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5 Biggest Mistakes Men Make With Prostate Health

Kimberly Wilkes

Note: This article originally appeared in Whole Health Insider.

The prostate gland isn't something a lot of men pay much attention to—until it starts to cause problems, or, even scarier, becomes cancerous. And if you're a male who's edging up there in years—or you have a father, brother, or husband who's getting older—chances are good the prostate will start to cause problems.

In fact, most men, if they live past 70, will develop an enlarged prostate, a noncancerous condition known as benign prostatic hyperplasia—BPH, for short. Studies have shown that BPH is present in only 10 percent of men in their 30s, but 20 percent of men in their 40s have BPH, 50 to 60 percent of men in their 60s, and 80 to 90 percent of men in their 70s and 80s.1

The threat of prostate cancer also becomes more real as a man ages. According to the National Cancer Institute, an estimated 220,800 new cases of prostate cancer will be diagnosed in 2015.2 And in the same year, an estimated 27,540 men will die from the disease.2

But developing a prostate condition later in life isn't inevitable. There are important actions men can take to protect themselves and to increase the odds of becoming part of the 10 to 20 percent of men over 70 who don't have BPH. When it comes to prostate health, avoiding five big mistakes can go a long way in reducing the risk of any problems down the road—or addressing the symptoms you already have.  

Mistake #1

Eating Too Much High-Saturated-Fat Animal Protein

If you're constantly in touch with your inner cave man and scarf down steaks, ribs, and hamburgers, your prostate gland may pay the price. Studies in mice have found that a high-fat diet promotes the growth of prostate tumors.3  And the story's the same in humans. In a study of 4,577 men with nonmetastatic prostate cancer—in other words prostate cancer that hasn't spread to other parts of the body—subjects who consumed the most vegetable fat after being diagnosed with the disease experienced a lower risk of lethal prostate cancer. In fact, the risk of lethal prostate cancer dropped 29 percent in men who ate more vegetable fat.4

And the men eating the most vegetable fat didn't just have a reduced risk of dying from prostate cancer. They also had a 35 percent lower risk of dying from any cause. On the opposite end of the spectrum, increasing saturated fat by five percent was linked to a 30 percent higher risk of death. Eating more polyunsaturated fat after diagnosis was associated with a lower death rate. Replacing five percent of calories from saturated fat with polyunsaturated fat caused the death risk to drop by 34 percent.4

The researchers in this study also looked at the type of food associated with a reduced risk of dying from prostate cancer in men who already had the disease. They found that increasing the amount of oil-based dressing eaten by one tablespoon daily was linked to a 29 percent lower risk of lethal prostate cancer and a 13 percent lower risk of death. Nuts also proved to be a power food for the prostate. Adding one ounce of nuts to the diet daily was linked to an 18 percent lower risk of dying from prostate cancer and an 11 percent lower risk of death from all causes.4  

Other studies have backed up these results. For example, when 161 prostate cancer patients ate flaxseeds or flaxseeds together with a low-fat diet, the rate at which prostate tumors spread was much lower compared to subjects in the control groups who didn't eat flaxseeds.5

Scientists can't say with 100 percent certainty why a diet high in saturated fats, especially animal fats, is linked to increased prostate cancer growth and a lower survival rate. But studies have hinted at a couple of reasons. First, a diet high in animal fat is linked to weight gain and weight gain also is linked to prostate cancer and BPH.3,6

Second, having high cholesterol promotes the spread of prostate cancer throughout the body,7 a process known as metastasis. And eating a diet high in saturated fats from animal proteins causes cholesterol levels to spike. Cholesterol is thought to cause the spread of prostate cancer for a number of reasons including the fact that when cholesterol becomes  oxidized in the body it can suppress immunity and promote angiogenesis, the creation of new blood vessels that tumor cells use to spread to other areas of the body.7

And diets low in saturated fat and high in vegetable fat protect against more than just prostate cancer. Studies have found a link between low-fat, vegetable-based diets and a reduced risk of developing BPH.8

If you have a hard time letting go of your cave man tendencies, your best bet is to choose grass-fed beef over conventional beef. Grass-fed beef is low in saturated fats and high in omega-3 fatty acids. And make sure you eat lots of nuts and flaxseeds every day.

Mistake #2

Not Eating Enough Tomatoes—or Eating Them the Wrong Way

One of the most powerful prostate-protecting foods is the tomato—or more specifically, a component of tomatoes called lycopene. Eating tomatoes and tomato products causes lycopene to build up in the prostate where it protects against DNA damage that is a starting point for cancer development.9 If you're not eating enough tomatoes or if you're not eating tomatoes together with the right types of food, your prostate could suffer.

Research shows lycopene may halt BPH in its tracks. In one study, 40 elderly men with BPH randomly received 15 mg per day of lycopene in supplement form or a placebo for six months. Prostate-specific antigen (PSA) levels fell in the men taking lycopene, but not in the placebo group. What's more, the prostates of the men in the placebo group enlarged during the study, but the prostates of the men taking lycopene remained the same size. Even though symptoms improved in both the placebo and lycopene group, the men taking lycopene experienced a greater improvement in their symptoms.10

In addition, scientists have looked at lycopene for its possible prostate-cancer protecting effects. Eating tomato paste a couple times per week can lower the risk of developing prostate cancer by about 20 percent, according to some studies.11,12

In men who already have prostate cancer, not every study has found that lycopene can be of benefit. But there's some evidence to show lycopene might have an effect. For example, in one study 20 men with metastatic prostate cancer took 10 mg per day of lycopene for three months. One of the subjects taking lycopene experienced a complete response, including normal PSA levels and no sign of disease for at least eight weeks. Six of the patients (30 percent) experienced a partial response after taking a lycopene supplement, 10 patients (50 percent) remained stable, and the disease progressed in only three (15 percent) of the patients taking lycopene.13

It won't do you any good to take a lycopene supplement or eat tomatoes if you're not also eating some form of fat along with them and making sure the tomatoes are cooked.  Cooking tomatoes and adding some extra virgin olive oil makes it easier for your body to absorb the lycopene and results in much greater antioxidant activity compared to when tomatoes are eaten raw.14

If you decide to bypass the tomatoes for a lycopene supplement, aim for 10 to 15 mg daily, taken with meals.

Mistake #3

Relying on the PSA Test

Since 1994, it's been standard practice for doctors to use the prostate-specific antigen (PSA) test on men who have prostate symptoms. PSA is an enzyme produced by the prostate gland. High levels are considered a red flag that a man has BPH, and may indicate he has prostate cancer.

So what's wrong with the PSA test? Its biggest flaw is that it has a low accuracy rate in actually detecting prostate cancer. And it's worthless for telling doctors which type of prostate cancer a man has, a less-lethal form of the disease or one that's more likely to result in death.

In addition, taking the PSA test will not necessarily stop a man from dying from prostate cancer.  The New England Journal of Medicine reported in 2009 that the death rate over seven to 10 years is no less in men who take the PSA test compared to men who don't take it.15

Another study also published in the New England Journal of Medicine in the same year found that PSA screening didreduce the rate of death from prostate cancer but only by 20 percent. And a high risk of over diagnosis tainted the PSA test results, meaning many of the men were diagnosed with prostate cancer when they didn't have it.16

In fact, based on these and other findings, the American Cancer Society cautioned against relying on this test. And the American College of Preventive Medicine also doesn't believe there's enough evidence to justify recommending routine use of the PSA test.

Instead of taking a PSA test, your best bet is to get regular prostate exams and to have your doctor test you for BRCA1 and BRCA2. You might have heard of these two genetic abnormalities in regards to breast cancer. But science is showing that BRCA1 or BRCA2 mutations are involved in prostate cancer, too.

Men who carry the BRCA1 mutation are two to five times more likely to develop prostate cancer compared to men who don't have this mutation. Men who carry the BRCA2 form are eight to nine times more likely to develop prostate cancer and are more likely to develop prostate cancer earlier in life (when they are under the age of 65). BRCA2 carriers also are at risk of developing a more aggressive form of the disease.17

If the test reveals you carry one of the mutations, don't lose hope—it's not a guarantee you'll get cancer. Lifestyle choices are important. Use the test results as a motivation to put into practice all the advice in this article.

Mistake #4

Not Using Saw Palmetto

When it comes to BPH, saw palmetto might just be a man's best friend. Evidence continues to pour in that saw palmetto (Serenoa repens) improves many symptoms of BPH. A 1998 analysis of the medical literature found that men treated with saw palmetto experienced a decrease in urinary tract symptoms and didn't have to urinate as frequently in the middle of the night (a condition known as nocturia).18

Other researchers have looked into saw palmetto's potential to reduce BPH-related sexual dysfunction—with promising results. When 82 elderly men with BPH took 320 mg of saw palmetto daily for eight weeks they experienced a decline in the International Prostate Symptom Score and improved sexual function and overall quality of life.19

Studies also have shown that saw palmetto is as effective as two drugs commonly given to BPH patients, finasteride and tamsulosin. In one study of 103 men, the combination of saw palmetto and tamsulosin was more effective than tamsulosin alone in reducing lower urinary tract symptoms in BPH patients during up to 12 months of treatment.20

When combined with lycopene and selenium, saw palmetto packs a particularly strong prostate-protective punch. Several human studies in men with BPH who had lower urinary tract symptoms found that these three supplements can team up to reduce inflammation and improve prostate symptoms.21-23 In one study, 102 men who had chronic prostatitis/chronic pelvic pain syndrome received either a combination of saw palmetto, lycopene, and selenium or saw palmetto alone. Chronic prostatitis symptoms declined dramatically in both groups, but the combination therapy resulted in a greater improvement than with saw palmetto alone.23 Another study found that the combination of saw palmetto, selenium, and lycopene was particularly effective in relieving BPH symptoms when used together with the prostate drug tamsulosin.22

An animal study in rats with testosterone-dependent BPH found that the combination of saw palmetto, lycopene, and selenium can block prostate enlargement by 43.3 percent. It accomplished this by increasing a process known as apoptosis, where unhealthy cells are programmed to die and cleared out of the body.24

The jury is still out on whether saw palmetto is useful in prostate cancer since randomized, controlled studies are lacking. But in a handful of cell culture studies saw palmetto reduced inflammation and the expression of genes involved in inflammation, blocked the growth of the cancer cells, and destroyed cancerous cells through apoptosis.25,26

Based on these limited cell culture studies, if you have prostate cancer, we don't recommend relying exclusively on saw palmetto to conquer the disease. But if you have BPH, taking 400 mg per day of saw palmetto together with 15 mg per day lycopene and 200 mcg per day selenium is a smart move.

Mistake #5

Skipping the Selenium

We've already talked about how selenium combined with saw palmetto and lycopene can improve the symptoms of BPH. But what about reducing your risk of prostate cancer?

By studying the data collected in the Nutritional Prevention of Cancer (NPC) trial, a 2003 study found that giving men selenized yeast supplements significantly decreased prostate cancer risk, but only in men with a history of cancer and whose selenium levels were lower at the study's start.27  Four years earlier, a group of researchers found that prostate cancer risk dropped by 30 percent in men who ate 88 to 119 micrograms/day of selenium compared to men who ate lower or higher amounts.28

The results of the SELECT trial, a large study published in 2009, dashed the hopes that selenium could prevent prostate cancer. This trial found that 200 mcg/day of selenomethione did not reduce prostate cancer risk. But, unlike many of the past studies, the study subjects weren't deficient in selenium and had no history of cancer.29

The bottom line? There's no guarantee that taking selenium will stop you from getting prostate cancer. But there are other good reasons to take selenium. For BPH, combining this mineral with lycopene and saw palmetto can offer some definite benefits. And certain areas of the U.S. such as the northwest, southeast, southwest, and much of Texas are plagued by low selenium levels in the soil. So if you're living in one of those regions it's an especially good idea to supplement with up to 200 mcg per day. As far as which type of selenium to choose, opt for methylselenocysteine, a form that more easily converts into methyl selenol, a metabolite studied for its potential anti-cancer abilities.30

In addition to taking selenium supplements, you can also munch on pumpkin seeds, which contain a fair amount of selenium. Brazil nuts actually have the highest amount of selenium of any food, but researchers have studied pumpkin seeds for their benefits in BPH, with some promising results. In a 12-week study, researchers gave pumpkin seed extract to 2,245 patients suffering from benign prostate hyperplasia and found that the International Prostate Symptom Score dropped by 41.4% while the men's quality of life improved.31

Just be certain not to overdo it. Taking more than 200 mcg of selenium per day will cause more harm than good, since high doses of selenium can be toxic.

