Testing For Adrenal Fatigue

November 27, 2017

Diagnosing Adrenal Fatigue from a single test or symptom is very difficult. To make an accurate diagnosis, it is important to look at a range of tests, sometimes conducted multiple times, and take note of every symptom. This requires experience and a thorough knowledge of the various systems in your body, as well as patience. It may require two or three visits to the doctor before you can be sure that you have adrenal fatigue.

Testing for adrenal fatigue can take several forms. First we have the standard hormone tests, which include testing for cortisol and various thyroid hormones. Then we have the tests that tend to look at the ratios of various hormones and neurotransmitters, in order to get a better idea of how are feeling. And lastly we have a set of more subjective physical tests, which were mostly developed in the early days of adrenal fatigue diagnosis.

To diagnose adrenal fatigue correctly requires using a combination of lab testing and patient feedback.

The major lab test used to diagnose adrenal fatigue is cortisol. But there is more than one type of cortisol testing, and the correct interpretation of results is also important. Taking a single measurement, or even a 24-hour average, is not enough. The best cortisol tests take 4 individual samples at various points of the day and then map your cortisol levels over the course of a 24-hour cycle. Our cortisol levels vary dramatically, starting high when we wake up and then tapering off until they reach their lowest point late at night. This usually represents approximately an 80% drop, which is perfectly normal. Your healthcare professional needs to see not just your average cortisol level, but also the size of the morning spike and how sharply it drops off afterwards. Interpreting the results correctly can be difficult. The reference ranges supplied by labs are so wide that they only flag up extremely low cortisol levels. Your doctor will need to look at the levels provided and make his or her own judgment. This is where the importance of using an optimal range, rather than the reference range, becomes clear. Lastly, your health care professional should be aware that more than one cortisol test will be necessary during your treatment for adrenal fatigue. Once you have been diagnosed and started on a treatment course, saliva cortisol testing is a good way to monitor progress as your cortisol levels begin to return to normal.

ACTH Challenge

This is another kind of cortisol test that can be very useful. First, your baseline cortisol levels are measured. Then, a dose of ACTH (adrenal corticotrophic hormone) is injected. Finally, your cortisol levels are measured again. The ACTH has the effect of stimulating your adrenal hormone output, just like it would if you were placed in a stressful situation. This test allows you to see the response of your adrenals to stress. If your cortisol exhibits a healthy spike higher (at least double in a blood test), your adrenals are probably in reasonably good shape. If the spike in cortisol is not so large, this suggests adrenal insufficiency.

Thyroid Tests

The complexity of the human body means that one part of the endocrine system cannot exist independently of another part. In reality, there are connections and relationships that exist between every system in the body, and a weakness in one area can easily translate into changes in another. In the case of adrenal fatigue, it has been shown that a weakening in the hypothalamus and pituitary gland can lead to lower thyroid function. In other words, if your blood tests suggest mild hypothyroidism, the underlying problem might actually be adrenal fatigue. There are a number of different tests for thyroid function, all blood tests. As with the cortisol test, your doctor should be looking beyond the reference ranges provided by the lab. In fact, these days it’s very common for someone to be diagnosed with mild hypothyroidism even if all their results are within the range.

TSH

Thyroid stimulating hormone is produced by the pituitary gland in response to instructions from the hypothalamus. As its name suggests, TSH stimulates the thyroid to produce T3 and T4, the two most important thyroid hormones. The level of TSH is inversely proportional to the activity of your thyroid. If your thyroid is producing lots of T3 and T4, your pituitary gland produces less TSH (because the thyroid needs to be stimulated less). Conversely, if you are hypothyroid then your TSH is likely to be high, as your brain is telling the thyroid to produce more hormones. This is the same kind of feedback loop that exists for many other hormones in the body, including cortisol. In the case of adrenal fatigue, the  thyroid is often performing weakly, so they will typically have a TSH reading of above 2.0. Note that the reference range provided by the lab will usually be around 0.50 – 4.50. Once again you can see the importance of looking for an optimal level rather than just blindly following the lab ranges.

Free T3 (FT3)

This is a test that is rarely conducted by doctors, and even then usually only on hyperthyroid patients. However, it can give a useful insight into the overall function of the thyroid. When used in conjunction with the other thyroid tests, this helps to give a complete picture of why the thyroid is underperforming. Optimal values should be somewhere in the 300-450 pg/ml range. However, the typical lab range allows values as low as 230 pg/ml.

Free T4 (FT4)

Similarly to T3, this hormone is produced when TSH stimulates the thyroid. Your thyroid makes much more T4 than T3, but T4 tends to have less of an effect on the body than T3. If your thyroid is producing too little T4, often your TSH level will be higher. This test measures Free T4, which is ‘unbound’ and available for immediate use.

Total Thyroxine (TT4)

This test should be used along with the free T4. While Free T4 measures the amount of unbound and available T4 in your blood, whereas total thyroxine includes the amount of T4 that is bound to carrier proteins (essentially held ‘in reserve’). Using this test together with the free T4 test can tell you how much T4 is available for your body to use, and how much is being held in reserve.

