#uric cuffe

[suggs444]

Snitch Part 2: Mark Hoffman x Reader

Synopsis: You know his secret. He knows you know. Erikson and Perez suspect him. What extent are you willing to go to protect him? Takes place during Saw 6.

TW: swearing, k1lling, guns, blood, violence, sexual themes.

Gif by evilvvithin

..

Strahm wasn’t the only one who had suspected Mark. Erikson and Perez are acting blatantly obvious that they suspect your partner. They were loose ends.

You and Mark were on duty when Erikson interrupted, Perez trailing beside him.

“Detectives.” He greets, nodding.

You hear Mark inhale deeply. He’s treading on thin ice.

“We’ve got news back on the Seth Baxter tape.”

“Oh?” Mark says, his tone low.

“Someone’s descrambling the tape as we speak,” Perez says, hands on her hips. You notice how she’s looking at Mark with caution. They must know.

“They’ve called us in.” She continues, looking to you. You play it cool and nod.

Erikson nods, “This is our smoking gun,” he says enthusiastically, backing up toward the door. You and Mark stand side by side.

“You guys are coming aren’t you?” He says, opening the door.

Mark stiffens. You look at him, then back at Erikson. Don’t look suspicious. You nod,

“Of course.”

..

The tension in the room was unbearable. A lady sat at a large desk trying to descramble the tape. Perez stood by the door, Erikson next to the desk. Mark was pacing. You felt ill. He was acting too obvious.

You walked to the coffee table, pouring him a cup to calm him.

This is it.

You think.

You won’t see him again. You both knew whose voice it was. It was Marks. Your partners. Your lovers.

Your heart sank low in your chest. The anxiety riveting. The thought of seeing him in cuffs. The thought of not holding him again. The idea was unbearable. You could sob if it wasn’t for the current situation.

You exhale, handing Mark the cup of steaming black coffee. No sugars, no milk. Just how he liked it.

“Thanks,” He gruffs.

You nod.

“There’s one thing I don’t understand,” Perez starts. You clench your jaw.

“What’s that?” Mark says.

“Strahm’s motivation. We were partners for five years and he never indicated signs of psychosis.”

Mark is quiet. You can tell he’s trying to figure out what to do or say.

“You never can tell when someone’s sinking on the inside.” You speak up, coming to Marks defence. His gaze whips to you. He seems surprised that you were helping him. But his eyes are acknowledging and grateful. You stare down Perez, feeling defensive of your partner.

She looks visibly irritated.

“There is an alternative,” Erikson perks up, walking to Mark. You were still staring at Perez before you snapped out of it. This was a part of you that you hadn’t realised was there. A careless part. A part that didn’t care for consequence. That would go to extents for Mark. The tension in the room was bearing down on you so strongly that you feel like you could snap.

Perez peered at you suspiciously before side stepping and drawing her attention to Mark and Erikson. You also listened in, crossing your arms. Though you kept a close eye on Perez.

“Say Strahm killed Seth Baxter specifically to set you up as an accomplice to Jigsaw.” Erikson said to Mark, approaching him.

“Okay,” Mark said, turning to place his coffee down. You could tell some weight lifted from him. You couldn’t deny that you signed of relief.

“But there’s a problem with that though.” Erikson finished.

Shit.

You saw all relief slip from Mark’s face.

Perez shifts. Your eyes snap to her, then back to Erikson. Anxiety stirring red hot in your stomach and blazing your face. It felt like an unattended adrenaline ready to burst of you.

“On further analysis of Strahm's fingerprints, it was found that the uric acid levels and the Eccrine gland residue were inconsistent for an individual with an active epidural metabolism.” He remarks and you feel yourself sweating. Your throat runs dry.

“In other words?” Mark replies, turning to pick his coffee up but quickly glancing to meet your eyes before turning back to Erikson. You took that as a heads up.

Your anxiety bubbles to it’s limit.

“In other words, when he left his fingerprints on the latest victims, Strahm was already dead!”

Right now you’re feeling helpless.

Mark’s voice comes through on the computer. Clear as day. You stumble back a bit, mouth dropping as you all turn to stare at the monitor.

“There it is!” The lady at the desk exclaims.

It’s not even a second before Mark drew his pocket knife and sliced it up the side of Erikson’s throat.

Despite being on his side, you still gasped - stumbling backward till your back hit the wall, eyes blown as you watched the scene unfold.

The man you loved was a true killer.

Your head snaps to Perez and she looks to you. She pulls her gun, but Mark turned, lashing his boiling coffee in her face. She exclaimed, stumbling backward into the wall.

Mark then grabs a screwdriver as Erikson topples over to the ground, and he stabs it into the electrical circuit - plunging the room into a deep red hue.

You try to move but the speed of Mark’s rampage stills you. Shocked by his capabilities. It isn’t till you see Perez aim her gun toward Mark that your adrenaline kicks in. You run at her and seize her wrists as you try to steer her aim. You both thrash against each other as she pulls the trigger multiple times. You look at Mark. He was using the other woman as a human fucking shield.

You sneered, eventually managing to overpower Perez as you lifted the butt of the gun to hit her in the face. Once, and then again. This allowing Mark to get close. Perez stumbled back and so did you as Mark seized her, instantly plunging his knife in her stomach.

He stabbed once, retracted the blade and then thrusted it back in with just as much force.

“Who else knows about me?” He presses, quite casually despite the atrocity he had just committed.

Perez pants helplessly. Heroic till the end, you think.

“Who else fucking knows about me?” He repeats, more aggressively and impatiently as he twists the knife causing Perez to whimper.

You can only watch.

Your eyes flickering to Erikson as he still wriggled on the ground.

“Everyone.” Perez manages to say, her voice strained through the pain.

“You lie,” Mark seethes through his teeth,

“You fucking lie.”

He stabs her once more.

You saw the life leave her eyes as she slipped down the wall. Leaving a smear of blood.

The room was silent now.

Only the heavy sounds of Mark’s pants.

You stare at him. Watching how his chest rises and falls with such ferocity. You couldn’t process what you just saw, and the fact that you actually helped. You helped.

Holy fuck. You helped him.

The revelation washes over you enormously like a tidal. So extreme and overwhelming. You lean against the wall for leverage but it’s hopeless as your legs give out beneath you, causing you to slide your back down the wall as you crumble.

Your ears ring, and your face welling with an unbearable heat.

Marks quick to your aid. At your side faster than you can blink. Cradling your face as he pulls your head up to look at him. You feel limp in his hold.

You can only stare at him.

His lips crash into yours in an instant. The blood on his face retracting onto your own skin as he does. He tastes like copper. He’s harsh and firm and it only lasts a second before he pulls away - his grip on your face merciless.

“That’s for having my back.” He gruffs, patting your cheek.

..

[cubicdesignzdm]

Top 5 Common Orthopedic Conditions Affecting Bones and Muscles

Arthritis:

Description: Arthritis refers to inflammation of the joints. It can affect any joint in the body, leading to pain, stiffness, and reduced mobility.

Types: Common types include osteoarthritis (wear-and-tear), rheumatoid arthritis (autoimmune), and gouty arthritis (due to uric acid crystals).

Treatment: Treatment aims to manage pain, reduce inflammation, and improve joint function. Medications, physical therapy, and lifestyle modifications play a key role.

Osteoporosis:

Description: Osteoporosis is characterized by weakened bones, making them more prone to fractures. It often affects older adults, especially women.

Risk Factors: Age, gender, low calcium intake, and lack of weight-bearing exercise contribute to osteoporosis.

Prevention and Treatment: Adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication help prevent and manage osteoporosis.

Bursitis:

Description: Bursitis occurs when the fluid-filled sacs (bursae) around joints become inflamed. It leads to localized pain, swelling, and limited joint movement.

Common Sites: Shoulder, elbow, hip, and knee bursitis are frequent.

Treatment: Rest, ice, anti-inflammatory medications, and sometimes physical therapy are recommended.

Rotator Cuff Tears:

Description: The rotator cuff consists of tendons and muscles around the shoulder joint. Tears can occur due to trauma or degeneration.

Symptoms: Pain, weakness, and difficulty lifting the arm.

Treatment: Conservative management (rest, physical therapy) or surgical repair, depending on the severity.

Lumbar Disc Herniation (Slipped Disc):

Description: The intervertebral discs in the spine can herniate, causing pressure on nearby nerves. This leads to lower back pain, leg pain (sciatica), and muscle weakness.

Treatment: Rest, pain management, physical therapy, and in severe cases, surgery to relieve nerve compression.

Remember, early diagnosis and appropriate treatment enhance the chances of recovery. If you experience any symptoms related to these conditions, consider seeking evaluation at a reputable orthopedic hospital like Orthomed. Their expertise and patient-centered approach can make a significant difference in your bone and muscle health!

[cubic-backlinks]

Top 5 Common Orthopedic Conditions Affecting Bones and Muscles

Arthritis:

Description: Arthritis refers to inflammation of the joints. It can affect any joint in the body, leading to pain, stiffness, and reduced mobility.

Types: Common types include osteoarthritis (wear-and-tear), rheumatoid arthritis (autoimmune), and gouty arthritis (due to uric acid crystals).

Treatment: Treatment aims to manage pain, reduce inflammation, and improve joint function. Medications, physical therapy, and lifestyle modifications play a key role.

Osteoporosis:

Description: Osteoporosis is characterized by weakened bones, making them more prone to fractures. It often affects older adults, especially women.

Risk Factors: Age, gender, low calcium intake, and lack of weight-bearing exercise contribute to osteoporosis.

Prevention and Treatment: Adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication help prevent and manage osteoporosis.

Bursitis:

Description: Bursitis occurs when the fluid-filled sacs (bursae) around joints become inflamed. It leads to localized pain, swelling, and limited joint movement.

Common Sites: Shoulder, elbow, hip, and knee bursitis are frequent.

Treatment: Rest, ice, anti-inflammatory medications, and sometimes physical therapy are recommended.

