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Archive for April, 2009
UNDERSTANDING IMMUNE-SYSTEM TESTS: PROTEIN
Author: admin
One of the most important things we doctors can evalaute in the blood is protein. The enzyme systems that keep the body running depend on protein. And the immune system cells, like all cells, can’t exist without protein.
“But, Dr. Fox,” some patients protest, “didn’t you say that the average person gets too much protein?” Yes, I do feel that most of us take in plenty of protein. Still, protein malnutrition is seen in hospitalized patients, those with colitis, cancer, pancreatitis, chronic illnesses, in alcoholics, persons on fad diets, people taking drugs and others. Protein calorie malnutririon (PCM) is more common than one would think it would be in the Western world. Unfortunatly, it’s an often overlooked medical-nutritional problem.
Twenty-five to 50 percent of all adults admitted to a hospital for medical or surgical reasons develop signs of PCM within two weeks after admission. I have seen many patients living on nothing but intravenous solutions of five percent glucose in water for a week, ten days, or many weeks.
PCM can occur even where there is plenty of food to eat. There may be excessive food, but it is of limited variety and very low in protein. Years ago a 35-year-old woman was referred to me by another doctor. She complained of weakness and had anemia. Taking her personal and medical history, I learned that this mother of three small children was extremely poor. She and her children ate lots of potatoes—fried, boiled, baked, mashed— and some white rice. Potatoes are good for you, but a diet of mostly potatoes is unhealthy. She and her children were overweight: full, but malnourished. With plenty of calories to eat, but not enough protein, the woman and her children wound up with PCM.
Elderly people who eat only a few different foods, mostly from cans or packages, can also run into trouble. It’s wonderful to see how bright and energetic these people become when they are fed correctly.
Thus, as part of the Immuno-Nutritional series of blood tests, I look at three proteins in the blood: retinol-binding protein, transferin and albumin.
Both retinol-binding protein and transferin are sensitive indicators of a person’s protein status, because they’re rapid-turnover proteins. This means that the body quickly manufactures and destroys the proteins, so a shortage of building blocks (amino acids) will affect these proteins sooner than it will longer-lived proteins. These two proteins provide a biochemical indication of poor nutrition before the clinical signs are evident.
I also look at the serum albumin, even though this is a relatively “long-lived” protein that takes longer to be affected by a nutritional deficit. It’s part of my standard laboratory panel, however, so it’s a readily available figure. It has been shown that low-serum albumin in hospitalized patients has been associated with longer hospital stays and sicker patients. A low-serum albumin not accounted for in other disease states, such as liver or kidney failure, is associated with a lowered immune response. Albumin is lowered in infections and often with cancer.
Results: …
Retinol-binding protein 3.0-6.0 mg/dl
Transferin 200-400 mg/dl
Albumin 3.5-5.0 gm/dl (I like to see it between 4.5 and 5.5 gm/dl.)
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read comments (0)MORE ABOUT VITAMINS: VITAMIN C
Author: admin
Years ago, when Nobel prize winner Dr. Linus Pauling announced that vitamin C has a beneficial effect on the immune system, I was unimpressed. Like many other medical doctors, I had little faith in vitamins. But as I studied vitamin C and saw the effects it had on patients, I became convinced that vitamin C is necessary for good immune-system functioning. Some years ago, when I met Dr. Pauling, I was pleased to tell him that he had helped me see the power of vitamin C. More importantly, his work increased my awareness of the health-giving properties of vitamins and minerals in general.
There is a genetic disorder called Chediak-Higashi disease, which is highlighted by a marked lowering of resistance to bacterial infections. Patients who have this disease suffer from recurrent tissue abcesses, sinusitis and pneumonia, all of which are difficult to treat, and the disease is often fatal. Their white blood cell count drops, and the killing power of the cells is reduced. This is a dangerous sign, because the white blood cells bear the brunt of defending the body against disease. Vitamin C has corrected the problem in many patients studied, and it therefore serves as a model for the use of nutrients in helping the immune system to function effectively.
Vitamin C also improves the mobility of white blood cells. Using a video camera and screen hooked up to a microscope, I have seen sluggish white blood cells taken from patients with recurrent infections. After giving these people an injection of vitamin C, I put a fresh sample of their blood under the microscope and watch as the previously “lazy” white blood cells move about energetically.
Vitamin C has been used to speed up recoverv from pneumonia, mononucleosis, hepatitis and almost all viral infections, including AIDS. Studies are underway to evaluate vitamin C as an interferon-releasing agent. (A natural substance produced by your lymphocytes, interferon is involved in the battle against virus and cancer.) Vitamin C stimulates T- and B-cells, as well as the giant “cell eaters” (macrophages) which gobble up and destroy bacteria, viruses, fungi and other disease-causing antigens. In addition, vitamin C is an antioxidant and scavenger of free radicals. (Oxidation of molecules in your body is analogous to the rusting of a piece of iron. See vitamin E, below, for more information on free radicals.)
