FitSugar

Sitting 101: Desk Ergonomics

FitSugar — Thu, 05 Jun 2008 14:30:00 -0700

I consider myself an active person and am definitely happier strolling about than sitting, but I sit for a large portion of the day. I blog – how could I avoid a chair? Like most things, there's a technique to sitting. A well-designed workstation can help keep you pain free while you toil away during the day.

Here are a few things to consider about how and where you sit:

Adjust the height of your chair so your hips are between 90 and 120 degrees. If adjusting your chair means your feet no longer rest comfortably on the floor, use a foot rest.
Your keyboard should be in line or lower than your elbow joint. The open angle of the elbow will help reduce elbow, wrist, and shoulder pain.

I have a few more suggestions, so read more.

Keep your wrists straight and never bend them up to type. I find a good wrist rest to be invaluable for maintaining correct wrist alignment. Check out these stretches for your wrists – they will help, too.
The top of your monitor should be at eye level. If it is too low you could be setting yourself up for neck pain. Put a book or two under the screen to raise it adequately.
You should sit with your back straight. Use a pillow if you need low back support. Do not lean forward because that will close you hip joint down and stress your low back and neck.

Don't forget to move around as much as you can during the day. Adding little walks throughout your workday is an effective way to relieve pressure you might feel on your bum and spine.

10 Ways to Pass the Time on Cardio Machines

FitSugar — Tue, 02 Jun 2009 05:52:00 -0700

If you can't get outside for a run or bike ride, using a cardio machine is a wonderful alternative. Since the weather is always perfect indoors, you never have an excuse not to work out. It can be agonizingly boring though, so here are some suggestions from FitSugar readers to help beat the boredom and make your cardio machine time more enjoyable.

Kimpossible and laellavita suggest doing interval training. Switch between moderate running and sprinting to keep your mind busy. This is also my favorite way to work out on a cardio machine.
You can also do intervals with the incline, as suggested by syako. Pump up the incline for a few minutes, then lower it for a few minutes.
FitSugar reader tangentlines suggests reading big novels to pass the time, but if you don't like flipping pages, shiningeyes suggests listening to audiobooks.

To hear the other great ideas, read more.

Listen to music on iPods or MP3 players. If you like more of a mix, there's a Pandora application on the iPhone that kyui707 recommends. It creates a music station for you based on music you like, and since you never know what's coming next, it's a great way to get you moving.
If you're bored with music, KMattes recommends listening to podcasts. You can download them from iTunes on just about any topic from wedding planning to cooking to fitness.
If you like watching TV, littlekaren suggests hitting the gym during times when your favorite shows are on. If you have a machine at home, kris0bot says to DVR TV shows and save them for when you exercise.
If there's a shelf on your machine, kakyke recommends watching TV episodes, like Grey's Anatomy or Lost, online on your laptop. Or you can watch movies.
If you're working hard and really pushing yourself, misskacie says it doesn't allow her the comfort to get bored. So pump up the intensity level.
Work out with a friend - mek123 says talking makes the time go by quickly.
Many readers such as darc5204 recommend daydreaming or deep thinking while on a cardio machine. You can distract yourself by working through a problem or making plans.

Source

Tomorrow Is Bike to Work Day!

FitSugar — Wed, 13 May 2009 12:00:00 -0700

If you're interested in experimenting with a two wheel commute, let me remind you that in the Bay Area, and elsewhere around the country, Thursday, May 14 is Bike to Work Day.

If you can't ride the whole way you can try to bike part of your commute - because something is better than nothing for both you and the environment. In many other cities, Bike to Work Day is Friday - check the League of American Cyclists for listing of events by state. Regardless, be sure to check in with your local bike coalition since chances are high they will have watering stations set up for cyclists and many offer goody bags for pedaling commuters. Will you be biking to work soon?

NYC Installing Treadmills in Subways

FitSugar — Wed, 01 Apr 2009 04:30:00 -0700

New York City is steadily becoming a healthier place to live for many reasons. Smoking was banned in most indoor work places and restaurants in 2003. Fast food chains and local restaurants ditched trans fat last year. They also have fruit and vegetable stands in both wealthy and low-income areas so folks can buy a healthy snack on the street instead of a hot dog. In 2007, eateries were also required to list calorie counts on their menu boards. To prevent the spread of HIV and other STIs, New York also gives away free condoms in public bathrooms. So it's no surprise that this hip city is doing more to keep its New Yorkers healthy by installing treadmills in subway stations. All that waiting around for the L Train can be time spent burning calories. It's a brilliant idea, really. To hear more about when you should start seeing them, read more.

April Fools! Ha! It is a great idea though, isn't it? I guess if you want to exercise while waiting for the subway, you can always jog in place. Since it's New York City, people won't think you're crazy!

Source

Post-traumatic stress disorder

FitSugar — Wed, 08 Oct 2008 17:35:45 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Post-traumatic stress disorder (PTSD) is an anxiety disorder that is brought on by memories of an extremely stressful event or series of events that cause intense fear, particularly if feelings of helplessness accompanied the fear. That event may be war, physical or sexual assault or abuse, an accident (such as an airplane crash or a serious motor vehicle accident), or a mass disaster. You can develop PTSD if the event happened to you or even if you witnessed it. It's normal to feel stress when you experience a traumatic event. PTSD persists long after the event and is characterized by the intensity of the feelings, how long they last, how you react to these feelings, and the presence of particular symptoms. More than 5 million adults in the United States are affected by PTSD each year.

Signs and Symptoms

Symptoms of PTSD may develop months or even years after the original traumatic event and may include the following:

Intrusive thoughts recalling the traumatic event
Nightmares
Flashbacks
Efforts to avoid feelings and thoughts that either remind you of the traumatic event or that trigger similar feelings
Feeling detached or unable to connect with loved ones
Depression, hopelessness
Feelings of guilt (from the false belief that you were responsible for the traumatic incident)
Irritability
Hypervigilance (Being overly aware of possible danger)
Hypersensitivity, including at least two of the following reactions: trouble sleeping, being angry, having difficulty concentrating, startling easily, having a physical reaction (rapid heart rate or breathing, increase in blood pressure)

What Causes It?

Experts aren't entirely sure what causes some people to develop PTSD, but many think it happens when you are confronted with a traumatic event and your mind isn't able to process all the thoughts and feelings as it usually does. Scientists studying the brain think there may be some differences in the brain structure or chemistry of those with PTSD. For example, certain areas of the brain involved with feeling fear may be hyperactive in people with PTSD. Other researchers have focused on the hippocampus, the area of the brain responsible for memory and for how we deal with stress, and are investigating whether changes in that area also appear in people with PTSD.

Who's Most At Risk?

How severe the traumatic event was and how long it lasted affect whether you are likely to develop PTSD. These factors also increase the risk:

A history of sexual or physical abuse
Working in a high-risk occupation, such as firefighting or law enforcement
A history of depression or other psychological disorder
Abusing drugs or alcohol
Not having adequate social support
Women are twice as likely as men to show signs of PTSD.

What to Expect at Your Provider's Office

There are no laboratory tests to detect PTSD. Your doctor will ask about your symptoms and ask you to describe the traumatic event. Your doctor will likely also use psychological assessment tools to confirm the diagnosis. You may be asked to see a specialist (such as a psychologist or psychiatrist) for evaluation and treatment.

Treatment Options

Prevention

Early intervention immediately after a traumatic event -- through support groups, psychotherapy, and certain medications -- may help prevent PTSD. Rituals such as prayer or healing ceremonies may be helpful in relieving stress and other effects of the trauma.

Treatment Plan

The treatment for PTSD includes:

Cognitive-behavior therapy -- With the help of a psychotherapist, you learn techniques to manage your thoughts and feelings when you are in situations that remind you of the traumatic event. You may gradually expose yourself to situations and thoughts that cause anxiety, as you build up a tolerance for them and your fear is lessened. Ultimately, the goal of cognitive therapy is to allow you to control your fear and anxiety.
Stress management therapy -- With a therapist, you work to learn relaxation techniques that help you overcome fear and anxiety, and to break the cycle of negative thoughts.
Medication may be used as well.

Drug Therapies

Antidepressants such as selective serotonin re-uptake inhibitors (SSRIs), including sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Luvox), or paroxetine (Paxil).
Benzodiazepines, a group of medications sometimes used for anxiety, including lorazepam (Ativan) and alprazolam (Xanax). These drugs have sedating properties and may cause drowsiness, constipation, or nausea. Do not take them if you have narrow-angle glaucoma, a psychosis, or are pregnant. They also interact with other drugs, including some antidepressants (such as Luvox).

