Stay Well!

A friend of mine was in the hospital two weeks ago due to a condition triggered by a reduced immune system. That got me thinking ...

Immune System Stressors

• emotional stress
• physical stress
  • inadequate sleep
  • athletic overtraining
• smoking
• diet
  • high fat consumption
  • alcohol consumption
  • high refined sugar consumption
  • inadequate protein consumption
  • inadequate calorie consumption
  • inadequate vitamin consumption, including inadequate Vitamin B12
  • inadequate mineral consumption, including inadequate iron and/or zinc
  • inadequate water intake
  • food allergies, mostly if not avoided
  • food intolerances, mostly if not avoided
• UV (sunburn!) and other types of radiation
• chemical sensitivities
• environmental and occupational chemical exposure
• any immunodeficiency or autoimmune condition
• common viral or bacterial infections
• cirrhosis of the liver
• certain drug therapies, including prednisone
• blood transfusions and surgery
• over age 40

[1] http://www.diagnose-me.com/symptoms-of/weakened-immune-system.php accessed 2016-07-09

How to Help Your Immune System

• wash your hands frequently to avoid infection
• get adequate sleep: 8 to 10 hours a night
• exercise regularly, but do not over-exercise
• maintain a healthy weight
• do not smoke
• do not drink alcohol, or only in moderation
• drink plenty of fluids, especially water
• reduce in your diet: saturated fat, refined sugar
• adequate amounts in your balanced diet: protein, calories, vitamins, minerals, and essential fatty acids
• eat a diet high in fruits, vegetables, and whole grains
• cook meats thoroughly to avoid infection
• do not over-eat
• to counter stress, try massage, mindfulness relaxation techniques, and spend time with good friends who make you laugh
• avoid false friends who tell you how to feel, and who your friends are/should be
• avoid allergies and food intolerances
• avoid sunburn
• avoid exposure to radiation and unhealthy chemicals
• control your blood pressure
• get regular medical screening

[2] http://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system accessed 2016-07-09

Against Bottled Water

I don't drink bottled water, because

1. making plastic bottles uses a lot of fuel and water: it takes several times more water to make the bottle than to fill it!, and
2. most bottled water is municipal water, but with less regulation for safety.

There are a few times when bottled water is appropriate (such as when local water is known to be unsafe), but generally it can be avoided for a more ecological choice. Consider a reusable water bottle and a water filter instead.

References:

• Ban the Bottle
• infographic
• Natural Resources Defense Council
• Rational Wiki

Dinner

Sunday night, while getting my boys cycled through the bath (one at a time due to Karston's toe surgery; he didn't want to take any chances) and getting all of us ready for Monday and oh-my-goodness-how-did-it-get-this-late, I had the thought, "I don't have time for dinner." Not merely was I thinking I didn't have enough time for a healthy dinner that I prepared, I was thinking I didn't have time for any dinner.

Screeeeech! Stop! Put on the brakes!

I may think some silly things, but I'd like to think that I can notice some of it, and improve.

So I thought about the problem while eating a big green salad (luckily that's my favorite food!) that I threw together quickly. In fact, I made two salads so I could chop up the whole head of lettuce. What I do in the late afternoon is fix dinner for my boys, and then fix dinner for myself. Especially when I'm not sure what I want, that can take some time. So I came up with a new plan: I'll eat leftovers for dinner, and then fix something tasty for the next meal(s). I don't have to rush with that meal preparation because I will have just eaten.

And that's what I did last night. I ate the other salad I made, and then I roasted a pan of vegetables (zucchini, mushrooms, onions, and red and yellow bell peppers with a little olive oil and salt). The only drawback is that I made the kitchen smell so good, I want to stay up and eat! Luckily I was too tired to eat, so I went to bed instead.

Antibiotic Overuse

This article, Antibiotic overuse: Stop the killing of beneficial bacteria, by Martin Blaser [doi:10.1038/476393a] kicked up opinions on antibiotic overuse. That article is a collection of observations, not a scientific study, but it is compelling. The CDC is also worried about antibiotic resistance, and this concern runs beyond the US with the Transatlantic Taskforce on Antimicrobial Resistance formed in 2009.

