Trying to Conceive

August 7, 2017

Infertility is defined as not being able to get pregnant after at least one year of trying. Additionally, (1) women over the age of 35 who having been trying for less than one year and (2) women who are able to get pregnant but then have repeat miscarriages are candidates for infertility evaluation.

Pregnancy is the result of a complex chain of events. Infertility can result from problems with any of these steps:

  • A woman must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus.
  • A man’s sperm must fertilize the egg along the way.
  • The fertilized egg must implant inside of the uterus.

Problems with ovulation account for most cases of infertility. Without ovulation, there are no eggs to be fertilized. Irregular or absent menstrual periods are a sign of no (or infrequent) ovulation. Less common causes of infertility in women include:

  • Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery
  • Physical problems with the uterus
  • Uterine fibroids

Many things can affect our ability to conceive: age, stress, diet, intense athletic training, being overweight or underweight, smoking, alcohol, sexually transmitted infections, hormone changes.

Sometimes we can find the cause of a couple’s infertility by doing a complete fertility evaluation. The process begins with physical exams and health and sexual histories. If there are no obvious problems, like poorly timed intercourse or absence of ovulation, further tests are needed. Finding the cause of infertility is often a long, complex, emotional process. It can take months to complete all the needed exams and tests.

For a man, we begin by testing semen. We look at the number, shape, and movement of sperm. For a woman, the first step in testing is to find out if she is ovulating each month.

Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times, treatments are combined. Two-thirds of couples treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery. Many fertility drugs increase a woman’s chance of having twins, triplets, or other multiples. Women who are pregnant with multiple fetuses have more problems during pregnancy. Multiple fetuses have a high risk of being born too prematurely. Premature babies are at a higher risk of health and developmental problems.

Assisted reproductive technology (ART) describes several different methods used to help infertile couples. ART involves removing eggs from a woman’s body, mixing them with sperm in the laboratory, and putting the embryos back into a woman’s body.

There is a small number of causes that are ‘preventable’. Reducing or eliminating life stressors, both emotional and physical, is important to increase the likelihood of conception.  Also, eating healthy can make a difference.  Being overweight or underweight can affect fertility potential.  Also, for women who enjoy intense athletic training, reducing or altering workouts can make a difference in the body’s ability to produce healthy, viable eggs.  Eliminating habits like caffeine, cigarette smoking, alcohol, drugs and even some over-the-counter and prescription medications can increase chance of conception.  If you are using prescriptions medications, do not stop these medications abruptly without consulting your medical provider.  Men and women can optimize their immunity and health by incorporating food or supplements rich in antioxidants, monounsaturated oils and omega 3’s.  Additionally, protecting oneself from exposure to sexually transmitted infections and getting immediate treatment if exposed to an infection, can reduce infertility.

Additionally, if you do not want to have children until later in life, consider freezing eggs.  By doing this, you can eliminate poor egg quality, that comes with advancing age, as a reason for infertility. Likewise, if a man or woman has cancer and requires chemotherapy or radiation, consider freezing sperm or eggs in the event cancer treatments destroy egg/sperm quality and/or quantity.

Being mindful of the above can certainly reduce the likelihood of infertility, but there are so many other causes that are not preventable.  For this reason, it is nearly impossible to ‘prevent’ infertility.

As indicated above, some women will turn to freezing eggs and sperm to increase likelihood of conceiving if planning to conceive later in life or receiving medical treatments that may destroy eggs and sperm.

 

Other infertility treatments include (1) initiating fertility and hormone medications (for both men and women) to correct hormonal imbalances, improve sperm health, enhance the ability to make good quality eggs and ensure ovulation, (2) hysteroscopic or laparoscopic surgical interventions to remove anatomical abnormalities, scar tissue or other blockages that affect females and male reproductive structures, (3) hysteroscopic or laparoscopic surgeries to remove fibroids or polyps or other uterine abnormalities that restrict adequate implantation of fertilized eggs, (4) surgical interventions to reverse vasectomies or tubal occlusions, (5) intrauterine insemination (IUI) to help sperm with decreased motility get to an egg for fertilization, (6) and more complex and technical procedures like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) where sperm is directly injected into the egg to allow fertilization.  Additional options include sperm and egg donation and using gestational carriers/surrogates.

 

There are a variety of struggles when it comes to infertility. The most obvious hurdle is the financial cost of infertility treatments. Some insurance plans cover infertility treatment, but coverage varies and is often not enough to cover all expenses or treatments.  Out of pocket expenses can often lead to fights or resentments if spouses disagree on cost effectiveness or either is pressured to go through with costly treatments.

