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Neuroplasticty ‘Rewire Your Brain’



Neuroplasticity or brain plasticity refers to the brain’s ability to modify, change, and adapt both structure and function throughout life and in response to experience. 

Canadian psychiatrist Norman Doidge has called neuroplasticity one of the most extraordinary discoveries of the twentieth century.

The brain is plastic throughout life – it is constantly changing. 

Changes associated with learning occur mostly at the level of the connections between neurons – new connections can form, and the internal structure of the existing synapses can change. 

New neurons are constantly being born, particularly in the learning and memory centers. 

When you become an expert in a specific domain, the areas in your brain that deal with this type of skill will grow.

Understanding of brain plasticity has its roots in animal brain research conducted in the 1950s, which was designed to investigate whether the environment had any effect on the structure and function of the animal brain. 

Researchers studied rodents raised in two distinct environments: enriched and unenriched. 

The animals raised in unenriched environments were kept in isolation and had no running wheels or toys to play with. 

When the two groups of rodents were compared following an autopsy, results yielded significant differences in their brains. 

The rodents raised in an enriched environment had a larger cortex, more cellular connections (synapses that lead to brain reserve), and the formation of new brain cells (neurogenesis) in the hippocampus (the structure critical to new learning and memory).

While the research offered highly significant and important findings regarding the effect of the environment on brain structure in animals, the critical issue of whether the same findings could be established for humans remained unknown until 1998.

Neuroplasticity and the Human Brain

A 1998 landmark study found that the human brain had the ability to develop new brain cells. This research challenged the prevailing theory that the human brain was a rigid system with no ability to generate new brain cells. Previously, most experts believed that humans were born with all of their brain cells, that we lose brain cells on a daily basis, and that our brains do not generate or replace the lost cells with new ones.

Many research studies followed, demonstrating the plasticity of the brain.

A study in 2000 discovered that London taxi drivers have a larger hippocampus, a brain structure known to be heavily involved in learning routes and spatial representations, than London bus drivers. The study found that the size of the hippocampus correlated with the length of time being a taxi driver, suggesting that driving taxis may develop and change the hippocampus.

Draganski and colleagues showed that extensive learning of abstract information could trigger some plastic changes in the brain. They imaged the brains of German medical students three months before their medical exam and right after the exam and compared them to the brains of students who were not studying for an exam at this time. Medical students’ brains showed learning-induced changes in regions of the parietal cortex as well as the posterior hippocampus. These regions of the brain are known to be involved in memory retrieval and learning

Ways to Rewire Your Brain

We cannot all become taxi drivers and medical doctors. Fortunately, there are easier ways to take advantage of brain plasticity:

1. Eat well, live well
An international team of researchers found that seniors who consumed the most nutritious food had a nearly 25 percent reduction in the risk of mental decline compared to those with the least healthy diets. This study was published in the online issue of Neurology. The researchers followed 27,860 people aged 55 or older from 40 different countries for an average of about five years. Everyone in the study had either diabetes or a history of heart disease, stroke, or peripheral artery disease.

Over the course of the study, 4,699 people suffered a decline in thinking and memory. Those consuming the most nutritious diets were 24 percent less likely to have cognitive declines compared to people consuming the least healthy foods. The results didn’t change when researchers accounted for factors that might impact cognitive health, including physical activity, high blood pressure, and a history of cancer.

2. Nap during the day
University of Berkeley researchers challenged a group of thirty-nine young adults to a tough learning task designed to give their memory skills a workout. Two hours later, half of the group took a ninety-minute nap, while the other group remained awake. Again, both groups were asked to learn a new set of learning skills. Which group did better? The young adults who napped after the first learning task improved their brain and memory skills the second time around, while the group who stayed awake had more learning and memory difficulties.

3. Get physical
A study, led by Arthur F. Kramer of the University of Illinois at Urbana-Champaign, involved well-educated men and women aged 55 to 79. Their fitness ranged from sedentary to very fit, competitive-ready athletes. While older adults show a decline in brain density in white and gray areas, the researchers discovered that fitness slows that decline.

Exercise programs involving both aerobic exercise and strength training produced better results on cognitive abilities than either one alone.

4. Learn to juggle
University of Regensburg neurologist Arne May and colleagues asked 12 people in their early twenties, most of them women, to learn a classic three-ball juggling trick over three months until they could sustain a performance for at least a minute. Another 12 were a control group who did not juggle. All the volunteers were given a brain scan with magnetic resonance imaging (MRI) at the start of the program, and a second after three months.

The scans found that learning to juggle increased the volume of gray matter in the mid-temporal area and left posterior intra-parietal sulcus by about three percent. These are parts of the left hemisphere of the brain that process data from visual motion. Students who had not undergone juggling training showed no such change.