Rotator Cuff Tears:

Description: The rotator cuff consists of tendons and muscles around the shoulder joint. Tears can occur due to trauma or degeneration.

Symptoms: Pain, weakness, and difficulty lifting the arm.

Treatment: Conservative management (rest, physical therapy) or surgical repair, depending on the severity.

Lumbar Disc Herniation (Slipped Disc):

Description: The intervertebral discs in the spine can herniate, causing pressure on nearby nerves. This leads to lower back pain, leg pain (sciatica), and muscle weakness.

Treatment: Rest, pain management, physical therapy, and in severe cases, surgery to relieve nerve compression.

Remember, early diagnosis and appropriate treatment enhance the chances of recovery. If you experience any symptoms related to these conditions, consider seeking evaluation at a reputable orthopedic hospital like Orthomed. Their expertise and patient-centered approach can make a significant difference in your bone and muscle health!

[cubicdesignz]

Top 5 Common Orthopedic Conditions Affecting Bones and Muscles

Arthritis:

Description: Arthritis refers to inflammation of the joints. It can affect any joint in the body, leading to pain, stiffness, and reduced mobility.

Types: Common types include osteoarthritis (wear-and-tear), rheumatoid arthritis (autoimmune), and gouty arthritis (due to uric acid crystals).

Treatment: Treatment aims to manage pain, reduce inflammation, and improve joint function. Medications, physical therapy, and lifestyle modifications play a key role.

Osteoporosis:

Description: Osteoporosis is characterized by weakened bones, making them more prone to fractures. It often affects older adults, especially women.

Risk Factors: Age, gender, low calcium intake, and lack of weight-bearing exercise contribute to osteoporosis.

Prevention and Treatment: Adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication help prevent and manage osteoporosis.

Bursitis:

Description: Bursitis occurs when the fluid-filled sacs (bursae) around joints become inflamed. It leads to localized pain, swelling, and limited joint movement.

Common Sites: Shoulder, elbow, hip, and knee bursitis are frequent.

Treatment: Rest, ice, anti-inflammatory medications, and sometimes physical therapy are recommended.

Rotator Cuff Tears:

Description: The rotator cuff consists of tendons and muscles around the shoulder joint. Tears can occur due to trauma or degeneration.

Symptoms: Pain, weakness, and difficulty lifting the arm.

Treatment: Conservative management (rest, physical therapy) or surgical repair, depending on the severity.

Lumbar Disc Herniation (Slipped Disc):

Description: The intervertebral discs in the spine can herniate, causing pressure on nearby nerves. This leads to lower back pain, leg pain (sciatica), and muscle weakness.

Treatment: Rest, pain management, physical therapy, and in severe cases, surgery to relieve nerve compression.

Remember, early diagnosis and appropriate treatment enhance the chances of recovery. If you experience any symptoms related to these conditions, consider seeking evaluation at a reputable orthopedic hospital like Orthomed. Their expertise and patient-centered approach can make a significant difference in your bone and muscle health! 😊

!Orthomed Hospital

Disclaimer: Always consult a healthcare professional for personalized advice.

[imagitory]

Re-reading Lack Of Lamb Sauce just now, just wanted to ask - what Hogwarts Houses were Jengu and Enrouge in? If you have any headcanons for that :D

It's a wonderful story!

I saw both as misguided Ravenclaws -- idealistic to a fault and seeing the world as they think it should be according to their own personal "logic," rather than how it truly is. I actually actively decided to develop original villains in Lack of Lamb Sauce for the other houses besides Slytherin, just to show how evil can come from more than just ambition: Enrouge and Jengu for Ravenclaw, Uric Cuffe for Gryffindor, and Etienne Montmercy for Hufflepuff. 💙

[carewyncromwell]

M E T and K for the OC ask >.>

Oooh, that’s a lot! x.x Okay! For M, I’m going to cheat a bit and use a surname, since a lot of the “M” first name characters I added onto in LOLS are expansions of canon characters (i.e. Millicent Bulstrode) -- the others I’ll use first names! :)

Full Name: Lydia Julien Montmercy

Nicknames, If Any: Caeneus Jove (pen-name)

Hogwarts House: Slytherin

Gender: Transgender Male

Sexuality: Gay

A Song I Associate With Them: Ascendance by Lindsey Stirling

3 Important Relationships

Eddie Carmichael ~ One of Julien’s best friends. They first met at school, and even though they were in different houses (Ravenclaw and Slytherin, respectively), Eddie and Julien bonded over their shared aspiration to join the Auror Department. Once they were both accepted into the ranks of that Department, they grew even closer, to the point that when Eddie was looking for people to help him with circulating a rebel newspaper during the Second Wizarding War, he knew he could depend on Julien, even if Julien’s father was one of the most high-ranking Death Eaters at the Ministry.

Antoinette Montmercy ~ Antoinette raised her child Julien almost entirely on her own, and so the two are incredibly close. There is nothing Antoinette wouldn’t do if it meant protecting her child -- even obeying the will of her cold-hearted Death Eater husband.

Etienne Montmercy ~ Julien’s father was in Azkaban most of Julien’s life for being a Voldemort supporter, and when he was released, it signaled a hellish new chapter in Julien’s life. Not only would Etienne never accept Julien’s gender identity, which forced Julien to stay in the closet longer than he’d intended for his own self-preservation, but Julien did not share Etienne’s blood purist beliefs in the slightest. To top it all off, Etienne forced Julien into an arranged marriage with the blood purist tabloid writer Uric Cuffe without even consulting Julien or caring if he objected. Etienne and Julien may look very alike, but they couldn’t be more diametrically opposed as people.

2 Fears

Losing his free will

His friends dying

1 Element of their backstory

Julien’s dead name is “Lydia,” which was a name Etienne had picked. “Julien” is derived from a line in an old poem that Antoinette used to read for her son about July gillyflowers.

Full Name: Erik Landon Apollo

Nicknames, If Any: Rick (by Eos Amari), Jarvey (by Orion), Apollo (by most of his students), Sour Patch (by Wendy Copper @drinkyoursoupbitch)

Hogwarts House: Slytherin

Gender: Cisgender Male

Sexuality: Bisexual

A Song I Associate With Them: “Remember the Name,” by Fort Minor

3 Important Relationships

Carewyn Cromwell ~ Erik’s legal guardian, after he lost his parents and was hauled before the Muggle-Born Registration Commission during the Second Wizarding War. Although Erik never calls Carewyn his mother due to the trauma of losing his actual mother Sadie, Erik admires and cherishes Carewyn like nobody else in the world. Although Erik by and large isn’t the sort to lose his temper, he’s never been able to let any insult toward Carewyn slide.

Roxanni “Roxi” Kim @mira-shard ~ Erik’s one true love and (in his mind) better half. Erik was immediately impressed by Roxi’s kindness, humor, and honesty, but was soon enough enthralled by her astounding emotional intelligence, to the extent that she could read people like a book and perfectly pinpoint the best way to help them solve their problems. Given that Erik himself has never been as attuned to his emotions and thinks with his head so much more than his heart, Roxi’s deep understanding of both herself and others is a marvel to Erik. And if you’ve so thoroughly awed Erik Apollo, especially while being drop-dead gorgeous like Roxi is, you’ve got yourself a rather awkward turtle for a suitor. :3

Alistair Schaefer @cursebreakerfarrier ~ Erik’s superior in name only and the mediating Obi-Wan to Erik’s reckless Anakin. Even if Erik is technically Alistair’s assistant, the two rarely see each other as anything other than equals, not just because of their equal levels of talent in Defense Against the Dark Arts and Wizard Dueling, but because of their immense respect for each other. Erik might swear and play favorites with their students way too much for Alistair’s liking, but their friendship is still resilient enough that it wouldn’t be unlikely that Erik could end up asking for Alistair’s help with an Auror assignment in the future, after leaving Hogwarts.

2 Fears

Dementors

Being helpless

1 Element of their backstory

Erik’s love for Star Wars comes from his father Phillip -- it was one of the main things they shared together before Phillip’s abrupt death. Erik’s middle name “Landon” is even a reference to one of Phillip and Sadie Apollo’s favorite Star Wars characters, Lando Calrissian.

Full Name: Tokala Kyon Mulligan

Nicknames, If Any: N/A

Hogwarts House: N/A (American: homeschooled)

Gender: Cisgender Male

Sexuality: Pansexual

A Song I Associate With Them: Dance Magic Dance by David Bowie

3 Important Relationships

Travis Fitzgerald ~ The Vice President of the MACUSA saw a lot of potential in Tokala from the get-go. Despite Tokala only being in his late 20′s, Fitzgerald (the real power behind the rather superficial and pompous President Aaron Crowe) was able to pull enough strings to move Tokala all the way up the ranks to become the Head of Major Investigations. Like Fitzgerald, Tokala is incredibly ambitious and determined to protect his country and all of the people in it, magical or otherwise, and so it’s unsurprising that both men are very glad to have such an valuable ally in their fight against the blood purity movement taking root in America.

Cho Chang ~ When the Chang family emigrated to the U.S. to escape Voldemort during the Second Wizarding War, there’s no way Cho would’ve expected to get wrapped up in the MACUSA’s Major Investigations Department. But when Cho and some of her Muggle friends were targeted by some American blood purists walking in the footsteps of the Death Eaters in Britain, Cho collided with Tokala, and soon they became unlikely allies and, later on, partners in espionage.

Mia Romero ~ Like Cho, Mia is a MACUSA employee who was secretly recruited as an agent for the Major Investigations Department for her strong dueling skills and expertise in human psychology. Mia would go on to become President of the MACUSA in the late 2010s, with her old cohort Tokala remaining as Head of Major Investigations -- it’s likely only thanks to friends like Tokala that Mia is able to deal with the chaotic whims of her Muggle counterpart, the so-called “Other President,” without going insane.