Complementary and Alternative Therapies

Conventional psychotherapy, such as cognitive behavior therapy, is the main treatment for PTSD. However, several mind-body techniques may be used as supportive treatments:

Eye Movement Desensitization and Reprocessing (EMDR), in which you move your eyes rapidly from side to side while recalling the traumatic event, seems to help reduce distress for many with PTSD. Doctors aren't sure how it works, and whether it is any better than standard treatment. It's also not clear how long PTSD symptoms are reduced using EMDR.
Biofeedback involves using a machine, at first, to see bodily functions that are normally unconscious and occur involuntarily (for example, heart rate and temperature). As you see how your body reacts to stress, you learn to control the reactions, and eventually you can perform the techniques to control the reactions without using a machine. Some studies suggest that biofeedback, among other forms of relaxation training, may be an effective treatment for some people with PTSD.
Hypnosis has long been used to treat war-related post-traumatic conditions. More recently it has been used in cases of sexual assault (including rape), anesthesia failure, Holocaust survival, and car accidents. Hypnosis induces a deep state of relaxation, which may help people with PTSD feel more safe and less anxious, decrease intrusive thoughts, and become involved in daily activities again. Hypnosis is usually used in conjunction with psychotherapy and requires a trained, licensed hypnotherapist.

Nutrition and Supplements

Although no studies have examined how nutrition can be used to treat PTSD, these general nutritional guidelines may be helpful:

Avoid stimulants, such as caffeine and nicotine.
Avoid alcohol.
Maintain balanced blood sugar to help stabilize mood. For example, eat small, frequent meals that include a small amount of protein. Avoid processed and refined foods.
Eat whole grains, fresh fruits and vegetables, protein from plants (legumes and nuts, for example) and fish to nourish the nervous system.
Inositol (18 g per day), a B vitamin that is found in citrus fruits, vegetables, cereal grains and meats, helps the nervous system function properly and may play a role in reducing depression and anxiety associated with PTSD.

Herbs

Herbs are a generally safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your doctor to get a clear diagnosis before you start any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerin extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures singly or in combination as noted.

Although studies using herbs specifically to treat PTSD are lacking, some herbs have been studied for symptoms such as depression and anxiety.

Kava kava (Piper methysticum, 100 - 200 mg two to four times per day) may help reduce mild to moderate anxiety, although it has not been studied specifically for PTSD. The FDA has issued a warning concerning kava kava's effect on the liver. In rare cases, severe liver damage has been reported. If you take kava, do not use it for more than a few days, and tell your doctor before taking it.
Valerian (Valeriana officinalis, 150 mg two to three times per day), sometimes combined with lemon balm (Melissa officinalis), has also proven effective for mild to moderate anxiety, although it has not been studied for PTSD either. Valerian may interact with other drugs that have a sedative effect, such as benzodiazepines, barbiturates, narcotics, antidepressants, and antihistamines. Do not take valerian if you are pregnant or nursing. Valerian also can affect the liver, so do not take it if you have liver problems.
St. John's wort (Hypericum perforatum, 300 mg three times per day) has been sued to treat mild to moderate depression and may help symptoms of PTSD, though studies are lacking. St. John's wort interacts with numerous other drugs and herbs, and should be avoided when pregnant or nursing. Speak to your doctor before using St. John's wort with any other medications.

The following herbs may help relieve restlessness, nervousness, and anxiety that can be associated with PTSD:

Passionflower herb (Passiflora incarnata)
Ginger (Zingiber officinalis)
Chamomile (Matricaria chamomilla)
Catnip ( Nepeta cataria)
Lemon balm (Melissa officinalis)

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for PTSD based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. When being treated with homeopathic remedies, it is possible to experience a brief intensification of symptoms before your condition improves. In the case of PTSD, it is important to have a qualified support team in place to help you handle any worsening of symptoms. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Aconitum -- for recurring panic following a traumatic experience. This remedy is most appropriate for individuals who have heart palpitations and shortness of breath which produce a tremendous fear of death. Aconitum is often the first remedy given for trauma, even if the trauma occurred years ago.
Arnica -- for chronic conditions (such as depression) that occur after a traumatic experience. This remedy is most appropriate for individuals who generally deny that anything is wrong.
Staphysagria -- for individuals who feel fearful, powerless, or unable to speak up or defend themselves.
Stramonium -- for anxiety disorders that occur after a shock or traumatic experience involving violence. The individual for whom this remedy is most appropriate tends to be generally fearful and have night terrors.

Acupuncture

Acupuncture may help with symptoms of PTSD, including insomnia, anxiety, and depression. In one case involving a Vietnam War veteran, acupuncture and relaxation with guided imagery reportedly reduced insomnia, nightmares, and panic attacks over a treatment period of 12 weeks. One study for anxiety (not PTSD-related) found that benefits lasted as long as 1 year after treatment. Acupuncturists treat people based on an individualized assessment of the excesses and deficiencies of qi located in various meridians in the body.

Prognosis/Possible Complications

If PTSD symptoms continue for longer than 3 months, the condition is considered to be chronic (ongoing). Chronic PTSD may become less severe even if it is not treated, or it may become severely disabling, interfering with many areas of life and causing physical complaints.

Supporting Research

Allen SN. Psychological assessment of post-traumatic stress disorder. Psychometrics, current trends, and future directions. Psychiatr Clin North Am. 1994;17(2):327-349.

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1678.

Benjamin J, Levine J, Fuz M, Aviv A, Levy D, Belmaker RH. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry 1995;152(7):1084-1086.

Blank AS Jr. Clinical detection, diagnosis, and differential diagnosis of post-traumatic stress disorder. Psychiatr Clin North Am. 1994;17(2):351-383.

Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, Mass: Integrative Medicine Communications; 2000.

Brady K, Pearlstein T, Asnis GM, et al. Efficacy and safety of sertraline treatment of posttraumatic stress disorder: a randomized controlled trial. JAMA. 2000;283(14):1837-1844.

Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S. Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up. Behav Res Ther. 2006 Sep;44(9):1331-5.

Cahill SP, Carrigan MH, Frueh BC. Does EMDR work? And if so, why?: A critical review of controlled outcome and dismantling research. J Anxiety Disord. 1999;13(1-2):5-33.

Cardena E. Hypnosis in the treatment of trauma: a promising, but not fully supported, efficacious intervention. Int J Clin Exp Hypn. 2000;48(2):225-238.

Chambers RA, Bremner JD, Moghaddam B, Southwick SM, Charney DS, Krystal JH. Glutamate and post-traumatic stress disorder: toward a psychobiology of dissociation. Semin Clin Neuropsychiatry. 1999;4(4):274-281.

Davidson J. Drug therapy of post-traumatic stress disorder. Br J Psychiatry. 1992;160:309-314.

Davies WH, Flannery DJ. Post-traumatic stress disorder in children and adolescents exposed to violence. Pediatr Clin North Am. 1998;45(2):341-353.

Friedman MJ. Progress in the psychobiology of post-traumatic stress disorder: an overview. Semin Clin Neuropsychiatry. 1999;4(4):230-233.

Jacobs WJ, Dalenberg C. Subtle presentations of post-traumatic stress disorder. Diagnostic issues. Psychiatr Clin North Am. 1998;21(4):835-845.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctor's Guide. New York, NY: Warner Books; 1996:249.

Levin P, Lazrove S, Van Der Kolk B. What psychological testing and neuroimaging tell us about the treatment of posttraumatic stress disorder by Eye Movement Desensitization and Reprocessing. J Anxiety Disord. 1999;13(1-2):159-172.

Mason S, Rowlands A. Post-traumatic stress disorder. J Accid Emerg Med. 1997;14(6):387-391.

Medley I. Post-traumatic stress disorder. Br J Hosp Med. 1996;55(9):567-70.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:3-4, 36-37, 364.

Novey DW, ed. Clinician's Complete Reference to Complementary and Alternative Medicine. St. Louis, Mo: Mosby; 2000:180-181.

Peniston EG. EMG biofeedback-assisted desensitization treatment for Vietnam combat veterans post-traumatic stress disorder. Clin Biofeedback Health. 1986;9(1):35-41.

Pitman RK, Orr SP, Shalev AY, Metzger LJ, Mellman TA. Psychophysiological alterations in post-traumatic stress disorder. Semin Clin Neuropsychiatry. 1999;4(4):234-241.

Raboni MR, Tufik S, Suchecki D. Treatment of PTSD by eye movement desensitization reprocessing (EMDR) improves sleep quality, quality of life, and perception of stress. Ann N Y Acad Sci. 2006 Jul;1071:508-13.

Scherer J. Kava-kava extract in anxiety disorders: an outpatient observational study. Adv Ther. 1998;15(4):261-269.