5. Learn a new language
Researchers at University College London studied the brains of 105 people, 80 of whom were bilingual, and found that learning a new language altered gray matter the same way exercise builds muscles. Moreover, those who learned a second tongue at a younger age were also more likely to have more advanced gray matter than those who learned later.

6. Play a musical instrument
Playing an instrument can go straight to a musician’s head, scientists have revealed. A study by researchers at Liverpool University has shown that practice and performance prevent a vital part of the brain from shrinking with age. Musicians in the Royal Liverpool Philharmonic Orchestra were found to have an average of 15 percent more gray matter in the brain region than nonmusicians. The part of the brain involved, called Broca’s area, deals with memory, language processing, and organization.

7. Meditate
Even thinking can change the brain! One experiment involved a group of eight Buddhist monk adepts and ten volunteers who had been trained in meditation for one week. All the people tested were told to meditate on compassion and love. Two of the controls, and all of the monks, experienced an increase in the number of gamma waves in their brain during meditation.

As soon as they stopped meditating, the volunteers’ gamma wave production returned to normal, while the monks, who had meditated on compassion for more than 10,000 hours in order to attain the rank of adept, did not experience a decrease to normal in the gamma wave production after they stopped meditating. The synchronized gamma wave area of the monks’ brains during meditation on love and compassion was found to be larger than that corresponding activation of the volunteers’ brains.

8. Give your brain a workout
In the same way that regular physical workouts keep the body limber and healthy, regular mental and neurological workouts help keep your mind and nervous system in good working order.

Use it or Lose it

Exercising or stimulating your brain is highly recommended as part of a brain-healthy lifestyle. Brain exercises have an impact on brain health thanks to the brain’s plasticity. When you exercise or stimulate your brain through new or merely unfamiliar activities, you can trigger changes in the brain, such as an increase of connections between neurons. These changes contribute to an increase in what is called your brain reserve. Research suggests that the more brain reserve, the more resistant the brain is to age-related or disease-related damages.

To better understand brain reserve, consider the following scenario: You are flying in an airplane 1000 feet above the ground. Looking down, you see two distinct scenes. The first scene is a jungle with so many trees you cannot see the ground. The second scene is an island with one palm tree blowing slowly in the wind.

A healthy brain should be like the jungle, with a tremendous number of synaptic connections. This is referred to as synaptic density and is a direct measure of brain reserve. A brain should not look like an island with one palm tree. The reason is simple. Alzheimer’s disease and other types of dementia will invade the brain and begin to cut down the neurons and synaptic connections, like a weed-whacker cutting through the weeds around your house. If the brain looks like a jungle, filled with synaptic connections, Alzheimer’s and other diseases will take a long time to show their ugly clinical face. However, if the brain looks like the island with one palm tree, the clinical signs of Alzheimer’s will manifest quickly because there is no reserve to fight it off.

Indeed, some research has shown that even though brains are diagnosed with Alzheimer’s disease at autopsy due to the presence of neuropathological changes, a significant number of these persons never demonstrated the clinical aspects of the disease in life. This is explained one way using the brain reserve concept. That is, persons who never manifested Alzheimer’s disease in life, even though they had the neuropathological characteristics in their brains at autopsy, had built up brain reserve to fight off or delay the onset of the disease.

University of N.S.W. neuroscientist Michael Valenzuela and colleague Perminder Sachdev concluded that people with high brain reserve have almost half as much risk of developing dementia as those with low brain reserve. In one sense, the brain appears to be no different from the muscles of the body, said Valenzuela: “It’s a case of use it or lose it.”

Nasal Vaccine for COVID19

The world’s first nasal vaccine for COVID19 – based on technology licensed from Washington University – was approved Tuesday, Sept. 6 in India for emergency use. Since the vaccine is delivered via the nose, right where the virus enters the body, it has the potential to block infection and break the cycle of transmission, as well as prevent lung damage.

Orthopoxviruses, including smallpox, cowpox, and monkeypox

Orthopoxviruses, including smallpox, cowpox, and monkeypox, cause disease in both humans and other animals. 

Many people are familiar with smallpox, a disease caused by the variola virus that killed approximately 400 million people in the 20th century. 

The name “smallpox” originated as a description of the disease’s hallmark skin lesions, which were smaller than those of “great-pox”, or syphilis. 

Another orthopoxvirus, monkeypox, was first discovered in 1958. Despite its name, monkeypox can also be carried by rats, squirrels, and shrews, and these rodents may play a significant role in transmitting the disease to humans.

The first documented case of monkeypox in humans occurred in the Democratic Republic of the Congo in September 1970, when a 9-month-old child suspected of having smallpox was actually discovered to be infected with monkeypox instead. Monkeypox is endemic to Central Africa and West Africa, where cases likely spread from local wildlife species to humans. 

