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<?xml version='1.0' encoding='UTF-8'?><?xml-stylesheet href="http://www.blogger.com/styles/atom.css" type="text/css"?><feed xmlns='http://www.w3.org/2005/Atom' xmlns:openSearch='http://a9.com/-/spec/opensearchrss/1.0/' xmlns:blogger='http://schemas.google.com/blogger/2008' xmlns:georss='http://www.georss.org/georss' xmlns:gd="http://schemas.google.com/g/2005" xmlns:thr='http://purl.org/syndication/thread/1.0'><id>tag:blogger.com,1999:blog-6366113899601223690</id><updated>2024-04-25T04:06:30.746-07:00</updated><title type='text'>Healthy on Purpose</title><subtitle type='html'>Providing relevant, evidence-based wellness information, health consulting and counseling, thus inspiring others to choose a healthy lifestyle</subtitle><link rel='http://schemas.google.com/g/2005#feed' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/posts/default'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/'/><link rel='hub' href='http://pubsubhubbub.appspot.com/'/><link rel='next' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default?start-index=26&max-results=25'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><generator version='7.00' uri='http://www.blogger.com'>Blogger</generator><openSearch:totalResults>180</openSearch:totalResults><openSearch:startIndex>1</openSearch:startIndex><openSearch:itemsPerPage>25</openSearch:itemsPerPage><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6684059742452606336</id><published>2022-01-12T08:00:00.001-08:00</published><updated>2022-01-12T08:00:00.156-08:00</updated><title type='text'>Conclusions - Alternative Treatments and ADHD </title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><i>Conclusions</i></span><br />
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<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 200%;">&nbsp; &nbsp; &nbsp;As
is abundantly clear following the discussion of the previously posted alternative
therapies, further research is necessary before clear statements can be made
regarding the efficacy of such treatments. Though research studies in the area
of alternative treatments in ADHD cases are plentiful, many are riddled with
inconsistencies, short trial periods, small subject sizes or non-standardized
assessment tools. In addition, possible harmful or negative side effect
profiles of each alternative treatment were not explored extensively in this
paper. <span style="mso-spacerun: yes;">&nbsp;</span>These factors call into question
many of the positive benefits initially observed and beg for clearer and more
convincing evidence before they can be called valid and efficacious treatment
alternatives. Further, though these therapies may provide slightly better
options for children with ADHD when compared to psychiatric medications, most
fulfill the same function of symptom management rather than addressing the root
cause of the cognitive and behavioral components at hand. Discussion of such
core factors, however, goes beyond the scope of this paper. The bottom line in
the investigation of alternative treatments in regard to the ADHD diagnosis is
the simple fact that multiple therapies have been tested, some positive
outcomes have been observed and there is extensive research still needed before
clear conclusions can be drawn in this field. <o:p></o:p></span></div>
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<br /></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/6684059742452606336/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/07/conclusions-alternative-treatments-and.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6684059742452606336'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6684059742452606336'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/07/conclusions-alternative-treatments-and.html' title='Conclusions - Alternative Treatments and ADHD '/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8622992626427933154</id><published>2022-01-05T08:00:00.001-08:00</published><updated>2022-01-05T08:00:00.155-08:00</updated><title type='text'>Part V - Alternative Treatments and ADHD - Homeopathic Remedies</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"></span>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<i><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;">Homeopathic Remedies<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 200%;">&nbsp; &nbsp; &nbsp;When
considering homeopathic treatments for any disorder or malady, a plethora of
articles can be found to support or dispute their effect. However, yet again,
it is important to look closely at the proposed treatment modalities to
determine efficacy. A review of available studies was conducted in regard to
the use of homeopathy in subjects with the ADHD diagnosis.<sup>Q </sup>Results
showed that the use of homeopathy did not provide significant treatment
outcomes and authors concluded that there is little evidence to support the use
of homeopathy in people with the ADHD diagnosis.<sup>Q </sup>A 2005 randomized,
double-blind, placebo controlled crossover trial studied the benefits of
homeopathic medication in 83 children diagnosed with ADHD over the course of 12
weeks.<sup>R </sup>Results indicated efficacy in those treated with homeopathic
medication when compared with the control group, specifically in terms of
behavioral and cognitive functioning.<sup>R </sup>Similarly, a group of 115
children with the ADHD diagnosis were treated with a traditional medicine
approach (methylphenidate) or a homeopathic medicine approach and evaluated in
terms of ADHD symptoms.<sup>S </sup>Though homeopathic remedies were shown to
have a positive effect in 75% of the subjects, limitations were also noted.<sup>S</sup>
The authors stated that though homeopathic medication showed a positive effect
on symptoms, response times were oftentimes lengthy, thus posing a potential
downfall in situations in which amelioration of symptoms is deemed urgent.<sup>S
</sup>Further, authors reported that, “The choice of the correct medication is
dependent on the individuality of the symptoms, if a patient only has the
‘standard symptoms’ of ADHD and nothing peculiar, the homeopathic physician may
have to make ‘therapeutic trials’ to find the correct medicine.”<sup>S</sup>
Authors also stated that homeopathic medication may have additional benefits
for treatment such as a low side effect profile, ease of administration, and no
abuse potential, leading to the conclusion that homeopathic medications may
have unique potential for benefit.<sup>S </sup>As has been mentioned before,
this treatment option may have potential in some cases but would require unique
and detailed investigation of the particular situation prior to recommendation.
<o:p></o:p></span></div>
<div style="text-align: center;">
<div style="text-align: center;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">References</span></i><br />
<div style="text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-indent: -0.25in;">Q.&nbsp;</span><span style="text-indent: -0.25in;">Heirs M, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder.&nbsp;</span><i style="text-indent: -0.25in;">Cochrane Database of Systematic Reviews.&nbsp;</i><span style="text-indent: -0.25in;">2007; 4: 1-3.</span></span></div>
</div>
<div style="text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-indent: -0.25in;">R. Frei H, Everts R, Von Ammon K, et al. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial.&nbsp;</span><i style="text-indent: -0.25in;">European Journal of Pediatrics.&nbsp;</i><span style="text-indent: -0.25in;">2005; 164: 758-767.</span></span></div>
<div style="text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-indent: -0.25in;">S. Frei H, Thurneysen A. Treatment for hyperactive children: Homeopathy and methylphenidate compared in a family setting.&nbsp;</span><i style="text-indent: -0.25in;">British Homeopathic Journal.&nbsp;</i><span style="text-indent: -0.25in;">2001; 90: 183-188.</span></span></div>
</div>
<div style="text-align: center;">
<i></i></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8622992626427933154/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-v-alternative-treatments-and-adhd.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8622992626427933154'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8622992626427933154'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-v-alternative-treatments-and-adhd.html' title='Part V - Alternative Treatments and ADHD - Homeopathic Remedies'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8681482998836209827</id><published>2021-12-29T08:00:00.001-08:00</published><updated>2021-12-29T08:00:00.199-08:00</updated><title type='text'>Part IV - Alternative Treatments and ADHD - Sweeteners</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><i><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 107%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">Sweeteners</span></i></span>
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<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 200%;">&nbsp; &nbsp; &nbsp;Another
topic of investigation within the ADHD world, has been the connection between
sugar and behavior. Some parents and researchers have claimed that sugar is one
of the key factors in the onset, severity and continuation of symptoms with
children diagnosed with ADHD. However, yet again, a glimpse of the evidence is
important before assuming this claim as true. A 1994 double-blind controlled
trial of 48 children was conducted to investigate the role of sugar in
behaviorally and cognitively challenged children (per parent report).<sup>M</sup>
Twenty-five of the children were considered the control group, with no reported
sensitivities to sugar and 23 of the children were classified as having sugar
sensitivities.<sup>M </sup>All of the children underwent three consecutive
three-week trials of differing sweetener combinations, the first consisting of
sucrose only with no artificial sweeteners, the second consisting of low
sucrose levels and mostly aspartame sweeteners, and the third consisting of
saccharin (placebo).<sup>M </sup>The researchers controlled for variables such
as preservatives, artificial dyes, and additives which are oftentimes blamed
for additional behavioral and cognitive complications.<sup>M </sup>Outcomes of
the study showed no difference among groups.<sup>M </sup>In addition to the
fact that no effect was observed, the researchers further stated that even when
intake of the listed sweeteners exceeded normal dietary levels, the effect
remained unsubstantial.<sup>M </sup>Similarly, in a randomized, double-blind,
placebo-controlled crossover study, researchers examined the effects of
heightened doses of aspartame on the behavior and cognition of children labeled
with the ADD diagnosis.<sup>N </sup>Children were given aspartame or placebo
for alternate 2-week periods to determine effect.<sup>N </sup>Outcomes of this
study showed no clinically significant differences between the placebo and
aspartame administrations in regard to symptoms, behavior or cognition.<sup>N </sup>Though
not as reliable as controlled research studies, anecdotal evidence has
suggested that there is a relationship between sugar intake and hyperactive
behaviors.<sup>O</sup> A 1994 research study looking at the connection between
sugar intake and hyperactive behavior in children showed that sweeteners do not
affect behavior.<sup>O </sup>This particular study examined the differences between
diets high in sucrose, aspartame, and saccharin and found that even when doses
exceeded normal intake levels, no differences were observed in hyperactivity.<sup>O
</sup>Similarly, a 1991 study looked at the difference between a
sugar-sweetened diet compared to a saccharin/aspartame-sweetened diet
(placebo).<sup>P</sup> Subjects in the study group were 17 children diagnosed
with ADHD and were compared to the control group of 9 children without the ADHD
diagnosis.<sup>P</sup> Results showed no difference in levels of aggression
between the study and control groups.<sup>P</sup> Despite this finding,
children with the ADHD diagnosis did show increased inattention following sugar
ingestion when compared to the control group.<sup>P</sup> However, the
researchers stated in conclusion, “This result is of questionable clinical
significance inasmuch as aggressive behavior was unchanged. The finding may be
due to the combination of the sugar challenge with a high-carbohydrate
breakfast. These findings should be replicated and any possible clinical
significance should be documented before any dietary recommendations can be
made.”<sup>P</sup> Again, though the elimination of sugar may have a positive
effect on some ADHD-diagnosed children, the apparent evidence is not
overwhelming.<o:p></o:p></span><br />
<div style="text-align: center;">
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: center;">
<i><span style="font-family: &quot;Times New Roman&quot;,serif;">References</span></i><span style="font-family: &quot;Times New Roman&quot;,serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">M. Wolraich ML, Lindgren SD, Stumbo
PJ, et al. Effects of diets high in sucrose or aspartame on the behavior and
cognitive performance of children.&nbsp;<i>The New England Journal of Medicine.</i>&nbsp;1994;
330: 301-306.&nbsp;<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">N. Shaywitz BA, Sullivan CM,
Anderson GM, et al. Aspartame, behavior, and cognitive function in children
with attention deficit disorder.&nbsp;<i>Pediatrics.&nbsp;</i>1994; 93:70-75.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">O. Kanarek RB. Does sucrose or
aspartame cause hyperactivity in children?&nbsp;<i>Nutrition Reviews.&nbsp;</i>1994;
52: 173-175.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">P. Wender EH, Solanto MV. Effects
of sugar on aggressive and inattentive behavior in children with attention
deficit disorder with hyperactivity and normal children.&nbsp;<i>Pediatrics.&nbsp;</i>1991;
88: 960-966.<o:p></o:p></span></div>
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<br /></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8681482998836209827/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iv-alternative-treatments-and-adhd.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8681482998836209827'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8681482998836209827'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iv-alternative-treatments-and-adhd.html' title='Part IV - Alternative Treatments and ADHD - Sweeteners'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-1405657340084101384</id><published>2021-12-22T08:00:00.001-08:00</published><updated>2021-12-22T08:00:00.170-08:00</updated><title type='text'>Part III - Alternative Treatments and ADHD - Multivitamins</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
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<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 200%;"></span><br />
<div class="MsoNormal" style="line-height: 200%;">
<i><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;">Multivitamins<o:p></o:p></span></i></div>
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 200%;">&nbsp; &nbsp; &nbsp;Though
it has been suggested that vitamin and nutrient deficiencies can lead to
significant cognitive impairment and declined performance on intelligence
tests, the assumption that such supplementation may subsequently aid children
diagnosed with ADHD has not been proven with extensive and convincing research
data.<sup>H </sup>Adequate research studies with large sample sizes, sufficient
trial times and randomized controls appears lacking in the investigation of the
role of multivitamins in relation to ADHD.<span style="mso-spacerun: yes;">&nbsp;
</span>Some studies have shown preliminary evidence of benefit for adults
taking multivitamin supplements to treat ADHD symptoms, yet caution to accept
efficacy is warranted due limitations such as small sample size and short-term
trials.<sup>I <span style="mso-spacerun: yes;">&nbsp;</span></sup>During an 8-week
trial, 14 adults diagnosed with ADHD were observed while taking a 36-ingredient
micronutrient formula.<sup>J</sup> Though results showed improvement of
symptoms, the effects are questionable at best due to the small sample size,
short trial length and method of evaluation (self, clinician and observer
reports).<sup>J</sup> In addition, researchers admitted that due to the
limitations of this study design, the outcome<span style="mso-spacerun: yes;">&nbsp;
</span>“does not in itself prove efficacy”.<sup>J</sup> Research studies
involving children have been performed with some level of similarity, yet also
with notable limitations. A fully blinded, randomized, placebo-controlled trial
looked at 93 children with the ADHD diagnosis and tested the efficacy of
multivitamin supplementation on symptoms.<sup>K</sup> Results indicated that
subjects receiving vitamin and mineral supplementation improved in overall
function, including reduced impairment and improved attention but did not show
reduced levels of hyperactive and impulsive symptoms when compared with the
control group.<sup>K </sup>The researchers subsequently commented that,
“Although direct benefit for core ADHD symptoms was modest, with mixed findings
across raters, the low rate of adverse effects and the benefits reported across
multiple areas of functioning indicate micronutrients may be a favourable
option for some children, particularly those with both ADHD and emotional
dysregulation.”<sup>K </sup>Therefore, though these findings point to potential
benefit, they do not provide overwhelming evidence for efficacy at this time. In
addition, though some benefit was found, it was mild and did not address all
levels of the symptom profile, namely the hyperactive and impulsive actions
that frequently are the most challenging to deal with in such cases. Some
research studies have performed trials with ADHD-diagnosed children to
determine if deficiencies in vitamin and hormone levels exist. By investigating
deficiencies, such studies have attempted to suggest the importance of
supplementation in these populations. In a 2014 study of 77 kids, researchers
looked at levels of ferratin, vitamin D, vitamin B12, adrenal and gonadal
steroid levels, celiac antibodies, and thyroid hormones and antibodies.<sup>L </sup>Subjects
were divided into three groups: children with the ADHD diagnosis, children with
the Asperger’s diagnosis, and children with no diagnosis (control group).<sup>L
</sup>Deficiencies were found in both diagnosed categories when compared with
the control group, thus leading the researchers to conclude that vitamin D and
B12 supplements would benefit these populations.<sup>L </sup>Despite the
observed levels of deficiency, however, this study did not investigate the
outcome of ADHD-diagnosed children taking these vitamins, thus bringing into
question the validity of the claim of likely efficacy.<o:p></o:p></span></div>
<div style="text-align: center;">
<div class="MsoNormal" style="line-height: normal; text-align: center;">
<i><span style="font-family: &quot;Times New Roman&quot;,serif;">References<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">H. Benton D. Symposium on nutrition
and cognitive efficiency. Proceedings of the Nutrition Society. 1992; 51:
295-302.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">I. Rucklidge JJ, Framptom CM,
Gorman B, Boggis A. Vitamin-mineral treatment of attention-deficit
hyperactivity disorder in adults: double-blind randomised placebo-controlled
trial. The British Journal of Psychiatry. 2014; 204: 306-315.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">J. Rucklidge JJ, Taylor M,
Whitehead K. Effect of micronutrients on behavior and mood in adults with ADHD:
evidence from an 8-week open label trial with natural extension. Journal of
Attention Disorders. 2011; 15:79-91.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">K. Rucklidge JJ, Eggleston MJ,
Johnstone JM, Darling K, Frampton CM. Vitamin-mineral treatment improves
aggression and emotional regulation in children with ADHD: a fully blinded,
randomized, placebo-controlled trial. Journal of Child Psychology and
Psychiatry, and Allied Disciplines. Published Online: October 2, 2017 (doi:
10.1111/jcpp.12817).<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">L. Bala KA, Dogan M, Mutluer T,
Aslan O, Dogan SZ. Hormone disorder and vitamin deficiency in attention deficit
hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). Journal of
Pediatric Endocrinology and Metabolism. 2016; 29: 1077-1082.<o:p></o:p></span></div>
</div>
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<div style="text-align: left;">
<br /></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/1405657340084101384/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iii-alternative-treatments-and.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1405657340084101384'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1405657340084101384'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iii-alternative-treatments-and.html' title='Part III - Alternative Treatments and ADHD - Multivitamins'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-437053997356340739</id><published>2021-12-15T08:00:00.001-08:00</published><updated>2021-12-15T08:00:00.149-08:00</updated><title type='text'>Part II - Alternative Treatments and ADHD - Magnesium</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
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<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-align: justify;">&nbsp; &nbsp; &nbsp;</span></span><i style="text-align: justify;"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;">Magnesium</span></i><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;">&nbsp; &nbsp; &nbsp;Another
supplement frequently recommended as an alternative or adjunctive treatment for
ADHD is magnesium. An initial look at the research gives reason to believe that
magnesium supplementation may offer some treatment benefit. In a 1997 research
study on the effectiveness of magnesium supplementation in hyperactive
children, 50 subjects ages 7-12 were observed over the course of 6 months.<sup>E</sup>
At the conclusion of the 6 month trial period, the test group showed increased
levels of magnesium as well as decreased incidence of hyperactivity when
compared to the control group.<sup>E </sup>The small sample size may pose a
limitation to the outcome of this study. With similar findings, a longitudinal,
observational study was conducted in Germany with 810 children ages 5-12 over
the course of 3 months.<sup>F </sup>Results showed that when subjects were
given Esprico<sup> </sup>(a food supplement combining omega 3, omega 6, zinc
and magnesium), they experienced substantial reductions in ADHD symptoms,
emotional and behavioral problems and sleep challenges.<sup>F </sup>Once again,
significant limitations to this study exist. A drop-out rate of 14% was noted
due to absence of positive effect, lack of compliance or adverse reactions.<sup>F</sup>
Further, 7.3% of the subjects were taking other medications or involved in alternate
treatment as well, such as medications for obstructive pulmonary disease,
thyroid therapeutics, psycho stimulants, unspecified amphetamines,
non-stimulant medication and homeopathic remedies.<sup>F</sup> In addition, the
study did not provide a control group, posing considerable limitation to the
reliability of the research outcomes.<sup>F</sup> Perhaps most significant of
the limitations of this study is the fact that it was funded by a grant from
Engelhard Arneimittel, a German Pharmaceutical company, likely leading to
investigator bias. A review of the literature regarding magnesium
supplementation in children with the ADHD diagnosis can shed light on the
problematic nature of stating that magnesium is an effective treatment for this
disorder. Esparham et al. reviewed multiple articles in the efficacy of
magnesium supplementation in ADHD-diagnosed children.<sup>G </sup>Though a
summary of the study outcomes showed benefit with this therapy, a marked number
of limitations were present across the studies.<sup>G </sup>Systematic review
revealed that the majority of the studies had methodological limitations such
as lack of double-blind randomized controlled study design and lack of
measurement standardization in regard to the levels of magnesium.<sup>G </sup>The
general outcome of these studies may, at best, offer reason to investigate this
treatment modality in future research.&nbsp;<o:p></o:p></span></div>
</div>
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<br />
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<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<i><span style="font-family: &quot;Times New Roman&quot;, serif;">References</span></i><span style="font-family: &quot;Times New Roman&quot;, serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">D. Moghaddam MF, Shamekhi M, Rakshani T. Effectiveness of
methylphenidate and PUFA for the treatment of patients with ADHD: a
double-blinded randomized clinical trial. Electronic Physician. 2017; 9:
4412-4418. Available from:&nbsp;<a href="http://www.ephysician.ir/"><span style="color: blue;">http://www.ephysician.ir</span></a>. Accessed December 15,
2017.<o:p></o:p></span></div>
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<span style="font-family: &quot;Times New Roman&quot;, serif;">E. Starobrat-Hermelin B, Kozielec T. The effects of