Protecting the Prostate

Prostate problems are common with age—but they're not inevitable. By avoiding all the mistakes mentioned in this article, you can give your prostate a fighting chance. It's also a good idea to make sure you're not packing on the pounds. Obesity is linked to a 98 percent increased risk of prostate cancer.32 Plus, doctors are less likely to recognize prostate cancer in obese men. One reason? Obese men have larger prostates, making it more difficult to detect cancer.32

References

1. Roehrborn CG. Rev Urol. 2005;7(Suppl 9):S3-14.

2. National Cancer Institute. http://seer.cancer.gov/statfacts/html/prost.html

3. Cho HJ, et al. Nutrients. 2015 Apr 9;7(4):2539-61.

4. Richman EL, et al. JAMA Intern Med. 2013 Jul 22;173(14):1318-26.

5. Demark-Wahnefried W, et al. Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3577-87.

6. Parsons JK. J Urol. 2007 Aug;178(2):395-401.

7. Moon H, et al. Oncotarget. 2015 Apr 10;6(10):7438-53.

8. Denis L, et al. Eur Urol. 1999;35(5-6):377-87.

9. Talvas J, et al. Am J Clin Nutr. 2010 Jun;91(6):1716-24.

10. Schwarz S, et al.  J Nutr. 2008 Jan;138(1):49-53.

11. Giovannucci E, et al. J Natl Cancer Inst. 1995 Dec 6;87(23):1767-76.

12.Giovannucci E, et al. J Natl Cancer Inst. 2002 Mar 6;94(5):391-8.

13.  Ansari MS, Gupta NP. Urol Oncol. 2004 Sep-Oct;22(5):415-20.

14. Vallverdú-Queralt A, et al. Int J Mol Sci. 2015 Apr 28;16(5):9588-99.

15. Andriole GL, et al. N Engl J Med. 2009;360:1310-9.

16. Schröder FH, et al. N Engl J Med. 2009;360:1320-8.

17. Walker R, et al. Can Urol Assoc J. 2014 Nov;8(11-12):E783-8.

18. Wilt TJ, et al. JAMA. 1998 Nov 11;280(18):1604-9.

19. Suter A, et al. Phytother Res. 2013 Feb;27(2):218-26.

20. Ryu YW, et al. Urol Int. 2015;94(2):187-93.

21. Morgia G, et al. Int Braz J Urol. 2013 Mar-Apr;39(2):214-21.

22. Morgia G, et al. Prostate. 2014 Nov;74(15):1471-80.

23. Morgia G, et al. Urol Int. 2010;84(4):400-6.

24. Minutoli L, et al. J Biomed Sci. 2014 Mar 10;21:19.

25. Silvestri I, et al. J Inflamm (Lond). 2013 Mar 14;10:11.

26. Baron A, et al. BJU Int. 2009 May;103(9):1275-83.

27. Duffield-Lillico AJ, et al. BJU Int. 2003;91:608-12.

28. Jain MG, et al. Nutr Cancer. 1999;34:173-84.

29. Lippman SM, et al. JAMA. 2009;301:39-51.

30. Marshall JR. Cancer Prev Res (Phila). 2011 Nov;4(11):1938-44.

31. Friederich M, et al. Forsch Komplementarmed Klass Naturheilkd. 2000 Aug;7(4):200-4.

32. Freedland SJ, et al. Urology. 2008 Nov;72(5):1102-5.

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Banish Your Bedroom Blues

This article originally appeared in Whole Health Insider.

By Kimberly Wilkes

When you're not performing your best in the bedroom, it's frustrating. And your relationship can suffer, too. For men, it can take a toll on self-esteem, cause irritability, and even be downright painful physically. For women who are unable to achieve sexual satisfaction or who have low sex drive, it’s just as frustrating. It puts strain on the relationship if a man feels he can’t please his woman or if one partner wants to have sex while the other is too tired to try.

If your libido has drained away, you're not alone. Erectile dysfunction affects 30 million men in the U.S.1 It's a big problem for women, too. Between 25 and 63 percent of all women suffer from sexual dysfunction. In postmenopausal women, it’s even more common with as many as 68 to 86.5 percent suffering from the condition.2

Furthermore, erectile dysfunction (ED) increases with age. By 40 years, 40 percent of men will experience some form of ED.3

And it doesn't just impact the elderly. A study in the Journal of Sexual Medicine found that one in four men who visited an outpatient clinic for erectile dysfunction was under the age of 40. And of the men under age 40, 48.8 percent had a severe case of ED compared with 40 percent of men older than age 40.4

There are a lot of reasons why you want to try to coax your libido back to life and why ignoring the problem isn't a good idea. Not only does sex forge a greater sense of intimacy between you and your partner—it also comes with a ton of health benefits.

Sex Can Keep You Healthy

For starters, having regular, safe sex boosts your immunity. In one study of college students, researchers found that the students who had sex the most often—one to two times per week—had the highest levels of salivary immunoglobulin A (IgA), which protects your body from viral, bacterial and other intruders.5

Then there’s your heart. Not having sex can put you at risk for heart disease. Researchers found that subjects who had sex once a month compared to two or more times per week were at greater risk of cardiovascular disease.6

Sex also can lower blood pressure, reduce the risk of prostate cancer, help you fall asleep faster, get rid of headaches, reduce chronic back, leg and menstrual pain, improve bladder control in women and melt away stress. Plus, for women, the more you have sex, the more enjoyable it is. Having sex often increases vaginal lubrication, blood flow and elasticity, so it feels more comfortable and makes you want more.7-10

There's another reason to find a solution for your low sex drive. For men, not being able to have or maintain an erection is linked to heart disease. In fact, erectile dysfunction may be one of the first signs of heart disease occurring in your body—even if you've had no other symptoms.11-12

What can you do to breathe new life into your libido? To answer that question, we must first look at all the reasons why your libido packed its bags in the first place.

Libido Drainer #1: Hormonal Imbalances

Your libido is at the mercy of your hormones. Sexual desire results from a complicated interaction between many neurotransmitters and hormones in your body. Some of these neurotransmitters and hormones stimulate sex drive and are called excitatory while others reduce sex drive and are called inhibitory. Sexual desire results because of a complex balance between inhibitory and excitatory pathways in the brain. For example, the neurotransmitter dopamine, and the hormones estrogen, progesterone and testosterone play an excitatory role, whereas serotonin and a hormone known as prolactin are inhibitory. If your libido is low, either there's a reduced level of excitatory activity in your body or an increased level of inhibitory activity—or both.13

Testosterone is one of the most important hormones controlling sex drive, both in men and women. In both men and women, testosterone levels hit their height between 25 to 30years of age. Thereafter, they drop by approximately one to two percent annually. By the time you're 60, testosterone levels are typically only 40 to 50 percent of what they were when you were younger—and they might be even lower than that depending on your stress levels, diet, exercise and sleep patterns.14

Testosterone deficiency is linked to weight gain and developing the metabolic syndrome—two conditions also strongly linked to erectile dysfunction. Metabolic syndrome is a cluster of risk factors for heart disease including high blood pressure, type 2 diabetes and weight gain, especially belly fat.15

Putting on the pounds also causes your testosterone levels to plummet, which in turn causes ED. Studies suggest this is a main cause of ED in younger men.16

The testosterone deficiency that occurs in people who have type 2 diabetes—paired with decreased circulation—likely plays a big role in why more than half of men with type 2 diabetes have erectile dysfunction.17

When it comes to enhancing sexual function, testosterone may be a women’s best friend as well. For women, administering testosterone is the principal treatment for low sexual desire disorder.18

Estrogen deficiency results in a lot of the same symptoms as testosterone deficiency including loss of libido in both males and females and development of the metabolic syndrome with belly fat. That's why after menopause, women's libido often takes a nosedive. To make matters worse, the low estrogen levels that occur after menopause can result in vaginal dryness, making sex uncomfortable or painful.19

DHEA is another hormone important in sexual health. Women with sexual arousal and desire problems have lower levels of DHEA compared to women without sexual difficulties.20 In some randomized placebo-controlled studies, postmenopausal women given DHEA experienced improved sexual function.20

Imbalances in three other hormones are involved in sex drive—or rather lack of it. High prolactin levels are known to put a damper on libido.21

Circulating prolactin levels actually increase after orgasm and can regulate further sexual arousal following orgasm in both men and women. But when high prolactin levels become chronic and last for a long time they’re associated with sexual dysfunction in both sexes. Low levels of prolactin are equally bad for your sex life since they are a possible risk factor for erectile dysfunction.22  

Growth hormone is another hormone regulating the sexual response of the genitals in men, and possibly also in women. A decrease of desire and sexual arousal both in men and women, together with an impairment of erectile function in men, occur in people who have growth hormone deficiency.22

Then there’s oxytocin—the “love” hormone—which your body needs to perform at its best. Oxytocin was best known for its role in female reproduction, since it's released in large amounts during labor and plays a role in childbirth and breastfeeding.  But now researchers realize oxytocin helps you bond with your sexual partner emotionally and is involved in both orgasms and erections as well as ejaculation.23

Libido Drainer #2: Nitric Oxide Deficiency

Nitric oxide is to an erection what fuel is to a car. An erection simply can't happen without it. Nitric oxide signals a series of events that lead to erection. Release of nitric oxide precedes the relaxation of muscles in two parts of the penis called the corpora cavernosa and corpus spongiosum, in a process similar to female arousal. Blood then engorges the corpora cavernosa, which expands to hold 90 percent of the blood involved in an erection.23-24 It also plays a role in female libido, too.

The key is to get your nitric oxide levels balanced—too little or too much isn't a good thing.

Libido Drainer #3: Stress and Anxiety

Another reason why you might not be in the mood or aren't performing at your best is stress. Let's face it, it's hard to keep your mind focused on sex when you have a major work deadline approaching. Or maybe you're worried about something else such as a family illness.

Stress and sexual arousal are on opposite ends of the hormonal spectrum. During sexual arousal, cortisol levels usually drop. During stress, cortisol levels increase, which in turn causes levels of sex steroids to fall.25  

However, stress can actually be a turn on for some women. Scientists think this may be because stress increases your sympathetic nervous system activity, which increases arousal.25 Stress can also cause some women to overproduce DHEA, because DHEA counteracts the effects of cortisol. DHEA is converted into testosterone, a libido-enhancing hormone.

Libido Drainer #4: Prescription Drugs

Certain medications can cause your libido to decline. For example, selective serotonin reuptake inhibitors can cause low libido, the inability to reach orgasm, genital numbness and erectile dysfunction. The scary part is that in some cases, these side effects didn't go away after treatment was stopped.26

Opioid painkillers also are not your libido's best friend. They often cause testosterone deficiency, leading to reduced libido, erectile dysfunction, and other symptoms that don't exactly encourage a healthy sex life such as fatigue, hot flashes and depression.27

Two drugs, finasteride and dutasteride, used for the treatment of benign prostate hyperplasia and male pattern hair loss, cause libido to decline, erectile dysfunction and problems with ejaculating and having orgasms.28

Libido Drainer #5: Diseases

As mentioned earlier in this article, heart problems and diabetes can cause problems in the bedroom. Diabetes not only causes low libido in men—more than 50 percent of women with diabetes have sexual problems, according to one study.29 Benign prostatic hyperplasia, hypothyroidism and hyperthyroidism also can trigger sexual dysfunction.30,2  

Libido Drainer #6: Depression

Depression is another factor that zaps sex drive. In men especially, depression may be caused by testosterone deficiency.31 And low testosterone is linked to low libido.

Women suffering from depression also have a low sex drive. In one study, pregnant women who were depressed reported less sexual desire and satisfaction, were less aroused and had reduced lubrication.32

Libido Drainer #7: Cigarettes and Alcohol

Cigarette smoking is a risk factor for sexual dysfunction. So is drinking too much alcohol. If you want to give your sex life a boost, find ways to kick the nicotine habit. And limit your alcohol intake to one drink daily.

Getting Back Your Desire

If you're not performing at your peak, there are a lot of natural ways to jumpstart your libido.

First, get out there and exercise. Not only does exercise help you lose weight—which is linked to enhanced libido—exercise in and of itself can get you more in the mood. Researchers have found that exercise increases genital arousal in healthy women.33

In addition, women who suffered from sexual dysfunction after taking antidepressant drugs experienced increased genital arousal after they exercised.34 Plus, men who are couch potatoes have a higher risk for erectile dysfunction.34

You'll also want your doctor to test your hormone levels. Depending on the results of the test, supplementing with natural progesterone cream, DHEA or using bioidentical estrogen or testosterone may be in order. It's best to work with a doctor who is familiar with bioidentical hormone therapy, since many synthetic hormones do more harm than good.

An adrenal function test will also give you an idea whether stress is wreaking havoc with your cortisol levels.

Getting your heart checked and having your blood sugar levels and your thyroid hormones tested are also good ideas if you're suffering from low libido. And nitric oxide test strips can tell you whether your NO levels are low.

Once you determine why your libido has tanked, you'll have a better idea which supplements are needed to restore it back to its former glory.

You can give your nitric oxide levels a boost and improve circulation by using a combination of beet root powder, hawthorn berry extract, L-citrulline and sodium nitrite.35 Plus, nitric oxide and oxytocin work together.36-37 So supporting healthy nitric oxide levels may make oxytocin work more effectively.

Another way to increase testosterone is to use Eurycoma longifolia, also called tongkat ali.  Eurycoma longifoliadoesn't actually increase your testosterone levels per se. Instead, it encourages sex-hormone-binding-globulin (SHBG) to release the testosterone it's holding on to, allowing more testosterone to be available for use by the body. Eurycoma longifolia also reduces levels of the stress hormone cortisol.38

Other libido-boosting supplements include beta sitosterol, Urtica dioica, myricetin and Tribulus terrestris. Myricetin blocks the conversion of testosterone to 5 alpha-dihydrotestosterone, a stronger version of testosterone implicated in prostate cancer.39 Urtica dioica has similar effects and reduces lower urinary tract symptoms in BPH, a condition linked to erectile dysfunction.40

Researchers believe Tribulus terrestris may be useful in ED since it can increase testosterone and DHEA levels.41

If your cortisol levels test high and if stress is putting a damper on your sex drive, aim for supplements that can soothe your adrenal glands. Stress-reducing botanicals such as Magnolia officinalis, Phellodendron amurense and ashwagandha (Withania somnifera) standardized to eight percent withanolides can give you more stamina under the sheets if stress is to blame for your low libido.42-43

Magnolia officinalis improves semen quality 44-45 while in an animal study Withania somnifera reduced the negative effects that chronic stress has on sexual function in males.46

Take Charge of Your Libido

You don’t have to stand by and watch your libido fade away. There are plenty of ways to have a more satisfying sex life. Balancing your hormones, taking care of any health issues that are putting a damper on your libido, and staying committed to a good exercise routine can all heat things up between the sheets. Add in a few key nutritional supplements and say goodbye to your bedroom blues for good.

[SIDEBAR

Sex and Safety in Seniors

There's no reason to deprive yourself of a healthy sex life—no matter what your age. But there are some things sexually active seniors need to know.

First, let's talk about sex after a heart attack. If you or your partner has had a heart attack and you’re worried about having sex soon after, you can put your fears to rest. Less than one percent of all heart attacks are triggered by sexual activity. If you don’t get a lot of exercise, your risk increases. A sedentary person's risk of having a heart attack roughly triples during sex. An active person's risk, on the other hand, rises by only 20 percent.47

The American Heart Association advises heart patients that if you can walk briskly or climb two flights of stairs without suffering from chest pain, abnormal heart rhythms or shortness of breath, you’re ready to start having sex again.47

If you’re a senior, single, and dating, the other thing you need to know is that HIV is a very real threat. The number of seniors who are living with HIV/AIDS is on the rise, according to the Centers for Disease Control and Prevention (CDC).

Currently, about 19 percent of all HIV/AIDS patients are over 55.48 Of the men over 50 who contracted HIV, 23 percent caught the virus through heterosexual contact, and 60 percent from male-to-male sexual contact with the remainder contracting it through injection drug use. Eighty-two percent of women over 50 with HIV caught the virus through heterosexual sex, with the remainder becoming infected after injection drug use.48

By 2017, half of all people in the U.S. living with HIV will be over 50, Yale Medical School predicts.49

Why the increase? Some of it has to do with the fact more effective anti-viral drugs have been developed, allowing people with the disease to live to an older age. But new cases of HIV/AIDS are also increasing among seniors. Higher divorce rates, the fact more seniors are having premarital sex and the use of sexual performance enhancing drugs, all mean seniors are more vulnerable than ever to HIV/AIDS. In addition, some senior women, no longer worried about becoming pregnant, stop insisting their partners use condoms.

Seniors are also more likely to become infected once they’re exposed to HIV. With age, the immune system isn’t as good at fighting off infections. Pre-existing health conditions that occur with age also make seniors more vulnerable to HIV. As the skin ages, it forms a less effective barrier, allowing the virus to enter the bloodstream.

Seniors are more likely than younger people to be diagnosed with HIV later in the course of the disease. Why? Because AIDS symptoms also mimic symptoms of other diseases usually associated with old age. For example, doctors might misdiagnose the dementia that AIDS patients suffer from as Alzheimer’s disease.

The bottom line? If you’re a senior and dating always ask your partner to get tested for HIV/AIDS before beginning intimate relations. It may make you feel embarrassed to bring up the subject, but your life simply isn’t worth the risk.

Since the HIV virus can take up to six months after exposure to be detected on a test, be sure to use a condom during that time. And then get retested. If your partner tries to convince you he/she doesn’t need to get tested and tries to talk you out of it—no matter how much attraction there is between the two of you—look elsewhere for a sexual partner who cares more about your health and safety.

END SIDEBAR]

References:

1. http://www.onhealth.com/impotence_ed/article.htm

2. Ambler DR, et al. Rev Obstet Gynecol. 2012; 5(1): 16–27.

3. Alsaikhan B, et al. Int J Gen Med. 2014 Jun 12;7:271-6.

4. Capogrosso P, et al.  The Journal of Sexual Medicine. 2013 July;10(7):1833-41.

5. Charnetski CJ and Brennan FX. Psychol Rep. 2004 Jun;94(3 Pt 1):839-44.

6. Hall SA, et al. American Journal of Cardiology. 15 January 2010;105(2):192-7.

7. Brody S. Biol Psychol. 2006 Feb;71(2):214-22.

8. Leitzmann MF, et al. JAMA. April 7, 2004;291(13):1578-86.

9. Hambach A, et al. Cephalalgia. February 19, 2013. [Epub ahead of print.]

10. http://www.webmd.com/sex-relationships/guide/sex-and-health

11. Miner M, et al. Can J Urol. 2014 Jun;21(3):25-38.

12. Unal M, et al. Med Sci Monit. 2014 May 29;20:884-8.

13. Simon JA. Postgrad Med. 2010 Nov;122(6):128-36.

14. Talbott SM, et al. J Int Soc Sports Nutr. 2013 May 26;10(1):28.

15. García-Cruz E, et al. J Sex Med. 2014 Jun 26. [Epub ahead of print.]

16. Jastrzębska S, et al. Endokrynol Pol. 2014;65(3):203-9.

17. Gur S, et al. Curr Diabetes Rev. 2014 Jan;10(1):61-73.

18. Reis SL and Abdo CH. Clinics (Sao Paulo) 2014;69(4):294-303.

19. Simpson ER and Jones ME. Ernst Schering Found Symp Proc. 2006;(1):45-67.

20. Hamilton LD, et al. Horm Behav. May 2011;59(5):765-71.

21. Baltzar MT, et al. Ugeskr Laeger. 2012 Jun 18;174(25):1745-6.

22. Galdiero M, et al. J Endocrinol Invest. 2012 Sep;35(8):782-94.

23. Magon N and Kalra S. Indian J Endrocrinol Metab. 2011 Sep;15 Suppl 3:S156-61.

24. Allain AV, et al. Curr Top Pharmacol. 2011;15(2):25-33.

25. Hamilton LD and Meston CM. Horm Behav. 2011 May;59(5):765-71.

26. Csoka AB, et al. J Sex Med. 2008 Jan;5(1):227-33.

27. Smith HS and Elliott JA. Pain Physician. 2012 Jul;15(3 Suppl):ES145-56.

28. Traish AM, et al. Korean J Urol. 2014 Jun;55(6):367-79.

29. Vafaeimanesh J, et al. Indian J Endocrinol Metab. 2014 Mar;18(2):175-9.

30. Alsaikhan B, et al. Int J Gen Med. 2014 Jun 12;7:271-6.

31. Khera M. Arch Esp Urol. 2013 Sep;66(7):729-36.

32. Chang SR, et al. J Sex Med. 2012 Oct;9(10):2582-9.

33. Lorenz TA and Meston CM. Depress Anxiety. 2014 Mar;31(3):188-95.

34. Shamloul R and Ghanem H. Lancet. 2013 Jan 12;381(9861):153-65.

35. Zand J, et al. Nutr Res. 2011;31:262-9.

36. Chaud M, et al. Proc Natl Acad Sci U S A. Sep 30, 1997;94(20):11049-54.

37. Rettori V, et al. Proc Natl Acad Sci U S A. Mar 18, 1997;94(6):2741-4.

38. Talbott SM, et al. J Int Soc Sports Nutr. 2013 May 26;10(1):28.

39. Hiipakka RA, et al. Biochem Pharmacol. 2002 Mar 15;63(6):1165-76.

40. Safarinejad MR. J Herb Pharmacother. 2005;5(4):1-11.

41. Gauthaman K and Ganesan AP. Phytomedicine. 2008 Jan;15(1-2):44-54.

42. Kalman DS, et al. Nutr J. 2008 Apr 21;7:11.

43. [No authors listed]. Altern Med Rev. 2004 Jun;9(2):211-4.

44. Shukla KK, et al. Reprod Biomed Online. 2011 Mar 7. [Epub ahead of print.]

45. Mahdi AA, et al. Evid Based Complement Alternat Med. 2009 Sep 29. [Epub ahead of print.]

46. Bhattarcharya SK and Muruganandam AV. Pharmacol Biochem Behav. 2003;75:547-55.

47. http://www.cnn.com/2012/01/19/health/sex-safe-heart-patients/index.html.

48. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/risk/age/olderamericans/

49. http://aginginstride.enewsworks.com/en/12/articles/263/Seniors-and-HIVAIDS-the-Statistics-Might-Surprise-You.htm

[writerkimwilkes-blog]

Conquering Urinary and Fecal Incontinence

By Kimberly Wilkes

This article originally appeared in Whole Health Insider

If you have urinary or fecal incontinence, it's probably not something you want to shout from the rooftops. So it's not surprising that researchers have found that only 38 percent of women with urinary incontinence talk about it with their doctors.1  And doctors aren't likely to bring up the topic either, as one study found that physicians initiated the conversation about urinary incontinence in only 7 percent of the cases.2 The same is true for fecal incontinence, which is just as embarrassing.

If you're having trouble reaching the bathroom in time, it's frustrating.  It can affect your mood and your quality of life. And as you grow older it can take away your independence. But you'll be glad to know it's not hopeless. In this article you'll learn about some ways you can find relief from these two pressing concerns.  

Urinary Incontinence

There are several types of urinary incontinence including stress incontinence, urge incontinence and overflow incontinence. Stress incontinence is caused by anything that increases pressure in your abdomen such as coughing, sneezing, exercise and laughing. Urge incontinence is what the name implies—you urgently have to urinate but might not get to the bathroom in time. There's also overflow incontinence, more common in men, where the bladder doesn't empty all the way and urine leaks out.  

Urinary incontinence doesn't affect younger women as much as older women. It's most common from menopause into later life. Many people who have incontinence suffer from either stress incontinence or a mixture of stress and urge incontinence. Severe incontinence occurs much less in young women, but its prevalence rapidly rises from age 70 to 80.3 The condition doesn't occur as often in men, but when it does urge incontinence accounts for 40 to 80 percent of all cases in men. Stress incontinence occurs most often in men who have had prostate surgery or neurological injury.3Men also experience an increase in urinary incontinence as they grow older, but even so, the presence of severe incontinence in 70- to 80-year-old males is about half that of females.3

Who's at Risk?

In women, many risk factors exist for incontinence including age, obesity, diabetes, high-impact exercise and estrogen deficiency.4Pregnancy also increases the risk of urinary incontinence because giving birth may damage the nerves that control the bladder, cause the urethra and bladder to move positions. When a doctor delivering a baby performs an episiotomy, an incision in the pelvic floor muscle during delivery to help the fetus emerge more easily, this also increases the risk of urinary incontinence.5 Men who have had their prostate gland removed due to cancer are at an increased risk.6

It also turns out that a weak heart may equal a weak bladder. As many as 50 percent of heart failure patients have lower urinary tract symptoms, including incontinence. Heart failure patients who also have urinary incontinenceare worse off than patients without urinary incontinence and urinary incontinence occurs three times more often in people who have New York Heart Association Class III and IV symptoms compared with people who have less severe heart disease.7The heart failure itself might contribute to the incontinence, but drugs such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and beta-blockers used to treat heart failure may also cause or worsen urinary incontinence.7

Being overweight won't do your bladder any favors, either. Women of all ages who pack on too many pounds are at an increased risk of urinary incontinence.8  When researchers reviewed the medical literature, they looked at six studies including 2,352 subjects and found that non-surgical weight loss improved urinary incontinence.9They concluded that weight loss "should be considered part of standard practice in the management of urinary incontinencein overweight women."

In addition, post-menopausal women who are treated with conjugated equine estrogens as part of hormone replacement therapy are at risk for the development and worsening of stress and urge incontinence.10 However, estrogen applied topically is associated with an improvement in urinary incontinence.

Natural Solutions for Urinary Incontinence

If you have urinary incontinence and you're overweight, losing weight should be the first priority. Not only will your bladder thank you, your wallet will, too. Urinary incontinence costs the United States $20 billion per year. In obese and overweight women who lost weight, improved urinary incontinence resulted in a savings of at least $327 per woman, per year.11

Physical exercise is important, too. Even though high-impact sports increase the risk of urinary incontinence, mild or moderate physical activity—for example, brisk walking—lowers the risk of developing this condition in the first place.12

Exercises to help strengthen the pelvic floor are another way to eliminate urinary incontinence in both women as well as in men who have undergone prostate surgery.

Pelvic floor muscle exercises assist with urinary control by improving the strength, endurance, and coordination of the pelvic floor muscles. The exercises also improves the function of the urethral sphincter, a muscle that controls the exit of urine from the bladder through the urethra.6

To perform pelvic floor muscle exercises, you "lift up" the pelvic floor so that the flow of urine stops. Voluntarily starting and stopping urination can help identify which muscles you need to exercise. In men, a biofeedback session before radical prostatectomy (surgery to have the prostate removed) together with pelvic floor muscle training after surgery and assisted monthly sessions, reduced urinary incontinence.13

There are several different types of pelvic floor muscle exercises, but the best known are Kegel exercises. A study of 38 women with stress incontinence and 34 women with mixed stress and urge incontinence found that 68.4 percent of the women in the stress incontinence group and 41.2 percent of the women in the mixed incontinence group experienced significant improvements after doing home-based Kegel exercises. Women who had stress incontinence experienced the greatest improvements.14

To learn how to do Kegel exercises correctly, take a look at the table below:

How to Do Kegel Exercises

1.     Identify the pelvic floor muscles by stopping urinationmidstream. If your urine stops, you've found the right muscles.  

2.     The exercises can be done in any position, although at first, doing them lying down might be easier.

Once you've identified the muscles, tighten andhold for five seconds, and then relax for five seconds. Do this four or five times. Ultimately, you'll want to work up to keeping the muscles tightened for 10 seconds and then relaxing for 10 seconds before repeating the exercise.

Be certain to tightenonly your pelvic floor muscles and not the muscles in your abdomen, thighs or buttocks. Make sure you're not holding your breath.

For the best results, plan on performing at least three sets of 10 repetitions daily.

Source: mayoclinic.org

Both men and women can benefit from a newer type of pelvic floor muscle exercise known as “Pfilates” (PelvicFloorPilates). Pfilates combines pelvic floor muscle exercises with Pilates, a type of exercise which is performed in order to improve core strength, stability, flexibility and muscle control of the body as a whole, as well as posture and breathing. One study of 62 women found that both pelvic floor muscle training and Pfilates were equally effective in improving pelvic muscle strength.15The women in the study did not have urinary incontinence, but the results are a good sign that both types of exercises may benefit people who have incontinence. A study is also underway of the effectiveness of Pfilates in men who have undergone radical prostatectomy.6You can learn how to do Pfilates by watching these videos.

Nutritional Supplements to Support Pelvic Muscles

First, make sure you're not deficient in vitamin D because some studies have shown that supplementing with vitamin D can result in the resolution of urinary incontinence.16

A combination of horsetail (

Equisetum

arvense

)and Crateva nurvalacan also help get your bladder back on track. Horsetail acts as a mild diuretic without causing your body to eliminate too many electrolytes. In a double-blind, randomized clinical trial of 36 healthy male volunteers, researchers divided the subjects into three groups who received a three-part treatment that included 900 mg/day of horsetail for four days then 25 mg per day of the diuretic drug hydrochlorothiazide for another four days, and then a placebo for another four days. There was a 10-day break between each of the treatments. When they subjects were taking the horsetail, they experienced a diuretic effect equivalent to that of hydrochlorothiazide.

17

Crateva when combined with horsetail can help relieve urinary incontinence. One study investigated the effectiveness of these two botanicals on 34 people (6 males and 28 females) with symptoms of urge incontinence and/or stress incontinence.18The researchers administered two questionnaires to determine how incontinence was impacting the life of the subjects before they were given Crateva and horsetail and at the first, second and third month of treatment. The Incontinence Impact Questionnaire (IIQ) measures impact on daily activities, such as household chores, physical activity and social activities, and the Urogenital Distress Inventory (UDI) measures physical symptoms such as leakage and urgency.

While supplementing with Crateva and horsetail, on average, daytime urinary frequency declined steadily during the three months of treatment. The amount of times the subjects needed to empty their bladders fell from 12.3 times per day before treatment to 9.3 times per day after one month and 7.4 times per day after two months. By month three urination frequency returned to a normal 6.2 times per day.

In addition, the subject's night awakenings to go to the bathroom gradually went from 2.5 times per night to 1.8 times in the first month, 0.94 times in the second month and 0.74 times per night in the third month.

What's more, the results of the UDI and IIQ questionnaires indicated that having  symptoms of incontinence negatively impacted quality of life as measured through difficulty in doing daily and social activities as well as emotional health and feelings of frustration caused by incontinence. Yet, after supplementing with the two botanicals, in all of these areas participants felt better about their life in all of these areas and were more confident within four weeks of treatment. And they continued to improve more throughout the rest of the study.

The study authors concluded that Crateva combined with horsetail was a suitable and effective treatment for both men and women with incontinence. Supplementing with the two botanicals was not associated with any adverse reactions.

And if your incontinence is caused by chemotherapy or radiation, try supplementing with L-glutamine. An animal study found that supplementingwith L-glutamine stops the damage that occurs in the bladder wall after radiation therapy.19

Fecal Incontinence

About 10 percent of adults have fecal incontinence.20 It can affect people of all ages, but it's more common in older adults, especially nursing home residents.21Fecal incontinence also is more common in women than men and it often goes hand in hand with urinary incontinence.21

Fecal incontinence falls into three categories: 1) passive incontinence voiding stool when you don't even feel like you have to go to the bathroom; 2) urge incontinence, when you're unable to wait to get to the bathroom; 3) fecal seepage, the accidental elimination of small amounts of stool.

Risk factors for fecal incontinence include anatomical changes that occur due to trauma as well as surgery, vaginal deliveries, radiation therapy for cancer, neurologic disorders, obesity, diabetes, smoking and aging.21,22

The reason why females suffer from fecal incontinence more than males is because of either maternal injuries that happened when they were giving birth or in the case of fecal incontinence that develops later in life, changes in the pelvic floor that occur due to menopause and aging.21If you suffered nerve damage during childbirth in your 20s and 30s, there can be a delayed reaction, with fecal incontinence developing in your 50s as the nerve damage grows worse over time.21

Fecal incontinence can cause a lot of embarrassment, disrupt quality of life and is associated with other complications such as dermatitis of the anal/rectal area.23

Solutions for Fecal Incontinence

If you or somebody you know suffers from this condition, there are several ways you can reduce the chance of any embarrassing accidents. First, try biofeedback, which is a technique that will train you to control muscle tension through the use of electrical sensors. Many studies have shown it's effective in fecal incontinence. For example, in one study of 75 people (mean age about 61) with fecal incontinence both quality of life and embarrassment improved, especially in the younger subjects.24

Biofeedback combined with anal sphincter exercises can re-train anal muscles and is more effective than doing just the exercises alone. Aim for 10 squeezes of five seconds each five times daily.21

Another good option is to take a fiber supplement that contains psyllium. One recent study compared the effects of 16 grams per day of three dietary fiber supplements— carboxymethylcellulose [CMC], gum arabic or psyllium—to a placebo in 189 people with fecal incontinence. In the 32-day study, frequency of fecal incontinence significantly decreased in the subjects supplementing with psyllium while the fiber CMC actually increasedfrequency of fecal incontinence. After supplementation, the number of fecal incontinence episodes per week was 5.5 for the placebo group, 2.5 for psyllium, 4.3 for gum arabic and 6.2 for CMC.20

Fiber lessens fecal incontinence by improving sensory awareness of the need to go to the bathroom, reducing the liquidity of feces or causing more stool to be eliminated during bowel movements, so that less remains in the rectum to leak.20Just be sure not to consume too much fiber or it can backfire. It's a good idea to consume no more than the 16 grams of psyllium, the amount used in the above study.

As with urinary incontinence, with fecal incontinence having your doctor test your vitamin D levels is important. Vitamin Dplays an important role in the functioning of muscles. Women who have fecal incontinence are more likely to have low vitamin D levels and have greater odds of vitamin D deficiency compared to women who don't have incontinence.25

Finally, experiment with avoiding possible food triggers such as caffeine, citrus fruits, spicy foods, alcohol or dairy products to see if it helps.21

When You Gotta Go. . .

Urinary and fecal incontinence are embarrassing problems that can make you avoid social activities and lead to depression. But there are plenty of ways you can help eliminate these two problems. For urinary incontinence, special exercises, supplementation with vitamin D, horsetail (Equisetumarvense)and Crateva nurvala, physical exercise, weight loss and L-glutamine (for incontinence from radiation therapy) can all help stop untimely accidents. For fecal incontinence, vitamin D is also important as well as a psyllium fiber supplement, biofeedback and anal sphincter exercises. Avoiding certain possible trigger foods might also help.  

References:

1. Kinchen KS, et al. J Womens Health (Larchmt). 2003 Sep;12(7):687-98.

2. Grzybowska ME, et al. BMC Womens Health. 2015 Sep 30;15(1):80.

3. Nitti VW. Rev Urol. 2001;3(Suppl 1):S2-6.

4. Newman DK, et al. Curr Opin Obstet Gynecol. 2013 Oct;25(5):388-94.

5. WebMD. http://www.webmd.com/urinary-incontinence-oab/america-asks-11/pregnancy

6. Santa Mina D, et al. BMC Urol. 2015 Sep 16;15:94.

7. Tannenbaum C, Johnell K. Drugs Aging. 2014 Feb;31(2):93-101.

8. Wesnes SL. Int Urogynecol J. 2014 Jun;25(6):725-9.

9. Vissers D, et al. Obes Rev. 2014 Jul;15(7):610-7.

10. Waetjen LE, et al. Menopause. 2013 Apr;20(4):428-36.

11. Subak LL, et al. Obstet Gynecol. 2012 Aug;120(2 Pt 1):277-83.

12. Nygaard IE, Shaw JM. Am J Obstet Gynecol. 2015 Sep 5. [Epub ahead of print.]

13. Tienforti D, et al. BJU Int. 2012 Oct;110(7):1004-10.

14. Cavkaytar S, et al. Obstet Gynaecol. 2015 May;35(4):407-10.

15. Culligan PJ, et al. Int Urogynecol J. 2010 Apr;21(4):401-8.

16. Gau JT. J Am Geriatr Soc. 2010 Dec;58(12):2438-9.

17. Carneiro DM, et al. Evid Based Complement Alternat Med. 2014;2014:760683.

18. Schauss AG, et al. Reducing the symptoms of overactive bladder and urinary incontinence: results of a two-month randomized, double-blind, placebo-controlled clinical trial. 2006 (unpublished research).

19. Rocha BR, et al. Nutrition. 2011 Jul-Aug;27(7-8):809-15.

20. Bliss DZ, et al. Res Nurs Health. 2014 Oct;37(5):367-78.

21. Lee YY. Front Med (Lausanne). 2014 Mar 24;1:5.

22. Fox A, et al. FP Essent. 2014 Apr;419:35-47.

23. Rohwer K, et al. J Wound Ostomy Continence Nurs. 2013 Mar-Apr;40(2):181-4.

24. Bartlett L, et al. J Clin Gastroenterol. 2015 May-Jun;49(5):419-28.

25. Parker-Autry CY, et al. Int Urogynecol J. 2014 Nov;25(11):1483-9.

[writerkimwilkes-blog]

Five Diseases That Are Often Misdiagnosed

By Kimberly Wilkes

This article originally appeared in Whole Health Insider. 

Doctors often have to be detectives on the hunt for what is causing a given disease in a given patient. Sometimes, they're successful at finding the cause. Other times, the "thief" that stole a patient's health avoids detection. But there are some diseases that are trickier to diagnose than others. Often, these diseases hide behind symptoms that are so similar to other types of health problems they can remain undiagnosed for years.

If you've ever suffered from one of these diseases in disguise you know how frustrating it is to be in pain and either not treated with something that actually works, have your health problems dismissed altogether—or, even scarier, have your life put in danger because the disease wasn't diagnosed early enough.

Here are five diseases that are often misdiagnosed, along with strategies you can use to reduce your risk of getting them in the first place. Plus, we'll offer some suggestions on what to do once you are correctly diagnosed.

