Author: Blessy Joseph

Everyday in the United States, 41 people lose their lives due to opioid prescription overdose.¹ National Pain Awareness Month is not only a time to bring awareness that chronic pain is real and that it can affect you emotionally, physically, and mentally, but that opioid abuse and misuse exists. Opioids are often prescribed after surgeries and trauma events like car accidents and to treat chronic pain, but they can have dangerous side effects. How can this be prevented? These effects can be avoided by using innovative, non-drug treatments that are safer!

What are opioids?²

Opioids are related to the opium poppy that comes from the opium plant that has pain relieving effects. Opioids act centrally at opioid receptors to affect your brain and spinal nerves by blocking pain signals from reaching your brain. They reduce the release of painful chemical signals, so pain is not felt. However, they come with risks of abuse, dependence, addiction, respiratory depression, confusion, restlessness, and euphoria or extreme pleasure. Opioids change how your brain functions, so they can lead to tolerance where you will need more of the drug to reach the same level of effect or dependence which is when you start to feel sick if you do not take them regularly. You do not know how opioids will affect your brain before you take them and not everyone on them becomes addicted. Addiction can even result from taking them as prescribed. 

Addiction or Opioid Use Disorder is associated with compulsive behaviors to continue getting and taking opioids. You continue to take them even when you know they hurt your relationships and damage your ability to perform your work, school, and home tasks. It is treatable through the use of recovery programs and medication-assisted treatments to reduce your cravings and withdrawal effects. Since opioids affect the part of the brain that is responsible for controlling your respirations, they can slow your breathing or cause death if a dose is too high. Since they can make you sleepy or sedated, they should not be combined with alcohol and other sedating medications like sleeping medications. Another limiting side effect of opioids is constipation, so if they are prescribed long-term, they are often taken with medications to stimulate your bowel movements. 

What is the opioid epidemic?^1-3

The opioid epidemic is a result of the increased opioid prescriptions that occurred during the 1990s when pharmaceutical companies reassured providers that they were not addictive. As they began to be misused, both prescription and non-prescription opioids, it was clear these drugs had dangerous effects like leading to addiction. Opioids are effective for treating pain, but they can result in misuse, overdose, and addiction if used for long periods of time or at high doses. 

According to the Centers for Disease Control and Prevention, about $78.5 billion is the “economic burden” of opioid misuse in the United States. The economic effects of opioid misuse include healthcare costs, loss of productivity, addiction treatment, and criminal justice involvement. It is estimated that over 650,000 opioid prescriptions are filled, but are not being used for medical purposes like moderate to severe pain relief. For people that are using opioids for long-term pain relief, about 1 out of 4 struggle with opioid addiction. Even during the COVID-19 pandemic, opioid-related overdoses and deaths continue to increase which could be related to mental health and financial issues. This really shows how big of a harmful impact opioids have!

How big of an issue is pain?^1-5

Over 30% of Americans live with chronic pain and it is the most common disability that affects daily activities and relationships in the United States. A 17-year study found that the prevalence of pain in adults of all ages is increasing in the United States. Joint pain cases have increased by 21%, neck pain cases have increased by 16%, and low back pain cases have increased by 15%. As pain continues to be an issue and opioid-related overdoses and addiction across the United States continue to rise, it is important that alternative and safe pain treatments are considered. 

What are other non-drug treatment options?^1,6

Continuous peripheral nerve block (cPNB) – cPNB utilizes a catheter to place at the target nerve that is causing pain, so it reduces the pain impulses that go to your brain for you to feel pain. It works by providing pain relief locally to the area by using non-opioid drugs that decrease the pain at that area. This treatment can be used during and after surgery to reduce the severity of post-surgical pain and the need for opioids. By reducing the need for opioids, this protects you from their addicting, dangerous, and unwanted side effects.

Peripheral Nerve Stimulation (PNS) – PNS is a unique way to provide pain relief because it occurs by using an electrical device. The small device is a wire that is implanted next to a peripheral nerve or a nerve that reaches beyond your brain and spinal cord. The device sends quick electrical pulses to your nerves to block pain signaling from reaching your brain. It is a quick and simple procedure that is likely painless due to the small size of the device. PNS is commonly used for diabetic peripheral neuropathy, and pain in the neck, back, and face. 

Deep Transcranial Magnetic Stimulation (TMS) – Deep TMS is a non-invasive procedure that involves using magnetic technology. Magnetic fields are created by a coil that is placed on your head to stimulate your brain to block pain signals from reaching your brain. As a result, your brain will not begin the process for you to feel the pain you are having. It only requires a few 20 minute sessions each week over six weeks to reach its full effects. Deep TMS has also been used for treating depression and obsessive compulsive disorder.

Pulsed Electromagnetic Field (PEMF) Therapy – PEMF therapy works by using electric and magnetic energy to stimulate your body to increase its pain relief mechanisms while decreasing the pain and swelling mechanisms. It flushes out toxic cells that cause inflammation while increasing the delivery of nutrients to your tissues. It is commonly used for neuropathic pain that is created within nerves, not from an injury like stomping your toe. This therapy is also non-invasive and can even be used at home.

Cryotherapy – Cryotherapy or cold therapy is typically used for treating warts and some cancers, but it has been shown to reduce pain for osteoarthritis and rheumatoid arthritis. Cryotherapy stimulates your body’s response to extremely cold temperatures which increases cell survival and strengthens your immune system. This results in decreased inflammation and swelling that can cause pain. The cold therapy is delivered to your peripheral nerves through a small, handheld device which reduces nerve activity of transmitting painful signals. It also reduces the use of opioids after surgery while increasing your body’s ability to reduce inflammation and promote healing. 

Botox – You may think of this as only for a cosmetic procedure or for treating migraines, but it can be used for pain too. Botox is a weak form of botulinum toxin type A that is produced from bacteria to block muscle contraction. For pain, it blocks the release of chemical signals and messengers that stimulate your brain to respond to pain. Research is still on-going with this therapy, but it has been shown to be useful in providing temporary pain relief for nerve and back pain.

If you currently take opioids, talk with your provider or pharmacist if you have questions or concerns about their effects. If you or someone close to you needs help for a substance use disorder, talk to your doctor or call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services Locator.

References:

1. Pain awareness month: Innovations in Pain. A4M blog website. https://blog.a4m.com/pain-awareness-month-innovations-in-pain-management-and-care/. Accessed September 27, 2021.
2. Opioids. Centers for Disease Control and Prevention website. https://www.cdc.gov/opioids/patients/materials.html. Accessed September 27, 2021.
3. Opioid overdose crisis. NIH website. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis. Accessed September 27, 2021.
4. 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
5. Americans in pain. McShane Welding website. https://www.mcshanemetalproducts.com/blog/americans-in-pain. Accessed September 27, 2021.
6. Botox for pain relief. Regional Neurological website. https://www.regionalneurological.com/botox-for-pain-relief-how-it-works/. Accessed September 27, 2021.

It may seem odd that September is National Pain Awareness Month since you know when you are in pain. This is a time to bring awareness to not ignore your pain, accept it as a valid problem, and seek treatment to maximize your quality-of-life. Pain is the most common cause of disability in the United States, that is more than cancer and heart disease combined!¹ Over 100 million people in the United States experience chronic pain or pain that does not completely go away and can result from other chronic diseases like diabetes and arthritis.¹ Chronic pain not only affects you physically and can limit your activities, but it affects you emotionally, behaviorally, and mentally. The pain is real and not an attempt to get powerful medications like opioids. Let’s bring the stigma associated with chronic pain!

What is pain?^2-4

When you stomp your toe or pull a muscle, your pain receptors in that area send a message to your central nervous system. This message acts as a signal to warn your body of danger. The central nervous system includes the brain and spinal cord. The message is delivered to your spinal cord through many nerves until it reaches your brain. Your brain interprets the signal and sends a message to that area to make you feel pain. This pathway typically ends when the pain is resolved such as when your wound has healed. With chronic pain, your nerves continue to fire to make you feel pain even when the injury is not present.

Acute pain is sudden and results from an illness or injury like cutting your finger or a mild headache. It typically lasts no more than a few weeks and the pain resolves with healing. Sub-acute pain lasts between six weeks and three months. 

Chronic pain is persistent and recurring pain that lasts over three months. It can result from an illness like cancer or injury with the pain still being felt in “on” and “off” episodes or continuous long after it. Other examples or conditions that can cause pain include migraines, headaches, nerve damage, arthritis, shingles, osteoporosis, peripheral vascular disease or poor blood flow, and back pain. Back pain is one of the most common health problems that greatly affects everyday functioning. It can also be caused without an illness or injury in the form of its own syndrome. It affects 28% of people between the ages of 46 to 64 years old, and over 65% of those over 65 years old and older. Unlike the other types of pain, chronic pain affects you from your daily activities to your social life. Pain is real and there is a need to bring awareness to its effects on the mind and body!