magnesium physiological supplementation on hyperactivity in children with
attention deficit hyperactivity disorder (ADHD). Positive response to magnesium
oral loading test.&nbsp;<i>Magnesium Research.</i>&nbsp;1997; 10: 149-156.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">F. Huss M, Volp A, Strauss-Grabo M. Supplementation of
polyunsaturated fatty acids, magnesium and zinc in children seeking medical
advice for attention-deficit/hyperactivity problems – an observational cohort
study.&nbsp;<i>Lipids in Health and Disease.</i>&nbsp;2010; 9: 105-117.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">G. Esparham A, Evans RG, Wagner LE, Drisko JA. Pediatric
integrative medicine approaches to attention deficit hyperactivity disorder
(ADHD).&nbsp;<i>Children.&nbsp;</i>2014; 1: 186-207.<o:p></o:p></span></div>
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</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/437053997356340739/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-ii-alternative-treatments-and-adhd.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/437053997356340739'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/437053997356340739'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-ii-alternative-treatments-and-adhd.html' title='Part II - Alternative Treatments and ADHD - Magnesium'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8196492282759272577</id><published>2021-12-08T08:00:00.001-08:00</published><updated>2021-12-08T08:00:00.209-08:00</updated><title type='text'>Part 1 - Alternative Treatments and ADHD - Omega 3/Fish Oil</title><content type='html'><br />
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<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-align: justify;">&nbsp;</span></span><i style="text-align: justify;"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;">Omega 3 Fatty Acids and Fish Oil</span></i><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<i><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></i></div>
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-align: justify;">&nbsp; &nbsp; &nbsp;Consistent
disagreement remains in the discussion regarding the benefit of including Omega
3 fatty acids or fish oil in the diets of those suffering from ADHD, yet the majority
of evidence seems to support the conclusion that this supplement is
questionable at best.</span><span style="text-align: justify;">&nbsp; </span><span style="text-align: justify;">A 2016 study
examined the effects of a marine oil extract on the levels of hyperactivity,
inattention, cognition, and mood in children.</span><sup style="text-align: justify;">A</sup><span style="text-align: justify;"> Researchers discovered
that the ingestion of such supplementation did not result in the improvement of
parental reports in regard to hyperactivity, inattention and impulsivity,
though some positive effect was seen in children without the ADHD diagnosis.</span><sup style="text-align: justify;">A&nbsp; </sup><span style="text-align: justify;">Additionally, extensive review articles
can be found on the subject, comparing numerous studies on this topic. </span><sup style="text-align: justify;">&nbsp;</sup><span style="text-align: justify;">In a review of 16 randomized controlled
trials including 1,514 youth with the ADHD diagnosis, overall conclusions displayed
that the use of Omega-3/6 supplementation had promising effects and could be
effectively used as adjunctive therapy to the more traditional approaches.</span><sup style="text-align: justify;">A
&nbsp;</sup><span style="text-align: justify;">However, this review has
significant limitations as the authors were funded by Equazen, a company that
manufactures Omega-3/6 supplements, thus likely bringing significant bias into
the findings.</span><sup style="text-align: justify;">B </sup><span style="text-align: justify;">Another review considered multiple studies
investigating the benefits of Omega-3 supplementation in children labeled with
the ADHD diagnosis and found multiple discrepancies among those examined.</span><sup style="text-align: justify;">C</sup><span style="text-align: justify;">
Lack of placebo groups, small sample sizes, and minimal trial length
contributed to the inconsistencies of the studies and subsequent lack of
reliability.</span><sup style="text-align: justify;">C </sup><span style="text-align: justify;">&nbsp;</span><span style="text-align: justify;">In a study
investigating the effectiveness of Omega 3 supplementation used in conjunction
with methylphenidate (a drug commonly prescribed for ADHD), researchers
concluded that the Omega 3 addition provided subjects with significantly better
outcomes when compared with controls.</span><sup style="text-align: justify;">D </sup><span style="text-align: justify;">Though this double-blinded
randomized clinical trial shows benefit, there are limitations which require
attention and are acknowledged by the researchers.</span><sup style="text-align: justify;">D</sup><span style="text-align: justify;"> The study looked
at a notably small sample size of 40 children within a limited age range of
6-12 years and lasted over a period of only 8 weeks.</span><sup style="text-align: justify;">D </sup><span style="text-align: justify;">These factors
alone bring into question the validity of the results, thus requiring further
investigation before concrete conclusions can be made. Therefore, though some
research points to the potential benefits of Omega 3 supplementation in
children with the ADHD diagnosis, it appears that greater bodies of research
point to the ineffectiveness or at best, minimal effectiveness of this
treatment.</span></span><br />
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-align: justify;"><br /></span></span>
<br />
<div align="center" class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: center;">
<i><span style="font-family: &quot;times new roman&quot; , serif;">References</span></i><span style="font-family: &quot;times new roman&quot; , serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif;">A. Kean JD, Sarris J, Scholey A, et
al. Reduced inattention and hyperactivity and improved cognition after marine
oil extract (PCSO-524<sup>R</sup>) supplementation in children and adolescents
with clinical and subclinical symptoms of attention-deficit hyperactivity
disorder (ADHD): a randomized, double-blind, placebo-controlled trial.&nbsp;<i>Psychopharmacology.&nbsp;</i>2017;
234: 403-420.<br />
B. Derbyshire E Do omega-3/6 fatty acids have a therapeutic role in children
and young people with ADHD.&nbsp;<i>Journal of Lipids.&nbsp;</i>2017; 2017:
1-9.<o:p></o:p></span></div>
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="text-align: justify;">
</span></span><br />
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<span style="font-family: &quot;times new roman&quot; , serif;">C. Konigs A, Kiliaan AJ. Critical
appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder
treatment.&nbsp;<i>Neuropsychiatric Disease and Treatment.</i>&nbsp;2016; 12:
1869-1882.<br />
D. Moghaddam MF, Shamekhi M, Rakshani T. Effectiveness of methylphenidate and
PUFA for the treatment of patients with ADHD: a double-blinded randomized
clinical trial. Electronic Physician. 2017; 9: 4412-4418. Available from:&nbsp;<a href="http://www.ephysician.ir/">http://www.ephysician.ir</a>. Accessed
December 15, 2017.<o:p></o:p></span></div>
</div>
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</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8196492282759272577/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/05/part-1-alternative-treatments-and-adhd.html#comment-form' title='7 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8196492282759272577'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8196492282759272577'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/05/part-1-alternative-treatments-and-adhd.html' title='Part 1 - Alternative Treatments and ADHD - Omega 3/Fish Oil'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>7</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-4681537539731539785</id><published>2021-12-01T04:54:00.001-08:00</published><updated>2021-12-01T04:54:00.161-08:00</updated><title type='text'>Healing Properties of Articum Lappa (Burdock Root)?</title><content type='html'><span style="font-family: Times, Times New Roman, serif;"><span style="font-family: Times, Times New Roman, serif;"><br /></span>
</span><br />
<div class="MsoNormal" style="line-height: normal;">
<a href="https://natureslegacies.com/wp-content/uploads/Vine-Vera-Ingredient-Spotlight-Actium-Lappa-Root-Extract.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Times, Times New Roman, serif;"><img alt="Image result for burdock root" border="0" height="133" src="https://natureslegacies.com/wp-content/uploads/Vine-Vera-Ingredient-Spotlight-Actium-Lappa-Root-Extract.jpg" width="200" /></span></a><span style="font-family: Times, Times New Roman, serif;">I recently read a statement on a
popular health blog, stating the benefits of Articum Lappa, also known as
burdock root. As is the case with many natural supplements, claims for the
benefits of Arctium Lappa are extensive. Ranging from a combatant for cancer, a
healer for skin and an antibacterial/antimicrobial agent, to an
anti-inflammatory substance, a natural diuretic and defense against diabetes,
Arctium Lappa is touted as a plant with almost magical properties. From this
list of claimed values, the question becomes one of reliability and evidence
supporting these advantageous assertions. As always, a little digging provides
a clearer understanding of the real story.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;">In a <a href="https://pdfs.semanticscholar.org/20f1/dbc370439986e6b7119dd8a66839f7de7560.pdf">study </a>aimed at determining
the beneficial properties of several plants, researchers attempted to evaluate
the antimicrobial activity of the combined plant extracts of artichoke,
dandelion and Arctium Lappa. A serial dilution method was employed to assess
the antimicrobial activity of this blend when introduced to bacterial strains
of Staphylococcus aureus, Escherichia coli, and Salmonella abony. Researchers
concluded that using this trifecta of plant extracts proved to be beneficial
against Escherichia coli and Salmonella abony but did not show antimicrobial
activity when tested with Staphylococcus aureus. Though this study points to
the possible benefit of Arctium Lappa&nbsp; on
health, the study has clear limitations for the claims of Arctium Lappa’s sole
benefit due to the fact that it was not tested apart from artichoke and
dandelion.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;">In a randomized, double‐blind
placebo‐controlled clinical <a href="https://www.ncbi.nlm.nih.gov/pubmed/29520881">trial</a>, 3 subjects infected with Helicobacter pylori
(H.pylori) were studied. Nineteen participants ingested a burdock complex (BC)
consisting of burdock (Arctium Lappa), angelica, gromwell and sesame oil and 17
subjects ingested a placebo for a total of eight weeks. Multiple markers were
tested, including anti-inflammatory properties, to determine the efficacious nature
of BC.&nbsp; Subjects were evaluated at
fourth, eighth, and tenths weeks, with endoscopic examination taking place at
the baseline and tenth weeks. Researchers determined that BC significantly
inhibited and alleviated inflammatory markers of H-pylori in subjects during
the course of the study period.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;">A <a href="http://mct.aacrjournals.org/content/13/1/49">study </a>of a key constituents
extracted from the seeds of Arctium Lappa, identified as Lappaol F, was
performed in regard to its anticancer effects in humans. During the course of
the study, researchers investigated Lappaol F and its effect on colon, breast,
lung, cervix, and prostate cancers as well as melanoma, osteosarcoma, and
leukemia.&nbsp; Results demonstrated that
Lappaol F suppressed cancer cell growth in human cancer cell lines in a variety
of tissue types and displayed a time- and dose-dependent relationship.&nbsp; Researchers stated that Lappaol F offers a
novel anticancer constituent, and has the capacity to mediate growth
suppression by initiating cell-cycle arrest as well as trigger cell death in
some tumor cell lines.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;">A number of limitations exist in
regard to the studies cited. Across studies, the method of plant compound
extraction greatly varied, ranging from extraction from seeds to extraction
from leaves and stems, suggesting possible differences in quality or potency of
the constituents. Some studies used a combination of plants rather than looking
solely at the medicinal properties of Arctium Lappa, pulling into question
which component was of greatest consequence and whether the effect was due to
the pooled benefits of all the components or based solely on one plant.&nbsp; Further, differing methods of administration
were performed, such as ingestion of tea versus consumption via liquid essence
form. Another key difference between studies was the method of investigation,
ranging from in vitro studies to those involving human participants. In
addition, the studies involving human subjects were limited in size and took
place over short periods of time. Another limitation is presented in the fact
that some studies focused on the benefits of Arctium Lappa as a whole and
others used isolated constituents of the plant to test and determine efficacy.
All of these factors point to the importance of further investigation into the
effectiveness of specific and consistent variables. In other words, examining
studies that focus on similar constituents, extraction protocol, testing
methods, administration, and observation might provide a better picture of
efficacy than studying the varied approaches listed above. However, the
purposes of this paper were to present a foundation of possible efficacy for
Arctium Lappa, thus presenting the need for further and more detailed research
opportunities.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
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</div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: Times, Times New Roman, serif;">It appears evident that benefit
exists in the use of Arctium Lappa for its healing properties, including its
anti-microbial, anti-bacterial, anti-inflammatory and anti-cancer effects.
Further, varied methods of extraction, administration and components used point
to the efficacious potential for this acclaimed medicinal plant. Clearly, as
mentioned above, consistency in extraction, test measures and administration
should be employed in future research studies to determine specific efficacy
but the initial display of benefits is evident following a brief review of the
literature.</span><o:p></o:p></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/4681537539731539785/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2018/06/healing-properties-of-articum-lappa.html#comment-form' title='7 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4681537539731539785'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4681537539731539785'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2018/06/healing-properties-of-articum-lappa.html' title='Healing Properties of Articum Lappa (Burdock Root)?'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>7</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7140139262147053885</id><published>2021-11-26T04:53:00.001-08:00</published><updated>2021-11-26T04:53:20.123-08:00</updated><title type='text'></title><content type='html'><br />
<div align="center" class="MsoNormal" style="line-height: 200%; text-align: center;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Ashwagandha: Overview, Efficacy,
Risk<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">With the use of supplements being a
popular practice, it likely comes as no surprise that a plant-based anti-stress
and anti-anxiety supplement has been advertised extensively. Withania
somnifera, more frequently referred to as ashwagandha, has been touted for its
beneficial capabilities, with significant implications regarding its ability to
reduce stress levels.<sup>1</sup> Despite its many claims, however, sufficient
information is questionable as to the benefits it provides. A further look at the
history of its use as well as its evidential efficacy is warranted,
particularly due to the widespread recommendations of its use.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">History<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Ashwagandha is a plant from which
the root and berries have historically been used to create medicinal compounds.
Utilized by Ayurvedic, Indian and Unani medicine, ashwagandha has been
prescribed for a whole host of physical and mental maladies ranging from
arthritis, tumors and tuberculosis to stress, difficulty thinking and anxiety.<sup>1
</sup>In a brief review article referencing ashwagandha, one author stated that
the health implications for this plant are extensive, being consistently used
in Indian and Ayurvedic medicine.<sup>2</sup> Further the author stated that
particularly noteworthy amongst uses were implications of benefit for tumors,
inflammation, infectious diseases, fevers and inflammatory conditions.<sup>2, 3</sup>
However, despite the plethora of assumed uses, the author noted that the
traditional use of this plant “may not be supported by scientific studies”.<sup>2
</sup>In addition to the long list of illnesses ashwagandha is suggested to
treat, it is also commonly referred to as an adaptogen (possessing the ability
to aid the body in the normalization and regulation of systemic stress).<sup>1 </sup>Ashwagandha
has frequently been used as a naturally-occurring anti-stress and anti-anxiety
agent, which will be the central focus of this paper.<sup>1<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Efficacy <o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<a href="https://www.blogger.com/u/1/null" name="_Hlk521469041"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a
review of clinical studies, authors examined the research surrounding the evidential
usefulness of plant-based medicines as anxiolytics.<sup>4 </sup>Of the 21
plants with research pertaining to human clinical trial evidence, 13 showed
anxiolytic effects when used in durations longer than one day, one of which was
ashwagandha.<sup>4 </sup>Though positive effect was observed, authors further
stated that the difference between the outcome of ashwagandha administration
compared to placebo was not statistically significant.<sup>4 </sup>Authors stated
that conclusions should be taken cautiously as many of the studies contained
study limitations such as small sample sizes, brief intervention periods, and
non-replication.<sup>4 <o:p></o:p></sup></span></a></div>
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="mso-bookmark: _Hlk521469041;"></span>
</span><br />
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a double-blind, randomized,
placebo-controlled study, researchers looked at the effect of ashwagandha
extract capsules (formulated from the roots and leaves) on chronically stressed
humans.<sup>5 </sup>The 98 subjects who completed the study were divided into
four groups, three with various dosages and frequency of dosages and one
control group.<sup>5 </sup>Results showed improvement of anxiety ratings in all
of the treatment groups when compared to placebo, thus leading researchers to
conclude that the claims regarding ashwagandha’s anxiolytic effects were
warranted.<sup>5 </sup>However, it is important to note that not only was the
research performed with the financial support of Natreon Inc., the patent
holder of withania somnifera but several of the researchers were employed or
worked voluntarily at Natreon<span style="mso-spacerun: yes;">&nbsp; </span>or
NutraGenesis LLC, a retailer of withania somnifera.<sup>5</sup> Therefore, the
results of this study should be accepted cautiously, due to the financial
investment and potential benefit these results may provide the companies
involved.<sup>5<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Looking at the anxiolytic efficacy
of an ethanolic extract of withania somifera (tablet form), <a href="https://www.blogger.com/u/1/null" name="_Hlk521300748">a double-blind, placebo-controlled evaluation</a> was
performed with 39 subjects diagnosed with ICD-10 generalized anxiety disorder,
mixed anxiety and depression, panic disorder, and adjustment disorder with
anxiety.<sup>6</sup> Participants were evaluated at two and six weeks using the
Hamilton Anxiety Scale, the Global Rating Scale and the Systematic Assessment
for Treatment Emergent Effects (SAFTEE) symptom checklist.<sup>6</sup>
Commenting on participant dropout during the study, researchers stated that
upon investigation, drop-outs occurred due to lack of benefit, adverse side
effects, need for increased medication and undisclosed reasons.<sup>6</sup>
Following a review of results, researchers concluded that a demonstration of
ashwagandha’s anxiolytic effects was evident and proved superior than placebo
at the two-week follow-up and statistically significant at the 6-week
follow-up.<sup>6 </sup>Once again of note, the research study was supported by
a grant provided by Gufic LTD, Bombay, the manufacturer of the ashwagandha
formulation tested.<sup>6 </sup>Though this acknowledgement does not infer
automatic inferiority of the study results, it does give rise for additional
caution of study bias.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a randomized controlled trial,
researchers examined the efficacy of naturopathic care for patients with
anxiety.<sup>7 </sup>All participants suffered from moderate to severe anxiety
for at least six weeks prior to the beginning of the study.<sup>7 </sup>Forty-one
subjects received naturopathic care (NC) and forty subjects received
standardized psychotherapy (PT), both for a duration of 12 weeks.<sup>7 </sup>Subjects
in the NC group received several forms of treatment including dietary
counseling, deep breathing relaxation techniques, a standard multi-vitamin and
ashwagandha (extracted from the root).<sup>7</sup> Similarly, the PT group
engaged in several treatments including deep breathing relaxation techniques
and placebo.<sup>7 <span style="mso-spacerun: yes;">&nbsp;</span></sup>Intended to
measure anxiety, mental health, and overall quality of life, results were evaluated
using the Beck Anxiety Inventory (BAI), the Short Form 36 (SF-36), Fatigue
Symptom Inventory (FSI), and Measure Yourself Medical Outcomes Profile (MY-MOP).<sup>7
</sup>Participants were observed for at least eight weeks, during which time,
BAI scores decreased by 56.5% in the NC subjects compared to 30.5% in the PT
subjects.<sup>7 </sup>Further, significant differences presented with the two
groups, with the NC group demonstrating greater clinical benefit in the areas
of mental health, concentration, fatigue, social functioning, vitality, and
overall quality of life.<sup>7 </sup>Though both groups demonstrated
improvement in levels of anxiety, researchers concluded that the NC group
benefited more from treatment when compared to the PT group.<sup>7 </sup>One
limitation worth noting is the variety of NC treatments employed makes it
difficult to draw conclusions regarding the efficacy of any one factor.<sup>7</sup>
Therefore, in regard to the positive effect of ashwagandha based on this
research, it may only prove to be a potential element for benefit with the
necessity of further research. Though results showed positive effect for
naturopathic treatment, including the use of ashwagandha, the products used in
the study were supplied free of charge by the company who makes them, thus
possibly giving rise to caution yet again.<sup>7<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">One prospective, randomized,
double-blind, placebo-controlled study was performed to determine the efficacy
of a high-concentration, full-spectrum extract of ashwagandha root when
administered to adults suffering from stress and anxiety.<sup>8 </sup>Based
upon the premise that Ayurvedic medicine, animal studies and clinical studies
all point to ashwagandha’s safe and effective role as an adaptogen, researchers
looked at 64 participants with a history of experiencing chronic stress.<sup>8 </sup>Through
the use of measured serum cortisol levels as well as stress-assessment
questionnaires, researchers evaluated the effect of ashwagandha on the
participants.<sup>8 </sup>Results indicated significant reduction in symptoms
on all measures in the ashwagandha group when compared to the placebo group.<sup>8
</sup>Further, serum cortisol levels decreased substantially in the ashwagandha
group when compared to the placebo group.<sup>8 </sup>Researchers concluded that
the outcomes of this study suggested that administering high concentration,
full-spectrum ashwagandha root had an anti-stress effect with little to no side
effects and an overall positive improvement on self-assessed quality of life.<sup>8</sup><span style="mso-spacerun: yes;">&nbsp; </span>Researchers admitted that the study was small
and the duration was limited, thus recommending studies with larger sample
sizes and longer treatment periods are warranted.<sup>8<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a