One problem is that antibiotics could be killing off beneficial bacteria for good, not temporarily as used to be believed. Furthermore, the reduction in H. pylori matches a rise in reflux and cancer. Ouch!

Some bacteria are good, and antibiotics are not selective. I've said it before ...

Acuvue Oasys

I wore toric contact lenses for severe myopia (-9) and a strong dipole astigmatism (-2) from 1988 until 2000; I had LASIK surgery early January 2001. After ten easy years, not counting the bouts with dry eye, I went myopic again.

I got Acuvue Oasys silicon hydrogel contact lenses about 2 years ago. I used the recommended RevitaLens cleaner with them. I spent a long time struggling with them, too. My eyes would feel itchy and uncomfortable if it weren't the first day of wearing the lenses.

I tried using an enzymatic cleaner (protein remover) after a few days. I was very familiar with the feeling of contact lenses that need protein removed. The lenses feel like they're wearing scratchy wool sweaters! However, I felt no improvement at all after the enzyme cleaner.

I considered switching to Clear Care cleaner instead of RevitaLens. However, I remembered what my eye doctor said, that when you experience contact lens discomfort, switching your solution is often effective. He said it rarely matters what brand you pick, as long as it's different. When I went to the store, I bought the cheapest cleaner, in this case BioTrue, that said it worked with silicon hydrogel lenses.

I did find several things that worked.

• Don't feel like you must wear your lenses for the full time. These are two-week lenses, and I was a lot happier when I allowed myself to wear a new pair every week (wearing them for 4 to 7 days total). I think my comfort is more important than using the full time in the directions. Too much discomfort is likely to lead to actual medical problems in my eyes, and that's even more expensive.
• Use saline to rinse my lenses instead of the solution. Very effective! This added 3 to 7 days back to how long I wore these lenses.
• Change your contacts solution. This added another 3 days.
• Use more solution in the storage case. I got tired of having solution spill over the sides when I was putting the lid on, so I started to use less solution. More solution, less itchy when I put lenses in the next morning! This added comfort more than days. At this point, I was back to two weeks on each of pair of lenses, without complaint.
• Put my lenses in earlier, so I have half an hour in the morning before I leave to decide if these are just too uncomfortable to wear today. Before, I was putting in my lenses and leaving, meaning the adjustment period was during my commute. That's not a good idea!

Healthy Bacteria and the Intertwingularity

I read this Mother Jones article this morning, Are Happy Gut Bacteria Key to Weight Loss? Reading it made me very happy, as so many different strands of knowledge were pulled together. Ted Nelson said "Everything is deeply intertwingled" (Intertwingularity at Wikipedia), and seeing it makes the treated subject more plausible to me (as does citing scientific studies that control for some bias). And that makes me twingle!

Women and Heart Disease

Women's heart attack symptoms are not like men's, so women go undiagnosed longer with worse outcomes. You should read Her Guide to a Heart Attack from WebMD.

Put Out That Cigarette!

Tobacco-related deaths per year according to the CDC are about 443,000 in the U.S. Compare that to under 40,000 motor vehicle deaths annually in the U.S. and cigarettes are scarier than cars!

Lactose Intolerance

I've always thought I had hereditary lactose intolerance because my aunt the medical doctor who collected the family history said so. She's even more sensitive to small amounts of dairy than I am, but we both get the bloating with painful cramps and borborygmi sound effects before we race to the nearest bathroom. I can usually eat cheese and yogurt, but milk is tough. Now I'm not so sure it's lactose intolerance.

The last three times I ate 1/2 cup of greek yogurt (that I strained myself) as a snack, it was some of the worst doubled-up-with-cramps I've ever had. Either greek yogurt concentrates lactose while draining the beneficial enzymes out with the whey (my first theory), or (since most of my Google results say Greek yogurt is lower lactose with the same enzymes and bacteria) this isn't lactose intolerance.