Disease in Disguise #1 - Ovarian Cancer

Among women, ovarian cancer is the fifth leading cause of cancer deaths, and is the most lethal of all the gynecologic cancers.1 Every year, more than 21,000 women in the U.S. are diagnosed with ovarian cancer, and it takes the lives of about 15,000 women.1

One of the reasons why ovarian cancer is so deadly is because women often aren't diagnosed until late in the disease. The National Ovarian Cancer Coalition reported that more than two-thirds of women were misdiagnosed by their doctors when the women first sought treatment, according to a national survey of 250 women with ovarian cancer.1In fact, almost 70 percent of the women reported that their doctor never even considered ovarian cancer as a cause of their symptoms.1

Doctors often mistake common ovarian cancer symptoms such as abdominal or pelvic pain and bloating for irritable bowel syndrome, a urinary tract infection, acid reflux or stress-related problems. Physicians also often mistake borderline ovarian tumorsas invasive ovariancancer. Borderline ovarian tumors usually don't pose as much of a threat as cancerous tumors and are cured using surgery alone. If a doctor misdiagnoses a borderline ovarian tumor, it can cause a woman to have to go through chemotherapy and radiation treatments she doesn't need.2

When Your Doctor Should Be Worried About Ovarian Cancer

If you're suffering from abdominal or pelvic pain and bloating for more than a few weeks, it's a good idea to ask your doctor for a blood test called CA-125 as well as a pelvic ultrasound. The CA-125 blood test won't tell your doctor for sure whether you have ovarian cancer. In fact, it often comes back with false positive and false negative results. But if the CA-125 test results are elevated, it's a reason for your doctor to investigate further.

Heading the Disease Off at the Pass

Of course, the best way to avoid a misdiagnosis is to avoid getting ovarian cancer to begin with. There's no guarantee that you can stop this disease, but by reducing the risk factors that you can control, it puts the odds in your favor.

Some risk factors you can'tcontrol such as older age at menopause or the fact your risk goes up as you grow older.3-4But you can do something about other factors that raise the risk of ovarian cancer. For example, high body mass index has been linked to increased risk of the disease, so losing weight may help.3Being on hormone replacement therapy (HRT) for a longer amount of time also increases the risk of ovarian cancer,3so consider looking into a more natural approach to HRT.  

The toxic chemical bisphenol-A (BPA)—found in some plastic water bottles and the lining of cans as well as in some cash register receipts and dental sealants—stimulates the growth of ovarian cancer cells in cell culture studies.5-7Wash your hands after touching cash register receipts and drink and eat out of BPA-free bottles and cans. Be certain any company that claims their product is BPA-free hasn't replaced it with an equally toxic chemical.

Another option is to eat more broccoli, cauliflower and Brussels sprouts. Diindolylmethane(DIM), a compound present in cruciferous vegetables, blocks ovarian cancer growth and angiogenesis—the process by which cancer uses new blood vessels to spread throughout the body—in animal and cell culture studies.8-9DIM also is available as a dietary supplement.

Disease in Disguise #2 - Heart Attacks in Women

Heart disease is the number one killer of women, yet it's also one of the most misdiagnosed diseases in females. When a woman visits her doctor or the emergency room complaining of heart attack symptoms, doctors often dismiss her complaints as anxiety or stress. That's because doctors tend to think of heart attacks as a man's disease due to the fact before menopause, women have a reduced risk of heart attacks compared to men. After menopause, there's a role reversal, when a woman's risk of having a heart attack is greater than a man's.10

Another reason doctors often misdiagnose heart attacks in women is because a woman's symptoms aren't always as obvious as a man's. Heart attack symptoms in women can run the gamut from symptoms you would expect such as pain or discomfort in the center of the chest to symptoms that at first glance seem unrelated to heart attacks such as pain or discomfort in the arms, back, neck, jaw, stomach or upper abdominal area as well as sudden extreme fatigue, shortness of breath, breaking out in cold sweats, nausea and light-headedness.10

Although the most common symptom in women is chest pain, women are more likely than men to experience the less obvious warning signs. In one study, chest pain, left arm pain and sweating was more common in men, while women were more likely to report nausea, jaw pain, neck pain and back pain.11 Sixty-nine percent of men having a heart attack have chest pain, but only half of all women.10

The notion that heart attacks are a man's disease can deprive women of fast and lifesaving treatment. Researchers have found that womensuffering from chest pain were less likely to be given a "priority 1" (lights and sirens) ambulance response compared to men with chest pain.12

Other researchers have discovered that female heart attack patients 55 years old and younger weren't administered electrocardiography (EKG, a test for heart attacks) or therapy to break up blood clots in a timely manner compared to men.13Delaying this therapy could increase the chance of dying from a heart attack or stroke.

It's not only doctors and healthcare workers that are to blame for the delay in treating females—many women don't seek treatment early enough. Some women wait hours or days after experiencing the signs of a heart attack before getting medical help.10

If you're a woman suffering any of the heart attack warning signs mentioned in this article seek help immediately. Resist the urge to just ignore it. And when you arrive at the emergency room insist the doctor test you with an EKG.

Decrease Your Risk of Heart Attacks

Your best bet to reduce the risk of having a heart attack in the first place is to make sure you eliminate all components of the metabolic syndrome: hypertension, abdominal fat and high triglycerides, blood sugar and cholesterol.

Exercise is, of course, an important way to reduce all those risk factors. But diet is important, too. One of the best types of diets you can adopt is a Mediterranean diet— high in fish, olive oil, nuts, red wine, whole grains, fruit and vegetables and low in red meat, sweets and dairy—especially a Mediterranean diet with a low glycemic load. Glycemic load refers to how much a particular food or meal raises your blood sugar and insulin levels. The lower the glycemic load, the healthier the food.

Eating a Mediterranean diet with a low/moderate glycemic load slashes the risk of coronary heart disease by 40 percent and the risk of death from coronary heart disease by more than 50 percent.14 You can find a list of different foods and their glycemic load on Harvard Medical School's website.

In addition to watching what you eat, adding the dietary supplement berberine into your daily routine may send the metabolic syndrome packing. In one randomized, double-blind, placebo-controlled clinical trial, berberine caused the metabolic syndrome to go into remission and decreased waist circumference, systolic blood pressure, triglycerides and insulin secretion.15

Disease in Disguise #3 – Celiac Disease

Celiac disease is an autoimmune disorder that causes damage to the small intestine when a person suffering from the disease eats gluten. In the United States, 1 in 133 people suffer from celiac disease. However, in people who are at risk for celiac disease—people who have relatives with the disorder or people who have gastrointestinal symptoms—celiac occurs much more often. One out of every 22 people who have first-degree relatives with celiac disease also have the disorder, as do one out of every 39 people who have second-degree relatives and one out of 56 people who have gastrointestinal symptoms.16  

There are probably more people who have celiac disease than estimated because 83 percent of Americans who have celiac disease don't know it.17 They either haven't been diagnosed with the disease or misdiagnosed with other conditions.

People with this disorder usually suffer for a long time before they even know they have it. On average, a person with celiac disease waits six to ten years before they're diagnosed correctly. Often doctors mistake celiac disease for irritable bowel syndrome, lactose intolerance or constipation and suggest taking laxatives or prescribe painkillers.

Since undiagnosed patients are never told to stop eating gluten, the damage continues to build up in their intestines until when they are finally diagnosed with celiac disease the harm that's been done takes longer to repair. Plus, since people with celiac disease have a hard time absorbing some nutrients, the longer it takes to diagnosis the condition, the more these nutrient deficiencies may start to inflict damage on the body outside of the GI tract. And in some cases, celiac disease can lead to osteoporosis, liver disorders and rarely to intestinal cancer.18

Part of the reason celiac disease is so hard for doctors to diagnose is that most celiac disease adult patients don't have GI symptoms—or if they do have GI symptoms they're very mild.19Only one-third of adults with celiac disease have diarrhea.20 A doctor is more likely to correctly diagnosis celiac disease when a patient has classic symptoms such as diarrhea, weight loss, fatty or foul-smelling stools, failure to thrive (in kids) and multiple vitamin deficiencies.21

Other patients can experience more silent symptoms such as anemia. Some experts believe celiac disease can have 300 possible symptoms. For example, bone and joint pain, arthritis, depression, tingling numbness in hands and feet, erratic menstrual periods and mouth sores can all signal the presence of celiac disease.20,22 To make matters even more complicated, some people with the disease have no symptoms.22

Celiac Disease Symptoms in Children and Adults

Children

  Abdominal bloating and pain

  Chronic diarrhea

  Vomiting

  Constipation

  Pale, foul-smelling, or fatty stool

  Weight loss

  Fatigue

  Irritability and behavioral issues

  Dental enamel defects of the permanent teeth

  Delayed growth and puberty

  Short stature

  Failure to thrive

  Attention Deficit Hyperactivity Disorder (ADHD)

Adults

  Unexplained iron-deficiency anemia

  Fatigue

  Bone or joint pain

  Arthritis

  Bone loss or osteoporosis

  Depression or anxiety

  Tingling numbness in the hands and feet

  Seizures or migraines

  Missed menstrual periods

  Infertility or recurrent miscarriage

  Canker sores inside the mouth

  Dermatitis herpetiformis (an itchy skin rash).

Source: Celiac Disease Foundation

Preventing Celiac Disease Symptoms

The only cure for celiac disease is to completely eliminate gluten from your diet. However, some studies have shown that the longer a child is breastfed, the lower the risk of developing celiac disease symptoms.23-24One researcher in the United Kingdom estimated that if all babies in Britain were breastfed at the time they first started eating gluten, it would prevent 2,500 cases of celiac disease per year.23

The time when parents introduce gluten into an infant's diet also is important. One study showed that exposure to gluten in the first three months of an infant's life increased the risk of celiac autoimmune symptoms by five times compared tothose exposed to gluten at four to six months. Children who ate gluten for the first time at seven months of age or older had a slightly increased risk compared to the children who ate it for the first time between four and six months.23

Unmasking Celiac Disease

If you have any of the celiac symptoms mentioned in this article, it's a good idea to talk to your doctor and suggest getting tested. This is done using a blood test to see whether you're producing celiac-related antibodies. If this test comes back positive, your doctor will then likely order a small intestine biopsy. Your doctor may also order a blood test for anemia.

If you're diagnosed with celiac, it's also a good idea to take a probiotic supplement to help heal any gluten-related damage in your intestinal tract and a high-quality multivitamin to help replenish any nutrient deficiencies.

Disease in Disguise #4 – Lyme

Lyme disease is caused when a tick infected with the bacterium Borrelia burgdorferi bites a human. There's also some evidence that an infected sexual partner can transmit Lyme. In 2013, more than 35,000 probable cases of Lyme disease were reported in the U.S. However, because Lyme is often mistaken for other diseases and because people with Lyme don't always visit a doctor, it's estimated that six to 12 times that number of people—at least 200,000—have Lyme.25

The first symptoms of Lyme disease include feeling like you have the flu with fever, chills, sweats, muscle aches, fatigue, nausea and joint pain. Bell's palsy, where part of the face becomes numb, is another symptom. Untreated Lyme can progress to a chronic form of the disease where sufferers are plagued by symptoms like persisting fatigue, muscle aches, memory problems, joint pain, arthritis and nerve pain.25

Doctors often mistake Lyme disease for chronic fatigue syndrome, fibromyalgia or depression.26One doctor, Chris Meletis, N.D., has seen two patients who were diagnosed with amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) by other doctors. When he tested them for Lyme, their results came back positive, indicating it was really Lyme that was causing their health problems. When they were treated for Lyme, their symptoms improved.

It's easy to misdiagnosis Lyme for many reasons. First, lab tests used to detect the disease can often be negative for the first four to six weeks after infection. What's more, even though 80 percent of patients with Lyme have some sort of rash,27 half or more of those patients don't have the typical bull's eyes rash normally associated with Lyme.26 And one study showed that up to 72 percent of doctors surveyed weren't able to tell the difference between a Lyme disease rash and other common rashes.27

In addition, the symptoms of Lyme disease resemble so many other conditions, that doctors often don't have Lyme on their radar.

Symptoms of Lyme Disease

Early Symptoms

• Flu-like illness (fever, chills, sweats, muscles aches, fatigue, nausea and joint pain)

• Rash

• Bell’s palsy

Later Symptoms

• Headache

• Stiff neck

• Light or sound sensitivity

• Cognitive impairment

• Sleep disturbance

• Depression, anxiety, or mood swings

• Arthritis

• Fatigue

• Abdominal pain, nausea, diarrhea

• Chest pain, palpitations

• Shortness of breath

• Tingling, burning or shooting pains

Children's Symptoms

• Headache

• Stiff neck

• Light or sound sensitivity

• Cognitive impairment

• Uncharacteristic behavior

• Inability to sustain attention

• Outbursts and mood swings

• Arthritis

• Fatigue

• Abdominal pain, nausea, diarrhea

• Chest pain, palpitations

• Shortness of breath

• Tingling, burning or shooting pains

Source: www.lymedisease.org

Testing for Lyme

Doctors use a couple tests to figure out if you have Lyme. The enzyme-linked immunosorbent assay (ELISA) test detects antibodies to B. burgdorferi. The ELISA test isn't always right and can provide false-positive results, so doctors use the Western blot test to confirm diagnosis. The Western blot detects antibodies to several proteins of B. burgdorferi.