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LUPUS ERYTHEMATOSUS, SYSTEMIC: an inflammatory disease of connective tissue, occurring mostly in young women. Believed to be an autoimmune disease. May progress over a long period of time and may ultimately lead to death in some cases.
Signs and Symptoms: fever and malaise, which can progress insidiously over a period of years; joint pains; joint swelling may occur; allergic-like skin eruptions or various skin rashes; a “butterfly” rash on the face; loss of hair; redness of the palms; spontaneous bruises may occur; pleurisy; chest pains; pericarditis (inflammation of the sac surrounding the heart); endocarditis (inflammation of the inner lining of the heart); swelling of the lymph glands; symptoms of small strokes (transient weakness or paralysis of extremities, momentarily forgetfulness, etc.); patients may have depression, epileptic convulsions, dementia, confusion and many other symptoms.
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Another example of immune-system cooperation is interleukin. Macrophages produce a substance called interleukin-I (IL-I), which leads to an increase in T-cells. The T-cells then manufacture interleukin-II (IL-2), which helps get the B-cells producing antibodies.
Interleukin-II has recently been hailed as an amazing breakthrough in the war against canceV. It seems that the immune systems of some cancer patients don’t fully mobilize to fight the cancer. For what ever reason, the antigen (cancer) doesn’t elicit a full immune response; the immune system doesn’t seem to pay proper attention to the problem. New studies have described how scientists took blood from these cancer patients, separated out the lymphocytes and mixed them with interleukin-II. The lymphocyte/interleukin complexes were injected back into the bloodstream, and the rejuvenated lymphocytes were better able to attack the cancer.
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CHEMICAL SENSITIVITY: WHAT ARE ‘CHEMICALS’?
Author: admin
All living things are made up of chemicals – chemicals and water and nothing else. So are rocks and the air and other inanimate objects. But when people use the word ‘chemicals’ that is not what they usually mean. Colloquially, it means man-made chemicals or synthetic chemicals – ones that do not occur in nature, or which only occur naturally in very small quantities, compared to the amounts that we manufacture.
Synthetic chemicals are not intrinsically different from naturally-occurring ones – their basic chemistry is much the same, although there are some novelties (eg chlorinated hydrocarbons – hydrocarbons are fundamental to life, but adding chlorine to them was a human innovation). What is more, many naturally-occurring chemicals are highly toxic: the natural foods we eat are stiff with potentially damaging chemicals – plants, in particular, spike their products with an armoury of defensive substances, fungi on the plants contribute their own toxins, and the bacteria in our gut add to the number we absorb. Human beings are well equipped to detoxify these natural chemicals, with a powerful array of enzymes.
For the most part, the enzymes that our ancestors evolved to tackle natural chemicals work pretty well on synthetic ones – as long as they are not overwhelmed by the amount they have to detoxify. However, the initial products of the enzyme reactions are sometimes more toxic than the original chemical. In other words, the body’s detoxification enzymes have evolved to deal with a certain range of naturally occurring chemicals – they can go to work on synthetic ones, but on the way to breaking them down they may produce intermediates that are harmful. For this reason, such changes are known as biotransformation rather than detoxification.
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Description and Possible Medical Problems
Sometimes, after a hard workout, your calves will feel painful, but it’s the kind of good ache that shows your muscles have been stressed so that they can become even stronger.
However, if your calf swells up and feels painful all over when walking and when you touch it, you may have a serious condition known as deep-vein thrombosis, which occurs when a blood clot forms in one of the main veins in the leg. Though such a clot is initially harmless, if it loosens from the side of the vein and begins to travel through the vein, it can eventually migrate to the lung and form a pulmonary embolus, which can block the flow of blood returning to the heart. People who are prone to developing a pulmonary embolus include those who are overweight and who smoke, as well as women who take hormonal birth control preparations.
If your doctor thinks you have deep-vein thrombosis, she will first perform a physical exam to confirm that you do have the condition. She will also recommend that you be hospitalized so that a number of tests can be performed to determine the extent of the thrombosis. She will administer a Doppler test in addition to a test called a venogram, in which a special dye is injected into your foot before an X ray is done to check the location and size of the clot.
An anticoagulant medication such as heparin will be prescribed. This will be followed by a six-month regimen of another anticoagulant, Coumadin.