 

Couples also deal with emotional/psychological hurdles.  A lot of couples feel shame and don’t want anyone to know they are having trouble conceiving naturally. Also, couples with infertility often feel like others cannot relate to what they are going through. These factors can cause couples to feel isolated as they compare themselves to family and friends who are parents. Because of this, they feel embarrassed and avoid family and friends for fear of judgement or criticism. Additionally, couples often try to avoid being questioned by family, friends and strangers. Insensitive inquires like: ‘Why don’t you have children?’ or ‘Which one of you has the problem?’ can take an emotional toll.  Not to mention unsolicited comments and recommendations that couples are often given.

 

Another difficulty is that couples can undergo many treatments before they achieve success (assuming they ever achieve success).  Fertility treatments have become more advanced, but couples still often face multiple disappointing failed treatments along the way.  Multiple treatments and failures can lead to both physical and psychological stress.  In addition to this, side effects of fertility treatment drugs, hormones and injections can cause mood swings, sleep disturbances, problems focusing, depression and anxiety.  Overall, there is often a rollercoaster of emotions.  It is hard enough when both partners are affected the same way.  Unfortunately, emotional factors often affect each partner differently, which can cause resentment, misunderstanding and arguments that can either bring couples closer together or take a significant toll on the relationship. On top of this, sex often becomes a chore that has to be timed perfectly in order to optimize success.  Sex loses its association with pleasure and intimacy.

 

Infertility has taken on a new face, with added struggles, with the emergence of same-sex couples and single individuals wanting to become parents.

 

At Tree of Life Medical we will perform a thorough evaluation of all the possible causes that are making it difficult for you to conceive.  We will prescribe some medications and make lifestyle recommendations to assist you in your attempt to conceive.  If more in-depth evaluation and management is needed, we will make sure you are referred to the appropriate specialists.  We will help coordinate your care and stand by you as you go through every step of the process.

 

Breast and Ovarian Self-Awareness

June 26, 2017

Facts:  1 in 8 women will develop breast cancer in their lifetime—it’s the leading cancer diagnosis among women. 1 in 75 women will develop ovarian cancer in their lifetime, and 2/3 of those diagnosed will die from their disease.

 

Prevention & Early Detection:  Beat those odds. When caught early, the five-year survival rate for breast and ovarian cancer can be greater than 92%.  Not only should you practice early detection strategies, but you can also actively reduce your risk by living a proactive healthy lifestyle. The power is in your hands to start practicing healthy behaviors early, so that they’ll last a lifetime.

Partner With A Medical Provider You Trust:  He or she should listen to your questions, pay attention to your concerns, and provide clear recommendations. Once you’ve “shopped around” and found a doctor you like, together you will develop a plan that is best for you. No matter which category you are re in, all women should have an annual well-woman exam as part of their comprehensive prevention plan.

Practice Breast and Ovary Self-Awareness:  Breast self-awareness is key when it comes to early detection. Everybody’s breasts are different, so it’s about getting to know the ‘normal’ look and feel of YOUR breasts, and speaking up if you notice any changes. We all have different breasts – different sizes, shapes, and with various types of lumps that may come and go. What is standard for you may not be your friend’s ‘normal’. Keep tabs on yourself to make sure your breasts are their usual size, shape, and color. Touch your breast tissue from multiple angles with varying pressure to feel both the deep and surface layers, from the interior by your ribs to just below the skin. Don’t forget that your breast tissue extends up your collarbone, around to your armpits, and into your breastbone. MEN, you have breast tissue too – and MEN can get breast cancer as well.

Don’t forget your ovaries. To be Ovarian Self-Aware, you also need to know the signs and symptoms of ovarian cancer and what is normal for your body. When you know your ‘normal’, you will be more likely to notice any changes — and speak up should they occur. Symptoms of ovarian cancer are vague and often confused with digestive or menstrual complaints, so never be afraid to ask your doctor.

It also means knowing your family history (and whether it increases your risk), the signs and symptoms of cancer, and how the lifestyle decisions you make in your daily life play a role in increasing or decreasing your risk.

Know Your Family History:  Find out which relatives (on both parents’ sides) have had cancer of any kind, which types, and how old they were when diagnosed. While breast and ovarian cancer history is important, other types of cancer can also be indicators — so capture everything you can. There are three categories of risk for breast and ovarian cancer with different recommended screening and risk reduction measures.

 

  • Average Risk:  Just by being a woman, you have a 12% chance of getting breast cancer and a 1.3% chance of getting ovarian cancer. Essentially, all women are at least at average risk. While the chance of developing cancer is smaller for women at average risk, it is important to know that this group accounts for approximately 75% of all breast and ovarian cancers that occur. You can’t exempt yourself from a proactive lifestyle just because you aren’t in the increased- or high-risk categories. Risk-reduction and early detection practices are important for all women, no matter the level of risk.