Schnurr PP, Jankowski MK. Physical health and post-traumatic stress disorder: review and synthesis. Semin Clin Neuropsychiatry.1999;4(4):295-304.

Seidler GH, Wagner FE. Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychol Med. 2006 Nov;36(11):1515-22.

Shapiro F. Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. J Trauma Stress. 1989;2:199-223.

Sherman JJ. Effects of psychotherapeutic treatments for PTSD: a meta-analysis of controlled clinical trials. J Trauma Stress. 1998;11(3):413-435.

Stapleton JA, Taylor S, Asmundson GJ. Effects of three PTSD treatments on anger and guilt: exposure therapy, eye movement desensitization and reprocessing, and relaxation training. J Trauma Stress. 2006 Feb;19(1):19-28.

Sutherland SM, Davidson JR. Pharmacotherapy for post-traumatic stress disorder. Psychiatr Clin North Am. 1994;17(2):409-423.

Tarrier N, Humphreys L. Subjective improvement in PTSD patients with treatment by imaginal exposure or cognitive therapy: session by session changes. Br J Clin Psychol. 2000;39(pt 1):27-34.

Tarrier N, Sommerfield C, Pilgrim H, Humphreys L. Cognitive therapy or imaginal exposure in the treatment of post-traumatic stress disorder. Twelve-month follow-up. Br J Psychiatry. 1999;175:571-575.

The expert consensus guideline series. Treatment of posttraumatic stress disorder. J Clin Psychiatry. 1999;60(suppl 16):3-76.

Turnbull GJ. A review of post-traumatic stress disorder. Part II: Treatment. Injury. 1998;29(3):169-175.

Ulett GA. Conditioned healing with electroacupuncture. Altern Ther Health Med. 1996;2(5):56-60.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 148-150.

Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders-a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry. 1997;30(1):1-5.

Watson CG, Tuorila JR, Vickers KS, Gearhart LP, Mendez CM. The efficacies of three relaxation regimens in the treatment of PTSD in Vietnam War veterans. J Clin Psychol. 1997;53(:917-923.

Wessely S, Rose S, Bisson J. Brief psychological interventions ("debriefing") for trauma-related symptoms and the prevention of post traumatic stress disorder. Cochrane Database Syst Rev 2000;No. 2:CD000560

Witt PH,Greenfield DP, Steinberg J. Evaluation and treatment of post-traumatic stress disorder. N J Med. 1993;90(6):464-467.

Review Date:
12/18/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Mononucleosis

FitSugar — Wed, 08 Oct 2008 17:35:26 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis and Possible Complications
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Infectious mononucleosis, also referred to as "mono" or "the kissing disease," causes symptoms that include fever, sore throat, and swollen glands. A person is infectious several days before symptoms appear and for some time after, possibly for months or, rarely, even years. Direct contact with virus-infected saliva, mainly through kissing, can transmit the virus and cause mono. Mono affects about 45 of 100,000 people.

Signs and Symptoms

The following signs and symptoms may accompany mono:

Fever
Fatigue
Sore throat, often severe
Swollen tonsils
Swollen lymph nodes in the neck
Enlargement of the spleen
Enlargement of the liver
Rash
Headache

Symptoms may take between 4 - 7 weeks to develop after exposure to the virus. Symptoms can last only a few days or as long as several months. In most cases, they disappear in 2 - 6 weeks.

What Causes It?

The Epstein-Barr virus (EBV) causes the vast majority of mono cases. Ninety percent of adults have antibodies to the virus reflecting former exposure and immunity against EBV. EBV infects and reproduces in the salivary glands. Direct contact with virus-infected saliva, such as by kissing, can transmit the virus and cause mono. You can also get mono through transfusions with infected blood products.

Who's Most At Risk?

The following factors can put a person at higher risk for developing mono:

Age -- the incidence peaks in the 15 - 19 year age group. After age 35, the rate is low.
Delayed exposure -- mono is more prevalent in areas with higher standards of hygiene, where infection with EBV is often delayed until adulthood.
Blood transfusion.
Diminished or suppressed immune function.

What to Expect at Your Provider's Office

Your health care provider will do a physical examination, checking for fever, sore throat, swollen glands, and for swelling of your spleen or liver. A blood test is performed to make the diagnosis of mono.

Treatment Options

Prevention

Since mono is not generally spread through the air, a person who has mono does not need to be isolated. Household members or college roommates have only a slight risk of being infected unless they kiss the person.

Treatment Plan

Rest is necessary when symptoms are severe. Increased activity is allowed as the symptoms improve, generally after about 2 weeks. Contact sports and heavy lifting should be avoided for 2 months due to the risk of rupturing the spleen.

Drug Therapies

Your health care provider may prescribe the following medications:

Acetaminophen
Corticosteroids, such as prednisone, are used only to treat airway obstruction from enlarged tonsils

Children with EBV should not take aspirin because of the risk of developing Reye's syndrome, a rare condition that can cause vomiting and can affect the liver, brain, and other organs.

Surgical and Other Procedures

In the case of a ruptured spleen associated with mono, surgical removal of the spleen may be necessary.

Complementary and Alternative Therapies

Several studies report that stress and relaxation affect our immune systems. Stress can increase susceptibility to infection. Steps that reduce stress may help prevent infection with viruses such as EBV.

There is some evidence that nutrition and plant-based medicines may help reduce the long-term effects of EBV infection and complications linked to EBV.

Always tell your health care provider about the herbs and supplements you are using or considering using.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

Try to eliminate all suspected food allergens, including dairy, wheat (gluten), soy, chocolate, corn, preservatives, and food additives. Your health care provider may want to test you for food allergies.
Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and fruits (such as blueberries, tomatoes, and cherries).
Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise moderately, if tolerated, at least 30 minutes daily, 5 days a week.

You may be able to address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil two to three times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
N-acetyl cysteine, 200 mg daily, for antioxidant effects.
Acetyl-L-carnitine, 500 mg daily, for antioxidant and muscle protective activity.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Resveratrol (from red wine), 50-200 mg daily, for antioxidant and antiviral effects.
L-theanine, 200 mg one to three times daily, for nervous system support.
Melatonin, 2 - 5 mg one hour before bedtime, for sleep and immune protection.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.
Rhodiola (Rhodiola rosea) standardized extract, 100 - 600 mg daily, for antioxidant, anti-stress, and immune activity.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
Elderberry (Sambucus nigra) extract, 1 tablespoonful two times daily, for antiviral and immune activity. Ask your health care provider about doses of elderberry extract for your children.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg two to three times daily, for inflammation and immunity. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antiviral activity.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for mono based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

The following remedies may be effective for fever related to EBV:

Belladonna -- for early stages of mononucleosis with sudden onset of fever.
Ferrum phosphoricum -- for individuals with the early stages of a fever accompanied by a painful cough and sore chest.
Kali muriaticum -- typically used for individuals with extremely swollen tonsils, but may also be useful for treating infectious mononucleosis when administered in conjunction with Ferrum phosphoricum

Professional homeopaths may also recommend the following remedies:

Mercurius -- for individuals with a fever accompanied by profuse sweating, alternating hot and cold body temperature, weakness in the limbs and painful, aching bones, a bluish-red throat with a constant desire to swallow, excessive salivation, teeth marks around the edges of a swollen tongue, and tremendous thirst.
Phytolacca -- for pain caused by throat inflammation that radiates to the ears upon swallowing.

Other helpful remedies include Lachesis, Conium, Hepar sulphuricum, and Baryta carbonica.

Research also suggests that a combination of homeopathy and Traditional Chinese Medicine (TCM) may effectively improve symptoms of mononucleosis. The most common homeopathic remedies used with TCM include Lycopodium, Silicea, Phosphorous, Sulphur, Mercurius, Nux vomica, Sepia, and Pulsatilla.

Acupuncture

Although no scientific studies have reviewed the use of acupuncture for mono, it may help to reduce symptoms, to improve immune function, and to relieve congestion (blockage of qi, or energy flow) of the liver, spleen, and lymph.

Traditional Chinese Medicine

Studies have reported that individuals with Epstein-Barr virus experience an improvement in symptoms when given a combination of homeopathic remedies noted in the section on homeopathy and TCM remedies including Atractylodes alba, Glycyrrhiza recens, Rehmannia preparata, Bupleurum, Cortex magnolia, Phragmites, Belamcanda, Sophora, subprostrata, Siler, Angelica dahurica, Paeonia alba, Dendrobium, Polygonatum officinal, and Cnidium.

Massage

No scientific studies have reviewed the use of massage for mono. However, it may help relieve the muscle aches and pains associated with chronic EBV infection and reduce stress. As discussed earlier, stress can increase a person's susceptibility to infections.