How does chronic pain affect me?^2,5

Chronic pain can make you feel frustrated, depressed, anxious, and stop you from completing your daily activities or things you enjoy like traveling. It is a continuous cycle of pain and uneasy feelings, so it can do more harm than just physical pain. When you feel pain, you may feel depressed or anxious that you are not able to complete your activities as easily. Performing these activities can even make your pain worse. You may feel stressed as you focus on your problem and have trouble sleeping which increase your pain. As you limit your activities, you may feel more depressed and anxious that you can not perform as well or do what you want to do. The pain continues which starts the cycle all over again.

What are the treatment options?^1,2,4-6

Acute pain is normally treated with rest, time, and over-the-counter pain medications while chronic pain requires an approach to treat the body, mind, and spirit. Acute pain is resolved upon healing while the pain never completely goes away with chronic pain. Therapies for chronic pain aim to improve you mentally, socially, emotionally, and physically, just minimizing the pain you feel for you to carry out your daily activities. The treatments include self-care, mental health, and pharmacological treatments. The encouraged treatment for chronic pain is self-care which include the following: 

Activity and stretching – Participating in workout classes, strength building, physical therapy, or even simply walking helps strengthen your muscles and lowers your pain. If you experience pain during your activities, the activities may be too intense. Just stop before it gets worse and build your way to doing more advanced activities.

Ice/heat – Ice and heat help relieve stiffness and pain, especially with arthritis and other joint conditions. Alternate sessions with ice or heat by applying for 20 minutes, then 20 minutes off a few times a day. 

Mindfulness and relaxation – Taking time for yourself to practice mindful meditation requires slowing your thoughts, taking deep breaths, and destroying your negative thoughts. This calms your body and mind down, so you can relax. Yoga is another technique that is used to reduce your stress levels which eases your pain.

Sleep – A lack of sleep affects your mood, relationships, and ability to function. Creating a sleep routine to get a good night’s rest, about seven hours a night consistently can help reduce your stress and pain. This will also make you feel more empowered to tackle your day!

Nutrition – A nutritious diet full of whole grains, fruits, vegetables, and lean meats while limiting your intake of processed/sugary foods, white bread, red meat, and salt gives your body more nutrients that can fight off inflammation and help your pain flares. Some key vitamins include iron, folic acid, and vitamins A, B6, C, and E. These are commonly found in nuts, leafy greens like spinach, berries, and whole grains.

Smoking cessation – Research has shown that smoking increases your risk of back pain and can increase the intensity of neck pain. Those that are smokers have reported that their pain is more intense than those that have never smoked.

Weight management – If you are overweight or obese, gradually losing about 5 to 10% of your weight can lower the amount of pain you are feeling. This is especially true if you have knee or hip pain since more weight adds pressure to the joints and stimulates pain.

Engaging in meaningful activities – Do not let chronic pain stop you – performing activities you enjoy increases your body’s natural painkillers while boosting your overall mood!

Family/friends support – Not only having the support of your family is helpful, but also sharing your experiences and learning from others in group or rehab programs. It may provide you comfort knowing that other people understand your experiences, fears, and discussing your worries. 

If these are not enough for pain relief, pharmacological treatments can be started or along with self-care measures. Pharmacological treatments include over-the-counter and prescription medications depending on the type of pain. Opioids are not a first-line treatment. Transcutaneous electrical nerve stimulation (TENS) is an alternative option that involves sending tiny electrical impulses to the painful area, so less pain signals are sent to your brain to make you feel pain. Regardless of the approach, self-care measures should be started to enhance your quality of life and limit the need for medications.

The Dangers of Alcohol For Pain Relief⁷

From the damaging effects of chronic pain on the mind, body, and relationships, about 28% of people use alcohol as a way to ease their pain. Mixing alcohol with pain medications can increase your risk of liver toxicity, gastrointestinal bleeding, or sedation. Alcohol does not treat the pain. Alcohol only depresses you from feeling the pain temporarily while it actually makes the condition worse. The Dietary Guidelines (2020-2025) recommend that females drink no more than one drink and males drink no more than two drinks daily, regardless of health conditions. Depressing your mind to interpret the pain requires a greater intake, so over time, your body becomes tolerant and requires more to lessen the pain. This increases your risk of developing dependence and experiencing withdrawal when you do not drink. If you misuse alcohol, this can cause peripheral neuropathy. Peripheral neuropathy is a painful neurological condition that causes chronic pain, tingling in the limbs, and disability. 

If you are experiencing pain and it does not get better, contact your physician or pharmacist today. 

References:

1. 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
2. About chronic pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_2. Accessed September 19, 2021.
3. Chronic pain. NHS inform website. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain. Accessed September 19, 2021.
4. September is national pain awareness month. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_1. Accessed September 19, 2021.
5. Chronic pain conditions. Metropolitan institute of pain website. https://mipainchicago.com/chronic-pain-conditions/. Accessed September 19, 2021.
6. Can diet heal chronic pain? Harvard website. https://www.health.harvard.edu/pain/can-diet-heal-chronic-pain. Accessed September 19, 2021.
7. Dangers of using alcohol to dull the pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_5. Accessed September 19, 2021.

Did you know 100 calories of broccoli has more protein, vitamins, minerals, and less fat than 100 calories of steak? But which protein source is better – animal or plant? Does it matter? Does animal protein increase the risk of cardiovascular disease? Is plant protein a poor source? There is conflicting research and information on this topic, but like how your body uses protein, we break down all the nutritious facts here!

What is protein?^1,2

Protein is a macronutrient that is involved in many of your body’s functional processes such as muscle and tissue repair, enzymatic reactions, hormone production, and transport of molecules like oxygen. Over 20% of your body is made of protein. Protein is made up of amino acids, but they are not stored in the body. Instead, amino acids are either made by your body or obtained from your food. The following nine amino acids are only obtained from your food: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

Protein is a component of the three macronutrients, along with carbohydrates and fat, that are essential in a healthy diet. Although the optimal diet type differs for everyone, diets should include a variety of whole foods like vegetables, fruits, whole grains, dairy, beans, seafood, lean meat, and nuts/seeds with minimally-processed foods like hot dogs, bacon, and ice cream. This method is called the Healthy Eating Plate. For more information on incorporating nutritious foods into your diet, servings, and meal examples, click here.

How much protein do I need?²

Without enough protein, your body becomes weaker and you lose muscle mass. This makes it harder to carry out normal functions like growth and breathing. Too much protein becomes stored as fat which can make you gain weight. According to the National Academy of Medicine, for every 20 lbs of body weight, you need 7 grams of protein. If you are more physically active, you may require higher amounts of protein. Protein is found in a variety of foods, but not all sources are equal. 

How are animal and plant protein sources different?^1,3,4

Animal protein sources are known as complete while plant sources are incomplete. This means that animal sources have the nine essential amino acids we mentioned earlier, unlike the plant sources. The chart below displays examples of each type, along with some of their key points to remember when selecting a protein. Most sources of protein are from animals, but be careful because some animal sources may be packaged with higher amounts of saturated fat, cholesterol, calories, and poor fiber. Plant sources have many other nutrients like plenty of fiber, antioxidants, vitamins, and minerals! 

Risk vs. Benefit^1-3,5

You may have heard that plant protein sources are higher in nutrients and can lower your risk of diseases while animal protein sources may increase your risk of diseases. Yet, this is not exactly true. Plant sources include more fiber, minerals, antioxidants, and vitamins. Animal sources can include more zinc, vitamin D, vitamin B12, heme-iron, and docosahexaenoic acid (DHA) which is important for brain health. They also add some protection against diseases, but it is all about the specific food. Foods contain other components like fat, calories, and cholesterol. Like getting the right amount of protein, it is important you are getting it from a nutritious source.

When considering the risk of certain diseases like diabetes and cancer, the section below indicates how your risk is affected by your selected protein sources.