Eliminating Lyme

Once your doctor diagnoses you with Lyme disease, he or she will probably start you on a course of antibiotics. Because antibiotics kill the good bacteria in your intestines, it's important to take a probiotic supplement during and after treatment.

Alternative practitioners may also suggest an herb called Uncaria tomentosa(Cat's claw). Many alternative doctors have used Uncaria tomentosawith success in Lyme patients. Even though there are no studies testing Uncaria tomentosaon the Borrelia burgdorferi bacterium, many cell culture studies show it can inhibit other forms of bacteria including Streptococcus mutans, Staphylococcus spp.and Enterobacteriaceae.28 In animals, Uncaria tomentosastrengthens the immune system and acts as an anti-inflammatory.29It works the same in humans.29

Diseases in Disguise #5 – Hypothyroidism

In hypothyroidism, the thyroid is sluggish—it doesn't produce enough thyroid hormone. According to the Cleveland Clinic, hypothyroidism occurs in 4.6 percent of U.S. adults—more often in people who are older.30

However, many alternative doctors believe that the prevalence of hypothyroidism is really more like 40 percent of U.S. adults since conventional medical tests are often unable to accurately diagnose the disease and hypothyroidism is so often mistaken for other conditions.31

Doctors often misdiagnosis hypothyroidism because its symptoms mirror those of other diseases. The most common symptoms of hypothyroidism include depression, fatigue, weight gain, high cholesterol, feeling cold and brain fog. But other symptoms can also serve as a hypothyroidism red flag including mania, hyperactivity, anxiety, a pounding heart, constipation, dry skin, thinning hair, muscle aches and weakness, heavy or irregular periods and insomnia.32

Testing for Hypothyroidism

A thyroid stimulating hormone (TSH) test is used to diagnosis hypothyroidism. Doctors disagree on what the ideal numbers are for this test. According to the latest recommendations from the American Association of Clinical Endocrinologists, the recommended reference range for TSH is from 0.3 to 3.0. But some labs and doctors don't follow these recommendations. Some doctors say anything above a TSH level of 5 or 10 indicates hypothyroidism while other doctors and some scientific papers indicate anything above 1.3 to 1.8 means your thyroid is sluggish.32,33 Conventional doctors tend to treat the numbers whereas alternative doctors gauge how a patient feels to determine the approach for treatment.

Giving Your Thyroid a Boost

Before treating a sluggish thyroid, it's important to pay attention to adrenal health. Increasing thyroid gland activity can burden the adrenals if they're not working properly. You can work with your doctor to get a salivary adrenal hormone panel to measure your levels of cortisol throughout the day. Cortisol, the stress hormone, is produced by the adrenal glands and levels that are too high or too low can indicate adrenal problems.  

Once your adrenals are repaired, focus on your thyroid. An iodine deficiency test can determine if you're low in this mineral, which is important to the thyroid gland. If the test warrants, supplement with a combination of iodide/iodine. If your thyroid needs more help, work with a doctor who may prescribe a thyroid hormone medication.

Mystery Solved

It's not always easy for a doctor to pinpoint the cause of your symptoms. Hopefully, after reading this article you'll be armed with the knowledge to start a discussion with your healthcare provider that will put you one step closer to solving the cause of your distress.

References

1. National Ovarian Cancer Coalition. http://www.ovarian.org/view_pr.php?id=28

2. Kommoss S, et al. Int J Gynecol Cancer. 2013 Oct;23(8):1376-82.

3. Li K, et al. Br J Cancer. 2015 Mar 5. [Epub ahead of print.]

4. Keng SL, et al. Asian Pac J Cancer Prev. 2015;16(2):537-40.

5. Ptak A, et al. Toxicol Lett. 2014 Sep 2;229(2):357-65.

6. Fenichel P, et al. Ann Endocrinol (Paris). 2013 Jul;74(3):211-20.

7. Hall JM and Korach KS.Mol Carcinog. 2013 Sep;52(9):715-25.

8. Kandala PK and Srivastava SK. Curr Drug Targets. 2012 Dec;13(14):1869-75.

9. Kandala PK and Srivastava SK. J Biol Chem. 2012 Aug 17;287(34):28745-54.

10. Jackson MN and McCulloch BJ. Rural Remote Health. 2014;14:2560.

11. Arslanian-Engoren C, et al. Am J Cardiol. 2006Nov 1;98(9):1177-81.

12. Coventry LL, et al. Prehosp Emerg Care. 2013 Apr-Jun;17(2):193-202.

13. Pelletier R, et al. CMAJ. 2014 Apr 15;186(7):497-504.

14. Turati F, et al. Nutr Metab Cardiovasc Dis. 2015 Mar;25(3):336-42.

15. Pérez-Rubio KG, et al. Metab Syndr Relat Disord. 2013 Oct;11(5):366-9.

16. Fasano A, et al. Arch Intern Med. 2003 Feb 10;163(3):286-92.

17. National Foundation for Celiac Awareness. http://www.celiaccentral.org/celiac-disease/facts-and-figures/

18. WebMD. http://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease-symptoms?page=2

19. Mohammad Rostami Nejad, et al. Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):102-8.

20. WebMD. http://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease-symptoms

21. Katz KD, et al. Am J Gastroenterol. 2011 Jul;106(7):1333-9.

22. Celiac Disease Foundation. http://celiac.org/celiac-disease/symptoms/

23. Silano M, et al. World J Gastroenterol. 2010 Apr 28;16(16):1939-42.

24. Akobeng AK, et al. Arch Dis Child. 2006Jan;91(1):39-43.

25. Aucott JN, et al. Qual Life Res. 2013 Feb; 22(1):75-84.

26. Donta ST. Open Neurol J. 2012;6:140-5.

27. Aucott JN, et al. Dermatol Res Pract. 2012 Oct 24;451727.

28. Ccahuana-Vasquez RA, et al. Braz Oral Res. 2007 Jan-Mar;21(1):46-50.

29.  Lamm S, et al. Phytomedicine. 2001 Jul;8(4):267-74.

30. The Cleveland Clinic. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/hypothyroidism-and-hyperthyroidism/Default.htm

31. Dr. Surikov's website. http://www.drsurikov.com/thyroid-adrenal-issues

32. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/symptoms/con-20021179

33. Gursoy A, et al. Int J Clin Pract. 2006 Jun;60(6):655-9.

[writerkimwilkes-blog]

The Surprising Health Benefits of Pets

Photo By Patrick Wilkes

By Kimberly Wilkes

This article originally appeared in Whole Health Insider

If you're trying to heal or prevent a health problem, turns out one of the most effective therapies is likely sitting at your feet or in your lap or is snoozing a stone's throw away.  I'm talking about your pets. You probably always knew that petting your dog or cat is soothing. But did you know it could save your life, too?

As far back as 1860, Florence Nightingale noticed "a small pet is often an excellent companion for the sick, for long chronic cases especially.” However, having a furry friend at your side can give you more than companionship. If you're one of the 68 percent of North Americans who live with a pet, you'll be glad to know that caring for a pet also can reduce your risk of developing certain health conditions and lower your chances of dying from other diseases.

What's more, people who have pets visit their primary care practitioners less frequently than people without pets.1 And researchers at the University of Pennsylvania Veterinary Hospital discovered that people who own pets report a large reduction in minor health problems and significant improvements in psychological well-being in the first month after acquiring their feline friend or canine companion.2

Pets are like a medicine cabinet on paws. Only instead of doling out pills, they provide less tangible benefits for both your emotional and physical health. Read on to discover all the ways your pets make you healthier.

Giving Your Emotional Health A Boost

Pets are uplifting for both children and adults. For example, pets help children develop social skills.3 Children who live with both a dog and cat also have greater empathy, self-esteem, cognitive development and participation in social and athletic pursuits.3,4 Kids with pets also have increased trust, a feeling of community, more self-confidence and feel safer.5

In adults and children, when there is an illness or death in the family, pets help family members cope and recover.3Pets also provide support and stability in military families when a family member is being relocated.3

Pets Are Good for the Heart

Many studies have found that owning a pet is linked to a reduction of cardiovascular disease risk factors. One study in Australia of 5,741 subjects found that pet owners had significantly lower systolic blood pressure and triglycerides compared with non-owners. Men who owned pets had significantly lower systolic but not diastolic blood pressure compared with people who did not own pets as well as significantly lower triglyceride and cholesterol levels. In women older than 40, systolic but not diastolic pressure was significantly lower in pet owners. Triglycerides also tended to be low in these women. Both the pet owners and non-pet owners had similar body mass indexes, so body weight did not account for the lower blood pressure in pet owners.6

Another study looked at 240 married couples experiencing psychological and physical stress. Some of the couples had pet dogs or cats others did not. The study found that couples with pets had significantly lower heart rate and blood pressure levels during the beginning of the study, significantly smaller increases in blood pressure after exposure to a stressful experience and faster recovery after the stressful experience.7

Most surprising of all, in a randomized, controlled study, owning a pet was more effective at lowering blood pressure in response to mental stress than an ACE-inhibitor drug.8

Most studies showing that pet ownership is good for the heart when you're under stress used dogs or cats. But some studies found that even owning a goat, fish,chimpanzee or snake could be equally good for the heart after exposure to stress.9Plus, when cardiac patients named and fed their fish, they experienced a sense of delight.2There was even one study where virtual animals seen in video recordings achieved the same effect on cardiovascular stress responses as live animals.10

Owning a Pet Can Save Your Life

In people who have cardiovascular disease, having a pet decreases the risk of dying. In a study of 369 subjects who had a heart attack and later suffered from abnormal heart rhythm, people who owned a pet of any kind were more likely to be alive one year after their heart attack. The strongest association with decreased mortality was among dog owners. And cardiovascular patients who didn't own a dog were about four times more likely to die compared to dog owners.11  

Not all studies have shown that spending time with a feline friend has the same heart healthy benefits as canine companionship. But one study of 2,435 current or previous cat owners found that cat ownership was linked to a lower risk of death from a heart attack as well as a lower risk of death from cardiovascular diseases as a whole. On the other hand, subjects without cats had an increasedrisk of death from cardiovascular diseases. This was true even after controlling for age, gender, ethnicity/race, systolic blood pressure, cigarette smoking, diabetes, cholesterol and body mass index.12

Dogs Force You to Exercise

In addition to reducing stress, one of the reasons why dogs are heart healthy is because they motivate their owners to take frequent walks.Walking a dog can help you lose weight or maintain a healthy body weight. Dog owners who walk their dogs are more likely to maintain weight loss over a year.13

Researchers estimate that if adults participated in 60 minutes of physical activity daily, it would eliminated 33 percent of all coronary-heart disease related deaths, 25 percent of stroke-related deaths, 20 percent of deaths related to type 2 diabetes and 20 percent of hypertension-related deaths.14

People who have dogs are more likely to exercise compared to people who don't own dogs.15 One study found that dog owners spent 322 minutes per week engaged in physical activity compared to only 267 minutes in non-owners.16Dog owners were 57 percent more likely to participate in the recommended level of physical activity compared to people who didn't own a dog.16 In addition, children who have dogs spend more time participating in physical activity and take more steps per day compared to kids who don't have a canine companion.17  

Soothing Anxiety

According to the Anxiety and Depression Association of America, approximately 40 million adults in the United States suffer from an anxiety disorder.18 Interacting with pets can do a world of good for people who suffer from anxiety. Spending time with pets switches the focus of anxious people away from themselves, making them less anxious and more motivated to interact with other people..3

The reason why pets calm anxiety may have to do with the hormone oxytocin, which helps you bond emotionally with your significant other. It also decreases stress, blood pressure, anxiety, and depression and increases social interaction, self-confidence, memory, and learning. Research shows that spending time with pets activates the oxytocin system.19 What's more, dog owners experience a spike in their oxytocin levels when their pets gaze at them.20 Even a single interaction with a pet triggers oxytocin release, but the effect is strongest and lasts longer with close interactions and the more time you spend with your pet.19

Anti-Stress Effects

Another way that pets reduce anxiety is by influencing levels of the stress hormone cortisol. In one study of 48 subjects, researchers investigated how stress affected cortisol levels and heart rate by assigning the subjects a human friend, a dog or a control. The researchers then exposed the subjects to stressful situations. The people who were paired with a pooch during the stressful experiences had lower cortisol levels and heart rate compared to the people who were paired with a human friend or a control.21                        