randomized, double-blind, placebo-controlled study, researchers examined the
effect of ashwagandha on generalized anxiety disorder (GAD).<sup>9 </sup>The study consisted of 86 patients
diagnosed with GAD, divided into two groups.<sup>9</sup> The treatment group
received four grams of ashwagandha root in granule form three times a day for
60 days while the placebo group received four grams of placebo for 60 days.<sup>9</sup>
Researchers measured a variety of symptoms including tension, fear, insomnia,
difficulty with concentration/memory, depressed mood, sensory and muscular
complaints, and anxiety.<sup>9</sup> Results<span style="mso-spacerun: yes;">&nbsp;
</span>showed that on all measures both groups experienced highly significant
improvement but on all measures except one, there was no significant difference
between the treatment and placebo groups.<sup>9</sup> Researchers stated that anxiety
was the only factor that improved in a superior manner with the administration
of ashwagandha compared to the placebo.<sup>9</sup> However, researchers commented,
“On the whole, despite having insignificant statistical difference in both the
groups, Group A, Ashwagandha (Withania somnifera) granules, showed a better
percentage improvement than Group B (placebo). Ashwagandha (Withania somnifera)
granules have shown superior results in the management of GAD as compared to placebo
granules. Hence, the alternate hypothesis is accepted i.e. Ashwagandha
(Withania somnifera) is effective in the management of Generalized Anxiety
Disorder”.<sup>9</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Pratte and colleagues performed a
systematic review of several of the above-mentioned studies and made several
interesting comments regarding the outcomes and validity of the studies.<sup>10
</sup>Across the five studies fitting inclusion criteria, researchers reported
consistently positive study results regarding the use of ashwagandha to lessen
stress and anxiety.<sup>10</sup> However, researchers illuminated multiple
study limitations in all of the reports reviewed including researcher bias,
small sample sizes, short duration of trials and lack of researcher blinding.<sup>10</sup>
Further, according to Cochrane criteria, none of the studies achieved low
risk-of-bias rating.<sup>10</sup> Therefore, researchers concluded that though
the results of the studies showed ashwagandha’s superiority over placebo, the
outcomes must be taken with cautionary optimism.<sup>10<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Side Effects and Risk<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Though ashwagandha has been reported
as a “possibly safe” plant for ingestion, it is important to investigate the
overall side effect profile as well as the potential risk of use.<sup>1</sup>
Some state that large doses of the plant may produce stomach upset, diarrhea
and vomiting and further, that the long-term safety of its use has not yet been
determined.<sup>1</sup> In addition, some caution has been recommended for
those suffering from various diseases, based upon possible risks associated
with interactions of medications or disease progression.<sup>1 </sup>Others
suggest ashwagandha may lower blood sugar levels or interfere with medications
in diabetic patients, decrease blood pressure in people with hypotension,
irritate the gastrointestinal tract, increase immune system activity in
autoimmune patients, slow down the central nervous system thus causing
complications with anesthesia, and increase thyroid hormone levels in those
suffering from thyroid disorders.<sup>1 </sup>These potential side effects and
risks present the importance of using ashwagandha with discretion. For the
current analysis, the studies previously reviewed shed further light on the
side effect profile of this so-termed medicinal plant. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">When human clinical trials were
reviewed in regard to the anxiolytic effects of plant-based medicines,
researchers concluded that ashwagandha was well tolerated by subjects and did
not produce any heightened levels of adverse effects when compared to placebo.<sup>4<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Of the 98 subjects who participated
in a double-blind, randomized, placebo-controlled study on the effect of
ashwagandha on chronically stressed humans, researchers reported that adverse
effects were absent in all subjects, including those who dropped out of the
study.<sup>5 </sup>Researchers clarified further, stating that the lack of
adverse effects was observed regardless of dosage or frequency of administration.<sup>5</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">When an ethanolic extract of
ashwagandha was used in a double-blind, placebo-controlled study involving
patients diagnosed with anxiety disorders, the plant was not only well
tolerated by participants but adverse side effects were comparable to those
demonstrated in participants using placebo.<sup>6 </sup>Researchers stated a
percentage of subjects dropped out of the study, reportedly due to adverse
effects, yet fewer came from the ashwagandha group when compared to the control
group.<sup>6</sup> Further, adverse effects were observed early in the study
and were reportedly easily managed by way of dosage adjustment.<sup>6 </sup><span style="mso-spacerun: yes;">&nbsp;</span>Of additional importance, though abrupt
withdrawal was initiated at six weeks, no withdrawal symptoms appeared in the
participants, thus leading researchers to state ashwagandha’s superiority to
the conventional anxiolytic drugs such as benzodiazepines, tricyclic
antidepressants, and buspirone which oftentimes have adverse withdrawal
effects.<sup>6<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a randomized study performed to
determine the effectiveness of naturopathic care on measures of anxiety
compared to standardized psychotherapy treatment, researchers looked at the
benefit of several treatments including ashwagandha.<sup>7</sup> Researchers
did not observe any serious adverse reactions from the dispensation of
ashwagandha.<sup>7<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">When used in a prospective,
randomized, double-blind, placebo-controlled study, high concentrations of
full-spectrum extract of ashwagandha root produced favorable results with few
side effects.<sup>8</sup> Follow-up interviews were conducted over the phone on
days 15, 30, and 45 to evaluate treatment compliance as well as evaluation of
any adverse reactions.<sup>8</sup><span style="mso-spacerun: yes;">&nbsp;
</span>Additional safety and efficacy evaluations were performed on day 60.<sup>8</sup>
Out of the 61 subjects reviewed, only six adverse events were reported, a
minimal number particularly when compared to the five adverse events reported
in the placebo group.<sup>8</sup> Reported side effects were nasal congestion,
constipation, cough/cold, drowsiness and decreased appetite in the treatment
group compared to dry mouth, fatigue, fever, headache, abdominal pain, diarrhea
and tremors in the legs in the control group.<sup>8</sup> Researchers further
stated that all adverse events were mild and “no known mechanisms relate these
adverse events to the study drug”.<sup>8<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Researchers in a randomized,
double-blind, placebo-controlled study examined the effect of ashwagandha on
generalized anxiety disorder (GAD) in 86 patients previously diagnosed with
this disturbance. Outcomes of the study indicated a lack of adverse side
effects for those ingesting ashwagandha over the course of the investigation.<sup>9<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Conclusions<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">From the above-reviewed studies, it
appears that ashwagandha may have beneficial potential for aiding in the
reduction of symptoms pertaining to stress and anxiety. It is important to note
that in some studies, though positive benefit was observed, the favorable
outcomes were not deemed statistically significant. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A point worth mentioning is the
fact that despite the varied nature of administration, it did not appear that
the manner in which the plant was distributed (i.e. tablet form, pill form,
granule form), the dosage or the frequency of ingestion significantly influenced
the outcomes of the plant’s efficacy rating. Of significant note is the lack of
reported adverse side effects as well as the lack of negative feedback in
regard to withdrawal symptoms. Though side effects, adverse reactions and
withdrawal symptoms may have been underreported, there did not appear to be
evidence pointing to their frequency or significantly problematic nature. These
factors point to the possible positive nature of ashwagandha in those dealing
with symptoms of anxiety and heightened stress without the added concern of
contracting adverse reactions. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">As previously mentioned, limitations
did exist across all of the studies, giving rise to caution when drawing conclusions
yet the preponderance of the evidence points to the prospective but cautionary
use of ashwagandha as an effective way treat symptoms associated with stress
and anxiety. However, it is important to recognize that though the use of
ashwagandha to ameliorate unpleasant symptoms may provide relief, it serves
primarily as a symptom manager. In other words, the underlying cause of the
anxiety and stress does not get addressed at the core if surface symptoms are
simply alleviated. Therefore, if this plant is used to aid in the process of
treatment, it may be advisable to utilize it as a complementary modality rather
than a primary method of therapy. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Clinical Note<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Within a practice setting, I would
likely veer away from recommending such a supplement due to the potential for
it becoming a crutch and thus preventing clients from delving into the real
issues at hand. However, I am not sure I would spend a whole lot of time
talking a client out of using such a product if he/she is set on using it,
namely because it does not appear that ashwagandha presents significant risks
or side effects. If a client chose to utilize this supplement as a symptom
reliever, I would be sure to explain the research behind it, my reservations
regarding its use, and ultimately the importance and necessity of the client
making a personal and informed decision about it.</span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
</div>
<div class="MsoNormal" style="line-height: normal; text-align: right;">
<div style="text-align: center;">
<br /></div>
</div>
<div style="text-align: right;">
<div class="MsoNormal" style="line-height: normal; margin-left: 0.25in; text-align: center;">
<i><span style="font-family: &quot;times new roman&quot; , serif;">References<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">1.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">WebMD.
Ashwagandha. Available at: </span><a href="https://www.webmd.com/vitamins/ai/ingredientmono-953/ashwagandha"><span style="font-family: &quot;times new roman&quot; , serif;">https://www.webmd.com/vitamins/ai/ingredientmono-953/ashwagandha</span></a><span style="font-family: &quot;times new roman&quot; , serif;">. Accessibility verified August 4,
2018. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">2.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Michigan
Medicine: University of Michigan. Ashwagandha. Available at: </span><a href="https://www.uofmhealth.org/health-library/hn-2039005#hn-2039005-uses"><span style="font-family: &quot;times new roman&quot; , serif;">https://www.uofmhealth.org/health-library/hn-2039005#hn-2039005-uses</span></a><span style="font-family: &quot;times new roman&quot; , serif;">. Accessibility verified August 4,
2018.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">3.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Duke
JA. In: <i>CRC Handbook of Medicinal Herbs</i>.
2<sup>nd</sup> ed. Boca Raton, FL: CRC Press; 2002: 41-42.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">4.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Sarris
J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, part
2: a review of clinical studies with supporting preclinical evidence. <i>CNS Drugs. </i>2013; 27(4): 301-19.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">5.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Auddy
B, Hazra J, Mitra A, Abedon B, Ghosal S. A standardized withania somnifera
extract significantly reduces stress-related parameters in chronically stressed
humans: a double-blind, randomized, placebo-controlled study. <i>Journal of the American Nutraceutical
Association. </i>2008; 11(1): 50-56.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">6.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Andrade
C, Aswath A, Chaturvedi SK, Srinivasa M, Raguram R. A double-blind,
placebo-controlled, evaluation of the anxiolytic efficacy of an ethanolic
extract of withania somnifera.&nbsp; <i>Indian Journal of Psychiatry</i>. 2000; 42(3):
295-301.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">7.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Cooley
K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized
controlled trial ISRCTN78958974. <i>PLoS ONE</i>.
2009; 4(8): 1-10. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">8.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Chandrasekhar
K, Kapoor J, Anishetty S. A prospective, randomized double-blind,
placebo-controlled study of safety and efficacy of a high-concentration
full-spectrum extract of ashwagandha root in reducing stress and anxiety in
adults<i>. Indian Journal of Psychological
Medicine</i>. 2012; 34(3): 255-262. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">9.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Khyati
S, Anup T. A randomized double-blind placebo-controlled study of ashwagandha on
generalized anxiety disorder. <i>International
Ayurvedic Medicine Journal</i>. 2013; 1: 1–7.<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: &quot;times new roman&quot; , serif; mso-fareast-font-family: &quot;Times New Roman&quot;;">10.<span style="font-family: &quot;times new roman&quot;; font-size: 7pt; font-stretch: normal; line-height: normal;">&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-family: &quot;times new roman&quot; , serif;">Pratte
MA, Nanavati KB, Young V, Morley CP. An Alternative Treatment for Anxiety: A
Systematic Review of Human Trial Results Reported for the Ayurvedic Herb
Ashwagandha (withania somnifera). <i>Journal
of Alternative and Complementary Medicine</i>. 2014; 20(12): 901-908.&nbsp;<o:p></o:p></span></div>
</div>
<div style="text-align: left;">
<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7140139262147053885/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/ashwagandha-overview-efficacyrisk-with.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7140139262147053885'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7140139262147053885'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/ashwagandha-overview-efficacyrisk-with.html' title=''/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6149499112047516432</id><published>2020-03-21T07:07:00.002-07:00</published><updated>2021-11-26T04:52:35.880-08:00</updated><title type='text'>Responding to the Corona Virus - a More Hopeful Approach</title><content type='html'><a href="https://images.unsplash.com/photo-1504567961542-e24d9439a724?ixlib=rb-1.2.1&amp;ixid=eyJhcHBfaWQiOjEyMDd9&amp;auto=format&amp;fit=crop&amp;w=1000&amp;q=80" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img alt="closeup photo of yellow sunflowers" border="0" height="150" src="https://images.unsplash.com/photo-1504567961542-e24d9439a724?ixlib=rb-1.2.1&amp;ixid=eyJhcHBfaWQiOjEyMDd9&amp;auto=format&amp;fit=crop&amp;w=1000&amp;q=80" width="200" /></a>There is no doubt the corona virus "pandemic" is enveloping every avenue of our society...our world right now. Fear is rampant, anxious thoughts inundate the minds of many, questions arise about the uncertainty and panic covers our world as if blanketing it with an eerie presence. People keep asking me what I think about all of this; is it real or is this a hoax? More questions filter in about whether or not I am afraid of contracting it or if I feel comfortable going to the grocery store. Clients ask me if I am still holding appointments in my office. Others question how to deal with the spirit of fear that is everywhere and how to effectively deal with the social isolation that is being mandated across the globe.<br />
<br />
I could delve deeper into detail in terms of what I believe to be true in the midst of this - the research, the numbers, the facts - but I will leave that to another day. My point in this post is different than the usual content of this blog because it is not a referenced article. However, I believe it is of key importance in the midst of this unprecedented circumstance. This idea was prompted following a conversation with my sister earlier this week. As we were discussing all that is unfolding, my sister said "I am hopeful that something good is going to come out of this...something surprisingly good". That struck me and I began to craft what that belief might look like in practical terms.<br />
<br />
The approach I have determined to take is one that bucks the current paradigm. "I choose hope" has become my mantra in these trying days. It is a complete shift in mindset when compared to the overwhelming message of despair that is covering our world and I believe it is essential. How easy it is to get wrapped up in all that is wrong right now and if we are not intentionally focused on something else, we too will fall prey to the spreading of despair. I don't want to simply roll my eyes and say "this is crazy" (which I have been guilty of doing) but rather I want to combat this fearful mentality with actionable hope. So what does that look like in practical terms? I'd like to use this post to point out a few ways that we can all engage in, not only with a hopeful outlook but also practical ways to implement hopeful actions.<br />
<br />
<br />
Actionable Step #1 - Fill your mind with goodness. It likely comes as no surprise that when we fill our minds with negativity, we begin to act in a like manner. So in other words, negative input produces negative output. Intentionally seek to fill the atmosphere of your mind with uplifting content. For me, that looks like reading my Bible daily, reading articles that reflect hope, listening to news that does not solely focus on despair and negativity but rather hope in the midst of chaos, listening to uplifting music.<br />
<br />
Actionable Step #2 - Creating a "hope list". This is a list of intentionality - choosing to be hopeful in the midst of chaos and negativity. The content focuses on ways to be intentional about embracing these days and weeks and months and making them joyful, deliberately fulfilling, productive and memorable.<br />
<br />
Actionable Step #3 - Looking for every opportunity to combat the spirit of fear. I won't sit in my house, secluded from society, fearful of being in someone else's presence. I will be respectful of the views of others and will not attempt to force my beliefs on anyone but I will not isolate myself. I will go to the grocery store, I will take walks in my neighborhood, I will welcome clients into my office, I will even shake someone's hand if they extend theirs to mine.<br />
<br />
Actionable Step #4 - Being wise in everyday practices. Be mindful of those who are at great risk and steer clear (nursing home residents, frail or sickly individuals, tiny babies). Don't plan a giant party. I will not be foolhardy but I will be mindful of health-related practices. I will be a bad host for illness by washing my hands after being in public, eating food that follows a pattern of dietary excellence, drinking plenty of water and exercising daily. In short, I will continue caring for my body the way I always do.<br />
<br />
Actionable Step #5 - Willingly accepting that I am not in control of these circumstances. I do not have the ability to change any of this. Therefore, I choose to leave the outcome up to God, thankful I have not been tasked with being in control!<br />
<br />
Not so difficult really. You might notice a theme interlaced throughout each actionable step - intentionality. These things may not come naturally to you...which is actually the point. These items are not complicated and yet they will remain undone if we do not deliberately embrace them. What impact would be made if more people followed these steps as opposed to actions that perpetuate fear and anxiety?<br />
<br />
<div style="text-align: center;">
I would encourage you to set this as your purpose in this season:</div>
<div style="text-align: center;">
Intentionally embrace hope by filling your mind with goodness and deliberately focus on actionable steps which reflect that mindset.</div>
<div style="text-align: center;">
<br /></div>
<div style="text-align: center;">
<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/6149499112047516432/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/responding-to-corona-virus-more-hopeful.html#comment-form' title='4 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6149499112047516432'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6149499112047516432'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/responding-to-corona-virus-more-hopeful.html' title='Responding to the Corona Virus - a More Hopeful Approach'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>4</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-3835648438038102096</id><published>2020-03-09T09:00:00.000-07:00</published><updated>2021-11-26T05:00:27.388-08:00</updated><title type='text'>Interstitial Cystitis Conclusion</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Conclusion<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">As this review has
demonstrated, IC is a life-altering disease riddled with multiple uncomfortable
and disruptive physical symptoms. Oftentimes the disease goes undiagnosed or
misdiagnosed and is oftentimes referred to as a diagnosis of exclusion. The
rate of comorbidity is elevated in those suffering from IC, displaying the
additionally challenging issues that accompany the management of multiple
disorders. Equally distressing is the elusive nature of causality for IC,
leaving patients with a sense of helplessness, in addition to the inability of
doctors to confidently recommend preventative measures. Though multiple
diagnostic tests are performed, none have been specifically created for the
diagnosis of IC. Some are invasive or uncomfortable and oftentimes the
diagnosis is a result of simply eliminating a whole host of other diagnostic
possibilities before arriving at the IC determination. This process can be
frustrating, lengthy and defeating to the patients who have been suffering for
long periods of time. Of even great importance is the questionable validity of
treatment modalities. As has been observed above, pharmacological treatment is
oftentimes ineffective or perhaps mildly effective but carries with it the
significant risk of adverse side effects. More complementary and alternative methods
(CAM) such as yoga, physical therapy, acupuncture, probiotics, dietary
interventions and psychological strategies have shown benefit in a number of
studies. However, oftentimes sample sizes are small and the amount of credible
and substantial evidence is lacking, thus calling into question the
advisability of assuming any one of these techniques provides the curative key
to IC. The overarching benefit to CAM is the absence of notable risks and
adverse side effect profiles. Perhaps the bottom line in light of this review
is to focus on the issues that can be improved or solved and let further
research determine the direction for the unanswered questions at hand. Using a
variety of CAM techniques provides the potential for benefit and should perhaps
be considered first-line treatment, while steering clear of the riskier
pharmacological methods.<span style="mso-spacerun: yes;">&nbsp; </span>Though this appears
to be a logical approach to a difficult problem, the unfortunate reality is
that oftentimes logic is lacking in the overall outlook on health. As always,
lots of work to be done.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<br /></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/3835648438038102096/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-conclusion.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3835648438038102096'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3835648438038102096'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-conclusion.html' title='Interstitial Cystitis Conclusion'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-1416125066791810351</id><published>2020-03-06T12:20:00.003-08:00</published><updated>2024-02-02T03:36:33.427-08:00</updated><title type='text'>Science of Essential Oils</title><content type='html'><a href="http://rec001.freeconferencecalling.com/mp3/1334873/196059/LA3977_05022016075907644_1094569.mp3">http://rec001.freeconferencecalling.com/mp3/1334873/196059/LA3977_05022016075907644_1094569.mp3</a></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/1416125066791810351/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/science-of-essential-oils.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1416125066791810351'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1416125066791810351'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/science-of-essential-oils.html' title='Science of Essential Oils'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7835588984827643027</id><published>2020-03-02T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.967-08:00</updated><title type='text'>Interstitial Cystitis Part VI</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Psychological Strategies<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Though perhaps not
