5 Health Questions To Ask Your Mom

Sunday was Mother’s Day and many were celebrating with cards, calls, flowers and brunch to honor the women in their lives.  Yet, how many know the full health history of their mom, grandmother and aunts?  This information could prove to be critical when it comes to your own health therefore these are 5 questions to ask the female family in your life.

1.       How was menopause?  This question is important as women tend to follow them other women in their family when it comes to peri-menopause and menopausal changes.  Do the hot flashes and night sweats start in the 40’s or 50’s?  How long did it take?  Was it rough?  Was it easy?  How did she treat it?  Any complications? 

2.       Who has had cancer in the family?  And at what age?  This applies to both the men and women however mom tends to know this information.  If grandma and the aunts had breast cancer at a younger age, this is more concerning than finding out grandma had it later in life.  Has anyone had thyroid cancer? Prostate cancer? Ovarian, cervical or uterine cancer? Skin cancer?  Know your family’s cancer history.

3.       What are the family trends?  If all the women eventually develop thyroid disease and go on thyroid medication, this helps both you and your health care provider to be extra diligent and pro-active.  Does heart disease run in the family?  What about obesity?  Fertility problems?  Endometriosis?  Osteoporosis?  Do the women tend to lose their hair as they age?  Everyone have their gallbladder?  What about digestive or food allergy problems?  All of this information is critical for future planning and may shed light into current symptoms.

4.       Any outliers in the family?  The 2^nd cousin with celiac’s disease may not strike you as important however as your gas and bloating worsens, it could be a direct link.  The weird uncle whose mood alternates from really happy and hyper to down and depressed may be suffering from undiagnosed bi-polar.  This can be genetically linked as can depression in the family.  If just grandma had aches and pains it could have been undiagnosed fibromyalgia or a certain type of arthritis – how is your pain?

5.       What about your siblings?  Not all brothers and sisters are close therefore they may not inform each other about different health issues, concerns, scares and symptoms but mom usually knows.  Ask her if your symptoms sound like anyone in the family or periodically check in on the health of the rest of the family.  You may find out that your older sister has been having problems getting pregnant too or that your brother experiences the same types of migraines that you do and the same medications are not working.

While some people may prefer to keep some of their health history private, the more you know the more you (and your family) can be pro-active and prevent when possible.  Let your health care provider know of any changes as well to routinely keep your chart up-to-date and help them provide the best care possible for you.

 

Learn more on the women's health website, Emowher!

References:

1.       Segurado, R., Deterawadleigh, S., Levinson, D., Lewis, C., Gill, M., Nurnbergerjr, J., Craddock, N. Depaulo, J.  (2003). "Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part III: Bipolar Disorder". Am J Human Genetics 73 (1): 49–62.

2.       Steiner, A., Baird, D., Kesner, J.  (2008). Mother’s Menopausal Age is Associated with her Daughter’s Early Follicular Phase Urinary, Follicle Stimulating Hormone Level.  Menopause. 15(5): 940–944.

5 Tips to Helping Arthritis Naturally

Many women suffer from arthritis aches and pains that linger for hours or stay for days.  The pain and stiffness can really inhibit daily activities such as putting on shoes, opening jars, and even walking.  Osteoarthritis is commonly known as degenerative arthritis and is due to repetitive use, injury, aging, genetics, and certain diseases.  Treatment can be difficult as many of the causes are not curable such as aging (sorry ladies) or genetics however these 5 natural tips may be helpful to reducing your inflammation.

1)      Tumeric – the spice that is also known as curcumin has pain reducing qualities as it inhibits the inflammatory pathway known as COX-2.  One cannot eat enough of the spice therefore taking a good quality supplement at 1500-2000mg one to two times per day.

2)      Green Lipped Mussels – these mussels from New Zealand have promising anti-inflammatory properties for those with arthritis.  The typical dose is 500-1000mg one to three times per day.  It can take 4-6 weeks to take effect however research is promising.  Be very careful for those who have an allergy to mussels.  Side effects may include nausea or diarrhea so start with a lower dose and work up.

3)      Devil’s Claw – also known as Harpagophytum procumens, is an herbal plant that comes from Africa and contains the active ingredient, harpagosides to lower pain and inflammation.  The typical dose is about 1000mg per day (totally 50-60mg harpagosides – read the label) in divided doses.  Those with ulcers or gallbladder disease should use this plant cautiously and those with blood sugar problems need to monitor their levels as Devil’s claw has been known to lower glucose levels.