A Boost To Your Immunity

Another possible benefit of having a pet is a stronger immune system. There's some evidence that petting a dog can increase levels of secretory immunoglobulin A, which is secreted by mucous membranes of the body and protects against the entry of viruses, bacteria and other foreign contaminants.22

When some kids are exposed to pets early in life—under the age of one—it can help strengthen the development of their immune system and reduce the chances of their developing allergies and asthma.23 However, one study found this was only true in children whose families did not have a history of eczema. In children from families with a history of eczema, dog exposure at birth was linked to a higherprevalence of asthma and eczema in two-year-old children.24

Lowering Your Risk of Cancer

Having a pet may protect you against certain types of cancers. Pet owners have a reduced risk of non-Hodgkin lymphoma (NHL)—a cancer of the immune cells known as lymphocytes—compared to people who never owned a pet. The longer people owned a cat or dog, the lower their risk of developing NHL.25 In another study, having a dog or cat in early childhood was associated with a reduced risk of developing thyroid cancer later in life.26 Regular contact with petsalso is linked to a reduced risk of childhood acute lymphoblastic leukemia, probably because exposure to pets at an early age stimulates the immune system.27

Some studies have found that birds may have the opposite effect—they might raisethe risk of developing lung cancer,especially in people under 65 years old.28-30But not all studies have confirmed the pet bird/lung cancer link. One group of researchers could not find a link between having a pet parakeet, canary, finch or parrot and an increased risk for lung cancer.31

Pets Provide Pain Relief

Because of all the research pouring in about the benefits of owning pets, hospitals and out patient clinics are using animals more often to help people who have many different health concerns. In one study, researchers divided fibromyalgia patients in an outpatient clinic into a group that spent time with a therapy dog while waiting for their appointment and another group that served as a control that didn't spend time with a dog. Fibromyalgia patients who spent time with the dog experienced significant pain relief and improvements in mood and other measures of distress. In the patients who spent time with a canine companion, 34 percent experienced significant pain relief, while only 4 percent of the controls experienced relief.32

In an earlier study, chronic pain patients experienced a significant improvement in pain, fatigue, stress and mood after a therapy dog visit compared to chronic pain patients who didn't spend time with a dog. Even the family and friends accompanying patients to appointments and the clinic staff showed reduced emotional distress and improved feelings of well-being after spending time around the dogs.33

Animal-Assisted Therapy in Dementia and Other Diseases

In a handful of studies, dementia patients who spent time with a dog experienced reduced aggression and agitation and were more likely to have improved social behavior.34And in one small study, the presence of aquariums in the dining rooms of dementia care units stimulated the appetites of residents and caused them to gain weight.34

Animal-assisted therapy can benefit people with other diseases, too. Dog therapy can help patients recovering from surgery as well as people with pervasive developmental disorders, cerebral palsy, speech disorders, cardiovascular disease, depression, schizophrenia, cancer, and spinal cord injuries, as well as people living in rehabilitation facilities and nursing homes.32,35, 36

Health Risks from Pets

Overall, having a pet is one of the best things you can do for your health. However, there are some diseases you can catch from your pet, so it's a good idea to take certain precautions.

Of infectious diseases affecting humans, 61 percent are of animal origin.For example, turtles can carry Salmonella. Other animal-transmitted diseases include ringworm (dermatophytosis), toxocariasis and avian psittacosis.3The most common source of ringworm in humans is infected cats. In fact, a doctor may not make the connection between a patient's recurrent ringworm and a pet's infection.3

Toxoplasmosis, which can cause severe and fatal disease in fetuses and people with weak immune systems, can be transmitted by cats, but is just as likely to infect people who consume contaminated food or touch contaminated soil while gardening.3Because of toxoplasmosis and ringworm, wear gloves when cleaning your cat's litter box. And make sure your pets are vaccinated against rabies.

Pets also can transmit intestinal parasites to their human owners.3So take your dog and cat to the veterinarian for regular deworming.

Your Health's Best Friend

Having a pet—especially a dog or a cat—can help you stay healthy. Pets can boost your mood, reduce your risk of heart disease, help you lose weight and keep it off and even reduce your risk of certain types of cancer.  In the case of heart disease, dogs and cats can even save your life, suggesting that one of the best medicines for any disease is to spend time with the furriest members of your family.

References:

1. McNicholasJ, et al. BMJ2005;331:1252

2. Halm MA. Am J Crit Care.July 2008;17(4):373-6.

3. Hodgson K, et al. J Am Board Fam Med.July-August 2015;28(4):526-34.

4. Daly B, Morton LL. Anthrozoos. 2006;19:113-27.

5. Smith B. Aust Fam Physician. 2012 Jun;41(6):439-42.

6. Anderson WP, et al. Med J Aust. 1992 Sep 7;157(5):298-301.

7. Allen K, et al. Psychosom Med. 2002 Sep-Oct;64(5):727-39.

8. Allen K, et al. Hypertension. 2001;38:815-20.

9. Levine GN, et al. Circulation.2013;127:2353-63.

10. Wells DL. Stress Health. 2005;21:209-13.

11. Friedmann E, Thomas SA. Am J Cardiol. 1995 Dec 15;76(17):1213-7.

12. Qureshi AI, et al. J Vasc Interv Neurol. 2009 Jan; 2(1):132-5.

13. Kushner RF, et al. Obesity (Silver Spring) 2006 Oct;14(10):1762-70.

14.Warburton DER, et al.  Can J Public Health. 2007;98(Suppl):S16-68.

15. Hoerster KD, et al. Prev Med. 2011 Jan;52(1):33-8.

16. Cutt H, et al. Am J Public Health. 2008 Jan;98(1):66-9.

17. Owen CG, et al. Am J Public Health. 2010 Sep;100(9):1669-71.

18. Anxiety and Depression Association of America. http://www.adaa.org/about-adaa/press-room/facts-statistics

19. Beetz A, et al. Front Psychol. 2012 Jul 9;3:234.

20. Nagasawa M, et al. Horm Behav. 2009 Mar;55(3):434-41.

21. Polheber JP, Matchock RL. J Behav Med. 2014 Oct;37(5):860-7.

22. Charnetski CJ, et al. Psychol Rep. 2004 Dec;95(3 Pt 2):1087-91.

23. Smith B. Aust Fam Physician. 2012 Jun;41(6):439-42.

24. Pohlabeln H, et al.  J Investig Allergol Clin Immunol. 2007;17(5):302-8.

25. Tranah GJ, et al. Cancer Epidemiol Biomarkers Prev. 2008 Sep;17(9):2382-7.

26. Clarke CA, et al.  Cancer Epidemiol. 2015 Aug;39(4):548-53.

27. Ajrouche R, et al.  Br J Cancer. 2015 Mar 17;112(6):1017-26.

28. Holst PA, et al. BMJ. 1988 Nov 19;297(6659):1319-21.

29. Holst PA. BMJ. 1997 May 3;314(7090):1353.

30. Jöckel KH, et al. Lung Cancer. 2002 Jul;37(1):29-34.

31. Morabia A, et al. Br J Cancer. 1998;77(3):501-4.

32. Marcus DA, et al. Pain Med. 2013 Jan;14(1):43-51.

33. Marcus DA, et al. Pain Med. 2012 Jan;13(1):45-57.

34. Filan SL, Llewellyn-Jones RH. Int Psychogeriatr. 2006 Dec;18(4):597-611.

35. Knisely JS, et al. US Army Med Dep J. 2012 Apr-Jun:30-7.

36. Marcus DA. Curr Pain Headache Rep. 2012 Aug;16(4):289-91.

[writerkimwilkes-blog]

Taking The Chill Out Of Raynaud’s Disease

By Kimberly Wilkes

Raynaud's (pronounced ray-nodes) isn't a disease you hear about very often. Yet, an estimated 28 million people in the U.S.—including 20 percent of all women in their childbearing years—have Raynaud's phenomenon, or Raynaud's syndrome as it's also called. What's more, four out of five people who have the disease suffer without getting medical help for the condition.1

What exactly is Raynaud's phenomenon, who is at risk and how can you reduce the symptoms naturally? Read on to find out.

The Big Chill

Named for a French physician Maurice Raynaud, who first identified the disease in 1862 while he was still a medical student, Raynaud's leaves anyone afflicted with the disorder extremely sensitive to cold temperatures.2 During a Raynaud's attack, smaller arteries that deliver blood to your fingers and toes—and in some cases other areas such as the nose, ears and tongue—narrow when exposed to cold temperatures or emotional stress.3These spasms in the blood vessels decrease circulation. Often, the skin turns white, then blue, then bright red. It's usually painful, too, and a Raynaud's episode also may include numbness, swelling or tingling. Holding a cold drink, reaching into the freezer, stepping into an air-conditioned room or going outside on a cold day all can trigger the attacks, which last anywhere from minutes to hours.  

If you have this disease, you can blame the pain and color changes in your skin on a malfunctioning autonomic nervous system. This part of the nervous system oversees bodily functions that you don't consciously control such as breathing, heartbeat and digestion. When the autonomic nervous system isn't working properly, it directs the blood vessels in affected areas such as the fingers and/or toes to constrict, starving those areas of blood supply. Blood delivers oxygen to tissues, so without the proper blood supply, tissues can undergo damage and in severe cases develop gangrene. Over the years, the small arteries feeding your hands, feet, nose and ears may thicken as they pay the price of the ongoing spasms. Not as much blood can flow through these thickened arteries.4

Who's At Risk?

There are two types of Raynaud's syndrome: primary and secondary. The most common form, primary Raynaud's is not associated with any other diseases. Secondary Raynaud's occurs along with other diseases, often autoimmune diseases such as scleroderma, lupus and rheumatoid arthritis. Secondary Raynaud's is usually a more severe form of the disease than primary, has worse symptoms, is more likely to cause tissue damage, and is less likely to respond to treatment.5However, even the primary form can be disabling in some people.6The primary form also usually affects all fingers, whereas in the secondary form only some fingers might suffer from the vessel spasms.7

Risk factors for Raynaud's are different for each form. Women are more likely to develop primary Raynaud's compared to men. Primary Raynaud's also usually develops in people aged 15 to 30 years old, although it can arise at any age. If you live in a colder climate or have a history of the disease your risk also goes up.8

Having an autoimmune disease such as scleroderma, lupus or rheumatoid arthritis is a risk factor for secondary Raynaud's. Unlike primary Raynaud's, secondary most often develops at a more advanced age, usually around 40 years old. If you have a job where you operate tools or machinery that vibrate such as tipping hammers, jackhammers, chain saws and machinery such as tractors, power shovels and bulldozers you're at a greater risk of developing the secondary form of the disease.9Ditto for any activity you perform regularly at home that involves repetitive movements such as typing or playing the piano. People who have carpel tunnel syndrome also are more susceptible.4

In people older than 60, secondary Raynaud's syndrome is often caused by atherosclerosis obstructing the arteries.3 Other arterial disorders such as Buerger's disease, caused by inflammation of the blood vessels of the hands and feet, and pulmonary hypertension, which impacts the arteries of the lungs, are also associated with secondary Raynaud's.4

In addition, certain drugs are linked to secondary Raynaud's including the drug OROS-methylphenidate used for attention deficit hyperactivity disorder (ADHD),10beta-blockers for high blood pressure, migraine medications containing ergotamine or sumatriptan, some chemotherapy drugs and over-the-counter cold medications that narrow blood vessels.4

Finally, other risk factors include smoking, which narrows blood vessels, hand or foot trauma including wrist fractures, surgery or frostbite, hemodialysis for kidney disease and exposure to certain chemicals such as vinyl chloride, a common environmental pollutant.4,11

The Homocysteine Connection

High levels of the amino acid homocysteine are linked to a number of health concerns, including cardiovascular disease, Alzheimer's, diabetes and osteoporosis. And now you can add Raynaud's to that list. Levels of this amino acid are typically high in both primary and secondary Raynaud's, even in teenage patients with the disease.12-17

Homocysteine injures the blood vessels in part by producing damaging free radicals, so researchers believe it could play a role in the development of Raynaud's. It also causes blood cells to clump together, interfering with circulation.18

Conventional Treatments

Simply dressing warmer during cold weather, and bundling up the feet and hands in warm socks and gloves is often enough for mild forms of Raynaud's. Conventional doctors will usually treat more severe cases by prescribing the class of blood pressure medications known as calcium channel blockers. These drugs act as vasodilators—in other words, they dilate the blood vessels. However, they can cause side effects such as rapid heartbeat, headaches, dizziness, fatigue, nausea, constipation and swelling in the feet and lower legs.19 Calcium channel blockers are also linked to lesions in the esophagus and gastrointestinal reflux disease (GERD).20

Conventional doctors also may prescribe drugs like prazosin (Minipress®) and doxazosin (Cardura®), which belong to a class of blood pressure medications known as alpha-adrenergicblockers. These drugs help dilate the blood vessels by blocking the action of norepinephrine, a blood-vessel-constricting hormone. However, this class of drugs also has its own share of side effects such as nausea, dizziness, headache, heart palpitations and low blood pressure.7 Another class of blood-vessel-dilating drugs are called prostaglandins. But higher doses can cause headaches, flushing and nausea.7For skin ulcers, nitroglycerin cream is used topically on the base of the fingers. In some people, the cream can cause dizziness, flushing, slow heartbeat, chest pain and fainting.21

In some cases, doctors recommend surgery to remove the nerves around the blood vessels. But this surgery doesn't work for everybody.22  Doctors also may inject anesthetics or Botox into the hands or feet to block the activation of nerves in those areas. This comes with its own set of side effects including swelling or bruising at the injection site, headaches or flu-like symptoms and the possibility that the toxin in the medication may spread to other areas of the body leading to symptoms similar to botulism such as muscle weakness, trouble speaking or swallowing, difficulty breathing and inability to control the bladder.22,23

Natural Support for Raynaud's

If you prefer natural options, there are a number of ways you can improve your circulation and keep yourself warm. Here are some suggestions, based on research and what alternative and integrative doctors have found helpful in their practices.