• Diabetes – Research has shown that a diet higher in red-meat increases your risk of type 2 diabetes while your risk can be lowered by eating more nuts and legumes. One study found that those who ate more red-meat had a higher risk of type 2 diabetes than those that rarely ate red or processed meat. The risk increased about 20% for each additional daily serving of red or processed meat. However, the risk lowered by 10% if a serving of nuts, whole grains, or low-fat dairy was consumed instead. Those that consume more plant protein sources tend to be less overweight which is another risk factor for type 2 diabetes.
• Cardiovascular disease – In the 20 year-long Nurses’ Health Study and Health Professionals Follow-Up Study, the risk of dying from cardiovascular disease such as heart disease, stroke, or heart attack increased by 13% for each additional daily 3 oz serving of red-meat the participants consumed. With each additional 1.5 oz serving of processed meat, the risk increased to 20%. However, this study did find that eating poultry, fish, and low-fat dairy was associated with a lower risk of cardiovascular disease. These results were mirrored by a meta-analysis with data from over 38 trials and 1,803 participants. Higher blood pressure, and levels of cholesterol, low density lipoprotein (LDL) or ‘bad’ cholesterol, and triglycerides were higher in those that consumed larger diets of red-meat than chicken, fish, or plant proteins.
• Cancer – Plant protein sources like vegetables and seeds contain phytochemicals which are chemicals that may protect you against cancer. A study conducted by the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) stated that processed meat is ‘carcinogenic to humans’ based on data from over 800 studies. These studies mainly showed an increased risk of colorectal cancer, but there were also associations with prostate, pancreatic, and stomach cancers. Even how the meat is cooked can affect the risk of cancer since grilling at high temperatures can release cancer-causing compounds.
• Premature death – From the Nurses’ Health Study and Health Professionals Follow-Up Study, the researchers found that a greater intake of red or processed meat like deli meats, sausage, and bacon was associated with a higher risk of death than plant protein sources. Eating processed or red-meat increased the risk of death by 13% to 20% in a study with data from over 21 countries.
• Weight control – After performing a 20 year-long study with 120,000 participants, the Harvard Chan School of Public Health found that those who ate more nuts lost about half a pound more weight every four years than those who ate more red and processed meats. Those that ate more red and processed meats gained an extra pound every four years. This study also found that eating more yogurt, chicken without skin, low-fat cheese, and peanut butter was associated with less weight gain than chicken with skin, regular cheese, and red-meat. Another study reported that by eating a daily serving of legumes, peas, or beans, this can increase fullness which may help with weight loss. Even eating eggs for breakfast has been shown to make you feel fuller.

What about vegans and vegetarians?^1,3

If you are vegan or vegetarian, it’s possible to have a nutritious diet with all of your protein from plants. However, be sure you are consuming enough protein by calculating your protein intake with the formula discussed earlier. It is unclear if a higher protein intake is needed due to the lower digestibility of plant proteins, but it can be improved by boiling, fementing, or soaking them. Research also shows that combining incomplete protein sources to equal a complete protein is not necessary. As long as you consume enough variety of plant protein throughout the day, you do not need to combine incomplete sources at your meal.

Plant sources of protein can be poor in zinc, vitamin D, vitamin B12, heme-iron, DHA, and calcium. Try to eat dairy, leafy greens and drink plant milk to increase your vitamin D and calcium intake. To increase your zinc, eat more whole grains and beans in your diet. Lentils, spinach, and tofu are great sources of heme-iron. To increase your DHA, this can be done through eating algae or dietary supplements.

Do animal proteins really affect the environment?¹

Greenhouse gases are those that are able to trap heat and radiation from Earth’s surface, creating a ‘greenhouse effect.’ About 17% of those gases come from nitrous oxide of fertilizers and irrigations, cutting down large areas of trees to make room for livestock, and methane from the manure of cattle, sheep, goats, and deer. As these effects increase, this contributes to climate change and destruction of ecosystems. It may seem like there is not much you can do to help this issue, but just by opting to eat less animal protein or eat more fish and chicken can make a difference!

Key Takeaways

Incorporating a variety of animal and plant protein sources are key for a nutritious diet. If you are vegan or vegetarian, be sure you eat a variety of plant protein sources to maximize your health. If you consume mostly animal, red-meat, or processed protein sources, try replacing some of those foods with plant proteins like beans, spinach, or nuts to lower your chance of diseases. You could even simply start with ‘Meatless Mondays!’ Before you make big changes to your diet or your protein intake, contact your health care provider or pharmacist today to ensure you are meeting your dietary needs.

References:

1. Best protein sources: Comparing animal and plant-based protein. Fullscript website. https://fullscript.com/blog/best-protein-sources. Accessed September 1, 2021.
2. Protein. Harvard University website. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/. Accessed September 1, 2021.
3. Animal vs plant protein – What’s the difference? Healthline website. https://www.healthline.com/nutrition/animal-vs-plant-protein. Accessed September 1, 2021.
4. Nutrition – Plant vs animal protein. Dr. Hillel Harris website. https://drhillelharris.com/nutrition-plant-vs-animal-protein/. Accessed September 1, 2021.
5. The difference between animal protein and plant protein. WebMD website. https://www.webmd.com/diet/difference-between-animal-protein-plant-protein#1. Accessed September 1, 2021.

What’s the body’s largest organ that offers protection and is your first defense against harm? If you said your skin, you’re correct! The skin is made up of about a trillion cells and gets its strength from a protein called collagen.¹ It is important that it is well taken care of. You may be familiar with collagen’s ability to slow down the process of aging skin or reduce wrinkles. Maybe you have lotions or shampoo with collagen. But what exactly is collagen and what does it do? This article gives you a quick overview of collagen and its benefits.

What is collagen?^1-4

Collagen, a protein highly produced by the skin, makes up a third of the protein in your body and is responsible for the skin’s flexibility and strength. Collagen is also found in your bones, muscles, tendons, teeth, and blood. Think of it like this, collagen is like a glue. It is strong and provides structure and support to your body’s tissues. 

The skin is made up of the outer epidermis, dermis, and inner hypodermis or the fat layer. Collagen is found on the outer layer of your cells and is greatly involved in the skin’s process of protecting, healing, and regenerating itself within the dermis. You may already know that your skin goes through a cycle to get rid of its old cells and make new ones, but did you know it happens every 27 days? To undergo this process effectively, it is important that collagen and its amino acids or building blocks are available.

Like glue, collagen comes in several types. Type I includes over 90% of your collagen. It is made of densely packed fibers to strengthen your skin, bones, teeth, and connective tissue. Type II is made of loosely packed fibers to provide support to your joints. Type III is found in your muscles, organs, and arteries while Type IV is located in the layers of your skin.

As you age, your body reduces its production of collagen and your skin may start to become more fragile and less firm. This can lead to wrinkles, sagging skin, and aching joints. Without enough collagen in your joints and muscles, your joints may be less flexible and your muscles may weaken. Even your hair can become thinner and start to go slower. That is why it is important that you are getting enough collagen in your life. The benefits of collagen extend well beyond protecting your skin!

What are the benefits?^1,2,5,6

1. Skin elasticity and hydration – As you enter your mid-20s, you begin to lose some of your collagen. For women in the first few years of menopause, they can lose over 30% of their collagen. This explains why collagen is often marketed as an anti-aging supplement. A recent meta-analysis with data from 19 studies and 1,100 patients determined that collagen supplements improved the skin’s hydration and elasticity. There was also improvement in their wrinkles after taking the supplements for four weeks and even four weeks afterwards.
2. Osteoarthritis – Since collagen makes up your joints and bones to provide support and function, collagen can be used to improve joint function and reduce pain. This was shown in a study with 81 patients that took collagen tablets for two months.
3. Strong bones – It is no surprise that as we age, our bones become more brittle that can lead to a higher fracture risk. Research has shown that by taking collagen supplements, this makes your bones more dense and stronger. 
4. Increase muscle mass – Are you trying to gain muscle? A study with physically active men found that taking collagen supplements with a strength training regime increased muscle mass more than men that did not take collagen. 
5. Healthier nails and hair – You may notice your nails are more brittle than your friend’s or that your hair is thinning. This may mean your body needs more collagen. One study found that collagen improved nail growth and strength, and hair thickness and growth by taking supplements for just a month.

What damages collagen?^2,3

• Sunlight – Excess ultraviolet radiation from the sun can damage collagen and cause it to break down faster. This causes collagen production to decrease, so the skin incorrectly rebuilds itself, causing wrinkles. Be sure to wear sunscreen and proper clothing when going outdoors to reduce your risk of skin damage.
• Smoking – Harmful chemicals in tobacco products like nicotine destroy your body’s collagen which can also lead to wrinkles. Nicotine causes your blood vessels to constrict, so less oxygen and nutrients is delivered to your skin. This affects your skin’s flexibility and protection from harm.
• High sugar and refined carbohydrate consumption – A diet high in sugar and refined carbohydrates can come from sodas, potatoes, and cookies can affect your body’s ability to use collagen. When too much sugar is consumed, the sugar begins to stick to your proteins to make advanced glycation end products (AGEs). The sugar affects the function of proteins like collagen, so they become weaker. One way to minimize the production of AGEs is by consuming less foods high in sugar, refined carbs, and processed foods like sugary cereals, white rice, white bread, and sweet manufactured treats. AGEs have been linked to increasing your risk of cardiovascular disease and type 2 diabetes.
• Autoimmune disorders – Lupus is a common inflammatory disorder where the body mistakenly attacks its own tissues and organs like the skin and joints. This damages your layer of collagen that can lead to fatigue, joint pain, and rashes. Rheumatoid arthritis typically causes inflammation in the joints of the hands and feet because of the body thinking your own cells are harmful. There can be painful swelling and joint stiffness since the protective collagen layer has been destroyed.