widely understood or considered, psychological strategies and techniques can
offer potential benefits to those suffering from pain disorders by aiding
patients in the development of better coping strategies and transforming
underlying pain beliefs.<sup>49 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a study of 138
participants with an IC diagnosis, patients were surveyed to determine the use
and effectiveness of psychological self-care strategies in the management of
symptoms.<sup>50</sup> Following review of results, researchers concluded that
women suffering from IC engaged in a number of psychological self-care such as
downward comparison, self-validation, empowerment, information-seeking, connection
with others and taking personal responsibility for illness.<sup>50</sup>
Results demonstrated improved ability to cope depended upon the use of <span style="mso-spacerun: yes;">&nbsp;</span>information-seeking, downward comparison,
empowerment, connection with others and self-validation.<sup>50</sup> Of most
significance, researchers stated that involvement in a support group was
perhaps the most important strategy employed.<sup>50</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A study of 108
subjects with pain-related distress and disability participated in several
acceptance-based strategies to determine effectiveness in dealing with pain.<sup>51
</sup>Treatment tools centered around increasing patient willingness to deal
with uncomfortable thoughts and feelings and instead focusing attention on
behaviors that encourage improved functioning in the long term rather than
caving to a momentary feeling.<sup>51 </sup>In addition, physical exercise,
health habits and meaningful life directions were addressed as components of
therapy.<sup>51 </sup>Researchers concluded that the pain and functional
ability of the patients improved significantly at post-treatment and at three
month follow-up when compared to pre-treatment.<sup>51 </sup>More specifically,
improvements across participants included 41.2% improvement in depression, 25%
improvement in physical disability, 39.9% improvement in psychosocial disability,
61.8% reduction in hours needed to rest as a result of pain during daytime
hours, and 48.2% improvement in the ability to repeatedly perform sit-to-stand
endeavors.<sup>51 </sup><span style="mso-spacerun: yes;">&nbsp;</span>Researchers
stated that psychological methods for dealing with chronic pain have significant
evidence to support their effectiveness yet confirmation of<span style="mso-spacerun: yes;">&nbsp; </span>particular treatment modalities that lead to
improvement are lacking.<sup>51</sup> Further, researchers stated that an
acceptance-based treatment approach challenges the pain experience overall and offers
a very promising avenue for further development in the management of pain.<sup>51</sup>
<o:p></o:p></span></div>
<br />
<br />
<div style="text-align: center;">
<div style="text-align: left;">
<div style="text-align: center;">
<i>References</i></div>
</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
49.<span style="white-space: pre;"> </span>Atchley MD, Shah NM, Whitmore KE. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States. Translational Andrology and Urology. 2015; 4(6): 662-667.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
50.<span style="white-space: pre;"> </span>Webster DC, Brennan T. Use and effectiveness of psychological self-care strategies for interstitial cystitis. Healthcare for Women International. 1995; 16(5): 463-75.</div>
</div>
<div style="text-align: center;">
</div>
<div style="text-align: center;">
<div style="text-align: left;">
51.<span style="white-space: pre;"> </span>McCrackena LM, Vowlesb KE, Eccleston C. Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy. 2005; 43: 1335–1346.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
<br /></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7835588984827643027/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-part-vi.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7835588984827643027'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7835588984827643027'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-part-vi.html' title='Interstitial Cystitis Part VI'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7494310461815718496</id><published>2020-02-24T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.806-08:00</updated><title type='text'> Interstitial Cystitis Part V</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Probiotics<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Contrary to
popular belief, the bladder is not sterile, a concept relatively recently
presented as truth.<sup>42 </sup>In a detailed article regarding the history
and current discoveries of the urinary microbiome, authors displayed evidence
for the validity of a microbiome housed in the bladder.<sup>42 </sup>Not only
is the urinary microbiome in existence, but in most people, it plays a
protective role much like the microbiomes found in the rest of the body.<sup>42
</sup>It has been postulated that disturbances in the urinary microbiome may
contribute to the symptomatology that accompanies urgency urinary incontinence.<sup>42
</sup>The authors of the review stated that future work is needed to better
understand the intricate world of the urinary microbiome as well as what
contributes to its development and healthy maintenance.<sup>42 </sup>Though
this review does not pertain directly to IC, it does bring up questions as to
whether or not the use of probiotics to ensure healthy microbiota would be
warranted in IC patients. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Though not a well-referenced
site, the Interstitial Cystitis Association (ICA) has presented the potential
benefit of probiotics for IC patients, stating that adding this supplement may
provide support for general wellness.<sup>43</sup> The ICA states that
probiotics initiate growth of good bacteria that will in turn help to boost he
body’s natural immune defenses, thus encouraging whole-body wellness.<sup>43 </sup>Further,
the ICA site reports that some IC patients have found benefit to taking
probiotics, therefore presenting the possibility of positive effect.<sup>43</sup>
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a
cross-sectional study, researchers compared variance between the urinary
microbiome and the cytokine levels of IC-diagnosed women and healthy controls.<sup>44</sup><span style="mso-spacerun: yes;">&nbsp; </span>Results demonstrated that the urinary
microbiome of IC participants was less diverse, less likely to be colonized
with lactobacillus, and linked with higher levels of proinflammatory cytokines.<sup>44
</sup>These results present the assumption that the microbiome of IC patients
is damaged or altered and would perhaps benefit from the introduction of
probiotics as an adjunctive treatment option. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A systematic
review was performed on the topic of the microbiome in the urinary tract<span style="mso-spacerun: yes;">&nbsp; </span>and the use of prebiotics and probiotics as
useful treatment for various urological disprders.<sup>45 </sup>Eighty-nine
studies were included in the review and focused on a variety of urologic
disorders including urinary incontinence, urologic cancers, interstitial
cystitis, neurogenic bladder dysfunction, sexually transmitted infections, and
chronic prostatitis/chronic pelvic pain syndrome.<sup>45</sup> Following an
assimilation of the data and subsequent investigation of the study outcomes,
the authors concluded that the microbiome in healthy individuals likely changes
from a healthy one to a damaged one with the presence of urologic disorders.<sup>45</sup>
Authors posed the hypothesis that the use of prebiotics and probiotics may
provide a useful modality in the treatment of urologic disorders but the need
for further study is apparent.<sup>45 </sup>Again, though the accumulation of
data regarding the proven benefit of using prebiotics and probiotics to treat
urologic disorders has not yet been widely collected, enough evidence exists to
support the assumption that this may offer a promising therapy for those
suffering from these disorders.<sup> <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Dietary Intervention<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Dietary
intervention has been widely suggested as a possible way to reduce flare ups
and symptoms of IC.<sup>3</sup> Though dietary changes do not appear to provide
a curative effect, studies reveal that the elimination of certain foods may be
helpful in the management of symptoms. One study on dietary triggers and IC was
performed to determine which foods most exacerbated symptoms.<sup>46.</sup>Three
hundred forty-four foods were considered in regard to problematic potential to
effect urinary frequency, urgency and/or pelvic pain symptoms.<sup>46 </sup>Researchers
discovered that out of the 598 responses submitted, 95.8% of the participants answered
affirmatively that certain foods and beverages contributed to their IC symptoms.<sup>46
</sup>The majority of food and beverages tested posed no effect on symptoms but
the items most frequently identified as problematic were citrus fruits,
tomatoes, coffee, tea, carbonated and alcoholic beverages, spicy foods,
artificial sweeteners, and vitamin C.<sup>46</sup> In addition, calcium
glycerophosphate (a calcium salt) and baking soda offered symptom relief in
some participants.<sup>46</sup> Researchers concluded that though IC diets do
not necessarily need to be significantly restricted, it would behoove patients
to abstain from the above-listed foods in order to provide preventative
measures as well as alleviate symptoms.<sup>46 </sup><span style="mso-spacerun: yes;">&nbsp;</span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a survey of 374
IC patients, the affect of certain beverages was tested in regard to IC
symptomatology.<sup>47 </sup>Researchers discovered that the inclusion of
acidic, alcoholic or carbonated beverages, and coffee or tea caused an increase
in overall pain in more than 50% of the participants, thus suggesting that the
elimination of such liquids would be beneficial to IC patients.<sup>47</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a study of 104
IC patients, researchers investigated the effect of 175 different foods and
beverages.<sup>48</sup> Out of those surveyed, 90.2% reported that the
consumption of particular foods irritated their symptoms, though no correlation
was found between allergic reactions and the effect of certain foods on
symptoms.<sup>48 </sup>The foods and beverages most widely identified as
problematic in terms of increased symptoms were caffeinated, carbonated and
alcoholic beverages, certain fruits and juices, artificial sweeteners and spicy
foods.<sup>48</sup> Looking at a compilation of the data, it appears fairly
apparent that certain groups of foods cause an increase in symptom presentation
and IC patients have potential benefit from eliminating such foods from the
diet. <o:p></o:p></span></div>
<br />
<br />
<div style="text-align: center;">
<i>References</i></div>
<div style="text-align: center;">
<i><br /></i></div>
<div style="text-align: center;">
<div style="text-align: left;">
42.<span style="white-space: pre;"> </span>Thomas-White K, Brady M, Wolfe AJ, Mueller ER. The bladder is not sterile: history and current discoveries on the urinary microbiome. Current Bladder Dysfunction Reports. 2016; 11(1): 18-24.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
43.<span style="white-space: pre;"> </span>Interstitial Cystitis Association. Do probiotics work? Available at: https://www.ichelp.org/diagnosis-treatment/treatments/ic-diet-self-management/do-probiotics-help-ic/. Accessibility verified July 18, 2018.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
44.<span style="white-space: pre;"> </span>Abernethy MG, Rosenfeld A, White JR, Mueller MG, Lewicky-Gaupp C, Kenton K. Urinary&nbsp; microbiome and cytokine levels in women with interstitial cystitis. Obstetrics and Gynecology. 2017; 129(3): 500-506.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
45.<span style="white-space: pre;"> </span>Aragón IM, Herrera-Imbroda B, Queipo-Ortuño MI, et al. The urinary tract microbiome in health and disease. European Urology Focus. 2018; 4(1): 128-138.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
46.<span style="white-space: pre;"> </span>Bassaly R, Downes K, Hart S. Dietary consumption triggers in interstitial cystitis/bladder pain syndrome patients. Female Pelvic Medicine and Reconstructive Surgery. 2011; 17(1): 36-39.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
47.<span style="white-space: pre;"> </span>Koziol JA, Clark DC, Gittes RF, Tan EM. The natural history of interstitial cystitis: a survey of 374 patients. The Journal of Urology. 1993; 149(3): 465-9.</div>
</div>
<div style="text-align: center;">
</div>
<div style="text-align: center;">
<div style="text-align: left;">
48.<span style="white-space: pre;"> </span>Shorter B, Lesser M, Moldwin RM, Kushner L. Effect of comestibles on symptoms of interstitial cystitis. The Journal of Urology. 2007; 178(1): 145-152.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
<br /></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7494310461815718496/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-v.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7494310461815718496'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7494310461815718496'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-v.html' title=' Interstitial Cystitis Part V'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-3796769172790604866</id><published>2020-02-17T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.641-08:00</updated><title type='text'> Interstitial Cystitis Part IV</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Yoga<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Due to the fact
that IC is a disorder oftentimes associated with poor musculoskeletal, neural
and myofascial function of the back and/or pelvis, yoga has been shown to be an
effective tool in the amelioration of IC symptoms as well as the accompanying
psychological challenges.<sup>34</sup> It has been suggested that programs
formulated to sustain balance of the main contributing muscles which affect the
pelvic structure and lower back should be used in IC patients to help with
symptom management.<sup>34 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a small
randomized controlled trial of 20 women, researchers looked at the use of
mindfulness-based stress reduction (MBSR), combining the modalities of
meditation and yoga, and its effect on IC.<sup>35 </sup>Researchers stated that
because stress exacerbates the symptoms of IC significantly, this treatment
method is highly warranted due to its strong stress-reducing effects.<sup>35 </sup>Women
in the study were divided into two groups, one receiving usual care (UC) and
the other receiving UC as well as engaging in MBSR.<sup>35</sup> Though the
MBSR group did not exceed symptom amelioration on all measures when compared to
the UC group, significant improvement was seen in the women engaged in MBSR.<sup>35
</sup>More MBSR patients reported post-treatment symptom improvement when
compared to the UC group (87.5% of MBSR group versus 36.4% of UC group).<sup>35</sup>
Though some of the MBSR group improvement was not statistically significant, it
still provides insight into the therapy method and its potential effect on IC.<sup>35</sup>
Researchers concluded that the results of this study provide evidence to
reinforce the role of MBSR as a significantly useful tool for the treatment of
IC and should be incorporated into the care plan of IC patients.<sup>35</sup>
Limitations presented by small sample size should also be taken into consideration.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Though not
specifically referring to IC, the results of a meta-analysis may shed light on
the possibility of the benefit of using yoga for IC patients.<sup>36 </sup>Though
small, the study further supports the use of yoga in those who suffer from
prolonged pain.<sup>36 </sup>Researchers concluded that the use of yoga as a
complementary approach for those suffering from pain is a useful tool that
produces moderate effect sizes on pain-ridden individuals.<sup>36 </sup>This
finding can indirectly be applied to the possibility of yoga providing similar
benefit to those suffering from the pain associated with IC.<sup>36<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Physical Therapy<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Physical therapy
(PT) has been used to treat IC patients and shown benefit.<sup>26 </sup>PT for
IC patients frequently centers around soft tissue manipulation and
rehabilitation that can help facilitate scar reduction and pain improvement.<sup>26
</sup>Exercises oftentimes focus on pelvic floor relaxation rather than
strengthening pelvic floor muscles.<sup>26</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">In a randomized,
multicenter clinical trial of 81 women suffering from IC, researchers looked at
the benefit of myofascial physical therapy (MPT) when compared to global
therapeutic massage (BTM).<sup>37</sup> Though results displayed superior
benefit of the MPT when compared to the GTM (59% improvement in the MPT group
versus 26% in the GTM group), both categories experienced amelioration of some
symptoms.<sup>37</sup> In addition, the sample size was small, thus presenting
the need for caution in regard to drawing broad conclusions.<sup>37</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A pilot study of
16 female IC-diagnosed patients who suffered from high-tone pelvic floor
dysfunction were monitored following manual PT.<sup>38</sup> Therapy included
several techniques including direct myofascial release, joint mobilization,
muscle energy techniques, strengthening, stretching, and neuromuscular
reeducation.<sup>38</sup> Patients were tested for symptoms before and after
treatment to determine levels of improvement.<sup>38</sup> Greatest improvement
was seen in frequency of pain and suprapubic pain, while improvement in urgency
and nocturia showed smaller changes.<sup>38 </sup>Researchers concluded that manual
PT may be a positive therapeutic tool in the treatment of IC.<sup>38 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Forty-five women
and seven men with IC or urgency-frequency syndrome were followed in a study to
determine the effects of manual PT on the symptoms of these disorders.<sup>39</sup>
Researchers stated that, “The rationale was based on the hypothesis that pelvic
floor myofascial trigger points are not only a source of pain and voiding
symptoms, but also a trigger for neurogenic bladder inflammation via antidromic
reflexes”, thus attempting to reach a deeper part of the problem.<sup>39 </sup>PT
centered around the pelvic floor and was conducted one to two times per week
for eight to twelve weeks.<sup>39 </sup>Results demonstrated that the specific
manual PT employed was highly effective in symptom amelioration for both groups
of patients.<sup>39</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Treatment
Modalities: Acupuncture<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Acupuncture has
long been known for its beneficial effect on pain. A study involving a small
sample of IC-diagnosed female patients examined the usefulness of acupuncture
on symptom reduction.<sup>40 </sup>All twelve participants received ten
acupuncture administrations twice a week and evaluations of symptoms were
completed in the 1<sup>st</sup>, 3<sup>rd</sup>, 6<sup>th</sup> and 12<sup>th</sup>
months.<sup>40 </sup>Results showed a statistically significant decrease in all
measures in the first month.<sup>40 </sup>Improvement scores varied at
different points in the study, with positive effect demonstrated in differing
areas during all evaluations.<sup>40 </sup>Despite the small sample size, based
upon the study results, researchers concluded that acupuncture displays a
promising, non-invasive and efficacious treatment option for those suffering
with IC.<sup>40 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A systematic
review of complementary therapies for bladder pain syndrome looked at 11
studies, all of which were evaluated for quality based on the Cochrane risk of
bias scale prior to their inclusion.<sup>41</sup> Several key interventions
were discussed amongst the studies including acupuncture, relaxation therapy,
physical therapy, hydrogen-rich therapy, diet and nitric oxide synthetase.<sup>41
</sup>Following careful evaluation, researchers concluded that dietary
management, acupuncture and physical therapy had the highest potential for
providing benefit to patients with bladder pain syndrome.<sup>41</sup>
Researchers advised caution in regard to these results due to the limited study
sizes included in the review.<sup>41<o:p></o:p></sup></span></div>
<br />
<br />
<div style="text-align: center;">
<i>References</i></div>
<div style="text-align: center;">
<div style="text-align: left;">
34.<span style="white-space: pre;"> </span>Ripoll E, Mahowald D. Hatha Yoga therapy management of urologic disorders. World Journal of Urology. 2002; 20: 306–309.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
35.<span style="white-space: pre;"> </span>Kanter G, Komesu YM, Qaedan F, et al. Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. International Urogynecology Journal. 2016; 27(11): 1705-1711.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
36.<span style="white-space: pre;"> </span>Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. Translational Andrology and Urology. 2015 4(6); 653-661.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
37.<span style="white-space: pre;"> </span>FitzGerald M, Payne C, Lukacz E, et al. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome (IC/PBS) and pelvic floor tenderness. The Journal of Urology. 2012; 187(6): 2113-2118.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
38.<span style="white-space: pre;"> </span>Lukban J1, Whitmore K, Kellogg-Spadt S, Bologna R, Lesher A, Fletcher E. The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac dysfunction. Urology. 2001; 57(6)(1): 121-122.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
39.<span style="white-space: pre;"> </span>Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. The Journal of Urology. 2001; 166(6): 2226-2231.</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
40.<span style="white-space: pre;"> </span>Sönmez MG1, Kozanhan B. Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome. Ginekologia Polska. 2017; 88(2): 61-67.</div>
</div>
<div style="text-align: center;">
</div>
<div style="text-align: center;">
<div style="text-align: left;">
41.<span style="white-space: pre;"> </span>Verghese TS, Riordain RN, Champaneria R, Latthe PM. Complementary therapies for bladder pain syndrome: a systematic review. International Urogynecology Journal. 2016; 27: 1127-1136.&nbsp;</div>
</div>
<div style="text-align: center;">
<div style="text-align: left;">
<br /></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/3796769172790604866/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iv.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3796769172790604866'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3796769172790604866'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iv.html' title=' Interstitial Cystitis Part IV'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-143709308762518164</id><published>2020-02-10T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.512-08:00</updated><title type='text'> Interstitial Cystitis Part III</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Treatment
Modalities: Medications<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">When it comes to
treatment options for IC, the list of possibilities is lengthy. However, it is
important to note the risks and benefits of the suggested treatments prior to
the engagement of any one modality. Treatments range from prescribed and
over-the-counter medications to so-called natural interventions, diet and
lifestyle modifications.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Nonsteroidal
anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium are
sometimes used for IC patients. The reasoning behind these types of prescriptions
is based upon the premise that inflammation plays an integral part in the
pathophysiology of IC.<sup>23</sup> With the use of these drugs, prostaglandin
