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Source: http://www.healthyonpurpose.org/feeds/posts/default

1. <?xml version='1.0' encoding='UTF-8'?><?xml-stylesheet href="http://www.blogger.com/styles/atom.css" type="text/css"?><feed xmlns='http://www.w3.org/2005/Atom' xmlns:openSearch='http://a9.com/-/spec/opensearchrss/1.0/' xmlns:blogger='http://schemas.google.com/blogger/2008' xmlns:georss='http://www.georss.org/georss' xmlns:gd="http://schemas.google.com/g/2005" xmlns:thr='http://purl.org/syndication/thread/1.0'><id>tag:blogger.com,1999:blog-6366113899601223690</id><updated>2024-04-13T11:31:53.915-07:00</updated><title type='text'>Healthy on Purpose</title><subtitle type='html'>Providing relevant, evidence-based wellness information, health consulting and counseling, thus inspiring others to choose a healthy lifestyle</subtitle><link rel='http://schemas.google.com/g/2005#feed' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/posts/default'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/'/><link rel='hub' href='http://pubsubhubbub.appspot.com/'/><link rel='next' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default?start-index=26&amp;max-results=25'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><generator version='7.00' uri='http://www.blogger.com'>Blogger</generator><openSearch:totalResults>180</openSearch:totalResults><openSearch:startIndex>1</openSearch:startIndex><openSearch:itemsPerPage>25</openSearch:itemsPerPage><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6684059742452606336</id><published>2022-01-12T08:00:00.001-08:00</published><updated>2022-01-12T08:00:00.156-08:00</updated><title type='text'>Conclusions - Alternative Treatments and ADHD </title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;i&gt;Conclusions&lt;/i&gt;&lt;/span&gt;&lt;br /&gt;
2. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
3. <span style="font-family: "times" , "times new roman" , serif; line-height: 200%;">     As
4. is abundantly clear following the discussion of the previously posted alternative
5. therapies, further research is necessary before clear statements can be made
6. regarding the efficacy of such treatments. Though research studies in the area
7. of alternative treatments in ADHD cases are plentiful, many are riddled with
8. inconsistencies, short trial periods, small subject sizes or non-standardized
9. assessment tools. In addition, possible harmful or negative side effect
10. profiles of each alternative treatment were not explored extensively in this
11. paper. <span style="mso-spacerun: yes;"> </span>These factors call into question
12. many of the positive benefits initially observed and beg for clearer and more
13. convincing evidence before they can be called valid and efficacious treatment
14. alternatives. Further, though these therapies may provide slightly better
15. options for children with ADHD when compared to psychiatric medications, most
16. fulfill the same function of symptom management rather than addressing the root
17. cause of the cognitive and behavioral components at hand. Discussion of such
18. core factors, however, goes beyond the scope of this paper. The bottom line in
19. the investigation of alternative treatments in regard to the ADHD diagnosis is
20. the simple fact that multiple therapies have been tested, some positive
21. outcomes have been observed and there is extensive research still needed before
22. clear conclusions can be drawn in this field. <o:p></o:p></span></div>
23. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
24. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
25. <div class="MsoNormal">
26. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
27. <div class="MsoNormal">
28. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
29. <div class="MsoNormal">
30. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
31. <div class="MsoNormal">
32. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
33. <div class="MsoNormal">
34. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
35. <div class="MsoNormal">
36. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
37. <div class="MsoNormal">
38. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
39. <div class="MsoNormal">
40. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
41. <div class="MsoNormal">
42. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
43. <div class="MsoNormal">
44. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
45. &lt;br /&gt;</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/6684059742452606336/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/07/conclusions-alternative-treatments-and.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6684059742452606336'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6684059742452606336'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/07/conclusions-alternative-treatments-and.html' title='Conclusions - Alternative Treatments and ADHD '/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8622992626427933154</id><published>2022-01-05T08:00:00.001-08:00</published><updated>2022-01-05T08:00:00.155-08:00</updated><title type='text'>Part V - Alternative Treatments and ADHD - Homeopathic Remedies</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;/span&gt;
46.  
47. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
48. <i><span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;">Homeopathic Remedies<o:p></o:p></span></i></div>
49. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
50. <span style="font-family: "times" , "times new roman" , serif; line-height: 200%;">     When
51. considering homeopathic treatments for any disorder or malady, a plethora of
52. articles can be found to support or dispute their effect. However, yet again,
53. it is important to look closely at the proposed treatment modalities to
54. determine efficacy. A review of available studies was conducted in regard to
55. the use of homeopathy in subjects with the ADHD diagnosis.<sup>Q </sup>Results
56. showed that the use of homeopathy did not provide significant treatment
57. outcomes and authors concluded that there is little evidence to support the use
58. of homeopathy in people with the ADHD diagnosis.<sup>Q </sup>A 2005 randomized,
59. double-blind, placebo controlled crossover trial studied the benefits of
60. homeopathic medication in 83 children diagnosed with ADHD over the course of 12
61. weeks.<sup>R </sup>Results indicated efficacy in those treated with homeopathic
62. medication when compared with the control group, specifically in terms of
63. behavioral and cognitive functioning.<sup>R </sup>Similarly, a group of 115
64. children with the ADHD diagnosis were treated with a traditional medicine
65. approach (methylphenidate) or a homeopathic medicine approach and evaluated in
66. terms of ADHD symptoms.<sup>S </sup>Though homeopathic remedies were shown to
67. have a positive effect in 75% of the subjects, limitations were also noted.<sup>S</sup>
68. The authors stated that though homeopathic medication showed a positive effect
69. on symptoms, response times were oftentimes lengthy, thus posing a potential
70. downfall in situations in which amelioration of symptoms is deemed urgent.<sup>S
71. </sup>Further, authors reported that, “The choice of the correct medication is
72. dependent on the individuality of the symptoms, if a patient only has the
73. ‘standard symptoms’ of ADHD and nothing peculiar, the homeopathic physician may
74. have to make ‘therapeutic trials’ to find the correct medicine.”<sup>S</sup>
75. Authors also stated that homeopathic medication may have additional benefits
76. for treatment such as a low side effect profile, ease of administration, and no
77. abuse potential, leading to the conclusion that homeopathic medications may
78. have unique potential for benefit.<sup>S </sup>As has been mentioned before,
79. this treatment option may have potential in some cases but would require unique
80. and detailed investigation of the particular situation prior to recommendation.