Prognosis and Possible Complications

Most people with mono recover uneventfully and can return to school or work in a few weeks. Fatigue can continue for months for a small percentage of people. Severe complications are uncommon, and may include problems with the central nervous system or liver, rupture of the spleen, or difficulty breathing.

Supporting Research

Auwaerter PG. Infectious mononucleosis in middle age. JAMA. 1999; 281(5):454-459.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co.; 1999:2336-2339.

Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Carillo-Vico A, Reiter RJ, Lardone PJ, et al., The modulatory role of melatonin on immune responsiveness. Curr Opin Investig Drugs. 2006;7(5):423-31.

Chiang LC, Ng LT, Cheng PW, Chiang W, Lin CC. Antiviral activities of extracts and selected pure constituents of Ocimum basilicum. Clin Exp Pharmacol Physiol. 2005;32(10):811-6.

Clancy RL, Gleeson M, Cox A, et al. Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med. 2006;40(4):351-4.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-75.

Eo SK, Kim YS, Lee CK, Han SS. Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. J Ethnopharmacol. 1999;68(1-3):129-36.

Gaby AR. The role of coenzyme Q10 in clinical medicine: Part 1. Alt Med Rev. 1996; 1(1):11-17.

Hunton M. The homoeopathic treatment of glandular fever. Br Homeopath J. 1986; 75(2):66-68.

Jacobson W, Wreghitt TG, Saich T, Nagington J. Serum folate in viral and mycoplasmal infections. J Infect. 1987; 14(2):103-111.

Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat. 2005;12(6):559-67.

Omori M. Mononucleosis. In: Adler J, Brenner B, Dronen S, et al., eds. Emergency Medicine: An On-line Medical Reference. Accessed on January 19, 2000.

Reiche EM, Morimoto HK, Nunes SM. Stress and depression-induced immune dysfunction: implications for the development and progression of cancer. Int Rev Psychiatry. 2005;17(6):515-27.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Schooley RT. Epstein-Barr virus (infectious mononucleosis). In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practices of Infectious Diseases. 4th ed. New York, NY: Churchill Livingstone Inc; 1995:1364-1377.

Van Benschoten MM. Clinical cases of Epstein Barr Virus infection treated with homeopathic and Chinese herbal therapeutics. Am J Acupunct. 1988; 16(1):19-25.

Van Rood YR, Bogaards M, Goulmy E, van Houwelingen HC. The effects of stress and relaxation on the in vitro immune response in man: a meta-analytic study. J Behav Med. 1993; 16(2):163-181.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

Williams JE. Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado. Altern Med Rev. 2001;6(6):567-79.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res. 2004;32(2):132-40.

Review Date:
9/6/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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Hemophilia

FitSugar — Wed, 08 Oct 2008 17:35:26 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis/Possible Complications
Following Up
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Hemophilia is an inherited disease in which your blood does not clot. People with hemophilia lack or have low levels of one of two blood-clotting substances, known as factor VIII and factor IX. As a result, they may bleed for a long time after an injury. They may also experience internal bleeding, especially in the joints. There are two types of hemophilia -- type A and type B -- but the symptoms are the same in both types. Hemophilia is the most common inherited bleeding disorder. About 18,000 people in the U.S. have the condition.

Signs and Symptoms

Hemophilia may be accompanied by the following signs and symptoms:

Joint pain and swelling, frequently in the knees and elbows
Heavy bleeding, or bleeding that lasts a long time, from an accident or other injury. The start of bleeding may be delayed.
Large bruises
Swelling under the skin and between muscles, with fever, skin discoloration, and pain
Internal bleeding in the abdominal region, airway, or central nervous system
Bleeding of the mouth and gums, tooth loss
Blood in the urine
Digestive problems
Nosebleeds

What Causes It?

Hemophilia is an inherited disorder that almost exclusively affects men. Women rarely have the disease but are the carriers who can pass the condition to their male children.

Who's Most At Risk?

Hemophilia affects people from all ethnic groups. All the daughters of men with hemophilia will be carriers. However, even if hemophilia runs in the family, only about half the sons of carriers will have hemophilia.

What to Expect at Your Provider's Office

Often the first sign that an infant has hemophilia is deep and easy bruising as the child is learning to crawl. For male children, heavy bleeding after circumcision may be the first sign. Cases of mild hemophilia may be diagnosed even later, after a tooth is extracted or following surgery. Your health care provider will take a family history and do a physical examination, checking for deep bleeding, muscle spasms, limited joint motion, joints that are warm and enlarged, and bruises. Blood tests can show whether clotting factors are low or missing. Computed tomography (CT) scans and magnetic resonance imaging (MRI) may be used to find bleeding in the joints.

Treatment Options

Prevention

Hemophilia cannot be cured, but a test can determine whether an unborn baby will have the disorder. If a person has hemophilia, the following cautionary measures should be taken:

Avoid taking aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
Vaccinate all patients, including infants, with the hepatitis B vaccine.
Administer factor VIII or IX (see below) on a regular basis, to help prevent bleeding and joint damage.
Avoid circumcising male infants of women known to be carriers until the baby has been tested for hemophilia.
Carry information at all times identifying the person as someone with hemophilia.

Treatment Plan

The primary treatment for moderate to severe hemophilia is factor replacement therapy, which involves replacing the blood's deficient clotting factor. It can be given to stop bleeding or as preventive therapy, to keep bleeding from starting. Regular infusions of clotting factor several times a week reduces the risk of bleeding. Infusions can be given at home. A health care provider may also prescribe pain relievers. If internal bleeding has damaged joints, physical therapy or, in severe cases, joint replacement may restore function.

Drug Therapies

A health care provider may prescribe the following medications:

Factor VIII or IX replacement therapy
Pain relievers other than aspirin or NSAIDs (Aleve, Motrin, ibuprofen), as they decrease the blood's ability to clot
Topical medications to control bleeding
The drug desmopressin (DDAVP) may be used in mild cases of hemophilia A. It stimulates your own low levels of clotting factor.

Surgical and Other Procedures

Certain types of surgery may become necessary, including:

Joint replacement
Removal of an uncontrollable, expanding hematoma (partially clotted blood under the skin that resembles a bruise)

Complementary and Alternative Therapies

Hemophilia should be treated with conventional medications. Always get medical help immediately when you have bleeding or have joint pain or swelling. Some CAM therapies may be helpful when used with conventional care for certain symptoms. For example, emotional and psychological stress has an effect on the amount of bleeding, and some mind-body therapies may help relieve stress and anxiety. Studies even suggest that hypnosis may reduce (but not eliminate) the need for blood transfusions.

Self Hypnosis

Several preliminary studies suggest that those who have learned self-hypnosis need far fewer blood products over an extended period of time (namely 2 - 3 years) than those who have not learned the technique. One study included relaxation training along with hypnosis. Published and unpublished reports on individual patients also suggest that hypnosis may help blood clot better and may reduce the need for blood transfusions.

Nutrition

No studies have examined the link between nutrition and hemophilia. However, it would be wise to avoid supplemental vitamin E and fish oil if you have hemophilia, as they seem to increase bleeding time by keeping platelets from clumping. Vitamin K plays a role in normal clotting and may be useful either from dietary sources or in supplement form, but research is needed in this area. Do not take vitamin K supplements without first talking to your doctor.

Herbs

No studies have examined the value of herbs for hemophilia specifically, and you should never use herbal therapies without your doctor's supervision. However, based on their own experience, health care providers may recommend herbs that strengthen blood vessels and act as astringents (causing contraction) to make bleeding less severe, such as the following:

Bilberry fruit ( Vaccinium myrtillus)
Grape seed extract (Vitis vinifera)
Hawthorn berry ( Crataegus monogyna)
Scotch broom (Cytisus scoparius)
Stinging nettle (Urtica dioica)
Witch hazel (Hamamelis virginiana)
Yarrow (Achillea millefolium)

In addition, people with hemophilia should avoid the following herbs, which tend to make bleeding more severe:

Ginkgo (Ginkgo biloba)
Garlic (Allium sativum)
Ginger (Zingiber officinale)
Ginseng (Panax spp.)
Horse chestnut (Aesculus hippocastanum)
Turmeric (Curcuma longa)

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. However, several case reports found that the following remedies were helpful for people with hemophilia and even reduced their need for blood-clotting substances like factor VIII. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors as well as any current symptoms when determining the most appropriate remedy for a particular person.