How do I increase my intake of collagen?^1-3

One of the easiest ways is to consume foods with collagen, its amino acids, or other precursors. You may already be obtaining collagen in your diet! Bone broth is a great source of collagen because it makes up most of the tissues of animals like chicken. Plus it has the extra benefit of hydrating your skin because it is water-based. Other high impact sources can be obtained from foods that directly increase the amount of collagen made by the body including: 

• Vitamin C – found in strawberries, kiwis, oranges, bell peppers, and broccoli
• Vitamin A – found in mangos, apricots, carrots, spinach, and sweet potatoes
  • Sources of vitamins, while fun in color, also have the extra benefit of reducing inflammation and harmful chemicals from your body’s regular processes!
• Proline – found in egg whites, meat, dairy, and cabbage
• Glycine –  found in chicken, turkey, seafood, peanuts, spinach, and asparagus
• Leucine – found in eggs, dairy, chicken, pork, pumpkin seeds, oats, and beans
• Zinc – found in beans, pork, beef, nuts, and seafood
• Copper – found in nuts, red meat, seafood, cocoa powder, and dark leafy greens

What kind of supplements are available?²

If you are not consuming enough collagen in your diet, then this easy option is for you! Collagen is available in capsule, powder, liquid, and topical forms. The most popular way it is consumed is by the powder form. Many of the powders are tasteless, so they can be simply added to foods and drinks like smoothies, coffee, tea, soups, oatmeal, and cookies. However, caution should be used with the topical creams because they may not work as well. Since collagen is a large protein, it is unlikely its benefits other than being a moisturizer are able to get absorbed through the tiny barriers of the skin. 

Some supplements may be called ‘collagen peptides’ or ‘hydrolyzed collagen.’ This just means that they are smaller strands of amino acids that make it easier for your body to absorb them and use for its strengthening and support benefits. These collagen supplements mainly come from animal skin and bones, so if you are vegan or vegetarian, they may not be suitable for you.

Since supplements like collagen are not Food and Drug Administration (FDA) approved, there are few ways you can make sure you pick a safe collagen. When selecting a collagen, make sure it has the NSF or United States Pharmacopeia (USP) seal on the product. This means the company has done its job to make sure the product is of high quality and safe for your use.

If you have any questions about collagen supplementation or wonder if it is right for you, contact your healthcare provider or pharmacist today.

References:

1. Greer J. Collagen for your skin. Thorne website. https://www.thorne.com/take-5-daily/article/collagen-for-your-skin?utm_source=Akreto&utm_medium=email&utm_campaign=Take%205%20Daily&utm_content=T5D%20Consumer%20-%20Aug%2018%202021&tid=611d542fd270895f839e8c6f. Accessed August 29, 2021. 
2. Collagen – What is it and what is it good for? https://www.healthline.com/nutrition/collagen#nutrients-that-increase-collagen. Accessed August 29, 2021. 
3. Collagen: What is it and what are its uses? Medical news today website. https://www.medicalnewstoday.com/articles/262881#roles. Accessed August 29, 2021.
4. Can collagen supplements really reduce signs of aging? Health matters website. https://healthmatters.nyp.org/can-collagen-supplements-really-reduce-signs-of-aging/. Accessed August 29, 2021.
5. Health benefits of collagen: Pros and cons, nutrition, and more. Webmd website. https://www.webmd.com/diet/collagen-health-benefits#1. Accessed August 29, 2021.
6. Collagen. Versus arthritis website. https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/collagen/. Accessed August 29, 2021.

The thyroid gland is the primary regulator of cholesterol, blood sugar, temperature, reproductive health, growth, and weight. Hypothyroidism or underactive thyroid affects over 30 million females and 15 million males in the United States.¹ No wonder this highly affects the population since it is common to have lifestyles with high stress, poor sleep, minimal exercise, and diets high in processed foods.² The most common type of hypothyroidism is Hashimoto’s thyroiditis. Hashimoto’s thyroiditis is an autoimmune condition where your body wrongly attacks your thyroid cells, resulting in cell death and improper thyroid hormone regulation.³ Lifelong pharmaceutical treatments are available to boost your thyroid, but can it be healed naturally through diet or lifestyle changes? The good news is that by identifying the culprit, you can incorporate the needed foods, vitamins, and wellness approaches into your lifestyle to support your thyroid naturally via functional medicine! 

The Functional Medicine Approach

Are you a fan of optimizing your lifestyle to promote your health? If so, a functional medicine approach is right for you in treating your thyroid! Once you determine your cause of hypothyroidism, take the necessary steps to modify your diet and lifestyle. This will increase your metabolism and overall thyroid wellbeing. This approach is different from conventional pharmacological therapy because it considers your disease-causing, lifestyle, and diet factors. The diagram below displays the main differences between the two approaches for hypothyroidism.⁴

Foods

Did you know that nutrient-dense foods can boost your thyroid’s health while processed, inflammatory foods promote harmful effects? Listed below are a few diet changes you can make to benefit your thyroid.

1. Remove gluten – Foods with gluten like bread, cookies, and crackers may be contributing to your thyroid issue if you have a gluten sensitivity.⁵ A gluten sensitivity blood test can be performed by your doctor to see if an inflammatory reaction occurs when you consume those foods, resulting in weight gain, fatigue, and headaches. You could also remove the foods with gluten for three weeks to see if any symptoms go away.⁵ If they do, this could indicate a diet lacking gluten may be right for you.
2. Increase anti-inflammatory and nutrient-dense food intake – Anti-inflammatory foods like leafy green vegetables, fruits, and healthy monounsaturated and polyunsaturated fats are beneficial for lowering your risk of heart disease and decreasing inflammatory reactions.⁶ Furthermore, these foods include vitamins that help make your thyroid hormones active to carry out metabolism. Healthy fats can be found in avocados, olive oil, cheeses, eggs, nuts, seeds, and peanut butter.⁶ Foods with refined sugar, refined vegetable oil, cow’s milk, and unhealthy trans and saturated fats should be avoided in your diet because they promote inflammatory processes.² These unhealthy fats are found in many processed foods, fried foods, red meats, ice cream, whole milk, and butter.

Vitamins

If you find it difficult to consume foods with crucial vitamins for thyroid functioning or your vitamin levels are still low, you may consider adding nutritional supplements to your diet. However, it is best to start with increasing your intake of nutritious foods to limit excess supplementation side effects. 

1. Iodine – You may recall that too much iodine damages your thyroid, but too little iodine inhibits the hormonal conversion of inactive thyroxine (T4) to active triiodothyronine (T3).⁷ Without T3, your thyroid is unable to regulate your temperature, weight, growth, and energy. Iodine is highly found in seaweed, shellfish, and eggs. It can be dangerous to increase your iodine intake, so be sure your iodine blood levels are monitored by your doctor.
2. Selenium – Selenium is vital to kick-starting the conversion of T4 to T3 and decreasing inflammation. The best options for selenium-dense foods include salmon, turkey, grass-fed beef, shrimp, and Brazil nuts. Yet, too much selenium is damaging because it causes upset stomach, fatigue, and nerve damage.⁷

3. Magnesium – Magnesium is needed to increase your T3 levels. If you experience constipation which is a common symptom of hypothyroidism, asthma, or muscle pain, you may have poor magnesium intake.⁷ The following foods are high in magnesium: nuts, dark chocolate, avocados, and spinach.
4. Omega-3 fatty acids – Like iodine and magnesium, omega-3 fatty acids are needed for active thyroid hormone production. Omega-3 fatty acids are polyunsaturated fats that decrease inflammation and relieve fatigue.⁶ Key foods include flax seeds; walnuts; and fish like salmon, sardines, and trout. Remember, you want to avoid fish that are high in mercury content because it can damage your thyroid’s ability to function.⁶
5. Vitamin A – Without enough Vitamin A, T3 is unable to be produced. The best foods for increasing this vitamin include liver, carrots, sweet potatoes, and kale. Keep in mind that too much Vitamin A can lead to stomach problems.⁷
6. Vitamin D – Low Vitamin D levels are associated with Hashimoto’s thyroiditis.^6,7 Vitamin D helps make T3, reduces inflammation, and relieves muscle pain. Even spending more time in natural sunlight can increase your levels. If your schedule does not allow for more outdoor time, you could increase your intake of dairy products, mushrooms, eggs, and salmon.

Wellness Approaches

Like treating many health conditions, lifestyle modifications play a role in stimulating your health and reducing risk of further complications. 

1. Stress relief – In today’s fast-paced world, you may find it hard to limit stressful situations or find stress relief. Increasing cortisol or the body’s stress hormone suppresses your thyroid hormones and promotes inflammation. You are at a higher risk of infection if you have chronic stress, so managing your stress and following-up with your doctor are beneficial.⁵ However, there are a few ways you can learn to manage your reaction to stress like joining a stress management program or finding things to do that make you calm. Some activities that can lower your stress include walking, working-out, drawing, journaling, and baking. The options are limitless, so find what works for you!

