Tag Archives: #healthandwellness

Shingles Vaccine: Who needs it?

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I have received a lot of questions about the shingles vaccine, and since I have gotten a bunch of emails related to it, I am now seeing it offered at every single pharmacy and the push is really on!  I want to clarify what shingles is, how the vaccine works, how effective it is, and who should be getting it.  Shingles is more prominent a risk than most people realize, at least 1 million people a year in the US get shingles and a large majority of them are over 50 years old.

What is Shingles?

Shingles is also known as the herpes zoster and it is caused by the Varicella zoster, the same virus that causes chickenpox. It is most common in people over 50 years of age with a weakened immune system (due to cancer, chemotherapy, HIV/AIDS, or steroid use).  It is a very similar disease process in that you have pain along with an itchy/painful blistery rash that lasts from 2 to 4 weeks.  Only someone who has had chicken pox can usually get shingles, because the virus lays dormant in the body (in a nerve) for a while then reactivates (which can be years later).  It is often started with one sided pain, burning, or intense tingling, then you start to have red patches which eventually start blistering; the path of the blisters are usually from the spine around the front of the body over the belly and/or chest, but the face, neck, eyes, and ears can also be involved.   The blisters eventually break open and start to crust, causing ulcerations in the skin, and the crusts eventually fall off in 2 to 3 weeks. Some other side effects you may have are: pain, muscle weakness, fever and chills, abdominal pain, headache, hearing loss, genital blisters, swollen glands, loss of vision (if in eyes), taste changes (if in mouth), and joint pain/decreased mobility. There can be scarring, although there usually isn’t, and depending on the extent of the virus in your eyes and ears, you can have long term vision and hearing loss.  All in all, not a fun virus to get! You can be treated with antivirals, but the virus usually still lasts 2 to 4 weeks, it can help to reduce they symptoms of the disease, and you can also take ibuprofen to help with the pain, swelling, fevers, and steroid creams/antihistamines can help with the rash and itching.  All of these help to alleviate some of the issues associated with the virus but will not make it go away.

Does the vaccine work?

The vaccine, Zostavax, was first approved for use in 2006 by the FDA.  I want to be very clear that the herpes zoster vaccine is NOT the same as the chicken pox vaccine.  It is a one time vaccination for people 60 years old and up, and is usually covered by Medicare and most other private insurance companies.  In clinical trials, the vaccine reduced the risk of getting active shingles by 50% and for people who did manage to get shingles after receiving the vaccine had significantly less pain and their symptoms were not as severe as those that did not take the vaccine.  So, yes it does work, and it is really helpful even if you do get the virus; the pain associated with shingles can be very debilitating and the worst part for many people, so reducing that makes the virus much more tolerable.

Are there any Side Effects?

There are some side effects associated with the vaccine, unfortunately. As with any medication that you take, you can have a serious allergic reaction, in which you should call emergency services (911) right away.  The only side effects are very mild: redness and swelling at the site of injection (1 in 3 people in clinical trials) and about 70% of people had a headache the night after getting the injection.  There have been no other documented side effects but it is constantly being monitored for long term and short term reactions.  If you do have a mild reaction, you should call your HCP right away, but if the reaction is more serious and you feel unwell (such as hives, wheezing, fast heart rate, dizziness, throat closing up, or difficulty breathing) you should go to the nearest emergency room or call 911 immediately.

Who should get the Vaccine?

Anyone who has had chicken pox and is 50 years old or above. Even if you have had shingles, you are recommended to get the vaccine, just wait a year after the virus has ended to be administered the vaccine.

Who should skip getting vaccinated?

If you are under 50 years of age, are currently immunocompromised (your immune system isn’t working perfectly) due to cancer with chemotherapy/radiation treatment, if you have HIV/AIDS, prolonged high-dose steroid treatments, or cancer affecting the bone marrow.  You should skip getting vaccinated if you are currently pregnant (or might be pregnant) and should wait at least 4 weeks from the time of vaccine to become pregnant. If you have every had a severe allergic reaction to gelatin or the antibiotic neomycin, you should not take this vaccine, as you will be at risk for another severe reaction.  Also, if you have a fever 101.3F or greater and/or signs of current bacterial or viral illness (a general feeling of unwell).

Overall, shingles can be a pretty nasty virus, and at 60+ years old, it can take you out of the game a while, even if you are otherwise completely healthy.  I do encourage all who qualify for the vaccine to get it, especially if your insurance pays for it, there is no reason not to, especially with minimal side effects.  It seems like a no brainer to me!