2 Fears

Losing his Metamorphagus abilities

A fascist government

1 Element of their backstory

Tokala, being half-Cherokee, was taught at home by the magical members of his family, rather than attending an American magic school like Ilvermorny. (Because seriously, there is no way in HELL either Tokala’s family or I as his writer would send him away to a British-style American boarding school. *glares at JK*)

Full Name: Kevin Elijah Whitby

Nicknames, If Any: N/A

Hogwarts House: Hufflepuff

Gender: Cisgender Male

Sexuality: Gay

A Song I Associate With Them: Merry-Go-Round of Life from Howl’s Moving Castle

3 Important Relationships

Astoria Greengrass ~ Despite being in the same year, Astoria and Kevin didn’t really spend much time together until they both ended up as contestants in Potions Professor Gordon Ramsay’s MagicChef contest (yes, really, that’s a thing, in Kevin’s fic). During the contest, the two really connected thanks to their similar personalities and shared interest in cooking, and they became even closer friends through the Cooking Club Kevin helped found. By the time they’re adults, they would both consider each other their best friend.

Colin Creevey ~ Like with Astoria, Kevin hadn’t interacted at all with Colin until the MagicChef contest and the founding of a Hogwarts Cooking Club right afterwards. After a traumatizing escape from an extremist group during the Second Wizarding War, Kevin ended up in a playground close to where the Creevey family was in hiding, and Colin and his brother Dennis brought Kevin home with them. It was thanks to the Creeveys that Kevin was able to heal both his physical and emotional wounds from that particular trauma. While living with the Creeveys, Kevin came to see Colin like the older brother he’d never had.

Dennis Creevey ~ Kevin bonded with Dennis while living with the Creevey family and came to see him like the younger brother he’d never had. After the end of the Second Wizarding War, Kevin and Dennis became even closer, with Kevin supporting Dennis not unlike how Colin had supported him.

2 Fears

Losing his family and friends

Being alone and unloved

1 Element of their backstory

Kevin is the son of an female Auror named Hattie Ollerton, who fell in love with a Muggle bobby, Elijah Whitby, during the First Wizarding War. It’s because of his parents that Kevin pursues becoming an Auror as an adult.

OC Asks! or Meet Julien, Tokala, and Kevin in Harry Potter and the Lack of Lamb Sauce!

[ashashyou]

ألف لا بأس على كل مرضى إرتفاع ضغط الدم

قياس الضغط يكون بطريقة معيارية في ظروف هادئة

لازم يعمل كشكول أو سجل للضغط.

شئ مهم جدا، أن ربنا لم يمنحنا في جسمنا أي شئ نحس به ضغط الدم. مثلما لا نسمع الموجات فوق الصوتية ولا نرى الأشعة فوق البنفسجية. الطريقة الوحيدة لمعرفة ضغط الدم هي قياسه بجهاز بطريقة معايرة.

لا يجب أن نعتمد على أي أعراض أو علامات لمعرفة إنضباط ضغط الدم.

أجهزة قياس ضغط الدم الإلكترونية غالبا تتلف بعد حوالي ستة شهور من إستخدامها، مهما كان نوعها، مهما كان ثمنها. وتحتاج معايرة.

ينصح بإستخدام جهاز الضغط الزئبقي للمتابعة. لأنه لا يلتف في ظروف الإستخدام العادية إلا بعد سنوات.

لو كان حجم ذراعه كبيرا ما شاء الله، فلابد من إستخدام cuff ذات حجم معياري مناسب.

يجب إستبعاد وجود أدوية يأخذها ترفع ضغط الدم لا قدر الله، مثلا بعض أدوية البرد، والمسكنات والكورتيزونات.

محتمل ضغط الدم بدأ معاه متلازمة الأيض/الإستقلاب Metabolic syndrome. لهذا ينصح بعمل عدة تحاليل للسكر ودهون الدم.

ويفضل عمل تحاليل الغدة الدرقية.

يبدأ بتحاليل

BUN, creat, Na, K, RBS, HbA1c, lipid profile, uric acid, Thyroid profile

علاج أي مرض ليس دواء فقط. الدواء جزء من العلاج.

العلاج الغير دوائي يكفينا شر الأدوية أو يقلل ضررها.

لا يوجد قرص سحري أو حبة سحرية

لابد يغير من نمط حياته،

لابد يغير من نمط حياته،

لابد يغير من نمط حياته،

إن لم يغير من نمط حياته، فليستعد لفقدان إحتياط صحته لا قدر الله. الله يعينه.

لازم يأخذ الموضوع جد جدا "كأن شخص جاي عايز يسرق صحته أو يسرق بيته أو حياته". يتوكل على الله وربنا ييسر أموره.

لابد يسحب *أملاح الصوديوم المزعج* من حياته (ملح الطعام/كلوريد الصوديوم بكل أنواعه وأشكاله عدا الملح البوتاسيوم، ملح بيكربونات الصوديوم في المياه الغازية مثل البيبسي والسڤن آب وبعض المخبوزات بالبيكربونات وليس الخميرة، الأطعمة المحفوظة بأي ملح صوديوم). يبدأ في تعلم تذوق الأكل بدون ملح تماما. ويتعود على إضافة ليمون أو خل أو كاري أو كمون أو بهارات بدلا من ملح الصوديوم. يجب أن يدرك أننا نولد لا نعرف طعم الملح ولا السكر، فنتعرف عليهم ونعتاد عليهم. ولكن يمكننا العودة للأكل والشرب بدونهم.

لابد من تغيير غذائه ويزيد *ملح البوتاسيوم الطيب* ، يأكل خضراوات طازجة ورقية مثل الخس والجرجير، وخضراوات ذات العصارة عالية ملح البوتاسيوم مثل الخيار والطماطم في الثلاث وجبات. ويمكن متوافر في بعض السوبرماركت ملح طعام بوتاسيوم لمرضى ضغط الدم. (ملح الطعام الهيمالايا الوردي كله صوديوم كلوريد وليس بوتاسيوم كما يظن البعض، فهو ممنوع). زيادة الخضراوات هي دواء، لابد منه. ملح البوتاسيوم هام في علاج ضغط الدم بشرط أن تكون وظائف الكلى طبيعية.

لابد أن يمارس الحركة، المشي وصعود السلالم ويا ريت الجري والسباحة. هي دواء تكلفته غالية لكنه ناجح.

لو وزنه زائد، فلازم يخفضه. خفض الوزن هو دواء تكلفته عالية لكنه ناجح.

خفض الكافيين (القهوة والشاي) تدريجيا.

يتم إعطاء الأقراص حسب تاريخه الصحي والتحاليل. ويفضل إعطاء قرص مر�� واحدة يوميا.

لو كان مدخنا، يشتري صحته ويبطل الهباب الرئوي القلبي. الله يعينه

ملحوظة: لاحظت في عدة مرضى تابعتهم سنوات، أنه يختفي مرض ضغط الدم تدريجيا في بعض مرضى الدمنشيا يتضاءل إحتياجهم لأدوية الضغط مع فقدانهم لإدراك العالم.

ربما الراحة الذهنية، وأن يفصل المرء عقله عما حوله، يساهم في حفظ ضغط الدم طبيعي أو السيطرة على ضغط الدم.

شفاهم الله وعافاهم.

[irispublisherscardiovascular]

Prognostic Value of Serum Uric Acid Levels to the Cardiovascular Events in Hypertensives

Authored by A Karamanou*

Prognostic Value of Serum Uric Acid Levels to the Cardiovascular Events in Hypertensives

Abstract

Aim: The aim of the study was to investigate the association of serum uric acid (SUA) levels with the major cardiovascular events (MACE) in hypertensive patients.

Methods and Materials: This is a prospective analysis including 652 hypertensive patients (52,6% female) of mean age at the entry: 57,2±13,1 years, mean office systolic/diastolic blood pressure (S/DBPo): 152,3±19,1/94,4±11,83 mmHg, mean office heart rate (HRo): 76,0±12 beats/min, treated or newly diagnosed untreated. The median follow-up period was 9 years. SUA were measured at the entry of the study. Major cardiovascular events (MACE) (myocardial infarction, unstable angina, transient ischemic attack or stroke, peripheral vascular intervention, heart failure events, cardiovascular death) were registered. We estimated the prognostic value of SUA to the MACE. Cox proportional hazard model was employed to determine the prognostic value of uric acid.

Result:The median follow-up period was 9 years. There were 264 (40,5%) MACE at the end of the study. Cox regression statistical analysis revealed that SUA was a strong predictor of MACE (HR: 1,14, 95%CI: 1,06 – 1,2 p-value=0,000)

Conclusion: SUA levels have statistically significant prognostic value to MACE in hypertensive patients.

Introduction

Uric acid is a product of the activity of xanthine oxidase, an enzyme increasingly implicated as a mechanistic participant in oxidant stress and cardiovascular disease. Contributing factors responsible for hyperuricemia are alcoholic and high-purine foods consumption, low water consumption and poorly exercising. In adults with essential hypertension an association with hyperuricemia is very common. Prevalence of hyperuricemia is 30% in untreated hypertensives and >75% in malignant hypertension. Uric acid is thought to play a pathogenic role in hypertension [1-3] mediated by several mechanisms such as inflammation, vascular smooth muscle cell proliferation in renal microcirculation, endothelial dysfunction, and activation of the renin – angiotensin – aldosterone system [4-7]. Animal models have shown that acute elevations of serum urate, by inhibition of uricase, induce a prompt rise in blood pressure and that chronic urate elevation maintains the rise in pressure and induces irreversible vascular damage and glomerular changes, and results in a form of salt-sensitive hypertension [8, 9]. Furthermore, studies have shown that in overweight and obese subjects, hyperinsulinemia secondary to insulin resistance may enhance their absorption of uric acid and thus contribute to the association of hyperuricemia with hypertension [10].