Circulation-Boosting Socks

The first step is to keep your feet warm. Incredisocks are a special type of foot covering invented by a chiropractor. Incredisocks work as thermoregulators to increase or decrease temperature in the feet. They also improve blood flow, feeding the tissues with enhanced oxygen.24This not only results in greater comfort and reduced swelling in people who are concerned about circulation, it also results in healthier skin tone and color in oxygen-deprived areas.

Incredisocks are made with a blend of bamboo charcoal, used in traditional Chinese medicine to improve circulation, and germanium, which has a long history of use in Japan to support healthy blood flow. When this combination is heated by the body anions are released.  An anion is an ion with more negatively charged electrons than positively charged protons, resulting in a net negative charge. These anions increase blood flow and nourish tissues with oxygen—the same process that occurs when a physical therapist uses infrared on an injured knee or body part. Although infrared exposes injured areas to negative ions for only a short time, the circulation socks constantly bathe the feet in these beneficial anions for as long as the socks are worn.

The improved circulation that occurs after anions are generated results in more oxygen being supplied to local tissues. Combined with the increase in blood flow, this allows the body to regulate temperature much easier. Thermographic image testing comparing regular socks to Incredisocks shows that the maximum area temperature of feet not wearing Incredisock was 29.4 degrees while the maximum area temperature of feet wearing Incredisock was 32.6 degrees.25

Acupuncture

There's a mixed bag of research on whether or not acupuncture can help people with Raynaud's. But one study indicates it's something worth looking into to see if it works for you. The controlled, randomized study investigated the effects of acupuncture on patients with primary Raynaud's syndrome for 23 weeks in winter. Seventeen patients were given seven acupuncture treatments during weeks 10 and 11 of the study and compared to 16 controls. Throughout the study, subjects noted in a diary every day whether they had experienced an attack, how long the attack lasted and how severe it was. In the acupuncture-treated subjects, there was a significant drop in the number of attacks experienced per day. The patients undergoing acupuncture also experienced other improvements in their blood flow.26

The study authors concluded, "These findings suggest that traditional Chinese acupuncture is a reasonable alternative in treating patients with primary Raynaud'ssyndrome."

Control Your Stress

Relaxation techniques can help Raynaud's patients chill out in more ways than one. Stress can trigger Raynaud's attacks so it's a good idea to find ways to cope with stress. One option is biofeedback, a mind-body technique that shows you how to control your autonomic nervous system. One randomized study investigated biofeedback in patients who had secondary Raynaud's together with systemic sclerosis. Eight Raynaud's patients participated in biofeedback three times a week for four weeks and experienced reduced scores for disease severity.27

In one review of the medical literature, scientists concluded that thermal biofeedback is effective in reducing the severity and frequency of Raynaud's attacks. The scientists came to this conclusion after reviewing a number of studies, including three randomized controlled trials performed in independent laboratories.28

Basically, anything you can do to reduce or manage your stress, including meditation, not pushing yourself too hard at work or deep-breathing exercises can help keep the Raynaud's attacks at bay.

Hyperbaric Oxygen

In this type of therapy, patients inhale oxygen while in a chamber. Because the tissues of Raynaud's patients are starved of oxygen, it makes sense that a therapy that can boost oxygen levels may reduce symptoms.29,30In one study, researchers treated six women between the ages of 46 and 71 with two, two-hour daily sessions of hyperbaric oxygen for 10 to 14 days. The hyperbaric oxygen not only improved the Raynaud's symptoms—the improvement lasted for more than a month after the treatments ended.30 Alternative practitioners report good success using this type of therapy.

A Circulation-Boosting Botanical

If you want to use nutritional supplements to improve circulation, one of your best bets is Ginkgo biloba, which supports healthy blood flow. A couple of trials show it may help people who have Raynaud's. In one of those studies, even though Ginkgo wasn't as effective as a standard drug, when researchers gave Ginkgo to primary Raynaud's patients for eight weeks, 31 percent of the patients improved.31

In another study, researchers randomly assigned primary Raynaud's patients to receive either Ginkgo bilobaextract or a placebo for 10 weeks. Both before and during the study, the subjects recorded how often the attacks occurred, their severity and how long they lasted. Subjects taking the Ginkgo experienced significantly less attacks down from an average of 13.2 per week to 5.8 per week. There were 56 percent less attacks in ginkgo group and only 27 percent less in the placebo group.32

Homocysteine-Lowering Vitamins

As mentioned earlier in this article, high homocysteine levels are linked to Raynaud's. When your body is deficient in folate, vitamin B12 and vitamin B6, it's not able to easily breakdown homocysteine, leading to high levels of this amino acid. People who have primary Raynaud's syndrome have lower levels of folate.13

To keep homocysteine from building up in the body, it's a good idea to take a good B-complex vitamin, ideally one that contains 5-MTHF, a more bioavailable form of the vitamin.

Help from the Sea

Fish oil protects the blood vessels of Raynaud's patients against low oxygen. In one double-blind, placebo-controlled study in 32 patients with primary or secondary Raynaud's, researchers gave subjects every day either an olive oil placebo or 12 fish oil capsules, which contained a total of 3.96 g eicosapentaenoic acid (EPA) and 2.64 g docosahexaenoic acid (DHA). The researchers evaluated the effects of the fish oil at six, 12 and 17 weeks by measuring the systolic blood pressures and blood flow in the fingers of the subjects at room temperature and in cold water baths. The study authors also timed how long it took for the patients to have a Raynaud's attack after exposure to the cold water.

In the fish oil group, it took longer to have a Raynaud's attack. Prior to supplementing with the fish oil, it took about 31.3 minutes for the subjects to have an attack. After taking the fish oil for six weeks, that time increased to 46.5 minutes. Subjects with the primary form of the disease who took fish oil capsules had the largest increase in the amount of time to an attack compared to patients with the secondary form. In fact, five of 11 patients with primary Raynaud's who took the fish oil capsules no longer had Raynaud's attacks beginning at six or 12 weeks into the study compared to 1 of 9 patients in the olive oil group.33

According to the study authors, "We conclude that the ingestion of fish oil improves tolerance to cold exposure and delays the onset of vasospasm in patients with primary, but not secondary, Raynaud'sphenomenon."

New Use for the Sunshine Vitamin

Vitamin D is another nutrient no Raynaud's patient may want to do without. Researchers have found many Raynaud's patients suffer from vitamin D deficiency. What's more, supplementing with this vitamin may actually improve symptoms. A recent randomized, placebo-controlled study investigated the effects of giving Raynaud's patients 600,000 IU of vitamin D3 per month for two months in the winter. The researchers randomly divided 42 patients deficient in vitamin D into two groups. One group received the vitamin D, the other group received a placebo. The patients receiving the vitamin D3 experienced an increase in their vitamin D levels and an improvement in their Raynaud's symptoms.34

Adding to the evidence that vitamin D deficiency may play a role in Raynaud's is the finding that as many as 80 percent of people with systemic sclerosis are deficient in Vitamin D.35

Raising Nitric Oxide

Nitric oxide is one of the chemicals in your body responsible for dilating blood vessels. However, in secondary Raynaud's, nitric oxide levels are low.7

When trying to boost nitric oxide levels, one good choice is the supplement L-arginine. A couple of medical journal articles have reported upon L-arginine's benefits in people who have secondary Raynaud's. One group of researchers reported uponfour cases in which  L-arginine supplementsimproved symptoms in patients with severe Raynaud's, including reversing the death of tissue.36

In another study, patients with secondary Raynaud's who also had systemic sclerosis, experienced several improvements after taking L-arginine including increased dilation of the blood vessels in their fingers and higher levels of tissue-type plasminogen activator, a protein that helps break down blood clots.37  

Boost Circulation, Warm Your Cold Hands and Feet

Improving blood flow and lowering emotional stress—or finding effective ways to cope with it—can reduce the number of Raynaud's attacks. Acupuncture, biofeedback and hyperbaric oxygen therapy may all help replenish oxygen-starved tissues while certain botanicals, vitamins and nutrients can give your blood vessels a helping hand.  

Originally published in Whole Health Insider.

References:

1. Raynaud's Association. www.raynauds.org

2. Bakst R, et al. J Am Acad Dermatol. 2008 Oct;59(4):633-53.

3. Belch JJ, Ho M. Drugs. 1996 Nov;52(5):682-95.

4. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/causes/con-20022916

5. Herrick A. Curr Treat Options Cardiovasc Med. 2008 Apr;10(2):146-55.

6. Sprynger M. Rev Med Liege. 2004 Jun;59(6):378-84.

7. Baumhäkel M, Böhm M. Vasc Health Risk Manag. 2010 Apr 15;6:207-14.

8. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/risk-factors/con-20022916

9. Matoba T. Ind Health. 2015;53(6):522-32.

10. Bayram Ö, Hergüner S. J Child Adolesc Psychopharmacol. 2015 Aug;25(6):521-2.

11. Czupryniak A, et al. Kidney Blood Press Res. 2005;28(1):27-31.

12. Lazzerini PE, et al. Autoimmun Rev. 2010 Jan;9(3):181-7.

13. Levy Y, et al. J Rheumatol. 1999Nov;26(11):2383-5.

14. Danese S, et al. J Rheumatol.2000Aug;27(8):2051.

15. Vayá A, et al. Clin Hemorheol Microcirc. 2014;56(2):153-9.

16. Cheng TT, Chiu CK. Clin Rheumatol. 2002 Jun;21(3):251-4.

17. Kutilek S, et al. Rev Bras Reumatol. 2012 Jan-Feb;52(1):128-30.

18. Stanger O, et al. Clin Chem Lab Med. 2003Nov;41(11):1392-403.

19. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/calcium-channel-blockers/art-20047605?pg=2

20. No authors listed. Prescrire Int. 2015 Sep;24(163):210-1, 213.

21. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682346.html  

22. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/treatment/con-20022916

23. Mayo Clinic. http://www.mayoclinic.org/tests-procedures/botox/basics/risks/prc-20009036

24. The test of acceleration in blood circulation by Taiwan Textile Research Institute tells that the speed of blood flowing increases above 50 percent. <The authentication No: FK991116-00.IMG, TFF4G123, TFF4K288>

25.  Tested 4/22/2010 Thermal Imaging Consultants LLC, Reno Nevada <Taiwan Textile Research Authentication: Fk99116-00, TFF4G123, TFF4K288)>

26. Appiah R, et al. J Intern Med. 1997 Feb;241(2):119-24.

27. Sporbeck B, et al. Rheumatol Int. 2012 May;32(5):1469-73.

28. Karavidas MK, et al. Appl Psychophysiol Biofeedback. 2006 Sep;31(3):203-16.

29. Ratner GL, Slutsker GE. Fiziol Zh. 1991 Jul-Aug;37(4):123-7.

30. Dowling GB, et al. Proc R Soc Med. 1967 Dec;60(12):1268-9.

31. Choi WS, et al. Clin Rheumatol. 2009 May;28(5):553-9.

32. Muir AH, et al. Vasc Med. 2002;7(4):265-7.

33. DiGiacomo RA, et al. Am J Med. 1989 Feb;86(2):158-64.

34. Hélou J, et al. Rheumatol Int. 2013 Mar;33(3):751-5.

35. Viswanath V, et al. Indian J Dermatol. 2013 Jul;58(4):255-68.

36. Rembold CM, Ayers CR. Mol Cell Biochem. 2003 Feb;244(1-2):139-41.

37. Agostoni A, et al. Int J Clin Lab Res. 1991;21(2):202-3.