Yours in Good Health

B

A trick best forgotten to alleviate diarrhea

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So, I am going to be honest with everyone, I received this question, and I have tried writing about it numerous times, and I know that it was asked in no uncertain terms as a serious question, it just seems like nothing anyone would try…..until I got out into researching it, and this is, apparently, used as a home treatment for diarrhea.  I was queried whether you could use a tampon to help stop uncontrollable liquid poop? I had no idea that this was something people did/do, and it does bring up some interesting thoughts, and I get where people are going with it, but SHOULD we be doing it is a whole other ball of wax. So, let’s dig deep, as it were, and really get to the crux if this issue.

 

What is the anatomy of the Anus?                        

The anus is a pretty tricky area of the body, no matter how you want to look at it.  Basically,  it is a 2.5 to 4cm long canal that has inner involuntary sphincters and outer voluntary sphincters that help to keep the canal closed. The voluntary sphincters open when you allow them to because you need to poop.  The canal itself is made of muscle and has different blood sources, such as the inferior rectal artery and the pudendal artery, so there is a lot of blood flow, and a lot of nerves ending in that musculature. With a lot of nerve endings and blood vessels present in the area, there is a risk for ulcerations due to pressure and lack of blood flow, when there is something causing continuous pressure in the area.  And, those sphincters should be closed at all times, unless actually needed.  

How would tampon use work?

The idea, as posed to me, was related to uncontrollable explosive diarrhea. So, if you had diarrhea to the point that you cannot control it, would a tampon help to prevent the anal leakage and act somewhat as a cork? As I was looking for true research based on this, I couldn’t really find anything related to this topic, but was completely overwhelmed by the number of people who use tampons for diarrhea and suggest use for other people.  They seem to think that it works and helps their issues, of course there is also a whole other genre of people who just put the tampons in their anus simply to feel something in their anus all day.  SO, back to people with pooping issues: Here’s the deal, tampons are created for women who are menstruating, hence there is a continuous flow (as it were) of fluids from the uterus/cervix onto the tampon, so it is easy to insert and remove.  One of the issues that can occur with tampons up the anus, is that your diarrhea may subside and the cotton from the tampon can stick to the inner walls of your anal canal.  It can also travel up continuously; vaginas have an endpoint, anal canals, not so much.  And, I also want people to remember that you are still at risk for Toxic Shock Syndrome (TSS): a bacteria infection (usually from Staphylococcus) that causes generalized shock syndromes and has a fast onset.  TSS was common with women with tampon usage but those rates have gone down, but anyone with any form of packing with a foreign body (i.e. a tampons) are at risk.  

The Bottom Line: 

I don’t suggest you use a tampon in your anus.  You can cause internal pressure ulcers, from pressure causing blood pooling or low blood flow, you can get TSS, and you may either lose the tampon in the anal canal OR just leave parts of the tampon stuck to the walls of your anal canal. All of these issues are not good.  The biggest downside?  You are pushing a sphincter continuously open that should be closed; you can cause weakness in that sphincter and henceforth problems with said sphincter in the future.  If you have such issues with diarrhea, you should see your HCP (Healthcare Practitioner) and find out what the problem is, and cure the diarrhea, rather than a quick fix by sticking a tampon up your butt.  Call me crazy, but I think that you should deal with your embarrassing issue with your HCP before it gets crazy embarrassing and you need to have invasive procedures to get a dislodged tampon out of your anal canal.  Agreed?  Be safe, be healthy, and leave tampons to the ladies during their menstruation time….

 

Yours in Good Health

B

Allergies? You may try want to try a Neti Pot!

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So many people suffer from late season allergies, and there are some obvious ways to treat them: by taking over the counter antihistamines, such as Benadryl, Zyrtec, Claritin, etc OR by using some alternative treatments. There is one alternative treatment that people SWEAR by and claim to get rid of their allergies altogether.  The main one? Neti pots.  I really cannot go anywhere without hearing about them and how amazing they are, so I finally decided to look into the science behind it and the theories surrounding why they work so well.

How to they work?
It is a nasal irrigation, you mix lukewarm water with usually a mixture of sodium bicarbonate, so that the solution is pH balanced and doesn’t irritate your nasal canals, fill the pot, and bend your head to the side and pour the contents of the pot (using gravity as a guide) into one nasal passage, and it comes out the other!  The theory is that it clears out the nasal passages and decreases your allergic reactions.

Is there any science behind Neti pots?
There have actually been a few pretty decent studies around the use of neti pots. Most of them support the use of neti pots because they decrease antibiotic days overall for people who get frequent sinus infections. As well, patients report less discomfort from seasonal allergies and decreased amounts of hay fever reaction and sinus infections.  Many HCPs (Healthcare Practitioners) suggest the use of neti pots to patients that have severe hay fever or chronic sinus infections. One rather large study did find that chronic use of neti pots actually increased the rates of sinus infections, so they are suggested to be used to treat seasonal allergies or for use to treat symptoms of a sinus infection but you should not use them chronically, only when you have symptoms that you want to clear.