Also, numerous studies have noted an association of elevated serum uric acid (SUA) levels also with heart failure [11], coronary artery disease [12] and stroke [13]. Several pathophysiological mechanisms have been postulated including multiple proatherogenic processes, increased oxidative stress [14, 15], vascular smooth muscle cell proliferation [16], leukocyte activation [17], platelet adhesiveness and aggregation [18] and crystal formation within coronary atherosclerotic plaques [19]. Xanthine oxidase activity is increased during ischemia and heart failure, and treatment with xanthine oxidase inhibitors has favorable effects on myocardial oxygen consumption and endothelium- dependent vascular function [20, 21]. Purpose of this study was to evaluate the predictive role of SUA levels with respect MACE (myocardial infarction, stroke, cardiovascular death) in a large Greek cohort of hypertensive men and women, in whom the SUA levels were routinely obtained at baseline.

Patient and Method

Patient Population

We studied 652 consecutive hypertensives (52,6% female) of mean age 57,2±13,1 years, treated or newly diagnosed nevertreated with anti-hypertensive drugs who were self-referred to our outpatient cardiology hypertensive clinic for BP evaluation. The median follow-up period was 9(5-14) years. Patients were excluded from the study, if they suffered from any cardiovascular disease, secondary hypertension, and any other clinically significant concurrent medical condition such as thyroidal, psychiatric, neuromuscular, chronic kidney disease, respiratory, hepatic or gastrointestinal illness, or systemic disease. None of the participants had any history or clinical/laboratory evidence of recent infection, inflammation or underwent any medical treatment (including antiinflammatory treatment and hormone replacement therapy) the last month before entry into the study. Patients under treatment for hyperuricemia were also excluded from the study. The primary endpoint of the trial was combined events of myocardial infarction or unstable angina, transient ischemic attack or stroke, peripheral vascular intervention, heart failure events or cardiovascular death during the study period. The study was approved by our hospital’s ethics committee and conformed to the 1964 Declaration of Helsinki. All subjects gave their written informed consent at the baseline of our study.

Baseline Measurements

At baseline, all participants were individually interviewed and information on gender, age, weight, height, waist circumference, hip circumference, smoking status, physical exercise status and diet was recorded. Body mass index (BMI) and waist to hip ratio (WHR) determined. Venous blood samples were drawn from all participants after an overnight fast (8-12 h) for the determination of SUA, fasting glucose (glo), lipids and serum creatinine (sCr). At baseline, resting sitting office BP was measured twice, using Cuff’s of a size appropriated to the arm circumference, with at least 5 min intervals using an automatic sphygmomanometer. If the difference between the first and second measurement was >10 mm Hg, then repeated measurements were performed. The average of the last two measurements was used for screening. Moreover, a bilateral measurement was performed to define the arm subjected to the relatively higher hemodynamic load and accordingly was used for all the following measurements.

Outcomes Measure

Follow-up data, based on interviews, health care facility medical records, and death certificates, were collected during the follow up period. Cardiovascular death was ascertained by either certificate, a proxy interview, or both. In the former case, the underlying cause of death was coded according to the International Classification of Disease, Ninth-tenth version (ICD-9 and ICD-10). Years of follow-up for each patient were calculated from baseline to the date of death for decedents and to the date of follow-up for those still alive.

Statistical Analysis

Continuous variables are presented as either mean (±standard deviation) or medians (interquartile range), and categorical variables as percentages. The significance of differences in baseline characteristics of the participants according to SUA were compared using Pearson’s Chi-square test or Student’s t-tests, as appropriate. Correlation analyses were performed using Pearson’s correlation coefficient. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the effect of baseline SUA. To assess independent associations of SUA with outcomes, covariates were considered confounders and were entered into the summary model. Statistical significance was set at p value<0,05. Results were analyzed with SPSS for Windows software.

Result

Clinical and laboratory characteristics of the study population are shown in (Table 1). The mean age of the study population at baseline was 57,2 year old (52.6% females) and the mean BMI was 28,0±4,3 kg/m2, median W/H: 0,88 (0,84-0,95). Moreover 57,8 % patients were newly diagnosed hypertensives. The mean serum glo was 104,3±31,6 mg/dl and the mean sCr was 0,95±0,4 mg/dl. Moreover, mean SUA level was 5,1 ±1,7 mg/dl (Table 1). During a median 9(5-14) years of follow-up, 270 (41,4%) persons of the study population developed MACE events. A total of 85 patients, (13 %) of the study population, developed myocardial infarction (MI), or unstable angina, 102 patients (15,6 %) developed transient ischemic attack (TIA) or stroke ,13 patients (1,99%) had hospitalization for heart failure, 12 patients (1,84%) underwent peripheral vascular intervention and 58 patients (8,89%) died from cardiovascular causes (Table 2) The median age at the time of occurring MACE was 67 (59-75) years old. Males had statisticaly significant increase risk of developing MACE compared to females Moreover, treated patients at baseline did not differ as far as it concern occurring MACE, compared to newly diagnosed nevertreated with anti-hypertensive drugs patients at baseline.

According to chi-square test hypertensive patients on treatment had statistically significant more cardiovascular events compared to hypertensive patients without treatment (p<0,001). Additionally, male hypertensive patients had significantly more cardiovascular events compared to female (p<0,001) (Table 3). At baseline, higher serum uric acid levels were associated with age (r=0,085, p=0,029), BMI (r=0,100, p<0,011), waist (r=0,247, p<0,001), waist to hip (r=0,288, p<0,001) and creatinine clearance (r=0,354, p<0,001) while SBP, DBP and heart rate were not significantly associated with serum uric acid (Table 4).

Cox regression analysis showed that serum uric acid, age, male gender and serum fasting glucose were independent predictors for MACE (Table 5). Finally, we found that, in entire cohort, serum uric acid was an independent predictor for MACE (HR:1,13, 95%CI: 1,004-1,2, p=0,038) (Table 6) (Figure 1).

Discussion

The main finding of our study is that elevated serum uric acid is a strong predictor of combined endpoint of myocardial infarction, stroke hospitalization for HF vascular intervention and cardiovascular death in essential hypertensive patients in a long term follow-up. Our findings are in accordance with several other studies and meta-analysis, which have shown that elevated uric acid levels predict an increased risk of cardiovascular events and cardiovascular and all cause mortality [22-27]. Moreover, a systematic review and meta-analysis found that hyperuricaemia may modestly increase the risk of CHD events independently of traditional CHD risk factors. Women were found to have a more pronounced increase in risk for CHD mortality than for men.28 A similar meta-analysis was performed for hyperuricaemia and stroke showing that hyperuricaemia modestly increased the risk of stroke incidence and mortality, independent of known risk factors, but without gender difference [29-31].

In contrary, some studies have failed to show uric acid as an independent predictor of death but they were underpowered, included too few events or did not adjust for known confounders [32-34]. Moreover, recent studies of losartan and atorvastatin showed that uric acid reduction contributes to attenuation of cardiovascular risk [35-36]. In a small randomized clinical trial, [37] allopurinol treatment in newly-diagnosed, hypertensive adolescents was associated with significant reductions in casual and 24-hour ambulatory blood pressure compared to placebo. Interestingly, a cohort study of hypouricemic patients enrolled in Veterans Affairs medical centers in the Pacific Northwest reported that the use of allopurinol was associated with a 23% lower allcause mortality rate [38].

The major strength of our study was that we used a large sample size and excluded for the presence of secondary hypertension, cardiovascular disease, chronic kidney disease, malignancy, and any other medical treatment. However, when interpreting our results, some limitations should be considered. First, bias from follow-up loss may have affected our results. Loss to follow-up is expected, especially in those who are in poor health. However, loss to followup of high-risk people would probably lead to a conservative bias and subsequent underestimation of risk. Furthermore, we were not able to include some important confounders in this study, such as the presence of or use of medication to treat gout and any dietary habits.

Conclusion

our findings, which were obtained from large cohort of Greek hypertensives, indicated that serum UA may be a predictor for the development of MACE in a large follow-up period, and this association was significant after adjustment for baseline covariates.

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[sweetclinics]

Arthroscopic Release of Frozen Shoulder Problems in Diabetics By Sweet Clinics..!!

Diabetics in India have an additional burden of joint problem in addition to their systemic problems of nerves, eyes, blood vessels, kidneys etc. Diabetics are prone to develop a condition of the shoulders called primary frozen shoulder. It can affect both shoulders in a small percentage of people. It usually resolves over a period of time but can leave behind a lasting deficit of certain movements.

Middle aged diabetics also develop tears of the rotator cuff and this can lead to a secondary frozen shoulder. Rotator cuff is group of tendons on top of the shoulder which help to stabilize the joint.

They can develop calcium deposition in the rotator cuff tendons.

They are prone to develop Gouty arthritis in their shoulders like in any other joints since Gout has an association with diabetes. Gout is a condition due to consumption of uric acid which is a by product of the digestion of red meat.

In this article I shall discuss frozen shoulder.

Definition-

Frozen shoulder (Adhesive capsulitis, periathritis) is a condition characterized by a loss all movements at the true shoulder joint. There is pain initially. Pain settles down and there remains stiffness which sets in over a short period of time. Clever people may recall a traumatic incident. In others it may come on slowly. Stiffness may be permanent. The movement that is maximally affected is external rotation (rotating the arm outwards away from the body). This results in inability to reach behind the head with the hand to tie the hair. When both shoulders are affected elderly women are in an embarrassing situation. Overhead activities are also affected as the degree of elevation of the arm is reduced.

Anatomy

The shoulder is the most mobile joint in the body. Its function is to position the arm in space to reach out to objects and deliver them to the mouth for eating and for other actions. The shoulder is a ball and socket joint formed by the upper end of the humerus (arm bone) and the socket formed by the glenoid of the shoulder blade. It is lined by a bag like capsule. The capacity of this joint is about 15- 20 cc. In frozen shoulder the capacity is reduced to 2- 3 cc. The movements at the shoulder joint occur synchronously with that at joint between the shoulder blade and the torso and are compensated to some extent by this.

History of frozen shoulder-

Only in the last few years has the ideal treatment been suggested. It is a relatively rare disorder of the shoulder and in a population of 20 shoulder patients there may be one or two with this condition.

However many doctors and orthopaedic surgeons label any painful condition as a frozen shoulder and advice physiotherapy. This can make the condition worse.