Cortisol / DHEA Ratio

This test tells us which point along the adrenal fatigue pathway the patient might have reached. In the initial stages of a stress reaction both cortisol and DHEA will be high. But as the body begins to struggle to produce sufficient stress hormones, DHEA levels start to fall. Put very simply, this is because the stress hormone production ‘steals’ resources from the sex hormone production. Further on in the development of adrenal fatigue, cortisol levels will begin to drop too.

17-HP / Cortisol Ratio

17-hydroxyprogesterone (17-HP) is a precursor to cortisol, in other words one of the ‘raw materials’ that the body uses to create cortisol. With adrenal fatigue, it is common to see higher levels of 17-HP vs. cortisol, as the adrenals struggle to make this conversion happen.

Neurotransmitter Testing

Neurotransmitters are chemical messengers that transmit messages between our cells and, just like cortisol, they can become depleted after long periods of stress. With recent developments in testing procedures it is now possible to compare a patient’s neurotransmitter levels to a reference range for healthy patients. This test is usually conducted first thing in the morning and is best accomplished via a urine test. It is only available from a small number of labs.

Alternative Tests

When adrenal fatigue was first diagnosed many of these tests did not even exist. To help provide a diagnosis, doctors developed a series of more physical tests that can be conducted quickly in a doctor’s clinic or at home. These tests are clearly much less accurate than the blood, saliva and urine tests mentioned above, and positive results may reflect other health problems besides Adrenal Fatigue. However, they can be a useful diagnostic tool in combination with all the other evidence provided.

The Iris Contraction Test

First described by Dr. Arroyo in 1924, this test measures the contraction of the iris in response to repeated exposure to dark light. In those with weakened adrenal function, the theory goes that the iris will be unable to maintain its contraction for long. To conduct the test, sit in a darkened room, in front of a mirror. Take a flashlight and shine it across your eye, from the side of your face. In a hypoadrenal state, your pupil will not be able to hold onto its contraction for more than 2 minutes and thus will begin to dilate despite light repeatedly shining on it. In those with healthy adrenals, the contraction should last much longer.

Postural Low Blood Pressure

When we stand up, those of us who are in good health experience an almost immediate rise in blood pressure. In contrast, with adrenal fatigue, there is little or no change in blood pressure, or even a slight fall. In very general terms, a larger drop in blood pressure signifies a more severe case of adrenal fatigue.

This is a very simple test to do at home. Use your regular blood pressure monitor and check your blood pressure while lying down. Then stand up and conduct the test again.

Hormonal Mood Disorders

October 17, 2017

FADS AND OVER-DIAGNOSIS

Over the past several decades psychiatric diagnostic acumen has improved significantly. However, more and more people seem to carry psychiatric diagnoses that are inaccurate and have negative consequences. Additionally, it seems that fads in psychiatric diagnosis come and go.  Likely they satisfy a deep-felt need to explain, or at least label, unexplainable human deviance. In recent years, the pace has accelerated and false ‘epidemics’ have come to involve an increasing proportion of the population. We are now in the midst of at least three such epidemics – autism, attention deficit disorder & childhood bipolar disorder. Estimates suggest that in any given year, 25% of the population (almost 60 million people) has a diagnosable mental disorder. A study showed that, by age thirty-two, 50% of the general population will ‘qualified’ for an anxiety disorder and 40% for depression. Imagine what the percentages will be by the time these people hit fifty, or sixty-five or eighty?  In this brave new world of psychiatric over-diagnosis, will anyone get through life without a mental disorder?

What accounts for the upsurge in diagnosis?  It is unlikely that we can blame it on our brains. Human physiology changes very slowly.  Could it be caused by our stressful society? There is no good reason to believe that life is any harder now than in the past.  It is more likely we are a more pampered and protected generation than ever before. Most likely that these ‘epidemics’ are caused by changing diagnostic fashions – in other words, people don’t change, the labels do. There are no objective tests in psychiatry –  no X-ray, laboratory, or exam finding – that say definitively that someone does or does not have a mental disorder.  Other factors contributing to the increase include:

1) DSM manuals being sold to more ‘ordinary’ people than to mental health professions.  This has made psychiatric diagnosis accessible to the general public, allowing self-diagnosis.

2) Definitional thresholds may be set too low. We seem to worry more about missing cases than about casting too wide a net and capturing people who do not require a diagnosis.

3) The pharmaceutical industry over-utilizes marketing. Drug companies are skilled at mounting a full court press that includes ‘educating’ doctors, ‘supporting’ advocacy groups, controlling research, and direct-to-the-consumer advertising.

4) Patient and family advocacy groups call attention to neglected needs (lobbying for clinical, school, and research programs; reducing stigma; and promoting group and community support). Advocating for those with a disorder can spill-over and promote the spread of the disorder to others who are mislabeled.

5) Recent ‘epidemics’ have occurred mostly in childhood disorders.  Perhaps a contributing factor is that the provision of special educational services often requires a DSM diagnosis?