 

  • Increased Risk:  Women of increased risk have up to a 25% chance of getting breast cancer and up to 5.5% chance of getting ovarian cancer — more than double that for average Risk. Those in this category usually have a family member with a history of breast or ovarian cancer, and sometimes more than just one relative on the same side of the family.

Knowing that you’re a woman at increased risk is an opportunity to be proactive and make decisions that can have a positive impact on your health. It’s important that women in this category develop an appropriate risk management strategy that incorporates increased or earlier screening. You may also want to consider genetic counseling if you’ve not yet taken this step.

 

  • High Risk:  Women of high risk have up to an 87% chance of getting breast cancer and up to 54% chance of getting ovarian cancer in their lifetime. These numbers are dramatic. They illustrate why it’s so important for women who are at high risk to identify and understand their risk and collaborate with a doctor on a personalized risk management strategy.

It is critical for high-risk women in this category to start incorporating risk reduction and early detection techniques above and beyond what is needed for the other two risk levels. If you’re at high risk, in addition to consulting with your doctor we also encourage you to talk to a genetic counselor, check out and consider one-on-one support or group support if that feels right for you. Just remember that knowledge is power — you’ve got what it takes to make changes that can have a profound impact on your health.

 

Simple, Everyday Choices for Risk Reduction:  There are easy things we can all do to lower risk, starting with leading a healthy lifestyle. Your 20’s and 30’s are the ideal time to start adopting new habits that can reduce your lifelong risk of breast and ovarian cancer, so give the following lifestyle choices the consideration your body deserves. And these risk-reduction steps can benefit women at all risk levels. They apply to everyone! While all of these activities can help reduce your breast and ovarian cancer risk, they do not eliminate it completely.

 

  • Regular Exercise:  Maintaining a healthy weight is crucial — there is a clear link between obesity and breast cancer because of the excess estrogen produced by excess fatty tissue. You’ve heard it before, but we’ll tell you again: being active is key. 30 minutes of regular exercise, enough to get your heart rate up or to break a sweat, on most days may reduce your risk by as much as 10-20%. Plus, it has lots of other benefits like lowering your risk for heart disease and reducing stress.
  • Eat Well, Live Well:  Research has shown that the food you put in your body has a direct link to your health. Fill up on cancer-fighting fruits and vegetables, make sure you get all your vitamins, and avoid red meat — research has shown a 12% increase in breast cancer risk per 50g of red meat consumed on average each day.

Excess Alcohol: Cut back on cocktails. Research shows a 10% increase in breast cancer risk for every 10g of alcohol — that’s one standard drink — consumed on average each day. Limit alcohol to one drink per day or eliminate it entirely.

  • Stop Smoking:  This one is simple, for a variety of reasons! There’s a known link between tobacco and many cancers (not just lung or other oral cancers). If you do smoke, commit to quitting today.
  • Having Children and Breastfeeding:  Pregnancy transforms and stabilizes the cells that comprise milk-producing glands and ducts, so the earlier this transformation happens, the lower the risk of breast cancer. Some studies have shown that women with first pregnancies under the age of 30 have a 40-50% lower risk of breast cancer than women who gave birth later or who were never pregnant.
  • Pregnancy can also reduce your risk of ovarian cancer by eliminating ovulatory cycles and therefore the number of chances for ovarian cells to ‘go rogue’ during cell division.

If it makes sense for you, breastfeeding for 1-2 years — not necessarily consecutively — lowers your risk for both breast and ovarian cancer by decreasing estrogen levels and the number of times you’ll ovulate over the course of your life. It also may reduce a female baby’s overall risk of developing breast cancer later in her life.

  • Taking Birth Control:  In addition to preventing pregnancy, studies have shown that oral contraceptives (birth control pills) can help prevent ovarian cancer. Taking birth control pills for 5 years — even non-consecutively — in your 20s and 30s can reduce your ovarian cancer risk by nearly half.
    Studies have shown that the increased risk of breast cancer risk related to birth control pills is very low— if it exists at all —temporary, and not associated with the most common, low-dose estrogen pills. The protective benefits of birth control pills when it comes to ovarian cancer risk are greater than the very slight associated increase in breast cancer risk.
  • Environmental Factors:  The chemicals in our environment play a role in altering our biological processes. We now know that exposures to toxic chemicals and radiation are connected to our breast cancer risk. Get to know the chemicals that have been linked to breast cancer and learn about what you can do in terms of personal, corporate and political action to limit your exposure, thereby reducing your risk of breast cancer.

Peri-Menopause, Menopause, Post-Menopause?

June 8, 2017

Peri-Menopause, Menopause, Post-Menopause…What Does This All Mean?? 

Wikipedia definitions: (1) Perimenopause: the period of a woman’s life shortly before the occurrence of the menopause. (2) Menopause:  the ceasing of menstruation; the period in a woman’s life (typically between 45 and 50 years of age) when this occurs. (3) Post-Menopause: having undergone menopause or occurring after menopause.

