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It is estimated that over 33 million people in the United States are uncomfortable leaving their homes or meeting with friends because they have an overactive bladder that forces them to be close to a bathroom at all times.

People with an overactive bladder may urinate eight or more times in 24 hours and multiple times during the night. Sixty percent of elderly women and 30% of middle-aged men and women experience symptoms of an overactive bladder, urinary incontinence (leaking urine). Individuals often hesitate to share this problem with their physician.

An overactive bladder, sometimes called a “spastic bladder”, is the name given to a group of urinary symptoms. There are two types of urinary incontinence, although one can have both at once. They are urge and stress incontinence. Urge incontinence is the strong, sudden urge to urinate that cannot be ignored. When one does not get to the bathroom “in time” there may be an involuntary leakage of urine. Stress incontinence happens when people leak urine while sneezing, laughing or being physical.

When it is time to empty the bladder, a signal goes out to the brain which “tells” the muscles of the bladder to contract, pushing urine out and to empty the bladder. In people with overactive bladders, the muscles of the bladder start to contract involuntarily even when the volume of urine in the bladder is low. This involuntary contraction creates the urgent need to urinate.

Several conditions are associated with an overactive bladder. These include diabetes, certain medications, stroke, urinary tract infections, bladder stones, tumors and excessive consumption of alcohol or caffeine. In too many cases the cause is unknown; this is called an idiopathic overactive bladder condition.

Recent studies suggest that individuals with an overactive bladder have higher levels of inflammation. High levels of the inflammatory marker, C-reactive protein, and inflammatory cytokines are found in patients. When analyzing over 1800 men and 1800 women with overactive bladders, and adjusting for other conditions including smoking and alcohol consumption, the higher the C-reactive protein levels, the greater the odds of having urgent episodes and frequency. The clinicians concluded that there may be a role of inflammation in the development of this condition.

Summary.

An overactive bladder is a common condition affecting all ages and has a severe impact on quality of life. Keeping the body and bladder in homeostasis, in balance, may be an important key to reducing the sudden urge to urinate.

Contact Dr. Hellen, she is there for you.  No fee is charged for the first 30 minutes of consultation.  She may be  contacted by using this form or calling:  302.265.3870 (ET-USA).

 

www.nafc.org/overactive-bladder
www.renalandurologynews.com/aua-2010-annual-meeting/overactive-bladder-linked-to-inflammation/article/171323/
www.tcs.org.tw/tcs_old/issue/Folder/3_1Suppl/09_IPFD_V3_Suppl_1_PP_17_19.pdf
www.ncbi.nlm.nih.gov/pubmed/29192418
journals.viamedica.pl/ginekologia_polska/article/view/55086
www.ncbi.nlm.nih.gov/pubmed/28953078
www.ncbi.nlm.nih.gov/pubmed/19275692
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754024/
www.frontiersin.org/articles/10.3389/fnins.2018.00931/full

 

 

 

 

 

 

 

Back pain is one of the most common health complaints among adults in the US. From 75-80% of individuals will suffer from lower back pain sometime in their lives.

Symptoms of back pain include shooting or stabbing pains in the back, limited mobility, and/or pain that radiates down the leg.

The majority of individuals experiencing back pain will become more comfortable within days or weeks without medical treatment. Some people however may experience chronic pain lasting 2-3 months or more.  Nonetheless, all low back pain results in major economic and social repercussions for both sufferers and society.

 

DrHellen 2018 (c)

There is no known cause of the pain in approximately 90% of patients; it is what is termed “idiopathic”.  However, sitting too long or doing a physical task incorrectly may trigger back problems.  The lack of physical activity, excess weight, genetics and the physical demands of a job also contribute to lower back pain. Sedentary lifestyles are associated with 1.41 times greater risk of developing back pain. Individuals that are not physically active, are 1.23 times more likely to develop lower back pain.

Individuals with back pain frequently have the same anatomically “abnormalities” as people without back complaints. Patients with occupation-related back pain who had magnetic resonance imaging (MRI) of their back were 8 times more likely to get surgery as those who had just x-rays. Since symptoms do not correlate with imaging testing, many practitioners will not recommend imaging testing within the first six weeks of pain (unless there is a strong suspicion of other underlying conditions)..

Inflammation in the body is tightly regulated, involving signals that initiate and maintain inflammation and others that turn inflammation off. Imbalances between the two, lead to unchecked inflammation.

Inflammation causes pain, and pain causes more inflammation.  When the body hurts, inflammatory cytokines, immune molecules, are triggered that initiate the healing process. The release in the spinal cord of certain cytokines is associated with inflamed nerves and pain.

CRP (C-reactive protein) is a biological marker of inflammation. Individuals with the most severe lower back pain have nearly twice the amount of CRP levels as those with less pain.

Back surgery may relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own. There are a number of treatments that are used to reduce inflammation and pain: nonsteroidal anti-inflammatory drugs (NSAIDS), epidural steroid injections, topically applied creams or sprays, and for some, hot and cold packs.

One of the best approaches to relieving lower back pain is exercise, especially McKenzie exercises [find the exercise best for you on YouTube].  Individuals that do back exercises find significant relief and if practiced consistently will find that their backs will be strengthened and they will have less discomfort.

[As previous posts have suggested, backed by clinical trials, exercise increases naturally-occurring anti-inflammatory cytokines and can provide significant and faster relief to those suffering with lower back pain.]