The rule of thumb is that food intolerance is to sugars (like lactose or fructose), and food allergy to protein (like casein or gluten). The two protein sources in yogurt are whey and casein; greek yogurt is yogurt with most of the whey (and tangy taste) drained off. So it's higher in casein, and now I wonder if I have a casein allergy instead. Guess I'll ask my doctor -- not my aunt, she's already made her diagnosis.

But for now, greek yogurt is off my snack list. It hurts!

The Saga, and some recovery

Earlier this year, I noticed I had gained 16 pounds in 8 months. I try to eat healthy food and not to worry about my weight, but obviously I was on a bad trajectory. Luckily I log my weight most mornings, so I could see that it was actually 3 weeks of gaining a pound a week, followed by a week of losing a pound. Travel and holidays tacked on extra weight, but the following week I worked to maintain. Not pretty. Of course the 3+1 pattern is obvious. Two children with bad tummies cause me enough sleepless nights! So oral contraceptives.

Then I thought about why, and I noticed that I had been ignoring nausea. Actually, it was a lot like morning sickness all over again, but milder. Day-long nausea that felt better while I was eating, with heartburn if I ate a full meal. Yeah, I'd rather not have morning sickness again, especially without a bundle of joy to make it worthwhile, and to know it will end. So I was eating too much to mask the nausea. Another confounding symptom was that exercise made me feel worn out, worn down, and just plain tired. Usually I expect exercise to wear me out, but with a side effect of feeling powerful and strong, just let me catch my breath.

Next I did my research to link nausea with ocp. Yes, it's a common side effect, so I made an appointment with my doctor and kept digging. I finally found an explanation that gave me an attack vector. Since nausea as a side effect is an androgenic effect, I could switch to an ocp with less androgenic activity (but also low estrogen since Cale still likes to nurse). Armed with what to reduce, I found what I needed to take to my doctor. As a side note, another reference pointed out that androgenic weight gain was caused by interference with carbohydrate metabolism. As someone with diabetes in the family, I don't want to take any medication that damages my carbohydrate metabolism!

That month (the ninth), I noticed that my biggest day-to-day weight gain was after a spaghetti dinner, a high carbohydrate meal. So I resisted carbs, but it was ever so tough!

First month on the new stuff ... first week or two! ... I noticed that resisting carbs was suddenly easy. The change was sudden and dramatic. I realized that I used to be able to resist temptation, but since I don't usually worry about my weight, I hadn't noticed. Realizing my own blindness made me empathize with people with addictive behaviors. It's hard to do what you know you should when there's that compulsion. I'm glad my bout was from an external cause I can control (once I noticed). Much less nausea, less heartburn, better control of what I ate, in one month. Compared to the previous month, when I knew but I had to fight the androgenic demon inside ... on the right track!

Last night's dinner was another example: I was still hungry after dinner of salad and meatloaf. On the previous regime, I would have been craving sweet carbs, probably chocolate too. A chocolate cake craving, in short. Instead, as I tried to figure out what I wanted to eat after dinner last night, I knew I didn't want sweets, and I wasn't in the mood for carbs or chocolate. I didn't want more meat(loaf). I was so sure I didn't want sweets that I didn't even want fruit! If it's not sweets or carbs, not fruits, and not proteins, that just leaves vegetables. Yes, I was in the mood for more veggies! I ate apple with the rest of my family instead of making another salad just for myself, but I would have been just as happy with a salad. There's a huge difference between the food craving that I used to have, and the milder food wanting I sometimes have now. I've been using the verb 'to crave' incorrectly most of my life. At least I'm more sympathetic to people who do have cravings now, because those are brutal.

The weight loss, not trying too hard, is about a pound a month. Exercise is no longer a chore, but back to being empowering and exhilarating. But the best part: I had spaghetti for dinner a couple nights ago, and it didn't spike my weight! So in 3 months, my damaged carbohydrate metabolism appears to be repaired! I was worried, what with my diabetic family history, that I might not be able to reverse the damage. But I could, I did, and I think I'm on the right track!