Arnica --for internal or external bleeding immediately following an injury. It is helpful for shock or trauma.
Carbo vegetabilis -- for people with pale skin and weakness who are extremely frail, even listless, but like cold and fresh air
Crotalus horridus -- used when there is bleeding into the muscles and when blood appears thin and dark. This remedy is most appropriate for people who are tall, thin, and pale and have diarrhea and an aversion to warm food and drink, or may have fears of being alone and death.
Hamamelis -- for bleeding from a cut or wound, especially useful in nosebleeds, hemorrhoids, and broken blood vessels in the eye
Lachesis -- for heavy bleeding that is dark in color, especially in red-headed individuals who are jealous and depressed
Millefolium -- for internal or external wounds with significant bleeding and poor clotting
Phosphorus -- for frequent, heavy bleeding. This remedy is most appropriate for people who experience cold sweats and have a desire for alcoholic beverages. The person may also feel as though clothing aggravates the throat.
Secale -- for bleeding that is worsened by heat and lessened by cold

Acupuncture

Acupuncture is not recommended for people with hemophilia because of the risk of bleeding. If you choose to try acupuncture, work with a trained, licensed acupuncturist who has experience dealing with hemophilia. Non-invasive acupuncture, such as laser acupuncture, may be better for those with hemophilia.

Physical Medicine

Regular exercise can build strong muscles and help prevent joint problems. People with hemophilia can do most kinds of exercise safely, although they should avoid contact sports. Physical therapy may also play an important role in reducing joint problems caused by repeated bleeding in those areas. The following exercises may be recommended by your physical therapist:

Stretching
Movement exercises
Resistance training (such as weight lifting)

Work with your health care provider to develop a program that is best for you. The routine should be used for at least 6 - 9 months to treat chronic joint inflammation and to prevent severe bleeding.

Prognosis/Possible Complications

Most people who have hemophilia can manage their condition and lead normal lives. In people who do not receive factor replacement therapy, however, complications include the destruction of bones and joints, life-threatening cysts, bleeding in the brain, gangrene, bleeding into muscles causing damage to nerves, chronic bruising, and anemia. Sudden bleeding can occur with emotional stress.

Following Up

Your health care provider will want to see you every 6 - 12 months. Your health care provider may also suggest centers where you can receive a range of treatments and learn more about how to manage your condition.

Supporting Research

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1085-1086.

Behrman RE, ed. Nelson Textbook of Pediatrics. 15th ed. Philadelphia, Pa: W.B. Saunders Co; 1996.

Blumenthal M, Goldberg A, Brinckmann J, et al., eds. Herbal Medicine: Expanded Commission E Monographs. Newton, Mass: Integrative Medicine Communications; 2000.

Buzzard BM. Physiotherapy for prevention and treatment of chronic hemophilic synovitis. Clin Orthop. 1997;343:42-46.

Hoots WK. Hemophilia and related conditions. In: Rakel RE, ed. Conn's Current Therapy. 51st ed. Philadelphia, Pa: W.B. Saunders; 1999.

Hunton M. Homoeopathy in the treatment of haemophilia. Br Homeopath J. 1991;80:82-100.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 256.

Koh TC. Acupuncture therapy in hemophilia. Am J Acupunct. 1981;9(3):269-270.

LaBaw W. The use of hypnosis with hemophilia. Psychiatr Med. 1992;10(4):89-98.

Lee GR, ed. Wintrobe's Clinical Hematology. 10th ed. Baltimore, Md: Williams & Wilkins, Inc.; 1999.

Lusher JM, Arkin S, Abildgaard CF, Schwartz RS. Recombinant factor VIII for the treatment of previously untreated patients with hemophilia A: safety, efficacy, and development of inhibitors. N Engl J Med. 1993;328(7):453-459.

Swirsky-Sacchetti T, Margolis CG. The effects of a comprehensive self-hypnosis training program on the use of Factor VIII in severe hemophilia. Int JClinExpHypn. 1986;34(2):71-83.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 54.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 224, 325-326, 332, 336.

Review Date:
12/10/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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Mumps

FitSugar — Wed, 08 Oct 2008 17:35:26 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis and Possible Complications
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Mumps is a highly contagious viral disease that causes painful swelling of the parotid glands (the largest of the three major salivary glands, located in the cheeks). The disease usually strikes children and adolescents. It is generally self-limited, which means that the virus usually clears up completely after running its course without long-term complications. Prior to the introduction of a mumps vaccine in 1967, about half of all children contracted mumps. Since then, the incidence of the disease has decreased about 99% in the United States, with only around 1,500 cases reported each year. A person develops lifelong protection against mumps after having the disease one time.

Signs and Symptoms

Mumps is accompanied by the following signs and symptoms:

Swelling of the salivary glands in the face and jaw line
Fever, chills, headache, loss of appetite, and a general feeling of discomfort
Pain when chewing or swallowing
Orchitis, or inflammation of the testicles (in up to 25% of males who get the disease after they reach puberty)

Symptoms usually start 14 - 24 days after infection with the virus.

What Causes It?

Mumps is caused by a virus (paramyxovirus ) spread through infected saliva. Most symptoms are the result of direct infection of the salivary glands, testes, pancreas, eyes, ovaries, or kidneys. The nervous system may be involved as well.

Who's Most At Risk?

People who are not immunized, particularly children and adolescents, are at risk for developing mumps. Mumps occur most often in children between the ages of 5 - 9.

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with mumps, you should see your health care provider. Your health care provider will check for swelling in the facial region, especially below the ear and above the jaw. Lab tests using samples from the throat, cerebrospinal fluid, blood, or possibly urine can reveal the presence of the virus. Routine hearing tests on young children can detect any temporary or, rarely, permanent loss.

Treatment Options

Prevention

Vaccination is the key to preventing mumps. The live mumps virus is about 95% effective in preventing the disease. The vaccine is available alone or in the combination vaccine of measles-mumps-rubella (MMR), and usually lasts at least 20 years with very few side effects. It is generally given at age 15 months, but may be given to adolescents and adults as well. Women should not be vaccinated during pregnancy, and people with severe fever or allergies to eggs will need to discuss vaccination with their health care provider.

Treatment Plan

If you have mumps, you should be kept out of school or work for 7 - 10 days after symptoms begin, as you are considered highly contagious during that period. You should eat soft foods, avoid acidic foods and beverages, such as citrus or tomato products, and take pain relievers as needed. A male with swollen testicles should rest in bed until symptoms subside. Pain may be relieved with ice packs, or by supporting the scrotum with cotton or gauze, or an athletic supporter. A health care provider may perform a hearing test on young children who develop mumps, to detect any possible loss of hearing. If the patient develops pancreatitis (inflammation of the pancreas) with nausea and vomiting, the provider may administer IV fluids. Please see the monograph on Pancreatitis for further information.

Drug Therapies

No medications other than pain relievers are needed for uncomplicated cases of mumps.

Complementary and Alternative Therapies

The mumps virus normally resolves on its own, and treatment is meant to relieve symptoms. Acupuncture may help clear up mumps faster. Other CAM therapies may also support recovery by reducing symptoms.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

Avoid acidic foods, such as eggs and dairy products (such as cheese and sour cream), meats, grains (such as rice, wheat, and oats), nuts, and chocolate.
Avoid refined foods, such as white breads, pastas, and sugar.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.

You may address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant and immune effects.

Herbs

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg two to three times daily, for antiviral and immune activity. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Elderberry (Sambucus nigra) extract, 1 tablespoonful two times daily, for antiviral and immune support. Ask your health care provider about dosing for your children.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antiviral activity.
Bromelain (Ananas comosus) standardized, 40 mg three times daily, if needed for pain and inflammation.

Soothing herbal teas may help decrease pain and swelling, such as chamomile (Matricaria chamomilla), licorice (Glycyrrhiza glabra), and marshmallow (Althea officinalis).

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for mumps based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Aconitum -- useful for childhood illnesses including the mumps, particularly when onset is sudden and the individual has a fever.
Belladonna -- most common treatment for mumps, particularly if it comes on rapidly.
Mercurius -- for mumps with swelling that is worse on the right side, excessive foul-smelling perspiration and salivation.
Phytolacca -- for mumps in which glands feel swollen and hard.
Pilocarpinum --for mumps with excessive perspiration and salivation, as well as considerable thirst. This is considered by some homeopaths to be the best remedy for this purpose.
Pulsatilla -- for the later stages of mumps, especially in adults or children approaching puberty.
Rhus toxicodendron -- for mumps with swelling that is worse on the left side.

Acupuncture

Acupuncture may make mumps less severe and shorten its course. However, it is difficult to test such claims since the mumps infection normally resolves on its own within 7 - 14 days.

Prognosis and Possible Complications

For uncomplicated cases of mumps, the prognosis is excellent. Complications are more likely in people who have reached puberty and beyond. These may include meningoencephalitis (inflammation of the brain and its membranous coverings), deafness, orchitis, pancreatitis, and miscarriage in early pregnancy.