The Orthopoxviruses, including smallpox, cowpox, and monkeypox are similar to those of smallpox: after an asymptomatic incubation period of up to 3 weeks, infected patients develop fevers, headaches, swollen lymph nodes, and fatigue. These symptoms typically last 1-4 days and are then followed by the development of a rash and skin lesions. The rash typically affects the face and then spreads to the extremities, including the palms and soles. The skin lesions are distinctive in appearance and are hard, round, and typically appear to be in the same stage of development. While the skin lesions of monkeypox are hard to distinguish from those of smallpox, they are very different than the skin changes associated with varicella (chickenpox). Chickenpox infection is characterized by superficial skin lesions with irregular borders that are typically in different states of development. In addition, chickenpox skin lesions commonly affect the face and trunk (stomach, chest, and back), whereas smallpox and monkeypox skin lesions are most commonly found on the face and extremities (arms and legs).

Monkeypox is contagious and can easily spread from person to person through respiratory secretions or contact with skin lesions. Fecal transmission of monkeypox may also occur. Compared with smallpox, the mortality rate of monkeypox is relatively low (ranging from 0-11%, depending on the strain of the virus). Pregnant women, young children, and patients with weakened immune systems may be more likely to experience serious complications or death related to monkeypox infection. Complications of monkeypox infection include pneumonia, dehydration, and sepsis (blood poisoning). Scarring of scabbed skin lesions is the most common long-term complication after monkeypox infection. To prevent transmission of infection, isolation (either at home or in the hospital) is recommended for infected individuals until all skin lesions have resolved.

Sporadic outbreaks of monkeypox have occurred in the United States for years. In 2003, 71 cases of monkeypox were reported in the Midwestern United States among people who had close contact with animals that were imported into the United States from Ghana. Although there is no cure for monkeypox, previous vaccination against smallpox may provide protection against monkeypox infection. Unfortunately, the effectiveness of smallpox vaccination decreases over time, and it is unclear whether previously vaccinated individuals still have immunity against smallpox.

A newer smallpox vaccine (Jynneos®) that was approved by the United States Food and Drug Administration (FDA) in 2019 can also be used for prevention of monkeypox infection in adults 18 years of age and older. 

Antiviral drugs have also been studied as potential treatments for monkeypox.

Cidofovir, an antiviral drug used for the treatment of severe eye infections in patients with acquired immune deficiency syndrome (AIDS), is effective in treating primates affected by monkeypox, although human studies of its use in monkeypox are limited. Cidofovir is associated with significant toxic effects, including kidney damage which may be fatal and which can occur after administration of just one or two doses of the drug.

Vaccinia immune globulin (VIGIV) is an intravenous formulation of human plasma that contains antibodies to another orthopoxvirus called the vaccinia virus. The Centers for Disease Control and Prevention (CDC) states that VIGIV can be used to treat outbreaks of monkeypox virus, although there is no evidence it provides adequate treatment for monkeypox infection.

Tecovirimat (TPOXX®) is a newer antiviral drug that was approved by the FDA in 2018 as a treatment for human smallpox disease. Tecovirimat targets and inhibits a specific protein in orthopoxviruses that assists with cell-to-cell transmission and viral spread. Tecovirimat is available in capsule formulation for oral administration and can be used in both adults and children weighing at least 13 kilograms. The safety profile of tecovirimat is favorable, with headache, nausea, abdominal pain, and vomiting among the most common side effects after use of the drug. The CDC currently includes tecovirimat as a treatment option for outbreaks of orthopoxviruses, including monkeypox.

Vitamin D could reduce ovarian cancer


Vitamin D is a class of fat-soluble secosteroids that enhances intestinal absorption of calcium, magnesium, and phosphate, among other things.

Among all cancers, ovarian cancer has one of the highest mortality rates. This is due, in part, to the cancer’s ability to turn the body’s defenses against it. Vitamin D may be able to successfully block one of the major pathways used by this cancer.

Ovarian cancer often undergoes a process called peritoneal metastasis. Its cells go to a secondary implantation location, such as the peritoneal wall or diaphragm, throughout this process after detaching from their primary site in the ovary. The peritoneum protects itself against this process by forming a barrier of mesothelial cells that prevent cancer cells from adhering and spreading. 

Ovarian cancer circumvents this barrier, however, by converting the shielding mesothelial cells into cancer-associated mesothelial cells. By fostering an environment that promotes metastasis, the cancer’s ability to metastasize and spread throughout the body is improved.

Suppression of ovarian cancer is by the restoration of peritoneal mesothelial cells. Vitamin D not only hindered this process but also returned cancer-associated mesothelial cells to their initial state. This process improved the mesothelial cells’ capacity to act as barriers, limiting the spread of the cancer. Their research implies that adding vitamin D therapy to the treatment of ovarian cancer could be helpful.

The peritoneal environment can be restored to its normal state where it prevents the adhesion and growth of cancer cells.”