Recent advances

It has been recently discovered that the answer to frozen shoulder lies in the genes. These genes may also be associated with Diabetes mellitus. The alterations in these genes and chromosomes lead to a distorted response to wound healing and scar tissue formation. Exuberant scar tissue forms in response to trauma. The remodeling of scar tissue collagen is less. When more scar tissue forms in the capsule of the shoulder joint, the normally possible movements are grossly reduced. Diabetics also develop nodules in their palms and feet, another evidence of the exaggerated healing process.

Standard treatment-

This is a combination of physiotherapy and steroid injections when the condition is initially painful. Physio can be done at home. The standard Orthopaedic treatment has been a manipulation under anaesthesia. This carries a theoretical risk of fracture but has not been validated in practice.

A manipulation is contraindicated when a x ray reveals that the bone is very osteoporotic. It is also contra indicated in diabetics as more exuberant scar tissue will form in response to the crude method.Top Diabetologist in navi mumbai

Since I have pointed out that sometimes rotator cuff tears can coexist with a frozen shoulder, the ideal management for a frozen shoulder would be an arthroscopic release of the contracted structures within the joint. An arthroscope is an instrument used to look into joints through tiny key hole incisions. The benefits are less pain after surgery and faster rehabilitation. Since scar tissue formation is minimized, chances of recurrence are less and greater are the chance of retaining the full range of movement achieved during the procedure. The range of movement achieved after the release has to be maintained with physiotherapy. In case there is some tear of the rotator cuff, repair can be done at a later stage.

[paullassiterca]

Gasoline Ingredient Found in Blood Pressure Meds

Many of the decisions you make each day, including what you eat and drink, how much you exercise and even how you breathe, have a compound effect on your overall health. Making small changes can pay big dividends. The same is true of the small unhealthy decisions you make.

Lifestyle choices also affect your blood pressure and your risk for heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC),1 nearly 33 percent of American adults have high blood pressure (hypertension) and another 33 percent have prehypertension — blood pressure higher than normal but not high enough to be classified as high blood pressure.

Only half of those with high blood pressure have the condition under control, and hypertension was a primary or contributing cause of death for more than 410,000 Americans in 2014. This is equal to more than 1,100 deaths every day. High blood pressure costs the U.S. $48.6 billion each year in health care services, medications and missed days of work.2

Medications for high blood pressure, also known as antihypertensives, come with a laundry list of side effects. Those side effects are related to how the medication interacts with your body. The U.S. Food and Drug Administration (FDA) recently recalled two antihypertensive medications after it was discovered the active ingredient was contaminated with a known human carcinogen.3

Blood Pressure Medication Recalled Due to Toxic Contaminants

The antihypertensive medication Valsartan is commonly used to control hypertension and heart failure. Only after being recalled by 22 other countries due to concerns over the active ingredient, sourced from China,4 the FDA issued a press release5 alerting health care professionals and patients of a voluntary recall.

The FDA estimates nearly 80 percent of active ingredients used in medications in the U.S. originate abroad, the majority of which come from China and India. The first recall in the U.S. occurred in July after the drug was being recalled across Europe following information that an impurity, N-nitrosodimethylamine (NDMA), had been identified as part of the manufacturing process.

NDMA was originally produced in the U.S. and used to make rocket fuel. It was discontinued when the chemical was detected in air, water and soil samples and was found to contribute to the development of liver and lung cancer. Consumption is also known to cause severe liver damage accompanied by internal bleeding, and potentially death.

Not all Valsartan products were recalled, only those from Major Pharmaceuticals, Solco Healthcare and Teva Pharmaceutical Industries. After 22 other countries, including Canada and the United Arab Emirates, had recalled the medications did Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, issue a statement saying:6

“We have carefully assessed the valsartan-containing medications sold in the United States, and we’ve found that the valsartan sold by these specific companies does not meet our safety standards. This is why we’ve asked these companies to take immediate action to protect patients.”

The active ingredient was produced by Standard Chemical and Pharmaceutical Company in Taiwan. A spokesperson for the company commented in the newscast video above, saying, “We are victims too. The active pharmaceutical ingredient came in. We took it and conducted all the required tests.”

Antihypertensive Medications Trigger Dangerous Side Effects

A Danish study, in collaboration with Florida State University, found one of the most popular drugs used to treat hypertension, hydrochlorothiazide, raises your risk of skin cancer sevenfold. The findings published in the Journal of the American Association of Dermatology7 demonstrated an association between the medication and squamous cell and basal cell carcinomas.

They looked at other antihypertensive medications but did not find associations between those and skin cancer. The results were based on data from over 80,000 individuals, compared against 1.5 million healthy control subjects. While squamous cell carcinoma has a low mortality rate, the treatments carry a risk of impairment and potential the cancer may spread.

Antihypertensive medications also increase your risk of more common side effects associated with how the medication works in your body or affects other organ systems. Although experts recommend starting any antihypertensive drug at the lowest possible dose and increasing gradually, even at low doses these drugs can trigger:8

Nervousness

Diarrhea

Constipation

Erectile dysfunction

Headache

Nausea

Vomiting

Skin rash

Weight loss or gain

Dizziness

Cough

The usual course of treatment is to begin with one drug and add a second if your blood pressure measurement does not fall to the desired level.9 As with any chemical added to your body, the more you add, the greater the risk you will experience side effects.

Current Hypertension Guidelines and Potential Measurement Inaccuracies

Maintaining your blood pressure within healthy limits is one of the more important methods of reducing your risk of cardiovascular disease and stroke. Recently, the American Heart Association (AHA) introduced new blood pressure measurements for the diagnosis of hypertension.10

Using this new criteria, it’s estimated nearly half of American adults could be diagnosed with hypertension. Previously, readings of 140/90 and above were considered hypertension, but the newest guidelines lower those numbers to 130/80. Using these new guidelines, it’s estimated the number of men and women under 45 with hypertension will triple and double respectively.

Health experts from the organizations who formulated the new guidelines, the AHA and the American College of Cardiology, stressed the importance of getting an accurate pressure measurement to ascertain the necessity for medications. It’s also important to have at least two elevated readings on two separate occasions before a diagnosis of hypertension is issued.11

Blood pressure measurements in the doctor’s office usually measure the pressure of the brachial artery in your upper arm. Central blood pressure (CBP) is considered a better prognostic marker of cardiovascular disease and indicator of the pressure experienced by your organs,12 but requires an invasive procedure.

Inaccuracies are related to several factors, including the size of the cuff, the placement of the cuff, calibration of the machine, body position and activity. Researchers also encourage health care providers to measure blood pressure once in each arm.

A number of studies have revealed a significant difference between your right and left arm pressure may indicate circulatory problems that raise your risk for stroke, peripheral artery disease or other cardiovascular issues.13 For further discussion of how to get the best blood pressure measurement at your doctor’s office, see my previous article, “Blood Pressure Testing Is Mostly Inaccurate.”

What Triggers a Rise in Blood Pressure?

Knowing what triggers a rise in blood pressure may assist you in determining the lifestyle choices needed to normalize your readings and reduce the risk of conditions linked to hypertension, such as kidney disease, cognitive decline and Alzheimer’s disease. The health problems associated with hypertension have nearly doubled in the past four decades.

As much as 95 percent of high blood pressure is called essential hypertension, meaning the underlying cause is unknown. However, a number of identifiable factors found globally contribute to the rise in blood pressure. This includes but is not limited to:

Insulin and leptin resistance. As your insulin and leptin levels rise, it causes your blood pressure to increase.14,15

Elevated uric acid levels are also significantly associated with hypertension,16 so any program adopted to address high blood pressure needs to normalize your uric acid level as well.

Poor nutrition in childhood has been shown to raise the risk of high blood pressure in adulthood.17

Lead exposure18

Air pollution affects blood pressure by causing inflammation while noise pollution asserts an effect via your nervous and hormonal systems. Air pollution19 has been shown to increase your risk of high blood pressure to the same degree as having a body mass index of 25 to 30.

Living in an area plagued by constant noise pollution (busy city streets with night time traffic) has also been shown to increase the risk of hypertension.20

Dietary Changes Can Help Normalize Your Blood Pressure

For an in-depth discussion of how blood pressure affects your body, see my previous article, “An Introduction to High Blood Pressure.” As noted by Majid Ezzati, Ph.D., a professor of global environmental health at Imperial College London and author of an analysis21 of worldwide data evaluating blood pressure trends:22

“The perception is that people are not getting enough calories, but the reality is, they’re not getting healthy calories. Making fresh, healthy food affordable and accessible for everybody should be a priority.”

One of the most important dietary changes you can make to affect your blood pressure is to eliminate or dramatically reduce sugar and processed fructose from your diet. The easiest way is to replace processed foods with real, whole foods.

This not only addresses insulin and leptin resistance but also helps reduce elevated uric acid levels, both of which are significant factors in blood pressure. In one study,23 researchers discovered those who consumed 74 grams or more per day of fructose had a 77 percent greater risk of high blood pressure.

It also increased the risk of a reading of 135/85 by 26 percent and a reading of 140/90 by 30 percent, both which fall in the range of hypertension. By checking your fasting insulin level, you can see whether insulin and leptin resistance is at play.

Aim for a fasting insulin level of 2 to 3 microU per mL (mcU/mL). If it’s 5 mcU/mL or above you definitely need to lower your insulin level to reduce the risk of high blood pressure and other cardiovascular health problems.

Nitric Oxide Helps Relax Your Arteries and Reduce Blood Pressure

Your body naturally produces nitric oxide to relax your arterial walls. You lose 10 percent of your body’s ability to make nitric oxide for every decade of life, which is why it’s important to take steps to improve your production as you age.

Beets contain nitrates that are converted into nitric oxide in your body. Raw beets may also boost stamina24 during exercise, and concentrated beet juice has led to improvements in those suffering from heart failure.25

However, they are also high in sugar, which is why I recommend only limited amounts, or eating them in fermented form. Fermenting beets gives you all the health boosting benefits without the concerns of high sugar content. Dark leafy greens or another good source of naturally-occurring nitrates that are converted into nitric oxide in your body.