Supporting Research

Advisory Committee on Immunization Practices (ACIP). Mumps Prevention. MMWR Morb Mortal Wkly Rep. 1989;38(22):388-392, 397-400.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co.; 1999:2325-2327.

Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.

Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, Mass: Integrative Medicine Communications; 2000:458-459.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

Clancy RL, Gleeson M, Cox A, et al. Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus. Br J Sports Med. 2006;40(4):351-4.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3^rd ed. New York, NY: Penguin Putnam; 1997.

Dong GR, Zhang Y, Yan YX. Bilateral Taichong and Hegu in treatment of mumps: an observation of 108 cases. Int J Clin Acupunct. 1995;6(1):65-66.

Eo SK, Kim YS, Lee CK, Han SS. Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. J Ethnopharmacol. 1999;68(1-3):129-36.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol. 2005;5(4):783-93.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.

Maceoin D, Cope E. A hearing for an alternative approach to vaccine. Guardian. October 19,1988.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:3-7, 58-62, 297-299, 310-315.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Song GY. 1000 cases of mumps treated with ear needling on Pingjian point (MA-T2). J Tradit Chin Med. 1989;9(1):14.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

A.D.A.M. Copyright

adam.com

Scleroderma

FitSugar — Wed, 08 Oct 2008 17:35:15 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Scleroderma is a connective-tissue disease that causes a progressive build up of tough scar-like tissue in the skin and internal organs. The term scleroderma is derived from the Greek words, skleros, meaning "hard," and derma meaning "skin." An individual with scleroderma may develop either a localized or systemic form of the disease. Localized scleroderma usually affects only the skin on the hands and face. Systemic scleroderma, however, affects the connective tissue in many parts of the body, including the skin, the esophagus, gastrointestinal tract, lungs, kidneys, heart, and other internal organs. It is unusual for localized scleroderma to progress to the systemic form. According to the Scleroderma Foundation, an estimated 300,000 people in the United States have the condition.

Signs and Symptoms

Symptoms of scleroderma may include one or more of the following:

Raynaud's phenomenon (abnormal sensitivity to cold in the hands or feet)
Swelling of the fingers, hands, forearms, feet, lower legs, and face
Thickening, hardening, and discoloration of the skin
Ulcers or lesions on fingers, face, tongue, and inner lining of the cheek
Joint pain, swelling, and stiffness (especially in the fingers and knees)
Carpal tunnel syndrome
Shortness of breath, cough
Dry eyes
Sexual dysfunction
Digestive and gastrointestinal problems including difficulty swallowing, bloating, and abdominal pain

Five particular symptoms occasionally occur together and are clinically recognized as a variation of scleroderma called CREST syndrome. The term CREST stands for Calcinosis (painful calcium deposits under the skin), Raynaud's phenomenon (abnormal sensitivity to cold in the hands and feet), Esophageal dysfunction (problems with swallowing caused by internal scarring), Sclerodactyly (tightening of the skin on the fingers or toes) and Telangiectasia (lesions on the hands, palms, forearms, face, and lips).

Causes

Scleroderma results from an overproduction of collagen, the primary connective tissue protein in the body. Scientists believe that the immune system mistakenly attacks the patient's own cells (an autoimmune response), producing too many white blood cells and other factors that cause a damaging inflammatory response and an overproduction of collagen, primarily in the skin. Researchers are not clear why this autoimmune response occurs, but they suggest that both genetic and environmental factors play a role in the development of the disease. For example, scleroderma has been associated with a number of industrial and pharmaceutical chemicals including:

Silica dust
Some plastic materials, such as epoxy resins and vinyl chloride
Aromatic hydrocarbons
L-tryptophan (synthetic supplement)
Rapeseed oil

Risk Factors

The following factors may increase a person's risk for scleroderma:

Gender -- approximately three times more women than men develop the disease.
Age -- scleroderma is most common among individuals between the ages of 20 - 50, and is relatively rare in children.
Race and Ethnicity -- young women of African ancestry and native Americans of the Choctaw tribe of Oklahoma have a high prevalence of the disease

Diagnosis

An individual with symptoms of scleroderma will most likely require consultations with both a rheumatologist (arthritis specialist) and a dermatologist (skin specialist). The doctor will conduct a physical examination in which he or she may feel the skin, checking for thickened and hardened areas and may also press affected tendons and joints. The doctor may also conduct the following procedures to diagnose the disease:

Blood tests -- may detect elevated levels of antibodies found in the majority of individuals with scleroderma.
Skin biopsy -- samples of skin may be taken to identify abnormalities suggestive of scleroderma.
Chest X ray or pulmonary function test -- may detect lung damage or altered lung capacity.
MRI or CT scan -- often detect early signs of damage to the muscles and internal organs.

Diagnosing scleroderma may be difficult, particularly in the early stages of the disease. This is because many individuals with scleroderma experience symptoms of other connective-tissue diseases, such as rheumatoid arthritis, lupus, and polymyositis. When these conditions overlap, it is called mixed connective-tissue disease.

Preventive Care

It is important for an individual with scleroderma to avoid developing infections, so the physician will administer the following:

Pneumococcal pneumonia vaccine
Annual flu vaccine

Treatment

There is no cure for scleroderma. While medications are often used to treat the symptoms of the disease, they are not always effective, and many have significant side effects. There are, however, less toxic ways to treat the symptoms of scleroderma, such as lifestyle and dietary changes and the addition of dietary supplements, which make living with the disease easier.

Lifestyle

While lifestyle adjustments will not stop the progression of scleroderma, these simple measures may enhance an individual's quality of life:

Eating small, frequent meals may reduce gastrointestinal problems.
Maintaining an active lifestyle may preserve muscle.
Avoiding smoke, exposure to cold, and stress may prevent blood vessel spasms that diminish circulation.
Applying soothing skin creams to affected areas may reduce pain, swelling, and stiffness.

Medications

Localized scleroderma often is treated with topical therapies such as moisturizers or topical corticosteroids. Oral medications may also be used to halt the progression of localized scleroderma if it involves a large area of the body, such as an entire arm or leg. Systemic scleroderma may be treated with medications that improve circulation, promote gastrointestinal function, preserve kidney function, and control high blood pressure. Some medications a physician may prescribe for scleroderma include:

Penicillamine -- can reduce skin thickening and delay spread of damage to internal organs. However, it has relatively high incidence of adverse reactions.
Pentoxifylline -- may improve circulation
Immunosuppressant medications (such as cyclophosphamide) -- often used for patients with life-threatening form of the disease. These are potent medications that damage cells' genetic information. These medications may cause significant side effects.
Anti-inflammatory medications (such as aspirin, ibuprofen, and corticosteroids) -- may reduce inflammation and swelling
Calcium-channel blockers (such as nifedipine and diltiazem) -- often used to treat Raynaud's phenomenon
Antibiotics -- prevent overgrowth of bacteria in the intestines and improve digestive processes
ACE inhibitors (such as captopril) -- may improve hypertension, prevent kidney damage, and dilate blood vessels

Surgery and Other Procedures

When symptoms of scleroderma become very severe, physicians may recommend the following procedures:

Surgery to repair damage to the stomach or intestinal walls
Amputation of severely diseased and infected fingers or toes
Kidney, heart, or lung transplantation (in rare cases)

Nutrition and Dietary Supplements

A comprehensive treatment plan for scleroderma may include a range of complementary and alternative therapies. Individuals with scleroderma tend to have deficiencies in many vitamins and minerals. Ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan. Always tell your health care provider about the herbs and supplements you are using or considering using.

Following these nutritional tips may help reduce symptoms:

Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Avoid refined foods such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein. Quality protein sources, such as organic meat and eggs, whey, and vegetable protein shakes, should be used as part of balanced program aimed at gaining muscle mass and preventing wasting.
Use healthy oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, five days a week.

You may address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil, one to three times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources, but are not substitutes for supplementation.
Vitamin C, 500 - 1000 mg, one to three times daily, as an antioxidant and for immune support.
L-glutamine, 500 - 1000 mg three times daily, for support of gastrointestinal health and immunity.
Dihydroepiandosterone (DHEA), start at 5 mg three times a day and work up to 100 mg daily for 7 - 12 months, for hormonal support. It is recommended to use DHEA under the supervision of a qualified health care professional. If adverse effects develop, discontinue use.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.
Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
Melatonin, 2 - 6 mg at bedtime as needed, for immune support and sleep.