81. <o:p></o:p></span></div>
82. <div style="text-align: center;">
83. <div style="text-align: center;">
84. <i><span style="font-family: "times" , "times new roman" , serif;">References</span></i><br />
85. <div style="text-align: left;">
86. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-indent: -0.25in;">Q. </span><span style="text-indent: -0.25in;">Heirs M, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. </span><i style="text-indent: -0.25in;">Cochrane Database of Systematic Reviews. </i><span style="text-indent: -0.25in;">2007; 4: 1-3.</span></span></div>
87. </div>
88. <div style="text-align: left;">
89. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-indent: -0.25in;">R. Frei H, Everts R, Von Ammon K, et al. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. </span><i style="text-indent: -0.25in;">European Journal of Pediatrics. </i><span style="text-indent: -0.25in;">2005; 164: 758-767.</span></span></div>
90. <div style="text-align: left;">
91. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-indent: -0.25in;">S. Frei H, Thurneysen A. Treatment for hyperactive children: Homeopathy and methylphenidate compared in a family setting. </span><i style="text-indent: -0.25in;">British Homeopathic Journal. </i><span style="text-indent: -0.25in;">2001; 90: 183-188.</span></span></div>
92. </div>
93. <div style="text-align: center;">
94. <i></i></div>
95. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8622992626427933154/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-v-alternative-treatments-and-adhd.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8622992626427933154'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8622992626427933154'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-v-alternative-treatments-and-adhd.html' title='Part V - Alternative Treatments and ADHD - Homeopathic Remedies'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8681482998836209827</id><published>2021-12-29T08:00:00.001-08:00</published><updated>2021-12-29T08:00:00.199-08:00</updated><title type='text'>Part IV - Alternative Treatments and ADHD - Sweeteners</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;i&gt;&lt;span style=&quot;font-family: &amp;quot;Times New Roman&amp;quot;,serif; font-size: 12.0pt; line-height: 107%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;&quot;&gt;Sweeteners&lt;/span&gt;&lt;/i&gt;&lt;/span&gt;
96. <br />
97. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
98. <span style="font-family: "times" , "times new roman" , serif; line-height: 200%;">     Another
99. topic of investigation within the ADHD world, has been the connection between
100. sugar and behavior. Some parents and researchers have claimed that sugar is one
101. of the key factors in the onset, severity and continuation of symptoms with
102. children diagnosed with ADHD. However, yet again, a glimpse of the evidence is
103. important before assuming this claim as true. A 1994 double-blind controlled
104. trial of 48 children was conducted to investigate the role of sugar in
105. behaviorally and cognitively challenged children (per parent report).<sup>M</sup>
106. Twenty-five of the children were considered the control group, with no reported
107. sensitivities to sugar and 23 of the children were classified as having sugar
108. sensitivities.<sup>M </sup>All of the children underwent three consecutive
109. three-week trials of differing sweetener combinations, the first consisting of
110. sucrose only with no artificial sweeteners, the second consisting of low
111. sucrose levels and mostly aspartame sweeteners, and the third consisting of
112. saccharin (placebo).<sup>M </sup>The researchers controlled for variables such
113. as preservatives, artificial dyes, and additives which are oftentimes blamed
114. for additional behavioral and cognitive complications.<sup>M </sup>Outcomes of
115. the study showed no difference among groups.<sup>M </sup>In addition to the
116. fact that no effect was observed, the researchers further stated that even when
117. intake of the listed sweeteners exceeded normal dietary levels, the effect
118. remained unsubstantial.<sup>M </sup>Similarly, in a randomized, double-blind,
119. placebo-controlled crossover study, researchers examined the effects of
120. heightened doses of aspartame on the behavior and cognition of children labeled
121. with the ADD diagnosis.<sup>N </sup>Children were given aspartame or placebo
122. for alternate 2-week periods to determine effect.<sup>N </sup>Outcomes of this
123. study showed no clinically significant differences between the placebo and
124. aspartame administrations in regard to symptoms, behavior or cognition.<sup>N </sup>Though
125. not as reliable as controlled research studies, anecdotal evidence has
126. suggested that there is a relationship between sugar intake and hyperactive
127. behaviors.<sup>O</sup> A 1994 research study looking at the connection between
128. sugar intake and hyperactive behavior in children showed that sweeteners do not
129. affect behavior.<sup>O </sup>This particular study examined the differences between
130. diets high in sucrose, aspartame, and saccharin and found that even when doses
131. exceeded normal intake levels, no differences were observed in hyperactivity.<sup>O
132. </sup>Similarly, a 1991 study looked at the difference between a
133. sugar-sweetened diet compared to a saccharin/aspartame-sweetened diet
134. (placebo).<sup>P</sup> Subjects in the study group were 17 children diagnosed
135. with ADHD and were compared to the control group of 9 children without the ADHD
136. diagnosis.<sup>P</sup> Results showed no difference in levels of aggression
137. between the study and control groups.<sup>P</sup> Despite this finding,
138. children with the ADHD diagnosis did show increased inattention following sugar
139. ingestion when compared to the control group.<sup>P</sup> However, the
140. researchers stated in conclusion, “This result is of questionable clinical
141. significance inasmuch as aggressive behavior was unchanged. The finding may be
142. due to the combination of the sugar challenge with a high-carbohydrate
143. breakfast. These findings should be replicated and any possible clinical
144. significance should be documented before any dietary recommendations can be
145. made.”<sup>P</sup> Again, though the elimination of sugar may have a positive
146. effect on some ADHD-diagnosed children, the apparent evidence is not
147. overwhelming.<o:p></o:p></span><br />
148. <div style="text-align: center;">
149. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: center;">
150. <i><span style="font-family: "Times New Roman",serif;">References</span></i><span style="font-family: "Times New Roman",serif;"><o:p></o:p></span></div>
151. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
152. <span style="font-family: "Times New Roman",serif;">M. Wolraich ML, Lindgren SD, Stumbo
153. PJ, et al. Effects of diets high in sucrose or aspartame on the behavior and
154. cognitive performance of children. <i>The New England Journal of Medicine.</i> 1994;
155. 330: 301-306. <o:p></o:p></span></div>
156. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
157. <span style="font-family: "Times New Roman",serif;">N. Shaywitz BA, Sullivan CM,
158. Anderson GM, et al. Aspartame, behavior, and cognitive function in children
159. with attention deficit disorder. <i>Pediatrics. </i>1994; 93:70-75.<o:p></o:p></span></div>
160. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
161. <span style="font-family: "Times New Roman",serif;">O. Kanarek RB. Does sucrose or
162. aspartame cause hyperactivity in children? <i>Nutrition Reviews. </i>1994;
163. 52: 173-175.<o:p></o:p></span></div>
164. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
165. <span style="font-family: "Times New Roman",serif;">P. Wender EH, Solanto MV. Effects
166. of sugar on aggressive and inattentive behavior in children with attention
167. deficit disorder with hyperactivity and normal children. <i>Pediatrics. </i>1991;
168. 88: 960-966.<o:p></o:p></span></div>
169. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
170. <br /></div>
171. <br />
172. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
173. <br /></div>
174. </div>
175. </div>
176. &lt;br /&gt;</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8681482998836209827/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iv-alternative-treatments-and-adhd.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8681482998836209827'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8681482998836209827'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iv-alternative-treatments-and-adhd.html' title='Part IV - Alternative Treatments and ADHD - Sweeteners'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-1405657340084101384</id><published>2021-12-22T08:00:00.001-08:00</published><updated>2021-12-22T08:00:00.170-08:00</updated><title type='text'>Part III - Alternative Treatments and ADHD - Multivitamins</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
177. <br />
178. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
179. <span style="font-family: "times" , "times new roman" , serif; line-height: 200%;"></span><br />
180. <div class="MsoNormal" style="line-height: 200%;">
181. <i><span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;">Multivitamins<o:p></o:p></span></i></div>