Despite the research being a little contradictory, the outcome is the same: neti pots do decrease symptoms related to sinus infections and nasal reactions to seasonal allergies.  Just like anything else, don’t overdo it, and only treat the symptoms you want to clear.  As well, make sure that you clean your neti pots, I can only imagine that if you are sticking something up your nose, that has allergens or bacteria on/in it, then putting it up your other nasal passage, and using the same pot later, there would be cross contamination. You can clean it using warm soapy water OR most are safe to throw in the dishwasher to get a good cleaning.

So, keep it clean, and for those of you who love to neti pot, keep on neti’ing but use some restraint!

Yours in Good Health
B

Jellyfish Stings: Should I Pee on that?

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For years people have been under the impression that if you get stung by a jellyfish, you are supposed to urinate on the other person as an antidote.  I think as far as the US is concerned, TV shows and movies have made it a bit of a joke; there was a particular episode of Friends, in which it was depicted that the only way to treat a jellyfish sting was to pee on the person. Good news, for those of us who love ocean swimming but don’t like to get peed on, it isn’t the only treatment, and it actually has never been shown to work in studies.  I’ve got some other home remedies that will help to prevent the burn and relieve symptoms faster.

How do Jellyfish sting?
Jellyfish have tentacles that are long and hang off of the bulbous “jelly” part and the tentacles are covered with nematocysts, which are coiled stingers that can become activated and cause a sting/burn.  The nematocysts that are on the tentacles can continue to sting for hours and sometimes days after the tentacles are no longer attached to the jellyfish.  The stinging ability is the jellyfishes defense mechanism and to ward off predators….it certainly wards me off!

Jellyfish

What are the treatments?
– Firstly, you need to remove the tentacles (and nematocysts) from your skin.  DON’T use fresh water or your hands, that activates the nematocysts to activate and sting your skin.  Try to brush the skin with a towel to remove the stingers from your skin, and pour salt water on your skin where the sting is occurring, it can help to get the nematocysts off without activating them.
– Try placing a towel soaked in warm water and vinegar (5% acetic acid solution)
– Unseasoned meat tenderizer or baking soda caked onto the areas can neutralize the stings (only leave on for about 15 minutes)
-If the stingers are still on the skin, put shaving cream on the skin and the tentacles will adhere to the shaving cream, and gently scrape the cream off with something hard-edged, but not sharp!
– After the stingers are removed, you can take 50mg of benadryl (for children give a children’s dose- age and weight appropriate) and for adults taking Ibuprofen can also help ease the discomfort, along with a hydrocortisone cream to decrease the swelling
– Ice packs can help to ease the pain
– Time is the only true treatment that will heal the stings….

*If you get stings near your eyes, flush your eyes out with Artificial Tears (or other saline solutions)
**Any stings in your eyes, mouth, or that cause trouble breathing, extreme swelling, etc. you should seek immediate medical attention and call 911 (or the emergency number where you live)

Why doesn’t urine work as a treatment?
Urine, depending on the person, is a majority of water, along with waste products from the body.  If someone has diabetes, dehydrated, on certain medications, on a low carb diet, etc. what the waste products in their urine are will be different and can actually make a jellyfish sting feel worse.  Ideally, if the urine is high in uric acid, it was thought that it would neutralize the stings but that has never been shown as true in research.

These treatments have been studied, but unfortunately all people’s skin reacts differently, so you have to try them out and figure out what works best for you.  The good news is that I gave you a bunch of other treatments, the bad news is that if you’ve had a stung and someone peed on you, you got peed on for no reason!  But, be safe, especially with children, and really look for jellyfish when swimming in warmer waters and ask locals about the ocean before swimming, just so you know what you’re getting into (pun intended).  So be safe and stay away from those pesky jellyfish!

Yours in Good Health
B

Asthma: Medications and Alternative Treatments

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As previously discussed, Asthma is a long-term disease that causes a narrowing of the airways due to an allergic or hypersensitive reaction.  The bronchus spasm, and make breathing very difficult.  There are numerous medications that can be taken either in pill form or inhaled, that are FDA  approved, or you can try some different alternative therapies: some include taking herbal supplements (which may or may not be helpful) and  some include diet, exercise, and breathing techniques.