You can also increase your nitric oxide levels by doing the Nitric Oxide Dump workout two to three times a day. These short bursts of high-intensity activity help release nitric oxide, relax your arterial walls and reduce your blood pressure. For a demonstration, see the video above. You can read more about each of the movements and the benefits in my previous article, “Incorporate the Nitric Oxide Dump.”

from Articles http://articles.mercola.com/sites/articles/archive/2018/12/05/blood-pressure-medicine-valsartan-recalled-due-to-toxic-contaminants.aspx source https://niapurenaturecom.tumblr.com/post/180818443276

[jakehglover]

Gasoline Ingredient Found in Blood Pressure Meds

Many of the decisions you make each day, including what you eat and drink, how much you exercise and even how you breathe, have a compound effect on your overall health. Making small changes can pay big dividends. The same is true of the small unhealthy decisions you make.

Lifestyle choices also affect your blood pressure and your risk for heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC),1 nearly 33 percent of American adults have high blood pressure (hypertension) and another 33 percent have prehypertension — blood pressure higher than normal but not high enough to be classified as high blood pressure.

Only half of those with high blood pressure have the condition under control, and hypertension was a primary or contributing cause of death for more than 410,000 Americans in 2014. This is equal to more than 1,100 deaths every day. High blood pressure costs the U.S. $48.6 billion each year in health care services, medications and missed days of work.2

Medications for high blood pressure, also known as antihypertensives, come with a laundry list of side effects. Those side effects are related to how the medication interacts with your body. The U.S. Food and Drug Administration (FDA) recently recalled two antihypertensive medications after it was discovered the active ingredient was contaminated with a known human carcinogen.3

Blood Pressure Medication Recalled Due to Toxic Contaminants

The antihypertensive medication Valsartan is commonly used to control hypertension and heart failure. Only after being recalled by 22 other countries due to concerns over the active ingredient, sourced from China,4 the FDA issued a press release5 alerting health care professionals and patients of a voluntary recall.

The FDA estimates nearly 80 percent of active ingredients used in medications in the U.S. originate abroad, the majority of which come from China and India. The first recall in the U.S. occurred in July after the drug was being recalled across Europe following information that an impurity, N-nitrosodimethylamine (NDMA), had been identified as part of the manufacturing process.

NDMA was originally produced in the U.S. and used to make rocket fuel. It was discontinued when the chemical was detected in air, water and soil samples and was found to contribute to the development of liver and lung cancer. Consumption is also known to cause severe liver damage accompanied by internal bleeding, and potentially death.

Not all Valsartan products were recalled, only those from Major Pharmaceuticals, Solco Healthcare and Teva Pharmaceutical Industries. After 22 other countries, including Canada and the United Arab Emirates, had recalled the medications did Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, issue a statement saying:6

"We have carefully assessed the valsartan-containing medications sold in the United States, and we've found that the valsartan sold by these specific companies does not meet our safety standards. This is why we've asked these companies to take immediate action to protect patients."

The active ingredient was produced by Standard Chemical and Pharmaceutical Company in Taiwan. A spokesperson for the company commented in the newscast video above, saying, "We are victims too. The active pharmaceutical ingredient came in. We took it and conducted all the required tests."

Antihypertensive Medications Trigger Dangerous Side Effects

A Danish study, in collaboration with Florida State University, found one of the most popular drugs used to treat hypertension, hydrochlorothiazide, raises your risk of skin cancer sevenfold. The findings published in the Journal of the American Association of Dermatology7 demonstrated an association between the medication and squamous cell and basal cell carcinomas.

They looked at other antihypertensive medications but did not find associations between those and skin cancer. The results were based on data from over 80,000 individuals, compared against 1.5 million healthy control subjects. While squamous cell carcinoma has a low mortality rate, the treatments carry a risk of impairment and potential the cancer may spread.

Antihypertensive medications also increase your risk of more common side effects associated with how the medication works in your body or affects other organ systems. Although experts recommend starting any antihypertensive drug at the lowest possible dose and increasing gradually, even at low doses these drugs can trigger:8

Nervousness

Diarrhea

Constipation

Erectile dysfunction

Headache

Nausea

Vomiting

Skin rash

Weight loss or gain

Dizziness

Cough

The usual course of treatment is to begin with one drug and add a second if your blood pressure measurement does not fall to the desired level.9 As with any chemical added to your body, the more you add, the greater the risk you will experience side effects.

Current Hypertension Guidelines and Potential Measurement Inaccuracies

Maintaining your blood pressure within healthy limits is one of the more important methods of reducing your risk of cardiovascular disease and stroke. Recently, the American Heart Association (AHA) introduced new blood pressure measurements for the diagnosis of hypertension.10

Using this new criteria, it's estimated nearly half of American adults could be diagnosed with hypertension. Previously, readings of 140/90 and above were considered hypertension, but the newest guidelines lower those numbers to 130/80. Using these new guidelines, it's estimated the number of men and women under 45 with hypertension will triple and double respectively.

Health experts from the organizations who formulated the new guidelines, the AHA and the American College of Cardiology, stressed the importance of getting an accurate pressure measurement to ascertain the necessity for medications. It's also important to have at least two elevated readings on two separate occasions before a diagnosis of hypertension is issued.11

Blood pressure measurements in the doctor's office usually measure the pressure of the brachial artery in your upper arm. Central blood pressure (CBP) is considered a better prognostic marker of cardiovascular disease and indicator of the pressure experienced by your organs,12 but requires an invasive procedure.

Inaccuracies are related to several factors, including the size of the cuff, the placement of the cuff, calibration of the machine, body position and activity. Researchers also encourage health care providers to measure blood pressure once in each arm.

A number of studies have revealed a significant difference between your right and left arm pressure may indicate circulatory problems that raise your risk for stroke, peripheral artery disease or other cardiovascular issues.13 For further discussion of how to get the best blood pressure measurement at your doctor's office, see my previous article, "Blood Pressure Testing Is Mostly Inaccurate."

What Triggers a Rise in Blood Pressure?

Knowing what triggers a rise in blood pressure may assist you in determining the lifestyle choices needed to normalize your readings and reduce the risk of conditions linked to hypertension, such as kidney disease, cognitive decline and Alzheimer's disease. The health problems associated with hypertension have nearly doubled in the past four decades.

As much as 95 percent of high blood pressure is called essential hypertension, meaning the underlying cause is unknown. However, a number of identifiable factors found globally contribute to the rise in blood pressure. This includes but is not limited to:

Insulin and leptin resistance. As your insulin and leptin levels rise, it causes your blood pressure to increase.14,15

Elevated uric acid levels are also significantly associated with hypertension,16 so any program adopted to address high blood pressure needs to normalize your uric acid level as well.

Poor nutrition in childhood has been shown to raise the risk of high blood pressure in adulthood.17

Lead exposure18

Air pollution affects blood pressure by causing inflammation while noise pollution asserts an effect via your nervous and hormonal systems. Air pollution19 has been shown to increase your risk of high blood pressure to the same degree as having a body mass index of 25 to 30.

Living in an area plagued by constant noise pollution (busy city streets with night time traffic) has also been shown to increase the risk of hypertension.20

Dietary Changes Can Help Normalize Your Blood Pressure

For an in-depth discussion of how blood pressure affects your body, see my previous article, "An Introduction to High Blood Pressure." As noted by Majid Ezzati, Ph.D., a professor of global environmental health at Imperial College London and author of an analysis21 of worldwide data evaluating blood pressure trends:22

"The perception is that people are not getting enough calories, but the reality is, they're not getting healthy calories. Making fresh, healthy food affordable and accessible for everybody should be a priority."

One of the most important dietary changes you can make to affect your blood pressure is to eliminate or dramatically reduce sugar and processed fructose from your diet. The easiest way is to replace processed foods with real, whole foods.

This not only addresses insulin and leptin resistance but also helps reduce elevated uric acid levels, both of which are significant factors in blood pressure. In one study,23 researchers discovered those who consumed 74 grams or more per day of fructose had a 77 percent greater risk of high blood pressure.

It also increased the risk of a reading of 135/85 by 26 percent and a reading of 140/90 by 30 percent, both which fall in the range of hypertension. By checking your fasting insulin level, you can see whether insulin and leptin resistance is at play.

Aim for a fasting insulin level of 2 to 3 microU per mL (mcU/mL). If it's 5 mcU/mL or above you definitely need to lower your insulin level to reduce the risk of high blood pressure and other cardiovascular health problems.

Nitric Oxide Helps Relax Your Arteries and Reduce Blood Pressure

Your body naturally produces nitric oxide to relax your arterial walls. You lose 10 percent of your body's ability to make nitric oxide for every decade of life, which is why it's important to take steps to improve your production as you age.

Beets contain nitrates that are converted into nitric oxide in your body. Raw beets may also boost stamina24 during exercise, and concentrated beet juice has led to improvements in those suffering from heart failure.25

However, they are also high in sugar, which is why I recommend only limited amounts, or eating them in fermented form. Fermenting beets gives you all the health boosting benefits without the concerns of high sugar content. Dark leafy greens or another good source of naturally-occurring nitrates that are converted into nitric oxide in your body.

You can also increase your nitric oxide levels by doing the Nitric Oxide Dump workout two to three times a day. These short bursts of high-intensity activity help release nitric oxide, relax your arterial walls and reduce your blood pressure. For a demonstration, see the video above. You can read more about each of the movements and the benefits in my previous article, "Incorporate the Nitric Oxide Dump."

from HealthyLife via Jake Glover on Inoreader http://articles.mercola.com/sites/articles/archive/2018/12/05/blood-pressure-medicine-valsartan-recalled-due-to-toxic-contaminants.aspx

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Top 5 Common Orthopedic Conditions Affecting Bones and Muscles

Arthritis:

Description: Arthritis refers to inflammation of the joints. It can affect any joint in the body, leading to pain, stiffness, and reduced mobility.