Summary:

The key to healing is a balanced immune response.  The body needs the right amount of inflammation to heal, but too much inflammation results in illness.

If you want to change how you feel, contact Dr. Hellen. No fee is charged for the first 30 minutes of consultation. Dr. Hellen may be  contacted by using this form or calling:  302.265.3870 (ET-USA).
mayohealthhighlights.startribune.com/2017/09/22/low-back-pain-caused-by-spinal-degeneration-and-injury/
www.statista.com/topics/4333/back-pain-in-the-us/
www.ncbi.nlm.nih.gov/pubmed/19407734
www.ncbi.nlm.nih.gov/pmc/articles/PMC4137474/
www.ncbi.nlm.nih.gov/pubmed/29740548
www.ncbi.nlm.nih.gov/pubmed/23270761
www.ncbi.nlm.nih.gov/pmc/articles/PMC5931150

The second leading cause of death for people under the age of 44 years is suicide. Overall, it is the the tenth leading cause of death in the United States, with veterans comprising 22.2% of this statistic.  Women are three times more likely to attempt suicide, but for every woman who takes her own life, four men will die from their attempt.

Although older adults make up only 12% of the population in the States, they account for 18% of all suicides. These fatal events in the elderly are probably under-reported by 40% with “silent suicides”, dehydration, “accidents”, medication over doses, etc. ending in death.  Additionally, double suicides involving spouses or partners occur most frequently in this population. Since the elderly are the fastest growing segment of the population, these later-life deaths are predicted to result in suicide becoming a major public health issue in the too-near future.

Inflammation and Suicide

C-reactive protein (CRP) is associated with high levels of inflammation found in people with inflammatory disorders, burn and trauma victims, in obese individuals, in people with infections or with cardiovascular disease. People with suicidal thoughts (known as suicidal ideation) or attempts, also exhibit high levels of C-reactive protein compared to people without such behaviors.

Inflammatory factors are triggered during stress and are associated with depression.

image

When compared to patients being treated for psychiatric disorders who are not suicidal, individuals who have contemplated or attempted suicide have increased levels of inflammatory cytokines, immune cell molecules in their blood and/or brain.

The ratio of inflammatory molecules to anti-inflammatory molecules in the body either promotes inflammation or limits it.  A healthy immune system constantly strives to maintain these factors in a delicate balance, in immune homeostasis. 

Importance of Balancing Immune Factors

Imbalances in immune regulators are harmful and lead to disease. Taking the following steps should make a major difference in helping the body and mind return to homeostasis, to its natural, healthy balance:

  • Engage in physical activity at least 30 minutes a day 5 days/week.
  • Add one or more daily servings of a superior immune support supplement to your diet.
  • Maintain a healthy weight.
  • Eat a wide variety of colorful fruits and vegetables.
  • Spend some time outdoors.

For decades I have helped people enhance their quality of life.  I can be contacted at: DrHellen@DrHellenGreenblatt.info, use this form or give me a call at 302.265.3870 (ET USA) and let us talk. Your first 30 minutes are on me!  You’ve tried everyone and everything else, let me help you feel good again, you deserve it!

 
afsp.org/wp-content/uploads/2016/06/2016-National-Facts-Figures.pdf

www.sciencedirect.com/science/article/pii/S1043466615300090

www.ncbi.nlm.nih.gov/pubmed/28211584

www.ncbi.nlm.nih.gov/pubmed/28135675

www.ncbi.nlm.nih.gov/pubmed/27824355

www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00794-X/fulltext

Delirium is an under-reported condition that may affect up to 56% of older individuals after surgery, patients that have been heavily sedated for a length of time, burn, cancer, and patients on ventilators for long periods. Patients experience vivid hallucinations that may be part of a vicious cycle if doctors attempt to control the delusions with larger amounts of sedatives; the medications may disorient and confuse the patient even more.

The delusions and accompanying cognitive issues can persist for months after patients leave the hospital and can lead to a misdiagnosis of dementia, rather than delirium. [Dementia develops gradually and gradually worsens, while delirium may be of sudden onset.]

Delirium is associated with excessive inflammation in the brain resulting from triggering specialized immune cells the microglia. If stimulated over a long time, the cells release inflammatory cytokines, molecules that damage nerve cells and contribute to damage and break down of the capillaries in the brain, the blood-brain barrier.

C-reactive protein, CRP, is one measure of inflammation. CRP levels were measured in elderly surgical patients who had ended up with complications such as delirium, cardiovascular issues, or infection. The levels of CRP in their blood were predictive as to how fully they recovered.

A recent study measured the levels of 12 different inflammatory and anti-inflammatory cytokines in older patients undergoing surgery. Those having episodes of delirium had consistently high levels of inflammatory cytokines as compared to patients that did not have high levels of cytokines. Similar results were seen in patients that developed delirium after procedures such as open-heart surgery and hip fracture repair.

Conclusion

In order for the body to heal after it is hurt, or to fight an infection successfully, a delicate balance of cytokines, immune messages are required. Too little of an inflammatory response and the individual may not survive an infection. Too much of an inflammatory response and healthy tissue is destroyed. Homeostasis, balance, is what the body strives for every moment.

Dr. Hellen would be pleased to provide guidance to helping enhance your quality of life.  She may be contacted by using this form or at: 302.265.3870 (ET, USA).

