Tuesday, May 27, 2008

Use of vitamin D in clinical practice by by John J. Cannell, Bruce W. Hollis

The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng/mL, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin [D.sub.3] per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng/mL In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55-70 ng/ mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH) D and serum calcium. Vitamin D should always be adjuvant treatment in patients with serious illnesses and never replace standard treatment. Theoretically, pharmacological doses of vitamin D (2,000 IU/kg/day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to cure common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science. (Altern Med Rev 2008; 13(1):6-20)

Introduction

A recent meta-analysis of 18 randomized controlled trials (RCT) found that cholecalciferol (vitamin D) significantly reduced total mortality. (1) This discovery is all the more remarkable because of the relatively low doses of vitamin D used (mean close 528 IU (13 mcg)) and because the finding persisted across a number of subgroup analyses. In spite of the low doses used and the short duration of the trials, vitamin D's mortality reduction was seven percent. (2) Indeed, the recent discovery that statins significantly increase 25-hydroxy-vitamin D (25(OH)D) levels raise the possibility that some--or all--of the mortality reduction of statins may be mediated through increases in vitamin D levels. (3,4)

Lappe et al recently reported the first RCT of vitamin D in preventing internal cancers and found a 60-percent reduction in such cancers by increasing baseline 25(OH)D levels from 29 ng/mL to 38 ng/mL with 1,100 IU (28 mcg) per day. (5) Baseline and treatment-induced serum 25(OH)D levels were strong and independent predictors of cancer risk. Lappe et al's study left open the possibility that higher doses and higher treatment-induced 25(OH)D levels might prevent even more cancers. (Note that 25(OH)D levels are reported in the literature as either ng/mL or nmol/L; 1.0 ng/mL equals 2.5 nmol/L.)

Besides cancer, vitamin D deficiency is associated with cardiovascular disease, hypertension, stroke, diabetes, multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, osteoporosis, periodontal disease, macular degeneration, mental illness, propensity to fall, and chronic pain. (6-10) A recent review presented considerable evidence that influenza epidemics, and perhaps even the common cold, are brought on by seasonal deficiencies in antimicrobial peptides (AMP), such as cathelicidin, secondary to seasonal deficiencies in vitamin D. (11) Results of an RCT support the theory, finding 2,000 IU of vitamin D/day for one year virtually eliminated self-reported incidence of colds and influenza (Figure 1). (12) Even the current triple childhood epidemics of autism (13) (Figure 2), asthma, (14) and type 1 diabetes, (15) all of which blossomed after sun-avoidance advice became widespread, might be the tragic and iatrogenic sequela of gestational or early childhood vitamin D deficiencies brought on by medical advice to avoid the sun.

[FIGURE 1 OMITTED]

Claims that vitamin D may help prevent such a wide variety of diseases seem incredible until one realizes vitamin D is not a vitamin; rather, it is the only known substrate for a potent, pleiotropic, repair and maintenance, seco-steroid hormone with a single endocrine function, but multiple autocrine functions. Previously, many practitioners thought vitamin D's activity was principally its endocrine function--the regulation of serum calcium--and was thus mainly involved in bone metabolism. Indeed, the classic endocrine function of vitamin D begins when the kidney hydroxylates 25(OH)D into 1,25[(OH).sub.2]D, which then acts, both directly and indirectly, to maintain serum calcium.

Effective Way to Treat Headache in Minutes by Brainpulse India

Chronic pains can be experienced in any form. Most of the people have gone through various stages of pain in their lives. And, hence, a variety of treatments have been given to them. With the fast growing technologies and science, it has become quite easier for the human being to treat most of the health problems of the patient. Headache, migraine problems and chronic pains are some common problems emerging from the fast moving day to day life. Fortunately, our medical science has sorted out this problem also.

Butalbital is one of the suggested medications to treat chronic pains, headache, migraine problems etc. Butalbital is a 5-allyl-5-isobutylbarbituric acid. It is a kind of Barbiturate with the intermediate duration of action. Its various formulations are combines with codeine are approved from FDA for the treatment of Tension headache. Combinations of Butalbital with other medications are marketed under various names; like Butalbital with Paracetamol is marketed under Axocet, Bucet, Cephadyn, Phrenilin and Forte; Butalbital in combination with aspirin is traded as Axotal are few to name.

