women at Harvard’s Brigham’s and Women’s Hospital, scientists found that pheromone colognes actually do work, provided they are used for about six weeks. A dash of pheromone in anticipation of a hot date just is not going to be successful.
Women of reproductive age are at their most receptive to sex pheromones at the middle of their reproductive cycle, 14 days before or after their periods. This is also the time when they are most likely to conceive. Pre-menopausal women are most receptive to hormones placed, or smelled, at their upper lip.
Certain aromas are definite sexual turnoffs in women. Almost any “man smells” discourage sexual arousal. Studies by Dr. Alan Hirsch found that women were turned off by stereotypically male odors, especially men's colognes and the scent of barbecued meat. The scent of cherries also reduced vaginal blood flow.
Finally, if the way to a man’s heart is through his stomach, might the way to a woman’s heart be through her stomach, too? Dr. Hirsch’s study found that women are far less aroused by food scents. However, a combination of the scent of a licorice-flavored candy called Good & Plenty plus cucumber increased vaginal blood flow the most. While men tend to respond to single scents, women also responded strongly to a combination of the scents of Good & Plenty and banana nut bread.
Guys, unless you can come up with an excuse to send a gift basket of cucumbers, banana bread, and Good & Plenty bars every day, your best bet is to use pheromone sprays and learn to become a really good kisser. Aromas and pheromones, however, are no substitute for old-fashioned romance.
Tuesday, December 30, 2008
After five to ten years of poorly controlled diabetes, many diabetics experience a form of nerve damage known as diabetic neuropathy. This condition manifests itself in an astonishing number of ways. There can be the well-known diabetic nerve damage to feet and hands causing the
- Numbness or insensitivity to pain or temperature
- Tingling, burning, or prickling
- Sensitivity to touch, even light touch and
- Sharp pains and cramps
of peripheral neuropathy. But there can also be the
- Bloating, alternating constipation and diarrhea (diarrhea is worse at night), nausea and vomiting, loss of appetite
- Copious sweating while eating
- Dizziness when moving from seated to standing position
- Overheating and
- Problems with bladder control
of autonomic neuropathy. And there can even be the
- Aching behind an eye
- Chest or abdominal pain sometimes mistaken for angina, heart attack, or appendicitis
- Double vision
- Inability to focus the eye
- Pain in the chest, stomach, or flank
- Pain in the front of a thigh
- Severe pain in the lower back or pelvis and
- Problems with hearing
of focal neuropathy, all caused or aggravated by prolonged, uncontrolled, high blood sugars in diabetes.
Can diabetic nerve damage be cured or helped?
All of these wide-ranging varieties of nerve damage in diabetes stem from a combination of high blood sugars, deficiencies in antioxidants, high triglycerides and cholesterol, and too much salt. Uncontrolled blood sugars cause an accumulation of hydroxyl radicals, peroxinitries, and superoxides, all of which soak up antioxidants needed to protect nerves. If there are enough antioxidants in circulation, however, the free radicals don't do damage.
When there is a shortfall in available antioxidants, free radicals attack the structure of a nerve, causing it to be riddled with holes, known as vacuoles. When enough vacuoles accumulate, the nerve simply dies.
Treating this panoply of nerve problems is accomplished, as you might imagine, with antioxidants. The best-studied antioxidant for this purpose is alpha-lipoic acid. Relatively high doses of alpha-lipoic acid, 600 to 1800 milligrams a day (the absolute maximum you should take), often restore sensation and then relieve burning over a period of 3 to 4 weeks.
You do have to continue to take the alpha-lipoic acid to get its benefits, and you should take a formula that combines alpha-lipoic acid with the B-vitamin biotin, which alpha-lipoic acid depletes. Or, even better, keep your blood sugars under control. Just a few weeks of keeping blood sugars under 100 mg/dl (5.5 mM) all the time, not just after meals, begins to reverse diabetic neuropathy in noticeable ways.
There are several other ways to treat this condition:
- Acupuncture relieves pain, but it won't work if you are on certain antidepressants. That's because the mechanisms through which acupuncture relieves pain depends on an adequate amount of serotonin at the nerves. If you are still building up serotonin levels, the acupuncture will not work.
- Transcutaneous electrical nerve stimulation (TENS) can relieve pain caused by neuropathy in the hands and feet. Just don't start with the setting too high.
- And if dizziness is a problem, try elastic stockings. Keeping circulation going to the brain prevents vertigo.
Recent reader questions:
Q. Are there natural cures for diabetic nerve pain in the head?
A. Any of these approaches should help, except TENS.
Q. What about diabetic neuropathy & vitamin D?
A. Taking vitamin D may relieve (1) pain from undetectably small bone fractures, common among diabetics who use Actos and Avandia and (2) burning and aching pain in neuropathy-affected hands and feet.
Q. Leathery skin, diabetes symptom, neuropathy symptom?
A. Yes, in the feet. But you would also notice changes in sensation or loss of sensation.
For starters, reduce or eliminate the amount of sugar in your diet. Sugar is enemy number one of circulation in the skin. Even in people who are not diabetic or pre-diabetic, excessive levels of sugar in the bloodstream can, through a process known as glycation, "sugar-coat" cells throughout the body. In the skin, glycation impedes circulation, restricting access of the immune system, and making the skin less supple. If you can't cut out the sugar, at least drink more water.
And alpha-lipoic acid, taken by mouth or applied to the skin in skin creams, partially offsets the effects of glycation. Many dermatologists use alpha-lipoic acid in creams to treat bags under the eyes, dull skin, and enlarged pores, and in lieu of botox injections to the neck area.
Beta-carotene, the famous nutrient from carrots, also provides needed antioxidants. Natural pharmacy experts Joe and Teresa Graedon tell the story of one of their counselees who misunderstood their recommendation to eat a few extra carrots, ate 3 pounds (about 1500 grams), and turned orange.
But eating carrots, or taking beta-carotene, or, better, mixed carotenoids, makes skin more resistant to damage from active UV-B and heat. Skin that is well supplied with alpha- and beta-carotene can take more UV exposure before damage sets in.
Omega-3 fatty acids, found in cold-water fish, microalgae, and nuts, reduce inflammation and increase the rate at which healthy cells multiply. And vitamin C and E applied directly to the skin in creams can reverse wrinkling. (Don't go the route of wrinkles and juicing.) There are two things to remember about C and E for your skin:
Use natural ingredient liquid foundations for oily skin and for dry skin alike, but remember, alpha-hydroxy acids are not helpful for people under 30 or over 70. That's because they shorten wrinkles rather than eliminating them. They work by stimulating the growth of the basal layer and forcing a turnover of old skin for new.