 

www.theatlantic.com/health/archive/2015/06/the-overlooked-danger-of-delirium-in-hospitals/394829/
www.mayoclinic.org/diseases-conditions/delirium/basics/definition/con-20033982
www.ncbi.nlm.nih.gov/pmc/articles/PMC2911011
intl-biomedgerontology.oxfordjournals.org/content/early/2015/07/24/gerona.glv083.full
www.sciencedirect.com/science/article/pii/S2210833511000773
www.ncbi.nlm.nih.gov/pubmed/17504139

 

 

This month was the 13th anniversary of the haunting September 11 event that has changed us, our Nation, and the world we thought we knew. It seems like yesterday that these events happened.

Three years ago, I posted my frustration of my inability to get First Responders, and/or their health practitioners, to consider addressing the issue of immune homeostasis, immune balance, to enhance the quality of life of individuals that had put themselves at risk to save others.

 Exposure to Air-Borne Particles

The World Trade Center Health Registry estimates about 410,000 people were exposed to air-borne particles and toxins attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings.

 Despite the fact that early in the World Trade Center (WTC)’ construction, builders abandoned asbestos as a fireproofing material, over 400 tons of asbestos were used in the building of the World Trade Center (WTC). Additionally ”mineral wool”, minerals that were melted and spun into fibers and bound together by cement like components was used in construction.

 Massive amounts of hazardous fiber, asbestos, glass, gypsum, and cement were pulverized into ultra-fine particles when the Towers imploded and collapsed on September 11. Virtually every surface was covered with a fine, white particulate dust, and downwind from the complex, the fine particulate matter settled to a depth of 3 inches or more.

Affected groups of Responders include firefighters, police, health professionals, clean-up crews, construction workers, truck drivers, transit workers, lower Manhattan residents, and office workers.

 Increase Risk of Cancer

Responders were exposed to hundreds, if not thousands, of toxic particulates, dust, and gases at Ground Zero. As many of these are known to be potential carcinogens, it is not surprising that two years ago, 58 different types of cancers were added to a list of diseases with which many World Trade Center responders suffer.

 Overall, First Responders at Ground Zero have a 15% increased cancer risk with a 239% higher risk for thyroid cancers. However, unfortunately, asbestos-related lung cancers such as malignant mesothelioma may not appear for 20-40 more years.

 Signature Illness: PSTD and Respiratory Illness

If having a significant increase in cancer risk was not enough, according to the findings of the Stony Brook [NY] Medicine’s World Trade Center Health Program, as many as 60% of 9/11 World Trade Center responders continue to experience “clinically significant symptoms of post-traumatic stress disorder (PTSD) and … respiratory illness”.

Coughing and breathing problems have been a major issue, even in Responders that were only “moderately” exposed. Additionally individuals with the most exposure were more likely to find that their asthma symptoms became worse.

Benjamin Luft, MD, Medical Director of the Stony Brook Program is of the opinion that “a signature illness” of a WTC Responder is having both PTSD and respiratory problems at the same time.

 Respiratory Difficulties and Inflammation

Inflammatory biomarkers have been monitored in those exposed to WTC dust and smoke. Elevated levels soon after exposure were associated with increased risk of difficulty breathing in the years that followed.

 PTSD and Inflammatory Responses

A few months ago I stated “Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.”

 “…individuals with PTSD are more likely to have significantly higher amounts of circulating CRP [an inflammatory marker] than those not diagnosed with PTSD.”

 The Combination of PTSD and Respiratory Issues

To repeat from my previous post,“The immune system mounts an immune, inflammatory response when the body is exposed to pathogens, pollutants, or toxins. The inflammatory cells release immune factors, such as cytokines, cellular messages, that are involved in cell-to-cell communication with the “purpose” of recruiting more inflammatory cells into an area to help eliminate a perceived threat.”

 “Pollutants and chemicals … trigger airway inflammation and increase mucous production. Other immune molecules cause narrowing of airways resulting in the contraction of the muscles lining the airways. The combination of inflammation and increased mucous makes it difficult for air to enter or leave the lungs and can result in breathing issues.”

“Additionally, lungs that do not function properly, are ideal for the multiplication of molds, bacteria, and viruses. The lungs continue their struggle to eliminate pollutants and pathogens, resulting in a chronic, persistent, dry cough and worsened lung function.”

 A Plea to Readers

I am convinced that immune inflammatory imbalances contribute in large portion to the reason that that First Responders experience so many health challenges.

 It is my heart-felt hope and expectation that helping individuals return to immune homeostasis, immune balance, may be the key to changing their quality of life. Despite numerous attempts and avenues, I have been unable to make reliable contact with decision makers or Responders.   I hope that you will forward my note to individuals that are still suffering the consequences of serving others.

 I can be reached at: DrHellen@DrHellenGreenblatt.info or at 302.265.3870. Thank you.

www.asbestos.com/world-trade-center/
sb.cc.stonybrook.edu/news/general/140910wtc.php
911research.wtc7.net/wtc/evidence/dust.html
www.sciencedaily.com/releases/2014/09/140910185910.htm
www.health.ny.gov/environmental/investigations/wtc/health_studies/responders.htm
www.cnn.com/2013/09/11/health/911-cancer-treatment/
www.thelancet.com/themed-911
www.mesothelioma.com/blog/authors/barbara/help-running-out-for-911-first-responders.htm
www.ncbi.nlm.nih.gov/pubmed/21998260

Post-traumatic stress disorder (PTSD) occurs in some individuals that are exposed to emotionally disturbing events such as combat, rocket, and terrorist attacks. Individuals that have suffered traumatic brain injury (TBI) or experienced natural disasters and sexual assault are also at higher risk of having this disorder.