2. Activity – By participating in activities that stimulate movement like walking, running, playing with your pets, or participating in sports, this encourages your thyroid to function properly and makes it easier for your hormones to work.⁵ The activity does not have to be performed all at once or be a strenuous activity. If you are not used to exercising, try walking 10 minutes a day for three days a week. Gradually increase your time each week to work towards a goal of 150 minutes a week.²

3. Adequate sleep – By establishing a sleeping routine to get quality sleep, this can help your overall health and thyroid functioning. According to the Centers for Disease Controls and Prevention (CDC), adults should get at least seven hours of sleep per night.⁸ If you are having trouble falling or staying asleep, you may find it helpful to meditate, read, or drink a cup of hot tea to relax your mind for a good night’s sleep.

4. Minimize toxin exposure – Excess exposure to toxins not only increases inflammation and your risk of health conditions, but it harms the thyroid. Limiting your exposure to radiation, contrast dyes, and pesticides can keep your thyroid hormones intact.⁵ Mercury, a common metal found in saltwater sea creatures, is highly toxic and affects your body’s regulation and development processes.² Therefore, you may need to reduce your intake of high mercury-containing foods like king mackerel and bigeye tuna.⁶ Other changes include avoiding tobacco products, eating organic foods, and using natural cleaners. One way that both reduces stress and toxins is using a sauna because it removes toxins from your fat cells while you relax.⁵

Insteading of solely treating you based on your hormone levels, signs, and symptoms, a functional medicine approach considers your physical, social, environmental, and nutritional needs. Assessing you fully helps to identify the primary cause of your thyroid disorder that may be a mystery if only conventional treatments are used. For more information on the functional medicine approach to hypothyroidism, talk with your doctor or functional medicine specialist. 

References: 

1. Hyman M. A 7-step plan to boost your low thyroid and metabolism. Dr. Hyman website. https://drhyman.com/blog/2010/05/20/a-7-step-plan-to-boost-your-low-thyroid-and-metabolis/#close. Accessed August 3, 2021.
2. Klimenko E. Functional medicine approach to autoimmune thyroid disease. Dr. Klimenko website. https://www.drelenaklimenko.com/autoimmune-thyroid-disease/. Accessed August 3, 2021.
3. Hypothyroidism (underactive thyroid). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed August 3, 2021.
4. Los angeles functional medicine doctors of holistic and integrative medicine. Southern california center for anti-aging website. https://socalbhrt.com/functional-medicine-doctor-los-angeles/. Accessed August 3, 2021.
5. Hyman M. 6-Steps to heal your thyroid. Dr. Hyman website. https://drhyman.com/blog/2015/06/10/a-comprehensive-6-step-strategy-to-heal-your-thyroid/. Accessed August 3, 2021.
6. Hyman M. The functional medicine approach to hypothyroidism and hashimoto’s disease. The doctor’s farmacy. 2021. https://drhyman.com/blog/2021/03/11/podcast-hc47/. Accessed August 2, 2021.
7. Drecher L. Supporting the thyroid: Food as medicine. https://www.ultrawellnesscenter.com/2018/03/15/supporting-thyroid-food-medicine/. Ultrawellness center website. Accessed August 3, 2021.
8. Are you getting enough sleep? CDC website. https://www.cdc.gov/sleep/features/getting-enough-sleep.html. Accessed August 3, 2021.

Autoimmune diseases affect over 24 million Americans, with thyroid disease responsible for about 20 million cases.¹ Autoimmune thyroid diseases can be underdiagnosed and many people may not know that they are affected. Do not let that scare you!¹ Look no further to learn about autoimmune thyroid diseases, risk factors, and the importance of early diagnoses.

What are autoimmune thyroid diseases?^1-3

Our immune systems are largely responsible for protecting us from infection, toxins, and other foreign substances. Autoimmune diseases like rheumatoid arthritis and lupus occur when the immune system begins to attack your body because it thinks your own cells are intruders and do not belong. The auto-antibodies produced cause inflammation and damage your body’s tissues, organs, and hormone production. When this occurs at the level of the thyroid, a butterfly-shaped gland at your neck, it can cause several effects to increase or decrease thyroid hormones. The thyroid’s job is to regulate your mood, metabolism, temperature, heart rate, breathing, and growth. The two chief autoimmune thyroid diseases include Hashimoto’s thyroiditis and Graves’ disease. Medical professionals and scientists are unsure why exactly these conditions occur, but they believe a dysfunctional immune system is a key cause. 

Hashimoto’s thyroiditis causes hypothyroidism or a decrease in thyroid hormone production. With Hashimoto’s thyroiditis, your body thinks your thyroid cells are foreign invaders. The immune system sends thyroid peroxidase antibodies (TPOAb) to attack your thyroid with the goal of weakening and killing the ‘foreign invaders.’ If you develop Hashimoto’s thyroiditis, you may experience the following signs and symptoms: enlarged thyroid or goiter, weight gain, muscle pain, depression, hair loss, brittle nails, constipation, swollen face, and cold sensitivity. 

Graves’ disease results in hyperthyroidism or an increase in thyroid hormone production. In Graves’ disease, the body spontaneously attacks itself and produces an antibody known as thyrotropin receptor antibody (TRAb) that stimulates thyroid hormone production. This results in an excess of thyroid hormones and inflammation of the thyroid. Common signs and symptoms include insomnia, anxiety, weight loss, goiter, irregular menstrual cycle, rapid heartbeat, frequent bowel movements, bulging eyes, fatigue, and heat sensitivity or increased sweating. 

It is important to note that these symptoms develop slowly over time, so talk with your doctor or pharmacist if you experience them. Your doctor may decide to run thyroid hormone and antibody blood tests, and inspect your thyroid to determine if you have an autoimmune thyroid disease.

Risk Factors for Autoimmune Thyroid Diseases^2-8

1. Autoimmune disease – If you have a current autoimmune disease like Type 1 diabetes, this increases your risk of having an autoimmune thyroid disease. This is the primary risk factor because if your immune system is already not functioning properly, then it may cause other organs and glands to malfunction. Therefore, it is important that you regularly visit your doctor to check your thyroid gland functioning and know the symptoms. 

2. Sex – Females are more likely to develop autoimmune thyroid diseases than males as it occurs in one out of eight females. They are more likely to develop after pregnancy or menopause due to hormonal imbalances like with estrogen, the main female sex hormone. A thyroid disorder can cause irregular periods or menopause symptoms like hot flashes and mood swings, so contact your doctor or pharmacist if you experience these symptoms. Yet, males with low testosterone levels, the main male sex hormone, have a higher risk of autoimmune thyroid diseases too.

3. Age – Although Hashimoto’s thyroiditis and Graves’ disease can occur at any age, they are most commonly developed between the early 40s and 60s. This is because the body undergoes many changes as we continue to age which can affect our hormone levels and regulation processes. Sadly, these conditions may be harder to diagnose as we age because of a lack or overlap of symptoms between the conditions. 

4. Chronic stress – As the amount of chronic stress you are under over a long period of time increases, you have a higher chance of developing a thyroid disorder. Examples of chronic stress include job loss, death of a loved one, marriage, depression, anxiety, and financial instability. The increase in cortisol or the body’s stress hormone inhibits the production of thyroid hormones which can lead to Hashimoto’s thyroiditis. Even infections can affect your thyroid functioning. Increased stress can lead to reactivation of viruses that may have been inactive in your body like Epstein-Barr virus or mononucleosis. This is why it is crucial that you manage your stress with activities like mediation or walking and visit your doctor regularly.

5. Food sensitivity – Food sensitivities like with gluten and inflammatory foods such as processed foods increase inflammation and antibody production in your body. This can lead to thyroid dysfunction if your thyroid is attacked. Gluten is one of the most common food sensitivities and affects about 15% of the United States population. It is a protein found in wheat, barely, rye, and oats that make up common foods such as pasta, beer, and bread. If you have a food insensitivity and eat that food, the food tricks your body into thinking that it is harmful. This causes your body to make antibodies and become inflamed to fight it off that can lower your thyroid’s hormone production. Removing these foods from your diet may improve your thyroid functioning.

6. Toxins or radiation – Exposure to toxins like pesticides, excess contrast dyes like iodine from x-rays, mercury, and radiation can cause your thyroid to release minimal thyroid hormones. This leads to poor metabolism, fatigue, and weight gain that are signs of Hashimoto’s thyroiditis. Minimizing your exposure to these harmful chemicals may benefit your overall energy, development, and body process regulations. 

7. Heredity – Unfortunately, we cannot change our family history or genes, but this may play a role in autoimmune thyroid disease. If someone in your family like your sister, grandfather, or mother has Hashimoto’s thyroiditis or Graves’ disease, then you have a higher chance of developing the condition.