My main androgenic complaint (nausea) is gone, along with a host of other possibly-related problems like utter exhaustion from exercise, food cravings, and a damaged carbohydrate metabolism. Still unanswered is if my hair experienced androgenic alopecia or something else, but hair growth takes at least six months to see any changes, so it's too soon to tell. I'm unsure about the heartburn, since I think my heartburn correlates more to my weight (so it goes away as my weight drops back to healthy levels) than to any actual androgenic effect. On the flip side, I am experiencing more headaches, many at the migraine level. I need to be sure I'm well-hydrated (I haven't been as good about drinking lots of water lately for stupid reasons like 'busy') before I know if this is a new side effect. It's certainly easier to tolerate the occasional headache than continuous nausea, so I'm not complaining. I'm curious to know if my cholesterol and my blood pressure have also improved.

Hungry Tired

Being sleepy always makes me hungry! Sounds like it's not just me.

Losing sleep may increase appetite and, as a result, weight.

from Lack of Sleep Increases Weight - NYTimes.com

Tummy Hurting

Now that Karston appears to be outgrowing the abdominal pain that caused four years of colic, I've found a great little chart to help figure out Long-Term Abdominal Pain. Here's hoping you don't need that resource!

A Little Math Makes It Better

I was a little discouraged recently when I couldn't find many choices for low-estrogen Pill with less-androgenic progestins. Since

progestins with less androgenic activity tend to have little to no effect on carbohydrate metabolism

(ref), I wanted my less androgenic choice (8 months on Loestrin Fe 1/20 added 16 pounds! 1 pound per week on active pills, then I could actually control my own weight and lose 1 pound the Fe week; the iron pills are a nice touch, and I think they made me feel better that week). As I was falling asleep after that post, I realized I could determine the least androgenic choice with a little math. Yes, better living with math!

First, copy this chart into a spreadsheet (no, I didn't use Excel). So I could sort by these columns later, I added a column for progestin formula (which progestin), making sure to separate out the norethindrones from the norethindrone acetates. Then I added a column for androgenic activity from this reference (the second table, not the first). Add another column for the androgenic potency that is the product of the "Progestin (mg)" column and the newly added androgenic activity column. Since Loestrin Fe 1/20 has a product of 1.6 (1 mg norethindrone acetate * 1.6 androgenic activity), I didn't consider anything with a higher value. And once you control for the few with mestranol instead of ethinyl estradiol (mestranol has 2/3 the estrogen activity), you can sort by either value.

Spreadsheets just make this easy. I could delete the rows with multiphasic drugs since those can increase headaches, and I had a doozie last week. I could delete the rows with more than 30mcg of ethinyl estradiol since Cale and I like breastfeeding. Sort by androgenic potency, and there's a list of candidates.

So that's how a little math, just a small dose of multiplication that my computer did for me, cheered me up. Alternatives exist, and I can try them.

Antihistamines while Breastfeeding

After scouring the web and coming to the same conclusion, I found this quick chart on Lactation Guidance for Antihistamines: Claritin and Zyrtec should be fairly safe to take.

Some charts, like kellymom, are more generous, but since diphenhydramine can cause drowsiness, it's not the best for baby. I'm going with the more conservative version ...

A Calorie Is NOT Just A Calorie

For some lucky people I know (I married one), body weight comes down to a simple calories in-calories out measurement. Myself, I see a big difference in my weight between eating spaghetti (on refined carbs like pasta, my weight goes up no matter what) and eating beans and rice (I can eat lots, but as long as I exercise a little, my weight goes down). So I agree with this post, A Calorie Is NOT Just A Calorie:

You’ve certainly heard “a calorie is just a calorie.” Meaning, if you stick to say, a 1500 calorie per day diet, it doesn’t matter if those calories come from potatoes, salad, or cheeseburgers. Wrong-o!

My addition: if refined carbs make your weight skyrocket, look for diabetic-friendly recipes.

Eat healthy!