Modern Medical Treatments:
Allergy medications– like Zyrtec or Claritin to prevent common allergies and possible flare-ups
Inhaled Corticosteroids- like Flovent or Pulmicort. These are inhaled medications that have low risks from long term use and take a few days to a week to build-up in your system and are used for long term prevention of symptoms.
Leukotriene Modifiers: Oral medications such as Singular that prevent asthma symptoms for 24 hours at a time. They can have some serious mental side effects like depression and hallucinations, so you need to be aware of any feelings of sadness that are new and unlike you.
Long Acting Beta Agonists (LABA): like Serevent are inhaled medications that open airways and prevent inflammation but they have been linked with severe asthma attacks if they are not taken along with an inhaled corticosteroid.
Combination Inhalers: a mixture of a LABA and corticosteroid, like Advair. They work well for long-term control of symptoms, but there is a risk of asthma attack because of the LABA involved.
Theophylline: a daily pill that helps to open the airways by relaxing the muscles around the airways. It is kind of a treatment of the past, and not used very frequently these days….it was a first line treatment years ago.

What are Alternative Treatments?
Breathing exercises: in which you stretch the volume of your lungs and learn to relax to take deep breaths, can help to decrease the amount you need medications. Yoga breathing techniques can help to learn to relax and the feelings involved with taking deep, relaxed breaths.
Diet: eating fresh fruits and veggies high in antioxidants can help improve lung functions and prevent asthma symptoms.  As well, Omega-3 Fatty Acids (found in fish, flax, etc) have been found to reduce inflammation throughout the body, including the lungs, so it can help to improve asthma symptoms as well.
Exercise: regular cardiovascular inducing workouts can hep to strengthen your lungs and improve their function.  Working out in cold weather can trigger asthma, or if outdoors during high allergy season, but in a gym with AC you can work out your lungs and body all at the same time!

Are there Herbal Supplements?
As always, they haven’t been extensively studied or FDA approved, so I can’t say I condone the use of herbal supplements but many people have reported decreased asthma symptoms when using these products, and they may benefit you: butterbur, dried Ivy, Ginko extract, Indian frankincence, reishi mushroom, and Choline.  It is best to take these under direction of your HCP or an herbal healer, so please discuss so they can talk to you about any interactions to look for and any reactions that may occur.

Does anything make Asthma worse?
Exposure to allergens: if you are allergic to something, and know it, it can make your asthma symptoms worse, or cause flare-ups so you should stay away from that allergen, or do your best to avoid it (like cigarette smoke, exhaust, or foods that cause allergic reactions.)
Cold weather: As stated above, it can cause constriction of the bronchioles and make asthma symptoms worse.
Foods:
– Anything high in saturated fats (meats, butters, etc) can make asthma symptoms worse
– Additives and preservatives can cause people to have reactions and common additives are artificial sweeteners and sulfites (found in cheeses, red wines, etc.)
– Milk products can cause an increase in mucus production and a thickening of the mucus, making asthma symptoms worse.

Asthma is different for everyone and the way we all react can be very different, so work with your HCP to see what best fits your lifestyle and your beliefs.  Work with your HCP on your Action Plan and take into account all aspects of alternative and medical therapies. You know your body best, so learn what your triggers are, and how to prevent them!

Yours in Good Health
B

Asthma: Action Plans

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There are more people with Asthma worldwide than is actually documented, because not everyone knows the signs and symptoms.  But for those of us with documented asthma, we should have an asthma action plan to prevent flare ups and hospitalization.

What exactly is asthma?
Asthma is a long-term disease that causes narrowing of the airways due to an allergic type reaction or hypersensitivity. The bronchus (airways) spasm, making breathing a very difficult task.

What are signs and symptoms?
Coughing: that is usually worse at night or early in the morning, making it difficult for you to sleep.
Wheezing: high-pitched whistling or squeaking that occurs when you breathe and coughing won’t make it go away.
Chest tightness: your chest just feels tight, like there is a vice on your upper body and you almost physically feel like you cannot take a deep breath.
Shortness of breath: no matter how much air you take in, it is not enough.

What can cause it to flare?
Since asthma can be caused by allergens, many of the “triggers” for asthmatics, are: Allergens: Dust, animal fur, bugs (such as cockroaches), mold and pollens
Irritants: cigarette smoke, chemicals, air sprays (hair, room scents), bug sprays
Medications: aspirin containing medications, beta blockers (for heart rate control)
Viruses: causing upper airway/respiratory infections
Physical activity: cardio exercise

Treatments:
There are tons of treatments, ranging from taking anti-allergy medication, to inhaled steroids to oral steroids, inhaled non-steroidal treatments, and emergency inhalers (which immediately open up the airway in an emergency).  I will talk more about Asthma treatments in my Asthma: Medical and Alternative treatments blog!