Vitamin D can do this because of the complicated way cancer spreads. Studies found that cancer cells secrete a protein called TGF-β1, which is associated with cell growth. This also increases the amount of protein, thrombospondin-1, through the TGF-β/Smad pathway. Thrombospondin-1 has long interested researchers of ovarian cancer because it is found in higher amounts in the later, more deadly stages of cancer. In ovarian cancer, thrombospondin-1 is a key protein that enhances the adhesion and proliferation of ovarian cancer cells to the peritoneum. As vitamin D disrupts the TGF-β/Smad pathway, it may prevent cancer. The administration of Vitamin D helps normalize the peritoneal environment. 

This suggests that the combination of Vitamin D and conventional remedies can enhance their therapeutic efficacy for ovarian cancer. This helps prevent the adhesion of cancer cells to the peritoneum, which may make it possible to prevent the recurrence of ovarian cancer.

The potential of a vitamin to combat a cancer that affects one in 75 women remains an exciting prospect, especially since it does so by restoring the natural defenses of the body. 

The creation of therapies using this research could offer new ways to combat the high death rate of ovarian cancer.

COVID-19 Update

COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.

Most common symptoms:

fever

cough

tiredness

loss of taste or smell


Less common symptoms:

sore throat

headache

aches and pains

diarrhoea

a rash on skin, or discolouration of fingers or toes

red or irritated eyes

Insulin Resistance and Diabetes


Insulin acts like a key to let blood sugar into cells for use as energy.

Invisible changes in the body begin long before a person is diagnosed with type 2 diabetes. That’s both bad news (no symptoms mean you won’t know you have it) and good news (you can prevent or delay it if you’re at risk). One of the most important unseen changes? Insulin resistance.

Insulin, Blood Sugar, and Type 2 Diabetes

Insulin is a key player in developing type 2 diabetes. This vital hormone—you can’t survive without it—regulates blood sugar (glucose) in the body, a very complicated process. Here are the high points:

  • The food you eat is broken down into blood sugar.
  • Blood sugar enters your bloodstream, which signals the pancreas to release insulin.
  • Insulin helps blood sugar enter the body’s cells so it can be used for energy.
  • Insulin also signals the liver to store blood sugar for later use.
  • Blood sugar enters cells, and levels in the bloodstream decrease, signaling insulin to decrease too.
  • Lower insulin levels alert the liver to release stored blood sugar so energy is always available, even if you haven’t eaten for a while.

That’s when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:

  • lot of blood sugar enters the bloodstream.
  • The pancreas pumps out more insulin to get blood sugar into cells.
  • Over time, cells stop responding to all that insulin—they’ve become insulin resistant.
  • The pancreas keeps making more insulin to try to make cells respond.
  • Eventually, the pancreas can’t keep up, and blood sugar keeps rising.

Lots of blood sugar in the bloodstream is very damaging to the body and needs to be moved into cells as soon as possible. There’s lots of insulin, too, telling the liver and muscles to store blood sugar. When they’re full, the liver sends the excess blood sugar to fat cells to be stored as body fat. Yep, weight gain. And what’s more serious, the stage is set for prediabetes and type 2 diabetes.

Do You Have Insulin Resistance?

How do you find out if you’re insulin resistant? No one test will tell you, but if you have high blood sugar levels, high triglycerides (a kind of blood fat), high LDL (“bad”) cholesterol, and low HDL (“good”) cholesterol, your health care provider may determine you have insulin resistance.

Important note: Type 1 diabetes is different; it’s thought to be caused by an autoimmune reaction (the body attacks itself by mistake). People with type 1 diabetes don’t make enough insulin and need to take it to survive.

What Causes Insulin Resistance?

It isn’t clear exactly what causes insulin resistance, but a family history of type 2 diabetes, being overweight (especially around the waist), and being inactive all can raise the risk.

You do not have to be overweight to have insulin resistance. You can’t tell if someone has insulin resistance by looking at them.

How to Reverse Insulin Resistance

If you have insulin resistance, you want to become the opposite—more insulin sensitive (cells are more effective at absorbing blood sugar so less insulin is needed).

Physical activity makes you more sensitive to insulin, one reason why it’s a cornerstone of diabetes management (and good health in general!). Don’t wait until you’re diagnosed with diabetes to start moving more. The earlier you take action (literally), the better off you’ll be.

Weight loss is important too, as is avoiding high blood sugarreducing stress, and getting enough sleep (physical activity can help you get more zzz’s too).

These lifestyle changes really work. Talk with your health care provider about how to get started.

Boost your immune system


Strengthen your immune system and fight off disease

How can you improve your immune system? 

On the whole, your immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it fails: A germ invades successfully and makes you sick. Is it possible to intervene in this process and boost your immune system? What if you improve your diet? Take certain vitamins or herbal preparations? Make other lifestyle changes in the hope of producing a near-perfect immune response?

What can you do to boost your immune system?