Hmmm? Still uncertain what this all means??

Reality: what you call it, isn’t all that important!! Perimenopause, Menopause, and Post-Menopause are all part of a continuous spectrum.

Perimenopause means ‘around menopause’ and refers to the time when your body makes the natural transition to menopause, marking the end of reproductive years. This time is also called the ‘menopausal transition’.  Women start perimenopause at different ages. You may notice signs, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.

The level of estrogen — the main female hormone — in your body rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don’t release an egg (ovulate). This period of time is also marked by decreasing levels of testosterone, another important female hormone. These hormonal changes/fluctuations may cause symptoms, such as hot flashes, sleep problems, vaginal dryness, irritability and mood swings, fatigue, decreased motivation, decreased libido, weight gain or difficult losing mid-section weight, decreased mental focus and decreased concentration.

Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached ‘menopause’…and perimenopause is over. Essentially, this is one, single day in time.

The time of a woman’s life following menopause is called post-menopause. During this time, many of the symptoms experienced before menopause can decrease. However, a lot of women may have persistent or worsening symptoms. **IMPORTANT** — just because your symptoms may decrease or go away completely, this does NOT mean your body is satisfied with its current hormonal state!!!

Postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease. Also, depletion of these hormones can exacerbate chronic pain disorders and mood disorders.  Medications and/or healthy lifestyle changes may reduce the risk of some of these conditions, but there is NO substitute for proper hormone balance!!

Menopause And Ovarian Cancer

Ovarian cancer starts in the ovaries and often spreads to other parts of the body. Although it can happen at any age, it is most common in women over age 50. Half of ovarian cancer cases are found in women age 63 or older, according to the American Cancer Society.  Menopause does not ‘cause’ ovarian cancer. But your chances of developing ovarian cancer increase as you get older. When you go through menopause, your risk increases just because of your age. If you start menopause late — usually after age 52 — your chance of ovarian cancer may be higher (because you’ve had more ovulations). Ovulation is when your menstrual cycle triggers your body to release an egg.

Breast Cancer and Menopause

Menopause itself is not associated with an increased risk of developing cancer. However, the rate of breast cancer increases with age.  Age is the single-most important risk factor for breast cancer. About 95% of women diagnosed with breast cancer each year are over age 40, and about half are age 61 and older. Personal risk is also greater if an immediate family member (mother, sister, or daughter) has had breast cancer, particularly if it was at an early age. Also, women who have had a breast biopsy (removal of breast tissue) that shows certain types of benign disease, such as atypical hyperplasia, are more likely to get breast cancer.

Other risk factors include:

  • Having cancer in one breast (may recur or develop in other)
  • Having a history of ovarian, uterine, or colon cancer
  • Having a genetic abnormality in breast cancer genes BRCA1 or BRCA2
  • Late menopause (after age 55)
  • Starting menstruation early in life (before age 12)
  • Having a first child after age 30
  • Never having children

Can I Prevent Breast Cancer?

While there is no definitive way to prevent breast cancer, there are steps you can take to reduce your risk:

  • Maintain a healthy weight
  • Be physically active and get at least 30 minutes of moderate to vigorous exercise five or more days per week.
  • Eat a healthy diet with at least five servings of fruits and vegetables daily; limit the amount of processed meat and red meat eaten.
  • Women should drink no more than one alcoholic beverage daily (men should drink no more than two alcoholic beverages daily).

Menopause and Heart Disease

People who have one or more specific risk factors for coronary heart disease may be at much greater risk of heart disease than people with no risk factors.

Common Risk Factors:

1) High blood pressure:  High blood pressure can strain the heart and increase wear and tear on the blood vessels, making blockage more likely.

2) African-American Race:  African-Americans are more likely than Caucasians to develop severe high blood pressure as well a heart disease. Heart disease risk is also higher among Mexican-Americans, American Indians, native Hawaiians, and some Asian-Americans. This may be partly due to higher rates obesity and diabetes.

3) Post-Menopausal Female:  Men have a higher risk of heart disease than women. However, the risk of heart disease in postmenopausal women increases and becomes similar to that of men.

4) Family History of Heart Disease:  The genetic make-up of some individuals increases their chances of developing heart disease.

5) Over Age 40:  The older you get, the more likely you are to develop heart disease.

6) High cholesterol:  High cholesterol can contribute to the build-up of plaques that can clog blood vessels leading to the heart, narrowing them and potentially blocking blood flow to the heart.

7) Smoker:  Cigarette smoking is a major cause of heart disease. It causes plaque to build up in the arteries and can greatly increase your risk for heart attack.

8) Diabetes:  About three-quarters of people with diabetes die of some form of heart or blood vessel disease. Even when blood sugar levels are under control, diabetes increases the risk of heart disease, but the risks are even greater if blood sugar is not well controlled.