182. <span style="font-family: "times" , "times new roman" , serif; line-height: 200%;">     Though
183. it has been suggested that vitamin and nutrient deficiencies can lead to
184. significant cognitive impairment and declined performance on intelligence
185. tests, the assumption that such supplementation may subsequently aid children
186. diagnosed with ADHD has not been proven with extensive and convincing research
187. data.<sup>H </sup>Adequate research studies with large sample sizes, sufficient
188. trial times and randomized controls appears lacking in the investigation of the
189. role of multivitamins in relation to ADHD.<span style="mso-spacerun: yes;"> 
190. </span>Some studies have shown preliminary evidence of benefit for adults
191. taking multivitamin supplements to treat ADHD symptoms, yet caution to accept
192. efficacy is warranted due limitations such as small sample size and short-term
193. trials.<sup>I <span style="mso-spacerun: yes;"> </span></sup>During an 8-week
194. trial, 14 adults diagnosed with ADHD were observed while taking a 36-ingredient
195. micronutrient formula.<sup>J</sup> Though results showed improvement of
196. symptoms, the effects are questionable at best due to the small sample size,
197. short trial length and method of evaluation (self, clinician and observer
198. reports).<sup>J</sup> In addition, researchers admitted that due to the
199. limitations of this study design, the outcome<span style="mso-spacerun: yes;"> 
200. </span>“does not in itself prove efficacy”.<sup>J</sup> Research studies
201. involving children have been performed with some level of similarity, yet also
202. with notable limitations. A fully blinded, randomized, placebo-controlled trial
203. looked at 93 children with the ADHD diagnosis and tested the efficacy of
204. multivitamin supplementation on symptoms.<sup>K</sup> Results indicated that
205. subjects receiving vitamin and mineral supplementation improved in overall
206. function, including reduced impairment and improved attention but did not show
207. reduced levels of hyperactive and impulsive symptoms when compared with the
208. control group.<sup>K </sup>The researchers subsequently commented that,
209. “Although direct benefit for core ADHD symptoms was modest, with mixed findings
210. across raters, the low rate of adverse effects and the benefits reported across
211. multiple areas of functioning indicate micronutrients may be a favourable
212. option for some children, particularly those with both ADHD and emotional
213. dysregulation.”<sup>K </sup>Therefore, though these findings point to potential
214. benefit, they do not provide overwhelming evidence for efficacy at this time. In
215. addition, though some benefit was found, it was mild and did not address all
216. levels of the symptom profile, namely the hyperactive and impulsive actions
217. that frequently are the most challenging to deal with in such cases. Some
218. research studies have performed trials with ADHD-diagnosed children to
219. determine if deficiencies in vitamin and hormone levels exist. By investigating
220. deficiencies, such studies have attempted to suggest the importance of
221. supplementation in these populations. In a 2014 study of 77 kids, researchers
222. looked at levels of ferratin, vitamin D, vitamin B12, adrenal and gonadal
223. steroid levels, celiac antibodies, and thyroid hormones and antibodies.<sup>L </sup>Subjects
224. were divided into three groups: children with the ADHD diagnosis, children with
225. the Asperger’s diagnosis, and children with no diagnosis (control group).<sup>L
226. </sup>Deficiencies were found in both diagnosed categories when compared with
227. the control group, thus leading the researchers to conclude that vitamin D and
228. B12 supplements would benefit these populations.<sup>L </sup>Despite the
229. observed levels of deficiency, however, this study did not investigate the
230. outcome of ADHD-diagnosed children taking these vitamins, thus bringing into
231. question the validity of the claim of likely efficacy.<o:p></o:p></span></div>
232. <div style="text-align: center;">
233. <div class="MsoNormal" style="line-height: normal; text-align: center;">
234. <i><span style="font-family: "Times New Roman",serif;">References<o:p></o:p></span></i></div>
235. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
236. <span style="font-family: "Times New Roman",serif;">H. Benton D. Symposium on nutrition
237. and cognitive efficiency. Proceedings of the Nutrition Society. 1992; 51:
238. 295-302.<o:p></o:p></span></div>
239. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
240. <span style="font-family: "Times New Roman",serif;">I. Rucklidge JJ, Framptom CM,
241. Gorman B, Boggis A. Vitamin-mineral treatment of attention-deficit
242. hyperactivity disorder in adults: double-blind randomised placebo-controlled
243. trial. The British Journal of Psychiatry. 2014; 204: 306-315.<o:p></o:p></span></div>
244. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
245. <span style="font-family: "Times New Roman",serif;">J. Rucklidge JJ, Taylor M,
246. Whitehead K. Effect of micronutrients on behavior and mood in adults with ADHD:
247. evidence from an 8-week open label trial with natural extension. Journal of
248. Attention Disorders. 2011; 15:79-91.<o:p></o:p></span></div>
249. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
250. <span style="font-family: "Times New Roman",serif;">K. Rucklidge JJ, Eggleston MJ,
251. Johnstone JM, Darling K, Frampton CM. Vitamin-mineral treatment improves
252. aggression and emotional regulation in children with ADHD: a fully blinded,
253. randomized, placebo-controlled trial. Journal of Child Psychology and
254. Psychiatry, and Allied Disciplines. Published Online: October 2, 2017 (doi:
255. 10.1111/jcpp.12817).<o:p></o:p></span></div>
256. <br />
257. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
258. <span style="font-family: "Times New Roman",serif;">L. Bala KA, Dogan M, Mutluer T,
259. Aslan O, Dogan SZ. Hormone disorder and vitamin deficiency in attention deficit
260. hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). Journal of
261. Pediatric Endocrinology and Metabolism. 2016; 29: 1077-1082.<o:p></o:p></span></div>
262. </div>
263. <div style="text-align: justify;">
264. <div style="text-align: left;">
265. <br /></div>
266. </div>
267. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/1405657340084101384/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iii-alternative-treatments-and.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1405657340084101384'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1405657340084101384'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-iii-alternative-treatments-and.html' title='Part III - Alternative Treatments and ADHD - Multivitamins'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-437053997356340739</id><published>2021-12-15T08:00:00.001-08:00</published><updated>2021-12-15T08:00:00.149-08:00</updated><title type='text'>Part II - Alternative Treatments and ADHD - Magnesium</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
268. <br />
269. <div class="MsoNormal" style="line-height: 200%; text-align: left;">
270. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-align: justify;">     </span></span><i style="text-align: justify;"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;">Magnesium</span></i><br />
271.  
272.  
273. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
274. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;">     Another
275. supplement frequently recommended as an alternative or adjunctive treatment for
276. ADHD is magnesium. An initial look at the research gives reason to believe that
277. magnesium supplementation may offer some treatment benefit. In a 1997 research
278. study on the effectiveness of magnesium supplementation in hyperactive
279. children, 50 subjects ages 7-12 were observed over the course of 6 months.<sup>E</sup>
280. At the conclusion of the 6 month trial period, the test group showed increased
281. levels of magnesium as well as decreased incidence of hyperactivity when
282. compared to the control group.<sup>E </sup>The small sample size may pose a
283. limitation to the outcome of this study. With similar findings, a longitudinal,
284. observational study was conducted in Germany with 810 children ages 5-12 over
285. the course of 3 months.<sup>F </sup>Results showed that when subjects were
286. given Esprico<sup> </sup>(a food supplement combining omega 3, omega 6, zinc
287. and magnesium), they experienced substantial reductions in ADHD symptoms,
288. emotional and behavioral problems and sleep challenges.<sup>F </sup>Once again,
289. significant limitations to this study exist. A drop-out rate of 14% was noted
290. due to absence of positive effect, lack of compliance or adverse reactions.<sup>F</sup>
291. Further, 7.3% of the subjects were taking other medications or involved in alternate
292. treatment as well, such as medications for obstructive pulmonary disease,
293. thyroid therapeutics, psycho stimulants, unspecified amphetamines,
294. non-stimulant medication and homeopathic remedies.<sup>F</sup> In addition, the
295. study did not provide a control group, posing considerable limitation to the
296. reliability of the research outcomes.<sup>F</sup> Perhaps most significant of
297. the limitations of this study is the fact that it was funded by a grant from