production is blocked and reportedly leads to control of inflammatory pain.<sup>23
</sup>Challenges may arise, however, due to the increased risk of serious
gastrointestinal and cardiovascular adverse effects with NSAID use.<sup>23</sup>
Some researchers go so far as to say that IC can be caused by NSAID use, a
condition known as drug-induced interstitial cystitis (DIC).<sup>24</sup> In a
review on DIC and the effects of particular drugs on the development or exacerbation
of symptoms, researchers found that NSAIDs may contribute to the initiation or
worsening of symptoms.<sup>24</sup> Authors were bold enough to state:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">“Although there is
no clear association between other NSAIDs and cystitis, there is sufficient
evidence to suspect strongly that they do occasionally induce cystitis…Unless
drugs are essential and cannot be replaced by suitable alternatives, they
should be stopped in sequence, starting with obvious candidates such as
NSAIDs…New drugs are being introduced all the time and as urologists, we need
to raise our level of awareness. It seems that many urologists do not read <i style="mso-bidi-font-style: normal;">Current Problems in Pharmacovigilance </i>or
<i style="mso-bidi-font-style: normal;">The British Medical Journal.”</i><sup>24<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Tricyclic
antidepressants are another class of drug frequently prescribed for IC. These
drugs such as amitriptyline or imipramine work by aiding in the relaxation of
the bladder which in turn facilitates blockage of pain.<sup>3 </sup>The
mechanism of action lies in the drug’s ability to inhibit the reuptake of
norepinephrine and serotonin from the brainstem to the spinal cord.<sup>25</sup>
However, though in theory these drugs may suggest benefit, some research has
shown that this class of drugs is useless for pain unless the patients taking
them are simultaneously suffering from depression.<sup>25 </sup>Therefore,
researchers conclude that in regard to pain, “if the patient is not depressed,
the SSRIs are virtually useless”.<sup>25</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">According to
Harvard Health, tricyclic antidepressants have the ability to relax the
bladder, slow the release of neurochemicals that initiate bladder pain and
inflammation and may also enhance sleep.<sup>26</sup> With most medications,
however, these drugs also carry with them side effect profiles that are less
than desirable.<sup>26<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal;">
<sup><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;"><span style="mso-spacerun: yes;">&nbsp;</span><span style="mso-tab-count: 1;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></sup><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">In a study of 94
patients, the long term use of tricyclic antidepressants was examined to
determine safety and efficacy.<sup>27 </sup>Though the researchers concluded
that patient satisfaction overall was highly positive (46% of patients),
several limitations are of note.<sup>27 </sup>Not only did 84% of the patients
experience negative side effects, but the dropout rate was 31%, a fairly large
percentage of the original group.<sup>27 </sup>Perhaps of even greater
significance was the fact that nonresponse to treatment was the leading
explanation for dropout with side effects contributing to 86% of those who
exited the study.<sup>27</sup> With these factors in mind, the so-called
“feasible, safe and effective” use of tricyclic antidepressants as a treatment
for IC is questionable.<sup>27<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Antihistamines are
another class of frequently prescribed medication in the management of IC. The
assumption is that these drugs will reduce issues of urgency and frequency and
in turn, relieve additional symptoms.<sup>3</sup> In a study of 90
participants, researchers observed the effects of using hydroxyzine as a
treatment for IC.<sup>28 </sup>Results demonstrated a positive and useful
effect of the drug for IC patients.<sup>28</sup> <span style="mso-spacerun: yes;">&nbsp;</span>Side effects such as sedation, increased
appetite, urinary retention and nightmares were reported.<sup>28</sup> Further,
researchers commented that the reasoning as to why hydroxyzine shows positive
effect remains unclear, stating that the antihistamine action is not enough to
explain positive action.<sup>28 </sup>Some postulate that since hydroxyzine is
a histamine antagonist and inhibits mast cell (found in connective tissue,
responsible for releasing histamine and contributing to inflammatory and
allergic reactions) degranulation, a reduction in the release of histamine
occurs.<sup>29 </sup>As histamine release is decreased, there may be a benefit
for IC patients due to the assumption that increased histamine release appears
to be present in the pathophysiology of IC.<sup>29 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">In a prospective,
randomized, double-blind placebo-controlled trial, researchers looked at the
effectiveness of cimetidine, an oral histamine antagonist, for IC patients.<sup>30
</sup>Of the 34 patients who completed the study,<span style="mso-spacerun: yes;">&nbsp; </span>significant improvement of symptoms, pain and
sleep disturbance due to voiding urgency was observed<span style="mso-spacerun: yes;">&nbsp; </span>in those taking the cimetidine.<sup>30</sup>
However, researchers also noted that no qualitative change was observed in the
bladder mucosa as a result of treatment and further, the mechanism of action
for symptom relief was unidentifiable.<sup>30<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Pentosan
polysulfate sodium (PPS), marketed as Elmiron and approved specifically for the
amelioration of IC symptoms, is also frequently used in the treatment regimen
of IC.<sup>3</sup> However, the mechanism of action is unknown.<sup>3</sup>
Another factor worthy of mention is the reality that pain reduction may take
two to four months and improvement in urinary frequency may take up to six
months, creating a significant challenge for many patients who have lived with
the disorder for extended periods of time.<sup>3</sup> <span style="mso-spacerun: yes;">&nbsp;</span>In a randomized, double-blind, placebo
controlled study, researchers examined the efficacy of using a third of the
recommended daily dose of PPS in IC patients.<sup>31 </sup>When compared to a
placebo, results demonstrated that there was no statistically significant
improvement between the study group and the placebo group.<sup>31 </sup>Further,
researchers concluded that despite the broad population of symptomatic patients
involved in the study, no treatment effect was revealed.<sup>31 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Retrospectively
reviewing the charts of 260 IC patients, authors of another study evaluated the
efficacy and safety of PPS.<sup>32</sup> Observations demonstrated that
symptoms of both groups improved over time but symptom improvement was greater
in terms of statistical significance in the treatment group compared to the
control group.<sup>32 </sup>Nocturia was unchanged in the treatment group when
compared with the control group.<sup>32 </sup>Authors concluded that though
some areas of symptomatology were unchanged between groups and 15% of patients
experienced negative side effects, that PPS remains an efficacious option for
symptom reduction in IC patients.<sup>32 </sup>A systematic review of
pharmacologic treatment of IC was performed to determine efficacy of the wide
variety of medication options. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">Researchers looked
at randomized controlled trials in regard to pharmacological options for IC
patients with the intention of evaluating the efficacy of medications, examine
the effect size of the trials and to begin to develop a clinical consensus in
terms of efficacious treatment options.<sup>33</sup> Twenty-one randomized
controlled trials were used in the review, including 1470 patients.<sup>33 </sup>Though
PPS showed modest treatment benefit, researchers concluded that there is an
insufficient amount of evidence available for any other pharmacological
treatments.<sup>33 </sup>Authors stated, “ A consensus on standardized outcome
measures is urgently needed”.<sup>33<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">It is clear that
many questions and limitations remain in terms of pharmacological treatment
options. Challenges such as unknown mechanisms of action, significant side
effects, and lengthy waits for symptom reduction all point to the use of
caution prior to the utilization of these medications. It would perhaps be
useful to examine what alternatives exist for those suffering from this
debilitating issue.<o:p></o:p></span></div>
<br /><br />
<br />
<div class="MsoNormal" style="line-height: normal; text-align: center;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">References<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
<br /></div>
<div style="text-align: center; text-indent: -24px;">
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">23. Gardella B, Porru
D, Allegri M, et al. Pharmacokinetic considerations for therapies used to treat
interstitial cystitis. <i style="mso-bidi-font-style: normal;">Expert Opinion on
Drug Metabolism and Toxicology.<sup> </sup></i>2014; 10(5): 673-684.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">24. Bramble FJ, Morley
R. Drug-induced cystitis: the need for vigilance. <i style="mso-bidi-font-style: normal;">British Journal of Urology.</i> 1997; 79: 3-7.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">25. Medscape.
Symptomatic treatment of neuropathic pain: a focus on the role of anticonvulsants:
tricyclic antidepressants (TCAs) for the treatment of neuropathic pain.
Available at: </span><a href="https://www.medscape.org/viewarticle/413110_3"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">https://www.medscape.org/viewarticle/413110_3</span></a><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">. Accessibility
verified July 17, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">26. Harvard Health
Publishing. Diagnosing and treating interstitial cystitis. Available at: </span><a href="https://www.health.harvard.edu/diseases-and-conditions/diagnosing-and-treating-interstitial-cystitis"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">https://www.health.harvard.edu/diseases-and-conditions/diagnosing-and-treating-interstitial-cystitis</span></a><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">. Accessibility
verified July 17, 2018. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">27. van Ophoven A,
Hertle L. Long-term results of amitriptyline treatment for interstitial
cystitis. <i style="mso-bidi-font-style: normal;">The Journal of Urology. </i>2005;174(5):
1837-1840.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">28. Theoharides TC,
Sant GR. Hydroxyzine for interstitial cystitis. <i style="mso-bidi-font-style: normal;">Urology. </i>1997; 49(5): 108-110.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">29. Association of
Reproductive Health Professionals. Screening, treatment, and management of
IC/PBS. Available at: </span><a href="http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Management"><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Management</span></a><span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">. Accessibility
verified July 18, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">30. Thilagarajah R,
Witherow ON, Walker MM. Oral cimetidine gives effective symptom relief in
painful bladder disease: a prospective, randomized, double‐blind
placebo‐controlled trial. <i style="mso-bidi-font-style: normal;">BJU
International. </i>2001; 87(3): 207-212.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">31. Nickel JC,
Herschorn S, Whitmore KE, et al. Pentosan polysulfate sodium for treatment of
interstitial cystitis/bladder pain syndrome: insights from a randomized,
double-blind, placebo-controlled study. <i style="mso-bidi-font-style: normal;">The
Journal of Urology.</i> 2015; 193(3): 857-62. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">32. Waters MG,
Suleskey JF, Finkelstein LJ, Van Overbeke ME, Zizza VJ, Stommel M. Interstitial
cystitis: a retrospective analysis of treatment with pentosan polysulfate and
follow-up patient survey. <i style="mso-bidi-font-style: normal;">The Journal of
the Osteopathic Association.</i> 2000; 100(3): S13-8.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
<span style="font-family: &quot;Times New Roman&quot;,serif; font-size: 12.0pt;">33. Dimitrakov J,
Kroenke K, Steers WD, et al. Pharmacological management of painful bladder syndrome/interstitial
cystitis: a systematic review. <i style="mso-bidi-font-style: normal;">Archives
of Internal Medicine</i>. 2007; 167(18): 1922-1929. <o:p></o:p></span></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/143709308762518164/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iii.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/143709308762518164'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/143709308762518164'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iii.html' title=' Interstitial Cystitis Part III'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5310357276656770283</id><published>2020-02-03T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.725-08:00</updated><title type='text'>Interstitial Cystitis Part II</title><content type='html'><br />
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Comorbidities<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Those suffering
from IC frequently present with multiple other maladies, creating an even more
challenging set of symptoms to manage. In a population-based study of 9,269 IC
patients and 46,345 randomly selected comparison subjects, researchers examined
the prevalence of 32 comorbidities ranging from cardiovascular, pulmonary and neurological
conditions to rheumatological, gastrointestinal and psychological conditions.<sup>9
</sup>Results displayed a significantly higher prevalence of all comorbidities
when compared to the control group, with the exception of metastatic cancer.<sup>9
<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A small
cross-sectional study of 132 subjects was studied in regard to interstitial
cystitis and comorbidities.<sup>10</sup> Researchers determined that multiple
comorbidities existed in physician and questionnaire diagnosed patients.<sup>10
</sup>Findings coincided with previous outcomes that showed comorbidities with
conditions such as migraines, irritable bowel syndrome, and overall bodily
pain.<sup>10</sup> However, results also showed several new apparent
comorbidities such as symptoms related to dyspepsia as well as orthostatic
intolerance (disorders with symptoms emerging during periods of standing
upright that are alleviated when reclining).<sup>10</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Etiology<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">It is widely
accepted that the specific cause of IC is still unknown, though several factors
appear to be influential. Some researchers state that furtherance of knowledge
in regard to the causes of IC may be limited due to the central focus on the
bladder and lower urinary tract as the genesis of symptoms without examining
other pelvic influences and systemic factors.<sup>11 </sup>Research has also
shown the possible influence of other illnesses on the contraction of IC (rather
than simply a comorbidity as discussed above) such as fibromyalgia, irritable
bowel syndrome and chronic fatigue syndrome, suggesting that IC may entail
systemic pathophysiology.<sup>11</sup> Therefore, researchers hypothesize that
a plethora of causes and contributing factors are likely involved in IC symptoms
which in turn lead to many sub-types of the disease.<sup>11</sup> Likewise,
additional sources infer that multiple components are involved in the
development of IC such as an autoimmune reaction, hereditary factors, infection
or allergies.<sup>3 </sup>However, these possible instigating factors have
remained unproven.<sup>3<span style="mso-spacerun: yes;">&nbsp; </span></sup>Similarly,
in a review of the literature, researchers studied possible causes of IC and
came up with a multitude of potential contributing factors including the
suggestion of infection and autoimmune response.<sup>12</sup> Certain studies
have shown a connection between bacterial infection in the bladder and IC as a
causal factor, but recent research contradicts this finding and no longer
assumes that infection is the main etiology from which IC stems.<sup>12, 13, 14</sup>
In regard to the autoimmune connection, results have been contradictory. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Researchers
evaluating lymphocyte populations in the blood and bladder tissue of IC
patients discovered that lymphocyte populations were normal and thus not
supportive of the theory that autoimmune disorders are an initiating factor.<sup>15
</sup>In a different review of the literature, researchers looked at the
intertwining of IC and systemic autoimmune disease and postulated that there is
a possible association between IC patients and autoimmune diseases.<sup>16</sup>
However, researchers stated “direct evidence clearly showing autoimmune
mechanisms is lacking”.<sup>16 </sup>A connection between IC and Sjogren’s
syndrome has shown a more significant connection, according to the researchers
involved, and may warrant additional studies.<sup>16</sup> Questions still
remain as to the causal or reactionary effect of autoimmune response in regard
to the etiology of IC and further research is necessary in this area.<sup>15</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Research in some
studies has pointed to the hereditary nature of IC as a causal variable.
Researchers looked at a small group of monozygotic and dizygotic twins to
determine incidence of interstitial cystitis within this population.<sup>17 <span style="mso-spacerun: yes;">&nbsp;</span></sup>Results showed that in the monozygotic
twin group, five out of eight monozygotic twin respondents had probable or
confirmed IC as compared to the group of 26 dizygotic twin respondents who
showed no signs of IC.<sup>17 </sup>Researchers concluded that based on this
finding, a genetic contribution is likely.<sup>17 </sup>It appears somewhat
obvious, however, that basing statements upon one finding is ill-advised. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">A pilot study
examining the prevalence of IC within groups of first-degree relatives with an
IC diagnosis was performed with a total number of 2,581 respondents.<sup>18</sup>
Out of those who responded, 101 participants reported an incidence of 107
first-degree relatives with IC.<sup>18</sup> Researchers reported more detailed
findings, stating that not only is there a genetic component involved but adult
female first-degree relatives of those diagnosed with IC may have as high as 17
times higher prevalence rate than that found within the general population.<sup>18
</sup>Concluding comments stated that, “This, together with previously reported
evidence showing a greater concordance of IC among monozygotic than dizygotic
twins, suggests, but does not prove, a genetic susceptibility to IC”.<sup>18</sup>
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">The connection
between allergies and IC has been examined and some studies indicate that
40-80% of patients experience allergies.<sup>19</sup> The nature of causation
versus correlation is not clear, however, and could be a comorbidity as easily
as it could be a predictive element. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Several popular,
but weakly referenced, IC blogs and websites suggest that leaky gut may be a
causal component of IC.<sup>20, 21 </sup>However, finding credible research
that points to causation, correlation or comorbidity does not appear easily
accessible. Due to the fact that there seems to be a possible connection
between IC and autoimmune disorders, it would make sense if leaky gut showed up
in IC patients (due to the role leaky gut plays in autoimmune disorders).
Despite this fact, little formal research has been done in this area. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Several risk
variables have been suggested that may contribute to the contraction of the
illness. Some articles state that risk factors range from heightened stress,
sex of the individual, fair skin, red hair, or having an existing chronic pain
disorder.<sup>3</sup> However, most of the research in these areas is, at best,
lacking. One report on the epidemiology, risk factors, and impact of
interstitial cystitis clearly stated that the only decisive risk factor for IC
is female gender.<sup>22</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">Many other
hypotheses for the causal factors of IC have been postulated, but the bottom
line to the question of causation is the frustrating yet simple conclusion that
the cause of IC is still unknown.<sup>3</sup> Though this does not provide
concrete data on what initiates the disorder, it may provide patients with a
clear understanding of the fact that a specific cause is not known, suggesting
time would be better spent on the prevention and treatment of IC.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: center;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;"><br /></span></i>
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;">References<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
<div style="text-align: left;">
<br /></div>
</div>
<div style="text-align: center;">
<br />
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">9.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Keller
JJ1, Chen YK, Lin HC. Comorbidities of bladder pain syndrome/interstitial
cystitis: a population-based study.&nbsp;<i>BJU International.</i>&nbsp;2012;
110(11): 903-909.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">10.&nbsp;&nbsp;Chelimsky G, Heller
E, Buffington CAT, Rackley R, Zhang D, Chelimsky T. Co-morbidities of interstitial
cystitis.&nbsp;<i>Frontiers in Neuroscience</i>. 2012; 6: 1-6.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">11.&nbsp;&nbsp;Mullins C, Bavendam
T, Kirkali Z, Kusek JW. Novel research approaches for interstitial
cystitis/bladder pain syndrome: thinking beyond the bladder.&nbsp;<i>Translational
Andrology and Urology</i>. 2015; 4(5): 524-533.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">12.&nbsp;&nbsp;Grover S, Srivastava
A, Lee R, Tewari AK, Te AE. Role of inflammation in bladder function and
interstitial cystitis.&nbsp;<i>Therapeutic Advances in Urology</i>. 2011;3 (1):
19-33.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">13.&nbsp;&nbsp;Domingue GJ1,
Ghoniem GM, Bost KL, Fermin C, Human LG. Dormant microbes in interstitial
cystitis.&nbsp;<i>The Journal of Urology.</i>&nbsp;1995; 153(4): 1321-1326.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">14.&nbsp;&nbsp;Wilkins EG1, Payne
SR, Pead PJ, Moss ST, Maskell RM. Interstitial cystitis and the urethral
syndrome: a possible answer.&nbsp;<i>British Journal of Urology.&nbsp;</i>1989;
64(1): 39-44.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">15.&nbsp;&nbsp;MacDermott JP1,
Miller CH, Levy N, Stone AR. Cellular immunity in interstitial cystitis.&nbsp;<i>The
Journal of Urology.</i>&nbsp;1991; 145(2): 274-278.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">16.&nbsp;&nbsp;Van de Merwe JP.
Interstitial cystitis and systemic autoimmune diseases. Nature Clinical
Practice – Urology. 2007; 4(9): 484-91.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">17.&nbsp;&nbsp;Warren JW, Keay SK,
Meyers D, Xu J. Concordance of interstitial cystitis in monozygotic and
dizygotic twin pairs.&nbsp;<i>Urology</i>. 2001; 57(6): 22-25.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">18.&nbsp;&nbsp;Warren JW, Jackson
TL, Langenberg P, Meyers DJ, Xu J. Prevalence of interstitial cystitis in
first-degree relatives of patients with interstitial cystitis.&nbsp;<i>Urology</i>.
2004; 63(1): 17-21.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">19.&nbsp;&nbsp;Van de Merwe JP,
Yamada T, Sakamoto Y. Systemic aspects of interstitial cystitis, immunology and
linkage with autoimmune disorders.&nbsp;<i>International Journal of Urology</i>.
2003; 10: S35–S38.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">20.&nbsp;&nbsp;Stop UTI Forever.
Can a leaky gut cause IC (Interstitial Cystitis)? Available at:&nbsp;<a href="https://www.stoputiforever.com/interview/leaky-gut-and-ic/">https://www.stoputiforever.com/interview/leaky-gut-and-ic/</a>.
Accessibility verified July 13, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">21.&nbsp;&nbsp;Eat Beautiful. How I
healed my interstitial cystitis. Available at:&nbsp;<a href="https://eatbeautiful.net/2015/10/04/how-i-healed-my-interstitial-cystitis/">https://eatbeautiful.net/2015/10/04/how-i-healed-my-interstitial-cystitis/</a>.
Accessibility verified July 13, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">22.&nbsp;&nbsp;Association of
Reproductive Health Professionals. Screening, Treatment, and Management of
IC/PBS. Available at:&nbsp;<a href="http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Epidemiology">http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Epidemiology</a>.