Butalbital is also combined with caffeine to give the better results. It is in general known to most of the people that caffeine helps in relaxing during the tension headaches and chronic pains. Therefore, many medications for headaches are suggested to take with tea and coffee as they have caffeine in some quantity as the ingredient. Caffeine helps in managing the blood flow to brain and the person feels light headed after taking it. Any patient of headache, chronic pains or migraine can be recommended to consider Butalbital for their treatment. It is an effective and approved medication for the treatment for relieving from pain. Butalbital has the same chemical formula as in Talbutal but with the different structure. The medication is usually recommended in the severe condition of the pains as it could have some adverse effects on the patient’s body.

Some of the common identified side effects of the medication are dizziness, feeling of intoxication, nausea, sedation, drowsiness and light headedness. These are some common side effects which could not affect the health of the patient in the long run; however, its other major side effect is the addictive nature of Butalbital. It has been observed that many people get addictive to the medicine it taken for the longer durations. It is highly recommended to the user to consult the doctor first before start taking the medicine. The doctor will study your case and will let you know whether you need to take the medicine and in how much quantity. One should not start and stop taking Butalbital without consulting the case to the doctor. Butalbital is an effective medication but should be taken with precaution.

Subtle, Undiagnosed Symptoms Could Be Signs Of Subclinical Hypothyroidism by by: Mark Hyman, M.D.

Do you have vague, uncomfortable symptoms with no obvious cause?

If so, you might be one of the 45 million people who have a chronic medical problem that is both under-diagnosed and under-treated.

Think about it…

Do you feel tired all the time and have trouble concentrating?

Is your skin dry? Do you retain fluid?

Has your sex drive gone downhill?

Are your hands and feet always cold?

Is your hair thinning, your voice a little hoarse, your fingernails a little thick?

Is your cholesterol high?

Do you have trouble losing weight or have you gained weight recently?

Are you depressed or anxious?

Do you have really bad PMS or trouble getting pregnant?

Do your muscles feel weak, crampy, and painful?

Most of these symptoms aren’t severe enough to send you to the emergency room.

In fact, we usually accept them as a normal part of life -- and so do conventional doctors. They don’t view these symptoms as serious.

But they certainly affect your quality of life. And they can lead to more serious problems, including heart attacks and diabetes.

So what causes these symptoms?

It’s called hypothyroidism.

In this condition, your overall metabolic gas pedal has slowed down because the master gland that controls it, your thyroid gland, isn’t functioning at full speed.

If your thyroid slows down, every other organ and system in your body slows down, including your brain, heart, gut, and muscles.

Thyroid function is really a gray area. But most doctors view it as black or white.

Conventional doctors tend to believe that you can diagnose hypothyroidism only through one blood test, called TSH, and that you only qualify for treatment if your blood level is over 5.0.

But this ignores a whole group of people who have what we call subclinical hypothyroidism. It is called that because doctors have a hard time diagnosing it.

Subclinical hypothyroidism may trigger many low-grade symptoms, like those described above. Yet it causes just slight changes in your blood tests.

In fact, it often only shows up in tests that most doctors never perform.

I see this all the time in my medical practice: Patients come in with vague complaints that alone may not seem too significant.

But when you put them all together, they tell an important story.

For example, take the 73-year-old woman who had fatigue, sluggishness, poor memory, slight depression, dry skin, constipation, and mild fluid retention.

Her doctor brushed her off.

But I believe that most of the symptoms of aging that we see are really symptoms of abnormal aging or dysfunction that is related to imbalances in our core body systems.

So I act as a medical detective to find clues where no one else is looking and put together a story about why a person feels sick. This gets them the answers and tools they need to get well.

In this case, we found that my patient had a sluggish thyroid. Although she didn’t meet all the conventional criteria for hypothyroidism, she had an autoimmune reaction that caused her thyroid to function poorly.