Heart Disease in Autoimmune Thyroid Diseases^2,3

By not regularly taking your thyroid medication, modifying your risk factors, or having an undiagnosed autoimmune thyroid disease, you may increase your risk of developing serious health problems. These include myxedema coma and thyroid storm that were discussed in last week’s article. Additionally, a common issue that both conditions can cause is heart disease. Heart disease is the leading cause of death in the United States, so it is vital you take steps to lower your risk. With Hashimoto’s thyroiditis, your low-density lipoprotein (LDL) or bad cholesterol blood levels may increase since the body’s metabolism ability is low. This can cause your heart to work harder to pump blood throughout the body as the walls of your arteries become clogged, causing heart failure. Graves’ disease can also lead to heart failure and irregular heart rhythms because an overactive thyroid increases your heart rate. As the blood is pumped at a faster rate, it can damage your arteries and distort your heart’s shape or functional ability.

Be sure your doctor knows your medical history and risk factors to determine if you should be tested for autoimmune thyroid disease. Hashimoto’s thyroiditis and Graves’ disease can be simply treated with an appropriate thyroid therapy to regulate thyroid hormone production, but they require lifelong treatment and follow-up. Fortunately, these medications can help you continue to live your life and perform your day-to-day activities!

References: 

1. Milas K. Risk factors of Hashimoto’s Thyroiditis. Endocrineweb website. https://www.endocrineweb.com/conditions/hashimotos-thyroiditis/risk-factors-hashimotos-thyroiditis. Accessed August 1, 2021. 
2. Hashimoto’s disease. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855. Accessed August 1, 2021. 
3. Graves’ disease. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240. Accessed August 1, 2021. 
4. Seed S. What is autoimmune thyroiditis? WebMD website. https://www.webmd.com/women/whatis-autoimmune-thyroiditis. Accessed August 1, 2021. 
5. Grunewald J. Why do thyroid disorders affect women more often than men? Experience Life website. https://experiencelife.lifetime.life/article/why-do-thyroid-disorders-affect-women-more-often-than-men/. Accessed August 1, 2021. 
6. Older patients and thyroid disease. American Thyroid Association website. https://www.thyroid.org/thyroid-disease-older-patient/. Accessed August 1, 2021. 
7. Klimenko E. Functional medicine approach to autoimmune thyroid disease. Dr. Klimenko website. https://www.drelenaklimenko.com/autoimmune-thyroid-disease/. Accessed August 1, 2021.
8. Hyman M. A 7-step plan to boost your low thyroid and metabolism. Dr. Hyman website. https://drhyman.com/blog/2010/05/20/a-7-step-plan-to-boost-your-low-thyroid-and-metabolis/#close. Accessed August 1, 2021.

Thyroid disease affects all ages and can be present at birth, inherited, medication-induced, related to a past thyroid or inflammatory condition like lupus or Type 1 diabetes, or develop over time like after menopause. Additionally, females are about seven times more likely to have thyroid disease than males.¹ An imbalanced thyroid may have a large effect on your overall mental, physical, and emotional health, but it can be restored with natural and chemical thyroid medications.

What is the thyroid gland?^1,2

The thyroid, a butterfly-shaped gland in the front of the neck, plays a crucial role in regulating the body’s growth, development, and metabolism or creating energy from food. It releases chemical signals or hormones called T3 (triiodothyronine) and T4 (thyroxine). T3 is the active form of thyroid hormone produced from T4 to help with your body’s functioning. T3 and T4 are released into the bloodstream to control weight, body temperature, breathing, and energy. Hormonal release by the thyroid is ultimately controlled by the pituitary gland, a bean-shaped gland located below the brain. The pituitary gland releases thyroid stimulating hormone (TSH) to increase T3 and T4 when it senses levels are low. Hormonal feedback to the pituitary gland plays a role in how many hormones need to be released by the thyroid. However, an improper thyroid functioning can greatly affect your body’s processes. Releasing too much thyroid hormone is known as hyperthyroidism while releasing too little thyroid hormone is called hypothyroidism. 

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 Types of Thyroid Diseases^1-4

When too much thyroid hormone is released, this is known as hyperthyroidism. This means that the body will use energy too fast, causing you to feel tired, lose weight, and intolerant to heat. Graves’ disease, an autoimmune disease where the body suddenly attacks itself and produces an antibody like TSH, is a common cause of hyperthyroidism. When the thyroid is attacked, excess thyroid hormones are released and the thyroid swells due to the antibodies. Rarely, thyroid cancer or abnormal growth of the thyroid and hormone production leads to thyroid disease. 

The opposite of hyperthyroidism is hypothyroidism. Too little release of thyroid hormone causes you to feel tired, gain weight, and affect your sensitivity to coldness. It can be caused by removal of the thyroid; excess hyperthyroidism treatment; too much iodine from contrast dyes for x-rays; amiodarone, a heart rate-controlling medication; and lithium, a mood disorder medication.

Thyroiditis results when the thyroid gland is inflamed or swollen, leading to an increase or decrease in thyroid hormone release. It is characterized by the following three phases: thyrotoxic, hypothyroid, and euthyroid. After the thyroid swells and over produces thyroid hormones in the thyrotoxic phase, there becomes a low supply of thyroid hormones to release or the hypothyroid phase. The hypothyroid phase is longer-lasting and can be permanent. Once the thyroid has recovered and hormone levels are normal, this is known as the euthyroid phase. 

Hashimoto’s thyroiditis is an inherited and autoimmune disease where the body thinks the thyroid cells are harmful invaders. This causes the body to attack, damage, and kill your thyroid cells to end hormone production. The causes of Hashimoto’s thyroiditis are unclear, but it is likely related to a family history of thyroid or autoimmune diseases, excess iodine or radiation, and sex hormones since it is more common in females.

Thyroid Disease Symptoms²

An irregular thyroid gland includes a wide range of symptoms from difficulty breathing to hair loss. Yet, it can be difficult to diagnose since the symptoms appear in many other conditions. Hyperthyroidism and hypothyroidism are the two most common thyroid diseases that best categorize the symptoms of disease. Symptoms of excess thyroid hormones or hyperthyroidism include a rapid heartbeat, sweating, bulging eyes or exophthalmos, difficulty sleeping, nervousness, irritability, weight loss, muscle weakness, frequent bowel movements, heat sensitivity, and irregular menstrual periods. The symptoms of a lack of thyroid hormones or hypothyroidism can mostly be thought of as the opposite of hyperthyroidism. Hypothyroidism symptoms include a slow heart rate, hair loss, fatigue, constipation, depression, dry skin, hoarseness, cold sensitivity, and frequent or heavy menstrual periods. Yet, both conditions can result in an enlarged thyroid or goiter due to an imbalance of thyroid hormones.

Thyroid Disease Diagnosis^2,5,6

Diagnosing thyroid disease is done through measuring your symptoms and blood levels of T3, T4, and TSH. If TSH is found to be abnormal, your doctor may assess your blood levels of T3 and T4. A normal TSH level is between 0.4 and 4.0 mIU/L, total T4 is between 5 and 11 mcg/dL, and total T3 is between 100 and 200 ng/dL. Normally when T3 and T4 are low, more TSH is produced to stimulate the thyroid to make more hormones. In the case of hypothyroidism, T3 and T4 are low while TSH is high because the thyroid is abnormally inactive. When excess T3 and T4 are in the blood, they feedback to the pituitary gland to decrease the amount of TSH. If you have hyperthyroidism, T3 and T4 are elevated while TSH is low. This is because the thyroid is overproducing hormones by itself regardless of TSH level regulation. 

Thyroid antibodies like thyroglobulin (TG) antibodies can be measured in your blood to determine if you have an autoimmune condition like Graves’ disease or Hashimoto’s thyroiditis.

An imaging procedure like an ultrasound can also be used to view the thyroid gland. After applying a gel and probe to the area, high frequency sound waves are transmitted to show the size of the thyroid. If you are experiencing any of the symptoms or think your thyroid is swollen, you can simply check your thyroid in the comfort of your home. First, locate your thyroid that is above your collarbone or under your Adam’s apple. Then, drink a cup of water while tilting your head back. Look at your thyroid in the mirror as you swallow to see if you notice any lumps. If you notice any lumps, reach out to your doctor for further evaluation.

Thyroid Disease Treatments^5,6

Treatments for thyroid disease have the common goal to either manage symptoms like lowering heart rate or affect the amount of hormones based on hormone levels. Hypothyroidism, Hashimoto’s thyroiditis, and the hypothyroid phase of thyroiditis are mainly treated with levothyroxine, a chemical thyroid hormone to restore your low T3 and T4 levels. If you prefer more natural treatments, medications with pig thyroid gland extracts are available. Furthermore, some dietary supplements you may already be taking like omega-3 fatty acids, zinc glycinate, Withania somnifera, tyrosine, selenium, and vitamins A, D, and E can assist with having a balanced thyroid.