The idea of boosting your immunity is enticing, but the ability to do so has proved elusive for several reasons. The immune system is precisely that — a system, not a single entity. To function well, it requires balance and harmony. There is still much that researchers don’t know about the intricacies and interconnectedness of the immune response. For now, there are no scientifically proven direct links between lifestyle and enhanced immune function.

But that doesn’t mean the effects of lifestyle on the immune system aren’t intriguing and shouldn’t be studied. Researchers are exploring the effects of diet, exercise, age, psychological stress, and other factors on the immune response, both in animals and in humans. In the meantime, general healthy-living strategies make sense since they likely help immune function and they come with other proven health benefits.

Immunity in action

A healthy immune system can defeat invading pathogens as shown above, where two bacteria that cause gonorrhea are no match for the large phagocyte, called a neutrophil, that engulfs and kills them (see arrows).

Your first line of defense is to choose a healthy lifestyle. 

Following general good-health guidelines is the single best step you can take toward naturally keeping your immune system working properly. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

Don’t smoke.

Eat a diet high in fruits and vegetables.

Exercise regularly.

Maintain a healthy weight.

If you drink alcohol, drink only in moderation.

Get adequate sleep.

Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.

Try to minimize stress.

Keep current with all recommended vaccines. Vaccines prime your immune system to fight off infections before they take hold in your body.

Increase immunity the healthy way

Many products on store shelves claim to boost or support immunity. But the concept of boosting immunity actually makes little sense scientifically. In fact, boosting the number of cells in your body — immune cells or others — is not necessarily a good thing. For example, athletes who engage in “blood doping” — pumping blood into their systems to boost their number of blood cells and enhance their performance — run the risk of strokes.

Attempting to boost the cells of your immune system is especially complicated because there are so many different kinds of cells in the immune system that respond to so many different microbes in so many ways. Which cells should you boost, and to what number? So far, scientists do not know the answer. What is known is that the body is continually generating immune cells. Certainly, it produces many more lymphocytes than it can possibly use. The extra cells remove themselves through a natural process of cell death called apoptosis — some before they see any action, some after the battle is won. No one knows how many cells or what the best mix of cells the immune system needs to function at its optimum level.

Immune system and age

As we age, our immune response capability becomes reduced, which in turn contributes to more infections and more cancer. As life expectancy in developed countries has increased, so too has the incidence of age-related conditions.

While some people age healthily, the conclusion of many studies is that, compared with younger people, the elderly are more likely to contract infectious diseases and, even more importantly, more likely to die from them. Respiratory infections, including, influenza, the COVID-19 virus and particularly pneumonia are a leading cause of death in people over 65 worldwide. No one knows for sure why this happens, but some scientists observe that this increased risk correlates with a decrease in T cells, possibly from the thymus atrophying with age and producing fewer T cells to fight off infection. Whether this decrease in thymus function explains the drop in T cells or whether other changes play a role is not fully understood. Others are interested in whether the bone marrow becomes less efficient at producing the stem cells that give rise to the cells of the immune system.

A reduction in immune response to infections has been demonstrated by older people’s response to vaccines. For example, studies of influenza vaccines have shown that for people over age 65, the vaccine is less effective compared to healthy children (over age 2). But despite the reduction in efficacy, vaccinations for influenza and S. pneumoniae have significantly lowered the rates of sickness and death in older people when compared with no vaccination.

There appears to be a connection between nutrition and immunity in the elderly. A form of malnutrition that is surprisingly common even in affluent countries is known as “micronutrient malnutrition.” Micronutrient malnutrition, in which a person is deficient in some essential vitamins and trace minerals that are obtained from or supplemented by diet, can happen in the elderly. Older people tend to eat less and often have less variety in their diets. One important question is whether dietary supplements may help older people maintain a healthier immune system. Older people should discuss this question with their doctor.

Diet and your immune system

Like any fighting force, the immune system army marches on its stomach. Healthy immune system warriors need good, regular nourishment. Scientists have long recognized that people who live in poverty and are malnourished are more vulnerable to infectious diseases. For example, researchers don’t know whether any particular dietary factors, such as processed foods or high simple sugar intake, will have adversely affect immune function. There are still relatively few studies of the effects of nutrition on the immune system of humans.

There is some evidence that various micronutrient deficiencies — for example, deficiencies of zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, and E — alter immune responses in animals, as measured in the test tube. However, the impact of these immune system changes on the health of animals is less clear, and the effect of similar deficiencies on the human immune response has yet to be assessed.

So, what can you do? If you suspect your diet is not providing you with all your micronutrient needs — maybe, for instance, you don’t like vegetables — taking a daily multivitamin and mineral supplement may bring other health benefits, beyond any possibly beneficial effects on the immune system. Taking megadoses of a single vitamin does not. More is not necessarily better.

Improve immunity with herbs and supplements?