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Description and Possible Medical Problems
When a woman’s body ceases to produce estrogen in the menopausal stage, the genitalia start to lose some of their elasticity, and the tissues begin to dry out. As a result, many women who have entered menopause frequently experience pain or irritation during intercourse. Unfortunately, this can increase your chances of contracting a urinary tract infection and experiencing incontinence. Because of this discomfort, many menopausal women start to lose their sexual desire.
One of the major benefits of estrogen replacement therapy is that it prevents the genital dryness, irritation, and pain that are common to menopause. If you don’t want to start a full course of ERT because of the risk factors, you’ll probably be able to use an estrogen cream such as Premarin to help ease your symptoms. You can apply either a half dose or a full dose with the applicator that comes with the cream, once a day for three weeks. You should then stop using the cream for one week before you start another three-week cycle. Premarin should not be used for more than six months. If the medication has no effect on your genital dryness, you should discontinue its use.
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Your doctor’s diagnosis depends on the color of the discharge, along with a recent history of your health practices, though in the women and men who get galactotrrhea with no cleat cause, the condition will usually clear up on its own without treatment. However, your doctor may want to order a test that will check the levels of thyroid hormones and prolactin in your blood. She may also want to conduct an MRI or CAT scan of your brain to check for a pituitary tumor.
If you’ve given birth in the past year, your discharge is white, and your doctor can find no reason for the galactorrhea, it’s probably not serious. If, however, you’ve never had children and you have a whitish discharge from your nipples, your doctor will look for medication to be the culprit; the discharge might also be a sign of an underlying endocrine disorder. To see if this is the case, she will run blood tests and perhaps a CAT scan to see if your hypothalamus—a gland that regulates your endocrine system—or your pituitary gland is damaged in some way. If the cause of your galactorrhea is found to be hypothyroidism, she will prescribe a thyroxine replacement medication such as Synthroid. The dosage of this medication depends on the results of blood tests that are taken over the course of several weeks or months and will be adjusted slowly when your doctor determines how your body is tolerating the medication.
If the condition is determined to be a side effect of a medication you’re taking, your doctor will recommend you stop taking the drug and may switch you to another type of medication.
If the discharge is greenish or brown—indicating a bloody tinge— you should see your doctor immediately. Your galactorrhea may be caused by cancer or another kind of tumor in the breasts.
If your doctor decides that a pituitary tumor is causing the galactorrhea, she may suggest you take a drug called bromocriptine, which will attack the tumor and reduce the gland’s production of prolactin. If the tumor has grown too large to treat with bromocriptine, he will probably want to remove it surgically. To ensure that the pituitary gland stays tumor free after surgery, your doctor will probably recommend that you take bromocriptine for several months after the operation.
Bromocriptine is typically prescribed to treat some of the symptoms of Parkinson’s disease; however, it also serves to suppress the production of prolactin.
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HINTS FOR A HEALTHY BACK
Author: admin
It’s easy to prevent back problems from occurring—and recurring—if you just start to pay attention to how you move your body. All that’s needed is a little common sense.
Sitting: When you sit in a chair, always sit all the way back and
keep your back erect. Adjust the chair so your feet reach the floor and rest flat.
Standing: When you must stand for a period of time, place one foot on a stool or small bench. Keep an erect posture; avoid sway-back. Tuck your pelvis forward to straighten your back. Try to walk and move around as much as possible.
Driving: In a car, keep your car seat back upright so that your body is erect. Adjust your seat position so that your legs reach the pedals comfortably without either having to stretch or getting cramped. Adjust the steering wheel, if possible, so your arms and shoulders are relaxed. On long trips, stop every hour or so and walk around to relieve tension and relax your muscles.
Lifting: When lifting any object from the floor, you should always bend your legs and keep your back straight. Don’t bend over at the waist to lift something; instead, let your leg muscles do the lifting work.
Sleeping: Sleep on a firm mattress or put a ? -inch plywood board under your mattress if it’s a soft one. If you sleep on your back, put a pillow under your knees, not under your head. If you sleep on your side, keep your knees bent. Avoid sleeping on your stomach.
Get regular exercise and take some time to relax every day. If your back starts giving you problems, don’t delay. See your doctor immediately.
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During an acute allergy attack, you’ll need to see your physician immediately. She will give you an injection of epinephrine as well as oral antihistamines to relieve your symptoms. She may also decide to give you cortisone. After your symptoms subside somewhat and you’re able to breathe and swallow freely again, your doctor will instruct you about the substances you should avoid and how to keep them to a minimum. If, for instance, you’re allergic to dust, an air purifier can help remove dust from the air. It may also help to remove pieces of upholstered furniture, which tend to harbor dust. Some people are also increasingly sensitive to fumes in carpets and dry-cleaned clothes, as well as processed wood that produces toxic fumes.
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