298. Engelhard Arneimittel, a German Pharmaceutical company, likely leading to
299. investigator bias. A review of the literature regarding magnesium
300. supplementation in children with the ADHD diagnosis can shed light on the
301. problematic nature of stating that magnesium is an effective treatment for this
302. disorder. Esparham et al. reviewed multiple articles in the efficacy of
303. magnesium supplementation in ADHD-diagnosed children.<sup>G </sup>Though a
304. summary of the study outcomes showed benefit with this therapy, a marked number
305. of limitations were present across the studies.<sup>G </sup>Systematic review
306. revealed that the majority of the studies had methodological limitations such
307. as lack of double-blind randomized controlled study design and lack of
308. measurement standardization in regard to the levels of magnesium.<sup>G </sup>The
309. general outcome of these studies may, at best, offer reason to investigate this
310. treatment modality in future research. <o:p></o:p></span></div>
311. </div>
312. <div class="MsoNormal" style="text-align: center;">
313. <br />
314. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
315. <br /></div>
316. <div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
317. <i><span style="font-family: "Times New Roman", serif;">References</span></i><span style="font-family: "Times New Roman", serif;"><o:p></o:p></span></div>
318. <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
319. <span style="font-family: "Times New Roman", serif;">D. Moghaddam MF, Shamekhi M, Rakshani T. Effectiveness of
320. methylphenidate and PUFA for the treatment of patients with ADHD: a
321. double-blinded randomized clinical trial. Electronic Physician. 2017; 9:
322. 4412-4418. Available from: <a href="http://www.ephysician.ir/"><span style="color: blue;">http://www.ephysician.ir</span></a>. Accessed December 15,
323. 2017.<o:p></o:p></span></div>
324. <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
325. <span style="font-family: "Times New Roman", serif;">E. Starobrat-Hermelin B, Kozielec T. The effects of
326. magnesium physiological supplementation on hyperactivity in children with
327. attention deficit hyperactivity disorder (ADHD). Positive response to magnesium
328. oral loading test. <i>Magnesium Research.</i> 1997; 10: 149-156.<o:p></o:p></span></div>
329. <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
330. <span style="font-family: "Times New Roman", serif;">F. Huss M, Volp A, Strauss-Grabo M. Supplementation of
331. polyunsaturated fatty acids, magnesium and zinc in children seeking medical
332. advice for attention-deficit/hyperactivity problems – an observational cohort
333. study. <i>Lipids in Health and Disease.</i> 2010; 9: 105-117.<o:p></o:p></span></div>
334. <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
335. <span style="font-family: "Times New Roman", serif;">G. Esparham A, Evans RG, Wagner LE, Drisko JA. Pediatric
336. integrative medicine approaches to attention deficit hyperactivity disorder
337. (ADHD). <i>Children. </i>2014; 1: 186-207.<o:p></o:p></span></div>
338. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
339. <br /></div>
340. <br /></div>
341. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/437053997356340739/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-ii-alternative-treatments-and-adhd.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/437053997356340739'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/437053997356340739'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/06/part-ii-alternative-treatments-and-adhd.html' title='Part II - Alternative Treatments and ADHD - Magnesium'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8196492282759272577</id><published>2021-12-08T08:00:00.001-08:00</published><updated>2021-12-08T08:00:00.209-08:00</updated><title type='text'>Part 1 - Alternative Treatments and ADHD - Omega 3/Fish Oil</title><content type='html'>&lt;br /&gt;
342. <div class="MsoNormal" style="line-height: 200%; text-align: left;">
343. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-align: justify;"> </span></span><i style="text-align: justify;"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;">Omega 3 Fatty Acids and Fish Oil</span></i><br />
344. <div class="MsoNormal" style="line-height: 200%; text-align: justify;">
345. <i><span style="font-family: "Times New Roman",serif; font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></i></div>
346. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-align: justify;">     Consistent
347. disagreement remains in the discussion regarding the benefit of including Omega
348. 3 fatty acids or fish oil in the diets of those suffering from ADHD, yet the majority
349. of evidence seems to support the conclusion that this supplement is
350. questionable at best.</span><span style="text-align: justify;">  </span><span style="text-align: justify;">A 2016 study
351. examined the effects of a marine oil extract on the levels of hyperactivity,
352. inattention, cognition, and mood in children.</span><sup style="text-align: justify;">A</sup><span style="text-align: justify;"> Researchers discovered
353. that the ingestion of such supplementation did not result in the improvement of
354. parental reports in regard to hyperactivity, inattention and impulsivity,
355. though some positive effect was seen in children without the ADHD diagnosis.</span><sup style="text-align: justify;">A  </sup><span style="text-align: justify;">Additionally, extensive review articles
356. can be found on the subject, comparing numerous studies on this topic. </span><sup style="text-align: justify;"> </sup><span style="text-align: justify;">In a review of 16 randomized controlled
357. trials including 1,514 youth with the ADHD diagnosis, overall conclusions displayed
358. that the use of Omega-3/6 supplementation had promising effects and could be
359. effectively used as adjunctive therapy to the more traditional approaches.</span><sup style="text-align: justify;">A
360.  </sup><span style="text-align: justify;">However, this review has
361. significant limitations as the authors were funded by Equazen, a company that
362. manufactures Omega-3/6 supplements, thus likely bringing significant bias into
363. the findings.</span><sup style="text-align: justify;">B </sup><span style="text-align: justify;">Another review considered multiple studies
364. investigating the benefits of Omega-3 supplementation in children labeled with
365. the ADHD diagnosis and found multiple discrepancies among those examined.</span><sup style="text-align: justify;">C</sup><span style="text-align: justify;">
366. Lack of placebo groups, small sample sizes, and minimal trial length
367. contributed to the inconsistencies of the studies and subsequent lack of
368. reliability.</span><sup style="text-align: justify;">C </sup><span style="text-align: justify;"> </span><span style="text-align: justify;">In a study
369. investigating the effectiveness of Omega 3 supplementation used in conjunction
370. with methylphenidate (a drug commonly prescribed for ADHD), researchers
371. concluded that the Omega 3 addition provided subjects with significantly better
372. outcomes when compared with controls.</span><sup style="text-align: justify;">D </sup><span style="text-align: justify;">Though this double-blinded
373. randomized clinical trial shows benefit, there are limitations which require
374. attention and are acknowledged by the researchers.</span><sup style="text-align: justify;">D</sup><span style="text-align: justify;"> The study looked
375. at a notably small sample size of 40 children within a limited age range of
376. 6-12 years and lasted over a period of only 8 weeks.</span><sup style="text-align: justify;">D </sup><span style="text-align: justify;">These factors
377. alone bring into question the validity of the results, thus requiring further
378. investigation before concrete conclusions can be made. Therefore, though some
379. research points to the potential benefits of Omega 3 supplementation in
380. children with the ADHD diagnosis, it appears that greater bodies of research
381. point to the ineffectiveness or at best, minimal effectiveness of this
382. treatment.</span></span><br />
383. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-align: justify;"><br /></span></span>
384. <br />
385. <div align="center" class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: center;">
386. <i><span style="font-family: "times new roman" , serif;">References</span></i><span style="font-family: "times new roman" , serif;"><o:p></o:p></span></div>
387. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
388. <span style="font-family: "times new roman" , serif;">A. Kean JD, Sarris J, Scholey A, et
389. al. Reduced inattention and hyperactivity and improved cognition after marine
390. oil extract (PCSO-524<sup>R</sup>) supplementation in children and adolescents
391. with clinical and subclinical symptoms of attention-deficit hyperactivity
392. disorder (ADHD): a randomized, double-blind, placebo-controlled trial. <i>Psychopharmacology. </i>2017;
393. 234: 403-420.<br />
394. B. Derbyshire E Do omega-3/6 fatty acids have a therapeutic role in children
395. and young people with ADHD. <i>Journal of Lipids. </i>2017; 2017:
396. 1-9.<o:p></o:p></span></div>
397. <span style="font-family: "times" , "times new roman" , serif;"><span style="text-align: justify;">
398.  
399.  
400.  