Action Plans: What are they?
Action plans are super important in the treatment of asthma.  Literally, they are plans that you, the patient, and your HCP come together and create; it’s a plan that works for YOU.  You create plans so that you know what the early signs and symptoms of a flare-up are, what your triggers are, and what you should do as soon as you realize you are going to have an asthma attack.  For some people, it is to take their rescue inhaler, some can stave off an attack by drinking ice-cold water, others just need some caffeine, and some people need to go immediately to the Emergency Department (ED) because they will have a major attack.  Action plans help to prevent those trips to the ED, and to prevent those major asthma attacks that can keep children out of school, and people out of work.

It is imperative that you are a part of the action plan, because it is your body and your life, if part of it is unfeasible, then you know you will not do it, so speak up and have open and honest conversations with your HCP, because we all want you to be successful and stay healthy.  So, if you are allergic to dogs, but have one, be honest and tell your HCP that you are not going to get rid of your dog, and work on a way that maybe your dog sleeps in another room, and you use a HEPA filter in your room to clear the air.  There are many different plans, and tons of different treatments, we need to create one that is good for you, and that you will stick to!

Read here for more treatments…….

Yours in Good Health
B

Pretty and healthy too?

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Hypertension (high blood pressure) is a health problem that affects millions of people worldwide, and drug therapy can be helpful and really work, but many people are borderline and drug therapy is rather aggressive, so we need to look towards alternative therapies.  For some, merely increasing the amount of exercise you get, cutting the amount of fats in your diet, and losing some weight can have huge effects….but what if you’ve done that and still have hypertension? It might be genetic, but maybe we need to look to certain fruits to help lower blood pressure…

What should your blood pressure be?
Any blood pressure readings less than 120/80 are usually considered “normal” and above 120/80 but less than 139/89 are considered borderline or “prehypertension” and above 140/90 is considered hypertension.  When you are in the borderline state, your HCP usually gives you the suggestions to make some lifestyle changes to try to lower your blood pressure, and even one blood pressure above 140/90 doesn’t mean that you are always hypertensive, but you need to start making a change because a couple of elevated readings, and your HCP will put you on medications.

What is this about berries?
A recent study from Nurses from the UK found that the anthocyanins (the water-soluble pigments that are found in plants/fruits tat create a blue/purple coloring) in blueberries, strawberries, and blood oranges help to lower blood pressure.  anthocyanins are a flavonoid, just like those found in tea, red wine, and dark chocolate, which have all been shown to help protect our hearts.  They found an average 10% decrease in blood pressure by increasing the intake of anthocyanins to one full serving a week of fruits with these flavonoids; they looked at blueberries, strawberries, and blood oranges but stated that only because they were easiest to add to the diets of their approx. 150,000 people studied.  The researchers said that any fruits and veg high in anthocyanins like black currants, raspberries, and eggplant can also help with the decrease in blood pressure.

What does this mean?
Well, a couple of things, really!  This means that eating a colorful plate of food really is healthy for you, and increasing the purple and blues on your plate can help to reduce your blood pressure.  If you are someone who is borderline and making changes to help reduce your blood pressure without having to take a pill daily, give it a try to see where it takes you.  Also, I urge you to check your blood pressure at home, in the morning and at night.  You can get a cheap blood pressure cuff that is automatic, and know where you stand between HCP visits, and that way you aren’t nervous, and you can show your HCP the trend in your blood pressure…and see the effects that your changes in health and diet are making!  Some people get nervous when HCP’s check their blood pressure…take the stress off and do it yourself….and eat your blues!!!

Yours in Good Health
B

Is too much exercise bad for your immune system?

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For years and years (healthcare providers) HCP’s have been telling you that “moderate” amounts of exercise are good for you, and your immune system, especially during the winter months to prevent colds, flu, respiratory infections, etc. And, I am not going to tell you any different, BUT I am going to give you an explanation as to why exercise can boost your immune system and how much exercise can actually put a strain on your immune system.  Actually, one study showed that people who didn’t exercise and started 12 weeks of moderate exercise had over a 50% drop in sick days over the next year!!

Who can benefit?
The best part is that everyone can!  Even with chronic diseases or autoimmune diseases, you can find YOUR level of moderate exercise and it will only benefit your body, your general health, and support a healthy immune system.  For example, if you are bed bound, there are arm exercises, rolling in bed, leg lifts…a form of exercise depends on what you are used to.  So, everyone should be getting some form of moderate exercise, there is NO excuse! There is always a way to find some small amount of time to add exercise to your day, even if it is taking stairs instead of the elevator running between meetings at work, parking far away from the place you need to be, or doing a fitness video at home; you can always shave a few minutes out of your day to fit it in!