Symptoms may include quality of life issues such as explosive outbursts of anger, difficulties in concentrating, being easily startled, feeling constantly “on guard”, expecting a threat to occur at any moment, depression, problems sleeping, avoiding people and circumstances that can trigger unpleasant memories or outbursts, limiting emotional relationships, and avoiding crowded locations.

Up to twenty percent of veterans serving in Iraq and Afghanistan, 10% of Gulf War (Desert Storm), and 30% of Vietnam Veterans have been diagnosed with post-traumatic stress disorder.

PTSD is not only a psychiatric issue. Individuals suffering with PTSD are at higher risk of being physically ill, and at increased risk of death from a multiple of causes.

PTSD is Associated with Inflammatory Responses.
Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.

A combination of high blood sugar, cholesterol, and blood pressure, coupled with excess fat around the abdomen (abdominal visceral fat), increases the risk of individuals for stroke, heart disease, and diabetes. This cluster of symptoms, metabolic syndrome, is associated with inflammation and is found in 48% of individuals with post traumatic stress syndrome compared to 25% of controls. Such clinical issues result in patients with PTSD utilizing a greater proportion of medical services and prescription medications.

IL-6 is a cytokine, an immune messenger, which plays a major role in inflammation, helping the body heal after tissue injury, and defending the body from pathogens. C-reactive protein (CRP) is another biological marker that is strongly related to heightened levels of inflammation. Elevated levels of IL-6 and CRP are associated with an increased risk of heart attacks and other cardiovascular events that are inflammatory in nature.

Reports of increased presence of inflammatory cytokines in individuals with PTSD are inconsistent. However, the evidence suggests in military personnel with PTSD or depression, IL-6 levels are higher than found in control subjects, and that the quality of life of these soldiers is poorer as well. Similarly, individuals with PTSD are more likely to have significantly higher amounts of circulating CRP than those not diagnosed with PTSD.

Intermittent explosive disorder is one of the more troubling aspects of some individuals with post traumatic stress disorder. This condition involves repeated episodes of impulsive, angry, verbal outbursts, and violent and aggressive behavior. CRP and IL-6 levels are significantly higher in personnel with intermittent explosive disorder compared with normal or other psychiatric controls, suggesting a direct relationship between inflammation and aggression.

Summary:
Fifty percent of individuals with post traumatic stress syndrome do not seek treatment, and of those that do, only half of these persons will get “minimally adequate” treatment. Until now, the primary treatments for PSTD are psychological counseling and psychiatric medications.

Inflammation is the result of a delicate balance between inflammatory and anti-inflammatory responses, and the body constantly strives to maintain a state of “immune homeostasis”, immune balance.

As in most disease, chronic low-grade inflammation is a likely contributor to post traumatic stress syndrome. If individuals with PTSD better controlled the amount of inflammation produced by their bodies, their quality of life would improve, both emotionally and physically.

 

There is no cost to speak with Dr. Hellen. She can be reached at 1.302-265.3870 ET [USA] or contacted at: drhellen@drhellengreenblatt.info.

 

www.ncbi.nlm.nih.gov/pubmed/23806967
www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
www.ncbi.nlm.nih.gov/pubmed/24157651
archpsyc.jamanetwork.com/article.aspx?articleid=1833091
www.medpagetoday.com/Psychiatry/AnxietyStress/44519
www.cdc.gov/niosh/topics/traumaticincident/
www.ncbi.nlm.nih.gov/pubmed/19780999
www.biomedcentral.com/1471-244X/13/40
www.ncbi.nlm.nih.gov/pubmed/24948537
archpsyc.jamanetwork.com/article.aspx?articleid=1790358
www.ncbi.nlm.nih.gov/pubmed/24559851
www.ncbi.nlm.nih.gov/pubmed/24875221
circ.ahajournals.org/content/101/15/1767.full
www.veteransandptsd.com/PTSD-statistics.html
www.hindawi.com/journals/cherp/2012/490804/

We humans exist in sea of microorganisms. According to the American Society for Microbiology, there are 10 fold the number of bacteria living in and on our bodies as cells that make up our bodies. Wherever our bodies are exposed to the outside world, for example our digestive tracts, skin, mouth, vagina, etc. we find specific varieties of bacteria and other organisms.

The totality of all the bacteria and other microorganisms that populate our bodies is called the microbiome. The microbiome is highly individualized, with the spectrum of bacteria differing from one person to another; much like an individual’s fingerprints. All people display wide variations in the kinds of bacteria that inhabit them. The types and numbers of bacteria in and on our bodies differ depending on our genetic makeup, our diet, and environmental factors.

Immune cells are found throughout the body where they are always on alert defending the body against infection. Inflammation is the primary way that the immune system controls infections and healing, but overactive immune responses can lead to debilitating inflammatory diseases such as atherosclerosis, diabetes, and bowel disorders.

There is considerable “cross-talk” between the microbiome and the immune cells. Microorganisms influence the responses of the immune system, and the immune system in turn affects the populations of the organisms that inhabit us. For example, evidence suggests that certain bacteria in the gut can decrease inflammation in the gut and decrease chronic disease. [Whether the organisms themselves are producing these molecules, or whether they are triggering immune cells to release anti-inflammatory compounds is not clear.]

Celiac Disease and Diabetes:
Individuals with celiac disease are highly sensitive to foods containing gluten, a protein found in barley, rye, and wheat. People with celiac disease have significant quality of life issues such as bloating, diarrhea, and/or constipation.

When the immune cells of celiacs see gluten, they mount an inflammatory response to try to eliminate the gluten from the intestines. The immune cells produce antibodies that attach to the inner surface of the gut and through inflammatory responses cause direct damage of the gut lining. Inflammatory responses against the body’s own tissues lead to autoimmune (against oneself) disease.

Diabetes is also the result of an autoimmune condition. Inflammatory immune cells destroy specialized cells in the pancreas that produce insulin, a hormone needed to control blood sugar.

Individuals with celiac disease have more than digestive issues, since they have almost 2.5 times a greater chance of developing diabetes than those without intestinal problems. Such conditions are associated with antibodies directed against the insulin-producing cells. When Individuals with celiac disease go on a strict gluten-free diet, they produce fewer anti-insulin-antibodies, suggesting that they are producing less of an inflammatory response.

Gluten intake changes the kinds of bacteria found in the gut. Diabetic-prone mice that eat regular mouse chow containing gluten are more likely to get diabetes than diabetic-prone mice on gluten-free chow. In addition, when the gut bacteria are analyzed, the diabetic-prone mice on gluten have the type of bacteria more often associated with inflammation, than the mice not on gluten. Thus, diet affects the responses of the immune cells and the microbiome.

As followers of this blog are aware, in the face of constantly changing external and internal challenges, the immune system of a healthy person makes adjustments to maintain immune balance, immune homeostasis.

One would expect that if inflammatory and autoimmune responses were better controlled by the body, that individuals with celiac disease and diabetes would experience a far better quality of life.

www.ncbi.nlm.nih.gov/pubmed/22699609
www.ncbi.nlm.nih.gov/books/NBK27169
www.ncbi.nlm.nih.gov/pmc/articles/PMC3256734
www.ncbi.nlm.nih.gov/pmc/articles/PMC2575488
www.ncbi.nlm.nih.gov/pubmed/22913724
www.ncbi.nlm.nih.gov/pubmed/24164337
www.ncbi.nlm.nih.gov/pubmed/24041379 www.sciencedaily.com/releases/2013/11/131113182423.htm
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078687

Exposure to chronic constant emotional or physical stress triggers a vicious cycle of inflammation. The stress increases the amount of inflammation that the body generates, and the additional inflammation “feeds” more stress.

Depressed individuals report that they experience high levels of tension and anxiety, fatigue, muscle discomfort, and/or gastrointestinal problems. Often they have a feeling that “something is very wrong”, but they cannot pinpoint what is bothering them.

Individuals suffering from depression often start by visiting physicians that specialize in specific organ systems of the body. For example a neurologist (specialty in the nerves), a gastroenterologist (digestive system), or a psychiatrist (medical doctor) or a psychologist, practitioners specializing in mental disorders. Unfortunately, most of these experts tend to focus on a single part of the body.

Since the human body is a single organism, and all the organ systems are integrated, it might be useful to realize that there is substantial and constant cross talk between all the organ systems of the body. Affect one part of the body and it has a ripple effect on all the other parts of the body.

As an example, when individuals are depressed, their immune cells produce large amounts of inflammatory molecules, pro-inflammatory cytokines, which circulate throughout the body. Since cytokines act in a hormone-like fashion, they affect all parts of the body and the brain.

Treatment Resistant Depression
Over seven million individuals with depression find little or no relief that prescribed antidepressant medications. A significant number of these patients have high levels of inflammatory cytokines, immune messages that result in inflammation. These inflammatory cytokines can interfere with the actions of medications.
Lifestyle Changes.

Too many individuals are convinced that only prescription medications can make a difference in their depression and anxiety. However, there are certain life style changes that may help them, with their clinician’s approval, decrease their medication.*

(*Note: The following lifestyle changes should only be incorporated after consultation with a qualified health practitioner. If you are on prescription medications, especially for depression or anxiety, DO NOT REDUCE OR STOP ANY MEDICATIONS without consulting with the prescribing health practitioner.)

Some naturally oriented steps that one can take are:

EXERCISE:
Researchers at Duke University Medical Center, Durham, NC, found that a brisk 30-minute walk or jog three times a week may be just as effective in relieving major depression as are antidepressant prescription medications. Patients were assigned to three groups: antidepressant medications only, exercise only, or a combination of both medication and exercise. The scientists found that the exercise by itself was just as effective as medication and “was equally effective in reducing depression…” as were antidepressants.

One reason exercise may be so effective in reducing the inflammatory-depression cycle is that every time a muscle contracts, it releases anti-inflammatory immune cytokines that reduce inflammation and a help to decrease anxiety, and improve mood.
SUNSHINE AND FRESH AIR:
The amount of time subjects are exposed to sunlight is directly related to the amount of a specific inflammatory cytokine they produce, and depressed individuals show differing levels of the cytokine when exposed to light for varying amounts of time.
Moderate exposure to sunshine and fresh air may contribute greatly to feeling less depressed. This may “simply” be because when one is exposed to sunlight, vitamin D is produced by the body.

Vitamin D is more like a “hormone” than a purely nutritional element, since it affects hundreds of genes and is a powerful immune system regulator. Although still not definitively proven, individuals living in temperate areas may find that taking vitamin D3 supplements may prove helpful.