401. </span></span><br />
402. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
403. <span style="font-family: "times new roman" , serif;">C. Konigs A, Kiliaan AJ. Critical
404. appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder
405. treatment. <i>Neuropsychiatric Disease and Treatment.</i> 2016; 12:
406. 1869-1882.<br />
407. D. Moghaddam MF, Shamekhi M, Rakshani T. Effectiveness of methylphenidate and
408. PUFA for the treatment of patients with ADHD: a double-blinded randomized
409. clinical trial. Electronic Physician. 2017; 9: 4412-4418. Available from: <a href="http://www.ephysician.ir/">http://www.ephysician.ir</a>. Accessed
410. December 15, 2017.<o:p></o:p></span></div>
411. </div>
412. <div class="MsoNormal" style="text-align: center;">
413. <br /></div>
414. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8196492282759272577/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/05/part-1-alternative-treatments-and-adhd.html#comment-form' title='7 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8196492282759272577'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8196492282759272577'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/05/part-1-alternative-treatments-and-adhd.html' title='Part 1 - Alternative Treatments and ADHD - Omega 3/Fish Oil'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>7</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-4681537539731539785</id><published>2021-12-01T04:54:00.001-08:00</published><updated>2021-12-01T04:54:00.161-08:00</updated><title type='text'>Healing Properties of Articum Lappa (Burdock Root)?</title><content type='html'>&lt;span style=&quot;font-family: Times, Times New Roman, serif;&quot;&gt;&lt;span style=&quot;font-family: Times, Times New Roman, serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
415. </span><br />
416. <div class="MsoNormal" style="line-height: normal;">
417. <a href="https://natureslegacies.com/wp-content/uploads/Vine-Vera-Ingredient-Spotlight-Actium-Lappa-Root-Extract.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Times, Times New Roman, serif;"><img alt="Image result for burdock root" border="0" height="133" src="https://natureslegacies.com/wp-content/uploads/Vine-Vera-Ingredient-Spotlight-Actium-Lappa-Root-Extract.jpg" width="200" /></span></a><span style="font-family: Times, Times New Roman, serif;">I recently read a statement on a
418. popular health blog, stating the benefits of Articum Lappa, also known as
419. burdock root. As is the case with many natural supplements, claims for the
420. benefits of Arctium Lappa are extensive. Ranging from a combatant for cancer, a
421. healer for skin and an antibacterial/antimicrobial agent, to an
422. anti-inflammatory substance, a natural diuretic and defense against diabetes,
423. Arctium Lappa is touted as a plant with almost magical properties. From this
424. list of claimed values, the question becomes one of reliability and evidence
425. supporting these advantageous assertions. As always, a little digging provides
426. a clearer understanding of the real story.<o:p></o:p></span></div>
427. <div class="MsoNormal" style="line-height: normal;">
428. <span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
429. <div class="MsoNormal" style="line-height: normal;">
430. <span style="font-family: Times, Times New Roman, serif;">In a <a href="https://pdfs.semanticscholar.org/20f1/dbc370439986e6b7119dd8a66839f7de7560.pdf">study </a>aimed at determining
431. the beneficial properties of several plants, researchers attempted to evaluate
432. the antimicrobial activity of the combined plant extracts of artichoke,
433. dandelion and Arctium Lappa. A serial dilution method was employed to assess
434. the antimicrobial activity of this blend when introduced to bacterial strains
435. of Staphylococcus aureus, Escherichia coli, and Salmonella abony. Researchers
436. concluded that using this trifecta of plant extracts proved to be beneficial
437. against Escherichia coli and Salmonella abony but did not show antimicrobial
438. activity when tested with Staphylococcus aureus. Though this study points to
439. the possible benefit of Arctium Lappa  on
440. health, the study has clear limitations for the claims of Arctium Lappa’s sole
441. benefit due to the fact that it was not tested apart from artichoke and
442. dandelion.<o:p></o:p></span></div>
443. <div class="MsoNormal" style="line-height: normal;">
444. <span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
445. <div class="MsoNormal" style="line-height: normal;">
446. <span style="font-family: Times, Times New Roman, serif;">In a randomized, double‐blind
447. placebo‐controlled clinical <a href="https://www.ncbi.nlm.nih.gov/pubmed/29520881">trial</a>, 3 subjects infected with Helicobacter pylori
448. (H.pylori) were studied. Nineteen participants ingested a burdock complex (BC)
449. consisting of burdock (Arctium Lappa), angelica, gromwell and sesame oil and 17
450. subjects ingested a placebo for a total of eight weeks. Multiple markers were
451. tested, including anti-inflammatory properties, to determine the efficacious nature
452. of BC.  Subjects were evaluated at
453. fourth, eighth, and tenths weeks, with endoscopic examination taking place at
454. the baseline and tenth weeks. Researchers determined that BC significantly
455. inhibited and alleviated inflammatory markers of H-pylori in subjects during
456. the course of the study period.<o:p></o:p></span></div>
457. <div class="MsoNormal" style="line-height: normal;">
458. <span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
459. <div class="MsoNormal" style="line-height: normal;">
460. <span style="font-family: Times, Times New Roman, serif;">A <a href="http://mct.aacrjournals.org/content/13/1/49">study </a>of a key constituents
461. extracted from the seeds of Arctium Lappa, identified as Lappaol F, was
462. performed in regard to its anticancer effects in humans. During the course of
463. the study, researchers investigated Lappaol F and its effect on colon, breast,
464. lung, cervix, and prostate cancers as well as melanoma, osteosarcoma, and
465. leukemia.  Results demonstrated that
466. Lappaol F suppressed cancer cell growth in human cancer cell lines in a variety
467. of tissue types and displayed a time- and dose-dependent relationship.  Researchers stated that Lappaol F offers a
468. novel anticancer constituent, and has the capacity to mediate growth
469. suppression by initiating cell-cycle arrest as well as trigger cell death in
470. some tumor cell lines.<o:p></o:p></span></div>
471. <div class="MsoNormal" style="line-height: normal;">
472. <span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
473. <div class="MsoNormal" style="line-height: normal;">
474. <span style="font-family: Times, Times New Roman, serif;">A number of limitations exist in
475. regard to the studies cited. Across studies, the method of plant compound
476. extraction greatly varied, ranging from extraction from seeds to extraction
477. from leaves and stems, suggesting possible differences in quality or potency of
478. the constituents. Some studies used a combination of plants rather than looking
479. solely at the medicinal properties of Arctium Lappa, pulling into question
480. which component was of greatest consequence and whether the effect was due to
481. the pooled benefits of all the components or based solely on one plant.  Further, differing methods of administration
482. were performed, such as ingestion of tea versus consumption via liquid essence
483. form. Another key difference between studies was the method of investigation,
484. ranging from in vitro studies to those involving human participants. In
485. addition, the studies involving human subjects were limited in size and took
486. place over short periods of time. Another limitation is presented in the fact
487. that some studies focused on the benefits of Arctium Lappa as a whole and
488. others used isolated constituents of the plant to test and determine efficacy.
489. All of these factors point to the importance of further investigation into the
490. effectiveness of specific and consistent variables. In other words, examining
491. studies that focus on similar constituents, extraction protocol, testing
492. methods, administration, and observation might provide a better picture of
493. efficacy than studying the varied approaches listed above. However, the
494. purposes of this paper were to present a foundation of possible efficacy for
495. Arctium Lappa, thus presenting the need for further and more detailed research
496. opportunities.<o:p></o:p></span></div>
497. <div class="MsoNormal" style="line-height: normal;">
498. <span style="font-family: Times, Times New Roman, serif;"><br /></span></div>
499. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
500. </div>
501. <div class="MsoNormal" style="line-height: normal;">
502. <span style="font-family: Times, Times New Roman, serif;">It appears evident that benefit
503. exists in the use of Arctium Lappa for its healing properties, including its
504. anti-microbial, anti-bacterial, anti-inflammatory and anti-cancer effects.
505. Further, varied methods of extraction, administration and components used point
506. to the efficacious potential for this acclaimed medicinal plant. Clearly, as
507. mentioned above, consistency in extraction, test measures and administration
508. should be employed in future research studies to determine specific efficacy
509. but the initial display of benefits is evident following a brief review of the
510. literature.</span><o:p></o:p></div>
511. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/4681537539731539785/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2018/06/healing-properties-of-articum-lappa.html#comment-form' title='7 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4681537539731539785'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4681537539731539785'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2018/06/healing-properties-of-articum-lappa.html' title='Healing Properties of Articum Lappa (Burdock Root)?'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>7</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7140139262147053885</id><published>2021-11-26T04:53:00.001-08:00</published><updated>2021-11-26T04:53:20.123-08:00</updated><title type='text'></title><content type='html'>&lt;br /&gt;
512. <div align="center" class="MsoNormal" style="line-height: 200%; text-align: center;">
513. <span style="font-family: "times" , "times new roman" , serif;">Ashwagandha: Overview, Efficacy,
514. Risk<o:p></o:p></span></div>
515. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
516. <span style="font-family: "times" , "times new roman" , serif;">With the use of supplements being a
517. popular practice, it likely comes as no surprise that a plant-based anti-stress
518. and anti-anxiety supplement has been advertised extensively. Withania
519. somnifera, more frequently referred to as ashwagandha, has been touted for its
520. beneficial capabilities, with significant implications regarding its ability to
521. reduce stress levels.<sup>1</sup> Despite its many claims, however, sufficient
522. information is questionable as to the benefits it provides. A further look at the
523. history of its use as well as its evidential efficacy is warranted,
524. particularly due to the widespread recommendations of its use.<o:p></o:p></span></div>
525. <div class="MsoNormal" style="line-height: 200%;">
526. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">History<o:p></o:p></span></i></div>
527. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
528. <span style="font-family: "times" , "times new roman" , serif;">Ashwagandha is a plant from which
529. the root and berries have historically been used to create medicinal compounds.