Accessibility verified July 13, 2018.<o:p></o:p></span></div>
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<br /></div>
<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5310357276656770283/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-ii.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5310357276656770283'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5310357276656770283'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-ii.html' title='Interstitial Cystitis Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7752970901507464612</id><published>2020-01-27T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.887-08:00</updated><title type='text'>Interstitial Cystitis Part I</title><content type='html'><div class="MsoNormal" style="line-height: normal; text-align: center;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Interstitial
Cystitis: A Comprehensive Overview <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Also known as
painful bladder syndrome, Interstitial Cystitis (IC) is a chronic disorder
causing pain and discomfort for many people, oftentimes impeding normal
life.<span style="mso-spacerun: yes;">&nbsp; </span>Though a malady affecting both
sexes, females are much more likely to suffer from the condition. Recent studies
report an IC incidence rate of 197 diagnoses in women per 100,000 compared to
41 diagnoses in men per 100,000.<sup>1</sup> Perhaps the numbers appear at
first to be negligible in the grand scheme of things, yet this disease can be
life-altering. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Symptomatology<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">As the name
implies, IC is an uncomfortable affliction, causing symptoms such as bladder
pressure and pain, bladder urgency with little output, painful intercourse, as
well as pelvic pain and discomfort. Ranging from mild to severe, the pain can
significantly impair everyday activities such as social engagements, exercise,
sleep and the ability to perform job duties.<sup>2, 3</sup> Further, many
people experience flare-ups due to triggering events such as menstruation,
stress, exercise and extended periods of sitting.<sup>2 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Diagnosis
<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Oftentimes
difficult to diagnose, doctors frequently attempt to rule out other illnesses
with similar symptom profiles such as kidney stones, bladder cancer, sexually
transmitted diseases, endometriosis, inflamed prostate, chronic pelvic pain
syndrome and infection before looking further into the possibility of an IC
diagnosis.<sup>2</sup> Frequently, IC symptoms may mirror signs of a chronic
urinary tract infection but generally no infection is present in those
suffering from this condition.<sup>2, 3</sup> If, however, an IC patient does contract
a urinary infection, symptoms are oftentimes heightened.<sup>3</sup> In
addition, most experts agree that due to IC’s wide range of symptoms and
intensity of pain and discomfort, that IC may actually be a combination of
multiple diseases.<sup>2</sup> Further complicating the diagnostic process is
the fact that not only are many family physicians lacking in knowledge in
regard to IC but there often tend to be multiple comorbidities with it as well.<sup>4,
5 </sup>These factors oftentimes present symptom-overlap and subsequent
misdiagnoses which will be discussed shortly.<sup>4, 5</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Though IC is
predominantly observed and diagnosed during middle age (average age of onset 40
years), both men and women can see the emergence of the disorder between the
ages of 20 and 50.<sup>6</sup> As mentioned previously, IC is much more common
in females than males due to the shorter length of the urethra in women.<sup>7</sup>
Because of this difference in anatomy, bacteria has an easier method of
reaching the bladder and becoming overpopulated, thus causing inflammation.<sup>2,
7</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">IC can be
categorized several different ways. Oftentimes it is divided into two
phenotypes, non-ulcerative and ulcerative.<sup>8 </sup>Non-ulcerative IC
accounts for approximately 90% of patients with the disorder and is typically
identified by the observance of pinpoint hemorrhages in the bladder wall
(indicating bladder inflammation is present).<sup>8 </sup>Ulcerative IC
comprises 5-10% of IC patients and is identified when patients present with
Hunner’s ulcers (red, bleeding areas) on the bladder wall.<sup>8 </sup>End
stage or severe IC has also been used as a classification of the disorder,
referring to patients who have developed very hard bladders as well as low
bladder capacity and excruciating pain.<sup>8</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">IC is also
sometimes identified as being uncomplicated and complicated in nature.<sup>7 </sup>Uncomplicated
IC is characterized by symptoms contained within the lower urinary tract as
well as the absence of risk factors for severe infection or long-term
impairment.<sup>7</sup> Further, uncomplicated IC is typically easily treatable
and eliminated without much difficulty.<sup>7 <span style="mso-spacerun: yes;">&nbsp;</span></sup>In contrast, complicated IC typically
does not respond to antibiotic treatment, may present an increased risk of
infection, possible spreading of infection to the kidneys, and inflammation of
the renal pelvis (pyelonephritis).<sup>7 </sup>Particular populations are at
greater risk for complicated IC including those with compromised immune
systems, kidney problems or who demonstrate anatomical abnormalities in the
urinary tract.<sup>7 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Diagnostic tests
for IC include urine samples to test for bacteria, white and red blood cells,
proteins and nitrites (can be an indicator of bacteria); ultrasound to examine
the kidneys and bladder; and in rare cases, cystoscopy or x-ray (only used when
a woman has severe and recurrent symptoms).<sup>7</sup> Additional tests that are
less common but sometimes performed include bladder and urethra biopsy, bladder
stretching and in men, prostate fluid culture.<sup>2<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
</div>
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<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">References<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<span style="font-family: &quot;times new roman&quot; , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">&nbsp;</span><span style="text-indent: -0.25in;">1.&nbsp; Arora HC, Shoskes DA. The enigma of men with interstitial cystitis/bladder pain syndrome.&nbsp;</span><i style="text-indent: -0.25in;">Translational Andrology and Urology</i><span style="text-indent: -0.25in;">. 2015;4 (6): 668-676.</span><br />
<div>
<span style="text-indent: -0.25in;"><br /></span></div>
<span style="font-family: &quot;times new roman&quot; , serif;">2. WebMD.
Interstitial Cystitis. Available at:&nbsp;<a href="https://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis#1">https://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis#1</a>.
Accessibility verified July 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">3.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mayo
Clinic. Interstitial Cystitis. Available at:&nbsp;<a href="https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357">https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357</a>.
Accessibility verified July 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">4.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Clemens
JQ, Calhoun EA, Litwin MS, et al. A survey of primary care physician practices
in the diagnosis and management of women with interstitial cystitis/ painful
bladder syndrome.&nbsp;<i>Urology</i>. 2010; 76(2): 323-328.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">5.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;American
Urological Association. First-ever clinical guidance on interstitial
cystitis/bladder pain Syndrome Released: Effective treatment includes valid
diagnosis, effective symptom control and focus on quality of life. Available
at:&nbsp;<a href="http://auanet.mediaroom.com/2011-03-01-FIRST-EVER-CLINICAL-GUIDANCE-ON-INTERSTITIAL-CYSTITIS-BLADDER-PAIN-SYNDROME-RELEASED">http://auanet.mediaroom.com/2011-03-01-FIRST-EVER-CLINICAL-GUIDANCE-ON-INTERSTITIAL-CYSTITIS-BLADDER-PAIN-SYNDROME-RELEASED</a>.
Accessibility verified July 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">6.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Harvard
Health Publishing Harvard Medical School: Trusted Advice for a Healthier Life.
Interstitial Cystitis. Available at:
https://www.health.harvard.edu/diseases-and-conditions/interstitial-cystitis.
Accessibility verified July 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">7.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;PubMed
Health. Cystitis: overview. Available at:
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072587/. Accessibility verified
July 6, 2018.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<br /></div>
</div>
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 12.0pt;"><sup></sup></span></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7752970901507464612/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-i.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7752970901507464612'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7752970901507464612'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-i.html' title='Interstitial Cystitis Part I'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5281788893334810634</id><published>2020-01-18T09:00:00.000-08:00</published><updated>2021-11-26T04:58:29.775-08:00</updated><title type='text'>Diet and Exercise: Implications for Those Suffering From Rheumatoid Arthritis</title><content type='html'><br />
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<div style="text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; text-indent: 0.5in;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Though the
prevalence of rheumatoid arthritis (RA) is relatively low at approximately
0.5-1% among most populations, for those suffering from the disease it can be a
life-altering reality.</span><sup style="font-family: times, &quot;times new roman&quot;, serif; text-indent: 0.5in;">1</sup><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; text-indent: 0.5in;"> According to the Centers for Disease Control
and Prevention (CDC), RA is an autoimmune disease and manifests itself by
causing the immune system to attack healthy cells in error. This, in turn,
causes painful swelling and inflammation in the affected regions of the body.</span><sup style="font-family: times, &quot;times new roman&quot;, serif; text-indent: 0.5in;">2
</sup><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; text-indent: 0.5in;">Typically, RA affects joints in the hands, wrists and knees and can lead
to stiffness, tenderness and swelling in the joints, weight loss, fatigue,
weakness, and chronic pain.</span><sup style="font-family: times, &quot;times new roman&quot;, serif; text-indent: 0.5in;">2</sup></div>
</div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Pharmacological
Treatment<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Treatment options
vary, though pharmacologic therapies are often the first line treatment options
recommended.<sup>3</sup> Nonsteroidal anti-inflammatory drugs, nonbiologic and
biologic disease-modifying antirheumatic drugs, immunosuppressants, and
corticosteroids are all classes used in medication-based therapies for RA.<sup>3
</sup>Side effects of these drugs are disturbing at best, including upper
respiratory tract infections, headache, diarrhea, inflammation of the mouth and
lips, nausea, vomiting, abdominal pain, dizziness, bleeding gums, blurred
vision, leukopenia, shaking fingers/hands, muscle spasms, and numbness.<sup>4,
5, 6 </sup>In addition, biologic agents that are oftentimes used for RA
patients have limited long-term safety data, presenting a point of particular
concern due to the possibility of enhanced risk of malignancies, more
specifically, lymphoma.<sup>7</sup> Further, the cost of the newer biologic
drugs is quickly escalating, presenting an obstacle for those planning to use
such interventions.<sup>7 </sup>When efficacy is measured across the span of
RA-specific drugs, production of positive effects show only low to moderate benefit,
pulling into question the risk versus advantage argument.<sup>8</sup> In
addition, pharmacological treatments carry significant risk and adverse event
profiles, oftentimes causing increased drop-out rates in clinical trials.<sup>8</sup>
A systematic review of multiple RA medications, such as conventional synthetic
disease-modifying antirheumatic drugs, glucocorticoids and tofacitinib showed
efficacy, thus suggesting their usefulness in the treatment of RA.<sup>9</sup>
However, the review was funded by multiple drug companies including Astra-Zeneca,
Lilly, Merck, Glaxo, Sanofi-Aventis, and Pfizer, calling into question the
validity of efficacy-reporting.<sup>9 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">With these factors
in mind, alternative treatment options appear a warranted area of study in the
management and treatment of this disease. Many non-pharmacologic therapies are
available, including diet, exercise, physical therapy, and other
lifestyle-related treatments.<sup>3 </sup>For the purposes of this paper, diet
and exercise will be explored as non-pharmacologic treatment modalities in RA
patients. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Diet<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Due to the
affordability, accessibility and presence of reliable scientific evidence that
display benefit, dietary interventions appear to provide a solid alternative to
pharmacologic treatments of RA.<sup>10 </sup>Further, research supports a
display of significant benefits from this modality in regard to reducing
symptoms such as pain, joint stiffness, swelling, tenderness and associated
disability with disease progression.<sup>10 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a review of the
research, authors deduced that the inclusion of vegetables, spices such as
turmeric and ginger and fruits can provide important sources of natural
antioxidants as well as anti-inflammatory effects for RA patients.<sup>10 </sup>Additionally,
data suggests that RA patients should employ a reduction in processed and high
fat foods as well as avoidance of foods such as oils, butter, sugar and animal
products.<sup>10 </sup>Research performed with patients suffering from a
variety of rheumatic diseases studied the effect of antioxidants in the diet
when compared to reduction of disease symptoms and overall improvement.<sup>11 </sup>Outcome
measures showed that RA subjects eating a diet consisting of berries, fruits,
vegetables, roots, nuts, germinated seeds and sprouts showed a significant
benefit in regard to symptoms on subjective and objective measures.<sup>11 </sup>Similarly,
in a study testing the effectiveness of eating an uncooked vegan diet rich in
lactobacilli, researchers determined that when compared to the control group,
the intervention group experienced subjective relief from RA symptoms.<sup>12 </sup>Further,
when participants returned to eating an omnivorous diet, the RA symptoms were
again aggravated.<sup>12</sup> Though the intervention group showed somewhat
inconsistent results on objective measures, there was an associated decrease in
disease activity overall and a prevention of the need for pharmacologic
intervention.<sup>12 </sup>A group of researchers took the diet restriction to
a new level by studying 66 patients with active RA and randomizing them to
either a gluten-free, vegan diet or a well-balanced, non-vegan diet.<sup>13 </sup>Participants
were studied at three, six, and 12 months and researchers concluded that 40.5%
of the gluten-free, vegan group improved while only 4% of the non-vegan group
improved.<sup>13 </sup>Researchers suggested that dietary modification such as
the one studied may provide a clinical benefit for RA patients.<sup>13 </sup>Outcomes
of additional studies show a potential for anti-inflammatory effects as well as
decreased blood lipids oxidized low-density lipoprotein levels and raised
natural atheroprotective antibodies against phosphorylcholine in RA patients
who consume a gluten-free, vegan diet.<sup>14 </sup>Further, in a single-blind
dietary intervention study, 24 patients with RA were given a very low-fat
(approximately 10% fat), vegan diet and followed for a four-week trial.<sup>15 </sup>Outcome
measures demonstrated that subjects with moderate-to-severe RA experienced a
significant reduction in RA symptoms when they ate a very low-fat, vegan diet.<sup>15</sup>
Additional research points to the beneficial inclusion of probiotics in
conjunction with a vegan or vegetarian diet, showing an improvement in symptoms
with such combinations.<sup>11, 12<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">The benefit of
fasting has also been studied in RA patients when coupled with dietary
interventions. A systematic review examined the effect of fasting for at least
three months followed by the adoption of a vegetarian diet.<sup>16 </sup>Results
showed that there was a statistically and clinically significant, beneficial,
long-term effect on RA patients.<sup>16 </sup>Due to the fact that the
literature review was limited to four applicable studies, concrete conclusions
may be premature. However, such convincing data warrants further investigation
by way of additional randomized, long-term studies. In a randomized,
single-blind, controlled trial, 27 patients with RA were allocated to an
intervention group, while 26 RA patients were placed in a control group.<sup>17
</sup>The intervention group subjects were allocated to a four-week stay at a
health farm and were placed on an initial 7-10 day fast.<sup>17 </sup>Following
the fasting period, subjects were put on an individually-adjusted gluten-free,
vegan diet for an additional three and a half months, followed by a gradual
transition to a lactovegetarian diet for a total trial period of one year.<sup>17
</sup>The control group was allotted to a four-week stay at a convalescent
home, eating an ordinary diet for the entirety of a year.<sup>17 </sup>Following
the initial four week period, study results showed a significant improvement in
symptoms for the intervention group such as number of tender and swollen
joints, duration of morning stiffness, and an improvement in overall health
assessment score.<sup>17 </sup>Further, the benefits in the intervention group
after the completion of one year again showed significant advantages in all
measured indices when compared to the control group.<sup>17 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">It appears clearly
evident that dietary interventions are beneficial in RA patients and provide a
viable and effective method of treatment. Of similar importance is the fact
that non-pharmacological interventions such as diet modification do not produce
dangerous results or adverse side effects. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Physical
Activity<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In addition to the
clearly beneficial components of dietary intervention, physical activity can
also be a significant factor in the management of RA. Research abounds in
regard to the overall positive effect of exercise for RA patients.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a study of 220
patients with RA, subjects were divided into a class exercise group, a home
exercise group and a control group.<sup>18 </sup>Subjects were measured at base
line and subsequently at six and 12-week marks.<sup>18 </sup>Results displayed
that in the class exercise group, grip strength, walk time and fatigue greatly
improved.<sup>18 </sup>Further, overall symptoms of pain and depression were
all positively affected in the class exercise group.<sup>18 </sup>Though some
improvements were made in the home exercise group, they were not as significant
in the class exercise group, despite the similarity of exercises completed,
possibly due to the differing levels of intensity.<sup>18 </sup>Researchers
concluded that exercise was a positive influence on RA symptoms.<sup>18<span style="mso-spacerun: yes;">&nbsp; </span></sup>A literature review looked at the
benefits of exercise for RA patients and also found a positive level of effect.<sup>19
</sup>Authors deduced that exercise in general showed a clear and proven method
of treatment that provided an improvement in overall function for RA patients.<sup>19
</sup>An additional meta-analysis and literature review of studies looked at
the effect of cardiorespiratory aerobic exercise for RA patients in regard to
quality of life, function and clinical and radiologic outcomes.<sup>20 </sup>Collective
results showed that cardiorespiratory aerobic exercise proved to be a safe
method of treatment, providing improvement in some of the most important
outcome measures for RA.<sup>20 </sup>Another meta-analysis examined the
efficacy of resistance exercises in RA patients.<sup>21 </sup>Following the
study of a total of 10 randomized, controlled trials with 547 patients, authors
concluded that not only was resistance exercise in RA patients safe, but it
also showed improvement in most outcomes and was statistically significant as
well as possibly clinically significant for the outcome of RA disability
measures.<sup>21</sup> Further, subgroup analysis also revealed a trend towards
increased efficacy in programs with high-intensity resistance exercise.<sup>21</sup>
Another literature review showed evidence that physical activity is a
significant factor in the common and distressing symptom of fatigue for RA
patient.<sup>22</sup> The review examined 24 studies with a total of 2,882
participants with RA.<sup>22</sup> Authors concluded that physical activity had
a positive effect on fatigue in RA patients.<sup>22</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Not only has
exercise been proven as an effective method of treatment for typical RA
symptoms, but it has also been shown to have a positive effect on mood for RA
patients.<sup>18, 23 </sup>In a review of the literature, authors concluded
that exercise improves depression for RA patients, a common yet not classic
symptom of RA.<sup>23 </sup>Additionally, a systematic review with
meta-analysis of 500 articles and 2,449 participants studied the effects of
exercise on depressive symptoms in adults with arthritis and rheumatic
conditions.<sup>24 </sup>Authors concluded that depressive symptoms were
reduced with the inclusion of exercise.<sup>24</sup> Again, though depression
is not an RA-specific symptom, it is a common factor experienced in those with
this disease and a symptom undeniably worth improving.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Conclusion<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Though some of the
studies cited in this paper have limitations such as measures of self-reported
data, small sample sizes or confounding variables, the preponderance of the
evidence clearly shows a positive effect of both dietary intervention and exercise
on the symptoms and overall outcome for RA patients. Of similar importance,
specific dietary interventions as well as various forms of exercise, like those
reviewed in this paper, have not only proven to be safe methods of reducing
overall disease markers but have also been shown to be significant factors in
symptom management, both without risk of side effects or negative outcomes. <span style="mso-spacerun: yes;">&nbsp;</span>RA patients would clearly benefit from dietary
intervention and exercise protocols as first-line treatment options rather than
the more commonly prescribed pharmacologic options. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">References</span></i><br />
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Silman
AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis.&nbsp;<i>Arthritis
Research &amp; Therapy.</i>&nbsp;2002; 4(3): S265-S272.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Centers
for Disease Control and Prevention. Rheumatoid Arthritis. Available at:&nbsp;<a href="https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html">https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html</a>.
Accessibility verified March 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">3.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Medscape.
Rheumatoid arthritis treatment &amp; management. Available at:&nbsp;<a href="https://emedicine.medscape.com/article/331715-treatment">https://emedicine.medscape.com/article/331715-treatment</a>.
Accessibility verified March 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">4.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;RxList.
Xeljanz side effect center. Available at:&nbsp;<a href="https://www.rxlist.com/xeljanz-side-effects-drug-center.htm">https://www.rxlist.com/xeljanz-side-effects-drug-center.htm</a>.
Accessibility verified March 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">5.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;RxList.
Trexall side effect center. Available at:&nbsp;<a href="https://www.rxlist.com/trexall-side-effects-drug-center.htm">https://www.rxlist.com/trexall-side-effects-drug-center.htm</a>.
Accessibility verified March 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">6.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;RxList.
Neoral side effect center. Available at:&nbsp;<a href="https://www.rxlist.com/neoral-side-effects-drug-center.htm">https://www.rxlist.com/neoral-side-effects-drug-center.htm</a>.
Accessibility verified March 6, 2018.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">7.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<i>Nurmohamed
MT, Dijkmans BA. Efficacy, tolerability and cost effectiveness of
disease-modifying</i>&nbsp;antirheumatic drugs and biologic agents in
rheumatoid arthritis.&nbsp;<i>Drugs</i>. 2005; 65(5): 661-94.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">8.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Donahue
KE, Jonas DE, Hansen RA, et al. Drug therapy for rheumatoid arthritis in
adults: an update (internet).&nbsp;<i>Comparative Effectiveness.&nbsp;</i>2012;
55: 1-159.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">9.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gaujoux-Viala
C, Nam J, Ramiro S, et al. Efficacy of conventional synthetic disease-modifying
antirheumatic drugs, glucocorticoids and tofacitinib: a systematic literature
review informing the 2013 update of the EULAR recommendations for management of
rheumatoid arthritis.&nbsp;<i>Annals of the Rheumatic Diseases</i>. 2014;
73(3): 510-515.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">10.&nbsp;&nbsp;Khanna S, Jaiswal
KS, Gupta B. Managing rheumatoid arthritis with dietary interventions.&nbsp;<i>Frontiers
in Nutrition</i>. 2017; 4(52): 1-16.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">11.&nbsp;&nbsp;Hänninen, Kaartinen
K, Rauma AL, et al. Antioxidants in vegan diet and rheumatic disorders.&nbsp;<i>Toxicology</i>.