EAT SMARTER:
Increase the amount of fresh and colorful fruits and vegetables, beans, fish, and chicken. Limit non-nutritious “foods”, especially fried foods, sweets, sodas (diet or regular!), white rice, and pasta. Eating in a nutritional manner may help the body regulate its daily inflammatory responses.

CONTROL YOUR WEIGHT:
Fat cells, adipose cells, especially those around abdomen produce a wide range of inflammatory cytokines. As the size of the cells decrease, the amount of inflammation that the body produces decreases. Lowering inflammation helps an individual to return to their natural immune homeostasis, their natural immune balance.

OMEGA-3 FATTY ACIDS FROM FISH OILS:
Studies suggest that daily consumption of omega-3 fatty acids from fish makes a difference in depression. In a recent randomized double-blind placebo-controlled study of shift workers, supplementation with omega-3 was associated with a reduction in high sensitivity C-reactive protein (an inflammatory marker) and depression. In another study of women, the highest intake of omega-3 was associated with a 49% decrease in symptoms of depression. In the latter study, investigators suggested that omega-3 was triggering the production of anti-inflammatory compounds.

RETURN THE BODY TO IMMUNE BALANCE, IMMUNE HOMEOSTASIS:
Inflammation in the body is a normal and desired process that is part of the healing cycle and it is the primary method by which the body defends itself from pathogens. The key to good health is to help the body achieve the right level of inflammation, immune homeostasis. We want the body to produce enough of an inflammatory response to defend itself from pathogens and cancerous cells, but not so much inflammation that healthy tissues are damaged.

Hyperimmune egg has been shown to help the body return to immune homeostasis, immune balance. In a university, double-blind placebo-controlled trial (the gold standard of human trials), subjects consuming hyperimmune egg reported lower levels of moodiness, anger, and hostility. [Med Sci Sports Exer 2009 5:228].

SUMMARY
Chronic inflammation, brought about by an over-expression or lack of control of the normal protective mechanisms of the body, has been linked to range of conditions including depression.
Individuals who control inflammatory responses will have a much higher emotional and physical quality of life.

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bit.ly/1enpcdi
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www.psychiatrictimes.com/depression/inflammation-and-treatment-resistance-major-depression-perfect-storm

Healthcare-associated infections (HAI), nosocomial infections, are caused by a wide variety of bacteria, fungi, and viruses.  One bacterium that commonly causes illness is Clostridium difficile, or C. difficile.  Hospitalized children and elderly people are at special risk of acquiring these bacteria, infections that result in severe diarrhea.  Individuals infected with C. difficile are more likely to be admitted to short and long-term care facilities, have longer hospital stays, are more likely to require colon surgery, and are at higher risk of death.

Nosocomial infections are on the increase, probably due to the heightened use of antibiotics used in hospitalized patients.  The antibiotics kill off beneficial bacteria that might offer protection against getting infections such as C. difficile.

Intriguingly, in a recent study, patients admitted to the hospital who were on statins, medications used to lower low-density lipoprotein (LDL) cholesterol levels, had a 45% lower risk of getting Clostridium difficile infections compared to individuals that were not on these sorts of medications.

Other studies suggest that statins affect immune responses by down-regulating, inhibiting inflammation.  For example, statins prevent and reverse chronic and relapsing disease in an animal model similar to multiple sclerosis, reduce lung inflammation in animals that exposed to airborne particles, and have been shown to lower the risk of death of individuals suffering from 13 different types of cancers.

In atherosclerosis, primarily caused by an inflammatory response directed against the wall inside blood vessels, statin therapy reduces blood vessel inflammation and significantly reduces markers of inflammation such as hsCRP, high sensitivity C – reactive protein.

Health warnings have been issued by the FDA for statins.  These risks include:  memory loss and confusion, liver damage, heightened diabetes, and for certain statins, muscle weakness.  I am certainly NOT advocating that people use statins to limit inflammation.  Instead, I want the reader to focus on the fact that the effects of statins appear to be due, in the long run, to their ability to modulate acute (short-term) and chronic (long-term) inflammation.

 As I try to emphasize in all my posts, the key to good health is to achieve immune homeostasis, the appropriate balance of inflammatory and anti-inflammatory responses

 Immune homeostasis is most easily achieved through a) consistent physical activity, b) controlling fat deposits around the abdominal area, c) increasing consumption of vegetables and fruits, d) moderate exposure to sunlight (or vitamin D3 supplementation when the sun is not sufficient), e) ingestion of omega-3 fatty acids from a fish source, and f) and daily consumption of hyperimmune egg.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

 

http://www.cdc.gov/hai/organisms/cdiff/cdiff_infect.html
http://www.medpagetoday.com/MeetingCoverage/ACG/35590?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=
http://www.mdjunction.com/forums/lyme-disease-support-forums/medicine-treatments/1722560-pubmed-report-c-diff-death-from-lyme-disease/limitstart/40
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http://www.nejm.org/doi/full/10.1056/NEJMoa1201735
http://content.onlinejacc.org/article.aspx?articleid=1389317
http://www.ncbi.nlm.nih.gov/pubmed/20421792
http://circ.ahajournals.org/content/106/16/2041.full
http://www.ncbi.nlm.nih.gov/pubmed/22910717
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1986656/
http://www.nejm.org/doi/full/10.1056/NEJMoa1201735

 

The journal of the American Geriatrics Society, just released a study of older women suggesting  that women, and we assume men as well, add years of healthy living by staying active and increasing their consumption of fruits and vegetables. 