How does it support your immune system?
So, the immune system is a whole network that has been created by our body to protect it from invasions from viruses and bacteria using various different hormones, chemicals, and cells to attack, as well as to remember the viruses in the future, to prevent further attacks and hone your body’s response.  In an effort to not get too deep into cellular anatomy and physiology, I just want to explain that some of the cells that respond are called cytokines (of which there are many different types).  Some of the cytokines release a signal to your white blood cells (the ones that increase in number to attack when there is an invader present in your system: your number will be elevated if you have a cold, for example, and get your blood drawn at your HCP, but it will drop back down to a “normal” level when you aren’t sick) that there is an invader (bacteria/virus), then there is an inflammatory response, and the white blood cells know to go in for the kill.  So, why am I telling you this?  Well, with a moderate amount of exercise, the cytokines are produced and released in moderate amounts, so your immune system is being challenged a little bit every time you exercise, and it strengthens your immune system because it is constantly working.

Why is too much bad?
If you overtrain, or exercise too much, you can cause damage to some of the muscles, or various different cells in your body, and it can stress your body.  When your body feels stressed, overexerted, or over taxed, your immune system is actually decreased because your body is working so hard to recover your muscles from training, that your immune responses can be lowered due to a release of higher cortisol levels.  Cortisol is a natural hormone that is released from the adrenal gland that helps to regulate metabolism, the immune system, inflammatory responses, as well as having other functions; it is basically your “stress” hormone and the one that jazzes you up during your “fight or flight” response.  The problem with is being constantly elevated, is that your body is never truly relaxed (which can occur in our modern way of living where everyone is running around, working tons, worried about everything, and constantly stressed even when we don’t realize it) and this can lead to slower immune system responses and slower healing by the body due to the way that cortisol makes your body react.  So, too much exercise can depress the cytokine release, and make your body slower to react to minor pathogens (viruses/bacteria) that may be trying to invade your body.

What is considered Moderate exercise?
Usually it is defined as 20-30 minutes of exercise 5 days a week.  For me, that is not enough because my baseline is much more than that, so that is a great guideline but it needs to be based on your level of exercise specifically.  So, I would tell you that “moderate” really means what you feel comfortable with in exercise, can get through without feeling tortured and on a scale of 1-10 (one being barely any effort and 10 being extreme effort), it would be a level 4-6; where you are comfortable and can even talk during the exercise (not a lot mind you, but you aren’t struggling for breath).  Moderate exercise can vary with days that are a 6-8 (a little harder) and days that are a 4-5 (a little easier) but try to stay around that range for cardio.  You can push harder twice a week, for better results, but if you are happy with how in shape you are, try to keep it relatively even.  As far as lifting, you definitely want to add some muscle strength on top of your cardio, but again, don’t stress yourself out (i.e. you can barely lift your arms afterwards), but push yourself daily to the point that you know you have worked out and feel stronger.

What is too much?
Pushing yourself to run at a super fast pace and for a long distance when every step you feel like to want to stop and your legs feel like lead…that is too much.  You need to listen to your body (and non-runners, will probably say, “my body says that every time I run”, so I’m talking to those who are runners baseline!) Or if you are working out on the scale of an 8-10 every day, that is too much!!  You can go 8-10 once or twice a week, but really no more than that. If you feel strains in your muscles or muscle tears, you need to take a break and your body will let you know.  I totally understand the feeling of wanting to push your body to the limits EVERY time you work out, I have done that in the past, and I looked fantastic, but it isn’t sustainable over time, because as you overtrain, your body loses interest in wanting to work out and it gets harder and harder to push yourself to do so. Not to mention, that it ends up decreasing your immune system.

For my avid exercising readers, just listen to your body; it will tell you when you are overtraining!  Sometimes every step feels so horrible you just can’t exercise- then STOP,  just lift weights, or take a break and catch up on some missed TV shows and DON’T FEEL GUILTY about it!! Just go back to your normal routine the next day, Nurses orders 🙂 You really need to look at exercise as everything else, do it in moderation, and it will be sustainable over your whole life, not something that you stop and start, which is the key to fitness; sustainability.

For those of you who don’t exercise, I hope this inspires you to park farther away from the store and get a walk, skip the elevator and take the stairs, and grab a friend (bundle up) and go for a wintry walk and a cup of coffee/tea!  Try to get out there and get that heart pumping to stimulate your immune system!!  It actually is good for you, gets you out, and can help you also beat the winter blues.

Yours in Good Health
B

Why should I add probiotics to my diet?

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Probiotics are live microorganisms that benefit the host in which they live. They can aid in digestion, and normalize the intestinal flora.  There are currently many studies being done to look at the use of probiotics in preventing the symptoms for IBS (Irritable Bowel Syndrome), IBD (Inflammatory Bowel Disease) as well as some other chronic diseases.  The most common probiotic is the lactobacillus strain and it is found in raw milk (unpasteurized), most yogurts, as a dietary supplement, or in Kombuchas (fermented teas.)