Hyperthyroidism is treated with medications to stop excess thyroid hormone production. Since radioactive iodine can damage your thyroid, leading to hypothyroidism, it can surprisingly be used to treat hyperthyroidism. A more irreversible option to decrease hormone production includes a thyroidectomy or removal of the thyroid, but this requires lifelong thyroid hormone treatment. Since the thyrotoxic phase of thyroiditis is typically short-lived, medications to manage symptoms like rapid heart rate, anxiety, sweating, and inflammation are used.

These conditions are treatable, but therapy is likely lifelong and may change based on your thyroid hormone levels and symptoms. By following an appropriate treatment plan, you will be able to live a normal, healthy life with a controlled thyroid. 

Thyroid Disease Complications^5,6

By not taking your medication as prescribed or left untreated, you are at risk for serious complications. If hypothyroidism is not treated, your metabolism slows down and puts you at risk for myxedema coma. This is a medical emergency and can leave you with hypothermia and altered mental status. If hyperthyroidism is not treated, your metabolism is overactive and could lead to thyroid storm. Because of excess thyroid hormones without regulation to keep levels within a normal range, your heart rate, blood pressure, and temperature increases to risky levels. Thyroid storm can lead to fever, psychosis, delirium, and dehydration. 

For more information and support, visit the American Thyroid Association (ATA) and Centers for Disease Control and Prevention (CDC) websites or talk with your doctor or pharmacist today. 

References: 

1. Thyroid cancer. Centers for Disease Control and Prevention website. https://www.cdc.gov/cancer/thyroid/index.htm. Accessed July 26, 2021.
2. Thyroid disease. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease. Accessed July 26, 2021.
3. Hypothyroidism (underactive thyroid). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed July 26, 2021.
4. Picture of the thyroid. WebMD website. https://www.webmd.com/women/picture-of-the-thyroid. Accessed July 26, 2021.
5. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014; 24(12): 1670-1751. http://doi.org/10.1089/thy.2014.0028.
6. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016; 26(10): 1343-1421. http://doi.org/10.1089/thy.2016.0029. 

1. Get enough sleep

Sleep and immunity are closely related. Inadequate or poor-quality sleep is linked to a higher susceptibility to illness. Adults need seven to eight hours of sleep each night.

Having good sleep hygiene is important to ensuring a good quality sleep.

• Set a sleep schedule and follow a nightly routine.
• Turn off the lights.
• Limit noise and distractions. Turn off your phone or put it on “Do Not Disturb.”
• Limit the use of your phone for the 2 hours before you plan to go to bed. Your phone emits a blue light that tells your body to suppress melatonin. Melatonin is an important sleep hormone that helps your body regulate its sleep patterns. See if you phone has a nighttime color setting to decrease the blue light emissions.
• Set a cool yet comfortable temperature. The ideal bedroom temperature is between 66^◦F and 68^◦F

Still having issues falling asleep? Consider these supplements to help you fall asleep.

• Best Rest
  • Take one to two capsules 30 to 60 minutes before bedtime

• Supports a healthy sleep cycle by encouraging an easy transition to sleep and a restful night’s sleep
  • This supplement contains passionflower, chamomile, lemon balm and hops which have been clinically shown to naturally calm and relax the central nervous system
• Melatonin
  • Take one capsule 30 to 60 minutes before bedtime

• Melatonin is a naturally occurring hormone that helps promote sleep. This sustained release formulation releases melatonin gradually to help promote extended sleep support

• Eat a healthy and balanced diet

Healthy foods help provide your body with the vitamins, nutrients, and minerals it needs to stay strong.  Eating high quality whole foods like whole grains, nuts, and fresh fruits and vegetables helps nourish your body. These foods are high in antioxidants and nutrients like vitamin C which may help in preventing the common cold. Healthy fats like olive oil and the omega-3 found in salmon also help your body by supporting heart health and reducing inflammation that can suppress your immune system.

Interested in boosting your immune system further? Try these supplements:

• O.N.E. Omega
  • Take one capsule daily with a meal
  • A powerful omega-3 fatty acid formula for cardiovascular, joint, skin and cognitive health

• Vitamin C
  • Take one tablet 1-2 times daily

• Vitamin C offers broad physiological support, including musculoskeletal, cardiovascular, neurocognitive, cellular, and immune health
  • One tablet contains the same amount of vitamin C found in eight oranges

• Exercise Regularly

 Moderate exercise can give your immune system the boost it needs to stay healthy. Being active is also associated with many physical and mental health benefits.

Aim for 150 minutes of moderate exercise weekly or about 30 minutes daily five days a week. Moderate exercise includes brisk walking/jogging, bicycling, and swimming.

• Stay Hydrated

Hydration may not protect you from germs and viruses directly like washing your hands or using hand sanitizer but it is very important in overall health. Dehydration can affect your mood, digestion as well as heart and kidney function. When you are dehydrated these systems do not work well and therefore lower your bodies ability to fight infection. It is recommended that you drink 64oz or ½ a gallon of water daily.

• Minimize Stress

Long-term stress is harmful to the immune system where short-term stress can be productive as it prepares your body to deal with challenges. However, finding the balance can sometimes be difficult. A few signs that you maybe more stressed than you realize are, hitting a wall in the afternoon, afternoon sugar cravings, feeling tired immediately upon waking, weight gain without a change in eating or exercise habits, a short temper, or dull emotions. (For more information on stress, check out our Adrenal blog) Finding ways to manage your stress is the key to good immune health. Ways to manage stress include meditation, exercise, yoga, adequate sleep, and mindfulness. If your stress is unmanageable, talk to your doctor, pharmacist, counselor, or therapist.

Still struggling with stress? Consider this supplement:

• Energy Xtra
  • One capsule once daily
  • Contains herbal blends to help promote energy, enhance stamina and help the body adapt and cope with occasional stress

• Don’t Smoke

Smoking, including vaping harms the overall immune system and can make it more difficult for your body to fight off infections.

• Supplement Appropriately

There is no FDA approved evidence to support the use of any supplements to treat or prevent COVID-19. However, studies do indicate that some supplements may help boost your bodies general immunity. Have more questions about supplements? Contact us and we will be happy to review your medications and make supplement recommendations.

• Vitamin D
  • Do not begin a Vitamin D supplement greater than 2,000 IU daily without first consulting a health care provider.
  • Take one capsule once daily
  • Vitamin D naturally supports calcium absorption and retention within the bones to promote optimal bone health
  • Vitamin D also has shown evidence of enhancing immunity.

• Zinc
  • Take one capsule once daily with a meal
  • Zinc is designed to support your bodies natural defense system as well as enhance digestion and metabolism of important vitamins, minerals, carbohydrates, and other essential nutrients

• O.N.E Multivitamin
  • Take one capsule once daily with a meal
  • Provides vitamins, minerals, and other essential nutrients to provide a comprehensive once-daily multivitamin.

• B Complex
  • Take one capsule 1-2 times daily
  • Offers a comprehensive blend of B vitamins designed to support cellular, cardiovascular, neurological, and psychological health

References:

1. Sleep & Immunity: Can a lack of sleep make you sick? (2020, November 19). Retrieved February 19, 2021, from https://www.sleepfoundation.org/physical-health/how-sleep-affects-immunity
2. What is sleep hygiene? (2020, August 14). Retrieved February 19, 2021, from https://www.sleepfoundation.org/sleep-hygiene
3. Daily nutritional supplements: Pure encapsulations®. (n.d.). Retrieved February 19, 2021, from https://www.pureencapsulations.com/
4. E;, H. (n.d.). Vitamin C for preventing and treating the common cold. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/23440782/
5. R;, S. (n.d.). Exercise and the regulation of immune functions. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/26477922/
6. Nieman, D., Henson, D., Austin, M., & Sha, W. (2011, September 01). Upper respiratory tract infection is reduced in physically fit and active adults. Retrieved February 19, 2021, from https://bjsm.bmj.com/content/45/12/987.abstract?sid=e6594508-3aaa-4c61-99ba-4ea138580947
7. Popkin, B., D’Anci, K., & Rosenberg, I. (2010, August). Water, hydration, and health. Retrieved February 19, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
8. FS;, D. (n.d.). Effects of stress on immune function: The good, the bad, and the beautiful. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/24798553/
9. Smoking and Overall Health. (n.d.). Retrieved February 19, 2021, from www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_overall_health_508.pdf
10. In the News: Coronavirus and “alternative” treatments. (n.d.). Retrieved February 19, 2021, from https://www.nccih.nih.gov/health/in-the-news-coronavirus-and-alternative-treatments
11. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886. doi:10.2310/JIM.0b013e31821b8755

For the past year, we have been faced with unprecedented times caused by the COVID-19 pandemic. As of December 2020, we are starting to see the light at the end of the tunnel as vaccines become available.

What are mRNA vaccines?

Traditional vaccines work by using a weakened/inactivate portion of the virus to help our body develop immunity. The COVID-19 mRNA (messenger ribonucleic acid) vaccines contain instructions on how to make a harmless “spike protein” that are unique to the COVID-19 virus.  Our bodies then recognize the protein should not be there and build antibodies that remember how to fight the virus if we become infected with it in the future. 