Walk into a store, and you will find bottles of pills and herbal preparations that claim to “support immunity” or otherwise boost the health of your immune system. Although some preparations have been found to alter some components of immune function, thus far there is no evidence that they actually bolster immunity to the point where you are better protected against infection and disease. Demonstrating whether an herb — or any substance, for that matter — can enhance immunity is, as yet, a highly complicated matter. Scientists don’t know, for example, whether an herb that seems to raise the levels of antibodies in the blood is actually doing anything beneficial for overall immunity.

Stress and immune function

Modern medicine has come to appreciate the closely linked relationship of mind and body. A wide variety of maladies, including stomach upset, hives, and even heart disease, are linked to the effects of emotional stress. Despite the challenges, scientists are actively studying the relationship between stress and immune function.

For one thing, stress is difficult to define. What may appear to be a stressful situation for one person is not for another. When people are exposed to situations they regard as stressful, it is difficult for them to measure how much stress they feel, and difficult for the scientist to know if a person’s subjective impression of the amount of stress is accurate. The scientist can only measure things that may reflect stress, such as the number of times the heart beats each minute, but such measures also may reflect other factors.

Most scientists studying the relationship of stress and immune function, however, do not study a sudden, short-lived stressor; rather, they try to study more constant and frequent stressors known as chronic stress, such as that caused by relationships with family, friends, and co-workers, or sustained challenges to perform well at one’s work. Some scientists are investigating whether ongoing stress takes a toll on the immune system.

But it is hard to perform what scientists call “controlled experiments” in human beings. In a controlled experiment, the scientist can change one and only one factor, such as the amount of a particular chemical, and then measure the effect of that change on some other measurable phenomenon, such as the amount of antibodies produced by a particular type of immune system cell when it is exposed to the chemical. In a living animal, and especially in a human being, that kind of control is just not possible, since there are so many other things happening to the animal or person at the time that measurements are being taken.

Despite these inevitable difficulties in measuring the relationship of stress to immunity, scientists are making progress.

Does being cold give you a weak immune system?

Almost every mother has said it: “Wear a jacket or you’ll catch a cold!” Is she right? Probably not, exposure to moderate cold temperatures doesn’t increase your susceptibility to infection. There are two reasons why winter is “cold and flu season.” In the winter, people spend more time indoors, in closer contact with other people who can pass on their germs. Also the influenza virus stays airborne longer when air is cold and less humid.

But researchers remain interested in this question in different populations. Some experiments with mice suggest that cold exposure might reduce the ability to cope with infection. But what about humans? Scientists have performed experiments in which volunteers were briefly dunked in cold water or spent short periods of time naked in subfreezing temperatures.  They’ve studied people who lived in Antarctica and those on expeditions in the Canadian Rockies. The results have been mixed. For example, researchers documented an increase in upper respiratory infections in competitive cross-country skiers who exercise vigorously in the cold, but whether these infections are due to the cold or other factors — such as the intense exercise or the dryness of the air — is not known.

A group of Canadian researchers that has reviewed hundreds of medical studies on the subject and conducted some of its own research concludes that there’s no need to worry about moderate cold exposure — it has no detrimental effect on the human immune system. Should you bundle up when it’s cold outside? The answer is “yes” if you’re uncomfortable, or if you’re going to be outdoors for an extended period where such problems as frostbite and hypothermia are a risk. But don’t worry about immunity.

Exercise: Good or bad for immunity?

Regular exercise is one of the pillars of healthy living. It improves cardiovascular health, lowers blood pressure, helps control body weight, and protects against a variety of diseases. But does it help to boost your immune system naturally and keep it healthy? Just like a healthy diet, exercise can contribute to general good health and therefore to a healthy immune system.

Graves Disease, Thyroid Eye Disease, and COVID-19

COVID-19 has caused disease in close to 500 million people worldwide, according to the World Health Organization. While the airways are its primary target, SARS-CoV-2 may enter many organs via the protein angiotensin-converting enzyme 2 (ACE-2).  ACE-2 is highly expressed in thyroid cells, and COVID-19 has been reported to cause thyroid dysfunction both during and after infection with SARS-CoV-2. COVID-19–related autoimmune thyroid manifestations include Graves’ disease and thyroid eye disease (TED), although COVID-19 can lead to multiple other thyroid dysfunctions.

Presentation of patients with new TED to a prominent chain of Indian eye hospitals had increased 25% during the first 2 years of the COVID-19 pandemic.

This observation poses enticing questions

Is there a link between COVID-19, thyroid autoimmunity, and its complications (including TED)? 

Could COVID-19 vaccination and thyroid autoimmunity be connected? 

Might these observations be influenced by COVID-19 public health measures and delays in seeking healthcare? 

Or are these findings purely coincidental and unrelated to the COVID-19 pandemic?