6) The internet provides a wealth of information and creates a network of ‘informed consumers’.  Disorder-focused web-sites provide an attractive forum & support system that draws people who inaccurately self ‘over-diagnose’.

7) The media both feeds off of and feeds public interest. It is not uncommon for the media to become obsessed with one or another celebrity whose public meltdown seems related to a real or imagined mental disorder. An example is the Tiger Woods media frenzy which will likely lead to an ‘epidemic’ of sexual addiction.  Popular movies can also be contagious:  Sybil helped cause a fad in multiple personality disorder.

8) We live in a society that is intolerant of normal individual difference. What was once accepted as aches and pains of everyday life is now labeled a mental disorder. Eccentrics who would have been accepted on their own terms are now labeled Asperger’s and in need of intervention. Criminal behavior has been medicalized (rape as a psychiatric disorder) because prison sentences are too short and such labeling allows for indefinite psychiatric commitment.

Despite all this uncertainty about diagnosis of mental health disorders, a few certainties exist.  There is sufficient research to indicate that a significant subset of people diagnosed with mental health disorders, in fact, have hormone imbalances. The connections between hormones and the brain is undeniable. Hormones impact brain chemistry and circuitry, and hence influence emotions, mood and behavior.

PUBERTY

For many adolescents, the first exposure to the mood-changing impact of hormones is puberty. Pubertal girls and boys can experience significant upheaval due to constant emotional ups and downs, irritability, depression, anxiety, brain fog, and moodiness. Boys can have additional symptoms of anger with rising and fluctuating testosterone. At the beginning of puberty, the brain releases GnRH, which triggers secretion of FSH and LH. In girls, FSH and LH instruct the ovaries to begin producing estrogen. In boys, the same hormones initiate production of testosterone. Many of the mood swings that teens experience are caused by fluctuations in these hormones. These same teen hormones will also affect the way they think about dating and sex. Teens become more interested in sex, sometimes to the point of obsession, as hormones kick into gear. Many adolescents feel that these hormone-related changes are weird or unnatural.

In adolescent girls, hormonal disorders are often overlooked because we tend to focus on the time they begin menstruating.  We forget that long before a girl undergoes menarche, a variety of other changes occur that commence with hormone fluctuations:  thelarche (breast development), pubarche (pubic hair growth), and the pubertal growth spurt. In considering anger, mood swings, and changes in behavior, we must consider their relationship to these other hormone-mediated events.

PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

PMS affects up to 85% of women. Irritability, tension, and dysphoria are the most consistently described symptoms. Women whose affective symptoms are especially severe may meet criteria for PMDD, which occurs in 2-10% of women. PMDD is a serious, disabling condition that can rob a woman of her functioning every month. PMS and PMDD are cyclical, with symptoms arising during the luteal phase of the menstrual cycle and lasting until the onset of menstrual flow. Prior to ovulation, estrogen rises, while during the luteal phase following ovulation, progesterone rises. Immediately before the onset of menstruation, estrogen and progesterone both decrease.  The tricky part about PMS and PMDD is that they are not always exactly the week before bleeding, nor do they last exactly a week.  It is further complicated in women who do not have the ‘classic’ 28-day cycle.

Arguably the most frequent, popular and incorrect diagnose associated with puberty is bipolar disorder, in all of its subtypes and flavors. It seems that any adolescent who is moody, angry, or temperamental is labeled bipolar. Bipolar disorder and PMS/PMDD have many similar symptoms. Both are characterized by cycling moods, including severe depression. There are hundreds, if not thousands, of adolescents running around with this diagnosis, yet many of them have never had a manic episode, which is the hallmark of bipolar disorder. Many of these kids have never had anything other than irritability. Load them up with cocktails of anxiolytics, antidepressants or medications like Seroquel, Depakote, Abilify, Lithium, Klonopin & Trazadone and their symptoms go away.  The proof is NOT in the pudding. All that is proven is that one’s affect can be obliterated by harsh medication cocktails.  But being incapacitated by medications does not prove bipolarity. This confusion is tragic because these therapies are often ineffective and more damaging, with serious long-term side effects in the form of obesity, metabolic syndrome, diabetes, sexual dysfunction & movement disorders.

After careful evaluation and consideration, these patients need to be detoxified from their toxic cocktails. Once these medications have worn off, consider a tailored titration onto a pulse pattern of a SSRI or Wellbutrin to control the PMS.  Sometimes Monoamine Oxidase Inhibitors (MAOI’s) are used because it is the surge in MAO that occurs abruptly when a woman’s estrogen drops.  The MAO is the enzyme that degrades all biogenic amines – dopamine, serotonin, norepinephrine, etc. and induces the moodiness and symptoms of PMS/PMDD.  These patients should also be started on therapies designed to suppress cyclical hormonal changes (suppress ovulation). Longstanding ‘bipolar depression’ often disappears when the premenstrual cycle is suppressed.