Herbs

Olive leaf (Olea europaea) standardized extract, 250 - 500 mg one to three times daily, for immune effects.
Turmeric (Curcuma longa) standardized extract, 300 mg three times a day, for pain and inflammation.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification and antioxidant support.
Rhodiola (Rhodiola rosea) standardized extract, 100 - 600 mg daily, for antioxidant, anti-stress, and immune activity.
Bromelain (Ananus comosus) standardized, 40 mg three times daily, for pain and inflammation.
Gotu kola (Centella asiatica) standardized extract, 50 - 250 mg two to three times daily, for blood vessel health and circulation.

Acupuncture

A few studies of patients with systemic scleroderma indicate that acupuncture may improve circulation in the hands and fingers, mend fingertip ulcers, and possibly reduce the formation of fibrous tissue. Acupuncture may also be effective for pain.

Massage and Physical Therapy

Research suggests that massage may be useful in improving circulation and preventing muscle distortion. More research is needed in this area to determine whether massage is truly an effective complementary therapy for scleroderma.

Mind-Body Medicine

Biofeedback appears to successfully control the temperature in the hands and feet of those with Raynaud's phenomenon, a symptom often found in those with scleroderma. Other mind-body techniques such as counseling, meditation, and emotional freedom technique (EFT) can be very useful.

Other Considerations

Prognosis and Complications

Possible complications that may result from scleroderma include the following:

Joint damage
Damage to smooth muscles in the gastrointestinal tract
Malnutrition
Formation of fibrous tissue in the heart muscle; may lead to permanent damage and degradation
Kidney damage and failure
Formation of fibrous tissue in the thyroid gland

The prognosis for those with scleroderma is highly variable and depends primarily on the form of the disease. For example:

The CREST syndrome tends to progress slowly and remains relatively benign for decades. The 10-year survival rate for those with CREST is 75%.
Those with localized scleroderma also have a 10-year survival rate of 75%.
Systemic scleroderma tends to progress faster in men and in those who are older at the onset of the disease. The 10-year survival rate for those with systemic scleroderma is 55%. If damage spreads to the heart, lung, or kidneys early in the course of the disease, prognosis is generally poor.
Spontaneous remissions from scleroderma have also been reported, with symptoms of the disease resolving in the reverse order that they appeared.

Supporting Research

Amento EP. Immunologic abnormalities in scleroderma. Semin Cutan Med Surg. 1998;17(1):18-21.

Arlett CM et al Identification of fetal DNA and cells in skin lesions from women with systemic sclerosis. N Engl J Med. 1998;338(17):1186-91.

Barr WG. Current topics in the diagnosis and treatment of scleroderma. Compr Ther. 1991;17(6):39-45.

Baur JA, Sinclair DA. Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev Drug Discov. 2006;5(6):493-506.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999. Section 5, Chapter 50.

Black CM. Prognosis and management of scleroderma and scleroderma-like disorders in children. Clin Exp Rheumatol. 1994;12(suppl 10):S75-81.

Black CM. Scleroderma in children. Adv Exp Med Biol. 1999;455:35-48.

Black CM. Scleroderma: clinical aspects. J Intern Med. 1993;234(2):115-8.

Burckdorfer KR, Hillary JB, Bunce T, et al. Increased susceptibility to oxidation of low-density lipoproteins isolated from patients with systemic sclerosis. Arthritis Rheum. 1995;38(:1060-1067.

Casale R et al Systemic sclerosis (scleroderma): an integrated challenge in rehabilitation. Arch Phys Med Rehab. 1997;78(7):767-73.

Cunningham BB, Landells, IDR, Langman C, et al. Topical calcipotriene for morphea/linear scleroderma. J Am Acad Dermatol. 1998;39(2 Pt 1):211-215.

Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-50.

Elst EF, van Suijlekom-Smit LWA, Oranje AP. Treatment of linear scleroderma with oral 1,25-dihydroxyvitamin D₃ (calcitriol) in seven children. Pediatr Dermatol. 1999;16(1):53-58.

Gaby AR. The role of coenzyme Q10 in clinical medicine: Part 1. Alt Med Rev. 1996; 1(1):11-17.

Gelber AC, Wigley FM. Treatment of scleroderma. Curr Opin Rheumatol. 1995;7(6):551-9.

Gilliland BC. Systemic sclerosis (scleroderma). In: Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:1888-1895.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol. 2005;5(4):783-93.

Haustein UF, Anderegg U. Pathophysiology of scleroderma: an update. J Eur Acad Dermatol Venereol. 1998;11(1):1-8.

Herrick AL, Worthington H, Rieley F, et al. Dietary intake of micronutrient antioxidants in relation to blood levels in patients with systemic sclerosis. J Rheumatol. 1996;23(4):650-653.

Herrick AL. Advances in palliative care for the patient with scleroderma. Curr Opin Rheumatol. 1996;8(6):555-60.

Herron GS, Romero LI. Vascular abnormalities in scleroderma. Semin Cutan Med Surg. 1998;17(1):12-7.

Hunzelmann N et al. Management of localized scleroderma. Semin Cutan Med Surg. 1998;17(1):34-40.

Jimenez SA et al. Pathogenesis of scleroderma. Rheum Dis Clin North Am. 1996;22(4):647-74.

Kerin K, Yost JH. Advances in the diagnosis and management of scleroderma-related vascular complications. Compr Ther. 1998;24(11-12):574-81.

Krane SM, Amento EP. Cellular interactions and control of collagenase secretion in the synovium. J Rheumatol Suppl. 1983;11:7-12.

Lundberg A-C, Åkesson A, Åkesson B.Dietary intake and nutritional status in patients with systemic sclerosis. Ann Rheum Dis. 1992;51(10):1143-1148.

Maeda M, Kachi H, Ichihashi N et al. The effect of electrical acupuncture-stimulation therapy using thermography and plasma endothelin (ET-1) levels in patients with progressive system sclerosis (PSS). J Dermatol Sci. 1998;17(2):151-155.

Mayes MD. Scleroderma epidemiology. Rheum Dis Clin North Am. 1996;22(4):751-64.

McGee BA et al. Current options for the treatment of systemic scleroderma. Clin Pharm. 1991;10(1):14-25.

Miller M. Scleroderma. Aust Fam Physician. 1993;22(12):2112-9.

Mitchell H, et al. Scleroderma and related conditions. Med Clin North Am. 1997;81(1):129-49.

Muller-Ladner U, et al. Current therapy of systemic sclerosis (scleroderma). Clin Investig. 1993;71(4):257-63.

Murray MT. The Healing Power of Herbs: The Enlightened Person's Guide to the Wonders of Medicinal Plants. Rocklin, Calif: Prima Publishing; 1991:209.

Olsen NJ, et al. Muscle abnormalities in scleroderma. Rheum Dis Clin North Am. 1996;22(4):783-96.

Pang BK, Munro V, Kossard S. Pseudoscleroderma secondary to phytomenadione (vitamin K₁) injections: Texier's disease. Australas J Dermatol. 1996;37(1):44-47.

Rose S, et al. Gastrointestinal manifestations of scleroderma. Gastroenterol Clin North Am. 1998;27(3):563-94.

Schachter RK. Localized scleroderma. Curr Opin Rheumatol. 1990;2(6):947-55.

Sheng FY, Ohta A, Yamaguchi M. Inhibition of collagen production by traditional Chinese herbal medicine in scleroderma fibroblast cultures. Intern Med. 1994;33(:466-471.

Shigematsu T, Tajima S, Nishikawa T, et al. Inhibition of collagen hydroxylation by lithospermic acid magnesium salt, a novel compound isolated from Salviae miltiorrhizae Radix. Biochem Biophys Acta. 1994:1200(1):79-83.

Silver RM. Scleroderma: clinical problems: the lungs. Rheum Dis Clin North Am. 1996;22(4):825-40.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Sjogren RW. Gastrointestinal features of scleroderma. Curr Opin Rheumatol. 1996;8(6):569-75.

Sjogren RW. Gastrointestinal motility disorders in scleroderma. Arthritis Rheum. 1994;37(9):1265-82.

Skibska B, Jozefowicz-Okonkwo G, Goraca A. Protective effects of early administration of alpha-lipoic acid against lipopolysaccharide-induced plasma lipid peroxidation. Pharmacol Rep. 2006;58(3):399-404.

Van den Hoogen FH, de Jong EM. Clinical aspects of systemic and localized scleroderma. Curr Opin Rheumatol. 1995;7(6):546-50.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

White B. Immunologic aspects of scleroderma. Curr Opin Rheumatol. 1995;7(6):541-5.

Wollina U, Abdel-Naser MB, Mani R. A review of the microcirculation in skin in patients with chronic venous insufficiency: the problem and the evidence available for therapeutic options. Int J Low Extrem Wounds. 2006;5(3):169-80.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Review Date:
10/19/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Lyme disease

FitSugar — Wed, 08 Oct 2008 17:35:11 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis and Possible Complications
Following Up
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Lyme disease is the most common tick-borne disease in the United States, with approximately 16,000 new cases reported each year. The disorder was first identified in 1975 when a group of children in Lyme, Connecticut, experienced mysterious arthritis-like symptoms. The deer tick carrying the bacterium B. burgdorferi is responsible for the spread of the disease in the United States. Cases have been reported in nearly all states, and the disease is also on the rise in large areas of Asia and Europe.

Signs and Symptoms

Lyme disease may be accompanied by the following signs and symptoms:

Red rash that appears within a few weeks of a tick bite, initially as a small red spot at the site of the bite. The spot expands over time, forming a circle or oval and sometimes resembling a bull's eye. The rash can range in size from that of a dime to the entire width of a person's back. As the infection spreads, rashes can appear at different places on the body.
Flu-like symptoms -- fever, headache, stiff neck, body aches, and fatigue.
Arthritis -- 60% of people not treated with antibiotics develop recurring attacks of arthritis, most commonly in the knees, that last a few days to a few months. About 10 - 20% of untreated individuals will develop ongoing arthritis.
Neurological symptoms -- stiff neck and severe headache (may indicate meningitis), temporary paralysis of muscles in the face (Bell's palsy), numbness, pain or weakness in the limbs, or poor motor coordination. Symptoms can develop weeks, months, or even years following an untreated infection, and can last for weeks or months. Symptoms usually resolve completely, but they may recur.
Heart problems -- heart abnormalities such as palpitations, lightheadedness, fainting, chest pain, and shortness of breath are uncommon. Symptoms may appear several weeks after infection and last a few days or weeks.

What Causes It?

Ixodes ticks carrying the bacterium B. burgdorferi bite people. The bacteria enter the skin at the site of the bite, after the infected tick has been in place 36 - 48 hours. Symptoms are primarily due to the body's response to this invasion.

Who's Most At Risk?

The following factors may increase the risk for developing Lyme disease.

Environment -- exposure to heavily wooded areas.
Season -- infection is most likely during the summer and fall.
Age -- most common in children and young adults.
Location -- 90% of cases occur in the coastal northeast, as well as in Wisconsin, Minnesota, California, and Oregon.

What to Expect at Your Provider's Office

Lyme disease can be difficult to diagnose because many of its symptoms mimic those of other disorders. About one quarter of people with Lyme disease do not develop a rash. Your health care provider will consider your risk factors and will check your blood for antibodies against B. burgdorferi to confirm the presence of the bacterium. A spinal tap may be performed to detect brain and spinal cord inflammation and to examine antibodies or genetic material of B. burgdorferi in the spinal fluid.

Treatment Options

Prevention

The best defense against Lyme disease is to guard against tick bites. Avoid heavily wooded areas, wear protective clothing, and apply tick repellant. Wear light-colored clothing (which makes ticks easier to detect), do a careful inspection of your body after outdoor activities in wooded or grassy areas, and, if ticks are found, remove them with tweezers. New evidence suggests that it may even be possible to prevent Lyme disease if antibiotics are administered within 3 days of a tick bite.

A vaccine against Lyme disease was approved by the FDA in December 1998. The vaccine is recommended for those who live, travel, or work in areas where Lyme disease is prevalent. Studies indicate that the vaccine is about 80% effective.

Drug Therapies

Your health care provider may prescribe the following medications:

Antibiotics, such as amoxicillin, doxycycline, cefuroxime axetil, or erythromycin are used. In the case of neurological symptoms, ceftriaxone or penicillin is used.
Nonsteroidal anti-inflammatory drugs (NSAIDs) for relief of symptoms.

Complementary and Alternative Therapies

Lyme disease affects many body systems, so treatment that includes complementary therapies, such as homeopathy and stress management, may have benefits. Chiropractic therapy may help relieve pain, make you more mobile, and improve range of motion.

Always tell your health care provider about the herbs and supplements you are using or considering using.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Avoid refined foods such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), and beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

You may be able to address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, folic acid, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to three times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources, but do not replace dietary supplementation.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial or antifungal activity and immunity.
Vitamin C, 500 - 1000 mg one to three times daily, as an antioxidant, and for immune support.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
SAMe (s-adenosyl-L-methionine), 100 - 200 mg before breakfast daily, for mood improvement.
L-theanine, 200 mg one to three times daily, for stress and nervous system support.
Melatonin, 2 - 5 mg before bed, when needed for sleep, and to improve immunity.

Herbs

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for antioxidant and heart health support.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antibacterial or antifungal activity.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg two to three times daily, for inflammation and for immunity. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg one to three times daily, for antibacterial or antifungal activity and immunity. You may also prepare teas from the leaf of this herb.
Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for antibacterial or antifungal and immune activity.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for Lyme disease based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your physical, emotional, and intellectual makeup. In some cases, such as Lyme disease, a professional homeopath may prescribe specific remedies without considering the individual's constitutional state. Such remedies for Lyme disease include:

Arsenicum album
Borrelia burgdorferi nosode
Carcinosin
Lac canimum
Ledum
Mercurius
Syphilinum
Thuja

Acupuncture

Acupuncture may help relieve pain, increase mobility, and reduce fatigue. Chinese herbal formulas, used by many acupuncturists, may help resolve joint, muscular, and neurological symptoms from B. burgdorferi infection after many courses of antibiotics.

Massage

Massage therapy may help relieve muscle pain and increase mobility as part of a physical therapy program.

Prognosis and Possible Complications

The long-term prognosis for most patients treated with antibiotics is excellent. Delay in treatment can result in complications.

Following Up

If you have a severe and advanced case of Lyme disease with varied symptoms, your health care provider may want to see you regularly.

Supporting Research

Ahlemeyer B, Krieglstein J. Neuroprotective effects of Ginkgo biloba extract. Cell Mol Life Sci. 2003;60(9):1779-92.

American College of Physicians. Guidelines for Laboratory Evaluation in the Diagnosis of Lyme Disease. Ann Intern Med. 1997;126:1106-1123.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co.; 1999:1189-1191.

Bell DR, Gochenaur K. Direct vasoactive and vasoprotective properties of anthocyanin-rich extracts. J Appl Physiol. 2006;100(4):1164-70.

Bock SJ. Integrative treatment of Lyme disease. Int J Integrative Med. 1999;1(3):19-23.

Brier SR. Lyme disease. J Manipulative Physiol Ther. 1990;13(6):337-339.

Burrascano JJ Jr. Advanced Topics in Lyme Disease: Diagnostic Hints and Treatment Guidelines for Tick Borne Illnesses. 13th ed. Accesssed August 8, 2000.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Cantorna MT, Hayes CE, DeLuca HF. 1,25-Dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr. 1998;128(1):68-72.

Cantorna MT, Hayes CE. Vitamin A deficiency exacerbates murine Lyme arthritis. J Infect Dis. 1996. 174(4):747-751.

Fontani G, Corradeschi F, Felici A, et al. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005;35(11):691-9.

Gaby AR. The role of coenzyme Q10 in clinical medicine: Part 1. Alt Med Rev. 1996; 1(1):11-17.

Heggers JP, Cottingham J, Gussman J, et al. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med. 2002;8(3):333-40.

Heitzman ME, Neto CC, Winiarz E, Vaisberg AJ, Hammond GB. Ethnobotany, phytochemistry and pharmacology of Uncaria (Rubiaceae). Phytochemistry. 2005;66(1):5-29.

Jonas WB. Do homeopathic nosodes protect against infection? An experimental test. Altern Ther Health Med. 1999;5(5):36-40.

Kacherski SE. The diagnosis and treatment of Lyme related TMJ utilizing the Bi-Digital O-Ring test, homeopathic dilutions of reference controlled substances and nutritional support. Acupunct Electrother Res. 1997;22(1):76.

Kimura K, Ozeki M, Juneja LR, Ohira H. l-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2006 Aug 21.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.

Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr. 2002;76(5):1158S-61S.

Ramachandran U, Divekar HM, Grover SK, Srivastava KK. New experimental model for the evaluation of adaptogenic products. J Ethnopharmacol. 1990 Jul;29(3):275-81.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.

Seltzer EG, et al. Long-term outcomes of persons with Lyme disease. JAMA. 2000;283:609-616.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Tarcher/Putnam; 1995.

Van Benschoten MM. Treatment of Lyme disease via Omura's test of acupoints and Chinese herbal formulas. Am J Acupunct. 1992;20(4):363-367.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

Whitmont RD. Homeopathy and Lyme disease. J Am Inst Homeopath. Winter 1997-98;90(4):186-198.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Review Date:
9/5/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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