530. Utilized by Ayurvedic, Indian and Unani medicine, ashwagandha has been
531. prescribed for a whole host of physical and mental maladies ranging from
532. arthritis, tumors and tuberculosis to stress, difficulty thinking and anxiety.<sup>1
533. </sup>In a brief review article referencing ashwagandha, one author stated that
534. the health implications for this plant are extensive, being consistently used
535. in Indian and Ayurvedic medicine.<sup>2</sup> Further the author stated that
536. particularly noteworthy amongst uses were implications of benefit for tumors,
537. inflammation, infectious diseases, fevers and inflammatory conditions.<sup>2, 3</sup>
538. However, despite the plethora of assumed uses, the author noted that the
539. traditional use of this plant “may not be supported by scientific studies”.<sup>2
540. </sup>In addition to the long list of illnesses ashwagandha is suggested to
541. treat, it is also commonly referred to as an adaptogen (possessing the ability
542. to aid the body in the normalization and regulation of systemic stress).<sup>1 </sup>Ashwagandha
543. has frequently been used as a naturally-occurring anti-stress and anti-anxiety
544. agent, which will be the central focus of this paper.<sup>1<o:p></o:p></sup></span></div>
545. <div class="MsoNormal" style="line-height: 200%;">
546. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Efficacy <o:p></o:p></span></i></div>
547. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
548. <a href="https://www.blogger.com/u/1/null" name="_Hlk521469041"><span style="font-family: "times" , "times new roman" , serif;">In a
549. review of clinical studies, authors examined the research surrounding the evidential
550. usefulness of plant-based medicines as anxiolytics.<sup>4 </sup>Of the 21
551. plants with research pertaining to human clinical trial evidence, 13 showed
552. anxiolytic effects when used in durations longer than one day, one of which was
553. ashwagandha.<sup>4 </sup>Though positive effect was observed, authors further
554. stated that the difference between the outcome of ashwagandha administration
555. compared to placebo was not statistically significant.<sup>4 </sup>Authors stated
556. that conclusions should be taken cautiously as many of the studies contained
557. study limitations such as small sample sizes, brief intervention periods, and
558. non-replication.<sup>4 <o:p></o:p></sup></span></a></div>
559. <span style="font-family: "times" , "times new roman" , serif;"><span style="mso-bookmark: _Hlk521469041;"></span>
560.  
561. </span><br />
562. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
563. <span style="font-family: "times" , "times new roman" , serif;">In a double-blind, randomized,
564. placebo-controlled study, researchers looked at the effect of ashwagandha
565. extract capsules (formulated from the roots and leaves) on chronically stressed
566. humans.<sup>5 </sup>The 98 subjects who completed the study were divided into
567. four groups, three with various dosages and frequency of dosages and one
568. control group.<sup>5 </sup>Results showed improvement of anxiety ratings in all
569. of the treatment groups when compared to placebo, thus leading researchers to
570. conclude that the claims regarding ashwagandha’s anxiolytic effects were
571. warranted.<sup>5 </sup>However, it is important to note that not only was the
572. research performed with the financial support of Natreon Inc., the patent
573. holder of withania somnifera but several of the researchers were employed or
574. worked voluntarily at Natreon<span style="mso-spacerun: yes;">  </span>or
575. NutraGenesis LLC, a retailer of withania somnifera.<sup>5</sup> Therefore, the
576. results of this study should be accepted cautiously, due to the financial
577. investment and potential benefit these results may provide the companies
578. involved.<sup>5<o:p></o:p></sup></span></div>
579. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
580. <span style="font-family: "times" , "times new roman" , serif;">Looking at the anxiolytic efficacy
581. of an ethanolic extract of withania somifera (tablet form), <a href="https://www.blogger.com/u/1/null" name="_Hlk521300748">a double-blind, placebo-controlled evaluation</a> was
582. performed with 39 subjects diagnosed with ICD-10 generalized anxiety disorder,
583. mixed anxiety and depression, panic disorder, and adjustment disorder with
584. anxiety.<sup>6</sup> Participants were evaluated at two and six weeks using the
585. Hamilton Anxiety Scale, the Global Rating Scale and the Systematic Assessment
586. for Treatment Emergent Effects (SAFTEE) symptom checklist.<sup>6</sup>
587. Commenting on participant dropout during the study, researchers stated that
588. upon investigation, drop-outs occurred due to lack of benefit, adverse side
589. effects, need for increased medication and undisclosed reasons.<sup>6</sup>
590. Following a review of results, researchers concluded that a demonstration of
591. ashwagandha’s anxiolytic effects was evident and proved superior than placebo
592. at the two-week follow-up and statistically significant at the 6-week
593. follow-up.<sup>6 </sup>Once again of note, the research study was supported by
594. a grant provided by Gufic LTD, Bombay, the manufacturer of the ashwagandha
595. formulation tested.<sup>6 </sup>Though this acknowledgement does not infer
596. automatic inferiority of the study results, it does give rise for additional
597. caution of study bias.<o:p></o:p></span></div>
598. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
599. <span style="font-family: "times" , "times new roman" , serif;">In a randomized controlled trial,
600. researchers examined the efficacy of naturopathic care for patients with
601. anxiety.<sup>7 </sup>All participants suffered from moderate to severe anxiety
602. for at least six weeks prior to the beginning of the study.<sup>7 </sup>Forty-one
603. subjects received naturopathic care (NC) and forty subjects received
604. standardized psychotherapy (PT), both for a duration of 12 weeks.<sup>7 </sup>Subjects
605. in the NC group received several forms of treatment including dietary
606. counseling, deep breathing relaxation techniques, a standard multi-vitamin and
607. ashwagandha (extracted from the root).<sup>7</sup> Similarly, the PT group
608. engaged in several treatments including deep breathing relaxation techniques
609. and placebo.<sup>7 <span style="mso-spacerun: yes;"> </span></sup>Intended to
610. measure anxiety, mental health, and overall quality of life, results were evaluated
611. using the Beck Anxiety Inventory (BAI), the Short Form 36 (SF-36), Fatigue
612. Symptom Inventory (FSI), and Measure Yourself Medical Outcomes Profile (MY-MOP).<sup>7
613. </sup>Participants were observed for at least eight weeks, during which time,
614. BAI scores decreased by 56.5% in the NC subjects compared to 30.5% in the PT
615. subjects.<sup>7 </sup>Further, significant differences presented with the two
616. groups, with the NC group demonstrating greater clinical benefit in the areas
617. of mental health, concentration, fatigue, social functioning, vitality, and
618. overall quality of life.<sup>7 </sup>Though both groups demonstrated
619. improvement in levels of anxiety, researchers concluded that the NC group
620. benefited more from treatment when compared to the PT group.<sup>7 </sup>One
621. limitation worth noting is the variety of NC treatments employed makes it
622. difficult to draw conclusions regarding the efficacy of any one factor.<sup>7</sup>
623. Therefore, in regard to the positive effect of ashwagandha based on this
624. research, it may only prove to be a potential element for benefit with the
625. necessity of further research. Though results showed positive effect for
626. naturopathic treatment, including the use of ashwagandha, the products used in
627. the study were supplied free of charge by the company who makes them, thus
628. possibly giving rise to caution yet again.<sup>7<o:p></o:p></sup></span></div>
629. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
630. <span style="font-family: "times" , "times new roman" , serif;">One prospective, randomized,
631. double-blind, placebo-controlled study was performed to determine the efficacy
632. of a high-concentration, full-spectrum extract of ashwagandha root when
633. administered to adults suffering from stress and anxiety.<sup>8 </sup>Based
634. upon the premise that Ayurvedic medicine, animal studies and clinical studies
635. all point to ashwagandha’s safe and effective role as an adaptogen, researchers
636. looked at 64 participants with a history of experiencing chronic stress.<sup>8 </sup>Through
637. the use of measured serum cortisol levels as well as stress-assessment
638. questionnaires, researchers evaluated the effect of ashwagandha on the
639. participants.<sup>8 </sup>Results indicated significant reduction in symptoms