9) Physically inactive, Overweight, or Obese:  An inactive lifestyle is a risk factor for heart disease. Regular physical activity helps prevent heart and blood vessel disease. And people who have excess body fat — especially around the waist — are more likely to develop heart disease even if they have no other risk factors.  Exercise can help control cholesterol, diabetes, and obesity, as well as help lower blood pressure.

10:  Other:  Other factors may also contribute to an increased risk of heart disease. These may include an individual’s stress level and consumption of alcohol. Talk to your doctor about your specific situation, taking all factors into consideration.

Osteoporosis and Menopause

Osteoporosis is a disease that weakens bones, increasing the risk of sudden and unexpected fractures. Literally meaning “porous bone,” osteoporosis results in an increased loss of bone mass and strength. The disease often progresses without any symptoms or pain. Many times, osteoporosis is not discovered until weakened bones cause fractures usually in the back or hips. Unfortunately, once you have a broken bone due to osteoporosis, you are at high risk of having another. And these fractures can be debilitating. Fortunately, there are steps you can take to prevent osteoporosis from ever occurring. And treatments can slow the rate of bone loss if you already have osteoporosis.

What Causes Osteoporosis?

Though we do not know the exact cause of osteoporosis, we do know how the disease develops. Your bones are made of living, growing tissue. An outer shell of dense bone encases a sponge-like bone. When a bone is weakened by osteoporosis, the “holes” in the “sponge” grow larger and more numerous, weakening the internal structure of the bone. Until about age 30, a person normally builds more bone than he/she loses. During the aging process, bone breakdown begins to outpace bone buildup, resulting in a gradual loss of bone mass. Once this loss of bone reaches a certain point, a person has osteoporosis.

How Is Osteoporosis Related to Menopause?

There is a direct relationship between lack of estrogen and development of osteoporosis. Early menopause (before age 40) and any prolonged periods in which hormone levels are low and menstrual periods are absent/infrequent can cause loss of bone mass.

What Are the Symptoms of Osteoporosis?

Osteoporosis is often called the “silent disease” because initially bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as stooped posture.

Who Gets Osteoporosis?

Important risk factors for osteoporosis include:

  • Age: After maximum bone density and strength is reached (generally around age 30), bone mass begins to naturally decline with age.
  • Gender: Women over the age of 50 are at the greatest risk. Women are four times more likely than men to develop osteoporosis. Women’s lighter, thinner bones and longer life spans account for some of the reasons why they are at a higher risk for osteoporosis.
  • Ethnicity: Research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Hip fractures are twice as likely to occur in Caucasian women as in African-American women. However, women of color who fracture their hips have a higher mortality.
  • Bone structure and body weight: Petite, thin women have a greater risk of developing osteoporosis because they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight.
  • Family history: Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may be at greater risk of developing the disease.
  • Prior history of fracture/bone breakage.
  • Certain medications: The use of some medications, such as the long-term use of steroids (like prednisone) can increase risk of osteoporosis.

How Do I Know If I Have Osteoporosis?

Bone mineral density (BMD) tests, or bone measurements, are X-rays that use very small amounts of radiation to determine bone strength. A bone density test is indicated for:

  • Women age 65 and older.
  • Women with numerous risk factors.
  • Menopausal women who have had fractures.

How Can I Prevent Osteoporosis?

There are many ways you can protect yourself against osteoporosis, including:

  • Exercise: Establish a regular exercise program. Exercise makes bones and muscles stronger and helps prevent bone loss. It also helps you stay active and mobile. Weight-bearing exercises, done at least 3-4 times a week, are best. Walking, jogging, playing tennis, and dancing are all good weight-bearing exercises. In addition, strength and balance exercises may help you avoid falls, decreasing your chance of breaking a bone.
  • Eat foods high in calcium. Getting enough calcium throughout your life helps to build and keep strong bones. The U.S. recommended daily allowance (RDA) of calcium for adults with a low-to-average risk of developing osteoporosis is 1000 mg (milligrams) daily. For those at high risk of osteoporosis, the RDA is 1,500 mg daily. Excellent sources of calcium are milk and dairy products, canned fish with bones like salmon and sardines, dark green leafy vegetables, and breads made with calcium-fortified flour.
  • Supplements: Calcium carbonate and calcium citrate are good forms of calcium supplements. Be careful not to get more than 2,000 mg of calcium a day. That amount can increase the chance of kidney stones.
  • Vitamin D: Your body uses vitamin D to absorb calcium.  You can get vitamin D from eggs, fatty fish like salmon, cereal and milk fortified with vitamin D, as well as from supplements. People aged 51-70 may need a higher amount of Vitamin D daily.
  • Medications: Actonel, Evista, Fosamax, and Boniva are some of the drugs available to help treat and/or prevent osteoporosis.
  • Estrogen and Testosterone: Estrogen helps protect against bone loss. It is used as treatment for the prevention of osteoporosis. Replacing estrogen lost after menopause slows bone loss and improves the body’s absorption and retention of calcium. Testosterone actually builds bone.
  • Avoid certain medications: Steroids, some breast cancer treatments (such as aromatase inhibitors), drugs used to treat seizures (anticonvulsants) and blood thinners (anticoagulants) increase the rate of bone loss if not used as directed. If you are taking any of these drugs, speak with your doctor about how to reduce your risk of bone loss through diet, lifestyle changes and, possibly, additional medication.
  • Other preventive steps: Limit alcohol consumption and do not smoke.  Smoking causes your body to make less estrogen, which protects the bones. Too much alcohol can damage bones and increase the risk of falling and breaking a bone.