Types: Common types include osteoarthritis (wear-and-tear), rheumatoid arthritis (autoimmune), and gouty arthritis (due to uric acid crystals).

Treatment: Treatment aims to manage pain, reduce inflammation, and improve joint function. Medications, physical therapy, and lifestyle modifications play a key role.

2.Osteoporosis:

Description: Osteoporosis is characterized by weakened bones, making them more prone to fractures. It often affects older adults, especially women.

Risk Factors: Age, gender, low calcium intake, and lack of weight-bearing exercise contribute to osteoporosis.

Prevention and Treatment: Adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication help prevent and manage osteoporosis.

3.Bursitis:

Description: Bursitis occurs when the fluid-filled sacs (bursae) around joints become inflamed. It leads to localized pain, swelling, and limited joint movement.

Common Sites: Shoulder, elbow, hip, and knee bursitis are frequent.

Treatment: Rest, ice, anti-inflammatory medications, and sometimes physical therapy are recommended.

4.Rotator Cuff Tears:

Description: The rotator cuff consists of tendons and muscles around the shoulder joint. Tears can occur due to trauma or degeneration.

Symptoms: Pain, weakness, and difficulty lifting the arm.

Treatment: Conservative management (rest, physical therapy) or surgical repair, depending on the severity.

5.Lumbar Disc Herniation (Slipped Disc):

Description: The intervertebral discs in the spine can herniate, causing pressure on nearby nerves. This leads to lower back pain, leg pain (sciatica), and muscle weakness.

Treatment: Rest, pain management, physical therapy, and in severe cases, surgery to relieve nerve compression.

Remember, early diagnosis and appropriate treatment enhance the chances of recovery. If you experience any symptoms related to these conditions, consider seeking evaluation at a reputable orthopedic hospital like Orthomed.

[cubic-backlinks]

Top 5 Common Orthopedic Conditions Affecting Bones and Muscles

Arthritis:

Description: Arthritis refers to inflammation of the joints. It can affect any joint in the body, leading to pain, stiffness, and reduced mobility.

Types: Common types include osteoarthritis (wear-and-tear), rheumatoid arthritis (autoimmune), and gouty arthritis (due to uric acid crystals).

Treatment: Treatment aims to manage pain, reduce inflammation, and improve joint function. Medications, physical therapy, and lifestyle modifications play a key role.

2.Osteoporosis:

Description: Osteoporosis is characterized by weakened bones, making them more prone to fractures. It often affects older adults, especially women.

Risk Factors: Age, gender, low calcium intake, and lack of weight-bearing exercise contribute to osteoporosis.

Prevention and Treatment: Adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication help prevent and manage osteoporosis.

3.Bursitis:

Description: Bursitis occurs when the fluid-filled sacs (bursae) around joints become inflamed. It leads to localized pain, swelling, and limited joint movement.

Common Sites: Shoulder, elbow, hip, and knee bursitis are frequent.

Treatment: Rest, ice, anti-inflammatory medications, and sometimes physical therapy are recommended.

4.Rotator Cuff Tears:

Description: The rotator cuff consists of tendons and muscles around the shoulder joint. Tears can occur due to trauma or degeneration.

Symptoms: Pain, weakness, and difficulty lifting the arm.

Treatment: Conservative management (rest, physical therapy) or surgical repair, depending on the severity.

5.Lumbar Disc Herniation (Slipped Disc):

Description: The intervertebral discs in the spine can herniate, causing pressure on nearby nerves. This leads to lower back pain, leg pain (sciatica), and muscle weakness.

Treatment: Rest, pain management, physical therapy, and in severe cases, surgery to relieve nerve compression.

Remember, early diagnosis and appropriate treatment enhance the chances of recovery. If you experience any symptoms related to these conditions, consider seeking evaluation at a reputable orthopedic hospital like Orthomed.

[sherristockman]

Blood Pressure Testing Is Mostly Inaccurate Dr. Mercola By Dr. Mercola About 29 percent of American adults suffer from high blood pressure, according to the U.S. Centers for Disease Control and Prevention (CDC),1 and it ranks as the second greatest public health threat. Of the one-third of adults who have high blood pressure, only half have the condition under control, even with medication.2 Your blood pressure is the force needed to push blood through your arteries coming from your heart to deliver oxygen rich blood around your body. When your blood pressure is measured, you get a high value (systolic) and a low value (diastolic). The high number measures the highest pressure that occurs in your blood vessels while your heart is contracting. The low value measures the pressure in your arteries between heartbeats when your heart is relaxed. Usually the systolic pressure, or top number, offers the most information about how stiff your arteries are and how much pressure is needed to push blood around your body. This is a major risk factor for cardiovascular disease. But individually, an elevated systolic or diastolic blood pressure may be enough to make a diagnosis of high blood pressure. Recent studies have demonstrated the risk of death from heart disease and stroke doubles with every 20 mmHg elevation in your systolic blood pressure or 10 mmHg elevation in your diastolic pressure in people ages 40 to 89.3 High blood pressure, or hypertension, is diagnosed when your pressure measures greater than or equal to 140 mmHg systolic pressure and greater than or equal to 90 mmHg of diastolic pressure. However, to reach the conclusion about treatment for hypertension, your physician must first have an accurate measurement of your blood pressure. Common Method of Measuring Blood Pressure May Be Inaccurate The method of taking blood pressure was invented in 1881 and refined in 1905 when Russian surgeon Dr. Nikolai Korotkoff discovered the difference between systolic and diastolic blood pressure measurements.4 Today, sphygmomanometers, the machine that measures blood pressure, continue to measure the appearance and disappearance of sounds in the arteries, known as Korotkoff sounds, as the standard blood pressure measurement. The blood pressure cuff usually measures the pressure in the brachial artery in your upper arm, but can also be measured using the femoral artery in your thigh. However, central aortic blood pressure (CBP) measurements are often considered a better prognostic marker of cardiovascular disease5 and are a better indicator of the pressure experienced by your organs, such as your brain and kidneys.6 The downside to measuring CBP is that it requires an invasive procedure to determine the measurement. Since the possibility of large differences between central aortic and peripheral (arm or leg) measurements could affect the decision to treat hypertension or direct the prescription of medication, researchers undertook a study to compare the differences between the two measurements.7 The researchers used data from over 2,500 people between 1950 and 2016 and compared their blood pressure cuff measurements against an invasive central aortic blood pressure measurement. They found that peripheral cuff measurements were reasonably accurate when compared to the reference standard — or invasive CBP — in people who had blood pressure lower than 120/80 or those who had pressure higher than 160/100. At these extreme ends of the risk spectrum the accuracy was up to 80 percent. However, the remaining population with blood pressure in the mid-range of systolic measurements between 120 and 159 mmHg and with diastolic measurements between 80 and 99 mmHg, the accuracy of the measure dropped dramatically to between 50 percent and 57 percent.8 Inaccuracies May Be Related to Several Factors As this study was performed retrospectively, it is impossible to determine why those blood pressure readings may have been inaccurate. However, there are several factors that play into the accuracy of your blood pressure reading that you should be aware of in order to ensure your pressure measurement is as accurate as possible.9,10,11,12 ✓ Cuff size The size of the cuff may change the blood pressure reading significantly. The blood pressure cuff will have an arm circumference range printed on the cuff. Using a cuff that is too small may artificially increase the systolic measurement between 10 mmHg and 40 mmHg. ✓ Placement of the cuff The cuff must be placed on a bare arm, not over clothing, with the edges of the cuff aligned and positioned at heart level, approximately 1 inch above the bend in your elbow. The sleeve of your shirt should be off and not rolled up. ✓ Hearing ability when using a stethoscope Many of the machines used today in hospitals and some clinics to take blood pressure are automated and don't require someone to manually listen for Korotkoff sounds in your brachial artery. However, there remain a large number of blood pressure measurements taken by an individual listening for the change in sounds in the brachial artery. Individuals who have some hearing loss may record an abnormal reading when they don't hear the change in sounds correctly. ✓ Machine calibration Home machines and automated machines must be accurately calibrated to ensure a proper reading. One study demonstrated some home pressure machines were off in up to 15 percent of patients.13 Readings from these machines may impact treatment recommendations. ✓ Body position Your body position has a great deal to do with how accurate a peripheral blood pressure measurement will be. The proper position is to have your feet flat on the floor, back supported in a chair, legs uncrossed for at least five minutes and your arm supported while sitting. ✓ Activity Talking to the person taking your blood pressure during the reading may increase your systolic pressure by 10 mmHg and a full bladder may increase your systolic reading by 10 mmHg. Prior to taking your blood pressure, it is important that you sit quietly for three to five minutes and do not exercise for at least 30 minutes prior to the reading. ✓ White coat hypertension In this instance your blood pressure consistently measures greater than 140/90 mmHg or above but measures less at home. For some people, seeing the doctor is an inherently stressful experience that may temporarily raise your blood pressure. An estimated 15 percent to 30 percent of people with documented high blood pressure have white coat hypertension.14 ✓ Nicotine, caffeine or alcohol All should be eliminated in the 30 minutes prior to having your pressure measured. Both High and Low Measurements Linked to Health Risks Accurate measurement of your blood pressure is necessary to prevent damage to your health and appropriately monitor your blood pressure. Both abnormally high and low pressure may be linked to health risks. Physicians will be concerned with low blood pressure when it triggers symptoms, such as:15 ✓ Dizziness ✓ Nausea ✓ Fainting ✓ Unusual thirst ✓ Lack of concentration ✓ Blurred vision ✓ Cold, clammy skin ✓ Rapid, shallow breathing ✓ Fatigue Low blood pressure may be the result of prolonged bed rest, pregnancy, blood loss, endocrine problems or nutritional deficiencies. High blood pressure increases your potential risk for cardiovascular disease, kidney disease, loss of vision, stroke and sexual dysfunction.16 While you may experience symptoms of low blood pressure, you often won't experience any immediate symptoms of high blood pressure. This is why the condition is called the silent killer, as the initial symptoms may be a stroke or heart attack. Assess Your Risk of Hypertension Without Measuring Blood Pressure Another noninvasive method of measuring your risk of hypertension without visiting the physician's office is to use your waist-to-hip ratio. Research suggests your waist size may be an effective measure for assessing obesity-related hypertension risk.17 If you have a high waist-to-hip ratio, i.e., you carry more fat around your waist than on your hips, you may be at an increased risk for obesity-related hypertension. To calculate your waist-to-hip ratio, measure the circumference of your hips at the widest part, across your buttocks, and your waist at the smallest circumference of your natural waist, just above your belly button. Then divide your waist measurement by your hip measurement to get the ratio. The Mayo Clinic uses the following waist-to-hip ratio designations to evaluate your health risk: Waist-to-Hip Ratio Norms Gender Excellent Good Average At Risk Gender: Male Excellent: 0.95 Gender: Female Excellent: 0.86 Hypertension Typically a Symptom of Insulin and Leptin Resistance Typically, high blood pressure is a symptom of insulin and leptin resistance. This means the vast majority of people may be able to normalize their blood pressure using dietary and lifestyle changes that avoid side effects from antihypertension drugs. However, if you are currently on medication, it is important you remain on the medication while making changes to your diet in order to reduce the potential for a stroke or heart attack while naturally bringing your blood pressure to within normal limits. One of the primary responses to a high-carbohydrate and processed food diet is an over production of insulin and leptin. As these rise, they also cause your blood pressure to rise. Elevated uric acid levels are also associated with hypertension. This means the program you choose should also address normalizing your insulin sensitivity and your uric acid levels. Interestingly, by eliminating excess sugar and fructose in your diet you'll address these issues all at once. Standard Medical Treatment for Hypertension Not Risk Free Download Interview Transcript In my interview with Dr. Andrew Saul, we discuss beta-blocker drugs commonly used in the treatment of high blood pressure. Yet, despite having over 100 antihypertension drugs approved and available on the market, the number of people whose blood pressure is not under control continues to rise. Beta-blockers are commonly used anti-hypertension medications that come with a laundry list of side effects, including cardiac failure or infarction (heart attack), impaired kidney function, depression and ischemic colitis. Diuretics may be used to help your body reduce a fluid overload. Side effects may include Stevens-Johnson syndrome, impaired hearing, abdominal pain and arthritic pain.18 Calcium channel blockers are a type of antihypertensive medication for which side effects include edema, dizziness, nose bleeds, rash and tinnitus.19 In fact, none of the medications your physician may prescribe to control blood pressure are free of side effects. Nitric Oxide Dump May Be Exactly What You're Looking For Exercise is an important lifestyle strategy that can help normalize your blood pressure. In this video I demonstrate the nitric oxide dump exercise I do daily. The exercise takes just three minutes, and should ideally be done two to three times a day, with at least two hours between each session. I am now convinced that this gentler strategy, which has not been evaluated or compared to the HIIT protocols discussed in previous articles, is a far healthier strategy to obtain the benefits of HIIT without the downside. I only wish I had known about this more effective approach earlier. This type of exercise stimulates the release of nitric oxide (NO) stored in your endothelial cells in your blood vessels. NO effectively: Causes your blood vessels to relax and dilate, lowering your blood pressure Stimulates and improves your immune function Decreases the viscosity of your blood, reducing platelet aggregation and the potential for stroke or heart attack Provides powerful anabolic stimulus, or increases lean body mass Start With Lifestyle Choices to Regulate Your Blood Pressure The most effective way to normalize your blood pressure is through healthy lifestyle choices. High blood pressure is typically associated with insulin resistance. Insulin helps your body to store magnesium, which helps relax your muscles. If your cells have grown resistant to insulin, you won't be able to store magnesium, which leads to blood vessel constriction and rising blood pressure. Trans fat is now known to trigger atherosclerosis (hardening of your arteries). This is another trigger for hypertension, so avoiding all trans fats or hydrogenated fats may help prevent atherosclerosis. This includes margarines, vegetable oils, butter-like spreads and baked goods. If your blood pressure is running high, you need to restore your insulin and leptin sensitivity, and the following five strategies are among the most effective for doing so: • Avoiding processed foods (as most are high in sugar/fructose, grains, harmful fats and artificial ingredients) • Making real food, ideally organic and locally grown, the focus of your diet • Swapping net carbs for healthy fat. Sources of healthy fats to add to your diet include: ✓ Avocados ✓ Butter made from raw, grass-fed organic milk ✓ Raw grass fed dairy ✓ Organic pastured egg yolks ✓ Coconuts and coconut oil ✓ Unheated organic nut oils ✓ Raw nuts, such as pecans and macadamia, which are low in protein and high in healthy fats ✓ Grass fed meats or pasture raised poultry • Intermittent fasting is one of the most effective ways I've found to normalize your insulin/leptin sensitivity. It's not a diet in conventional terms, but rather a way of scheduling your eating to promote efficient energy use. Essentially, intermittent fasting means eating all your calories during a specific window of time each day, and fasting during the rest. When you eat, your body reacts by elevating insulin and leptin. Starchy carbohydrates cause a far greater insulin elevation than protein, while fat requires no insulin for digestion. If you're constantly snacking (or drinking) on sugary fare, your insulin/leptin levels will remain chronically elevated, which tends to promote high blood pressure. The more sensitive your body is to insulin/leptin, the more likely you'll be to use the food you consume efficiently, which will help improve insulin resistance, and promote weight loss and the creation of muscle. Your body is most sensitive to insulin/leptin following a period of fasting. (Fasting also boosts growth hormone secretion — another important key to weight loss and muscle growth.) • Exercising regularly. On a side note, I recommend training yourself to breathe through your nose when exercising, as mouth breathing during exercise can raise your heart rate and blood pressure, sometimes resulting in fatigue and dizziness. To learn more about this, please refer to my previous article on the Buteyko breathing method. My optimized nutrition and exercise plan can help guide you step-by-step toward normalizing your insulin and leptin levels, which in turn will help normalize your blood pressure and help you shed excess weight. These are free resources that can help improve your health, or take it to the next level if you've already started making some changes.