640. on all measures in the ashwagandha group when compared to the placebo group.<sup>8
641. </sup>Further, serum cortisol levels decreased substantially in the ashwagandha
642. group when compared to the placebo group.<sup>8 </sup>Researchers concluded that
643. the outcomes of this study suggested that administering high concentration,
644. full-spectrum ashwagandha root had an anti-stress effect with little to no side
645. effects and an overall positive improvement on self-assessed quality of life.<sup>8</sup><span style="mso-spacerun: yes;">  </span>Researchers admitted that the study was small
646. and the duration was limited, thus recommending studies with larger sample
647. sizes and longer treatment periods are warranted.<sup>8<o:p></o:p></sup></span></div>
648. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
649. <span style="font-family: "times" , "times new roman" , serif;">In a
650. randomized, double-blind, placebo-controlled study, researchers examined the
651. effect of ashwagandha on generalized anxiety disorder (GAD).<sup>9 </sup>The study consisted of 86 patients
652. diagnosed with GAD, divided into two groups.<sup>9</sup> The treatment group
653. received four grams of ashwagandha root in granule form three times a day for
654. 60 days while the placebo group received four grams of placebo for 60 days.<sup>9</sup>
655. Researchers measured a variety of symptoms including tension, fear, insomnia,
656. difficulty with concentration/memory, depressed mood, sensory and muscular
657. complaints, and anxiety.<sup>9</sup> Results<span style="mso-spacerun: yes;"> 
658. </span>showed that on all measures both groups experienced highly significant
659. improvement but on all measures except one, there was no significant difference
660. between the treatment and placebo groups.<sup>9</sup> Researchers stated that anxiety
661. was the only factor that improved in a superior manner with the administration
662. of ashwagandha compared to the placebo.<sup>9</sup> However, researchers commented,
663. “On the whole, despite having insignificant statistical difference in both the
664. groups, Group A, Ashwagandha (Withania somnifera) granules, showed a better
665. percentage improvement than Group B (placebo). Ashwagandha (Withania somnifera)
666. granules have shown superior results in the management of GAD as compared to placebo
667. granules. Hence, the alternate hypothesis is accepted i.e. Ashwagandha
668. (Withania somnifera) is effective in the management of Generalized Anxiety
669. Disorder”.<sup>9</sup> <o:p></o:p></span></div>
670. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
671. <span style="font-family: "times" , "times new roman" , serif;">Pratte and colleagues performed a
672. systematic review of several of the above-mentioned studies and made several
673. interesting comments regarding the outcomes and validity of the studies.<sup>10
674. </sup>Across the five studies fitting inclusion criteria, researchers reported
675. consistently positive study results regarding the use of ashwagandha to lessen
676. stress and anxiety.<sup>10</sup> However, researchers illuminated multiple
677. study limitations in all of the reports reviewed including researcher bias,
678. small sample sizes, short duration of trials and lack of researcher blinding.<sup>10</sup>
679. Further, according to Cochrane criteria, none of the studies achieved low
680. risk-of-bias rating.<sup>10</sup> Therefore, researchers concluded that though
681. the results of the studies showed ashwagandha’s superiority over placebo, the
682. outcomes must be taken with cautionary optimism.<sup>10<o:p></o:p></sup></span></div>
683. <div class="MsoNormal" style="line-height: 200%;">
684. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Side Effects and Risk<o:p></o:p></span></i></div>
685. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
686. <span style="font-family: "times" , "times new roman" , serif;">Though ashwagandha has been reported
687. as a “possibly safe” plant for ingestion, it is important to investigate the
688. overall side effect profile as well as the potential risk of use.<sup>1</sup>
689. Some state that large doses of the plant may produce stomach upset, diarrhea
690. and vomiting and further, that the long-term safety of its use has not yet been
691. determined.<sup>1</sup> In addition, some caution has been recommended for
692. those suffering from various diseases, based upon possible risks associated
693. with interactions of medications or disease progression.<sup>1 </sup>Others
694. suggest ashwagandha may lower blood sugar levels or interfere with medications
695. in diabetic patients, decrease blood pressure in people with hypotension,
696. irritate the gastrointestinal tract, increase immune system activity in
697. autoimmune patients, slow down the central nervous system thus causing
698. complications with anesthesia, and increase thyroid hormone levels in those
699. suffering from thyroid disorders.<sup>1 </sup>These potential side effects and
700. risks present the importance of using ashwagandha with discretion. For the
701. current analysis, the studies previously reviewed shed further light on the
702. side effect profile of this so-termed medicinal plant. <o:p></o:p></span></div>
703. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
704. <span style="font-family: "times" , "times new roman" , serif;">When human clinical trials were
705. reviewed in regard to the anxiolytic effects of plant-based medicines,
706. researchers concluded that ashwagandha was well tolerated by subjects and did
707. not produce any heightened levels of adverse effects when compared to placebo.<sup>4<o:p></o:p></sup></span></div>
708. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
709. <span style="font-family: "times" , "times new roman" , serif;">Of the 98 subjects who participated
710. in a double-blind, randomized, placebo-controlled study on the effect of
711. ashwagandha on chronically stressed humans, researchers reported that adverse
712. effects were absent in all subjects, including those who dropped out of the
713. study.<sup>5 </sup>Researchers clarified further, stating that the lack of
714. adverse effects was observed regardless of dosage or frequency of administration.<sup>5</sup><o:p></o:p></span></div>
715. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
716. <span style="font-family: "times" , "times new roman" , serif;">When an ethanolic extract of
717. ashwagandha was used in a double-blind, placebo-controlled study involving
718. patients diagnosed with anxiety disorders, the plant was not only well
719. tolerated by participants but adverse side effects were comparable to those
720. demonstrated in participants using placebo.<sup>6 </sup>Researchers stated a
721. percentage of subjects dropped out of the study, reportedly due to adverse
722. effects, yet fewer came from the ashwagandha group when compared to the control
723. group.<sup>6</sup> Further, adverse effects were observed early in the study
724. and were reportedly easily managed by way of dosage adjustment.<sup>6 </sup><span style="mso-spacerun: yes;"> </span>Of additional importance, though abrupt
725. withdrawal was initiated at six weeks, no withdrawal symptoms appeared in the
726. participants, thus leading researchers to state ashwagandha’s superiority to
727. the conventional anxiolytic drugs such as benzodiazepines, tricyclic
728. antidepressants, and buspirone which oftentimes have adverse withdrawal
729. effects.<sup>6<o:p></o:p></sup></span></div>
730. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
731. <span style="font-family: "times" , "times new roman" , serif;">In a randomized study performed to
732. determine the effectiveness of naturopathic care on measures of anxiety
733. compared to standardized psychotherapy treatment, researchers looked at the
734. benefit of several treatments including ashwagandha.<sup>7</sup> Researchers
735. did not observe any serious adverse reactions from the dispensation of
736. ashwagandha.<sup>7<o:p></o:p></sup></span></div>
737. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
738. <span style="font-family: "times" , "times new roman" , serif;">When used in a prospective,
739. randomized, double-blind, placebo-controlled study, high concentrations of
740. full-spectrum extract of ashwagandha root produced favorable results with few
741. side effects.<sup>8</sup> Follow-up interviews were conducted over the phone on
742. days 15, 30, and 45 to evaluate treatment compliance as well as evaluation of
743. any adverse reactions.<sup>8</sup><span style="mso-spacerun: yes;"> 
744. </span>Additional safety and efficacy evaluations were performed on day 60.<sup>8</sup>
745. Out of the 61 subjects reviewed, only six adverse events were reported, a
746. minimal number particularly when compared to the five adverse events reported
747. in the placebo group.<sup>8</sup> Reported side effects were nasal congestion,