A Little History….
Just for a little background, in the beginning of the 20th century, it was presumed that the bacteria that is in our guts (totally normal and appropriate) can cause toxins when we breakdown certain foods, like proteins (they are called proteolytic bacteria).  This process, diet and body depending, can build up a lot of toxins in the gut can cause various stomach discomforts like bloating, gas, diarrhea, constipation, etc. So, a Russian scientist at the Pasteur Institute in Paris, who had noticed a link between long life span (completely observational in his hometown in rural Russia)and drinking fermented milk (AKA sour milk), started drinking it himself, and found that he felt much healthier.  After that, he started to test it on friends and patients, and it became a widely followed trend in Europe and MD’s even prescribed it to patients as a treatment for stomach ailments.  They found that the lactic-acid bacteria helped to change the pH in the intestine and prevented the proteolytic bacteria from having damaging effects.  In 1989 Roy Fuller defined probiotics as “A live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance.” And thus, the modern studies of probiotics on health really began!

Why are they so good for me?
All of the modern research on probiotics is very new and hasn’t had the full battery of testing including randomized control trials (the gold standard in research!) Lactobacillus has been shown to prevent antibiotic associated diarrhea and is being studied for its usefulness in other diseases.
Lactose Intolerance: The strain of bacteria turns lactose into lactic acid, so you are able to tolerate more lactose than you would have.  For example, eat some yogurt before eating ice cream (or pizza with cheese) and you won’t get the normal response that you usually get. It is being tested to see how many different strains of bacteria aid in this process.
Lowering Cholesterol: In animal studies the addition of probiotics has shown to increase the breakdown of bile (which is stored in the gallbladder and released into the stomach when you ingest food) in the stomach before it gets reabsorbed; when bile is re-absorbed it is in the form of cholesterol. It needs MUCH more human testing.
Lowering Blood Pressure: A few small studies have shown that fermented milk with certain strains of probiotics can break down and create these peptides, which are similar to proteins in chemical nature but smaller, and they can have similar effects to certain blood pressure lowering medications (specifically ACE inhibitors). It needs larger studies to be performed.
Strengthening immune system and prevent Infection: Some studies have been performed and it has shown that they can reduce respiratory infections, by increasing the number of “killer” cells that attack pathogens (viruses and bacteria that we are exposed to) and can decrease cavities in children.  As well, induction of probiotics in your diet has been studied as far as decreasing the severity of rotavirus and shortening symptoms, along with preventing altogether. (rotavirus is a highly contagious virus that causes usually stomach issues like diarrhea along with fevers and it is very common among children.)
AND, probiotic use is still being studied (very promising) in the areas of: colon cancer prevention, IBS, IBD, eczema, reducing inflammation (generalized in the body), improving absorption, in relief of UTI and bacterial vaginosis, and the decrease of ulcers during stress.

Any side effects?
You are introducing live bacteria to your system, so immunocompromised people (due to illness or medications taken) should probably not add probiotics to your diet.  As well, you need to be very careful with the very young and the elderly; babies immune systems are not fully developed, and I am generalizing when I say “elderly”, but for the most part, older adults have other chronic medical issues which puts their immune system under strain and they are considered immunocompromised.  Also, as I’ve stated a billion times, full side effects aren’t known because more studies are needed to find out the short and long-term effects of probiotic use.  One study did show that children under six months of age that were given doses of various probiotics had much higher rates of food allergies/sensitivities!

Best Sources of probiotics:
Yogurts, pickles (naturally fermented- not with vinegar), miso, kimchi (pickled cabbage), Kefir (fermented milk), buttermilk, raw milk, raw or aged cheeses, kombuchas, and probiotic supplements that can be added to a smoothie, for example, or other foods.
Oral Supplements:
A few of them are align, culturelle, phillips, jarrow, and nature made brands.  You can find them at basically any pharmacy, grocery store, or health food/vitamin store.

Personally, I am a huge believer in probiotics even though some of the data is weak.  I eat only raw dairy products and try to eat foods that are high in probiotics whenever I can.  I did used to take supplements, but I don’t think they are absorbed as well, and you need to ingest them regularly to see their effects, and I am HORRIBLE with taking supplements; I always forget, which is why I just eat a healthy diet!  So the choice is up to you, and if you do have medical issues I would discuss with your HCP if probiotics are right for you.  If you are healthy, the choice is yours if you want to wait for more studies to come out or not!

Yours in Good Health
B

A little overhung??

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Why do we get hangovers? I think people don’t really understand the metabolism of alcohol, because there are ways to prevent hangovers, and make that fun night that you may have imbibed too much, into a much softer morning wake up!