4)      Krill oil – everyone knows about the vast importance of fish oil but Krill oil is quickly making a name for itself with it comes to reducing pain and inflammation (especially c-reactive protein) with arthritis.  The typical dose is 300mg per day (along with your normal fish oil supplement) for joint protection.  Like fish oil, side effects can include ‘fish burps’ especially in poorer quality supplements, heartburn and nausea.  Those who have allergies to certain seafood such as shrimp should avoid it and krill oil (like fish oil) can potentially act as a blood thinner so be aware with blood thinner medications or before surgery.

5)      Glucosamine and Chondroitin – these supplements are the most commonly used for arthritis and joint pain however they must be taken at the appropriate dose and can take up to 8 weeks to have an effect.  If they are stopped then the beneficial effect goes away.  Glucosamine and chondroitin have both been shown to lower c-reactive protein and lowers inflammatory cytokines.  Glucosamine must be taken at doses of 1500mg per day and chondroitin at 400-500mg per day.  Some supplements are from a seafood source therefore those with allergies need to be aware.  Side effects may be gastrointestinal in nature such as diarrhea or nausea.

Other than krill oil, the other four natural supplements should not be used in pregnant women and remember to discuss all supplements with your health care provider.

 

Read more at the women's health website, Empowher, here!

References:

1) Lev-Ari, S., Strier, L., Kazanov, D., Elkayam, O., Lichtenberg, D., Caspi, D., and Arber, N. Curcumin synergistically potentiates the growth-inhibitory and pro-apoptotic effects of celecoxib in osteoarthritis synovial adherent cells. Web. 7 May, 2013.

http://www.medscape.com/medline/abstract/16249246

2) De Silva, V., El-Metwally, A., Ernst, E., Lewith, G., and MacFarlane, G. Evidence for the Efficacy of Complementary and Alternative Medicines in the Management of Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/741637_3

3) Deutsch L. Evaluation of the effect of Neptune Krill Oil on chronic inflammation and arthritic symptoms. J Am Coll Nutr. 2007 Feb;26(1):39-48.

4) Kelly, J. Glucosamine, Chondroitin, Fish Oil May Reduce Inflammation. Web. 7 May, 2013.

http://www.medscape.com/womenshealth

5) Rovati, L., Girolami, F., and Persiani, S. Crystalline Glucosamine Sulfate in the Management of Knee Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/7657351)

     

Arthritis happens when inflammation occurs in the joints causing pain and stiffness.  It can occur in any joint as many people can experience it in the large joints such as the hips or knees while others feel it in the smaller ones such as the fingers, neck or toes.  The symptoms of arthritis may come and go or rotate around locations in the body.  They may occur continually throughout the day or feel worse in the morning and improve with movement and stretching.  Regardless of the symptoms, here are 5 tips to help when working with arthritis.

First, know the type of arthritis you have.  Many assume that their symptoms are a result of age, overuse or injury which is known as ‘osteoarthritis’ however there is an autoimmune inflammatory type known as rheumatoid arthritis.  The symptoms can be different in that the joints may become swollen, hot and tender to touch.  Additionally those with the skin condition, psoriasis, may have psoriatic arthritis.

Second, take fish oil regularly.  The omega-3 fatty acids help lower inflammation by reducing cyclooxygenase-2 (COX-2) activity which is similar to the effect of over the counter pain medications.  Choose a good quality oil and take between 1000-3000mg per day.  Be careful if you have bleeding problems as fish oil can act as a blood thinner.

Third, consider cutting out the nightshade family, otherwise known as the Solanaceae group who have specific alkaloids known to irritate your joint spaces.  This family includes potatoes, tomatoes, eggplants and peppers.  Cut out these foods for 2-4 weeks and see if it makes a difference in your pain and inflammation. 

Fourth, do not stop exercising but you may need to tweak your routine.  Consider lighter impact moves that do not put added pressure on the knees, hips or feet.  Look at yoga, pilates, Barre method, or swimming.  Continue your cardio and weight routine with appropriate adjustments for when your joints are feeling more inflamed.  Switch to walking instead of running or try the low impact elliptical machine.

Fifth, add in the spice, Tumeric, however the supplement form is more concentrated and therefore more potent.  Tumeric is known to be anti-inflammatory and helpful for those with all forms of arthritis.  Like fish oil, make sure to get a good quality supplement and consider taking 1000-2000mg per day. 

References:

Norling, LV., and Perretti, M.  The role of omega-3 derived resolvins in arthritis.  Web.  29 April, 2013.

http://www.ncbi.nlm.nih.gov/pubmed/23434193

Childers, NF, and Margoles, MD.  An Apparent Relation of Nightshades (Solanaceae) to Arthritis.  Web.  29 April, 2013.

http://noarthritis.com/research.htm

Iversen, MD., Brawerman, M., and Iversen, CN.  Recommendations and the state of the evidence for physical activity interventions for adults with rheumatoid arthritis: 2007 to present.  Web.  29 April, 2013.

http://www.ncbi.nlm.nih.gov/pubmed/23538738

Asher, GN., and Spelman, K.  Clinical utility of curcumin extract.  Web.  29 April, 2013

http://www.ncbi.nlm.nih.gov/pubmed/23594449

3 Tips For When A Gluten Free Diet Does Not Work

According to research, 1 in 133 people have celiac disease which is the inherited autoimmune condition where eating foods containing the protein gluten causes damage to the villi in the intestines leading to a number of malabsorption problems and physical symptoms.  There are more than 2 million people in the United States who have celiac but have not been worked up or diagnosed.  It has been suggested that even more people suffer from non-celiac gluten sensitivity which is not an autoimmune disorder however eating the protein, gluten, causes significant symptoms throughout the body that are not necessarily all centered in the intestines.  With either diagnosis, people must go on a strict gluten-free diet however what happens when a gluten-free diet does not work and the symptoms do not resolve?  Here are 3 tips to try.

1.      Really evaluate how gluten-free you are on a daily basis.  As it takes 6-12 months for the intestines to heal, eating gluten ‘here and there’ by choice or by accident can take its toll on the healing of the tissue.  Really read labels, do your research on key words to look for and do not assume.  Gluten products are often used in places one may not think such as in sauces, salad dressing, yogurt, soy sauce, BBQ sauce, soups, spices, and gravies.  Really ask when at restaurants about seasonings and sauces or read labels, even some ice creams use gluten flour as an ingredient.

2.      Could it be something else?  There are over 300 document symptoms of celiac disease and gluten sensitivity however many of those symptoms overlap with other conditions.  Perhaps your migraines are related to hormones or stress, your fatigue is due to insomnia or a thyroid problem, your joint pain is osteoarthritis or genetic, or your ongoing heartburn is related to a lower esophageal problem, stomach acid issues or eating too quickly.  Both constipation and diarrhea can occur with different thyroid problems.  Cracks at the corners of the lips can be due to deficient B-vitamins, particularly vitamin B12. 

3.      Are you sensitive or allergic to another food?  Research points out that many that have celiac also have a problem with dairy products.  In fact, the top ten most common food allergies are: dairy, gluten/wheat, eggs, peanuts (not a nut), tree nuts, fish, shellfish, soy, tomatoes and corn.  It may be worthwhile to consider removing all traces of dairy from the diet for a few months and then re-evaluate your symptoms from there.

Talk with your healthcare provider if giving up gluten has not resolved your symptoms and consider these tips in order to continue to improve your health.

References:

1.      The University of Chicago Celiac Center.  (n.d.)  Celiac Facts and Figures.  Web.  20 April, 2013.

http://www.uchospitals.edu/pdf/uch_007937.pdf

2.      The University of Chicago Celiac Center.  (2013).  About Celiac Disease.  Web.  20 April, 2013.

http://www.cureceliacdisease.org/archives/category/faq-about-celiac-disease

3.      Woodward, J.  (2013).  The Management of Refractory Coeliac Disease.  Web.  20 April, 2013.

http://www.medscape.com/viewarticle/779873_2

Birth Control Pills or IUD: Which Is Right For You?

There are several different types of birth control on the market now leaving women with many questions as to their effectiveness, side effects and long term consequences.  Unfortunately there is no perfect option that is ‘side effect –free’ (unless, of course, abstinence is counted however many opt not to make this choice) therefore it is important to combine your current health with your goals (true pregnancy prevention or other women’s health issues as well) and talk with your health care provider.  Here are some things to consider when looking at the two most common forms that might work for you.

First and most common is the birth control pill also known as the oral contraceptive pill.  This pill is taken daily for 3 weeks then stopped for 7 days to allow for a "period," or continued in some cases for 3 months straight or in rare cases done continuously without a bleed.  The pill is typically a combination of a synthetic estrogen and progestin that works to suppress ovulation therefore a woman cannot become pregnant if there is no egg release.  There are various forms of the pill and amounts of estrogen and progestin within. 

Typical side effects can include: change in menstrual cycle, mood changes, increased vaginal discharge, decreased libido, skin changes, weight changes, increased risk for gall stones, and increased risk for blood clots.  Women who smoke, have migraines with aura, have diabetes, or have a personal history of cardiovascular disease should not use the pill.  When used correctly (ie. taken at the same time every day) the effectiveness against pregnancy is 92-98% effective.  It does not protect against sexually transmitted infections such as gonorrhea, Chlamydia, HIV/AIDS, HPV or trichomonas. 

Next most common is the IUD or intrauterine device. This is a small T-shaped device that is inserted up into the uterus during an office procedure (only local anesthesia required).  There are two types of IUDs.  First is the Paragard that is also known as the copper-T as it does not have any hormone in it and instead relies on the copper wrapped around the T-frame causing local inflammation to create a non- hospitable environment for the egg and sperm.  This IUD lasts 10-12 years after insertion.  The Mirena and Skyla IUDs are hormonally based in that they both contain progestin, similarly to that found in the birth control pill.  They are inserted the same way as the Paragard however the Mirena lasts 5-7 years and Skyla (which is newer and has a smaller design for those women who have never been pregnant) lasts 3 years.  Their effectiveness is about 99% against pregnancy and can be removed relatively easily in office through a simple, quick procedure. 

The most common side effects for all three IUDs are pain with insertion, spotting or irregular cycles for the first 3-6 months during the adjustment period, and back pain.  There is the small risk for expulsion after insertion and perforation through the uterus.  The Paragard may increase menstrual cramps and increase menstrual flow.  The Mirena typically diminishes cramps and reduces flow however there is a risk for ovarian cysts and acne.  None of the IUDs prevent against sexually transmitted infections such as gonorrhea, Chlamydia, HIV/AIDs , HVP or trichomonas.

There are other forms of birth control such as barrier methods (condoms or diaphragm), the depo-provera injection, the implant, the patch, the ring, tubal sterilization, ablation and tubal blockers (essure).  Please talk with your health care provider about which form suits your needs and your health best.

Read more at www.empowher.com

References:

1)  Foster, D. (2009).  Optimizing the Use of Oral Contraceptives.  Web.  14 April, 2013.

http://www.medscape.com/viewarticle/588425

2)  Reuter’s Health Information (2013).  U.S. Approves First New IUD in 12 Years.  Web.  14 April, 2013.

http://www.medscape.com/viewarticle/777413

3)  Waknine, Y. (2009).  Levonorgestrel IUD Approved to Treat Heavy Menstrual Bleeding.  Web.  14 April, 2013.

http://www.medscape.com/viewarticle/709854

4)  Barclay, L.  (2011). IUDs, Implants Most Effective Reversible Contraceptive.  Web.  14 April, 2013.

http://www.medscape.com/viewarticle/745108

Headaches: Migraines, Tension, or Sinus?

Headaches in any stage can be a real pain in the…head.  Millions of people experience headaches but knowing which type may help you better understand the triggers and ways to prevent them.  Three common ones include migraines, tension and sinus/allergy related.

Migraines are usually moderately to severely intense and can include an aura (pre-symptoms to let you know it is coming such as flashing lights, change in vision, tingling sensations) or no aura. The pain is often described as throbbing or pulsating in a particular area of the head as opposed to the entire head.  Many experience nausea, vomiting, dizziness, and light sensitivity due to the pain requiring medication, ice, cold wash cloths, or sleep in a dark room.  Migraines may follow a pattern such as onset with weather/barometric changes or ovulation and menses or they be sporadic which is why tracking them may be helpful.  Common triggers include stress, lack of sleep, wine, MSG, chocolate, diet sodas, tight muscles, food sensitivities, and skipping meals/hypoglycemia.  Common treatments include over-the-counter pain medications, prescription pain medications, migraine medications, avoiding triggers, acupuncture, massage, chiropractic, Vitamin B2 (riboflavin), and the herbs feverfew and butterbur.

Tension headaches generally occur with stress, too little sleep, tight muscles and poor posture.  Unlike a migraine, tension headaches are generally described as milder pain that is dull and aching or squeezing like a band on the head and possibly extending into the neck and upper shoulders.  These headaches can occur sporadically or daily depending on the trigger.  Many people report tension headaches in certain situations, such as during long work days, after family events or other stressful situations.  Common treatments include over-the-counter pain medication, avoiding triggers, focusing on proper posture, acupuncture, chiropractic, massage, and finding ways to reduce stress.

Sinus and allergy type headaches are triggered by congestion and pressure build up in the sinuses which are the open cavities located behind your cheeks, nose, and forehead/eyes.   During allergy season, sinus infections or a cold, the sinuses can become inflamed leading to pain in the forehead, behind the eyes, at the bridge of the nose and the cheeks.  Common treatment includes allergy medications, nasal sprays, decongestants, antibiotics if necessary, and avoiding allergic triggers.

It is important to note that tension or sinus/allergy headaches can turn into a migraine therefore being proactive and knowing your triggers can help prevent this progression.  Talk with your health care provider for additional help and work-up especially if your headaches are changing or worsening.

 

Read more at www.empowher.com

References:

1)      A.D.A.M. Medical Encyclopedia (2011).  Migraine.  Web. 7 April, 2013.

 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728/

2)      Barclay,L. (2009).  Sleep Disturbance Linked to Tension Headache.  Web.  7 April, 2013.

http://www.medscape.com/viewarticle/588351

3)      Busko, M. (2009).  Migraines, Tension-Type Headaches Respond to Acupuncture.  Web.  7 April, 2013.

http://www.medscape.com/viewarticle/587243

4)      Wells, R., Bertisch, S., Buettner, C., Phillips, R., McCarthy, E. (2011).  Complementary and Alternative Medicine Use Among Adults with Migraines/Severe Headaches.  Web. 7 April, 2013.

http://www.medscape.com/viewarticle/746815

2013 Update: When Should You Get Your Pap?

The national pap guidelines seem to have changed a lot over the years with new guidelines debuting in 2009, some updates again in 2012 and now in 2013 it appears that some final decisions have been approved.  It used to be that a woman started having their pap smears in the teenage years and went yearly for the rest of her life.  While yearly physicals with her health care provider are important, a yearly pap is not necessarily required. 

According to most major women’s health and gynecology groups, a woman should have her first pap smear at 21 years of age.  This is different from 18 years old or age of first intercourse.  The younger a woman’s age, the healthier her immune system is therefore she is more likely to clear any abnormal cells caused by the human papilloma virus (HPV).  Additionally, if the results are normal, she is to have a pap test every 3 years.  Abnormal results may require more frequent follow up testing.

Once a woman turns 30 years old, the HPV test is added on to her pap smear as various factors, including age and immune system, may reduce her ability to clear the virus from her cervix.  If her pap smears continue to remain normal, she can continue with the ‘every 3 years’ recommendation.  If her results are abnormal, she again may require additional work-up and more frequent testing.

The new guidelines state that unless a woman has a history of a higher grade abnormal pap result, she can stop having pap smears at 65 years of age.  She should continue to have yearly physicals with her health care provider however.  Additionally, if a woman has had a total hysterectomy in which her cervix was also removed for non-cancerous reasons she does not need further pap smear testing however if she still has her cervix or if her hysterectomy was due to higher grade lesions or cancer, she will need to talk with her health care provider as she still needs some screening.

Remember that the purpose of pap smear screening is to evaluate the cells of the cervix for abnormal changes due to HPV and cervical cancer.  According to the Centers for Disease Control, cervical cancer used to be the most common cause of cancer death amongst women however with the increase in education and awareness for pap smear testing and HPV checks, the levels have greatly declined.  In fact in 2009, 12,357 women were diagnosed with cervical cancer and 3,909 died from it.  Therefore, if you have not had a pap smear test in the last 3 years or are not following up from an abnormal result, please do not be a statistic and make an appointment with your health care provider today.

For more information, read the women's health website Empowher, here!

References:

1.      Barclay, L.  (2013). Cervical Screening Guidelines Updated.  Web.  23 March, 2013.  http://www.medscape.com/viewarticle/781190

2.      Broder, J.  (2012). Pap Test Less Frequent Under New Guidelines.  Web. 23 March, 2013.

http://www.medscape.com/viewarticle/773282

3.      Centers for Disease Control (CDC).  (2012). Cervical Cancer Statistics.  Web. 23 March, 2013.

http://www.cdc.gov/cancer/cervical/statistics/