The perplexing thing about alpha-hydroxy acids for consumers is that they come under a tremendous variety of labels. Here is a partial list:
Alpha hydroxy acid ingredients may be listed as:
• alpha hydroxy and botanical complex
• alpha hydroxycaprylic acid
• alpha hydroxyethanoic acid + ammonium alpha hydroxyethanoate
• alpha hydroxyoctanoic acid
• citric acid
• glycolic acid
• glycolic acid + ammonium glycolate
• glycomer in cross-linked fatty acids alpha nutrium (3 AHAs)
• hydroxycaprylic acid
• lactic acid
• L-alpha hydroxy acid
• malic acid
• mixed fruit acid
• sugarcane extract
• tri-alpha hydroxy fruit acids
• triple fruit acid
And vitamin C esters are preferable to vitamin C. Ascorbyl palmitate is about 10 times as active in restoring skin as regular vitamin C.
What else can you do about wrinkles?
For most people who experience wrinkling, a combination of factors over a period of decades make skin "tired." Air pollution, fungal infection, UV-A exposure, some prescription medications, autoimmmune conditions, and inflammation conspire to release massive amounts of toxic free radicals. They accumulate in skin cells and activate a sodium channel that essentially floods the cell with the sodium from salt. The skin cell survives but it cannot draw in the nutrients it needs or produce the collagen that undergirds its neighbors. The result is old-looking skin.
And even people who use sun screen religiously can suffer aging skin. The problem is that most sunblocks with SPF values of 15 to 30 let the most damaging ultraviolet rays, the UV-A rays, right on through. Sunblock protects against UV-B, which is worst between 10 am and 3 pm, but not against UV-A, which is present all day. And there is just as much UV-A in winter sun as in summer sun, even though the UV forecasts show lower numbers.
Exposure to the more harmful UV-A rays for just one hour a day for five days a week for five weeks will damage skin. UV-A activates a system of enzymes known as the metalloproteinases. These enzymes break down the connective collagen in the skin. Tiny cracks appear, then full-blown wrinkling. This leaves more skin surface to dry out and become even more fragile and more wrinkled.
The skin does have ways to protect itself, primarily through making pigments. These pigments, of course, are what make tanned skin beautiful, but the also can accumulate into freckles and age spots. Add to this process any deficiency of vitamin C, vitamin E, and coenzyme Q10, and non-smokers can become just as wrinkled as smokers. Sun, winter, summer, spring, or fall, is the enemy of smooth skin.
Every nutritional approach to vitiligo requires both taking the nutrient and getting sun exposure. Swedish scientists found that taking supplemental folic acid and vitamin B12 just before getting sunbed treatment enhanced healthy tanning of depigmented skin. Even when patients got no other drug or supplement, just taking these two B vitamins, plus using a tanning bed, improved vitiligo more than 50 per cent of the time. The caveat is, this simple approach took about two years to work, and only 6 per cent of patients in the study achieved completely normal skin. But it's a cheap, safe, and helpful approach most American doctors don't know about.
Another nutritional approach to vitiligo involves supplementing with the amino acid L-phenylalanine. The peculiar chemistry of depigmentation works in a way that pigment-making melanocytes build up L-phenylalanine they can't break down, but need even more L-phenylalanine to maintain their ability to make energy from glucose in the citric acid cycle. Affected skin cells simultaneously have too little and too much L-phenylalanine.
It turns out that more L-phenylalanine relieves vitiligo, slowly. Taking L-phenylalanine for six months, in one clinical trial, restored color to at least 25 per cent of skin for 75 per cent of patients. Taking the supplement for six years brought 100 per cent restoration of color to the face in 85 per cent of patients, although complete restoration of color to other affected skin only occurred rarely in this long clinical study.
Phenylalanine is dosed by weight, although dosages do not have to be precise. You take one 500-milligram capsule for every 20 pounds or, for simplicity's sake, 10 kilos of body weight. For instance, a man weighing 200 pounds would take 10 capsules. Phenylketonurics should avoid this approach.
Remember, even though sunlight is required for these treatments (and most vitiligo medications) to work, it's still important to avoid sunburn and overexposure in the tanning bed. And remember, sunburn, like tattooing, can reactive herpes in people who have had prior infection.
Recent reader questions:
Q. What about self needling for hypopigmentation (self-tattoos)?
A. As I mentioned, if you have ever had herpes, or cold sores or shingles, this is a really bad idea. Also, it hurts. Moreover, if you ever get over your vitiligo, you're left with the tattoo. I don't recommend self needling for hypopigmentation.
Q. What about coal tar & vitiligo?
A. Since coal tar derivatives are activated by sunlight, the folic acid and vitamin B12 treatment mentioned above should help them work more effectively, too.
Q. For depigmentation, black pepper is an effective remedy?
A. Well, almost certainly not. There have been some studies with lab animals that used a hot-water extract (that is, a chemical extracted from black pepper with hot water, not pouring hot water and pepper on the skin), piperine. It reversed depigmentation in lab rats. Whether it reverses depigmentation in humans, I frankly don't know. On the other hand, if you aren't pouring hot water on yourself, or getting hot pepper in your eyes, nose, throat, or other sensitive orifices, I don't see that it would hurt.
Q. What about vitamin D and vitiligo?
A. There was a study of vitamin D creams as a treatment for vitiligo reported in the British Journal of Dermatology last fall (October 2008). The study basically found that if you exposed white patches of skin to sunlight, it didn't make any difference whether you treated them with a vitamin D cream. Whether a vitamin D cream might work "where the sun don't shine" is an open question.
Vitiligo most commonly results in loss of pigment in skin that can be seen, on the feet, hands, forearms, face, and lips. It less frequently causes loss of coloration on skin around the eyes, nose, mouth, or genitals. Hair growing from affected skin may be snow-white.
Modern science recognizes that this condition of chronic decoloration results from an autoimmune disease. White blood cells attack the melanocytes, skin cells specializing in the production of the pigment melanin. The pigment's job is to absorb the UV-A rays of sunlight that otherwise would damage the skin. Melanin is most abundant in the darkest skin, and this skin condition is most destructive in the darkest skin, although persons of every race may be afflicted.
Vitiligo occurs concurrently with other common autoimmune diseases: Grave's disease (overactive thyroid), pernicious anemia, type 1 diabetes, or alopecia areata, the sudden baldness that is not due to an excess of the male hormone testosterone. In all of these conditions there is an imbalance in the white blood cells known as helper-T cells versus the white blood cells known as killer-T cells. Essentially the helper-T cells act as a brake and the killer-T cells act as an accelerator for the immune system. Immune destruction just around the melanocytes goes unchecked, as if the immune system thought these skin cells were an infection, and pigment is destroyed.
While the mechanism of vitiligo involves the immune system, the trigger for the process may be stress. Some Italian researchers have found that skin in the early stages of depigmentation contains unusually high concentrations of the stress hormones epinephrine and norepinephrine, and also dopamine.
And nutrition may also be a factor. Some studies suggest that people who get this form of skin depigmentation lack a gene that helps break down the amino acid L-phenylalanine into tyrosine. The L-phenylalanine builds up in melanocytes to an extent they can no longer make pigment.
While vitiligo is hard to understand, it can be treated. Earlier treatment always results in greater success, especially in children.