POLYCYSTIC OVARIAN SYNDROME (PCOS)

The subset of girls who will eventually be diagnosed with PCOS creates an even bigger set-up for misdiagnosis.  Most PCOS patients are diagnosed after menarche – in other words, adolescents diagnosed with mental health disorders, who have PCOS, often haven’t been diagnosed with PCOS yet. PCOS is characterized by irregular menses, elevated testosterones, masculinization, hirsutism, weight gain, metabolic disturbances and many other features. These patients have significant hormone fluctuations without a menstrual cycle. They have florid mood swings, affective dysregulation, depression, impulsivity, suicidal gestures…the whole gamut. True psychotic symptoms are rare.  Most mood medications these girls are started on cause weight gain and some directly increase blood glucose and all of this is quite bad for a PCOS patient.

PREGNANCY AND POSTPARTUM

Pregnancy and postpartum are other key times when mind and hormones intersect. Some women have their first experience with significant moodiness, emotional ups and downs, and frank depression during or after pregnancy. Postnatal depression and psychosis are key mental illnesses that have a major hormonal component to their onset and course. This is thought to be triggered by the sudden, rapid drop in the high levels of pregnancy hormones shortly after birth.

MENOPAUSE

The next commonly recognized — but not well-understood — time, is broadly referred to as ‘menopause’. Broadly, because the term isn’t really used properly. Menopause is a single moment in time when a woman has not had a period for a full year. In the United States, the average age is 51. But most symptoms associated with menopause — erratic periods, hot flashes, mood swings, sleep disturbances, mental fog and decreasing mental focus, weight redistribution, decreasing motivation, diminished exercise endurance, muscle & joint aches, diminished exercise recovery, headaches, and changes in sex drive— take place during perimenopause — the time before menopause — when testosterone, estrogen and progesterone can go up and down erratically. These fluctuations can actually start as early as late thirties.  During this transition, women experience major hormonal shifts. During this time, women are 14 times more likely to experience depression. It affects women differently than other types of depression, causing anger, irritability, poor concentration, memory difficulties, low self-esteem, poor sleep and weight gain. Perimenopausal depression isn’t well recognized and is often poorly treated with standard antidepressants. Women with this type of depression respond better to hormone treatments.

DIAGNOSIS

Diagnosis of hormone-responsive depression should be made through the patient’s history and not through the measurement of hormonal levels, since hormonal levels in premenopausal women are typically normal. Instead, carefully consider the patient’s history that point to hormonally based depression.

  • A history of mild or severe PMS as a teenager
  • Relief of depressive symptoms during pregnancy
  • Postpartum depression, with new-onset or newly recurring depressive symptoms
  • Recurrence of premenstrual depression following resumption of menstruation after delivery
  • Worsening of premenstrual depression with age, blending into the menopausal transition and becoming less cyclical thereafter
  • Coexistence of cyclical somatic symptoms, such as menstrual migraine, bloating, or mastalgia, which are not associated with bipolar disorder
  • Runs of 5 to 20 euthymic days per month
  • Recurrent episodes of depression, often severe and related to menstrual periods, but without episodes of mania

Beyond the patient’s personal history, family history can shed light on the origin of depressive symptoms. If the mother and sisters also suffer from PMS and postnatal depression, it can be suggestive of a familial hormonal basis for the symptoms. Alternatively, a history of bipolar disorder and suicide in male relatives would suggest mixed etiology.

MEN & HORMONES

Low testosterone leads to andropause, which can result in erectile problems, diminished libido, decreased muscle strength and decreased bone mass. To complicate matters, testosterone is converted to estradiol in men (via aromatase enzyme). So, testosterone exerts its effects independently (as itself) and indirectly via conversion to estrogen. Too much estrogen can lead to excess breast tissue, depression or mood swings. Too little estrogen contributes to mood disturbances, low sex drive, decreased motivation and diminished ability to retain muscle mass. Fluctuating estrogen levels, also cause mood swings, which further complicate the picture.  A discernable PMS pattern of behavior is often recognized with these fluctuations. If all this wasn’t complicated enough, the relationship between E and T is also very important, especially with regard to mood changes. Altered estrogen/testosterone ratio (both too high and too low) can cause problems with memory function, depression, irritability, sleep, fatigue and occasionally even hot flashes/sweats.

After seeing a series of men diagnosed with a putative mental health disorder, prescribed all of the usual drugs, there is a discernable pattern of diminished libido, sexual dysfunction, subtle feminization and new/strange sexual thoughts & fantasies.  Initially, these were considered  medication side effects. However, evaluation of hormone levels indicates relative to absolute hypogonadism. Furthermore, these findings are not attributable to psychiatric drugs because this phenomenon is also seen in men who present with similar complaints and no prior treatment with these mood medications. In addition to having low testosterone levels, these men often have high normal or abnormal estrogen levels.  If these men are weaned off mood medications and started on testosterone replacement, their moodiness, irritability, insomnia and other symptoms resolve as they are re-masculinized & estrogen levels fall.

When considering testosterone replacement in men, avoid topical preparations (when possible) if concerned about increased conversion of testosterone into estrogen.  The enzyme that coverts testosterone into estrogen is found in increased quantities in adipose tissue.  Use of injectable long-acting, slow-release testosterone works best for these men.