 How the body responds to alcohol metabolism:
Its how our bodies convert substances into other compounds that we can either use  or excrete . Oxidation is the process by which alcohol is metabolized in the blood. Obviously the alcohol is distributed throughout the body, including the brain, organs, and tissues after ingestion and during metabolization, and small amounts are excreted through your breath and urine in unmetabolized forms.
You have your favorite adult beverage, it goes into your intestines, then is absorbed into your blood stream, it is metabolized by various enzymes.  In the liver the enzyme that breaks down alcohol is called alcohol dehydrogenase (ADH) which turns alcohol into acetaldehyde, which is then broken down to carbon dioxide and water.  Alcohol is also broken down by an enzyme in the liver called P450IIE1, which can increase in number with chronic drinking (hence how people build up a “tolerance” for drinking….increase P450IIE1) and this is where most alcohol is metabolized.

The liver can only metabolize a certain amount of alcohol per hour, no matter if you are a virgin drinker or if you have your sea legs.  That being said, the ability to metabolize alcohol is dependent upon the number of metabolizing enzymes, which varies in each individual and can be genetic (i.e. over half of all east Asians have low numbers of ADH enzymes so they tend to get drunk easily, have wicked hangovers, and get flushed with drinking which is due to a fast heart rate which is how their bodies respond to metabolism of alcohol.) Usually, once you have a drink, your blood alcohol level peaks within 30-45 minutes.

Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 197
 
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What other factors influence alcohol Metabolism?
Food: The higher the dietary fat content in the stomach/GI tract increases the amount of time it takes for the alcohol to get absorbed into the blood stream.  One study showed that people who ate a meal of fat, carbs, and protein absorbed alcohol 3 times more quickly than those who drank on an empty stomach.
Gender: Unfortunately, women absorb alcohol differently than men.  Us ladies will have a higher Blood Alcohol Content (BAC) than men drinking the same amounts, and we are more susceptible to alcoholic liver disease, heart muscle damage, and brain damage.  It is presumed that the difference is due to women having a smaller amount of body water and we may have a lower amount of ADH (never been proven but highly likely based on numerous studies).
Effects of Alcohol:
Body Weight: interestingly, Women who drink (moderately) tend to have significantly lower body weights than those who don’t drink at all.  Men, there is no weight difference, but if non drinkers add alcohol to their diet, they don’t tend to gain any weight.  Chronic alcoholics tend to lose weight because they substitute alcohol for food….
Sex Hormones: Chronic alcohol intake causes significant hormonal imbalances; the liver metabolizes estrogen into testosterone, but when damaged, it is unable to do that, so you can have decreased sperm production.  In men who consume 220 grams of alcohol daily for 4 weeks, testosterone levels decreased after 5 days and kept dropping throughout the study period.  Also, chronic alcohol intake in men can lead to testicular atrophy (getting smaller) and the growth of male breast tissue. In women, we can create estradiol, which increases bone density and decreases the risk of cardiac disease (whoo hoo!!)
Medications: Tylenol (paracetamol, acetaminophen) can be toxic in the liver in large doses by itself, but add alcohol and it is a HUGE problem that can lead to immediate liver failure.  Like 4-5 extra strength pills in the course of the day with someone who is drinking can cause death. Other drugs such as pepcid (famotidine), ranitidine (zantac), and cimentidine (tagamet) can cause alcohol to be metabolized slower for reasons truly unknown at this point.
What can also cause increased rate of metabolism?  
The only thing known to increase the rate of metabolism of alcohol is fructose!! Consuming 100 grams of fructose has been shown to increase alcohol metabolism by 80%!  So, not helpful for people like me that drink vodka sodas, but great for the rum and coke (not diet coke) drinkers of the world!!  I guess I need to go back to my gin and Q-Tonic beverages OR maybe a handful of skittles after every drink???
So, the best way to prevent a hangover is to eat a meal with fat, protein and carbs (cheeseburger anyone?), increase your water (before bed chug a coconut water if you have one, or just regular water) because we all know the metabolism process dehydrates our bodies (because of the effects of alcohol), and increase your sugar intake….high fructose corn syrup does count!!  So seriously, a great idea for a bar is to hand each patron a bag of candy with each drink!!  Actually, one of the reasons why “fruity” drinks tend to make you less drunk 🙂 hmmmm…..  BUT I must say, carbonation supposedly increases your alcohol absorption, so maybe a Harvey Wallbanger is the way to go…and try to stick with the same kind of alcohol.  Really, I think we all knew these tips except for the sugar.
So, ladies apparently drinking is good for you?!?!  And men, if you are looking to be more manly, you may want to lay off the booze for a bit….
Yours in Good Health
B