2000; 155(1-3): 45-53.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">12.&nbsp;&nbsp;Nenonen MT, Helve
TA, Rauma AL, Hänninen OO. Uncooked, lactobacilli-rich, vegan food and
rheumatoid arthritis.&nbsp;<i>British Journal of Rheumatology.&nbsp;</i>1998;
37(3): 274-281.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">13.&nbsp;&nbsp;Hafström I, Ringertz
B, Spångberg A, et al. A vegan diet free of gluten improves the signs and
symptoms of rheumatoid arthritis: the effects on arthritis correlate with a
reduction in antibodies to food antigens.&nbsp;<i>Rheumatology (Oxford).</i>2001;
40(10): 1175-1179.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">14.&nbsp;&nbsp;Elkan A-C, Sjöberg
B, Kolsrud B, et al. Gluten-free vegan diet induces decreased LDL and oxidized
LDL levels and raised atheroprotective natural antibodies against
phosphorylcholine in patients with rheumatoid arthritis: a randomized
study.&nbsp;<i>Arthritis Research &amp; Therapy</i>. 2008; 10(2): 1-8.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">15.&nbsp;&nbsp;McDougall J, Bruce
B, Spiller G, Westerdahl J, McDougall M. Effects of a very low-fat, vegan diet
in subjects with rheumatoid arthritis.&nbsp;<i>Journal of Alternative and
Complimentary Medicine.</i>&nbsp;2002; 8(1): 71-75.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">16.&nbsp;&nbsp;Müller H, de Toledo
FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid
arthritis: a systematic review.&nbsp;<i>Scandanavian Journal of
Rheumatology.&nbsp;</i>2001; 30(1): 1-10.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">17.&nbsp;&nbsp;Kjeldsen-Kragh J,
Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one-year
vegetarian diet in rheumatoid arthritis.&nbsp;<i>Lancet.</i>1991; 338(8772):
899-902.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">18.&nbsp;&nbsp;Neuberger GB,
Aaronson LS, Gajewski B, et al. Predictors of exercise and effects of exercise
on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid
arthritis.&nbsp;<i>Arthritis Rheumatism.&nbsp;</i>2007; 57(6): 943-952.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">19.&nbsp;&nbsp;Cooney JK, Law R-J,
Matschke V, et al. Benefits of exercise in rheumatoid arthritis.&nbsp;<i>Journal
of Aging Research</i>. 2011; 2011(681640): 1-14.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">20.&nbsp;&nbsp;Baillet A, Zeboulon
N, Gossec L, et al. Efficacy of cardiorespiratory aerobic exercise in
rheumatoid arthritis: meta-analysis of randomized controlled trials.&nbsp;<i>Arthritis
Care and Research.</i>2010; 62(7): 984-992.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">21.&nbsp;&nbsp;Baillet A, Vaillant
M, Guinot M, Juvin R, Gaudin P. Efficacy of resistance exercises in rheumatoid
arthritis: meta-analysis of randomized controlled trials.&nbsp;<i>Rheumatology
(Oxford).&nbsp;</i>2012; 51(3): 519-527.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">22.&nbsp;&nbsp;Cramp F, Hewlett S,
Almeida C, et al. Non-pharmacological interventions for fatigue in rheumatoid
arthritis.&nbsp;<i>Cochrane Database of Systematic Reviews</i>.2013; 23(8):
doi: 10.1002/14651858.CD008322.pub2.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">23.&nbsp;&nbsp;Kelley GA, Kelley
KS. Exercise reduces depressive symptoms in adults with arthritis: evidential
value.&nbsp;<i>World journal of rheumatology</i>. 2016; 6(2): 23-29.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">24.&nbsp;&nbsp;Kelley GA, Kelley
KS, Hootman JM. Effects of exercise on depression in adults with arthritis: a
systematic review with meta-analysis of randomized controlled trials.&nbsp;<i>Arthritis
Research and Therapy.</i>2015; 17(21): 1-22.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<br /></div>
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">
</span></i><br />
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<br /></div>
<i style="mso-bidi-font-style: normal;"><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span></i></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5281788893334810634/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/diet-and-exerciseimplications-for-those.html#comment-form' title='3 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5281788893334810634'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5281788893334810634'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/diet-and-exerciseimplications-for-those.html' title='Diet and Exercise: Implications for Those Suffering From Rheumatoid Arthritis'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>3</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-9178802235413768008</id><published>2020-01-18T04:47:00.001-08:00</published><updated>2021-11-26T04:58:38.218-08:00</updated><title type='text'>Interstitial Cystitis Part II</title><content type='html'></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/9178802235413768008/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-ii.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/9178802235413768008'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/9178802235413768008'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-ii.html' title='Interstitial Cystitis Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5127946837858376991</id><published>2019-12-02T08:30:00.000-08:00</published><updated>2021-11-26T04:58:41.250-08:00</updated><title type='text'>Radon Exposure and Cancer Risk: Warranted Caution or Unnecessary Hype?</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Concern for a
multitude of chemicals, environmental elements and toxic substances has been on
the increase in recent years. Clearly, being surrounded by such influential
components is not preferable, yet it remains to be proven that they are the
primary cause of ill-health in our world. With that being said, there can be
benefit to investigating the true effects of assumed toxins to determine
whether or not they pose negative implications to health.&nbsp;<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Radon, a
naturally-occurring radioactive gas found typically in rocks and soil, is
produced when thorium and uranium radioactively decay.<sup>1</sup> It is an
odorless, colorless, inactive gas that does not chemically bond with other
substances.<sup>1</sup> With a half-life as long as 3.8 days, it has the
potential of remaining in the air for an extended time.<sup>2</sup> <span style="mso-spacerun: yes;">&nbsp;</span>Radon has been the culprit of multiple claims
suggesting its link to cancer, particularly for those exposed to it via
occupational means (mining). As mentioned previously, however, it is important
to review the evidence behind such hypotheses before engaging in great measures
to eliminate exposure. Further, for the purposes of this analysis, focus will
be given solely to indoor radon exposure rather than outdoor exposure
experienced in situations such as underground mining. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a nested
case-control study, researchers in Finland examined the effect of indoor radon
exposure and lung cancer risk, due to the conflicting outcomes observed in
other studies.<sup>3 </sup>Study participants consisted of 517 case-control
pairs in the matched analysis, and 1055 case subjects and 1544 control
subjects<span style="mso-spacerun: yes;">&nbsp; </span>in the unmatched analysis.<sup>3</sup>
All participants lived within radon-exposed homes over a period of multiple
years.<sup>3 <span style="mso-spacerun: yes;">&nbsp;</span></sup>Outcomes demonstrated
that the odds ratio of lung cancer in the matched and unmatched analyses
displayed no statistically significant indications for a heightened risk of
lung cancer in relation to indoor radon concentration.<sup>3 </sup>Subsequently,
researchers concluded that radon exposure did not appear to pose a causal
threat to the incidence of lung cancer.<sup>3 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a French
hospital-based case-control study, researchers looked at the connection between
radon exposure and cancer risk.<sup>4</sup> Four hundred eighty-six cases and
984 controls with radon measures in at least one dwelling were examined.<sup>4</sup>
Following adjustments for age, sex, region, cigarette smoking and occupational
exposure, lung cancer risk was studied in relation to indoor radon exposure.<sup>4
</sup>Researchers concluded that a minimal increased lung cancer risk existed
in relation to indoor radon exposure.<sup>4</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A meta-analysis of
17 case-controlled studies was performed to determine the relationship between residential
radon exposure and risk of lung cancer, based upon the exposure rate of 150
Bq/m3.<sup>5</sup> Adjusted odds ratios with 95% confidence intervals (CI) in
regard to lung cancer risk and concentration of radon exposure were extracted
and quality of studies was examined.<sup>5</sup> Authors noted that it was
difficult to draw definitive conclusions based upon confounding variables,
while also mentioning the caution that was taken to eliminate as many of these
as possible to display accurate results.<sup>5</sup> Further, authors stated
that despite the inability to fully predict or assume direct association
between residential radon exposure and lung cancer risk, a dose-response
relationship was demonstrated in the review.<sup>5</sup> Authors concluded that
enough evidence was displayed to suggest the importance of developing
strategies to reduce human exposure to radon.<sup>5<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Researchers<span style="mso-spacerun: yes;">&nbsp; </span>in Germany performed two case-control studies
during 1990-1997 and analyzed data from 2,963 lung cancer patients and 4,232
controls.<sup>6</sup> Results demonstrated a linear dose-response relationship
between the level of radon exposure and lung cancer in all subjects (smokers
and never-smokers alike).<sup>6</sup> Incidence of lung cancer among smokers
with radon exposure showed even higher rates of lung cancer incidence.<sup>6 </sup>Researchers
concluded that the risk for developing cancer as a result of radon exposure was
significant.<sup>6</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A New Jersey study
was conducted amongst 433 female lung cancer cases compared to 402 control
cases.<sup>7 </sup>After controlling for smoking and occupational histories, results
showed a notable trend of increased risk of lung cancer in those exposed to
residential radon.<sup>7</sup> Though researchers acknowledged study
limitations such as differences in housing construction and ventilation, age
and socioeconomic status of participants and diet and lifestyle choices of
those included, evidence remained that radon exposure posed a threat for many
people in regard to cancer risk.<sup>7</sup> Researchers concluded that though
the study resulted in a positive correlation, limitations of the study should
prompt further research, taking into account such variables before drawing firm
conclusions.<sup>7</sup> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Based upon the
preponderance of the evidence presented here, it appears that the risk
associated with radon exposure is significant enough to pay attention to.
Though future research is warranted in regard to confounding variables and
study design, recommendations to limit radon exposure seem wise. <o:p></o:p></span></div>
<div style="line-height: 150%; text-align: center; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><o:p>&nbsp;</o:p><i style="text-align: center;">References</i></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">1.&nbsp;Yoon JY, Lee JD, Joo SW,
Kang DR. Indoor radon exposure and lung cancer: a review of ecological
studies.&nbsp;<i>Annals of Occupational and&nbsp; Environmental Medicine.&nbsp;</i>2016;28:15.
doi:10.1186/s40557-016-0098-z.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">2.&nbsp;International Commission on
Radiological Protection (ICRP) Protection against radon-222 at home and at
work. A report of a task group of the International Commission on Radiological
Protection. Ann ICRP. 1993;23(2):1–45. doi: 10.1016/0146-6453(93)90002-P.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">3.&nbsp;Auvinen A, Mäkeläinen I,
Hakama M, et al. Indoor radon exposure and risk of lung cancer: a nested
case-control study in Finland.&nbsp;<i>Journal of the National Cancer
Institute.&nbsp;</i>1996;17;88(14):966-72.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">4.&nbsp;Baysson H, Tirmarche M,
Tymen G. Indoor radon and lung cancer in France.&nbsp;<i>Epidemiology.&nbsp;</i>2004
Nov;15(6):709-16.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">5.&nbsp;Pavia M, Bianco A, Pileggi
C, Angelillo IF. Meta-analysis of residential exposure to radon gas and lung
cancer. Bull World Health Organization. 2003;81(10):732–738.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">6.&nbsp;Wichmann HE, Rosario AS,
Heid IM, Kreuzer M, Heinrich J, Kreienbrock L. Increased lung cancer risk due
to residential radon in a pooled and extended analysis of studies in
Germany.&nbsp;<i>Health Physics.</i>&nbsp; 2005;88(1):71-9.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">7.&nbsp;Schoenberg JB, Klotz JB,
Wilcox HB, et al. Case-control study of residential radon and lung cancer among
New Jersey women.&nbsp;<i>Cancer Research</i>. 1990; 50(20):6520-4.<o:p></o:p></span></div>
<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5127946837858376991/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/12/radon-exposure-and-cancer-risk.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5127946837858376991'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5127946837858376991'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/12/radon-exposure-and-cancer-risk.html' title='Radon Exposure and Cancer Risk: Warranted Caution or Unnecessary Hype?'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-4349469152372070125</id><published>2019-11-27T06:27:00.001-08:00</published><updated>2021-11-26T04:58:44.412-08:00</updated><title type='text'>Acupuncture for the Treatment of Tinnitus</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
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<div align="center" class="MsoNormal">
<b><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 107%;">Acupuncture
for the Treatment of Tinnitus<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">Tinnitus,
the perception of noise or ringing in the ears, is a prevalent problem in the
United States, affecting approximately 45 million Americans each year.<sup>1,2 </sup>Though
tinnitus is not considered a disease on its own, it is a significant symptom
stemming from some kind of underlying condition.<sup>3</sup> Root causes of
tinnitus range from age-related hearing loss to ear injury or circulatory
disorder.<sup>1</sup> Further, tinnitus can appear in those with structural
lesions or those with conditions such as Meniere’s disease and multiple
sclerosis.<sup>3</sup> Pulsatile and non-pulsatile tinnitus are two ways to
classify the problem, though many subtypes are frequently identified in the
literature (somatic, neurological, objective, subjective). Pulsatile tinnitus
involves the sensation of a rhythmic sound that resembles a heartbeat,
swooshing or whooshing not externally sourced.<sup>4,5</sup> This form of
tinnitus is often caused by sounds such as personal pulse, vascular problems or
changes in the ear canal.<sup>5 </sup>By comparison, non-pulsatile tinnitus is
attributed to problems with the nerves involved with hearing and may be experienced
in one or both ears.<sup>5 </sup>This form of tinnitus is oftentimes described
as originating inside the head.<sup>5<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">Determining
the cause of tinnitus, regardless of type, is of key importance in the terms of
treatment. Clearly, if the underlying problem can be addressed and rectified or
improved, the associated symptoms may be alleviated or improved as well.
However, finding effective treatments for tinnitus have been challenging to
date.<sup>3 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">Acupuncture,
originating in ancient China, has been used for thousands of years to treat a
variety of conditions. Due to its efficacious outcomes in treating multiple
maladies, it seems appropriate to examine its usefulness when applied to those
suffering from tinnitus. Research surrounding this topic is abundant, yet simultaneously
inconsistent with many studies demonstrating efficacy and some &nbsp;presenting its lack of usefulness. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">In
a review of 40 research studies, the efficacy of acupuncture as a treatment for
tinnitus was examined.<sup>6 </sup>Eight different types of acupuncture were
analyzed, some of which were tested in conjunction with additional
interventions such as supplementary medicine.<sup>6 </sup>&nbsp;A total of 3657 subjects were included across
the 40 studies.<sup>6</sup> Researchers concluded that all eight methods of
acupuncture were effective in the treatment of neurological tinnitus (tinnitus
caused by disease such as Meniere's disease).<sup>6</sup>&nbsp; <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">Similarly,
a &nbsp;2019 study was performed to determine
the usefulness of acupuncture as a treatment choice for patients suffering from
tinnitus.<sup>7 </sup>One hundred seven tinnitus patients were examined over
the course of 17-24 acupuncture treatments.<sup>7 </sup>Researchers concluded
that patients experienced improvement in their tinnitus condition following the
course of treatment.<sup>7 <o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">A
clinical observation study was performed to determine the difference in outcome
between acupuncture combined with the intake of an herbal formula compared with
the intake of the same herbal formula alone.<sup>8</sup> Sixty patients were
randomized into two groups - a combined therapy group and an herbal formula
only group and treatment was administered according to a specific regimen for a
total of six weeks.<sup>8</sup> Tinnitus severity score and tinnitus handicap
inventory were used to determine clinical effects of the treatments over the
course of the study.<sup>8</sup> Results showed an efficacy rate of 93.3% in
the combined therapy group when compared to the 67.9% efficacy rate in the
herbal formula only group.<sup>8</sup> Researchers concluded that acupuncture
used in conjunction with an herbal formula provided improvement for tinnitus
patients.<sup>8<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">&nbsp;A randomized clinical trial of 50 participants
tested the effectiveness of acupuncture on tinnitus when compared to no
treatment.<sup>9</sup> Subjects were divided into equal groups and were
evaluated for five weeks.<sup>9 </sup>Results showed a statistically
significant effect between groups, leading researchers to conclude the efficacy
of acupuncture to reduce tinnitus intensity and improve the quality of life of
the tinnitus patients.<sup>9<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">In
a &nbsp;systematic review of literature, tinnitus
and the effect of acupuncture as a treatment modality was studied.<sup>10</sup>
Six randomized controlled studies were examined and results showed positive
effect in two unblinded studies and no significant effect in four blinded
studies.<sup>10 </sup>Researchers concluded: “The belief that acupuncture is a
specifically effective treatment for chronic tinnitus is not based on the
evidence of rigorous randomized controlled trials. Further research on this
subject seems to be warranted but should be conducted according to the highest
methodological standards.”<sup>10<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; An additional study demonstrated the ineffective nature of
acupuncture on tinnitus patients.<sup>11 </sup>The randomized, single-blind,
placebo-controlled study followed 50 patients suffering from the condition and
divided participants into a manual acupuncture group, an electrical acupuncture
group and a placebo group.<sup>11</sup> Researchers studied frequency of
tinnitus, tinnitus intensity, and reduction of life quality among patients over
the course of the study.<sup>11 </sup>Patients were evaluated before treatment,
following six sessions of treatment and one month following the completion of
treatment.<sup>11</sup> Results demonstrated no statistically significant
effect of either form of acupuncture.<sup>11 </sup>Despite the lack of statistically
significant improvements, researchers noted relative advantages of electrical
acupuncture when compared to the other two groups.<sup>11<o:p></o:p></sup></span></div>
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; line-height: 150%;">From
the preponderance of the evidence, it appears that acupuncture holds a distinct
amount of possibility in terms of an effective treatment modality for those
suffering from tinnitus. There are several factors to acknowledge in regard to
the studies reviewed, including small sample sizes and relatively brief
treatment periods. However, it is important to note that though the evidence
for the efficacy of acupuncture as a treatment option is perhaps not
overwhelming, it does not include extensive risk. Therefore, it likely would be
wise to consider acupuncture as a treatment option for those suffering from
tinnitus, particularly if other therapies have not yielded results or have
created negative side effects.<o:p></o:p></span></div>
</div>
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<div style="text-align: left;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span></div>
</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><span style="font-family: &quot;times new roman&quot; , serif;"><o:p>&nbsp;</o:p></span><span style="font-family: &quot;times new roman&quot; , serif;"><i>References</i></span></span></div>
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<br />
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">1.Mayo
Clinic. Tinnitus. Available at:
https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156.
Accessibility verified November 24, 2019.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">2.American
Tinnitus Association. Understanding the Facts: Demographics. Available at: https://www.ata.org/understanding-facts/demographics.
Accessibility verified November 24, 2019.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">3.Naderinabi
B, Soltanipour S, Nemati S, Saberi A, Parastesh S. Acupuncture for chronic
nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018;9(1):38–45.
doi:10.22088/cjim.9.1.38<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">4.Department
of Radiology and Biomedical Imaging. Pulsatile Tinnitus Clinic. Available at:
https://radiology.ucsf.edu/pulsatile-tinnitus. Accessibility verified November
24, 2019.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">5.My
Health Alberta. Ringing in the ears (tinnitus). Available at:
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tinit.
Accessibility verified November 24, 2019.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">6.
Pang P, Shi Y, Xu H, et al. Acupuncture methods put to the test for a tinnitus
study: A Bayesian analysis. Complementary Therapies in Medicine. 2019;
42:205-213.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">7.
Lin TY, Yang SW, Lee YS, et al. Analysis of Factors Influencing the Efficiency
of Acupuncture in Tinnitus Patients. Evid Based Complement Alternat Med.
2019;2019:1318639. Published 2019 May 26. doi:10.1155/2019/1318639.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">8.
Chen S, Tan X, Fei L, Xiang X. Clinical observation on idiopathic tinnitus
treated with acupuncture, buzhong yiqi tang and cizhu wan. Zhongguo Zhen Jiu.
2018;38(4):369-73. doi: 10.13703/j.0255-2930.2018.04.007.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">9.
Doi MY, Tano SS, Schultz AR, Borges R, Marchiori LL. Effectiveness of acupuncture
therapy as treatment for tinnitus: a randomized controlled trial. Braz J
Otorhinolaryngol. 2016;82(4):458-65. doi: 10.1016/j.bjorl.2016.04.002.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">10.