Fish Oil vs Flax Seed Oil

I've seen a number of variations on Fish Oil versus Flax Seed Oil, and I think the most best answer is to use whichever one (or neither, or algae) suits you best. However, looking at this metabolic pathway chart, I agree that

fish oil is a superior source of omega-3's since it is already in an active form upon ingestion.

In fact, that metabolic chart explains both of these "contradictory" results: ALA is the left side with all of the inflammatory agents (hmm, needs COX2 inhibitors), while flax is upper right (fish lower right) with the anti-inflammatory agents.

Better Vitamins?

I have a reasonable diet (I love salad!), but as I mentioned yesterday, I love my prenatal multivitamins too. Since I probably get most of my trace minerals in my diet, I prefer that my multivitamin is low in vitamins with accessible toxicity (Vitamin A, I'm looking at you) and low in the heavy metal sort of trace minerals (selenium linked to infertility). I don't like B vitamins from GNC because most of those have thousands of percents over the USRDA, and that sounds like overkill in the unhealthy direction to me. Once again, my "current" brand of prenatals went unavailable, so I've been trying other brands that meet my desire not to do over-do certain items while still bumping up the B's.

The first one I tried was a pretty traditional women's multivitamin. It lacked the slightly higher levels of B vitamins, but there weren't any prenatals at the store. Back to sprue (especially about 30 minutes to an hour after I drink a cola), back to the search. The next one I tried is OneADay Energy, although I wouldn't've bought it if I had noticed then that it has caffeine. (Most of the others that were high on some B vitamins were low on B6 and B12. Which would be one way to test which one helps me!) Although I drank tea for years, coffee gives me sweats and shakes, so "contains the caffeine of about 1 cup of coffee" isn't reassuring. It's even higher on those B vitamins than prenatal multivitamins, so I might alternate days with the standard women's. New discovery! With those B vitamins generally at 200% (but not an unacceptable 6000%), my weight seems to be stabilizing! I was having annoying cyclic weight gain, a little loss, then back to the gain grind. How much I ate didn't seem to affect the cyclic pattern much (so why starve).

Extra B vitamins beyond prenatal multivitamin levels, and (#1) I'm back to being in control of my weight and I like to be in charge of my own destiny, and (#2) for the first time in absolutely years, I'm not facing afternoon doldrums with a severe urge to snack on something sweet! Wow! I can probably learn to live with caffeine for that, but I notice that the OneADay Teen mixtures look similar but without the caffeine. In fact, the only amount I disagree with on those is the Chromium since it can affect appetite too. I think I like the Teen Boy formula best because it's lower in iron and some weeks I average 3x USRDA for iron ... I don't need to take an iron supplement unless I like brittle hair and nails. I even think the RDI for iron is high since, at least for blood hemoglobin, the elemental iron is usually recycled into new hemoglobin: it's a fairly closed cycle for iron in hemoglobin, not much loss. I think iron loss is 20 mg for childbirth, and most other times much lower than that ... so I don't think I need it. I do remember what anemia feels like (that lethargy, particularly in my elbows: my elbows felt weak) and I would know to take moderate levels of iron.

I really like that the US RDI tables are available online because these tables include the suggested upper limit too. There you can see that while the RDI for sodium is 1500 mg (a big drop from the old USRDA values), the suggested upper limit is 2300 mg! I think the old USRDA for sodium was 3500 mg. Yeah. So the suggested limit works out to about 3/4 teaspoon of salt ... per day. Since fruits and veggies contain some natural sodium, it's possible to get enough sodium with very little, if any, added salt.

So I used to think that prenatal multivitamins were the gold standard to balance my body, but I learn new things all the time. This time it seems to be that even a little bit more of those B vitamins is a better thing.

Bursitis

I have had hip bursitis since January 2001, and it hasn’t gone away. The general recommendations are to think about what caused it, and don’t do that any more. Hip bursitis can often be caused by a tight piriformis muscle. Tight muscles respond well to exercise (that doesn’t exacerbate it - listen to your body). I take 500 mg of glucosamine daily for osteoarthritis in my knees; if I stop taking it, my knees start to ache about a week later.