Will the COVID-19 vaccine alter my DNA?

No. The COVID-19 vaccine is a mRNA vaccine that does not change or interact with your DNA in any way.

What vaccines are available?

There are currently two COVID-19 vaccines (Pfizer and Moderna) that have been approved by the Food and Drug Administration (FDA). There are 3 other vaccines (AstraZeneca, Janssen, Novavax) currently undergoing Phase 3 clinical trials that could become available once they receive FDA approval.

How many doses of the vaccine do I have to get?

Both Pfizer and Moderna vaccines require two doses spaced 21-28 days apart.

Can I get the COVID-19 vaccine if I have had COVID-19?

The CDC recommends that people who have had COVID-19 still get the COVID-19 vaccine. Since re-infection with COVID-19 is possible, getting the vaccine can still help protect you. However, you should not receive the vaccine if you have a current infection with COVID-19, you should wait until you are no longer symptomatic before receiving the vaccine.

Is the COVID-19 vaccine safe?

The FDA, Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices have all been actively involved in the vaccine evaluation process and have deemed the two current COVID-19 vaccines safe.

Can the COVID-19 vaccine make me sick with COVID-19?

No. None of the COVID-19 vaccines contain the live virus that cause COVID-19.

If I get the COVID-19 Vaccine, will I test positive for COVID-19 on a viral test?

No. None of the vaccines currently available for COVID-19 cause you to test positive on a viral test. Getting the vaccine allows your body to develop antibodies against COVID-19 so it is possible to test positive on an antibody test.

How long will the vaccine protect me?

At this time, it is unknown how long protection from the vaccine or from having COVID-19 (natural immunity) will last. More research is needed to know how long the immunity from the COVID-19 vaccine or natural immunity lasts and if a booster dose will be required.

What are the benefits of getting vaccinated?

Both vaccines currently available have shown approximately 95% efficacy 7-14 days after the second dose of the vaccine is received.

Can I get other vaccines along with my COVID-19 vaccine?

The CDC recommends that you do not receive any other vaccines within 14 days of the COVID-19 vaccine.

If I get the COVID-19 vaccine, do I still have to wear a mask?

Yes. Both vaccines currently available are 95% effective meaning that 1 out of every 20 people who have received the vaccine may not have full protection from the vaccine. It is also unknown if you could still be a carrier (have no symptoms) and spread the virus after vaccination. This is why until we know more, you should continue to wear masks and social distance.

How is the vaccine being distributed in North Carolina?

In North Carolina, vaccine distribution is being completed in groups. Availability of the vaccine worldwide is limited, so please be patient. Everyone who wants a vaccine will be able to receive a vaccine, it is just going to take time to get everyone vaccinated since demand is currently higher than the supply.  

• Group 1
  • Health care workers
  • Long-term care staff and residents
• Group 2
  • Older adults (65+)
• Group 3
  • Frontline Essential Workers
    • First responders (firefighters and police officers), correction officers, food and agricultural workers, U.S. postal service workers, manufacturing workers, grocery store workers, public transit workers, and those in the education sector (teachers, support staff and childcare workers)
• Group 4
  • Adults at high risk for exposure and increased risk of severe illness
    • Anyone 16-64 with high-risk medical conditions that increase the risk of severe disease from COVID-19
    • Anyone incarcerated or living in other close group living situations
    • Essential workers not yet vaccinated
      • Workers in transportation and logistics, water and wastewater, food service, shelter and housing (construction), finance (bank tellers), information technology and communications, energy, legal, media, public safety and public health workers
• Group 5
  • All persons 16 and older

What should you do while you’re waiting for the COVID-19 vaccine?

Continue to wear your mask over your nose and mouth, social distance at least 6 feet from others that do not live in your household whenever possible, wash your hands often and stay home if you are sick.

What should I expect once I get the vaccine?

The most common side effect from the vaccine is arm soreness/tenderness. Other symptoms include fatigue, low-grade fever, body aches and mild headaches that last one to three days. Side effects are seen more frequent after the second dose. These mild symptoms are your bodies way of telling you that your immune system is responding to the vaccine and producing antibodies to the COVID-19 virus. Meaning if your body sees the virus again it already has antibodies and knows how to respond, either preventing infection or making your infection less severe.

References:

1. COVID-19 vaccines. (n.d.). Retrieved February 19, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
2. COVID-19 vaccine: What you need to know. (n.d.). Retrieved February 19, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccine-what-you-need-to-know
3. Find your spot to take your shot. (n.d.). Retrieved February 19, 2021, from https://covid19.ncdhhs.gov/vaccines/find-your-spot-take-your-shot

What is the Coronavirus?

Coronavirus is a virus that attacks the respiratory tract and causes a flu-like illness. There are many different coronaviruses but the one we are going to focus on today is the 2019 novel coronavirus also known as SARS-CoV-2 or COVID-19. The abbreviated name (COVID-19) can be broken down into its individual parts; “CO” standing for Corona, “VI” standing for virus and “D” standing for disease. This new coronavirus was first identified in December of 2019 hence the “-19” and originated from Wuhan, China.

How does COVID-19 spread?

The coronavirus is a respiratory virus that is spread by droplets or through direct contact. The virus can be spread by people who have COVID-19 but are asymptomatic, meaning they have no symptoms.

What can you do to protect yourself?

Hand washing is one of the best ways to protect yourself from getting sick. Wash your hands with soap and water for at least 20 seconds often throughout the day especially after blowing your nose, coughing/sneezing, going to the bathroom and before eating or preparing food. If soap and water are not available, use an alcohol-based hand sanitizer. Another way to protect yourself and others is to stay home if you are sick. It is also important to cover your nose and mouth if you cough or sneeze. Wearing a mask that covers your nose and mouth in public settings when not around people that live in your household when social distancing is not attainable. Wearing a mask in public settings provides an extra layer of protection against respiratory droplets. Social distancing or staying at least six feet away from others is important since people can have no symptoms and still spread the virus.

What are the symptoms of COVID-19?

Symptoms may appear 2-14 days after an exposure to the virus

• Cough
• Fever or Chills
• Shortness of breath or difficulty breathing
• Muscle or body aches
• Sore throat
• New loss of taste or smell
• Diarrhea
• Headache
• New fatigue
• Nausea or vomiting

If you have trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake or bluish lips or face, seek emergency medical care immediately.

How is COVID-19 diagnosed?

Diagnosis can be difficult because in some cases COVID-19 may appear similar to the flu or other respiratory illnesses. A laboratory test (nasal swab) is used to confirm the diagnosis of COVID-19.

If you test positive for COVID-19, stay home, take care of yourself by staying hydrated and getting plenty of rest. Stay in contact with your doctor and be sure to seek emergency medical attention if you have trouble breathing or emergency warning signs. Stay away from others as much as possible and tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours or 2 days before they become symptomatic or test positive.

If you test negative for COVID-19, you are probably not infected at the time your sample was collected. However, this does not mean that you will not get sick. You could test negative if the sample was collected early in your infection and then test positive later in your infection. If you develop symptoms later, you might need to be re-tested to determine if you are infected with the virus.

How is COVID-19 treated?

As of now, there is no specific treatments for COVID-19. People who become sick with COVID-19 are treated with supportive measures to treat the symptoms.

What should I do if I have had close contact with someone who has been diagnosed with COVID-19?

The best thing to do if you have been in contact with someone diagnosed with COVID-19 is to stay home for 14 days. Be alert for symptoms associated with COVID -19 and stay away from others whenever possible until your quarantine period is complete.

What individuals are at an increased risk for severe illness if infected with COVID-19?

Severe illness means that a person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe.

• Older adults
  • Anyone 65 years of age or older
  • The greatest risk is among those aged 85 and older
• People of all ages with certain underlying medical conditions
  • Cancer
  • Chronic kidney disease
  • Chronic lung diseases
    • Chronic obstructive pulmonary disease (COPD)
    • Cystic fibrosis
    • Pulmonary fibrosis
  • Dementia
  • Down syndrome
  • Heart conditions
    • Heart failure
    • Coronary artery disease
    • Cardiomyopathies
    • Pulmonary hypertension
  • Immunocompromised (weakened immune system)
    • Solid organ transplant
    • Bone or blood transplant
    • HIV
    • Use of corticosteroids or other immune weakening drugs
  • Liver Disease
  • Moderate to severe asthma
  • Obesity and severe obesity
    • BMI >30kg/m²
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus
• Pregnant women

Is there anything I can do to decrease my risk of severe disease?

There are many ways to help strengthen your immune system. Read our blog on “Seven Ways to Help Strengthen your Immune System’ to give your immune system a boost.

References:

1. Coronavirus (covid-19) frequently asked questions. (n.d.). Retrieved February 19, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/faq.html
2. Sauer, L. (n.d.). What is Coronavirus? Retrieved February 19, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus