It’s PB&J Day, but It’s Not What You Think

Today is World Pediatric Bone and Joint (PB&J) Day, created by the multi-disciplinary Pediatric Specialty Group of the United States Bone and Joint Initiative (USBJI).  The United States Bone and Joint Initiative Group’s goal is to identify the primary areas of concern with regard to children’s musculoskeletal health, including those that relate to other health issues, and to develop programs and activities through research, education and advocacy to promote improved health and reduce the burden of disease.

  • Nearly 48% of adults have a musculoskeletal condition, many of which began in childhood.
  • Children represent 10% of the population with a disabling musculoskeletal condition.

Since 2012, this day has been set aside to urge doctors and parents to recognize the effects of musculoskeletal issues in children, and take action, so they do not lead to lifelong challenges. While every year has had its own theme, there has been an ongoing focus on obesity.  The percentage of children who are overweight or obese has more than tripled since 1980, rising from 7 percent  to nearly 30 percent today. Obesity can affect bones and joints at an early age.

In addition, a child who is overweight may not consistently eat foods rich in vitamin D, calcium and other important nutrients which contribute to healthy bones and joints. The child’s weight may lead him or her not to want to exercise and build bone mass, critical to maintain and improve their health.  All these may cause undue stress on the musculoskeletal system and can impair growth and contribute to serious childhood or lifelong conditions.

 

10 Tips to Keep Bones and Joints Healthy

 

As the summer comes to an end and the weather starts to cool, we find our kids indoors more often clutching video games or deep in social media. That means less physical activity. Any change in activity makes us more susceptible to joint- and bone-related issues. It is important we guide children in healthy living and activity to prevent damage, reduce pain, and improve their overall quality of life and health.

Following are 10 Tips we can all benefit from:

Exercise to protect and strengthen your joints. Overall, by strengthening muscles and aiding in weight loss, exercise can reduce the strain on joints. Squats and lunges, as well as certain exercises with weights, can help strengthen quadriceps and reduce the pressure on knees. Weight-bearing exercise such as walking also helps maintain bone density, no matter a person’s age. However, note that running and other high-intensity exercise may damage joints and ligaments, leading to inflammation, pain and, eventually, arthritis.

Stretch and warm up prior to exercising. Our bodies need to be warmed up in order to work properly and avoid excess injuries. This allows our tendons to flex and become suppler, helps the muscles to loosen up and work better, and gets the blood flowing through our body. Bodybuilding and weight lifting-related joint pain problems can be caused by tendonitis, an inflammation or irritation of the tendons. This type of joint pain can be reduced or eliminated by stretching and warming up tendons before working them too hard. This makes them more flexible and able to handle the added weight or exercise loads we put on them.

Change exercises. Both avid and novice exercisers should consider changing exercise routines. Impact-style exercising, such as step aerobics or kick boxing, is harder on our joints than exercises such as yoga and water-based workouts.

Don’t over-exercise. Regardless of the type of exercise, or how heavy the workout, our bodies need time to repair. Someone who does hours of intense exercising daily will have more problems with chronic joint pain than someone who allows their body to recuperate. Our muscles, tendons and ligaments all need time to rest and repair after a hard workout. That’s what causes them to strengthen over time.

Lose weight, if advisable. Extra body weight creates strain on our joints, particularly the knee joints. Losing as little as 10 pounds of body weight can help reduce pain and improves breathing and circulation.

Understand the value of omega-3 fatty acids. Omega-3 acids are primarily found in fatty fish and some nuts and seeds, such as flaxseeds. Omega-6 acids are found in many vegetables, such as corn and corn oil. While the anti-inflammatory benefits of omega-3 fatty acids (which include fish oil supplements) is well known, less known is the fact that your intake of these fats can affect both bone formation and the rate at which bone is broken down. It’s important to consume both varieties, though consuming more omega-3 fatty acids improves bone mineral density, particularly important for good hip health. Eating a fatty fish like salmon twice a week is recommended, and many physicians suggest fish oil supplements.

We need Vitamin D. Vitamin D helps our body absorb calcium and maintain enough calcium and phosphate in our blood so it doesn’t get pulled out of bone. It also enables bone growth and the breaking down and building up of bone. Low levels of vitamin D contribute to osteoporosis and a condition called osteomalacia, which produces an aching pain in our bones as the bone weakens. Low vitamin D also causes muscle weakness, which can lead to falls and fractures as we age. The best source of D is sunlight, but it’s nearly impossible to get enough in the fall and winter, or if we’re using sunscreen. That’s why supplements are helpful. The Institute of Medicine (IOM) recommends a daily level of vitamin D to 600 international units (IUs) for anyone up to age 71 years old, including children, and as much as 800 IUs for those 71 and older. As with all medicines or supplements, consult with your physician or nutritionist to ensure the best regimen for your personal wellness needs.

Evaluate shoes. Proper footwear is important for bone and joint health. It is important that all shoes, including tennis and athletic shoes, fit properly. Toes need room and there should be good arch support. Some sort of cushion, especially under the ball and heel areas of feet, also is recommended.

Change positions. Sitting or standing all day, day after day, can cause joint pain. We need to vary our routines to give both our bodies and joints variety and rest periods. Getting up and moving around is helpful to break up a routine and keep our bodies in shape.

Listen to biofeedback. Overdoing it can be costly. Make sure kids are staying bio aware and addressing any aches and pains.

 

Among the signs of strain on the musculoskeletal system:

  • Back pain.
  • Pain in the groin or inside of the thigh and knee, which may signal a significant problem with the growth plate of the hip.
  • Bowed legs (where the knees bend outward). Some bowing of the legs is common in children age 2 and younger; however, an ongoing or worsening spread of the knees are not normal.
  • Knock knees, or knees bending inward or even touching, may cause early arthritis and knee, shin and foot pain.

 

Getting Help

 

If you notice any of these conditions in a child, especially if they worsen over time, please contact your health care provider as soon as possible. After an examination, which may include X-rays or other imaging, a diagnosis and appropriate treatment protocol will be determined.

To find a great health professional, use HealthLynked. It is the first of its kind medical network built as a social ecosystem with a Higher Purpose – Improving HealthCare.  Go to HealthLynked.com to learn more, sign up for free find our additional resources and health information.

 

Adapted From:

usbji.org

prnewswire.com

cbia.com

 

 

In observance of this day, the USBJI is asking you to share your event or your thoughts on Facebook or via Twitter @USBJI.

 

Beware the Fungus Among Us – 10 Questions to Ask

Today marks the end of Fungal Disease Awareness Week, sponsored by the Centers for Disease Control and Prevention.  The CDC organized this week to raise awareness about the importance of recognizing serious fungal diseases early enough in the course of a patient’s illness to provide life-saving treatment.

Fungal Disease Awareness Week highlights the grave reality some fungal diseases go undiagnosed and cause serious infections in people in the United States and around the world, leading to illness and even death. Increased awareness about fungal diseases is one of the most important ways to improve early recognition and reduce delays in diagnosis and treatment. A key clue to when a sick person may have a fungal infection is that he or she is being treated with medications for other types of infection without expected improvement.

Healthcare providers and their patients are encouraged to Think Fungus when symptoms of infection do not get better with treatment.  Fungal diseases range from relatively minor superficial and mucosal infections to severe, life-threatening systemic infections. Delayed diagnosis and treatment can lead to poor patient outcomes and high medical costs. The overall burden of fungal diseases in the United States is challenging to quantify because they are likely substantially underdiagnosed.

 

Facts

It is estimated that fungal diseases cost more than $7.2 billion in 2017, including $4.5 billion from 75,055 hospitalizations and $2.6 billion from 8,993,230 outpatient visits. Hospitalizations for Candida infections (n=26,735, total cost $1.4 billion) and Aspergillus infections (n=14,820, total cost $1.2 billion) accounted for the highest total hospitalization costs of any disease. Over half of outpatient visits were for dermatophyte infections (4,981,444 visits, total cost $802 million), and 3,639,037 visits occurred for non-invasive candidiasis (total cost $1.6 billion).[1]

Fungal diseases are often misdiagnosed as their symptoms sometimes resemble other conditions. For example, Valley fever — an inhaled fungal infection that incites cough, fever and a distinctive rash on the upper body or legs — is often misdiagnosed as bacterial pneumonia. While an estimated 150,000 cases of Valley fever occur every year, only 10,000 cases are diagnosed.

About 46,000 healthcare-associated invasive fungal infections occur in the U.S. annually. Growing drug resistance is also making certain fungal strains more difficult to treat.

 

The fungus is among us.

Fungi are everywhere. There are millions of distinct species of fungi on Earth, but only about 300 of those are known to make people sick. Fungal infections are often caused by microscopic fungi that are common in the environment. Fungi live outdoors in soil and on plants and trees as well as on many indoor surfaces and on human skin.

Mild fungal skin infections can look like a rash and are very common. For example, ringworm is a skin infection that’s caused by a fungus, not a worm! Fungal infections in the lungs can be more serious and often cause symptoms that are similar to other illnesses, such as the flu or tuberculosis.

Fungal meningitis and bloodstream infections are less common than skin and lung infections but can be life-threatening. Because the symptoms of fungal infections can be similar to other illnesses, proper diagnosis and treatment are often delayed. The more you know about fungal infections and your chances of getting one, the better prepared you can be to protect your health.

 

10 questions you can use to understand fungal infections, learn how you can get sick, and know what you need to do to stay healthy.

 

Where do you live and travel? Fungi that can cause serious infections are more common in some parts of the United States and world. For example, the fungus that causes Valley fever (also called coccidioidomycosis) is found mainly in the southwestern United States. Histoplasmosis and blastomycosis occur most often in the eastern United States. These infections usually cause a lung infection that is often mistaken for flu or a bacterial infection.

What types of activities are you doing? Harmful fungi can be found in air, dust, and soil. Histoplasma grows especially well in soil that contains bird or bat droppings. Activities like digging, gardening, cleaning chicken coops, and visiting caves can result in you breathing in fungi that may cause infection.

Do you have a dog or cat? People can get ringworm from their pets. Dogs and cats with ringworm sometimes have circular, hairless patches on their skin or other types of rashes. Adult animals do not always show signs of ringworm infection.

Have you recently taken antibiotics? Antibiotics can make women more likely to get vulvovaginal candidiasis, also known as a vaginal yeast infection. Women who are pregnant and have weakened immune systems also are more likely to get this condition. Men also can get genital candidiasis.

Are you taking any medications that affect your immune system? Medications used to treat conditions like rheumatoid arthritis or lupus may weaken your immune system and increase the chance of getting a fungal infection.

Are you living with HIV/AIDS? People living with HIV/AIDS may be more likely to get fungal infections. Two well-known fungal infections associated with HIV/AIDS in the United States are oral candidiasis (thrush) and Pneumocystis pneumonia. Worldwide, cryptococcal meningitis is a major cause of illness in people living with HIV/AIDS.

Will you be hospitalized? In the United States, one of the most common bloodstream infections in hospitalized patients is caused by a fungus called Candida. Candida normally lives in the gastrointestinal tract and on skin without causing any problems, but it can enter the bloodstream during a hospital stay and cause infection.

Have you recently had a transplant? People who have recently had an organ transplant or a stem cell transplant have a greater chance of developing a fungal infection while their immune systems are weakened. Doctors prescribe antifungal medication for some transplant patients to prevent fungal infections from developing.

Are you receiving chemotherapy or radiation treatments? Cancer treatment, such as chemotherapy and radiation, weakens your immune system and may increase the chance you will get a fungal infection.

Do you have symptoms of pneumonia that are not getting better with antibiotics? Fungal infections, especially lung infections like Valley fever, histoplasmosis, and aspergillosis, can have similar symptoms as bacterial infections. However, antibiotics don’t work for fungal infections. Early testing for fungal infections reduces unnecessary antibiotic use and allows people to start treatment with antifungal medication, if necessary.

 

Conclusions

Anyone can get a fungal infection, and fungal diseases impose a considerable economic burden on the healthcare system. Since they are often under-diagnosed, it is important to learn more about the signs, symptoms, and treatment of fungal infections and get prevention tips by visiting CDC’s fungal diseases website and by talking with your healthcare provider.

To connect quickly with the right healthcare provider in your area, go to HealthLynked.com – the FUTURE OF CONNECTED HEALTHCARE.  There, you will find one comprehensive platform that connects doctors, families and medical data to Improve HealthCare.

 


Adapted from the CDC pages on fungal infections.

 

[1] Estimation of direct healthcare costs of fungal diseases in the United States

Kaitlin Benedict  Brendan R Jackson  Tom Chiller  Karlyn D Beer

Clinical Infectious Diseases, ciy776, https://doi.org/10.1093/cid/ciy776

Published: 10 September 2018

 

The Good, The Bad, The Hela | by Alexandra de Carpio

Today marks the death of the woman in whom the most famous (and infamous) immortal cell line was discovered.  Henrietta Lacks, a hard-working woman and loving mother, passed away from the virulent Cervical cancer that was taking over her body.  In honor of the woman, whose family just recently won the right to determine what happens with HeLa cells, we are sharing an article from a research student who insightfully describes all that has occurred with this incredible cell line – The Good, The Bad and the HeLa.


Ask most people and they’ll say that being first is best: you win medals at races, get best dibs on cookies at a reception, avoid getting scooped on research, and ride shotgun in a car. Sometimes, however, being first has both positive and negative consequences, as anyone familiar with the history of HeLa cells can tell you.

HeLa cells have the distinction of being the first immortal cell line cultured by scientists. Unlike a normal population of human cells, which divide about 40 to 50 times before dying away, HeLa cells have the remarkable ability to divide indefinitely. Coming in first secured their status as one of the most popular cell lines used by scientists for research, making them the cornerstone of some of the most significant biological advances. UC Berkeley researchers are also no stranger to HeLa: an estimated 200 labs on campus have used HeLa cells. Today, Berkeley scientists have a wider array of cell lines to choose from, but HeLa’s familiarity and hardy growth continues to make it a popular choice.

In the early 1950’s, however, scientists had yet to meet HeLa. In fact, the original HeLa cells were still attached to a living, breathing human being; a woman who put her family first in every situation, even when battling an unyielding cancer. This cancer would overcome her, but her cancerous cells would continue to grow in laboratories across the world. As the first immortal human cell line, HeLa cells, along with their involuntary donor’s family, had to deal with the growing pains of a society who could develop the technology for cell and tissue culture faster than the ethical rules needed to regulate it.

Both the good and the bad, this is the story of a woman, her legendary cells, and how they have touched the lives of research scientists at UC Berkeley.

A prominent mother figure: paving the way for breakthrough research

For most scientists, Henrietta Lacks represents the mother of all HeLa cells. As the first and, for many years, only cell line able to divide indefinitely out of the body, their popularity among research scientists flourished, and HeLa cells quickly became workhorses in the laboratory. Their first formidable task? To aid in the development of the polio vaccine in 1953. Jonas Salk, a virologist at the National Foundation for Infantile Paralysis, had created a vaccine from inactivated viruses. It seemed promising, but he needed cells—lots of them—to test his vaccine before human trials. HeLa cells were the perfect tool. Not only did they grow vigorously, making it easy to amass the enormous quantity of cells required for the study, but they also become easily infected by the poliomyelitis virus. Within less than a year, the vaccine was ready for human patients.

From there, the list of HeLa’s accomplishments only continued to grow. Known as the mother of virology, cell and tissue culture, and biotechnology, HeLa cells were used to jumpstart research on how viruses act and reprogram cells, as well as to develop standard lab practices for freezing and culturing cells and tissues. Scientists used them to develop cell cloning, in vitro fertilization, and isolation of stem cells, as well as to research AIDS, cancer, and the effects of radiation and toxic substances. HeLa cells have been infected with an array of diseases, from tuberculosis to salmonella, and have helped scientists understand that a normal human cell has 46 chromosomes, thus making genetic disorders easier to diagnose. It is easy to see why many have also named HeLa the mother of modern medicine. HeLa cells were a welcome development for researchers around the world.

For Lawrence, Elsie, Sonny, Deborah, and Zakariyya Lacks, Henrietta was simply known as mom. Described as a strong but caring woman, Henrietta kept her growing family together while her husband, Day, worked at a steel mill. She was no stranger to hard work after growing up with her grandfather on a tobacco farm in Virginia. For the youngest children in the family, however, much of what they know of their mother would come second hand. Henrietta was diagnosed with cervical cancer a mere four and a half months after giving birth to her fifth child, Zakariyya, and would perish from it less than a year later.

Henrietta’s battle with cancer began when, worried about a knot that she felt in her abdomen, she made the 20-mile trip to Johns Hopkins Hospital. At the time, Johns Hopkins was the only option in the area for African Americans seeking medical treatment. A biopsy of her cervix revealed that she had cervical carcinoma, a type of cancer that grows from the epithelial cells that line and protect the cervix. Extensive treatment ensued, which began by inserting tubes of radium into her cervix to reduce the tumor, followed by daily X-ray therapy. Despite the debilitating treatments, Henrietta’s commitment to her family never wavered, and she was able to keep her condition secret from most family members in order to spare them the worry. In turn, she endured much of it alone while Day was at work. Her cancer proved to be too resilient, however, and began to weaken both body and spirit. Tumors overcame nearly all the organs in her abdomen, and relief from the excruciating pain was the only service available at Johns Hopkins. Henrietta passed away on October 4th, 1951.

Her death left a family without its mother.

The birth of HeLa: an exceptional cell line

HeLa as we know it today was born in the lab of George Gey, the director of the Tissue Culture Laboratory at Johns Hopkins Hospital in the 1950s. Gey’s agenda? Cure cancer. His tactic? Develop an immortal human cell line that could be used for research. Fortunately, his position at Johns Hopkins meant he had plenty of tissue samples from which he could try growing human cells in the lab. Unfortunately, most of these cell samples would die within a few generations. That is, until one of them did not: HeLa. Gey obtained HeLa from the surgeon treating Henrietta’s carcinoma, who had been taking cancerous tissue samples from patients for Gey’s research. As with his other samples, Gey named the cell line using the first two letters of the patient’s first and last name. Henrietta Lacks became HeLa.

True to his ultimate goal of curing cancer, Gey was generous with his newly discovered gem, and gave away samples to a few close colleagues working to eradicate cancer. From its beginning in Baltimore, Maryland, HeLa soon traveled the world as scientists far and wide learned of this remarkable immortal cell line.

So, what makes HeLa special? As cancer cells, HeLa cells are unlike normal human cells, and there is no better proof of this than to take a look at its chromosomes, or karyotype. Normal human cells have 46 chromosomes, while HeLa has 76 to 80 heavily mutated chromosomes. The origin of this deviation from normalcy stems from the human papilloma virus (HPV), the cause of nearly all cervical cancers. HPV inserts its DNA into a host cell, causing it to begin producing a protein that binds to and inactivates the native p53 protein. p53 is known as the guardian of the genome due to its role in preventing mutations and suppressing tumors. Non-functional p53 protein can therefore have disastrous consequences.

Relative to other cancer cells, however, HeLa cells still grow unusually fast. Gey was amazed to see that within 24 hours of culturing his first HeLa sample, the number of cells had doubled. The source of this abnormal vigor lies in HeLa’s telomerase enzyme. During normal cell division, the string of repetitive DNA at the tips of all chromosomes, known as telomeres, are shortened. This leads to cell aging and ultimately to apoptosis, or cell death. Normal cells have a maximum number of divisions before these telomeres are depleted. HeLa cells, meanwhile, have an overactive telomerase enzyme that rebuilds telomerases after cell division, thus circumventing the aging process and skirting death. This internal fountain of youth is what has allowed HeLa cells to divide indefinitely, making them now older than Henrietta was when she died.

The birth of HeLa: at the expense of proper consent

For decades, Henrietta’s side of the story has been largely ignored, but thanks to Rebecca Skloot’s novel, The Immortal Life of Henrietta Lacks, she finally has a voice. When Henrietta stepped into the public ward of Johns Hopkins on January 29th, 1951, she could have had no knowledge of what was to ensue. She hoped that her radium treatments would cure her of cervical carcinoma. She hoped that she would still be capable of having children. She hoped to see her family thrive and grow. Unfortunately, she was let down on many counts; Henrietta’s cancer proved too powerful for the doctors at Johns Hopkins to treat, despite their best efforts.

No effort, however, was made to treat Henrietta herself as a woman capable of making her own medical decisions. Without question, Henrietta would have opted out of treatment had she been informed that it would leave her infertile, a fact that she only discovered once it was too late. She also never discovered that her surgeon had taken tissue samples for Gey’s research. Would she have consented? Would she have appreciated Gey sending her cells to his colleagues? What about having her cells commercialized and sold for profit, as they are commonly done today? Would she mind that strangers would profit from her cells, selling them to researchers making important medical advances, while her own family is unable to pay for health care?

It’s too late for Henrietta to answer these questions, but her story has forced scientists and doctors to make sure that such questions are addressed by patients and research participants. Since 1991, scientists and doctors have been governed by the Common Rule, which requires them to inform people when they are participating in research, and that their participation be completely voluntary. Patients must sign consent forms which clearly state what the research is, how long it will last, what the potential risks are, if there is any compensation, and more. Unfortunately, the Common Rule did not come soon enough to protect Henrietta’s family. After HeLa cells exploded on the scene and became associated with many significant scientific advances, people became curious about the woman behind the cells. Along with consent, anonymity and privacy were not issues that had been properly addressed in the medical arena, and Henrietta’s identity was soon revealed. Having her name so closely related to HeLa probably did not help.

This is how, 22 years after her death, Henrietta’s children learned that pieces of their mother were still alive and thriving. Scientists came knocking, asking for blood samples to supply the genetic information needed to better understand HeLa. Again, no consent was obtained, and with a limited background in biology, the family misunderstood the purpose of these samples; they thought they were being tested for cancer. Marginalized by the media and the medical community, it would take decades for them to uncover the true story of what happened to their mother and to gain an understanding of what HeLa means to the world today.

Life in the lab as a hearty membrane source

When Pengcheng Zhang steps into his lab in Li Ka Shing Center to start another day, he is often met by HeLa. Zhang is a fifth year molecular and cell biology PhD student working in the lab of Professor Randy Schekman. The Schekman lab focuses on understanding how proteins produced in a cell are shuttled out via the secretory pathway, an intricate assembly of membranes and proteins. Schekman’s goal is to decipher this pathway by pinpointing the proteins and biomolecules that make it run and determining just how they do it. So far, he has been successful in yeast.

“[Schekman] started out in yeast because it’s much less complex than tissues and organs,” explains Zhang. “After about 20 years of work they came up with this protein complex called COPII, which is required for the first step into this secretory pathway.”

COPII (coatomer protein complex II) is a set of five proteins that work together to create vesicles, or sacs, that bud from protein-producing subunits in the cell, known as the endoplasmic reticulum. These vesicles are then transported to other membranes in the cell for unloading, including export through the outer membrane. The Schekman lab was able to recreate the process in test tubes with only the cargo, purified yeast membranes, and COPII, thus identifying the key components required for the secretory pathway. “This is a very central concept in biochemistry: that we can reconstitute biological processes in the test tube,” says Zhang. “We look at biological processes as a series of chemical reactions.”

Although cells are composed of a vast amount of material, if the proper proteins or biomolecules required for a given cellular reaction are identified and isolated, that same reaction can be carried out in a cell-free system. This is how the Schekman lab was able to identify and isolate the COPII complex of yeast. More recently, however, they have set their sights on understanding the secretory pathway in higher order organisms such as mammals. “We know for a fact that in mammals COPII does the same thing,” explains Zhang. “But the thing is, from yeast to humans the number of proteins that go through the secretory pathway expands.”

For some of these larger, more complex proteins, the Schekman lab has found that COPII alone is insufficient in their test tube “cell”. Understanding the modifications, such as additional proteins, that are required for mammalian cells is now the goal. Zhang, for instance, is trying to understand the necessary components for shuttling transforming growth factor alpha (TGF-α), a protein that is involved in the development of epithelial tissue such as skin or the lining of the cervix. This is where HeLa comes in. “HeLa cells are the major membrane source for my biochemical reactions,” says Zhang. “They are desirable in our case because it’s a human cell line and it grows relatively fast.”

Faster growth means more membranes for Zhang’s experiments. Zhang also uses another mammalian cell line derived from rat liver cells to harvest its cytosol, which is the cellular fluid containing all the proteins and biomolecules of the cell. Zhang transfects, or introduces, additional TGF-α cargo into these liver cells in order to yield better signals. By combining purified COPII, HeLa’s cell membranes, where the secretory mechanism occurs, and the harvested cytosol containing the TGF-α cargo and Zhang’s mystery proteins, Zhang has all that he needs to recreate the secretory pathway in vitro. The trick, however, is figuring out which protein or proteins in the cytosol are doing the work.

“We fractionate the cytosol, separate the protein content, and analyze where the activity goes,” explains Zhang. When one of the fractions successfully reproduces the secretory pathway, Zhang knows that it contains his desired protein. Unfortunately, it’s usually not the only protein present. “[The fractions are] not pure enough that we can assign the function to a particular protein or couple of proteins with confidence. That’s why we need many fractionation steps to get down to a pure enough fraction to have confidence to say that we think these things are responsible for this secretory function.”

So far, the protein of interest remains a mystery. Once identified, however, the Schekman lab can determine if changes or mutations in the protein are linked to any human diseases, with the ultimate goal being treatment of such a disease.

Zhang is not the only graduate student at Berkeley taking advantage of HeLa’s utility in the lab. Ann Fischer, who has been running the Tissue Culture Facility in Barker Hall since 1989, supplies HeLa cells for many of the labs who use them today. She is no stranger to HeLa: Fischer has been working in tissue culture facilities, first at UCSF, then at UCLA, and finally here at UC Berkeley, since 1971.

Fischer says the use of HeLa cells by UC Berkeley researchers has gone through various phases during her time here. Initially, she would grow hundreds of liters of HeLa cells for researchers in the biochemistry department to extract large quantities of a given protein of interest.

“That was the heyday of just biochemistry: using cells to get proteins out,” explains Fischer. “People [later] started using cells for overexpression.” Overexpression involves inserting a gene of interest into the DNA of HeLa cells and stimulating the cells to express it, thus enabling researchers to obtain larger quantities of protein with fewer cells. Today, overexpression is still a popular application of HeLa cells, but the utility of HeLa has expanded. Zhang, for instance, uses HeLa to harvest its membranes, while others take advantage of HeLa’s large size for imaging. In the end, HeLa’s vigor is what makes it so popular.

“It’s because they grow so well,” explains Fischer. “That’s the reason people use HeLa cells.”

Life in the lab: as a hearty contaminant

When Professor Gertrude Buehring steps into her lab in Koshland Hall, she is never met by HeLa cells. In fact, she makes a point of it. “We never grow them,” she says. “I wouldn’t want to take that risk, actually.”

Buehring, a professor of virology in the School of Public Health, has a reason to be wary of HeLa. Both her PhD and postdoc careers were spent working at UC Berkeley’s Cell Culture Laboratory housed in the Naval Biosciences Laboratory in Oakland, a cell repository funded by the federal government that characterized and maintained cell lines for research scientists. She happened to be working there at a time when Dr. Walter Nelson-Rees, the co-director, was working hard to expose HeLa’s misdeeds. The vigorous cell’s crime? The contamination of other, less hardy cell lines.

Nelson-Rees was not the first to suspect contamination by HeLa cells. In the 1960s, Dr. Stanley Gartler, a research geneticist, released the initial “HeLa bomb”. Gartler had discovered that the 18 different cell lines he had collected for his research all turned out to be genetically identical, with genes only present in people of African descent. HeLa was a suspect, but many scientists refused to accept the implications of his discovery, and chose instead to ignore it. Ten years later, Nelson-Rees picked up where Gartler left off, and discovered several HeLa specific chromosomal markers that could be used to test the identity of cell lines.

“Since this repository had so many cell lines, [Nelson-Rees] was going through all of them and examining them for these markers,” recalls Buehring. “While he was there he came up with 40, which was more than one expected.”

In that instant, any tissue-specific research that used the cell lines identified as HeLa contaminants was suddenly invalid. How can research on breast cancer cells be taken seriously when the cells used were actually cervical cancer cells all along? It has been estimated that over 500 research papers and more than 20 million dollars of funding have been wasted. The problem stems from the adolescent days of cell culture.

“After Dr. Gey established the HeLa line, everybody was so excited and thought they could establish a human cell line, too,” Buehring explains. Unfortunately, most of these labs did not have the knowledge or equipment to properly culture cells. What they did have was plenty of HeLa cells around, and due to HeLa’s hardiness, a single cell could outgrow and overtake all normal human cells in a culture. “Suddenly everybody was able to establish a human cell line,” jokes Buehring. It turned out that many of them were just HeLa.

Even years after being exposed for what they really were, HeLa contaminants continued to be sold by the American Type Culture Collection (ATCC), one of the largest international cell line repositories, and scientists continued to request the cells they had become so familiar with. In fact, many scientists were hostile towards Nelson-Rees, and unable to accept the implications of his work. Over time, however, the ATCC refused to sell HeLa contaminants. This doesn’t mean, however, that they are no longer used in labs today. Since her days working at the Naval Science Laboratory, Buehring kept HeLa in the back of her mind, and was curious about the extent to which HeLa contaminants were still used, as well as how aware researchers were about HeLa’s potency.

“I couldn’t find any research papers where people actually looked at that,” she says. So, in 2004 she decided to look into it herself. With the help of an undergraduate student, Professor Buehring conducted a survey of researchers known to culture cells and asked what kinds of cell lines they worked with, whether it was for tissue-specific work or not, and if they ever tested the identities of their cell lines. The results surprised her.

“There were so many people who used HeLa cells in their laboratory, and only about 50% did any kind of check to see if there was contamination,” she says. Not only that, but about 60% of respondents had acquired at least one cell line from another laboratory rather than from a repository like the ATCC.

“Often times people will think they’re getting a good cell line from a colleague down the hall, but they don’t know it’s already been contaminated,” she explains. “If it isn’t checked, you never know that.” Buehring herself rarely gets cells from other labs, but if she does, she makes sure to check their identity before trusting them.

The survey also revealed that about 10% of respondents still used HeLa contaminants, 30% of which used them for tissue-specific purposes. The original “HeLa bomb” of the 1960s and 70s had lingering effects, it appeared.

The truth is, however, that many researchers today don’t see HeLa as a contamination threat anymore. “Back when cell cultures started, they were using glass. It was so easy to contaminate,” says Fischer. The use of disposables today helps eliminate some of the threat. “Nowadays, I don’t worry about that at all.”

Like Buehring, Fischer also insists on getting cells from reputable sources like the ATCC; otherwise, she suggests verifying their identity. Going back to frozen stocks of cells every week or two is another method of avoiding contamination. Zhang says that he, too, is not concerned. “If it gets contaminated with a different cell line it’s very recognizable because looking under the microscope every cell line has a very distinct shape,” he explains. HeLa cells, for instance, are often very large and triangular.

Not only have cell culturing methods improved, but HeLa’s days as the easiest and fastest growing cell line are over. New cell lines have emerged that work just as well, if not better, for certain applications. Insect cells, for instance, can also be used to overexpress proteins, but can be grown in larger quantities. This makes them ideal little protein factories for when researchers need large quantities of a given protein for study. “People don’t use HeLa cells as much because they’re harder to grow than insect cells,” says Fischer. “Believe it or not! Harder to grow!”

Bacteria cells are actually the easiest cell type to grow but may not be capable of making some of the more complicated human proteins that often require more intricate modifications before they become fully functional. Yeast cells, which have a more advanced protein assembly system, are the next line of attack, followed by insect cells. Only if these three cell types are unable to produce the human protein of interest do researchers consider human cells such as HeLa.

There are other reasons that HeLa cells are finding themselves at the bottom of the list: as a cancer cell, its DNA is a major liability. “[HeLa cells] have the strangest karyotype,” says Fischer. “They have 3 copies of this, and 2 copies of this, and 5 copies of that. They’re not normal.”

Many researchers today choose to work with cells that more closely resemble normal human cells, thus taking their in vitro systems one step closer to mimicking how a real human functions. IMR-90 cells are one such example. Cultivated from the lungs of a human fetus in the Netherlands, IMR-90s have a normal karyotype with 46 chromosomes. Of course, there are drawbacks to working with “mortal” cells.

“They only go up 60 populations and then they [die],” says Fischer. “We have to thaw those every three weeks.” Not only that, but as the cell line becomes older and older, they show signs of aging and may not be ideal for research anymore. Luckily, Zhang doesn’t have to worry about trying to work with more normal, but finicky, cell lines.

“Since we’re looking at such a fundamental process in the cell, we think that although HeLa cells are very different from normal human cells, the basic processes that keep the cell alive should essentially be unaltered,” reasons Zhang.

Buehring agrees that there is an important distinction between using HeLa to obtain basic cellular material versus using HeLa as a whole cell and expecting all of its cellular processes to be the same. As a “bag to hold the biomolecules of study,” however, they work just fine.   For other purposes, HeLa may not be top dog anymore.

A wealth of information: making research faster and easier

Like a celebrity, the more scientists learn and work with HeLa, the more popular it becomes. It began in the early days of cell culture, when HeLa’s vigor and human origin made it unique. Today, scientists take comfort in HeLa because of its familiarity.

It’s well-characterized because so many labs have been working on it,” explains Zhang. “There are many tools that work with HeLa cells that don’t necessarily work well with obscure cell lines.”

This is because many of these tools or techniques were originally developed using HeLa cells and are thus optimized for them. One example, gene knockdowns, can be used to stop HeLa from expressing a specific protein, thus helping Zhang determine if and how it affects the secretory pathway. HeLa also has good transfection efficiency, ensuring that when Zhang transfects his HeLa cells with a protein, a higher percentage of the population will have his protein of interest.

Not only can HeLa do a lot, we also know a lot about it. As a human cell line, the human genome database becomes an important source of genetic information. Zhang, for instance, uses the database to design his knockdowns and target a specific gene of interest. Though not crucial, HeLa’s specific genome would make things even easier. Luckily, this is now a possibility. Since August of 2013, researchers can submit proposals to gain access to the HeLa genome on the National Institute of Health’s (NIH) database.

“You would know which genes are expressed instead of empirically testing it, which can take a week,” says Zhang. Access to the NIH database would let him see what genes are expressed and to what degree, therefore making it easier to design effective knockdowns.

Simply put, HeLa cells are just plain simple.

 

A wealth of information: crossing the boundaries of privacy

As HeLa’s popularity in the lab grew and the list of medical discoveries reached the ears of non-scientists, public interest sprouted. Articles began to surface that speculated on the identity of this mystery woman. Credit was given to Helen Lane or Helen Larson, until eventually Henrietta’s true identity was revealed.

Researchers, members of the media, and con artists soon hounded the family, all hungry to use them for their genetic information, family history, or as pawns for a fraudulent money-making lawsuit against Johns Hopkins, respectively. No one, however, provided the family with any information in return, and they were often left in the dark about their mother’s final months, the origin of HeLa, and the implications of HeLa in research. The infamous cells became a burden.

This kind of disclosure about a human cell line would be unthinkable today, and rightly so. “Nowadays, if you take their cells, you wouldn’t call them by that patient’s name because of confidentiality,” says Fischer. “What if you found a genetic abnormality that could be traced back to the family?”

Which is, in fact, a very real question posed by members of the Lacks family. In March of 2013, HeLa’s complete genome was published without the family’s knowledge. Researchers like Zhang sit on both sides of the fence on the issue. “It would be helpful to get some genomic information that would be specific to HeLa cells,” he begins, “but there’s this privacy issue, an ethical issue.”

The genome was removed after the family voiced its concerns. A few short months later, however, a compromise was reached, known as the HeLa Genome Data Use Agreement. Researchers can obtain controlled access to the genome after submitting a proposal, and any data obtained from the genome must be openly shared on the NIH database. Access to the genome will be tightly regulated by a committee of six, two of whom are members of the Lacks family.

It may not have been a simple journey, but the family is in the dark no more.

Over the years the family has come to learn about the use and importance of HeLa cells, and the research and medical communities have, in turn, learned to respect them. Credit, in large part, must be given to Rebecca Skloot, whose book, The Immortal Life of Henrietta Lacks, was the first to focus on the story of Henrietta and her family rather than HeLa. Skloot took a different, more constructive, approach than the scientists and members of the media who came before her. She chose to work with the family rather than use them and helped them understand all parts of their mother: from life to death to HeLa. In turn, scientists can now learn about the history of the cells they have become so familiar with in the lab and understand their significance outside of the lab.

“The wealth of information that we’ve learned from her cells is just so overwhelming,” says Zhang. Not only has this information resulted in valuable medical advances, research papers, and PhD theses, but also in crucial laws and policies governing the use of cells and tissues, and a greater awareness of cell line contamination. It may be that with good comes bad, but the key is converting the mistakes of the past into something constructive for the future. Zhang would argue that acknowledging those who deserve the credit is also important: “I think we should all be grateful to her.”

 

This article appears in the print edition of the Berkeley Science Review. All authors and editors are graduate students in the Bay Area.

16 Ways to Celebrate National Women’s Health & Fitness Day

Today is National Women’s Health & Fitness Day, a nation-wide effort to focus attention on the importance of regular exercise and healthy living for women. There will be local events all over the country, from talks on healthy aging to free Kettlebell demos and yoga and Zumba classes.

There’s no denying the importance of our health, yet we’ve all been guilty of putting it on the back burner from time to time.  Whether it be for our families, a job, or an over-indulgent weekend with friends, it’s easy to forget the importance of our health, physical fitness and mental well-being as we manage the stress and celebrate the joys of every day life.

In case you’ve found yourself in one of those slumps, today offers another  great reason to help get you back on track.  National Women’s Health and Fitness Day is a day dedicated to women of all ages focusing attention on the importance of regular exercise and healthy living.  In honor of a healthier you, check out these sixteen ideas to help you celebrate your body, mind, and well-being––and get the journey to a stronger you started!

  1. Find a Local Event. Over 500 community groups across the nation will be hosting health and fitness related events throughout the day, and up to 75,000 women of all ages are expected to get involved. From exercise demonstrations to health information workshops, there will be something for everyone––so grab a friend and join an activity! Get in touch with your local health and fitness organizations, such as senior centers, universities, or park and recreations departments to find out what’s happening in your area.
  2. Get your thyroid checked. A sluggish or hyperactive thyroid can wreak havoc on your concentration, mood, and weight—-and can go undetected for years.
  3. Eat some superfoods! You may not be Superwoman or WonderWoman (well, not every day), but you can eat superfoods. We’re talking broccoli, apples, turnips, zucchini — and lots of other good stuff you can find at your local farmer’s market. Try superfoods that may help you lose weight, fight colds, boost your heart health, support your immune system and may even help you live longer.
  4. Take a nap. You know it’s good for you, so here’s how to power-nap like a pro. New research is shedding light on the health benefits of sleep, which is good for your heart, mind, weight, and more.
  5. Ask a friend to work out. Not only will exercising be more fun, but research has shown that working out with a pal can help you stay motivated and lose more weight than those who go solo.
  6. Give yourself a healthy beauty treatment. Try DIY food facials or find out how to check yourself for skin cancer.
  7. Eat for your bones. A healthy diet can go a long way towards helping you get enough calcium and vitamin D to keep your bones healthy and strong.
  8. Stay hydrated. Not a fan of the 8-glasses-of-water-a-day rule? Try juicy, water-filled foods.
  9. Toast up some squash seeds! Chock full of nutrients and crunch, these little seeds will become a healthy addiction. Plus, they are rich in iron, fiber and zinc.  Markets are filled with them and zucchini this time of the year.
  10. Rub out stress with a massage. While a little bit of stress is fine for the body, prolonged stress can take a toll on your body, including weight gain, hair loss, and blood sugar swings.
  11. Give your back a break. Try lightening up your bag or making other changes to help your back. And don’t forget to add back-strengthening moves to your workout to stop problems before they get started.
  12. Eat some chocolate.  Not only does chocolate (the dark kind) have all sorts of health benefits, letting yourself savor the foods that give you pleasure is one of the healthiest things a woman can do, says Sue Ann Gleason of Consciousbitesnutrition.com.
  13. Try Something New. Have you always wanted to incorporate strength training into your exercise routine but didn’t know where to start? Have you ever wanted to try SoulCycle but were too nervous to sign up for a class? Changing up your work outs can actually be good for your health and fitness, so seize the day and give something new a go.
  14. Schedule a Checkup. The HHS Office on Women’s Health recommends booking an appointment with a doctor or nurse for a well-woman checkup and any preventative screenings that might be eligible for your age group. Staying on top of any required tests and health concerns now can save you a lot of stress, time and money in the future.
  15. Pay Attention to your Mental Health. Stop and listen to what you, your mind and your body need today. Try some relaxing yoga or a 5 minute meditation to help you be present, relieve stress and refresh yourself.
  16. Shake Things Up at Work.  Even if you can’t escape a busy work schedule to get to a gym, there are many ways you can celebrate your health on the job. Take the stairs instead of the elevator, choose a parking spot further away from the door, or get a co-worker out on a walk during your lunch hour. This could even be your chance to start up a weekly healthy recipe club in your team.

However you choose to celebrate, let National Women’s Health and Fitness Day be a reminder that a healthier, happier you is right around the corner––and if you’re already celebrating your health and wellness on a daily basis, give yourself a pat on the back and encourage others to join in on your path to wellness.

Get Connected!

Finding the right physician and keeping up with your wellness can be challenging.  We are here to help!  HealthLynked is the first of its kind portable health record designed with those on the go in mind.  It allows you to gather all your relevant health information and providers in one place – including your medications, pharmacy and healthcare team – to ensure you get the very best care possible.

Ready to get Lynked?  Go to HealthLynked.com now to register for free and start taking control of your health today!

 

 

Sources:

FitnessMagazine.com

Health.com

 

14 Proven Treatments for Restless Leg Syndrome

Restless legs syndrome (RLS), also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them.  Symptoms commonly occur in the late afternoon or evening hours and are often most severe at night when a person is resting, such as sitting or lying in bed.  They also may occur when someone is inactive and sitting for extended periods (for example, when taking a trip by plane or watching a movie).

Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up.  Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.

What is restless legs syndrome?

RLS is classified as a sleep disorder since the symptoms are triggered by resting and attempting to sleep, and as a movement disorder, since people are forced to move their legs in order to relieve symptoms.  It is, however, best characterized as a neurological sensory disorder with symptoms that are produced from within the brain itself.

RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships.  Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.  Untreated moderate to severe RLS can lead to about a 20 percent decrease in work productivity and can contribute to depression and anxiety.  It also can make traveling difficult.

It is estimated that up to 7-10 percent of the U.S. population may have RLS.  RLS occurs in both men and women, although women are more likely to have it than men.   It may begin at any age.  Many individuals who are severely affected are middle-aged or older, and the symptoms typically become more frequent and last longer with age.

More than 80 percent of people with RLS also experience periodic limb movement of sleep (PLMS).  PLMS is characterized by involuntary leg (and sometimes arm) twitching or jerking movements during sleep that typically occur every 15 to 40 seconds, sometimes throughout the night.  Although many individuals with RLS also develop PLMS, most people with PLMS do not experience RLS.

Fortunately, most cases of RLS can be treated with non-drug therapies and if necessary, medications.

What are common signs and symptoms of restless legs?

People with RLS feel the irresistible urge to move, which is accompanied by uncomfortable sensations in their lower limbs that are unlike normal sensations experienced by people without the disorder.  The sensations in their legs are often difficult to define but may be described as aching throbbing, pulling, itching, crawling, or creeping.  These sensations less commonly affect the arms, and rarely the chest or head.

Although the sensations can occur on just one side of the body, they most often affect both sides.  They can also alternate between sides. The sensations range in severity from uncomfortable to irritating to painful.

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations.  They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.

A classic feature of RLS is that the symptoms are worse at night with a distinct symptom-free period in the early morning, allowing for more refreshing sleep at that time.  Some people with RLS have difficulty falling asleep and staying asleep.  They may also note a worsening of symptoms if their sleep is further reduced by events or activity.

RLS symptoms may vary from day to day, in severity and frequency, and from person to person.  In moderately severe cases, symptoms occur only once or twice a week but often result in significant delay of sleep onset, with some disruption of daytime function.  In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.

People with RLS can sometimes experience remissions — spontaneous improvement over a period of weeks or months before symptoms reappear — usually during the early stages of the disorder.  In general, however, symptoms become more severe over time.

People who have both RLS and an associated medical condition tend to develop more severe symptoms rapidly.  In contrast, those who have RLS that is not related to any other condition show a very slow progression of the disorder, particularly if they experience onset at an early age; many years may pass before symptoms occur regularly.

What causes restless legs syndrome?

In most cases, the cause of RLS is unknown (called primary RLS).  However, RLS has a genetic component and can be found in families where the onset of symptoms is before age 40.  Specific gene variants have been associated with RLS.  Evidence indicates that low levels of iron in the brain also may be responsible for RLS.

Considerable evidence also suggests that RLS is related to a dysfunction in one of the sections of the brain that control movement (called the basal ganglia) that use the brain chemical dopamine.  Dopamine is needed to produce smooth, purposeful muscle activity and movement.  Disruption of these pathways frequently results in involuntary movements.  Individuals with Parkinson’s disease, another disorder of the basal ganglia’s dopamine pathways, have increased chance of developing RLS.

RLS also appears to be related to or accompany the following factors or underlying conditions:

  • end-stage renal disease and hemodialysis
  • iron deficiency
  • certain medications that may aggravate RLS symptoms, such as antinausea drugs (e.g. prochlorperazine or metoclopramide), antipsychotic drugs (e.g., haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (e.g., fluoxetine or sertraline), and some cold and allergy medications that contain older antihistamines (e.g., diphenhydramine)
  • use of alcohol, nicotine, and caffeine
  • pregnancy, especially in the last trimester; in most cases, symptoms usually disappear within 4 weeks after delivery
  • neuropathy (nerve damage).

Sleep deprivation and other sleep conditions like sleep apnea also may aggravate or trigger symptoms in some people.  Reducing or completely eliminating these factors may relieve symptoms.

How is restless legs syndrome diagnosed?

Since there is no specific test for RLS, the condition is diagnosed by a doctor’s evaluation.  The five basic criteria for clinically diagnosing the disorder are:

  • A strong and often overwhelming need or urge to move the legs that is often associated with abnormal, unpleasant, or uncomfortable sensations.
  • The urge to move the legs starts or get worse during rest or inactivity.
  • The urge to move the legs is at least temporarily and partially or totally relieved by movements.
  • The urge to move the legs starts or is aggravated in the evening or night.
  • The above four features are not due to any other medical or behavioral condition.

A physician will focus largely on the individual’s descriptions of symptoms, their triggers and relieving factors, as well as the presence or absence of symptoms throughout the day.  A neurological and physical exam, plus information from the person’s medical and family history and list of current medications, may be helpful.  Individuals may be asked about frequency, duration, and intensity of symptoms; if movement helps to relieve symptoms; how much time it takes to fall asleep; any pain related to symptoms; and any tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function.

Laboratory tests may rule out other conditions such as kidney failure, iron deficiency anemia (which is a separate condition related to iron deficiency), or pregnancy that may be causing symptoms of RLS.  Blood tests can identify iron deficiencies as well as other medical disorders associated with RLS.

In some cases, sleep studies such as polysomnography (a test that records the individual’s brain waves, heartbeat, breathing, and leg movements during an entire night) may identify the presence of other causes of sleep disruption (e.g., sleep apnea), which may impact management of the disorder.  Periodic limb movement of sleep during a sleep study can support the diagnosis of RLS but, again, is not exclusively seen in individuals with RLS.

Diagnosing RLS in children may be especially difficult, since it may be hard for children to describe what they are experiencing, when and how often the symptoms occur, and how long symptoms last.  Pediatric RLS can sometimes be misdiagnosed as “growing pains” or attention deficit disorder.

How is restless legs syndrome treated?

RLS can be treated, with care directed toward relieving symptoms.  Moving the affected limb(s) may provide temporary relief.  Sometimes RLS symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy, diabetes, or iron deficiency anemia.

Iron supplementation or medications are usually helpful, but no single medication effectively manages RLS for all individuals.  Trials of different drugs may be necessary.  In addition, medications taken regularly may lose their effect over time or even make the condition worse, making it necessary to change medications.

Treatment options for RLS include:

Lifestyle changes.  Certain lifestyle changes and activities may provide some relief in persons with mild to moderate symptoms of RLS.  These steps include avoiding or decreasing the use of alcohol and tobacco, changing or maintaining a regular sleep pattern, a program of moderate exercise, and massaging the legs, taking a warm bath, or using a heating pad or ice pack.  There are new medical devices that have been cleared by the U.S. Food & Drug Administration (FDA), including a foot wrap that puts pressure underneath the foot and another that is a pad that delivers vibration to the back of the legs.  Aerobic and leg-stretching exercises of moderate intensity also may provide some relief from mild symptoms.

Healthy sleep habits.  Having good sleep habits is advisable for anyone, but perhaps especially for people who have trouble sleeping, such as those with RLS.

While sleeping better may not resolve your RLS symptoms, it could help you offset the sleep loss you suffer from your condition.

Try the following tips to make your sleep as restful and restorative as possible.

  • Go to sleep and wake up at the same times each day.
  • Keep your sleep area cool, quiet, and dark.
  • Keep distractions, such as the TV and phone, to a minimum in your bedroom.
  • Avoid electronic screens for the two to three hours before you go to sleep. Blue light from these screens can throw off your circadian rhythm, which helps you keep a natural sleep cycle

Iron and Vitamin Supplements.  For individuals with low or low-normal blood tests called ferritin and transferrin saturation, a trial of iron supplements is recommended as the first treatment.  Iron supplements are available over-the-counter.  A common side effect is upset stomach, which may improve with use of a different type of iron supplement.  Because iron is not well-absorbed into the body by the gut, it may cause constipation that can be treated with stool softeners such as polyethylene glycol.  In some people, iron supplementation does not improve a person’s iron levels.  Others may require iron given through an IV line in order to boost the iron levels and relieve symptoms.

In addition, vitamin D deficiency could be linked with RLS. A 2014 study found that vitamin D supplements reduced RLS symptoms in people with RLS and vitamin D deficiency.

And for people on hemodialysis, vitamins C and E supplements may help relieve RLS symptoms.

Exercise can help you feel better if you have RLS.  The National Institutes of Health states that moderate exercise may help ease mild RLS symptoms.

And a 2006 study of 23 people with RLS found that aerobic exercise and lower body resistance training, done three times per week for 12 weeks, significantly decreased RLS symptom.

Other studies have also found exercise very effective for RLS, especially in people with ESRD.

Given these studies, plus others showing that activity can help improve sleep, exercise seems a natural fit for people with RLS.

One recommendation from the Restless Legs Foundation — exercise in moderation. Don’t work out to the point of aches and pains, as this could make your RLS symptoms worse.

Yoga and stretching.  Like other types of exercise, yoga and stretching exercises have been shown to have benefits for people with RLS.

A 2013 eight-week study of 10 women found that yoga helped reduce their RLS symptoms. It also helped improve their mood and reduce their stress levels, which could in turn improve their sleep. And a 2012 study showed that yoga improved sleep in 20 women with RLS.

Another study showed that stretching exercises made significant improvements in the RLS symptoms of people on hemodialysis.

It’s not entirely clear to researchers why yoga and stretching works, and more research would be beneficial. But given these results, you might want to add some calf and upper leg stretches to your daily exercise routine.

Massaging your leg muscles could help ease your RLS symptoms. Many health organizations, such as the National Institutes of Health and the National Sleep Foundation, suggest it as an at-home treatment,  Although there’s not a lot of other research that backs up massage as an RLS treatment, a 2007 case study illustrated its benefits.

A 35-year-old woman who had 45-minute leg massages twice a week for three weeks had improved RLS symptoms throughout that time period. Her massages included a range of techniques, including Swedish massage and direct pressure to leg muscles.

Her RLS symptoms eased after two massage treatments and didn’t start to return until two weeks after the massage regimen ended.  The author of that study suggested that the increased release of dopamine caused by massage could be a reason for the benefits. Also, massage has been shown to improve circulation, so that might be a reason for its effects on RLS.

As an added bonus, massage can aid in relaxation, which could help improve your sleep.

Foot wrap (restiffic)A foot wrap has been shown to help relieve RLS symptoms.

Called restiffic, the foot wrap puts pressure on certain points on the bottom of your foot. The pressure sends messages to your brain, which responds by telling the muscles affected by RLS to relax. This helps relieve your RLS symptoms.

A 2013 study of 30 people using the foot wrap for eight weeks found significant improvements in RLS symptoms and sleep quality.

The restiffic foot wrap is available by prescription only, and per the company’s website, it costs about $200. It may or may not be covered by your insurance.

Pneumatic compression.  If you’ve ever stayed overnight in the hospital, you may have had pneumatic compression. This treatment uses a “sleeve” that goes over your leg and inflates and deflates, gently squeezing and releasing your limb.

In the hospital, a pneumatic compression device (PCD) is typically used to improve circulation and prevent blood clots. Improved circulation might also be the reason pneumatic compression has been shown to help relieve RLS symptoms.

Some researchers believe that a cause of RLS is low oxygen levels in the limbs. They think that the body responds to this problem by increasing circulation via the muscle contractions that occur when the person moves their limb.

Whatever the reason, some research has shown that pneumatic compression can help relieve RLS symptoms.

A 2009 study of 35 people who used a PCD for at least an hour every day for a month had markedly improved RLS symptoms, sleep quality, and daytime function. However, other research has not shown the same effects.

Some PCDs are rented, and others can be purchased over the counter or with a prescription. Insurance coverage for a PCD might be easier to acquire for people who can’t tolerate RLS medication

Vibration pad (Relaxis).  A vibrating pad called the Relaxis pad may not relieve your RLS symptoms, but it could help you sleep better.

You use the vibrating pad while you’re at rest or sleeping. You place the pad on the affected area, such as your leg, and set it to the desired vibration intensity. The pad vibrates for 30 minutes and then shuts itself off….

The idea behind the pad is that the vibrations provide “counter stimulation.” That is, they override the uncomfortable sensations caused by RLS making you feel the vibrations instead of your symptoms.

There’s not a lot of research available on the Relaxis pad, and it hasn’t been shown to actually relieve RLS symptoms. However, it has been shown to improve sleep.

In fact, one study found it to be as effective in improving sleep as the four FDA-approved RLS drugs: ropinirole, pramipexole, gabapentin, and rotigotine.

The Relaxis pad is available only by prescription from your doctor. Per the company website, the device is not covered by insurance, and it costs a little over $600.

Near-infrared spectroscopy (NIRS).  A noninvasive treatment that’s not yet in wide use for this purpose could help relieve RLS symptoms.

This painless treatment is called near-infrared spectroscopy (NIRS). With NIRS, light beams with long wavelengths are used to penetrate the skin. The light causes blood vessels to dilate, increasing circulation.

One theory posits that RLS is caused by low oxygen levels in the affected area. It’s thought that the increased circulation caused by NIRS increases that oxygen level, helping to relieve the RLS symptoms.

Several studies have found this treatment effective. One study treated 21 people with RLS with NIRS three times per week for four weeks. Both circulation and RLS symptoms showed significant improvement.

Another showed that people treated with twelve 30-minute treatments of NIRS over four weeks also had significantly reduced symptoms of RLS. Symptoms were improved up to four weeks after treatment ended.

NIRS devices can be purchased online for several hundred dollars to over $1,000.

Anti-seizure drugs.  Anti-seizure drugs are becoming the first-line prescription drugs for those with RLS.  The FDA has approved gabapentin enacarbil for the treatment of moderate to severe RLS, This drug appears to be as effective as dopaminergic treatment (discussed below) and, at least to date, there have been no reports of problems with a progressive worsening of symptoms due to medication (called augmentation).  Other medications may be prescribed “off-label” to relieve some of the symptoms of the disorder.

Other anti-seizure drugs such as the standard form of gabapentin and pregabalin can decrease such sensory disturbances as creeping and crawling as well as nerve pain.  Dizziness, fatigue, and sleepiness are among the possible side effects.  Recent studies have shown that pregabalin is as effective for RLS treatment as the dopaminergic drug pramipexole, suggesting this class of drug offers equivalent benefits.

Dopaminergic agents.  These drugs, which increase dopamine effect, are largely used to treat Parkinson’s disease.  They have been shown to reduce symptoms of RLS when they are taken at nighttime.  The FDA has approved ropinirole, pramipexole, and rotigotine to treat moderate to severe RLS.  These drugs are generally well tolerated but can cause nausea, dizziness, or other short-term side effects.  Levodopa plus carbidopa may be effective when used intermittently, but not daily.

Although dopamine-related medications are effective in managing RLS symptoms, long-term use can lead to worsening of the symptoms in many individuals.  With chronic use, a person may begin to experience symptoms earlier in the evening or even earlier until the symptoms are present around the clock.  Over time, the initial evening or bedtime dose can become less effective, the symptoms at night become more intense, and symptoms could begin to affect the arms or trunk.  Fortunately, this apparent progression can be reversed by removing the person from all dopamine-related medications.

Another important adverse effect of dopamine medications some experience is the development of impulsive or obsessive behaviors such as obsessive gambling or shopping.  Should they occur, these behaviors can be improved or reversed by stopping the medication.

Opioids.  Drugs such as methadone, codeine, hydrocodone, or oxycodone are sometimes prescribed to treat individuals with more severe symptoms of RLS who did not respond well to other medications.  Side effects include constipation, dizziness, nausea, exacerbation of sleep apnea, and the risk of addiction; however, very low doses are often effective in controlling symptoms of RLS.

Benzodiazepines.  These drugs can help individuals obtain a more restful sleep.  However, even if taken only at bedtime they can sometimes cause daytime sleepiness, reduce energy, and affect concentration.  Benzodiazepines such as clonazepam and lorazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia.  Because these drugs also may induce or aggravate sleep apnea in some cases, they should not be used in people with this condition.  These are last-line drugs due to their side effects.

Treatments with less scientific backup

 The above treatments have some research to support their use. Other treatments have less evidence but may still work for some people with RLS.

Hot and cold treatments .  While there’s not a lot of research backing up using heat and cold to relieve RLS symptoms, many healthcare organizations recommend it. They include the National Sleep Foundation and the Restless Legs Syndrome Foundation.

These organizations suggest taking a hot or cold bath before going to bed, or applying hot or cold packs to your legs.

Some people’s RLS symptoms are aggravated by cold, while others have problems with heat. This could explain the benefits of these hot or cold treatments.

Repetitive transcranial magnetic stimulation (rTMS).  A noninvasive procedure that’s typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising .

Repetitive transcranial magnetic stimulation (rTMS) sends magnetic impulses to certain areas of the brain.

It’s not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS.

In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended.

Transcutaneous electrical nerve stimulation (TENS).  With transcutaneous electrical nerve stimulation (TENS), a device sends small electrical currents to parts of your body to help relieve pain.

There’s not a lot of research on the use of TENS to treat RLS, but it could work.

The idea is that like the Relaxis vibrating pad, it uses counter stimulation. One study showed that regular use of TENS along with a vibration treatment completely relieved one man’s RLS symptoms.

Acupuncture can be helpful in the treatment of many health conditions, and RLS might be one of them.

A 2015 study of 38 people with RLS who were treated with acupuncture for six weeks showed that their abnormal leg activity from RLS was greatly reduced.

However, more research is needed to confirm acupuncture as a reliable treatment for RLS.

Surgery for varicose veins.  For people with certain circulatory issues, surgery could be the most effective treatment for their RLS.

Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency (SVI), which means your body can’t properly circulate blood. As a result, the blood pools in your legs.

In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery.

Again, more research is needed on this surgery as a treatment for RLS.

What is the prognosis for people with restless legs syndrome?

RLS is generally a lifelong condition for which there is no cure.  However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep.  Symptoms may gradually worsen with age, although the decline may be somewhat faster for individuals who also suffer from an associated medical condition.  A diagnosis of RLS does not indicate the onset of another neurological disease, such as Parkinson’s disease.  In addition, some individuals have remissions—periods in which symptoms decrease or disappear for days, weeks, months, or years—although symptoms often eventually reappear.  If RLS symptoms are mild, do not produce significant daytime discomfort, or do not affect an individual’s ability to fall asleep, the condition does not have to be treated.

What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.  The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

While the direct cause of RLS is often unknown, changes in the brain’s signaling pathways are likely to contribute to the disease.  In particular, researchers suspect that impaired transmission of dopamine signals in the brain’s basal ganglia may play a role.  There is a relationship between genetics and RLS.  However, currently there is no genetic testing.  NINDS-supported research is ongoing to help discover genetic relationships and to better understand what causes the disease.

The NINDS also supports research on why the use of dopamine agents to treat RLS, Parkinson’s disease, and other movement disorders can lead to impulse control disorders, with aims to develop new or improved treatments that avoid this adverse effect.

The brain arousal systems appear to be overactive in RLS and may produce both the need to move when trying to rest and the inability to maintain sleep.  NINDS-funded researchers are using advanced magnetic resonance imaging (MRI) to measure brain chemical changes in individuals with RLS and evaluate their relation to the disorder’s symptoms in hopes of developing new research models and ways to correct the overactive arousal process.  Since scientists currently don’t fully understand the mechanisms by which iron gets into the brain and how those mechanisms are regulated, NINDS-funded researchers are studying the role of endothelial cells—part of the protective lining called the blood-brain barrier that separates circulating blood from the fluid surrounding brain tissue—in the regulation of cerebral iron metabolism.  Results may offer new insights to treating the cognitive and movement symptoms associated with these disorders.

The takeaway

RLS can cause significant discomfort, sleep issues, and problems with daily functioning, so treatment should be a priority. Your first step should be to try the at-home options on this list. But if they don’t help you, be sure to talk to your doctor.

Your doctor can provide more information about each of these treatments and which one — or ones — might be a good choice for you.

Keep in mind that what works for one person may not work for another, and you may need to try several different drugs or treatments. Keep trying until you find the treatment plan that works for you.

Whatever health concerns you have today, making sure you are connected to the right physicians and they have all of your most up to date information is what HealthLynked is all about.  It is the first of its kind social ecosystem designed to “Lynk” patients with their healthcare team in new ways to ensure they receive the best possible care and are restored to the best health possible.

Ready to get “Lynked”?  Go to HealthLynked.com, right now, and get signed up for free.

 

Sources:

ninds.nih.gov

healthline.com

 

 

 

 

 

What is Idiopathic Thrombocytopenic Purpura ?

Our six year old came in from playing on a warm summer’s day.  She seemed her normal, happy and carefree self, but when she jumped into my lap, I noticed dime sized bruises all over her legs, evenly spaced.  It looked odd to say the least, and she couldn’t say anything had happened, so we called the clinic to discuss with the on duty nurse.

“So, you have an active 6 year old with bruises on her legs; doesn’t seem like a big deal to me,” was her response.  After sharing with the nurse I didn’t think she quite understood, which she agreed – at least she couldn’t understand the worry in my voice – she asked we bring her in….

We found out she had Henoch-Schonlein purpura (HEN-awk SHURN-line PUR-pu-ruh) – a disorder that causes inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys.  While this is not ITP, it was our introduction to the words purpura, platelets and thrombocytopenia.

September is National ITP Awareness Month

Chronic ITP and platelet function disorders are perhaps the most common bleeding disorder. It affects both sexes and all ages and races. While we don’t know for sure, there are an estimated 120,000 persons with ITP in the United States. That’s more than 10 times the number of people with Hemophilia!

The purpose of ITP awareness month is to increase the public’s awareness and understanding of ITP and to let patients and families know that there are resources and support available to help them have the best possible outcomes. Patients and families are not alone.

What is ITP?

Platelets are relatively small, irregularly shaped components of our blood. They are required to support the integrity of our blood vessel walls and for blood to clot. Without enough platelets, a person is subject to spontaneous bleeding or bruising.

Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term.

If you don’t have signs of bleeding and your platelet count isn’t too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Symptoms

Idiopathic thrombocytopenic purpura (ITP) may have no signs and symptoms. When they do occur, they may include:

  • Easy or excessive bruising (purpura)
  • Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
  • Bleeding from the gums or nose
  • Blood in urine or stools
  • Unusually heavy menstrual flow

Causes

In some people thrombocytopenia is caused by the immune system mistakenly attacking and destroying platelets. If the cause of this immune reaction is unknown, the condition is called idiopathic thrombocytopenic purpura. Idiopathic means “of unknown cause.”

In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. It may be that the infection triggers the immune system malfunction.

Increased breakdown of platelets

In people with ITP, antibodies produced by the immune system attach themselves to the platelets, marking the platelets for destruction. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case of mistaken identity is a lower number of circulating platelets than is normal.

A normal platelet count is generally between 150,000 and 450,000 platelets per microliter of circulating blood. People with ITP often have platelet counts below 20,000. Because platelets help the blood clot, as their number decreases, your risk of bleeding increases. The greatest risk is when your platelet count falls very low — below 10,000 platelets per microliter. At this point, internal bleeding may occur even without any injury.

Risk factors

Idiopathic thrombocytopenic purpura can occur in anyone at almost any age, but these factors increase the risk:

  • Your sex. Women are two to three times more likely to develop ITP than men are.
  • Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles or a respiratory infection.

Complications

Spontaneous bleeding can also occur in mucous membranes inside the mouth or in the gastrointestinal tract. ITP is often accompanied by fatigue and sometimes depression.

A rare complication of idiopathic thrombocytopenic purpura is bleeding into the brain, or disruptive bleeding into internal organs, which can be fatal.

Pregnancy

In pregnant women with ITP, the condition doesn’t usually affect the baby. But the baby’s platelet count should be tested soon after birth.

If you’re pregnant and your platelet count is very low, or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.

When to see a doctor

Make an appointment with your doctor if you or your child develop symptoms that worry you.

Bleeding that won’t stop is a medical emergency. Seek immediate help if you or your child experiences bleeding that can’t be controlled by the usual first-aid techniques, such as applying pressure to the area.

The best way to find a physician to talk to you about abnormal bleeding or bruising is to search online through the large data base at HealthLynked.  We are connecting physicians and patients in new ways so they can more closely collaborate on care and wellness.

Ready to get Lynked?  Go to HealthLynked.com to get started, today, for free!

 

 

What Are the Signs of Fetal Alcohol Spectrum Disorders?

International Fetal Alcohol Spectrum Disorders (FASD) Awareness Day, recognized every year on Sept. 9th, is an important reminder prenatal alcohol exposure is the leading preventable cause of birth defects and developmental disorders in the United States. Almost 40 years have passed since it was recognized drinking during pregnancy can result in a wide range of disabilities for children, of which fetal alcohol syndrome (FAS) is the most severe. Still, 1 in 13 pregnant women report drinking in the past 30 days. Of those, about 1 in 6 report binge drinking during that time.

The disabilities associated with FASD can persist throughout life and place heavy emotional and financial burdens on individuals, their families, and society. Alcohol use during pregnancy can cause physical, behavioral, and intellectual disabilities. Often, a person with an FASD has a mix of these problems. It is recommended women who are pregnant or might be pregnant not drink alcohol. Fetal alcohol spectrum disorders are completely preventable if a developing baby is not exposed to alcohol before birth.

What We Know

  • Women who are pregnant or who might be pregnant should be aware that any level of alcohol use could harm their babies.
  • All types of alcohol can be harmful, including all wine and beer.
  • The baby’s brain, body, and organs are developing throughout pregnancy and can be affected by alcohol at any time.
  • Alcohol use during pregnancy can also increase the risk of miscarriage, stillbirth, preterm (early) birth, and sudden infant death syndrome (SIDS).

Cause and Prevention

FASDs are caused by a woman drinking alcohol during pregnancy. Alcohol in the mother’s blood passes to the baby through the umbilical cord. When a woman drinks alcohol, so does her baby.

There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant. All types of alcohol are equally harmful, including all wines and beer.

To prevent FASDs, a woman should not drink alcohol while she is pregnant, or when she might get pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks. In the United States, nearly half of pregnancies are unplanned.

If a woman is drinking alcohol during pregnancy, it is never too late to stop drinking. Because brain growth takes place throughout pregnancy, the sooner a woman stops drinking the safer it will be for her and her baby. Resources are available here.

FASDs are completely preventable if a woman does not drink alcohol during pregnancy—so why take the risk?

Signs and Symptoms

FASDs refer to the whole range of effects that can happen to a person whose mother drank alcohol during pregnancy. These conditions can affect each person in different ways and can range from mild to severe.

A person with an FASD might have:

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school (especially with math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Types of FASDs

Different terms are used to describe FASDs, depending on the type of symptoms.

Fetal Alcohol Syndrome (FAS): FAS represents the most involved end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others.

Alcohol-Related Neurodevelopmental Disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.
Alcohol-Related Birth Defects (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): ND-PAE was first included as a recognized condition in the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013. A child or youth with ND-PAE will have problems in three areas: (1) thinking and memory, where the child may have trouble planning or may forget material he or she has already learned, (2) behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another, and (3) trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children. In addition, to be diagnosed with ND-PAE, the mother of the child must have consumed more than minimal levels of alcohol before the child’s birth, which APA defines as more than 13 alcoholic drinks per month of pregnancy (that is, any 30-day period of pregnancy) or more than 2 alcoholic drinks in one sitting.

Diagnosis

The term FASDs is not meant for use as a clinical diagnosis. CDC worked with a group of experts and organizations to review the research and develop guidelines for diagnosing FAS. The guidelines were developed for FAS only. CDC and its partners are working to put together diagnostic criteria for other FASDs, such as ARND. Clinical and scientific research on these conditions is going on now.

Diagnosing FAS can be hard because there is no medical test, like a blood test, for it. And other disorders, such as ADHD (attention-deficit/hyperactivity disorder) and Williams syndrome, have some symptoms like FAS.

To diagnose FAS, doctors look for:

  • Abnormal facial features (e.g., smooth ridge between nose and upper lip)
  • Lower-than-average height, weight, or both
  • Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
  • Prenatal alcohol exposure; although confirmation is not required to make a diagnosis

Treatment

FASDs last a lifetime. There is no cure for FASDs, but research shows early intervention treatment services can improve a child’s development.

There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No one treatment is right for every child. Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way.

Also, “protective factors” can help reduce the effects of FASDs and help people with these conditions reach their full potential. These include:

  • Diagnosis before 6 years of age
  • Loving, nurturing, and stable home environment during the school years
  • Absence of violence
  • Involvement in special education and social services

What Can Be Done to Prevent Fetal Alcohol Spectrum Disorders

Women Can

  • Talk with their healthcare providers about their plans for pregnancy, their alcohol use, and ways to prevent pregnancy if they are not planning to get pregnant.
  • Stop drinking alcohol if they are trying to get pregnant or could get pregnant.
  • Ask their respective partners, families, and friends to support their choice not to drink during pregnancy or while trying to get pregnant.
  • Ask their healthcare providers or other trusted people about resources for help if they cannot stop drinking on their own.

Healthcare providers can

  • Screen all adult patients for alcohol use at least yearly.
  • Advise women not to drink at all if there is any chance they could be pregnant.
  • Counsel, refer, and follow up with patients who need more help.
  • Use the correct billing codes so that alcohol screening and counseling is reimbursable.

Get Help!

If you or the doctor thinks there could be a problem, ask the doctor for a referral to a specialist (someone who knows about FASDs), such as a developmental pediatrician, child psychologist, or clinical geneticist. In some cities, there are clinics whose staffs have special training in diagnosing and treating children with FASDs. To find doctors and clinics in your area visit the National and State Resource Directory from the National Organization on Fetal Alcohol Syndrome (NOFAS).

At the same time as you ask the doctor for a referral to a specialist, call your state’s early intervention program to request a free evaluation to find out if your child can get services to help. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child’s age:

If your child is younger than 3 years old, Call your state or territory’s early intervention program and say: “I have concerns about my child’s development and I would like to have my child evaluated to find out if he/she is eligible for early intervention services.”

If your child is 3 years old or older, contact your local public school system. Even if your child is not old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.

Conclusion

Research to understand how alcohol exposure during pregnancy interferes with fetal development and how FASD can be identified and prevented is ongoing. Scientists continue to make tremendous strides, providing important new insights into the nature of FASD and potential intervention and treatment strategies.

The message is simple, not just on Sept. 9, but every day. There is no known safe level of drinking while pregnant. Women who are, who may be, or who are trying to become pregnant, should not drink alcohol.

If you or pregnant, may become pregnant, or are a new parent wondering about the effects of alcohol on your child, find a caring physician who can advise you using the first of its kind social ecosystem for HealthCare.  At HealthLynked, your can connect with providers in new and unique ways to collaborate on your wellness and the health of your family.

Ready to get Lynked?  Got to HealthLynked.com to sign up for Free, and start taking control of your health today?

Sources:
CDC.gov

References

Streissguth, A.P., Bookstein, F.L., Barr, H.M., Sampson, P.D., O’Malley, K., & Young, J.K. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pediatrics, 5(4), 228-238.

Streissguth, A.P., Barr, H.M., Kogan, J. & Bookstein, F. L., Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Final report to the Centers for Disease Control and Prevention (CDC). Seattle: University of Washington, Fetal Alcohol & Drug Unit; August 1996. Tech. Rep. No. 96-06.

What are the First Five Steps in First Aid?

According to a Red Cross Survey, too many people have a fear of taking action when someone needs help. The report suggests, for anyone finding themselves in a life-threatening emergency situation, there’s a 50-50 chance  someone will actually step forward to offer first aid.

The survey found:

  • While most (88%) would want someone to come to our aid, only half (50%) of adults would actually feel confident about helping.
  • The majority of those asked (70%) said that they would worry about making it worse or doing something wrong.
  • Most worryingly, just 4% of people knew the correct first aid skills, and said they were both confident and likely to help someone in three of the most life-threatening scenarios, such as heavy bleeding or someone stopping breathing.

By administering immediate care during an emergency, you can help an ill or injured person before EMS, or Emergency Medical Services, arrive.  You may even help save a life.  However, even after training, remembering the right first aid steps – and administering them correctly – can be difficult.  In order to help you deliver the right care at the right time, the Red Cross has created this simple step-by-step guide that you can print up and place on your refrigerator, in your car, in your bag or at your desk.


1.  Before administering care to an ill or injured person, check the scene and the person. Size up the scene and form an initial impression.

Pause and look at the scene and the person before responding. Answer the following questions:

  • Is the scene safe to enter?
  • What happened?
  • How many people are involved?
  • What is my initial impression about the nature of the person’s illness or injury?
  • Does the person have any life-threatening conditions, such as severe, life-threatening bleeding?
  • Is anyone else available to help?

2.  If the Person is awake and Responsive and there is no severe life-threatening bleeding:

  • Obtain consent: Tell the person your name, describe type and level of training, state what you think is wrong and what you plan to do, and ask permission to provide care.
  • Tell a bystander to get the AED and first aid kit: Point to a bystander and speak out loud.
  • Use appropriate personal protective equipment (PPE); Put on gloves, if available.
  • Interview the person: Use questions to gather more information about signs and symptoms, allergies, medications, pertinent medical history, last food or drink and events leading up to the incident.
  • Conduct a head-to-toe check: Check head and neck, shoulders, chest and abdomen, hips, legs and feet, arms and hands for signs of injury.
  • Provide care consistent with knowledge and training according to the conditions you find.

3.  If the Person Appears Unresponsive:

Shout to get the person’s attention, using the person’s name if it is known. If there is no response, tap the person’s shoulder (if the person is an adult or child) or the bottom of the person’s foot (if the person is an infant) and shout again, while checking for normal breathing. Check for Responsiveness and breathing for no more than 5-10 seconds.

4.  If the person is breathing:

  • Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  • Proceed with gathering information from bystanders using questions.
  • Conduct a head-to-toe check.
  • Roll the person onto his or her side into a recovery position if there are no obvious signs of injury.

5.  If the person is NOT breathing:

  • Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  • Ensure that the person is face-up on a firm, flat surface such as the floor or ground.
  • Begin CPR (starting with compressions) or use an AED if one is immediately available.
  • Continue administering CPR until the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or trained medical responders arrive on scene.

Note:  End CPR if the scene becomes unsafe or you cannot continue due to exhaustion.


Often, the first responders that save lives are not medically trained professionals.  It is essential, in those first few minutes, those who need medical attention receive care, even from those not necessarily medically trained.

The first steps you take in medicine are often the most important.  Just like taking control of a First Aid situation, taking control of your healthcare today can be the first important step toward wellness.  At HealthLynked, we can help.

Mange your own medical records and those of your family, carry them with you wherever you go, and make appointments on the fly.  All this for Free!

Go to HealthLynked.com, now, to take the fist steps to better wellness.

What Are the Signs and Symptoms of Ovarian Cancer?

Each year, the first Friday in September is designated as Wear Teal Day.  On this day, organizations unite in an effort to encourage you to dress in teal and educate yourself and those around you about the symptoms and risk factors of Ovarian Cancer.

What is Ovarian Cancer?

Ovarian cancer is a disease in which, depending on the type and stage, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

Cancer Basics

Cancer develops when abnormal cells in a part of the body (in this case, the ovary) begin to grow uncontrollably. This abnormal cell growth is common among all cancer types.

Normally, cells in your body divide and form new cells to replace worn out or dying cells, and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to create new abnormal cells, forming a tumor. Tumors can put pressure on other organs near the ovaries.

Cancer cells can sometimes travel to other parts of the body, where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells move into the bloodstream or lymph system of the body. Cancer cells that spread from other organ sites (such as breast or colon) to the ovary are not considered ovarian cancer. Cancer type is determined by the original site of the malignancy.

What is the general outlook for women diagnosed with ovarian cancer?

In women ages 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime. The American Cancer Society estimates that there will be over 22,280 new cases of ovarian cancer diagnosed this year and that more than 14,240 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is over 90 percent. Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, about 20 percent of all cases are found early, meaning in stage I or II.

If caught in stage III or higher, the survival rate can be as low as 28 percent. Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis. With almost 80% of women diagnosed in advanced stages of ovarian cancer, when prognosis is poor, we know that more needs to be done to spread awareness of this horrible disease that will take the lives of more than 14,000 women this year.

What are the Signs & Symptoms of Ovarian Cancer?

Ovarian cancer is difficult to detect, especially in the early stages. This is partly due to the fact that the ovaries – two small, almond-shaped organs on either side of the uterus – are deep within the abdominal cavity. The following are often identified by women as some of the signs and symptoms of ovarian cancer:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected.

Persistence of Symptoms

When the symptoms are persistent, when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest) it is imperative for a woman to see her doctor. Persistence of symptoms is key. Because these signs and symptoms of ovarian cancer have been described as vague or silent, only approximately 19 percent of ovarian cancer is diagnosed in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

Treatment Options

Surgery

Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.

Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals.

Chemotherapy

Before treatment begins, it is important to understand how chemotherapy works. Chemotherapy is the treatment of cancer using chemicals designed to destroy cancer cells or stop them from growing. The goal of chemotherapy is to cure cancer, shrink tumors prior to surgery or radiation therapy, destroy cells that might have spread, or control tumor growth.

Radiation

Radiation therapy uses high-­energy X­-rays to kill cancer cells and shrink tumors. Please note that this therapy is rarely used in the treatment of ovarian cancer in the United States. It is more often used in other parts of the body where cancer has spread.

Complementary Therapies

Some women with ovarian cancer turn toward the whole ­body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and lessen side effects, such as fatigue, pain, and nausea.

Complementary therapies are diverse practices and products that are used along with conventional medicine. Many women have tried and benefited from the complementary therapies listed below. Speaking with other women, in addition to the healthcare team, can suggest the therapies that may be most helpful and appropriate for each woman’s lifestyle.

Clinical Trials

Clinical trials are research studies designed to find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. Many women undergoing treatment for ovarian cancer choose to participate in clinical trials. Through participation in these trials, patients may receive access to new therapy options that are not available to women outside the clinical trial setting.

How am I Diagnosed with Ovarian Cancer?

Most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III or IV). This is because the symptoms of ovarian cancer, particularly in its early stages, often are not acute or intense, and present vaguely. In most cases, ovarian cancer is not detected during routine pelvic exams, unless the doctor notes that the ovary is enlarged. The sooner ovarian cancer is found and treated, the better a woman’s chance for survival. It is important to know that early stage symptoms can be difficult to detect, though are not always silent. As a result, it is important that women listen to their bodies and watch for early symptoms that may present.

Did You Know?

The Pap test does not detect ovarian cancer. It aids in evaluating cells for the detection of cervical cancer.

Screening Tests

Although there is no consistently-reliable screening test to detect ovarian cancer, the following tests are available and should be offered to women, especially those women at high risk for the disease:

  • Pelvic Exam: Women age 18 and older should have a mandatory annual vaginal exam. Women age 35 and older should receive an annual rectovaginal exam (physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness).
  • Transvaginal Sonography: This ultrasound, performed with a small instrument placed in the vagina, is appropriate, especially for women at high risk for ovarian cancer, or for those with an abnormal pelvic exam.
  • CA-125 Test: This blood test determines if the level of CA-125, a protein produced by ovarian cancer cells, has increased in the blood of a woman at high risk for ovarian cancer, or a woman with an abnormal pelvic examination.

While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at average risk for ovarian cancer.

Positive Tests

If any of these tests are positive, a woman should consult with a gynecologic oncologist, who may conduct a CT scan and evaluate the test results. However, the only way to more accurately confirm an ovarian cancer diagnosis is with a biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

Research into new ovarian cancer screening tests is ongoing, and new diagnostic tests may be on the horizon. The National Ovarian Cancer Coalition monitors the latest scientific developments. Please visit their Research page for additional information.

Getting Help

To locate a physician in your area who can help with the symptoms you are suffering and aid in treatment, if necessary, please find one today using HealthLynked.com.  We are the first of its kind social ecosystem designed to connect physicians and patients for the efficient exchange of information in a secure platform designed for communication and collaboration.

Ready to get Lynked?  Go to HealthLynked.com, right now, to start getting the help you need, for free.

 

Source:

Ovarian.org

A Woman’s Story of Overcoming PCOS | 20 (plus) things you Need to Know

If you are looking for the stuff you “need to know” from the title, it’s further on down in the article.  In observance of PCOS Awareness Month, we thought we would share the true story of a young woman living with polycystic ovary syndrome (PCOS).  I know her well but interviewed her for the article anyway.  She’s my super cool middle, Delaney.

Delaney grew up a very active, wonderfully gregarious kid who moved around a few times with the Navy until we exited and settled in SoCar – that’s South Carolina, for those who don’t know.  A natural athlete, fast, nimble and taller than her peers, she quickly found herself to be a standout soccer player.  She didn’t know she couldn’t score every time she had the ball at her feet, and so she did.  Because she was quick and had incredible endurance, she also was recruited by the track coach to run the varsity 800m in seventh grade, along with a teammate who was her opposite on the field.

But soccer was her thing, and she eventually dropped the spikes to focus solely on futbol.  Running upwards of 8 miles every day in practice – anywhere from trotting to full Sprint, even backwards and sideways as an outside midfielder, she was fit in all the ways a peak performing Athlete would be.  To fuel it all, she would eat FOUR big meals every day – each bigger than those her 220 lbs weight Training father would consume.  She ate it and burned it with a ferocity on the Field we all admired.

Attack, fight, victory was her personal motto, in everything and in all ways.  Then came college.  She decided to focus on her studies and didn’t go out for the team.  In fact, just about every bit of working out came to a screeching halt.  And then, her period stopped….for a full year.

She had gained the average “freshman fifteen”, which wasn’t surprising when considering her eating habits, if anything, were filling her with added calories, and she had stopped using those calories on the field.  So, if she had always had her period as an athlete and now had even more body fat, why was she experiencing amenorrhea  (the technical term for missing your period)?   Stress?  All the life changes in general?  Purely hormonal?

Poly cystic ovarian syndrome is, at its most basic level, a hormonal imbalance, where too much of the “male” hormones are produced in a female.  While the only apparent symptom she displayed at the time was amenorrhea, her ever diligent homeopathic healer in residence, aka, her mom, was convinced she had PCOS.

First stop, her old pediatrician, who told her everything was normal; but she could go on birth control to start her period again.  After all, having one is important for so many other things in a young woman’s life, like the other hormones it generates that aid in creating increased bone density.

Not enough info, so on to an Ob/Gyn.  There, the feedback was little more along the lines of what her mom had already assumed, but they were even skeptical.  “So, let’s get an ultrasound,” my wife suggested.  The physician said you couldn’t see PCOS on an ultrasound.  As a DMS, my wife knew better.

On ultrasound, it was clear her ovaries were encased in cysts.  They were covered in follicles too numerous to count – today, 20 on an ovary will typically be used as a clear diagnosis.

Diagnosis in hand, the physician gave her the long list of troubles she was set to endure in her life – infertility, type II diabetes, a constant struggle with weight gain, hirsutism, and skin issues to name a few.  And, as if on queue, while the lack of period was the only thing she went to the physician for, she began to experience all of the negative symptoms save diabetes.

“I started to use PCOS as an excuse to eat whatever I wanted,” she says today.  “I just stopped caring about what I put in my body,” and she may have even begun to somewhat celebrate the new-found freedom from lack of discipline around diet.  Pictures of food became the standard in her social feed, and she did start to suffer the weight gain her MD predicted.  Along with that came the added pain of body image issues.

She started taking birth control to manage her cycle, and it worked.  At least, it did ensure she became regular; but deep down inside, she knew it wasn’t fixing the problem.  “I knew it was a bandaid put on to cover what was really wrong, so I quit after a year.  It wasn’t really doing anything.  It definitely was not helping fix whatever was at the root,” she said to me this Labor Day morning.

She finished college as a star student, winning all but one of the math awards given out by the University of South Carolina.  I guess I forgot to mention, she’s also brilliant, and I am very proud, of her and all of our kids.  On to New York City!

Always called to serve, Delaney decided to teach in the high schools of the Bronx.  She was not sure if it was the added stress or the increased disregard for dietary discipline, but she added even more weight with the move, though she began to workout more than before.  And, the skin issues and extra hair growth kicked in….

“I began to understand I had to do something.  Thankfully, Mom has always been a huge proponent of natural healing, so I started a few different regiments of eating more mindfully and living more intentionally,” Delaney says now.  She went through a few rounds of Whole 30, and really started to stop eating when full.  “I used to empty my plate, no matter what;… but now come home with leftovers routinely,” she says.  “If I want to have pizza, I still have pizza.  I just don’t eat a WHOLE pizza.”

The changes in diet and exercise, along with a few other healthy changes in her life, over a two-year period, have restored this vivacious young lady to the same level of health she had when she entered college in 2011.  She would say her PCOS is in remission.

“I still wonder, on occasion, about my ability to have a family; but, since my cycle is normal, naturally, I am ovulating, and my health is optimized, I think that won’t be a problem, either.”  We hope not!  We love grandkids!

Delaney would tell anyone asking her results may not be normal.  She would encourage you to seek to control PCOS in the most natural ways possible – through diet, exercise and healthy living – but she also acknowledges those methods may not be for everyone.  Definitely seek medical counsel.

So, What Is PCOS, Really?

Polycystic ovary syndrome is a hormonal condition. Hormones are substances your body makes to help make different processes happen. Some are related to your ability to have a baby, and also affect your menstrual cycle. Those that are involved in PCOS include.

  • Androgens: Often called “male” hormones, women have them, too. Those with PCOS tend to have higher levels, which can cause symptoms like hair loss, hair in places you don’t want it (such as on your face), and trouble getting pregnant.
  • Insulin: This hormone manages your blood sugar. If you have PCOS, your body might not react to insulin the way that it should.
  • Progesterone: With PCOS, your body may not have enough of this hormone. That can make you to miss your periods for a long time, or to have periods that are hard to predict.

With PCOS, your reproductive hormones are out of balance. This can lead to problems with your ovaries, such as not having your period on time, or missing it entirely.  In women who have it, it can:

  • Affect your ability to have a child (fertility)
  • Make your periods stop or become difficult to predict
  • Cause acneand unwanted hair
  • Raise your chances for other health problems, including diabetesand high blood pressure

There are treatments for the symptoms, and if you want to get pregnant, that’s still possible, though you may need to try different methods.  Many women who have PCOS don’t have cysts on their ovaries, so “polycystic” can be misleading. You might have cysts, and you might not.

What Are the Symptoms of PCOS?

If you have things such as oily skin, missed periods, or trouble losing weight, you may think those issues are just a normal part of your life. But those frustrations could actually be signs that you have polycystic ovary (or ovarian) syndrome, also known as PCOS.

The condition has many symptoms, and you may not have all of them. It’s pretty common for it to take women a while – even years – to find out they have this condition.

Things You Might Notice

You might be most bothered by some of the PCOS symptoms that other people can notice. These include:

  • Hair growth in unwanted areas. Your doctor may call this “hirsutism” (pronounced HUR-soo-tiz-uhm). You might have unwanted hair growing in places such as on your face or chin, breasts, stomach, or thumbs and toes.
  • Hair loss. Women with PCOS might see thinning hair on their head, which could worsen in middle age.
  • Weight problems. About half of women with PCOS struggle with weight gain or have a tough time losing weight.
  • Acne or oily skin. Because of hormone changes related to PCOS, you might develop pimples and oily skin. (You can have these  PCOS, of course).
  • Problems sleeping, feeling tired all the time. You could have trouble falling asleep. Or you might have a disorder known as sleep apnea. This means that even when you do sleep, you do not feel well-rested after you wake up.
  • Headaches. This is because of hormone changes with PCOS.
  • Trouble getting pregnant. PCOS is one of the leading causes of infertility.
  • Period problems. You could have irregular periods. Or you might not have a period for several months. Or you might have very heavy bleeding during your period.

How Do I Know If I Have PCOS?

There’s no single test that, by itself, shows whether you have polycystic ovary syndrome, or PCOS. Your doctor will ask you about your symptoms and give you a physical exam and blood tests to help find out if you have this condition.

PCOS is a common hormone disorder that can cause problems with your period, fertility, weight, and skin. It can also put you at risk for other conditions, such as type 2 diabetes. If you have it, the sooner you find out, the sooner you can start treatment.

What Your Doctor Will ask

Your doctor will want to know about all the signs and symptoms you’ve noticed. This is an important step to help figure out whether you have PCOS, and to rule out other conditions that cause similar symptoms.

You’ll need to answer questions about your family’s medical history, including whether your mother or sister has PCOS or problems getting pregnant. This information is helpful — PCOS tends to run in families.

Be ready to discuss any period problems you’ve had, weight changes, and other concerns.

Your doctor may diagnose PCOS if you have at least two of these symptoms:

  • Irregular periods
  • Higher levels of androgen (male hormones) shown in blood tests or through symptoms like acne, male-pattern balding, or extra hair growth on your face, chin, or body
  • Cysts in your ovaries as shown in an ultrasound exam

What’s the Treatment for PCOS?

Treatments can help you manage the symptoms of polycystic ovary syndrome (PCOS) and lower your odds for long-term health problems such as diabetes and heart disease.

You and your doctor should talk about what your goals are, then you can come up with a treatment plan. For example, if you want to get pregnant and are having trouble, then your treatment would focus on helping you conceive. If you want to tame PCOS-related acne, your treatment would be geared toward skin problems.

Healthy Habits

  • One of the best ways to deal with PCOSis to eat well and exercise
  • Many women with PCOS are overweightor obese. Losing just 5% to 10% of your body weight may ease some symptoms and help make your periods more regular. It may also help manage problems with blood sugar levels and ovulation.
  • Since PCOS could lead to high blood sugar, your doctor may want you to limit starchy or sugary foods. Instead, eat foods and meals that have plenty of fiber, which raise your blood sugarlevel slowly.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.

Hormone Treatments and Medication

Birth control is the most common PCOS treatment for women who don’t want to get pregnant. Hormonal birth control — pills, a skin patch, vaginal ring, shots, or a hormonal IUD (intrauterine device) — can help restore regular periods. The hormones also treat acne and unwanted hair growth.

These birth control methods may also lower your chance of having endometrial cancer, in the inner lining of the uterus.

Taking just a hormone called progestin could help get your periods back on track. It doesn’t prevent pregnancies or treat unwanted hair growth and acne. But it can lower the chance of uterine cancer.

Metformin (Fortamet, Glucophage) lowers insulin levels. It can help with weight loss and may prevent you from getting type 2 diabetes. It may also make you more fertile.

If birth control doesn’t stop hair growth after 6 months, your doctor may prescribe spironolactone (Aldactone). It lowers the level of a type of sex hormone called androgens. But you shouldn’t take it if you’re pregnant or plan to become pregnant, because it can cause birth defects.

Weight Loss

When a healthy diet and regular exercise aren’t enough, medications can make losing weight easier. Different drugs work in different ways. For example, orlistat (Alli, Xenical) stops your body from digesting some of the fat in your food, so it may also improve your cholesterol levels. Lorcaserin (Belviq) makes you feel less hungry. Your doctor will prescribe the medication they think will be the most successful for you.

Weight loss surgery could help if you’re severely obese and other methods haven’t worked. The change in your weight afterward can regulate your menstrual cycle and hormones and cut your odds of having diabetes.

Hair Removal

Products called depilatories, including creams, gels, and lotions, break down the protein structure of hair so it falls out of the skin. Follow the directions on the package.

A process like electrolysis (a way to remove individual hairs by using an electric current to destroy the root) or laser therapy destroys hair follicles. You’ll need several sessions, and though some hair may come back, it should be finer and less noticeable.

Fertility

Your doctor may prescribe medication to help you get pregnant. Clomiphene and letrozole encourage steps in the process that trigger ovulation. If they don’t work, you can try shots of hormones called gonadotropins.

A surgery called ovarian drilling might make your ovaries work better when ovulation medications don’t, but it’s being done less often than it used to. The doctor makes a small cut in your belly and uses a tool called a laparoscope with a needle to poke your ovary and wreck a small part of it. The procedure changes your hormone levels and may make it easier for you to ovulate.

With in vitro fertilization, or IVF, your egg is fertilized outside of your body and then placed back inside your uterus. This may be the best way to get pregnant when you have PCOS, but it can be expensive.

What Are the Complications of PCOS?

If you have polycystic ovary syndrome, your ovaries may contain many tiny cysts that cause your body to produce too many hormones called androgens.

In men, androgens are made in the testes. They’re involved in the development of male sex organs and other male characteristics, like body hair. In women, androgens are made in the ovaries, but are later turned into estrogens. These are hormones that play a vital role in the reproductive system, as well as the health of your heart, arteries, skin, hair, brain, and other body parts and systems.

If you have PCOS and your androgen levels are too high, you have higher odds for a number of possible complications. (These may differ from woman to woman):

Trouble Getting Pregnant

  • Cysts in the ovaries can interfere with ovulation. That’s when one of your ovaries releases an egg each month. If a healthy egg isn’t available to be fertilized by a sperm, you can’t get pregnant.
  • You may still be able to get pregnant if you have PCOS. But you might have to take medicine and work with a fertility specialist to make it happen.

Insulin Issues

Doctors aren’t sure what causes PCOS. One theory is that insulin resistance may cause your body to make too many androgens.

Insulin is a hormone that helps the cells in your body absorb sugar (glucose) from your blood to be used as energy later. If you have insulin resistance, the cells in your muscles, organs, and other tissue don’t absorb blood sugar very well. As a result, you can have too much sugar moving through your bloodstream. This is called diabetes, and it can cause problems with your cardiovascular and nervous systems.

Other Possible Problems

You might have metabolic syndrome. This is a group of symptoms that raise the risk of cardiovascular disease, such as high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.  Other common complications of PCOS include:

  • Depression
  • Anxiety
  • Bleeding from the uterus and higher risk of uterine cancer
  • Sleep problems
  • Inflammation of the liver

Some complications of PCOS may not be serious threats to your health, but they can be unwanted and embarrassing:

  • Abnormal body or facial hair growth
  • Thinning hair on your head
  • Weight gain around your middle
  • Acne, dark patches, and other skin problems

Most women at some point have to contend with weight, but for women with polycystic ovary syndrome(PCOS), losing weight can become a constant struggle.

PCOS is the most common hormonal disorder in women of childbearing age and can lead to issues with fertility. Women who have PCOS have higher levels of male hormones and are also less sensitive to insulin or are “insulin-resistant.” Many are overweight or obese. As a result, these women can be at a higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.

If you have PCOS, certain lifestyle changes can help you shed pounds and reduce the disease’s severity.

Why does polycystic ovary syndrome cause weight gain?

PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition — called insulin resistance– can cause insulin and sugar — glucose — to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods — and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen. That is where men tend to carry weight. So, instead of having a pear shape, women with PCOS have more of an apple shape.

Abdominal fat is the most dangerous kind of fat. That’s because it is associated with an increased risk of heart disease and other health conditions.

What are the risks associated with PCOS-related weight gain?

No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

  • Type 2 diabetes
  • High cholesterol
  • High blood pressure
  • Sleep apnea
  • Infertility
  • Endometrial cancer

Many of these conditions can lead to heart disease. In fact, women with PCOS are four to seven times more likely to have a heart attack than women of the same age without the condition.

Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne.

What can I do to lose weight if I have polycystic ovary syndrome?

Losing weight not only cuts your risk for many diseases, it can also make you feel better. When you have PCOS, shedding just 10% of your body weight can bring your periods back to normal. It can also help relieve some of the symptoms of polycystic ovary syndrome.

Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications.

To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index. Body mass index is also called BMI, and it is the ratio of your height to your weight.

Your doctor may also prescribe medication. Several medications are approved for PCOS, including birth control pills and anti-androgen medications. The anti-androgen medications block the effects of male hormones. A few medications are used specifically to promote weight loss in women with PCOS. These include:

  • Metformin (Glucophage). Metformin is a diabetes drug that helps the body use insulin more efficiently. It also reduces testosterone production. Some research has found that it can help obese women with PCOS lose weight.
  • Thiazolidinediones. These should be used with contraception. The drugs pioglitazone (Actos) and rosiglitazone (Avandia) also help the body use insulin. In studies, these drugs improved insulin resistance. But their effect on body weight is unclear. All patients using Avandia must review and fully understand the cardiovascular risks. Research has found that Flutamide (Eulexin), an anti-androgen drug, helps obese women with PCOS lose weight. It also improves their blood sugar levels. The drug can be given alone or with metformin.

In addition to taking medication, adding healthy habits into your lifestyle can help you keep your weight under control:

  • Eat a high-fiber, low-sugar diet. Load up on fruits, vegetables, and whole grains. Avoid processed and fatty foods to keep your blood sugar levels in check. If you’re having trouble eating healthy on your own, talk to your doctor or a dietitian.
  • Eat four to six small meals throughout the day, rather than three large meals. This will help control your blood sugar levels.
  • Exercise for at least 30 minutes a day on most, if not all, days of the week.
  • Work with your doctor to track your cholesterol and blood pressure levels.
  • If you smoke, get involved in a program that can help you quit.

PCOS and Your Fertility — and What You Can Do About It

One of the most common reasons a woman has trouble getting pregnant is a condition called polycystic ovary syndrome (PCOS).  It’s a hormone problem that interferes with the reproductive system.   When you have PCOS, your ovaries are larger than normal. These bigger ovaries can have many tiny cysts that contain immature eggs.

Hormone Differences

PCOS causes a woman’s body to produce higher-than-normal levels of androgens. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgens than women.

Androgens are important in the development of male sex organs and other male traits.  In women, androgens are usually converted into the hormone estrogen.

Ovulation Problems

Elevated levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation.

If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. PCOS can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies.

Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production.

If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.

You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.

Medicines to Help You Ovulate

You won’t be able to get pregnant while you’re taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines may help:

  • Clomiphene is an anti-estrogen drug that you take at the beginning of your cycle.
  • If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin.
  • If clomiphene and metformin don’t work, your doctor may prescribe a medication containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You get this medicine in a shot.
  • One other drug that helps with ovulation is letrozole. It’s sometimes used when other medications aren’t effective.

If you have PCOS and you want to get pregnant, you should work with a doctor who is a specialist in reproductive medicine. This type of doctor is also known as a fertility specialist.

A specialist will help make sure you get the right dose of medicines, help with any problems you have, and schedule regular checkups and ultrasounds to see how you’re doing. (An ultrasound is a machine that uses sound waves to create images of the inside of your body. It’s a painless procedure that can track the growth and development of your baby).

Lifestyle Changes

For some women, gaining a lot of weight can affect their hormones. In turn, losing weight, if you’re obese or overweight, may help get your hormones back to normal levels. Losing 10% of your body weight may help your menstrual cycle become more predictable. This should help you get pregnant.

In general, living a healthier lifestyle with a better diet, regular exercise, no smoking, less stress, and control of diabetes and other medical conditions should improve your fertility odds.

Remember, if your period isn’t happening when it should, or you’ve already been diagnosed with PCOS, work closely with your doctor to help get it under control. And if you want to get pregnant, talk with a fertility specialist.

Getting Help  

If you’re having irregular periods or are unable to get pregnant, see your doctor. The same holds for:

  • Mood changes
  • Unexplained weight gain
  • Changes in your hair or skin

These symptoms may might not be caused by PCOS but could signal other serious health issues.

If anything is this article sounds like something you are dealing with, get connected with a doctor in your area who can help.  Using HealthLynked, you can find a physician and securely share relevant health information with them, collaborating more closely on your healthcare than ever before possible.

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Adapted from – WebMd