OTHER HORMONES INVOLVED IN MOOD

In addition to our male & female hormones, there are other hormonal imbalances that can have profound effects on mood.

Thyroid issues are an often overlooked, hormonally-triggered cause of symptoms. When the thyroid becomes overactive – hyperthyroidism — symptoms can include anxiety, insomnia, moodiness, panic attacks, and depression. Some men and women have even been mistakenly misdiagnosed as having panic disorder or anorexia, before properly diagnosed with an overactive thyroid. An underactive thyroid — hypothyroidism — can cause depression, moodiness, fatigue, and anxiety.

While conventional doctors often rush to prescribe antidepressants, it is essential to routinely check patients for thyroid imbalances prior to prescribing any medication for depression or other mood disorders. Interestingly, one symptom of undiagnosed hypothyroidism is depression that does not respond to antidepressant therapy. Thyroid problems are also more likely to show up during periods of hormonal flux – puberty, pregnancy, post-partum, perimenopause, menopause and andropause — which makes it even more important to have a full thyroid evaluation done if you experience depression or anxiety during these times of life.

Adrenal issues — imbalances in the body’s stress hormones adrenaline and cortisol, and the precursor hormone DHEA — can cause a variety of symptoms that seem to be mental health-related, including depression, anxiety, and insomnia. In patients that have experienced trauma or violence, chronically elevated levels of cortisol can result, causing significant mental illness at any time in a person’s life. High cortisol levels have huge impacts on many brain regions, resulting in rage, suicidal thoughts, obesity & infertility. A chronic excess of stress hormones can make you feel jittery, anxious, unable to sleep, and irritable. A chronic deficiency of stress hormones can make you feel sluggish, tired (even after sleep), moody, depressed, and have difficulty concentrating. Daily fluctuations and imbalances can cause a mix of these symptoms.

TRANSGENDER PATIENTS

Hormone replacement is also often part of the transition process for transgender patients. This is, yet, another area where hormones and mood intersect. Many transgender patients experience dysphoria, or psychological distress due to the discrepancy between the sex they were assigned at birth and their gender identity. There is a high prevalence of depression, anxiety & suicidal thoughts.

Hormones help align physical characteristics with gender identity. Many individuals report hormone therapy is extremely beneficial because it enables them to maintain a physical appearance that more closely matches their gender identity, thus increasing their comfort with their physical appearance and decreasing dysphoria & distress. The effects on physical characteristics from HRT can usually be seen in one to three years, but a person receiving hormones will continue taking them for the rest of their life in order to maintain the effects. Research shows that HRT significantly reduces depression, anxiety, and sensitivity, along with feelings of hostility. Additionally, HRT often has the effect of increasing self-esteem and feelings of attractiveness. During gender transition, people who receive hormones typically experience a second puberty, during which secondary sex characteristics change to align with gender identity.

Trans-women receive estrogen in addition to antiandrogens to block testosterone. Trans-men take testosterone, which stops the menstrual cycle, lowers voice, and facilitates facial hair growth, though there may be other effects as well. Non-binary individuals (those whose gender is not specifically male or female) take hormones to produce characteristics that align with their identity or eliminate characteristics causing distress/dysphoria.

It is essential to remember that it is not possible to choose which characteristics result from HRT, and hormone therapy will affect people in different ways. Because of this, the initiation of hormone replacement can also increase feelings of dysphoria and distress.  Many transgender patients don’t quite know what to expect.  Often the changes in hormones they experience from replacement do not yield results that they anticipated or have side effects that were not considered.  For the reason, it is essential to counsel these patients thoroughly before initiating a regimen.

THE TAKE HOME MESSAGE

Before you go down the road of antidepressants and/or anti-anxiety medications, make sure you take a complete medical history, assess symptoms, do a thorough clinical exam, and run comprehensive blood testing to evaluate and diagnose any hormone balances. Unlike most medications and supplements that support and balance hormones, antidepressants and anti-anxiety medications often have significant side effects, and frequently don’t even resolve your symptoms if the underlying cause is a hormonal issue.

Cancer Risk in Women

September 15, 2017

Cancers that most affect women are breast, colon, endometrial, lung, cervical, skin, & ovarian.

Doing what you can day to day to prevent cancer is your best defense. Knowing about cancer & what you can do to reduce your risk can help save your life.  Another key is early detection. Finding cancer early, before it has spread, gives you the best chance to do something about it.  You can take control of your health & reduce your cancer risk by doing the following:

  • Stay away from tobacco.
  • Get to and stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat healthy with plenty of fruits and vegetables.
  • Limit how much alcohol you drink (if you drink at all).
  • Protect your skin.
  • Know yourself, your family history, and your risks.
  • Get regular check-ups and cancer screening tests.

 

Breast cancer is the most common cancer that women face in their lifetime (except for skin cancer). It can occur at any age, but risk goes up as you age. Because of certain factors, some women may have a greater chance of having breast cancer than others. Every woman should know about breast cancer, their personal an&d family risks, and what can be done about it.