Three Things Women Should Know

I try to tell my girlfriends these.

• Prenatal vitamins can cure a weekly+ bout of sprue without the suffering of a diagnosis of IBS. I thought I was headed for IBS myself, but prenatal vitamins fixed that when a regular multivitamin didn't. This has worked for me and for two friends who are also professional women with stressful jobs. I note that prenatal vitamins are slightly higher in B vitamins, and I know research studies have shown that stress interferes with the absorption of some B vitamins. So my theory is that stress is blocking some vitamin B absorption (not sure which one or ones) causing the bouts of sprue, but prenatal multivitamins shore up your levels of B. (Yes, IBS is real, but for some women there could be a simple, effective solution. Note that a sample size of three women plus a heuristic argument does not make for good science. No harm in trying either!)
• Your menstrual cycle could be two days shorter without tampons. I heard this at a women's health seminar. I went to be moral support for a friend so she would go, and it wasn't the touchy-feely blather I was afraid of. The speaker cited research studies, although I haven't been able to find them. So I'll just say my sample size is one plus hearsay of research, but I don't miss those two days one bit.
• Talc, although it comes in powder form, is still a rock. Talc in the panties has been causally linked to increased infections. If you really want to powder, use a cornstarch one unless you have a yeast infection. Cornstarch is from corn, a food item. Yeast can eat it and thrive. So no powder is best, but the occasional puff of cornstarch baby powder is fine.

These are non-obvious tips that can make life better. Share!

Sidetracked

I was multi-tasking searching the web for two topics, looking for GFCF recipes and looking for possible causes of Karston's abdominal pain.

From the GFCF recipe search, I ran across mention of a low oxalate diet (LOD) helping severe pediatric abdominal pain! Interesting! So I went looking for LOD and quickly got to the specific carbohydrate diet (SCD) (with recipes). Those might be worth trying, but it's so hard to get Karston to eat anything that I shudder to think about trying to get him to eat from an approved list. On the other hand, maybe tracking his diet for oxalates and carbs while tracking how he feels ...

I found this doctor, and he's not that far away either. Hmm, a specialist ... wouldn't be the first one, but we haven't gotten anywhere yet either.

I suspect either intestinal allergies (sadly, there's no test for these T-cell-mediated allergies, so you just have to associate symptoms with diet) or colitis. Since Cale was diagnosed with colitis and it can run in the family, I think it needs to be considered for Karston. Unfortunately, it looks like differential diagnosis is a current research topic, explaining why it's tough to get medical traction.

So, flipping through Pediatric Gastroenterology, I read up on Colitis and Short Stature. We already tested for Celiac Disease although he hadn't had any wheat that week (should be able test for any wheat in past six weeks, though). I read Cholecystitis, which is interesting since we were worried about possible bilirubin earlier this month (but we think it was artificial color from lollipops). I read Colic, linked to milk protein allergy, and found the differential diagnosis of soy protein intolerance interesting. However, colic weight gain is typical, which doesn't cover Karston falling off the weight charts at 6 months. I read about Crohn Disease (often considered with colitis) and other Malabsorption Syndromes. Protein Intolerance was interesting: "cow's milk proteins are most frequently implicated as a cause of food intolerance during infancy," "only a few of these [intolerances] have a clear allergic immunoglobulin E (IgE)–mediated pathogenesis" and "in children, GI symptoms are generally most common, with a frequency ranging from 50-80%, followed by cutaneous symptoms (20-40%), and respiratory symptoms (4-25%)." Constitutional Growth Delay mentions falling off the growth charts at 3-6 months of age, then resuming growth on the right slope but below the curve. Where have I seen that??? Silver-Russell Syndrome usually starts with low birthweight, which didn't happen. Oh, and your word of the day is borborygmus: tummy rumbles!; can be caused by "incomplete digestion of carbohydrate-containing foods including milk, gluten, fruits, vegetables, beans, legumes, and high-fiber whole grains."