 Women between the ages of 70 to 79 years were followed for a five-year period.  Investigators monitored the amount of physical activity they reported, and their carotenoid blood levels.  [Carotenoids are a class of pigmented, phyto [plant] nutrients found in the yellow, orange, and plants.  Blood levels of carotenoids are associated with the quantity of vegetables and fruits consumed.  The more fruit and veggies consumed, the higher the levels of carotenoids in the bloodstream.]

In the study, women that were most physically active and consumed large amounts of fruits and vegetables, were eight times more likely to be alive after the study’s five years of follow-up, compared to women who were not active, and did not eat many fruits and vegetables.

 Exercise increases survival times

More than half of the 713 participants (53%) did no exercise, 21% were moderately active, and the 26% were very active.  The active women engaged in twice the amount of activity as did women who were not active.  Active woman reported that they walked, or were involved in strength training, bowling, dancing, household, or outdoor chores.  Physical activity resulted in active woman experiencing five-year death rates 71% lower than those of the least active women.

 Fruits and vegetable consumption increases survival times

During the five-year follow-up period, women who consumed the most fruits and vegetables, and had the highest blood levels of carotenoids, were 46 percent less likely to die than woman that ate fewer fruits and vegetables.  Blood carotenoid levels were 12% higher in the women who survived, compared to blood samples taken from women that would die earlier.

 This study supports previous results demonstrating that eating more vegetables and fruits, and consuming moderate amounts of wine products, which also contain phytonutrients,  is linked to people living longer.

 Down-regulation of inflammation:  A probable reason for the reported results.

Most scientists have only vague ideas as to why exercise, and heightened consumption of fruits and vegetables should make a difference in longevity.  However, decades of literature reviews, and successful counseling of individuals in the importance of balancing immune system inflammation, make it evident to me, that exercise and healthy food consumption helps the body limit run-away inflammatory responses, and therefore helps the body balance its natural levels of inflammation.

 Inflammation is the body’s protective response to infection, cancer cell growth, and injury.  However, when inflammatory responses are not controlled, inflammation ends up doing more harm than good, and becomes the origin of most illnesses.

 It has been documented that unhealthy aging is accompanied by excessive inflammation with increases in cytokines that cause inflammation, and inflammatory markers such as C-reactive protein (CRP).

 But the body expends a great deal of energy to naturally control inflammatory responses, and return to immune homeostasis, immune balance.   So for example, moderate exercise lowers inflammation. 

Every time muscle contraction occurs, potent anti-inflammatory cytokines are released.  Therefore, as the women in this study were physically active, their bodies were naturally reducing the amount of inflammation in their bodies.

 As to the contribution of fruits and vegetables in lowering inflammation, hundreds of studies support the fact that carotenoids affect cytokines, the immune system messengers that modulate inflammation. 

 There are many ways to help the body modulate immune system-generated inflammatory responses, but simple lifestyle changes such as regular exercise, and increased consumption of fruits and vegetables, are two simple steps to consider for a healthier, longer, and more active life.

www.ncbi.nlm.nih.gov/pubmed/22587851

www.ncbi.nlm.nih.gov/pubmed/22162208

www.sciencedaily.com/releases/2012/05/120530100512.htm

www.sciencedaily.com/releases/2009/06/090624093353.htm

 www.ncbi.nlm.nih.gov/pubmed/19549997

www.ncbi.nlm.nih.gov/pubmed/22483785

www.ncbi.nlm.nih.gov/pubmed/22473333

www.ncbi.nlm.nih.gov/pubmed/22708923

The retina is the “flat screen” at the back of the eye onto which light is projected when we look at an object.  The center of the retina is called the macula.  When it is damaged, a condition called  macular degeneration, there is a “hole” at the center of one’s vision, making it difficult to recognize faces, read, or drive a car.

 As people grow older, they are at greater risk of getting macular degeneration.    Risk factors for this condition are:  being Caucasian, obese, female, and having a family history of macular degeneration.  High blood pressure, high cholesterol, and eating few fruits and vegetables, also add to one’s risk.

 However, the greatest known risk of damaging the retina comes from smoking tobacco.  Current and former smokers have 6.6 times the chance of developing macular degeneration as compared to those who never smoked. [Unfortunately, if you smoked one or more packs a day, even having quit 15 years previously, still increases the risk that you will have damaged your retina in some way.]

Even after decades of study, we do not understand the underlying mechanisms of macular degeneration. Increasingly however, the literature suggests that inflammation is a major contributor to destruction of the retina.

Immune system inflammation is the body’s first line of defense against pathogens such as viruses, bacteria, fungi, and parasites.  Inflammation is also important to control mutating, cancer cells. 

 However, excessive amounts of tissue-damaging inflammation can damage healthy neighboring tissue.  High sensitivity C-reactive protein (hs-CRP) is a blood marker associated with inflammation, and an indication that too great an inflammatory response is being generated by the immune system.

  A seven year study of hs-CRP levels of 4900 people was conducted in the Netherlands.  Individuals with high levels of C-reactive protein had a significantly greater risk of acquiring macular degeneration compared to those with “normal” baselines of the inflammatory marker. Additionally, other studies suggest that 75% of patients with macular degeneration have “inflammatory” genes that release pro-inflammatory cytokines that are associated with the condition.