Park J, White AR, Ernst E. Efficacy of Acupuncture as a Treatment for Tinnitus:
A Systematic Review. Arch Otolaryngol Head Neck Surg. 2000;126(4):489–492.
doi:https://doi.org/10.1001/archotol.126.4.489.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; text-align: left;">
<span style="font-family: &quot;Times New Roman&quot;,serif;">11.Wang
K, Bugge J, Bugge S.&nbsp;A randomised, placebo-controlled trial of manual and
electrical acupuncture for the treatment of tinnitus.&nbsp;<i>Complement Ther
Med.</i>&nbsp;2010;18(6):249-55. doi: 10.1016/j.ctim.2010.09.005.<o:p></o:p></span></div>
<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/4349469152372070125/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/acupuncture-for-treatment-of-tinnitus.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4349469152372070125'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4349469152372070125'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/acupuncture-for-treatment-of-tinnitus.html' title='Acupuncture for the Treatment of Tinnitus'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7710164449604801340</id><published>2019-11-10T09:00:00.000-08:00</published><updated>2021-11-26T05:00:27.471-08:00</updated><title type='text'>Protein Needs in Compromised Populations Part II</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
<div class="MsoNormal" style="line-height: 150%;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">HIV Patients<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a randomized,
double-blind, multicenter trial of 59 HIV positive subjects, researchers
studied the effect of high protein whey supplementation when compared to a matched
isocaloric control supplement without added protein for patients with a history
of weight loss (a typical and potentially dangerous factor for HIV positive
patients).<sup>7 </sup>Following the 12-week study, researchers concluded that
there was no observed difference in regard to increased energy intake or
changes in weight/lean body mass.<sup>7 </sup>However, researchers stated that
CD4 lymphocytes (white blood cells responsible for fighting bacteria, viruses
and germs) did increase in the protein group, a potential benefit according to
the authors.<sup>7 </sup>However, researchers also stated that gastrointestinal
symptoms were more commonly reported in the high protein whey <span style="mso-spacerun: yes;">&nbsp;</span>group.<sup>7</sup> It is important to note
that this study was supported by the whey supplement company, drawing into
question the validity of accurate findings.<sup>7 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A 1999 three-arm
randomized controlled trial of 536 HIV patients with CD4 counts below 200
looked at the impact of nutrients on the prevention of weight loss over a
four-month period.<sup>8</sup> Researchers<span style="mso-spacerun: yes;">&nbsp;
</span>studied the implementation of three nutritional regimens to determine
their effect on the prevention of weight loss in patients.<sup>8 </sup>Therapies
consisted of a <span style="mso-spacerun: yes;">&nbsp;</span>500 kcal daily of caloric
supplement with peptides and medium-chain triglycerides plus a multivitamin and
mineral supplement, 500 kcal of a caloric supplement with whole protein and
long-chain triglycerides plus a multivitamin and mineral supplement, and a
multivitamin and mineral supplement only.<sup>8 </sup>At the conclusion of the
four-month study, researchers concluded that no differences were observed
(including the increased protein group), stating that caloric supplements did
not provide a viable treatment modality for this population.<sup>8</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a 2003 study of
467 weight-stable HIV-infected men with CD4 counts lower than 200 were observed
in regard to protein intake and body composition variables, including body cell
mass (the depletion of which is a predictor of disease progression and death).<sup>9</sup>
Researchers concluded that increased protein intake was related to increased
body cell mass, suggesting efficacy in the use of protein to boost health
variables in HIV patients.<sup>9</sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Researchers in a
2006 study of children suffering from rapidly-progressing AIDS, examined the
effect of<span style="mso-spacerun: yes;">&nbsp; </span>a whey protein supplement in
regard to <a href="https://www.blogger.com/u/1/null" name="_Hlk23585985">erythrocyte glutathione concentration, T
lymphocyte counts and occurrence of additional infections</a>.<sup>10</sup> In
the prospective double-blind clinical trial, 18 HIV-infected children
undergoing antiretroviral therapy were followed for four months.<sup>10</sup>
The subjects were divided into three groups and given whey protein,
maltodextrin or placebo, followed by an evaluation of erythrocyte glutathione
concentration, T lymphocyte counts and occurrence of additional infections.<sup>10</sup>
Results demonstrated<span style="mso-spacerun: yes;">&nbsp; </span>that in the whey
protein group, erythrocyte glutathione levels increased and co-infection
occurrence decreased, while T lymphocytes remained unchanged when compared to
the control group (placebo).<sup>10<span style="mso-spacerun: yes;">&nbsp; </span></sup>Researchers
concluded that the inclusion of a whey protein supplement was advisable for
this population.<sup>10 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Summary of Findings and
Limitations<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Though this brief
review may appear to point to the overall benefits of increased protein intake
and health-compromised people groups, it is important to note the existence of
study limitations. Several of the studies reviewed involved very small sample sizes.
Though this fact does not necessarily fully discount the findings, it does give
reason to be cautious when evaluating the efficacy of information. Many of the
studies reviewed also examined multiple factors combined with increased protein
intake, making the definitive factor of efficacy more difficult to deduce. Further,
as mentioned previously, one of the studies presented was funded by the maker
of the protein supplement used in the study, thus giving reason to again be
mindful of the bias potential. Length of the studies is also a factor to
consider due to the fact that the relevance of data was not studied extensively
in terms of long-term outcomes. Oftentimes interventions appear positive in the
short-term but neutral or negative in the long-term. Further, though some
benefit was shown in some of the presented studies, it is important to note
that reduction in wound size or increased levels of CD4 levels for example,
does not necessarily imply positive health outcomes for the individual overall.
Symptom management, symptom reduction and more acceptable biomarkers do not
always suggest optimal health, a point of key importance when evaluating
treatment modalities.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Risks<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">It is always
important to examine the level of risk associated with any type of intervention,
even if the added measure appears to be harmless. Though protein is a necessary
nutrient, an increase of consumption does not come without risk. Consuming
large amounts of protein carries with it a significant amount of risk such as
increased risk of cancer, diabetes and overall mortality.<sup>11</sup> Eating a
high protein diet also creates excessive strain on the kidneys, causing
complications such as the formation of kidney stones and other kidney-related
health issues.<sup>13</sup> In addition, the inclusion of high protein
supplements made from dairy products carries with it a considerable amount of
risk due to the detrimental effects of dairy consumption. Higher mortality
rates, cancer, fracture risk and heart disease can all be linked to the
consumption of dairy, a fact that should give significant pause to the
recommendation to increase the consumption of it, particularly in
immune-compromised populations.<sup>,14, 15, 16<o:p></o:p></sup></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Conclusions and Future Research
Opportunities<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">As reviewed above,
some evidence appears to exist in regard to increased protein intake. However,
study limitations exist and multiple risks exist to the implementation of
increased protein intake. Additional research into alternative methods of
improvement that do not involve increased protein intake would be wise to
conduct, in addition to a more extensive evaluation of the risk-benefit ratio
of protein intervention and the detrimental effects of engaging in such
measures.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left;">
<div style="text-align: center;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><i>References</i></span></div>
</div>
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">7. Sattler FR, Rajicic N, Mulligan
K, et al. Evaluation of high-protein supplementation in weight-stable
HIV-positive subjects with a history of weight loss: a randomized, double-blind,
multicenter trial. American Journal of Clinical Nutrition.
2008;88(5):1313–1321. doi:10.3945/ajcn.2006.23583<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">8. Gibert CL, Wheeler DA, Collins
G, et al. Terry Beirn Community Programs for Clinical Research on AIDS:
randomized, controlled trial of caloric supplements in HIV infection. Journal
of Acquired Immune Deficiency Syndrome. 1999;22:253–259.&nbsp;<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">9. Williams SB, Bartsch G,
Muurahainen N, et al. Protein intake is positively associated with body cell
mass in weight-stable HIV-infected men. Journal of Nutrition. 2003; 133(4):
1143-1146.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">10. Moreno YF,&nbsp; Sgarbieri VC,
da Silva MN, Toro AADC, Vilela MMS. Features of whey protein concentrate
supplementation in children with rapidly progressive HIV infection. Journal of
Tropical Pediatrics. 2006; 52(1): 34–38.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">11. Levine ME, Suarez JA,
Brandhorst S, et al. Low protein intake is associated with a major reduction in
IGF-1, cancer, and overall mortality in the 65 and younger but not older
population. Cell Metabolism. 2014;19(3):407–417.&nbsp;<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">12. &nbsp;Fontana L, Klein S, O Holloszy
J, Long-term low-protein, low-calorie diet and endurance exercise modulate
metabolic factors associated with cancer risk. American Journal of Clinical
Nutrition. 2006; 84(6):1456–1462.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">13. Robertson W, Heyburn P, Peacock
M, Hanes F, Swaminathan R. The effect of high animal protein intake on the risk
of calcium stone-formation in the urinary tract. Clinical Science. 1979;
57(3):285-288.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">14. Michaëlsson K, Wolk A,
Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women
and men: cohort studies. British Medical Journal.&nbsp; 2014; 349 :6015.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif;">15. Aune D, Rosenblatt DAN, Chan
DSM, et al. Dairy products, calcium, and prostate cancer risk: a systematic
review and meta-analysis of cohort studies. American Journal of Clinical
Nutrition. 2015;101:87-117.&nbsp;&nbsp;<o:p></o:p></span></div>
<div style="text-align: left;">
<span style="font-family: &quot;times new roman&quot; , serif; font-size: 11.0pt; line-height: 107%;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;16. Chen M, Li Y, Sun
Q, et al. Dairy fat and risk of cardiovascular disease in 3 cohorts of US
adults.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;American Journal of Clinical Nutrition. 2016;104(5):1209–1217.&nbsp;</span></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7710164449604801340/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised_10.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7710164449604801340'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7710164449604801340'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised_10.html' title='Protein Needs in Compromised Populations Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8755372626436617988</id><published>2019-11-03T03:41:00.005-08:00</published><updated>2021-11-26T05:00:27.555-08:00</updated><title type='text'>Protein Needs in Compromised Populations Part I</title><content type='html'><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><br /></span>
<br />
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif; text-indent: 0.5in;">There does not
appear to be much debate when discussing the importance of nutrition on patients
suffering from wounds and burns and likewise with people who are HIV positive. More
specifically, increased intake of protein is often posed as the essential
nutrient for such patients. However, as is always the case, it is of paramount
importance to examine the scientific findings of such claims before making the
assumption that the recommendations are sound. For the purposes of this paper,
a brief review of the literature concerning the afore-mentioned populations in
relation to protein intake will be presented.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<i><span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">Wound and Burn Healing<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">According to an
article published in the British Journal of Nursing, author Linda Russell
reported that protein deficiency poses many detriments to the healing process
such as reduction in collagen formation.<sup>1 </sup>Further, Russell commented
that high exudate loss has the potential to deplete protein stores by 100 grams
per day, thus indicating the need for heightened intake of protein.<sup>1 </sup>It
should be noted that in addition to increased protein intake, the author
encouraged a comprehensive evaluation of nutrition overall, stating that a
holistic approach to nutrient load is vital to wound healing.<sup>1 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A 2014 review of
the literature looked at the necessity of nutrition, including the subset of
protein, in relation to wound healing.<sup>2 </sup>Researchers stated that
increased<span style="mso-spacerun: yes;">&nbsp; </span>protein needs were noted as a
result of protein loss due to large surface area of unhealed wounds, wound
exudates, chronic wound sites, and losses in lean body mass.<sup>2, 3</sup>
Further, researchers stated that in order to experience wound healing, protein
losses must be accounted for and replaced by increased intake of protein.<sup>2
</sup>Once again, it is noteworthy to mention that the authors recommend a
comprehensive overview of nutrition and possible supplementation of various
sources to enhance wound healing, rather than solely relying upon increased
protein intake. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a 1993 study of
28 malnourished patients with truncal pressure ulcers, researchers examined the
effect of protein on wound healing.<sup>3 </sup>Patients were divided into two
groups, one receiving 24% protein (high intake) and the other receiving 14%
protein (moderately high intake).<sup>3 </sup>Researchers observed a decrease
in wound surface area in the higher protein group but not the moderate protein
group.<sup>3 </sup>Higher caloric intake was also noted as a contributing
factor to the reduction in wound surface area in the higher protein group.<sup>3
</sup>Though the researchers concluded that high protein diets may improve
wound healing, it is important to point out the uniqueness of the population
studied (malnourished nursing home patients) and not automatically apply the
findings to the general population. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A 2009 review of
the literature studied the connection between nutrition and wound healing and
confirmed conclusions previously mentioned. Authors stated, based upon their
review, <span style="mso-spacerun: yes;">&nbsp;</span>that protein is a vital
component to wound and burn healing.<sup>4 </sup>Skin regrowth, according to
the review, is dependent upon cell proliferation and protein synthesis, both of
which require increased protein consumption.<sup>4 </sup>In addition,
researchers concluded that rapid protein initiation was vital in preventing
protein malnourishment in patients.<sup>4 </sup>Researchers not only
recommended protein intake increase but also the inclusion of anabolic hormones
to heighten the body’s response to protein<sup>4 </sup><span style="mso-spacerun: yes;">&nbsp;</span>Of key importance would be an additional review
of the data concerning risks involved with this type of supplementation,<span style="mso-spacerun: yes;">&nbsp; </span>a suggestion not examined in the current
article. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">A literature
review in the Indian Journal of Critical Care Medicine examined the importance
of hydration and nutritional intake in relation to pressure ulcers.<sup>5</sup>
Researchers noted that though hydration is of key importance to the
regeneration of skin, nutrition is equally imperative to the wound healing
process.<sup>5</sup> Protein, along with a multitude of other nutrients, was
recommended<span style="mso-spacerun: yes;">&nbsp; </span>as essential to the process
of wound healing, stating that protein was the most important macronutrient
involved in the repair of tissues.<sup>5 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: &quot;times&quot; , &quot;times new roman&quot; , serif;">In a 2014 Cochrane
Review, researchers studied a variety of factors in regard to wound healing,
including increased protein intake.<sup>6 </sup>Outcome results showed a lack
of efficacy in regard to the incorporation of increased protein and wound
healing.<sup>6</sup> Furthermore, out of the fourteen studies reviewed, authors
concluded that nutritional supplements overall showed no benefit to wound
healing (with the questionable exception of arginine which showed possible but
not convincing efficacy).<sup>6 </sup><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
<div style="text-align: center;">
<br />
<br /></div>
</div>
<div style="text-align: center; text-indent: 48px;">
<div class="MsoNormal" style="line-height: normal; text-align: center;">
</div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<i><span style="font-family: &quot;times new roman&quot; , serif;">References</span></i><br />
<br /></div>
<br />
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">1. Russell, L. The importance of patients'
nutritional status in wound healing. </span><i style="font-family: &quot;Times New Roman&quot;, serif;">British Journal&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;of Nursing</i><span style="font-family: &quot;Times New Roman&quot;, serif;">. 2013;
10(1): 44-49.</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">2. Molnar JA, Underdown MJ, Clark
WA. Nutrition and chronic wounds. </span><i style="font-family: &quot;Times New Roman&quot;, serif;">Advanced</i><span style="font-family: &quot;Times New Roman&quot;, serif;">&nbsp;</span><i style="font-family: &quot;Times New Roman&quot;, serif;">Wound&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Care</i><span style="font-family: &quot;Times New Roman&quot;, serif;"> (New
Rochelle). 2014;3(11):663–681.</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">3. Breslow RA, Hallfrisch J, Guy
DG, Crawley B, Goldberg AP. The importance of&nbsp;dietary&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;protein in healing
pressure ulcers. </span><i style="font-family: &quot;Times New Roman&quot;, serif;">Journal of the American Geriatric Society.</i><span style="font-family: &quot;Times New Roman&quot;, serif;">&nbsp;1993;
41(4):&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;357-362.</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">4. Demling RH. Nutrition,
anabolism, and the wound healing process: an overview.&nbsp;</span><i style="font-family: &quot;Times New Roman&quot;, serif;">Eplasty</i><span style="font-family: &quot;Times New Roman&quot;, serif;">.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 2009;9:e9.</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">5. Saghaleini SH, Dehghan K,
Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z. Pressure&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ulcer and nutrition. </span><i style="font-family: &quot;Times New Roman&quot;, serif;">Indian
Journal of Critical Care Medicine</i><span style="font-family: &quot;Times New Roman&quot;, serif;">.&nbsp;2018;22(4):283–289.&nbsp;</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">6. Langer&nbsp; G, Fink&nbsp; A.
Nutritional interventions for preventing and treating pressure&nbsp;ulcers.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</span><i style="font-family: &quot;Times New Roman&quot;, serif;">Cochrane
Database of Systematic Reviews</i><span style="font-family: &quot;Times New Roman&quot;, serif;"> 2014, Issue 6. Art. No.:CD003216.&nbsp;</span></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<span style="font-family: &quot;Times New Roman&quot;, serif;">DOI:&nbsp; 10.1002/14651858.CD003216.pub2.</span></div>
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<br /></div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8755372626436617988/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8755372626436617988'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8755372626436617988'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised.html' title='Protein Needs in Compromised Populations Part I'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8123086630238659660</id><published>2019-09-23T08:02:00.000-07:00</published><updated>2024-02-02T03:36:38.605-08:00</updated><title type='text'>A New Take on Breast Cancer Awareness Month...</title><content type='html'><div class="" data-block="true" data-editor="6v26a" data-offset-key="8kspd-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="8kspd-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<span data-offset-key="8kspd-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>October is Breast Cancer Awareness Month, and it is discouraging to see misguided the “celebration” is – there are pink M&amp;Ms, pink buckets of fried chicken, and of course the constant reminder that the best way to reduce your risk of breast cancer is to have mammograms.</b></span></span></div>
</div>
<div class="" data-block="true" data-editor="6v26a" data-offset-key="86c8-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="86c8-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<span data-offset-key="86c8-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>This year, we have a constructive alternative. Healthy on Purpose is partnering with Wellness Forum Health and the Physicians Committee for Responsible Medicine (PCRM) to promote a different awareness campaign designed to educate women and show them how to really reduce their risk of breast cancer.</b></span></span></div>
</div>
<div class="" data-block="true" data-editor="6v26a" data-offset-key="dgakn-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="dgakn-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<span data-offset-key="dgakn-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Women will be asked to sign a pledge card with 4 commitments:</b></span></span></div>
</div>
<div class="" data-block="true" data-editor="6v26a" data-offset-key="72g43-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="72g43-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<ul>
<li><span data-offset-key="72g43-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Choose plant-based foods</b></span></span></li>
<li><span data-offset-key="6qsn5-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Exercise regularly</b></span></span></li>
<li><span data-offset-key="45a0o-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Limit alcohol</b></span></span></li>
<li><span data-offset-key="1dl8e-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Maintain a healthy weight</b></span></span></li>
</ul>
</div>
</div>
<div class="" data-block="true" data-editor="6v26a" data-offset-key="f0v6p-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="f0v6p-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<span data-offset-key="f0v6p-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Those who sign the pledge through Healthy on Purpose and Wellness Forum Health will receive a $100 coupon good toward one of our online educational programs, and also have access to a free lecture on breast health. We will be donating $25 to PCRM and the wonderful work this organization does for every coupon redeemed by November 15.</b></span></span></div>
</div>
<div class="" data-block="true" data-editor="6v26a" data-offset-key="ebkti-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
<div class="_1mf _1mj" data-offset-key="ebkti-0-0" style="direction: ltr; font-family: inherit; position: relative;">
<b style="color: #e06666; font-family: inherit;">This promotion starts October 1. If you would like to sign a pledge and/or help by asking women to sign the pledge, please send an email to kylea.rorabaugh@gmail.com</b></div>
</div>
</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8123086630238659660/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/09/a-new-take-on-breast-cancer-awareness.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8123086630238659660'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8123086630238659660'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/09/a-new-take-on-breast-cancer-awareness.html' title='A New Take on Breast Cancer Awareness Month...'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6000466500811799131</id><published>2019-01-20T18:27:00.001-08:00</published><updated>2024-02-02T03:36:37.188-08:00</updated><title type='text'>about me</title><content type='html'><span style="font-family: Georgia, serif; font-size: 16px;">My name is Kylea and I am a mom and wife with a passion for maintaining a vibrant and intentional lifestyle and sharing what I have learned with others. I am also a Licensed Professional Counselor, crazy about research, and am always looking for new ways to learn. This blog is intended to showcase key components of what it means to live a life that is healthy on purpose.</span><br />
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