The best defense is to find breast cancer early: called ‘early detection’.  All women should perform routine self-breast exam and should be familiar with the benefits, limitations, and potential harms linked to breast cancer screening. Women should be familiar with how their breasts normally look & feel and report any changes to a healthcare provider immediately. Women ages 40-54 should have a yearly clinical breast exam, and a mammogram every 1-2 years.  The frequency of mammograms should depend on careful discussion with your doctor. Women 55 and older can switch to mammograms every 2 years, along with yearly clinical breast exam. Screening should continue as long as a woman is in good health and is expected to live at least 10 or more years. Women at high risk for breast cancer should be screened with MRIs along with mammograms. Talk with your doctor about your risk for breast cancer and the best screening plan for you.

 

Colon Cancer.  Most colon cancer (cancers of the colon or rectum) are found in people age 50 or older. People with a personal or family history, or who have polyps in their colon or rectum, or those with inflammatory bowel disease are more likely to have colon cancer. Also, being overweight, eating a diet mostly of high-fat foods, smoking & being inactive can increase risk.

Colon cancer almost always starts with a polyp – a small growth on the lining of the colon or rectum. Screening can help save lives by finding polyps before they become cancer. If pre-cancerous polyps are removed, cancer can be prevented. People should have one of the following tests, starting at age 50:

  • Colonoscopy every 10 years, or
  • CT colonography (virtual colonoscopy) every 5 years (if positive, a colonoscopy should be done)
  • Flexible sigmoidoscopy every 5 years (if positive, a colonoscopy should be done)
  • Double-contrast barium enema every 5 years (if positive, a colonoscopy should be done)

If you are at high risk of colon cancer based on family history or other factors, you may need to start testing at a younger age. Talk to your doctor about your risk for colon cancer to know when you should start testing.

 

Endometrial cancer (cancer of the lining of the uterus) occurs most often in women age 55 and older. Taking estrogen without progesterone and taking tamoxifen for breast cancer treatment or to lower breast cancer risk can increase risk. Having an early onset of menstrual periods, late menopause, a history of infertility, or not having children can increase risk, too. Women with a personal or family history of hereditary non-polyposis colon cancer (HNPCC) or polycystic ovary syndrome (PCOS), or those who are obese are also more likely to have endometrial cancer.

Women should watch for symptoms, such as unusual spotting or bleeding not related to menstrual periods, and report these to your doctor. It is also recommended that women who have or are likely to have HNPCC be offered yearly testing with an endometrial biopsy by age 35.

 

Lung cancer:  Eight out of 10 lung cancer deaths result from smoking. But people who don’t smoke can also have lung cancer.

Lung cancer is one of the few cancers that can often be prevented by not smoking.  If you are a smoker, ask your doctor to help you quit. If you don’t smoke, don’t start, and avoid breathing in other people’s smoke. Certain women at high risk for lung cancer may want to talk to a healthcare provider about whether getting yearly low-dose CT scans to test for early lung cancer is right for them. Testing may benefit adults who are current or former smokers ages 55-74 who are in good health and who have a 30 pack-year or more smoking history (A pack-year is 1 pack of cigarettes per day per year). You should discuss the benefits, limitations, and risks of lung cancer testing with your doctor.

 

Cervical cancer can affect any woman who is or has been sexually active. It results from the human papilloma virus (HPV). This virus is acquired during sex. Cervical cancer is also more likely in women who smoke, have HIV or AIDS, have poor nutrition, and who do not get regular Paps. A Pap smear can find changes in the cervix that can be treated before they become cancer. The following is recommended:

  • Cervical cancer screening starting at age 21. Women under age 21 should not be tested.
  • Women ages 21-29 should have a Pap every 3 years. HPV testing should not be used unless it’s needed after an abnormal Pap.
  • Women ages 30-65should have a Pap plus HPV testing (co-testing) every 5 years. This is the preferred approach, but it’s OK to have a Pap alone every 3 years.
  • Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Women with a history of a cervical pre-cancer should continue testing for 20 years after the diagnosis, even if testing continues past age 65.
  • A woman who has had a hysterectomy (removal of uterus and cervix) for reasons not related to cervical cancer & who has no history of cervical cancer or pre-cancer should not be tested.
  • If vaccinated against HPV, you should still follow screening recommendations for your age group.

Some women (because of their history) may need testing more often. You should talk to your doctor about your history.

 

Skin cancer.  Anyone who spends time in the sun can get skin cancer. People with fair skin, especially those with blond or red hair, are more likely to get skin cancer than people with darker coloring. People who have had a close family member with melanoma & those who had bad sunburns as children are more likely to get skin cancer.

Most skin cancers can be prevented by limiting exposure to ultraviolet (UV) rays. When outside, try to stay in the shade, especially midday. If you are going to be in the sun, wear hats with brims, long-sleeve shirts, sunglasses, and use broad-spectrum sunscreen with SPF 30 or higher. If you have children, protect them from the sun and don’t let them get sunburned. Do not use tanning beds or lamps.  Be aware of moles and spots on your skin, and report any changes to your doctor immediately. Have a skin exam done during routine wellness check.