 Some clinicians have recommmended using-steroidal anti-inflammatory medications to control macular degeneration, yet contradictory studies suggest that frequent aspirin use leads to macular degeneration. 

 We know that high aspirin consumption leads to excessive bleeding in digestive tracts and the eyes.  Perhaps the association of high aspirin use and macular degeneration is due the bleeding aspect of excessive aspirin consumption.

Inflammation is important for our survival, but it must be the appropriate amount of inflammation; it must be a balanced response of just enough inflammation to defend and heal, but not so much that it damages tissues.

Controlling excessive inflammation, without  the  side-effects of medications such as bleeding,  would likely help limit degeneration of the retina.

 www.blindness.org/index.php?option=com_content&view=article&id=46&Itemid=56

www.ophsource.org/periodicals/ophtha/article/S0161-6420(00)00580-7/abstract

www.ncbi.nlm.nih.gov/pubmed/21920607

www.ncbi.nlm.nih.gov/pubmed/21183941

www.ncbi.nlm.nih.gov/pubmed/17923549

www.csmd.ucsb.edu/news/md_science_article.pdf

Obstructive sleep apnea syndrome  (OSAS) occurs when an individual repeatedly stops breathing, sometimes as many as 1-2 times a minute during their sleep.  It is most frequently associated with heavy snoring, broad swings in heart rate, and, as one would expect, extreme daytime sleepiness.  Those that suffer with sleep apnea are prone to accidents; they are twice as likely to be involved in car crashes as compared to individuals without the condition.

 The relationship between inflammation and sleep apnea is complicated, with not only inflammation of the airways, but  body-wide inflammation as well.

 As with other inflammatory conditions, obstructive sleep apnea is associated with cardiovascular disease, diabetes, and obesity.  Visceral fat, belly fat, is a major predictor of having obstructive sleep apnea syndrome, since fat cells produce large amounts of immune modulating molecules, that trigger inflammation.

 People suffering with sleep apnea have complex imbalances of immune factors, cytokines.  Their levels of immune modulating cytokines, such as tumor necrosis factor and interleukin (IL)-6, are markedly high, as are levels of other inflammatory proteins, including  C-reactive protein (hsCRP). [CRP is a blood protein typically associated with the presence and amount of inflammation in the body.]  Additionally,  hormones that regulate insulin and hunger levels are higher than levels found in those without sleep apnea.

 There is conflicting data about the affect of CPAPs, continuous positive airway pressure breathing devices,  on inflammation. Some studies suggest that the devices help lower the number of inflammatory molecules circulating in the body, other studies suggest that using a CPAP increases inflammation.

 Successfully battling disease, and healing , is determined by inflammatory immune cells and the types and ratios of cytokines they generate.  Restoring balance, immune homeostasis, to the body, helps the body stay healthy, and recover rapidly when in ill health.

emedicine.medscape.com/article/295807-overview
www.sciencedaily.com/releases/2008/02/080218214401.htm
www.ncbi.nlm.nih.gov/pubmed/22515302
www.chestjournal.chestpubs.org/content/127/3/1074.full
www.chestjournal.chestpubs.org/content/126/1/1.long
www.mayoclinic.com/health/sleep-apnea/DS00148
www.ncbi.nlm.nih.gov/pubmed/22408197

According to the World Health Organization smoking is the second largest preventable cause of disease and premature death. Globally, tobacco products are responsible for 5 million deaths annually. A person dies every 6 seconds from smoking-related diseases including chronic diseases and cancer.

Among its many effects, smoking triggers an immunologic response in arteries and veins which is associated with increased levels of inflammatory markers, such as C-reactive protein and increases in white blood cells. C-reactive protein is strongly associated with lifetime smoking exposure as measured by pack-years. Several studies have shown that such markers predict future cardiovascular events including atherosclerosis.

However, once smokers quit, their risk of future cardiac events and death gradually declines, and within 5 years, smoking-associated inflammatory responses start to return to normal.

Cigarette smoking has also been linked to increased risk of autoimmune diseases, including lupus, rheumatoid arthritis, multiple sclerosis, thyroid, and liver. Autoimmune diseases are immune disorders where the body attacks itself resulting in excessive inflammation and tissue damage.

Considering that cigarette smoke contains over 7000 chemicals, the likelihood that smoking triggers autoimmune and other excessive inflammatory immunological responses makes sense. An example of smoke-induced illness is chronic obstructive pulmonary disease (COPD) in which a person has difficulty in getting enough air.

The lungs, in response to cigarette smoke, activate cells lining the lungs and immune cells, resulting in inflammatory responses. If an individual is infected with a bacterial or viral infection in addition to the smoke assault, it results in a vicious cycle of more difficulties in breathing and greater inflammation. Studies have indeed shown that patients with COPD have autoantibodies and inflammatory responses against lung cells.

Researchers have reported that in female smokers, physical activity, known to help reduce inflammation, reduced their relative risk of developing lung cancer by more than 65 percent.

Thus, it might be expected that if smokers were better able to control their inflammatory responses and return to immune homeostasis, that they might be less likely to develop chronic diseases.

 

www.ncbi.nlm.nih.gov/pmc/articles/PMC1160597/

www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020160

www.ncbi.nlm.nih.gov/pubmed/21907865

www.ncbi.nlm.nih.gov/pubmed/17975205

www.medicalnewstoday.com/releases/58661.php

 

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