How To Get Calcium If You Are Lactose Intolerant

If you are lactose intolerant or have difficulty digesting milk, you may not be getting enough calcium in your diet. Although most dairy products may be intolerable, some yogurt and hard cheeses might be digestible. You can also eat lactose-containing food by first treating it with commercial preparations of lactase (which can be added as drops or taken as pills). There are also lactose-free dairy products you can buy. You can also eat lactose-free foods high in calcium, such as leafy green vegetables, salmon (with bones), and broccoli.

Weight-Bearing Exercises and How They Help Strengthen Bone

Weight-bearing exercises are activities that make your muscles work against gravity. Walking, hiking, stair-climbing, or jogging are all weight-bearing exercises that help build strong bones. Thirty minutes of regular exercise (at least 3 to 4 days a week) along with a healthy diet may increase peak bone mass in younger people. Older women and men who engage in regular exercise may experience decreased bone loss or even increased bone mass.

Protecting Yourself From Fractures If You Have Osteoporosis

If you have osteoporosis, it is important to protect yourself against accidental falls, which may result in fractures. Take the following precautions to make your home safe:

  • Remove loose household items, keeping your home free of clutter.
  • Install grab bars on tub and shower walls and beside toilets.
  • Install proper lighting.
  • Apply treads to floors and remove throw rugs.

 

MAY is National Celiac Disease Awareness Month

May 10, 2017

WHAT IS CELIAC DISEASE?

Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.  It affects 1 in 100 people worldwide.  Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.


When a person with celiac disease eats gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly. The only treatment for celiac disease is a strict, gluten-free diet. Most patients report symptom improvement within a few weeks, although intestinal healing may take several years.

Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.

Celiac disease is also known as coeliac disease, celiac sprue, non-tropical sprue, and gluten sensitive enteropathy.

Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems.

Long-Term Health Conditions
* Iron deficiency anemia
* Early onset osteoporosis or osteopenia
* Infertility and miscarriage
* Lactose intolerance
* Vitamin and mineral deficiencies
* Central and peripheral nervous system disorders, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy and multifocal leucoencephalopathy
* Pancreatic insufficiency
* Gall bladder malfunction

Malignancies
* Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types)
* Small intestinal adenocarcinoma
* Esophageal carcinoma
* Papillary thyroid cancer
* Melanoma

Associated Autoimmune Disorders and Conditions
Celiac disease is associated with a number of autoimmune disorders and other conditions, with the most common being thyroid disease and Type 1 Diabetes.

Celiac Disease Symptoms
There are more than 200 symptoms associated with celiac disease, which makes diagnosis difficult. A large percentage of people with celiac disease, both adults and children, have no or minimal symptoms.

Screening and Diagnosis
A simple blood test is available to screen for celiac disease. People with celiac disease who eat gluten have higher than normal levels of certain antibodies in their blood. These antibodies are produced by the immune system because it views gluten (the proteins found in wheat, rye and barley) as a threat.  You must be on a gluten-containing diet for antibody (blood) testing to be accurate.

The only way to confirm a celiac disease diagnosis is by undergoing an endoscopic biopsy of the small intestine.

Non-Celiac Wheat Sensitivity
Some people experience symptoms found in celiac disease, such as “foggy mind”, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, yet do not test positive for celiac disease. The terms non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) are generally used to refer to this condition, when removing gluten from the diet resolves symptoms.

Treatment
Currently, the only treatment for celiac disease and non-celiac wheat sensitivity is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye and barley, such as bread and beer. Ingesting small amounts of gluten, like crumbs from a cutting board or toaster, can trigger intestinal damage.

Initial and Annual Follow-Up
Once diagnosed, initial follow-up with your physician and a registered dietitian is necessary to monitor nutritional deficiencies and your compliance with a gluten-free diet, as well as assess for associated conditions. You should have an annual visit with your physician.

An Apple A Day…

April 22, 2017

Did you know that apple cider vinegar can help promote health?? Check out 18 of the best health benefits of apple cider vinegar.

1. Calm an upset stomach
When we eat (or drink) something that does not agree with us, a stomach ache ensues and can cause pain and gas. This is usually from bacteria build up. If you are experiencing acute stomach pain and feel it is not severe enough to visit a healthcare provider, consider having apple cider vinegar to ease the pain. The pectin in apple cider vinegar is known to soothe intestinal aches, spasms and pain. The best mixture should include two tablespoons of apple cider vinegar with some water, juice or apple juice.

2. Eliminate annoying hiccups
Hiccups are usually caused by excess air in the digestive system, which your body is attempting to eliminate through muscular spasms. A teaspoon of apple cider vinegar is great for alleviating this problem. It is possible that the strong acidic nature of apple cider vinegar helps to prevent the spasms that cause hiccups, which will help reduce the risk of getting these unwanted spasms.

3. Sore throat cure
There are many reasons a sore throat occurs. An effective way to help eliminate a sore throat is to gargle with apple cider vinegar. The bacteria in the throat causing pain do not like the strong acid content of apple cider vinegar, which means they will die off when you gargle. Gargle with a combination of two ounces of apple cider vinegar and two ounces of warm water once per hour for throat pain relief.

4. Reduce your cholesterol
There has been quite a bit of research and studies on how to reduce cholesterol. There have been a few studies that have shown apple cider vinegar to be beneficial for lowering cholesterol. As little as one tablespoon a day can lower cholesterol. The acetic acid contained in the vinegar is what is believed to help fight off cholesterol in the body.

5. Stop indigestion
If you are a victim of frequent indigestion after meals, and your doctor or healthcare provider is aware of your condition, then consider using apple cider vinegar prior to meals to help prevent indigestion. Take one teaspoon each of honey and apple cider vinegar and a tall glass of warm water prior to eating.

6. Clear nasal congestion and stuffiness
Cold medicine is a costly purchase year after year and tends to have many side effects. Rather than using cold medication to help relieve a stuffy nose, consider having some apple cider vinegar. The potassium in apple cider vinegar thins mucus, and the acid in the vinegar helps reduce the total amount of bacteria in your nasal cavity. Only one teaspoon is needed and you can mix it with a glass of water to gain these benefits.

7. Lose weight
The acid content in apple cider vinegar is known to suppress appetite, which means that you are not as likely to overeat. In addition, apple cider vinegar can increase your metabolism, which will cause you to burn more calories throughout the day. Lastly, consuming apple cider vinegar can help your body eliminate harmful water retention, which actually has heart health benefits as well.

8. Dry scalp
Dry scalp is prevalent in the colder months of the year. Using apple cider vinegar as an addition to your shampoo can help eliminate dandruff and leave it healthy. Mix a batch with two ounces of water and two ounces of apple cider vinegar and apply to your scalp when you shampoo. The acidity of the vinegar prevents harmful germs from growing on your scalp and it will help to eliminate dry scalp.

9. Avoid blemishes on your face
Acne can affect anyone at any time. There are a handful of products that are great for zapping acne off your face, but the most effective way to eliminate acne is to kill the bacteria on your skin and prevent it from growing. Using a little apple cider vinegar on your face can be a great way to kill the bacteria on your face to help prevent acne from growing. Dab it on a cotton ball and use it like you would any toner.

10. Skip your midday coffee and look for apple cider vinegar instead
Midday lulls are common for a number of reasons, but when it happens, many simply go to the nearest coffee store to load up on more caffeine. Instead of another cup of coffee, consider having one tablespoon of apple cider vinegar with some water or juice to increase your energy levels for the day.

11. Prevent harsh leg cramps at night
If you wake up in the middle of the night with achy legs due to cramping, consider having some apple cider vinegar. It contains potassium, which is good for cramping symptoms. Blend one ounce of apple cider vinegar with a little honey and some warm water to cut those cramps out of your night.

12. Eliminate chronic bad breath
If your bad breath persists and your dentist or doctor does not indicate a tooth problem, then try some apple cider vinegar. Gargle with apple cider vinegar to help eliminate bacteria in your mouth (dilute the vinegar if you desire). The high acid content of apple cider vinegar kills germs in your mouth if your usual mouthwash is not getting the job done.

13. A natural teeth whitener
Using apple cider vinegar is a safe and natural way to reduce or eliminate staining on teeth. Swishing or gargling every day with apple cider vinegar can to help reduce staining of teeth. In addition, it can help whiten your teeth and stop any bacteria from growing in your mouth. This is a win-win combination for the health of your mouth.

14. Stop bruising on your skin
Bruises are caused from broken or inflamed arteries and veins in the vasculature. The anti-inflammatory properties of apple cider vinegar can prevent bruising. The best way to diminish bruises is to apply apple cider directly to the bruise. It will initially cause the bruise to change its color, but over time it will help eliminate it and heal the area.

15. Improve blood sugar
Apple cider vinegar can help control blood sugar in a way similar to various prescription medications. Researchers have followed the effects of apple cider vinegar and have found that it prevents and slows the breakdown of starches during digestion. When this happens, blood sugar benefits and is not elevated as high as it normally would.

16. Protect you heart
Cardiovascular disease is the number one killer of adults. One way to reduce heart disease risk among adults is to consume apple cider vinegar. The regular consumption of apple cider vinegar can help to reduce blood pressure, which is a major marker of those with heart disease.

17. Prevent cancer
Cancer is the number one killer worldwide and is caused from many factors that are still unknown. Foods that contain high amounts of natural antioxidants are known to help prevent the risk of cancer. This is why apple cider vinegar is beneficial. Apple cider vinegar contains high amounts of polyphenols, which are also found in wine, and can help to reduce your risk and fight free-radicals in your body.

18. Alleviate sunburn pain
Skin pain due to sunburn can be reduced by soaking the area in some apple cider vinegar. In as little as 10 minutes, your pain from sunburn can be reduced dramatically.

Omega-3

April 12, 2017

What are Omega-3 Fatty Acids?

Omega-3 fatty acids are common nutritional supplements often taken in the form of fish oil or flaxseed oil. They’re classified as a polyunsaturated fat, one of the “good” fats (as opposed to “bad” fat, which is saturated.)

Omega-3s are believed to play many important roles, including:

  • Aiding brain development and function
  • Reducing inflammation
  • Reducing back and neuropathic pain
  • Preventing heart disease
  • Lowering blood pressure
  • Lowering risk of cancer, diabetes and Alzheimer’s disease.
  • They may also help alleviate depression, asthma, painful periods and rheumatoid arthritis. However, evidence is less compelling in these areas.

Omega-3s for Fibromyalgia & Chronic Fatigue Syndrome

Some studies show that omega-3s may improve symptoms of fibromyalgia and chronic fatigue syndrome. One survey showed that omega-3 fatty acids are among the most common supplements taken by people with fibromyalgia.

Some researchers hypothesize that omega-3 fatty acids may help alleviate oxidative stress, which studies suggest may play a role in these conditions.

Many people take omega-3 supplements, or eat a diet rich in omega-3s, in order to combat inflammation. Chronic fatigue syndrome is believed to be associated with pro-inflammatory cytokines. Some research suggests that fibromyalgia may involve inflammation of the fascia.

We don’t know yet whether they help counter the cognitive dysfunction or unique pain types of these conditions or the cardiovascular irregularities that are common in chronic fatigue syndrome.

Omega-3 Dosage

Some health professionals recommend that people who don’t eat a diet rich in omega-3s take 500-1000 milligrams a day in supplements.

Doctors may recommend that people with certain conditions, such as heart disease, take more. It’s important for you to discuss your supplement needs with your doctor.

Omega-3 Fatty Acids in Your Diet

You can get dietary omega-3 fatty acids in several foods, including:

  • Fatty fish (salmon, tuna, herring, sardines, anchovies)
  • Seaweed
  • Algae
  • Walnuts
  • Canola and hemp seed oils
  • Flaxseeds and flax seed oil
  • Soybeans

Side Effects of Omega-3 Fatty Acids

Just because omega-3s are natural doesn’t mean they’re safe for everyone or in any amount. It’s important for you to be aware of possible side effects.

Common side effects include:

  • Upset stomach
  • Diarrhea
  • Increased burping
  • Heartburn/acid reflux
  • Abdominal pain and bloating

Some people don’t like the “fishy” taste these supplements can leave behind. Taking them with meals can help alleviate this problem as well as other side effects. It may also help to start with a low dosage and gradually increase it.

While rare at lower dosages, omega-3s may increase your risk of bleeding problems, including a type of stroke.

Higher doses may also be linked to nosebleeds and blood in the urine. A blood sugar increase in diabetics is possible, but unlikely.

Those with major depression or bipolar disorder may experience mania, restlessness, or a crawling sensation on the skin.

Some fish may contain contaminants, including polychlorinated biphenyls (PCBs), dioxins and methylmercury. These substances are believed to build up in the meat, not the oil, so supplements are considered safe.

Long-term supplementation may cause vitamin E deficiency. Your doctor can test you for this problem.

Is Omega-3 Right for You?

It’s always a good idea to talk to your doctor about supplements you’d like to try so you can make sure it won’t be a problem with any of your other medications or conditions.

However, omega-3 is generally considered safe and is readily available anywhere that sells supplements, so it’s an easy one to add to your treatment regimen.