The most important nutrients for preventing basal cell carcinoma are antioxidants, principally n-acetyl cysteine (NAC), selenium, and vitamins C and E. NAC works synergistically with vitamins C and E to protect the "watchdog" gene p53 that keeps skin cells with damaged DNA from continuing to grow and multiply. Selenium and vitamin E help the skin make the "super-antioxidant" glutathione, and another antioxidant, alpha-lipoic acid, will help keep glutathione from being broken down in the liver. Alpha-lipoic acid is especially important for people who work or exercise outdoors.
Should antioxidants be used "in" or "on?" I recommend both, for nearly everyone. Men who take Viagra, Levitra, or Cialis may find that supplemental NAC taken by mouth causes headaches when the erection drug "kicks in." Smokers and people with chronic obstructive pulmonary disease (COPD) sometimes get a bad reaction to NAC, too. If your doctor or pharmacist tells you that you should not eat grapefruit, then you should not take vitamin C with bioflavonoids for the same reasons, but "straight" vitamin C should be OK for you.
It's not necessary to megadose. As little as 100 mg a day of alpha-lipoic acid or Vitamin C, 100 micrograms of selenium, 200 IU of vitamin E, and 200 mg of NAC every day can protect the skin, although more is better. If you take more than 100 mg of alpha-lipoic acid daily, make sure you are getting biotin, either from a complete B vitamin supplement (B-100) or biotin capsules. Selenium is absorbed better if it is not taken at the same time as vitamin C.
What else can you do to relieve and prevent basal carcinoma? Number one, wear sunscreen. The recommendation used to be to use at least SP-15 on sun-exposed skin in the summer. Now more doctors tell their patients to use a stronger (higher number) sun screen any time of year.
Recent reader questions:
Q. Is there a herbal remedy for skin cancer?
A. No, although aloe gel will relieve itching and inflammation while you are waiting for treatment.
Q. What about basal cell carcinoma and clove oil?
A. Oil of cloves may relieve the itching, but it won't stop the cancer.
Q. Can there be regrowth of basal cell after treatment?
A. Not if it is removed completely. That's why freezing or surgical treatment, typically a five-minute-or-less procedure in the doctor's office, is best. It usually is not at all difficult for the physician to remove the basal cell carcinoma.
Q. Does basal cell become other kinds of cancer?
A. No, but there are the same risk factors for both basal cell carcinoma and the more aggressive squamous cell carcinoma, so people who get one sometimes get the other.
Q. Can basal cell carcinoma result from sun exposure and drug interaction?
A. When the drug is a psoralen for psoriasis, sometimes yes. Other drugs, such as lisinopril for high blood pressure, supposedly no, although I'd use sunscreen just in case.
Q. What about bloodroot salve for basal cell carcinoma (also known as sanguinaria)?
A. No. Absolutely, positively not. Bloodroot can burn (and by burn, I mean hurt you) the skin surrounding and containing a basal cell carcinoma, but leave just enough of the cancer that it continues growing underneath the skin where it won't be detected. There will be a scar, and a few years later, there can be a major problem that requires surgery.
Q. Is there a cream to rub on basal cell carcinoma?
A. To ease inflammation while you are waiting for treatment, aloe gel. Your dermatologist sometimes will prescribe 5-FU ointment to shrink the basal cell carcinoma or to prevent its recurrence.
Q. What about basal cell carcinoma treated with garlic?
A. There was a clinical study in the Netherlands about five years ago that looked at taking a chemical from garlic, ajoene, and applying it to early-stage basal cell carcinoma. The garlic compound shrank basal cell carcinomas in 17 out of 21 patients, but surgery works virtually every time. Nonetheless, if surgery is completely unavailable to you for the time being, you could try a garlic poultice on a regular basis for six to twelve weeks. Unfortunately, this is likely to have an effect on your marriage, family, work, and social life.
A basal cell is, as its name suggests, a skin cell from which the very top layers of the skin are based. Basal cells are pluripotent, that is, they can form skin cells, hair cells, or sweat glands. These cells are not exposed to the damaging UV-A rays of the sun as much as top levels of skin, but when they are, the damage is more serious. UV-A rays rearrange the sequence of the A-G-C-T bases in DNA and disable the gene that "turns off" cells when they become cancerous.
Even though basal cells are below the surface of the skin, cancerous basal cells typically work their way to the top and are just sloughed off. Only when they are trapped in a hair shaft or a pore do they typically survive long enough to cause problems.
Unlike another common skin condition, actinic keratosis, basal cell carcinomas do not occur exclusively on sun-damaged skin. It's possible to get them anywhere on the body, although their appearance on normally covered skin surfaces suggests a severe immune deficiency. Also unlike an actinic keratosis, cancerous basal cells tend to bleed, a lot. They can be a pink bump surrounded by tiny blood vessels radiating out, or a just a pink bump that bleeds easily. That's also the answer to the common question of why does basal cell carcinoma get itchy. This kind of skin cancer is well supplied with blood vessels ready to deliver inflammatory hormones, but it also traps peroxides and other irritants in the pore or hair shaft it blocks.
These tiny skin cancers may present as a tiny open sore that just does not heal after 3 weeks, or, most dangerously, as white, yellow, or waxy spot with a scar or a crust. All basal cell cancers tend to bleed easily. (There may be more symptoms of the condition that these; always consult a physician about persistent skin abnormalities.)
What happens if you never treat this form of skin cancer? Unless you have HIV or receive chemotherapy, it will not spread through your body. It can, however, scar. If near the eyes, it can interfere with vision. And, especially in the elderly, it can cause unsightly black blotches on ears and nose. Fortunately, this skin condition is relatively easy to treat.
Recent reader questions:
Q. Is it true that repeated sun exposure leads to melanoma?
A. It's much more likely to lead to basal cell carcinoma. Melanoma depends on a number of factors including, ironically, vitamin D levels. When Australia's ministry of health vigorously promoted the use of sunscreen, melanoma rates unexpectedly went up.
Q. Why does basal cell carcinoma get itchy?
A. This cancer spreads from the lesion itself. It doesn't get into the bloodstream or the lymphatic system and metastisize throughout the body. The inflammatory process by which the basal cell carcinoma displaces neighboring tissues causes the itch.
Scientists studying skin cells in the laboratory have found that provided cells with selenium, vitamin C, and vitamin E before they are exposed to the UV-A rays of the sun stops the genetic damage that can lead to this form of skin cancer. Selenium and E work together to help the skin make glutathione, which in turn keeps ultraviolet rays from damaging skin cell DNA. And N-acetyl-cysteine, also known as NAC, works with vitamins C and E to protect a "watchdog" gene called p53, which ensure that those cells that do suffer DNA damage do not continue to grow and develop into cancers.
If you work or exercise in bright sunlight on a regular basis, especially if you have fair skin, you need additional antioxidant protection. Alpha-lipoic acid, taken orally, keeps the liver from breaking down glutathione, which in turn helps maintain the supply for the skin.
Should you take your other antioxidants by mouth or use antioxidant creams directly on sun-exposed skin. My recommendation is to use both. usually. Diabetics who have uncontrolled sugars may get false readings for ketones if they take NAC orally. Men who take Viagra should not take NAC, either, because it can cause headaches. And "natural vitamin C," like grapefruit juice, is not a good mix with the statin drugs used to lower high cholesterol, prevent prostate cancer, and treat certain kinds of inflammation.
So creams are your best bet. Additionally:
And, don't forget to see your doctor. Anyone who has a personal history of skin cancer should get a skin exam twice a year.
So how do you recognize actinic keratoses? Typically, you can feel them before you see them. There may be a tiny patch of itchy, scaly, dry skin that could be caused by any number of conditions that are not cancer. Then this patch of skin becomes elevated, then gritty. At first it may be the same color as adjacent skin, but later it becomes pink or red or bleeds. Or it may just feel like sandpaper. Older people sometimes develop "horns" of sun-damaged skin.
What sunlight, more specifically, UV-A light, does to cause actinic keratosis is to trigger a switch of the G and C bases (of the A-G-C-T) of the DNA in the skin. This "turns off" the gene that repairs sun damage and prevents skin cancer. Skin cells that lying flat on the skin usually just die and get sloughed off even if they become cancerous. Skin cells lining a hair shaft or a pore, however, stay put and can allow the genetic damage to accumulate.
In North America, about one person in eight develops this precancerous condition of the skin at some point in life. The fairer the skin, the greater the risk of this particular kind of skin damage. People who have had Epstein-Barr virus are at greater risk, as are people who have had psoriasis treated with psoralen.
The good news about this condition is, it develops slowly. If you notice these subtle changes in your skin, you don't have to run to the emergency room. It's enough to ask your doctor about it at your annual or semiannual checkup, assuming you have not let the lesions go unchecked for a number of years. And in the meantime, you can slow the development of actinic pre-cancer with antioxidant therapies.
Sunday, December 28, 2008
It's OK to use more than one remedy at a time, but it's always best to use the remedy that matches your particular symptoms. Start with 6 C and increase to 12C and on upwards to get more relief, but don't take any one remedy more than three times without it doing you any good. That would mean that you haven't matched the remedy to your symptoms.
Nothing about homeopathy requires you to stop any prescription medication, and, generally speaking, stopping a prescription medication abruptly can make migraines more frequent or more severe. Your medications are also part of the "issues" addressed by homopathic treatment.
Read about Migraine & Diet.
Q. Can adults get heat rash?
A. Yes. Typically what's called heat rash is really ringworm.
Q. What are ringworms?
A. Actually, ringworms aren't worms. Ringworm (known in the medical literature as tinea captis) is a fungal infection of the skin, related to athlete's foot, that causes a characteristic round rash. It usually starts as a pimple and grows outward. It can make the skin scaly and the hair brittle, brittle enough to break off leaving a temporary bald spot. There are many strains of ringworm, and the species causing infectons in the United States (T. tonsurans) is the most likely to leave a bald spot.
The ringworm fungus gets it start on dead skin. Simply exfoliating with a gentle cleanser and warm water every day cuts down on ringworm infection.
Q. What are the chief symptoms?
A. Chief symptoms: persistent skin rash and flaky skin, but spreading out in a circular pattern.
Q. Are there vitamins that can cause ringworm? Are there vitamins that cause skin rash?
A. One, but it's really rare. If you got a massive overdose of vitamin D, about 30,000 IU and up, you would become extremely sensitive to sun and burn very easily. When this has happened is with hamburger. Hamburger makers add vitamin D to meat to keep it rosy red. If they add too much, and this is really unusual, it's possible to get the skin reaction if you eat it. It's very unpleasant but it does go away.
Q. What about raw vinegar for ringworm?
A. The thing about raw vinegar for ringworm is, it goes on you, not in you. Dilute a quarter-cup (60 ml) of vinegar in three-quarters cup (180 ml) of warm water and dab on the affected area three times a day. If you don't want to smell like pickles, be sure to rinse the vinegar off your skin after it's been allowed to set for about 5 minutes. Improvement should be visible in 2-3 days.
Q. What can you tell me about ringworm medication? Diabetes is my main health problem.
A. When it comes to ringworm medication, diabetes is a concern primarily because it is associated with dry skin. But you'd need moisturizers no matter what. In diabetic children, the natural remedies for healing ringworm are the same as for non-diabetic children.
About medications, the thing about prescription medication is that it's for use in you, not on you, the opposite of natural remedies of healing ringworm. If you have chronic hair loss, a medication your physician prescribes, like griseofulvin, will hold the fungus at bay inside the hair shaft long enough for new keratin to grow around the hair follicle.
If you don't have hair loss yet, herbal remedies may actually be more effective. Tea tree oil, in an 8-20% cream, rubbed on the skin three times a day may stop the progression of ringworm into the hair follicle. It's the best of the herbal remedies for neck rashes.
What you need to know about tea tree oil is, it does more to improve symptoms than to kill ringworm at the source--but if the fungus is just munching away on dead skin that's flaking off, you don't care. Clinical trials have shown that tea tree oil is superior to at least one medication (tolnaftate) in controlling itching, inflammation, scaling, and redness, while the prescription Rx is better at killing the fungus. It is possible to use both.
Q. How do you treat ringworm on children?
A. Natural remedies for healing ringworm are the same for children and adults, except you do want to be very sure not use pure tea tree oil with children. (Creams are always preferable.) Additionally, it's a good idea to make sure children don't share combs or bed linens, and that you wash you hands every time you help your child wash or groom.
Q. How often do people get ringworm? How many people have ringworm?
A. Less than 1% of the population in developed countries has ringworm at any given time, although some areas of Southeast Asia have local infection rates of up to 14%. In North America, ringworm outbreaks mostly occur among children aged 6 to 10 and is passed around at school. The strains of ringworm that occur in the Middle East are passed between family members of all ages.
Q. What's the difference between ringworm and impetigo?
A. Ringworm itches, impetigo hurts. Hair falls out in ringworm, hair stays put in impetigo.
Q. How long can ringworm live on the furniture, on doorknobs, etc.?
A. Ringworm can survive as a spore indefinitely, but you are more likely to get it from people who have the infection without symptoms or pets who have the infection without symptoms. Dusting and cleaning will take care of household surfaces, but you need to make sure no people and no pets have infections for your whole household to stay infection-free.
Medical researchers at the VU University Medical Center in Amsterdam tested the effects of eating a meal containing 50 grams of fat (about 450 calories from fat), 55 grams of carbohydrate (about 220 calories from carbs), and 30 grams of protein. Their test subjects were healthy men.
The first high-fat meal didn't have a big effect on blood flow, oxidation of LDL cholesterol (which changes it into the form that can "clog"), or blood glucose levels. A second consecutive high-fat meal, however, stiffened the brachial artery, increased the oxidation of LDL into atherogenic forms, and elevated blood sugar levels, even though the clinical study participants were not diabetic.
A single high-fat meal, spaced at least six hours from any other high-fat meals, however, may have a paradoxical effect. A research team at the same university found that in diabetic women, a high-fat meal actually lowered stress on the cardiovascular system, provided it was not accompanied by carbs. For diabetic women and possibly diabetics of both sexes, there's at least some recent evidence that the way to escape the artery-clogging effects of dietary fat is to avoid the carbs.
Recent reader questions:
Q. Can red pepper cure heart diseases?
A. By itself, no, although an Australian research study found that regular consumption of chili peppers by men resulting in measurably slower resting heart rate and seemed to increase the perfusion (spread of oxygen) through the heart. Eating chili sauce won't compensate for eating a basket of tortilla chips followed by the enchilada special.
Q. How does this relate to the benefits of walking with heart disease?
A. Walking long distances will burn fat, and the fewer carbohydrates you have to burn, the more fat your body will use. Real benefits of walking with heart disease kick in after about 90 minutes of walking, however.
Q. What is the best cheap cure for arteriosclerosis?
A. Well, avoiding arterial stress after high-fat meals is free, and a good place to start. But it's not a substitute for a doctor's care.
Tushuizen ME, Nieuwland R, Scheffer PG, Sturk A, Heine RJ, Diamant M. Two consecutive high-fat meals affect endothelial-dependent vasodilation, oxidative stress and cellular microparticles in healthy men. J Thromb Haemost. 2006 May;4(5):1003-10.
Schindhelm RK, Alssema M, Diamant M, Teerlink T, Dekker JM, Kok A, Kostense PJ, Nijpels G, Heine RJ, Scheffer PG. Comparison of two consecutive fat-rich and carbohydrate-rich meals on postprandial myeloperoxidase response in women with and without type 2 diabetes mellitus. Metabolism. 2008 Feb;57(2):262-7.
Dr. Won Song of Michigan State University and collaborators reported in the Journal of the American Dietetic Association that you're 30 per cent less likely to be overweight if you regularly eat breakfast--and you're a woman. The Michigan States Study of data from more than 4,000 people did not find that eating breakfast was linked to staying slimmer in men.
The study also found that:
(1) Older people are more likely to eat breakfast than younger people and (2) Older people are more likely to eat cereal than eggs or breakfast meats.
Whether eating cereal makes you slim or slim people happen to eat cereal was not established by the study. This study did not break out statistics for diabetics. But a later-published study by Dr. Song found that people who consume ready-to-eat breakfast cereals are much more likely to get adequate calcium in their diets, presumably because most people put milk on their cereal.
The more calcium you get, for reasons not entirely clear to science, the lower your weight, at least if you are getting the calcium from dairy products. Dr. Song's research suggests that just about the only people who get enough calcium from drinking milk by the glass are children under the age of nine and seniors over the age of 70.
And who gets the most antioxidants with their breakfast? Dr. Song's research finds that it may be hot tea drinkers. Even among Americans who do not drink hot tea for breakfast, the single largest source of antioxidants, at least those from food, is tea, more than fruit, more than fruit juices, more than vegetables, and more than red wine.
If you are a diabetic, your doctor or nutritionist may have told you that your diabetic diet must contain some level of recommended carbohydrates per day, despite the fact that diabetes is a disease all about your blood sugars being too high and carbohydrates raise your blood sugars, because "your brain has to have 130 grams of glucose" every day. While it is true that your brain is a unique organ that can only burn glucose, other organs being able to use nutrients for energy, your body can get those 130 grams from foods that will not raise your blood sugars.
In the "old days," the only way most diabetics could measure their blood sugars was with little strips of paper they dunked in their urine. If the paper turned blue, then blood sugars were too high and they needed insulin. If the paper did not turn color, then blood sugars were not too high, but there was no way to tell whether they were normal or low.
To protect their diabetic patients against the dangers of hypoglycemia and insulin shock, they recommended every diabetic eat carbohydrate. Hypoglycemia can be immediately fatal, as in the case of a diabetic in insulin shock driving into a utility pole. High blood sugars were fatal only slowly, so eating carbs was better than not.
In modern times, however, diabetics can measure their blood sugars more precisely, so the old "insurance" of eating carbs with every meal is not necessary (unless, of course, you are taking too much insulin or too much medication). The human brain can get the glucose it needs in many ways that do not require eating sugary, carb-loaded foods.
The liver can convert up to 58 per cent of the protein you eat into glucose, slowly enough that it does not raise blood sugars, but fast enough to provide energy to the brain. About 10 oz (280 grams) of protein foods every day is enough to provide your brain with the energy it needs. If you just eat a measly half-ounce (15 grams) of carbohydrate at every meal, say a great big salad or one slice of bread, you still get all the carbs you really need. And if you eat the salad instead of the bread, you keep your blood sugars low while getting other important nutrients.
If you eat all the carbs recommended by the American Diabetes Association diet, you will go through a daily cycle of sugar high (as all the "healthy" carbs are converted to glucose) followed by adrenal crash, every single time you eat. Or, in terms of popular diet plans, the answer to the question of how long should you stay on the Atkins diet (or something very similar) is, pretty much indefinitely. Keeping your carbs to a minimum, even less than the 130 grams recommended by doctors before glucose meters or the 400-500 grams on the ADA diet, will keep your blood sugars and your brain on an even keel throughout the day.
While obstetricians will insist that expectant mother's keep their blood sugars in check, after delivery the follow up care for women who have gestational diabetes is usually minimal. There might be one HbA1C reading to make sure it's below 7, and maybe a finger stick or two to make sure the fasting sugars aren't too high. One or two "clean" tests and the diabetes case is closed.
The problem is that women who get gestational diabetes tend to be "blood sugar impaired," but not fully diabetic. Some research published in late 2008 found that women who have diabetes during pregnancy have most but not all of the same genes found in type 2 diabetics of both sexes. They will have normal fasting blood sugars because their beta cells get around to churning out enough insulin to take care of the glucose released from food at night, but they do not make enough insulin to keep blood sugar levels low in the 2-3 hours after meals.
High post-prandial, or "after-meal," sugars can do just as much damage as high fasting sugars, but most doctors never test for them. Over time they can poison the remaining beta cells so that they stop making insulin, leading to diabetes that is only detected after it has done damage.
And, just as some women who have an Rh+ blood type have trouble bearing an Rh- baby, sometimes pregnancy triggers a series of autoimmune reactions that cause a kind of diabetes known as LADA (latent autoimmune diabetes in adults). It's something like juvenile diabetes in adults (and I have it, myself, obviously not because I got pregnant, which would no doubt get me an appearance on Oprah). Both men and women can get the condition, initiated most often by pregnancy in women or a viral infection in men.
Fasting blood sugars are fine because the pancreas retains its ability to produce some insulin, slowly. It just can't produce enough insulin quickly to keep blood sugars down after meals. The problem is, those high blood sugars after meals eventually "burn out" beta cells so blood sugars are high all the time.
If you are a new mother who had gestational diabetes, what should you do? To make sure you don't have LADA or type 2 diabetes that just happened to begin when you became pregnant, test your blood sugars about 2 hours after you eat, at least 3 or 4 times. If you get a reading of over 200 mg/dl (11 mM), first, make sure you didn't just happen to have sugar on your hands. But if you get two readings over 200 mg/dl, see your doctor about follow-up care.
Recent reader questions:
Q. What are acceptable levels for gestational diabetes?
A. I'm assuming you mean blood glucose levels. Blood sugars too high during pregnancy can harm both mother and child, producing unusually large babies and causing difficult delivery. Expectant mothers who have gestational diabetes or any other kind of diabetes should be under a doctor's care, but generally, mothers want to keep their sugars under 125 mg/dl (7 mM) at all times, not just fasting. This gets tricky as you eat for two, but the result is an easier birth and a healthier baby.
The standard medical recommendation for diabetic retinopathy is laser coagulation surgery. What most diabetics do not realize until after the procedure is, laser surgery tiny blind spots in the filed of vision of the affected eye. As its name suggests, laser coagulation coagulates the proteins in targeted blood vessels. Those areas of the retina no longer receive light, and there is also reduction in night vision and color perception.
But there is a reliable, non-surgical approach. The very best thing any diabetic can do to reduce the risk of and even reverse retinopathy is to keep blood sugars down. This means, preferably, keeping blood sugars low not just every morning, but after meals, too.
The United Kingdom Prospective Diabetes Study, running from 1977 to 1997, studied 5,200 people with type 2 diabetes. By the standards of the time, diabetics who kept their blood sugars down to an average of 165 mg/dl (corresponding to an HbA1C of about 7) were considered to achieving “tight control.” Just keeping HbA1C, however diabetics managed to do it, reduced the risk of both diabetic changes to the retina and kidney disease by 25 per cent.
And if diabetics also managed to keep their blood pressure down to an average of 144/82, which by current standards is still “high,” the risk of diabetic changes to the retina dropped by 47 per cent. A much better approach to treating diabetic retinopathy is “tight control” of blood sugars. Nothing you can do does more for eye health that controlling both blood sugars and blood pressure.
And nothing in blood sugar control, at least from the standpoint of preserving vision, is more mportant than avoiding corn syrup and other high-fructose sweeteners. Especially during times of emotional stress, adrenalin-related hormones and high levels of fructose in the bloodstream can synergize to induce high blood pressure, high cholesterol, and high triglycerides, all of which are harmful to the eye. Fresh fruit has one advantage over fructose sweeteners: The fructose in fruit is absorbed more slowly because of the fibers and pectin in the fruit. Diabetics who cannot tolerate fructose sweeteners may be able to tolerate small amounts of fruit.
Some supplements also help. The most useful supplements are inexpensive and free of side effects.
The cells of the retina use magnesium to store energy in the form of ATP, and without magnesium, they cannot use glucose. Diabetics of European descent who have retina damage usually are magnesium-deficient, but diabetics of African descent who have retina damage usually are not. This means that not everybody will be helped by taking a magnesium supplement.
Magnesium citrate and magnesium tartrate are best absorbed. Don’t overdose. Magnesium supplements, like the namesake Milk of Magnesia, can cause diarrhea.
Magnesium supplements will not do you any good if you do not get your B vitamins. Vitamin B6 (pyridoxine) is essential for transporting magnesium into the cell.
Vitamin C supports the production of collagen that keeps the blood vessels in the retina in their normal courses. The retina uses vitamin C to make collagen and hang blood vessels in much the same manner as carpenters hang sheet rock on a wall. All diabetics are at risk for vitamin C deficiency even if they get a lot of vitamin C foods in their diets, but just 100 milligrams a day can be enough to slow down retina changes.
The jury is still out on vitamin E. Researchers at the Joslin Diabetes Center and Harvard found that really high doses of vitamin E in the form of alpha-tocopherol, up to 1,800 milligrams a day, could not just prevent retina changes, but even reverse them. The drawback is, taking that much vitamin E can interfere with various medications you take for your circulatory system. Ask your eye doctor before you start a high dose.
OPCs (oligomeric proanthocyanidins) like the ones found in grape seed extract protect collagen from injury from high blood pressure. They stop a collagen-destructive enzyme. Bilberry works in a simlar manner, and ginkgo may help color vision in milder cases.
Read Causes Retinopathy. Robert Rister is author or co-author of nine books on natural healing.
Diabetic retinopathy can strike both type 1 (insulin-dependent) and type 2 (initially non-insulin dependent) diabetics. There are two types of the disease.
The more common, less serious form of the disease is known as background, nonproliferative, or simple retinopathy. This kind of retina damage is due to increased “leakiness” in the microscopic capillaries providing blood supply to the eye. There can be tiny sites of hemorrhage, swelling, or “oozing,” tiny aneurysms in the retina. Where the blood vessels leak, the visual field is impaired.
The second, less common, and more serious form of the disease is known as proliferative or malignant retinopathy. (The term “malignant” here refers to the severity of the condition, not to any danger of cancer.) Proliferative retinopathy, new blood vessels start growing forward from the retina into the fluid filling the eyeball. There can be scarring, and the fibers supporting the new blood vessels obscure the fall of light onto the retina where images are received and processed to be sent to the brain.
Both kinds of diabetic retinopathy result from a process called glycoslylation. Most diabetics are familiar with glycosylation from the measurement of glycosylated hemoglobin, of HbA1C. When blood sugars stay high, red blood cells eventually become “caramel coated.” They stick to the linings of blood vessels, and the injury slows the flow of blood, which in turn triggers the growth of misplaced, competing, microscopic blood vessels.
One of the risk factors for retinopathy diabetics are seldom warned about is high homocysteine. It’s a special risk factor for any diabetic who has kidney damage. And the damage done by too much homocysteine is compounded by high LDL or low HDL.
And if there’s any dietary additive that can bump up the risk of retinopathy even more than sugar, it’s the sweetener sorbitol. In diabetics and non-diabetics alike, sorbitol is a byproduct of the breakdown of blucose. In non-diabetics, sorbitol can be turned into fructose and flow into circulation. In diabetics, sorbitol, whether a byproduct of burning glucose or absorbed from the bloodstream, stays in the cell. The cell takes in water to dilute the sorbitol and swells, interfering with normal circulation. Sorbitol causes problems all over the body, but especially in the eye.
Recent reader questions:
Q. What's effect of kidney transplants on diabetic retinopathy?
A. Generally, it's positive, but the longer the period of dialysis before transplant, the greater the risk of eye complications after transplant, and the older the kidney, the greater the risk of retinopathy. Drug treatment makes a difference, too. Diabetic retinopathy is accelerated by the administration of recombinant erythropoietin to patients waiting for transplant. Getting off the erythropoietin may halt the progression of retinopathy.
Read about what you can do to treat High Homocysteine and Treating Diabetic Retinopathy Naturally.
Saturday, December 27, 2008
A “paresis” is paralysis and “gastro” refers to the stomach. Gastroparesis (gas-tro-par-EES-is) is a kind of paralysis of the upper digestive tract that causes a delay in emptying the stomach into the small intestines. Eventually afflicting up to 50 per cent of diabetics, this overlooked form of nerve damage typically occurs after a long period of poorly controlled blood sugars, at least 5 to 10 years. Not every diabetic who has this problem experiences all its symptoms all the time, but about half of bloating, constipation, diarrhea, nausea, and vomiting in diabetics may be related to this disease.
The way diabetes results in diabetic gastroparesis is by injury to the stomach’s “pacemaker.” The upper part of the stomach, the fundus, collects food and rink. The lower part of the stomach, the antrum, churns the food around in the acidic gastric juices until it is broken up into tiny fragments and ready for release to the duodenum, the forward part of the small intestine.
A healthy antrum releases food about 3 times a minute, its rate controlled by the vagus nerve, the same nerve that controls the speed of the heart. But when the vagus nerve is damaged by years of high blood sugars, it slows down the stomach. Food accumulates and the stomach has to rely more on stomach acids to break up food and gravity to push partially digested food further along.
So what can you do about gastroparesis? Number one, keep your blood sugars in check. Number two, chew thoroughly and use digestive enzymes, like bromelain, when you eat your food.
High-fat foods slow stomach emptying, and high-fiber foods are something you should avoid when symptoms are severe. Eating smaller meals more often may help, too, but you need to adjust insulin, if you take it. Certain South American herbs, like guarana and mate, aggravate gastroparesis, so be careful with energy drinks. Finally, and ironically, the anti-neuropathy drug Elavil (amitriptyline) makes gastroparesis worse.
To prevent diabetic ulcers, diabetics who have neuropathy in the feet, and diabetics in general, should:
Inspect feet and toes every day for any bruises, bumps, cuts, contusions, scrapes, or infections, including fungus infections like athlete’s foot. If you can’t look at your feet yourself, it is very important to find someone who can look at your feet for you.
Only use warm water, not hot, and mild soap (no Lava), to wash your feet. Test the temperature of the water by using your wrist before you immerse your heat. This will help prevent burns.
Dr. Robert Bernstein cautions against soaking your feet if you have diabetes. Too much exposure to water may loosen protective calluses. Dry feet carefully with a soft towel, and don’t forget to dry between your toes. It’s a good idea to wash your feet every day.
Before you put on your socks, make sure your feet are dry, but then moisturize with a foot cream, cold cream, lanolin, or petroleum jelly. Moisturize will keep the skin on the foot from cracking and letting infection in.
And you don't want tight-fitting socks. Specially designed "diabetic socks," that don't leave grooves on your calves and ankles when you take them off, are both better for circulation and a lot more comfortable. Diabetic socks are pricey, you can find a wholesale diabetic sock section at most WalMarts throughout North America. Medipeds Diabetic Socks are also available at K-Mart and Sears and occasionally for as little as US $1.50 a pair on eBay.
Be picky about your shoes. Make sure you get shoes with firm heels that support and stabilize. There should be plenty of room for your toes. Break news shoe in gradually, only an hour or two at a time.
There are open-toed sandals designed especially for diabetics, such Ambulator Conform Sandals. These sandals accommodate bunions, hammer toes, claw toes, and mallet toes, problems that are not unusual in diabetics’ feet. It's OK to buy cheap diabetic shoes as long as they have inserts to minimize skin damage in daily use.
Every time you see your primary health care provider, make sure he or she examines your feet. Do not hesitate to call if a sore on your feet is not healing well.
Try not to sit with your legs crossed. Crossing legs reduces blood flow to the feet.
Examine your shoes regularly to make sure they have not picked up any stones, tacks, nails, or street debris.
If your feet get cold at night, wear socks, but do not use heating pads, because diabetic neuropathy make prevent your feeling burns.
It’s OK to remove dead skin, but do not remove calluses covering a wound.
Read Diabetics Beware: The Secret Source of Blood Sugar and Vitamin D & Diabetes. Robert Rister is the author or co-author of nine books on natural health.
Before diabetics develop foot ulcers, they usually have diabetic neuropathy of the feet. This condition can manifest itself as a simple feeling like the foot is “asleep,” or maybe a tingling or burning sensation, usually worse at night. The condition can progress so that the feet feel the same way your mouth does after you get a shot of anesthetic at the doctor’s office, only the feeling never goes away.
Loss of sensation in itself is something diabetics can deal with, as long as they can see their feet. The problem comes when a diabetic does not feel a broken bone or notice an infection after a cut or a scrape. Clogged capillaries cannot carry immune cells to clear out infection, and gangrene can set in. Treating gangrene without surgery is not impossible, but it is very difficult.
Doctors at the Hospital General in Durango, Mexico have published a study that almost 95 per cent of their diabetic patients presenting foot ulcers suffer low magnesium levels. Another study found that low magnesium levels are associated with a 300 per cent greater risk of foot ulcers in type 2 diabetics. When diabetics take supplemental magnesium (something to be done carefully and in moderation, since, like Milk of Magnesia, magnesium supplements can cause diarrhea), modest improvement usually comes about in 3 or 4 days. It lasts as long as you take the supplement, or eat magnesium-rich foods like greens or spinach every day.
Recent reader questions:
Q. What's the significance of bites or bumps just on toes of a diabetic?
A. I can't diagnose you, but my question would be whether there weren't really bites further up the foot and leg and only the toes were not healing quickly? Toes are the first part of the foot, usually, to show diabetic changes.
Read Tips for Preventing Diabetic Foot Ulcers.
There are two diabetes diet that can help diabetics control their blood sugars, although no useful diet is recommended by the American Diabetes Association. The first approach, promoted by well-known diabetes experts like Dr. Robert Bernstein and Janet Ruhl, is to drastically reduce or essentially eliminate all carbs from all sources. Their approach is an an eating plan similar to the Atkins diet, although even more restricted.
In the really low-carb approach, there are no sweets at all, ever. There are no juices, no desserts, no crackers, no beets, carrots, corn, or potatoes, and only limited amounts of dairy. (Janet Ruhl’s approach is a little more liberal than Dr. Bernstein’s.) Just about the only safe carbohydrates in a truly low-carb diabetic diet are those from high-fiber crackers that you may have trouble finding in your supermarket, Scandinavian crisp breads and bran crisps. There are never, ever any occasions when bread, sugar-sweetened ice cream, or candies are permitted. Since there are virtually no carbs, the glycemic load of this diet is just about zero.
Diabetics who go on this diet find it really does help lower blood sugars, the drawback being that the human body can convert protein into sugar, too, so too much protein on a low-carb diet also raises blood sugars. But this approach really is easiest for diabetics who do not want to start medication or insulin, and for diabetics who cannot or choose not to exercise.
Moreover, the ultra-low-carb diabetic diet prevents diabetic complications. Almost all diabetics, even those who take diabetics, will have high blood sugars (over 200 mg/dl, or, in the European system, over 11 mM) a couple hours to five hours after eating. It is these post-prandial, or after-eating, blood sugars that cause nerve damage in the feet, hands, heart, and digestive tract. Even if you eat too much protein, your liver does not convert the unneeded amino acids into glucose right away. Avoiding carbohydrate almost altogether is an almost sure-fire way to minimize complications and minimize your dependence on diabetes drugs.
A low-carb diet won’t damage the kidneys or raise your cholesterol unless factors other than diabetes are at work. When cholesterol receptors in the liver are not clogged by glucose, the organ can clear cholesterol out of the bloodstream. When the kidneys are not stressed by having to remove glucose, they are generally not damaged by protein.
There is another approach that works, but it works for diabetics who exercise. Not for diabetics who would exercise, or for diabetics who think about exercise, but for diabetics who actually exercise. All carbs, at least all carbs that actually get digested (some pass through to the stool), turn into glucose. Even lettuce and carrot sticks in sufficient amount can raise blood sugar. High-glycemic index carbohydrates, however, are turned into sugar slowly.
This gives pancreas, if you are an early-stage type 2 diabetic, or your insulin injection, a chance to work. The catch is, you have to be active enough to burn the sugars as they are released. And sugar will not build up in your bloodstream if fatty acids do not compete for hepatic “processing.” Active diabetics sometimes (but not always) can make a high-healthy-carb diet work.
So when do you get your cookie? Isn't that somewhere in the American Diabetes diet recommendations and guidelines?
Once in a while, of course, your body needs extra glucose. When you lift weights, when you do aerobic exercise to the point of huffing and puffing, and even when do some kind of physical activity your body is not used to, like moving the couch, you burn more sugar. Eating a cookie or another sweet about 20 minutes before you exercise will provide you the energy you need. But eating two can be too much.
One more consideration? Food sensitivities. Wheat, potatoes, and oat products, scientists tell us, are among the diabetes foods that are important to avoid. The problem is not their carbohydrate content, or not just their carbohydrate content. The problem is that they cause inflammation that may change the way fat cells use insulin.
Learn more about what kind of food to eat for type 2 diabetes. You may also be interested in Cholesterol Do's and Don'ts for Diabetes, or my latest article on a new diet to reverse diabetic kidney disease.
Fortunately, most cases of lower back pain are self-limited. That is, they go away no matter how they are treated. For some people lower back pain becomes chronic, meaning it is does not go away and causes problems indefinitely.
Lower back pain usually develops over a period of years from accumulated abuses of the spine, many of which are not painful when they are incurred. Even when there is a single identifiable acute injury that causes the lower back to hurt, the overall condition of the back, not just the condition of the spine, determines the speed of recovery and whether back pain becomes permanent.
Nutritional supplements do not have a direct or immediate on back pain. They prevent further injury to bone. Over the course of months and years, this reduces back pain, but you will not see immediate results.
Is there a food that can give you fast relief from back pain? Actually, there are two: Almost any entree made with ginger and/or a peppery food will offer you a slight amount of relief. For long-term improvement of back pain, however, you will do best to follow the guidelines for osteoporosis.
Friday, December 26, 2008
Hives are intensely itchy. They may involve any area of the body from the scalp to the soles of the feet, and appear in crops of 24- to 72-hour duration. The most common sites for hives are the hands, feet, and face. Angioedema, a swelling below the skin caused by the same allergic mechanism, usually occurs around the eyes and in the lips. While hives usually go away without treatment, angioedema in the upper respiratory tract may be life threatening and requires immediate medical attention.
A survey of college students indicates about one in five people has hives at some point in life. Hives may occur at any age, but young adults in their twenties are the most frequently affected. The precise causes of the condition vary person to person. They are discussed by category below.
Aspirin sensitivity is observed in up to 67 percent of persons who have recurrent outbreaks of hives. Aspirin alters the metabolism of free fatty acids so that it favors the production of leukotrienes. These are hormonal messengers that make the walls of blood vessels more permeable to histamine. Aspirin also makes the lining of the intestines more permeable to allergens, increasing the risk of reaction to common food allergens such as cheese, chocolate, eggs, milk, pineapple, shellfish, and strawberries. At least one study found taking a single adult aspirin daily for three weeks desensitizes the immune system to aspirin and also to foods, but the benefits vanish if aspirin is discontinued.
Two factors increase the risk of outbreaks of hives after eating allergenic foods. One is incomplete digestion. A study published in the 1940’s reported that of 77 patients diagnosed with chronic hives, 65 had failures to produce enough stomach acid to break down the proteins that cause allergies. Treatment with hydrochloric acid and a vitamin B complex relieved symptoms in most of the patients in the study. Failure to secrete sufficient gastric acid is especially common in persons over the age of 60. It may be a major contributing factor in repeated outbreaks of hives after consuming allergenic foods in older persons.
Another contributing factor to recurrent food allergies is the permeability of the intestinal wall. This is the reason reactions to food are more severe when they are consumed after taking aspirin. Aspirin irritates the lining, increasing its permeability and easing transport of allergens into the bloodstream. Alcohol, NSAIDs, and many food additives have a similar effect. Consuming any substance that irritates the lining of the digestive tract increases the severity of the food allergy that causes hives.
Food colorings, especially yellow dye #5 (tartrazine), can provoke hives in about 0.1 percent of the population. Tartrazine is added to almost every food and even antihistamines, antibiotics, sedatives, and steroids. This yellow dye modifies fatty acid metabolism in the same manner as aspirin and increases the susceptibility of the skin to allergic inflammation.
Food flavorings are a major factor in many cases of hives in children. A wide range of salicyclic acid esters flavors cake mixes, chewing gum, puddings, and soft drinks. These chemical relatives of aspirin also occur naturally in curry powder, dill, licorice, oregano, paprika, peppermint, prunes, raisins, and turmeric. The average child consumes as much 200 mg of salicylate per day. This dosage approaches the amount of salicylate in children’s aspirin. Other flavorings, including aspartame, cinnamon, menthol, and vanilla may produce urticaria in some individuals.
The food preservatives BHA (butylated hydroxyanisol) and BHT (butylated hydroxytoluene) provoke reactions in about 15 percent of individuals who have chronic hives. As many as 44 percent of persons with chronic hives are allergic to benzoates, which occur in relatively high concentrations in fish and shrimp. Sulfites, which are sprayed on fruits, vegetables, and shrimp to keep them fresh in countries outside the United States, aggravate a wide range of allergic conditions, including asthma as well as hives. Sulfites occur naturally in beer and wine.
About 1 in 10 people is allergic to penicillin, and about 1 in 4 of those allergic to penicillin will develop urticaria, angioedema, or anaphylaxis after taking it. Penicillin is a common additive to livestock feeds. Hives and anaphylactic reactions have been traced to penicillin in frozen dinners, milk, and soft drinks. Among patients with chronic hives and an allergy to penicillin, about half will improve on a dairy-free diet.
Recent reader comments:
"Rice dream rice milk cured hives in both of my children. You are really right about the virtues of a dairy-free diet."
Recent reader comments:
Q. Can eating raw liver cause hives?
A. You eat a lot of raw liver, do you? Or are you getting hives after using raw liver formula? If the animal was given penicillin while it was still on the farm, yes. And dairy products will aggravate the reaction.
Q. Is is true dehydration causes hives?
A. If you have a sensitivity to aspirin, it might. The lowered amount of blood volume results in an increased concentration of salicylates, triggering a reaction. But dehydration is very simple to remedy. Drink more water, preferably with a pinch of salt and sugar (or an electrolyte mix, if you want to get fancy) so your colon can absorb it more readily.