Understanding Graves Disease and TED

To address these questions, we must review our understanding of how Graves disease and TED occur. Graves disease is an autoimmune disorder of the thyroid caused by stimulatory thyroid-stimulating hormone receptor antibodies, leading to hyperthyroidism.

Graves disease is the most common cause of hyperthyroidism and affects > 1% of the US population.

TED is the most common complication of Graves disease that occurs outside of the thyroid gland. TED causes a variety of eye signs and symptoms that can negatively affect patients’ quality of life, be disfiguring, and in rare cases threaten vision.

The exact events that trigger thyroid autoimmunity are not known; however, we believe a complex interplay between genetic and environmental factors occur, including:

Genetics: Genes with polymorphisms predisposing to Graves disease include human leukocyte antigens (HLA), particularly class II genes for HLA-DR; TSHR; CLTA-4; CD40; and PTPN22.

Age: Graves disease has a low incidence in childhood, rising thereafter until the age of approximately 50 years, after which the incidence plateaus or decreases slightly.

Sex: Women have an approximately five times higher risk for Graves disease than men.

Race: Black persons and possibly Asian persons/Pacific Islanders have higher rates of Graves disease, at least in the United States.

Cigarette smoking: Cigarette smoking is a clear environmental risk factor for the development of Graves disease and TED.

Two other possible triggers for Graves disease are stress and infection.

Stress and Graves Disease. Stress has been implicated as a trigger of Graves. Other autoimmune diseases have also been suggested to have increased risk after stressful events. 

One theory of how stress could cause Graves disease in susceptible people is by releasing hormones, including catecholamines and cortisol, that shift the immune response toward antibody production that is pathognomonic of Graves disease. 

Psychological stress imposed by a global pandemic is therefore a potential (although unproven) trigger for Graves disease and TED.

Infection and Graves diseaseInfection with such bacteria as Yersinia enterocolitica and Helicobacter pyloriand by viruses including parvovirus, Epstein-Barr virus, and hepatitis C virushave also been proposed to cause Graves disease.

One hypothesis for this link is that the hyperinflammatory disease state associated with COVID-19 triggers a series of immune responses in genetically susceptible individuals, leading to activation (or reactivation) of Graves disease and TED. 

Most cases have occurred in middle-aged women, the prime demographic for developing Graves disease. 

The smoking status of these individuals has not been reported.

Reactions Induced by Adjuvants?

Thyroid autoimmune phenomena have been reported after both inactivated and messenger RNA COVID-19.

Graves disease and/or TED have been reported to occur days to weeks after receipt of either a first or second dose of vaccine. Investigators have questioned whether these reactions may represent an autoimmune/inflammatory syndrome induced by adjuvants (ASIA). 

Adjuvants in vaccines are used to enhance the immune response using a reduced amount of antigen, thus creating an extended and lasting immune response. 

Potential mechanisms by which adjuvants disrupt the ‘immunologic balance’ of the host include molecular mimicry (similarities between foreign and self-antigens), excessive cytokine production (promoting inflammation), and defective immune regulation (by regulatory T cells). Association does not necessarily imply causation. Given the sheer number of people being diagnosed with COVID-19 worldwide every day, it is inevitable that some patients seeking medical attention for respiratory symptoms (or other COVID-19 complications) may have preexisting Graves disease and/or TED.

Reassuringly, cases of postvaccination ASIA leading to thyroid autoimmunity appear to be exceedingly rare, although there is potential for underreporting of cases or a lack of awareness among clinicians.

COVID-19 restrictions, lockdowns, and stay-at-home orders have also led to delayed healthcare-seeking behavior. 

“This has been observed across a spectrum of disease, including medical emergencies (eg, acute coronary syndrome), and surgical emergencies (eg, acute appendicitis), and in cancer care. “

Abnormal thyroid function is associated with more severe TED. 

Any delays in diagnosis of Graves disease and timely commencement of antithyroid therapy will undoubtedly contribute to more severe disease at presentation.

COVID-19 has presented the world with many challenges, not least in deciphering causation from association. 

However, the pandemic also presents opportunities for us to ask questions and then learn more about disease processes in many organs. 

The anecdotal data from India regarding recent TED presentations is one such example. 

With additional high-quality data, we will be able to definitively address the roles of stress, infection, possibly vaccination, and behavioral adaptations to the public health responses in the development.