 

Ovarian cancer is more likely to occur as women age. Women who have never had children, who have unexplained infertility, or who had their first child after age 30 are at increased risk. Women with a personal or family history of HNPCC, ovarian cancer, or breast cancer are more likely to have this disease. Women who don’t have any of these conditions can still get ovarian cancer.

There are no good tests for finding ovarian cancer early. A pelvic exam should be part of a woman’s regular health exam. Also, talk to a healthcare provider about your risk for ovarian cancer and whether there are tests that may be right for you. You should talk to your doctor right away if you have any of these symptoms for more than a few weeks:

  • Abdominal (belly) swelling
  • Digestive problems (including gas, loss of appetite, and bloating)
  • Abdominal or pelvic pain
  • Feeling like you need to urinate (pee) all the time

 

Research shows poor diet and not being active are two key factors that increase cancer risk. Twenty percent of cancers are related to obesity, physical inactivity, excess alcohol, and/or poor nutrition. Besides quitting smoking, you can help reduce your cancer risk by: (1) get to and stay at a healthy weight, (2) be physically active and (3) make healthy food choices.

Getting to and staying at a healthy weight reduces risk of cancer and other chronic diseases, such as heart disease and diabetes. Excess weight causes the body to produce and circulate more estrogen and insulin, hormones that can stimulate cancer growth. When trying to control weight, watch portion size, especially of foods high in calories, fat, and added sugars. Also, limit intake of high-calorie foods and drinks. Try writing down what and how much you eat & drink to see where you can cut down on portion sizes and cut back on unhealthy foods and drinks.  Losing even a small amount of weight has health benefits.

Next, increase your physically activity. Being active helps improve weight, and it can help improve hormone levels and the way your immune system works. The recommendation for adults is at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week. This is over and above usual daily activities like using the stairs instead of the elevator at your office or doing housework. For kids, the recommendation is at least 60 minutes of moderate or vigorous intensity activity each day, with vigorous intensity activity occurring at least 3 days each week. Moderate activities are those that make you breathe as hard as you would during a brisk walk. Vigorous activities make you use large muscle groups and make your heart beat faster, make you breathe faster and deeper, and also make you sweat. It’s also important to limit sedentary behavior such as sitting, lying down, watching television, or other forms of screen-based entertainment.

Eating well is an important part of improving your health and reducing cancer risk. Read food labels to become more aware of portion sizes and calories. Low-fat or non-fat does not necessarily mean low-calorie. Eat smaller portions when eating high-calorie foods. Choose vegetables, whole fruit, legumes such as peas and beans, and other low-calorie foods instead of calorie-dense foods such as French fries, potato and other chips, ice cream, donuts, and other sweets. Limit your intake of sugar-sweetened beverages such as soft drinks, sports drinks, and fruit-flavored drinks. When you eat away from home, choose food low in calories, fat, and added sugar, and avoid eating large portion sizes. Limit how much processed meat and red meat you eat. Eat at least 2½ cups of vegetables and fruits each day. Choose whole grains instead of refined grain products. If you drink alcohol, limit intake to 2 drinks per day for men and 1 drink per day for women. The recommended limit is lower for women because of their smaller body size and slower breakdown of alcohol. A drink of alcohol is defined as 12 ounces of beer, 5 ounces of wine, or 1½ ounces of 80-proof distilled spirits (hard liquor).

It has been shown that people who experience high levels of psychological stress or who experience stress repeatedly over a long time may develop health problems (mental and/or physical).

The body responds to physical, mental, or emotional pressure by releasing stress that increase blood pressure, speed heart rate & raise blood sugar levels. Research shows that people who experience intense and chronic stress can have digestive problems, fertility problems, urinary problems, and a weakened immune system. Chronic stress makes people more prone to viral infections such as the flu or common cold and to have headaches, sleep trouble, depression, and anxiety. Although stress can cause a number of physical health problems, the evidence that it causes cancer is weak. Apparent links between psychological stress and cancer could arise in several ways. For example, people under stress may develop certain behaviors, such as smoking, overeating, or drinking alcohol, which increase a person’s risk for cancer. People who have cancer may find the physical, emotional, and social effects of the disease to be stressful. Those who attempt to manage their stress with risky behaviors such as smoking or drinking alcohol or who become more sedentary may have a poorer quality of life after cancer treatment. In contrast, people who are able to use effective coping strategies to deal with stress, such as relaxation and stress management techniques, have been shown to have lower levels of depression, anxiety, and symptoms related to the cancer and its treatment. People who have cancer who are under increased stress have poorer outcomes. Patients can develop a sense of helplessness or hopelessness when stress becomes overwhelming. This response is associated with higher rates of death, although the mechanism for this outcome is unclear. It may be that people who feel helpless or hopeless do not seek treatment when they become ill, give up prematurely on or fail to adhere to potentially helpful therapy, engage in risky behaviors such as drug use, or do not maintain a healthy lifestyle, resulting in premature death. Despite this, there is no evidence that successful stress management improves cancer survival.

Emotional & social support can help patients cope with psychological stress. Support can reduce depression, anxiety, and disease- and treatment-related symptoms. Approaches can include:

  • Training in relaxation,meditation or stress management
  • Counseling or talk therapy
  • Cancer education sessions
  • Social support in a group setting
  • Medications for depression or anxiety
  • Exercise

Hereditary Cancer Testing

September 5, 2017

Why Genetic Testing?

 

You’ve heard the phrase, “it runs in the family”? Whether it be an obvious family resemblance to a not-so-obvious inherited trait, much of who we are comes from our DNA.  We have about 20,000 genes, which are our blueprints.  All cancers are caused by mutations, or changes in DNA. Most mutations occur by chance and are usually automatically repaired by the body.  Sometimes, however, the mutation is not repaired and is passed on when the cell divides. If the mutation is harmful and interferes with a critical function, the mutation can make the cells cancer-like. If enough mutations occur, cancer may result. Mutations can also be part of our genetic makeup from birth. These mutations are inherited and are passed from generation to generation. Mutations in genes passed one generation to the next can drastically increase our risk of disease, including many cancers.

 

Most cancers develop from random mutations, but up to 10% are inherited, or hereditary. Certain inherited genetic mutations make it more likely that we will get cancer, as well as develop cancer earlier or even develop multiple cancers in a lifetime.  If you carry an inherited mutation that has been linked to cancer, knowing your risk can help you and your doctor make better, more informed decisions about your healthcare. If you have a mutation that puts you at increased risk of cancer, you and your doctor can take action to reduce your risk. Once the risk of cancer is identified, you and your doctor can choose the best way to delay, or even prevent, the cancer. There are also effective options to help lower your risk of cancer such as earlier and more intensive screening, preventive medications and risk-reducing surgeries.

 

Having information about your cancer risk can help improve health and quality of life. Hereditary cancer testing has helped millions of people make more informed choices. Testing is available for several inherited cancers including breast, ovarian, colon, skin (melanoma), uterine (endometrial), pancreatic, gastric and prostate cancer.  These tests provide vital information to help people with a strong personal or family history of cancer understand their own risk of developing the disease. With this information, they can take steps to potentially prevent cancer, delay the onset of the disease or catch it at an earlier stage when outcomes and survival rates are better.

 

When talking about your genetic family history, the only family members who matter are your biological relatives.  To learn more about your biological inheritance, talk to your relatives, gather information on their health history and fill out a family tree. If you find that certain illnesses, such as breast or ovarian cancer, have appeared in more than one relative, you should talk with your doctor and discuss the possibility of a hereditary cancer.  Just as an increased risk of cancer can run in families, some inherited conditions are more likely to occur in certain populations. People in these groups can inherit a specific genetic makeup from their ancestors. If the genes that are common to a group include a genetic mutation that cause disease, that disease can occur more frequently in that group. For example, hereditary breast and ovarian cancer is more common in people of Ashkenazi, or Eastern European Jewish, ancestry.

 

The goals of genetic testing are to:

  • Provide valuable information for use in customizing medical management plans;
  • Determine whether you have genetic mutations that increases your risk for inherited cancers;
  • Help your doctor make a timely and accurate diagnosis;
  • Enable your doctor to better predict disease aggressiveness to help make more informed treatment decisions;
  • Assist you and your doctor in making important decisions about disease management.

 

If you have had cancer at a young age, a rare cancer or if cancer occurs frequently in your family, genetic testing may be recommended. If a greater than average risk of cancer is found, there are a number of things you and your doctor can do to manage that risk:

  • More frequent monitoring to help detect cancer at an earlier, more treatable stage and improve survival.
  • Preventive strategies, including risk-reducing medications or surgeries, that may reduce your risk of developing cancer.
  • Make more informed decisions on your treatment options.
  • Can help your relatives learn more about their inherited risk and how it may affect them.

 

Common questions:

Q. I already know I have a family history of cancer. Why should I get tested?

A. Testing for a hereditary cancer risk helps you and your doctor understand your risk so you can make the best medical decisions. Knowing family history is important, but testing can give a more accurate picture of your risk.

Q. I already have cancer. Why should I get tested?

A. Testing for a hereditary cancer could help identify your risk for developing a second primary cancer.

Q. Is testing recommended for everyone?

A. Only people who have cancer in their family or a personal history of disease need to be tested.

Q. How do I get tested?

A. Ask your doctor if testing is right for you. Most testing can be done right in the office.

Q. How long does it take to get the test results?

A. It may be as soon as two weeks from the date your test is performed.

Q. Does a positive test result mean that I have cancer?

A. No. Genetic testing does not tell you if you have cancer. Results tell your inherited risk of developing cancer in the future.

Q. Does a positive test result mean that I will definitely develop cancer?

A. No. A positive test result simply tells you that you have an increased risk of cancer.

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.