[imagitory]

UPDATE YAY! Whew, this chapter was tricky to write -- these next few chapters are going to be very action-heavy, but I also don’t want to rush through too much of the emotional stuff, like friendships and characters arcs, so...yeah, I’ll try to keep this pacing quick as the last chapter, this one, and the next few chapters will all be taking place in about two days, but at the same time, we gots lots of characters to check up on!!

In this chapter we get focus on Percy Weasley (OMG YAY!!), Cho Chang, Tokala Kyon Mulligan, their MACUSA cohort Mia Ramero, Kingsley Shacklebolt, Dolores Umbridge, Uric Cuffe, Marietta Edgecombe, Elijah Whitby, Jacques Jengu, Gordon and Tana Ramsay (YES, THEY’RE BACK TOO!), Bridget Jaheem, and the mysterious Lavrov (who oh who could he be...?)

Next chapters: the Golden Trio returns to Hogwarts and the Battle of Hogwarts begins!

Hope you enjoy!

[darwinjorely-blog]

How To Keep Your Bones, Joints And Muscles Strong With Herbal Supplements?

The musculoskeletal system of our body mainly consists of muscles, bones, ligaments, and tendons. Healthy joints are necessary to ensure healthy movement. It is necessary to consume diet rich in vitamin D to promote absorption of calcium to strengthen joints and maintain healthy bones. It safeguards you from inflammation, osteoporosis, stiffness, redness and arthritis. However, many people are not finding time to consume healthy diet daily. Such people can make use of herbal remedies like Freeflex capsules to keep your bones, joints and muscles strong. Key ingredients in Freeflex capsules include Ashwagandha, Rasna Extract, Suranjan, Ashthisanhar Extract, Godanti Hadtal and Chobchini. Freeflex capsules are developed using potent herbs to improve health joints and bones. It boosts flexibility and strength of the joints. Regular use of this herbal pill is recommended to safeguard you from calcium deficiency, thinning of bones and bone atrophy as well. It nourishes and energizes the muscles. Powerful herbs in this herbal supplement boosts calcium metabolism apart from supplementing with vitamin D to regenerate the bone tissues. It keeps the bones stronger, denser and flexible. It eliminates deficiency by supplementing your body with vitamin D and calcium in bioavailable form. Therefore, it naturally cures osteoporosis and helps to keep your bones, joints and muscles strong for healthy living. It heals the damaged joints and bones. It safeguards you from fibromyalgia and neuralgia. Only pure plant ingredients are used in the production of this herbal supplement. You can use this herbal supplement daily twice with milk or water after food at night and after breakfast at morning to keep your bones, joints and muscles strong. Order for these herbal pills can be placed using a debit or credit card from the comfort of home. You can also enjoy free shipping to your doorstep. Ashwagandha is widely used for the treatment of stress, hypertension, asthma, arthritis, inflammation and rheumatism. It boosts your immunity by providing antioxidants. It has anti-inflammatory properties to reduce pain and inflammation. It is a natural aphrodisiac to boost fertility as well as vitality. Suranjan is used for the treatment of sciatica, joint pain, dysurea, blood infection, gouty arthritis, osteoarthritis and rheumatoid arthritis. It prevents indigestion and heals wounds. Chobchini promotes digestion and eliminates toxins and feces through the urine. It maintains mental peace. It offers effective cure for high uric acid and diabetes. All these herbs are blended using an advanced herbal formula to keep your bones, joints and muscles strong. You are also advised to practice exercises regularly. Older adults usually suffer from knee dysfunction and joint pain. Such people are advised to balance with just one leg at a time for 30 seconds. It helps to strengthen your muscles and makes the knees stable. You can also practice rotator cuff exercises regularly. You can also practice Squats for strengthening your muscles. It is also suggested to consume healthy diet and ensure sound sleep daily. You are advised to avoid long sitting and move for a while.    

Read about Natural Supplements For Bone, Joint And Muscle. Also know Herbal Bone And Joint Support Pills. Read about Natural Bone, Joint And Muscle Support.