INFLAMMATION

A.  Foods cause inflammation 

AVOID ✖️

1 SUGAR,

CANDY, 

PROCESSED FOODS 

2 SODA, SPORTS & ENERY DRINKS

3 FULLY HYDROGENATED OILS

IN SNACKS, FOODS, CHIPS, MARGARINE,
PEANUT BUTTER

4 TRANS FAT:

FAST FOODS,

COOKIES 

CAKES 

CRACKERS 

5 MILK

6 FRIED FOODS

7 SATURATED FATS:

CHEESE 

FATTY BEEF & 

BUTTER

8 MEATS (GRAIN FED)

9 PROCESSED MEATS:

LUNCH MEATS, 

HOT DOGS, 

CURED MEATS

10 ALCOHOL >7d/w

11 REFINED CARBS:

BREAD, 

PASTA, 

FLOUR, 

CRACKERS, 

LOW FIBRE CEREAL

12 GLUTIN:

BREAD, 

BAKED GOODS, 

SOUPS, 

PASTA, 

CEREAL,

SAUCES & 

SALAD DRESSINGS

13 ARTIFICIAL SWEETNER

14 MSG CHINESE

15 PRESERVATIVES

ARTIFICIAL COLORING 

16 PERSONAL FOOD INTOLERANCES:

EGGS

CORN

NUTS

WHEAT 

SOY

DAIRY

B. Foods to reduce inflammation

INGEST✔️

HERBS:

GARLIC

OREGANO 

TUMERIC

CINNAMON 

ROSEMARY 

CLOVES

OLIVE OIL EXTRA VIRGIN

NUTS

SEEDS

LEFY GREENS:

SPINACH

ARUGULA 

KALE

(VITAMIN K)

BERRIES

FATTY FISH:

ANCHOVIES

HERRING

TUNA

SALMON (ALASKAN FRESH)

SARDINES

LEGUMES

WHOLE & CRACKED GRAINS

TOFU ORGANIC

MUSHROOMS ASIAN SHIITAKE 

EGGS omega3

TUMERIC

GINGER

TEA:

GREEN

WHITE

OOLONG

CHOCOLATE DARK

Kidney Stones

Diagnosis

If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
  • Urine testing. The 24-hour urine collection test may show that you’re excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
  • Imaging. Imaging tests may show kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may reveal even tiny stones. Simple abdominal X-rays are used less frequently because this kind of imaging test can miss small kidney stones.

Ultrasound, a noninvasive test that is quick and easy to perform, is another imaging option to diagnose kidney stones.

  • Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what’s causing your kidney stones and to form a plan to prevent more kidney stones.

Treatment

Treatment for kidney stones varies, depending on the type of stone and the cause.

Small stones with minimal symptoms

Most small kidney stones won’t require invasive treatment. You may be able to pass a small stone by:

  • Drinking water. Drinking as much as 2 to 3 quarts (1.8 to 3.6 liters) a day will keep your urine dilute and may prevent stones from forming. Unless your doctor tells you otherwise, drink enough fluid — ideally mostly water — to produce clear or nearly clear urine.
    • Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
    • Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Examples of alpha blockers include tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn).

Large stones and those that cause symptoms

Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:

  • Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.

ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

  • Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.

You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL is unsuccessful.

  • Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.

Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.

  • Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam’s apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.

Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that’s causing your parathyroid gland to overproduce the hormone.

Prevention

Prevention of kidney stones may include a combination of lifestyle changes and medications.

Lifestyle changes

You may reduce your risk of kidney stones if you:

  • Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend drinking enough fluids to pass about 2.1 quarts (2 liters) of urine a day. Your doctor may ask that you measure your urine output to make sure that you’re drinking enough water.

If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine. If your urine is light and clear, you’re likely drinking enough water.

  • Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper and soy products.
  • Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose nonanimal protein sources, such as legumes. Consider using a salt substitute, such as Mrs. Dash.
  • Continue eating calcium-rich foods, but use caution with calcium supplements.Calcium in food doesn’t have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise.

Ask your doctor before taking calcium supplements, as these have been linked to increased risk of kidney stones. You may reduce the risk by taking supplements with meals. Diets low in calcium can increase kidney stone formation in some people.

Ask your doctor for a referral to a dietitian who can help you develop an eating plan that reduces your risk of kidney stones.

Medications

Medications can control the amount of minerals and salts in the urine and may be helpful in people who form certain kinds of stones. The type of medication your doctor prescribes will depend on the kind of kidney stones you have. Here are some examples:

  • Calcium stones. To help prevent calcium stones from forming, your doctor may prescribe a thiazide diuretic or a phosphate-containing preparation.
  • Uric acid stones. Your doctor may prescribe allopurinol (Zyloprim, Aloprim) to reduce uric acid levels in your blood and urine and a medicine to keep your urine alkaline. In some cases, allopurinol and an alkalizing agent may dissolve the uric acid stones.
  • Struvite stones. To prevent struvite stones, your doctor may recommend strategies to keep your urine free of bacteria that cause infection, including drinking fluids to maintain good urine flow and frequent voiding. In rare cases long-term use of antibiotics in small or intermittent doses may help achieve this goal. For instance, your doctor may recommend an antibiotic before and for a while after surgery to treat your kidney stones.
  • Cystine stones. Along with suggesting a diet lower in salt and protein, your doctor may recommend that you drink more fluids so that you produce a lot more urine,. If that alone doesn’t help, your doctor may also prescribe a medication that increases the solubility of cystine in your urine.
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