So we replaced her missing thyroid hormone, supported her nutrition, and made some simple lifestyle changes. She soon felt alert, energetic, and youthful -- and all of her other symptoms cleared up.

Another patient was a 28-year-old chronically constipated woman.

She also felt tired in the mornings, always needed coffee, and had trouble staying up at night.

She thought this was normal. She didn’t know she had a sluggish thyroid.

But as soon as we supported her nutrition and eliminated her food allergens (particularly gluten), which create inflammation and interfere with thyroid function, she improved.

Low thyroid function affects people of all ages.

It is very common because of our exposure to toxins such as heavy metals and pesticides, nutritional deficiencies, and chronic stress, all of which interfere with our thyroid function.

And your thyroid isn’t just linked to the symptoms described here.

It is the master metabolism hormone that controls the function and activity of almost every organ and cell in your body -- so when it is sluggish or slow, everything slows down.

Fortunately, we can diagnose and treat problem, with a comprehensive functional medicine approach that uses the concepts of UltraWellness.

First, I determine if you have any of the chronic symptoms of hypothyroidism or diseases associated with it, such as:

• sluggishness in the morning
• poor concentration and memory
• low-grade depression
• dry skin
• hoarse voice
• thinning hair
• coarse hair
• being very sensitive to cold and having cold hands and feet
• low body temperature
• muscle pain
• weakness or cramps
• low sex drive
• fluid retention
• high cholesterol

Next, I do a physical examination for clues to a low-functioning thyroid.

I check for a low body temperature. Anything lower than 97.6 degrees F may be a sign of hypothyroidism.

I might also find fluid retention, a thick tongue, swollen feet, swollen eyelids, an enlarged thyroid gland, excessive earwax, a dry mouth, coarse skin, low blood pressure, or decreased ankle reflexes. I might even find that the outer third of the eyebrows is gone.

These are all physical signs that can be put together along with other symptoms to form a story of what is causing the problem.

Then I perform specific blood tests that give me a full picture of thyroid problems.

Finally, I design a nutrition, lifestyle, and supplement regimen and hormone replacement plan as needed to help people regain their health.

In my next article, I will discuss the major preventable -- and mostly hidden -- factors that slow your thyroid down. And I’ll tell you more about the special tests I use to diagnose thyroid problems, as well as how to specifically treat low thyroid function.

High Blood Pressure – Basic Information and Its Causes by Brainpulse India

High blood pressure is also referred as hypertension. The condition of high blood pressure arises when the force of blood flow increases significantly from the normal pressure in the walls of the arteries. High blood pressure is of two types - Primary and secondary. The primary high blood pressure indicates that there is no specific medical cause or reason to explain the patient’s condition. It is also referred as essential high blood pressure. The secondary high blood pressure happens due to the other conditions of the body such as kidney problems or tumors.

During the high blood pressure period, the force of blood flow increases and which raises the pressure on the arteries to flow the blood in the entire body. Arteries are the vessels that carry the blood from the pumping heart to the entire organs of the body. Every time when the heart beats, it pumps out the blood in the vessels with the systolic pressure and when it comes to rest between the beats, it has the low pressure which is called as diastolic pressure.

High blood pressure has several reasons. This means that the multiple factors jointly cause the high blood pressure in the body. However, all the reasons for the problem are not identified; but it has been observed that the high blood pressure tends to develops in the people who have high intake of salt in their diet. The other causes commonly found for the problem are obesity, hereditary susceptibility, advancing age and kidney failure etc. The genetic factor is one of the essential reasons for the hypertension in the younger generations of the family.

The treatments for high blood pressure are few. The patient needs to make significant changes in the diet plan. Intake of salt and caffeine should be reduced from the daily diet. If you have the habit of smoking and drinking habits then it also need to be controlled. The high blood pressure could be controlled even without taking the help of drugs and medicines. It can be cured by herbal medicines and by making some changes in the diet plan. But if the condition of the patient becomes severe then it is recommended to consult the doctor as soon as possible.