748. constipation, cough/cold, drowsiness and decreased appetite in the treatment
749. group compared to dry mouth, fatigue, fever, headache, abdominal pain, diarrhea
750. and tremors in the legs in the control group.<sup>8</sup> Researchers further
751. stated that all adverse events were mild and “no known mechanisms relate these
752. adverse events to the study drug”.<sup>8<o:p></o:p></sup></span></div>
753. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
754. <span style="font-family: "times" , "times new roman" , serif;">Researchers in a randomized,
755. double-blind, placebo-controlled study examined the effect of ashwagandha on
756. generalized anxiety disorder (GAD) in 86 patients previously diagnosed with
757. this disturbance. Outcomes of the study indicated a lack of adverse side
758. effects for those ingesting ashwagandha over the course of the investigation.<sup>9<o:p></o:p></sup></span></div>
759. <div class="MsoNormal" style="line-height: 200%;">
760. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Conclusions<o:p></o:p></span></i></div>
761. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
762. <span style="font-family: "times" , "times new roman" , serif;">From the above-reviewed studies, it
763. appears that ashwagandha may have beneficial potential for aiding in the
764. reduction of symptoms pertaining to stress and anxiety. It is important to note
765. that in some studies, though positive benefit was observed, the favorable
766. outcomes were not deemed statistically significant. <o:p></o:p></span></div>
767. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
768. <span style="font-family: "times" , "times new roman" , serif;">A point worth mentioning is the
769. fact that despite the varied nature of administration, it did not appear that
770. the manner in which the plant was distributed (i.e. tablet form, pill form,
771. granule form), the dosage or the frequency of ingestion significantly influenced
772. the outcomes of the plant’s efficacy rating. Of significant note is the lack of
773. reported adverse side effects as well as the lack of negative feedback in
774. regard to withdrawal symptoms. Though side effects, adverse reactions and
775. withdrawal symptoms may have been underreported, there did not appear to be
776. evidence pointing to their frequency or significantly problematic nature. These
777. factors point to the possible positive nature of ashwagandha in those dealing
778. with symptoms of anxiety and heightened stress without the added concern of
779. contracting adverse reactions. <o:p></o:p></span></div>
780. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
781. <span style="font-family: "times" , "times new roman" , serif;">As previously mentioned, limitations
782. did exist across all of the studies, giving rise to caution when drawing conclusions
783. yet the preponderance of the evidence points to the prospective but cautionary
784. use of ashwagandha as an effective way treat symptoms associated with stress
785. and anxiety. However, it is important to recognize that though the use of
786. ashwagandha to ameliorate unpleasant symptoms may provide relief, it serves
787. primarily as a symptom manager. In other words, the underlying cause of the
788. anxiety and stress does not get addressed at the core if surface symptoms are
789. simply alleviated. Therefore, if this plant is used to aid in the process of
790. treatment, it may be advisable to utilize it as a complementary modality rather
791. than a primary method of therapy. <o:p></o:p></span></div>
792. <div class="MsoNormal" style="line-height: 200%;">
793. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Clinical Note<o:p></o:p></span></i></div>
794. <div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
795. <span style="font-family: "times" , "times new roman" , serif;">Within a practice setting, I would
796. likely veer away from recommending such a supplement due to the potential for
797. it becoming a crutch and thus preventing clients from delving into the real
798. issues at hand. However, I am not sure I would spend a whole lot of time
799. talking a client out of using such a product if he/she is set on using it,
800. namely because it does not appear that ashwagandha presents significant risks
801. or side effects. If a client chose to utilize this supplement as a symptom
802. reliever, I would be sure to explain the research behind it, my reservations
803. regarding its use, and ultimately the importance and necessity of the client
804. making a personal and informed decision about it.</span></div>
805. <div class="MsoNormal" style="line-height: 200%; text-align: center;">
806. </div>
807. <div class="MsoNormal" style="line-height: normal; text-align: right;">
808. <div style="text-align: center;">
809. <br /></div>
810. </div>
811. <div style="text-align: right;">
812. <div class="MsoNormal" style="line-height: normal; margin-left: 0.25in; text-align: center;">
813. <i><span style="font-family: "times new roman" , serif;">References<o:p></o:p></span></i></div>
814. <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
815. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
816. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">WebMD.
817. Ashwagandha. Available at: </span><a href="https://www.webmd.com/vitamins/ai/ingredientmono-953/ashwagandha"><span style="font-family: "times new roman" , serif;">https://www.webmd.com/vitamins/ai/ingredientmono-953/ashwagandha</span></a><span style="font-family: "times new roman" , serif;">. Accessibility verified August 4,
818. 2018. <o:p></o:p></span></div>
819. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
820. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
821. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Michigan
822. Medicine: University of Michigan. Ashwagandha. Available at: </span><a href="https://www.uofmhealth.org/health-library/hn-2039005#hn-2039005-uses"><span style="font-family: "times new roman" , serif;">https://www.uofmhealth.org/health-library/hn-2039005#hn-2039005-uses</span></a><span style="font-family: "times new roman" , serif;">. Accessibility verified August 4,
823. 2018.<o:p></o:p></span></div>
824. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
825. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
826. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Duke
827. JA. In: <i>CRC Handbook of Medicinal Herbs</i>.
828. 2<sup>nd</sup> ed. Boca Raton, FL: CRC Press; 2002: 41-42.<o:p></o:p></span></div>
829. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
830. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
831. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Sarris
832. J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, part
833. 2: a review of clinical studies with supporting preclinical evidence. <i>CNS Drugs. </i>2013; 27(4): 301-19.<o:p></o:p></span></div>
834. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
835. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">5.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
836. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Auddy
837. B, Hazra J, Mitra A, Abedon B, Ghosal S. A standardized withania somnifera
838. extract significantly reduces stress-related parameters in chronically stressed
839. humans: a double-blind, randomized, placebo-controlled study. <i>Journal of the American Nutraceutical
840. Association. </i>2008; 11(1): 50-56.<o:p></o:p></span></div>
841. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
842. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">6.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
843. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Andrade
844. C, Aswath A, Chaturvedi SK, Srinivasa M, Raguram R. A double-blind,
845. placebo-controlled, evaluation of the anxiolytic efficacy of an ethanolic
846. extract of withania somnifera.  <i>Indian Journal of Psychiatry</i>. 2000; 42(3):
847. 295-301.<o:p></o:p></span></div>
848. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
849. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">7.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
850. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Cooley
851. K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized
852. controlled trial ISRCTN78958974. <i>PLoS ONE</i>.
853. 2009; 4(8): 1-10. <o:p></o:p></span></div>
854. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
855. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">8.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
856. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Chandrasekhar
857. K, Kapoor J, Anishetty S. A prospective, randomized double-blind,
858. placebo-controlled study of safety and efficacy of a high-concentration
859. full-spectrum extract of ashwagandha root in reducing stress and anxiety in
860. adults<i>. Indian Journal of Psychological
861. Medicine</i>. 2012; 34(3): 255-262. <o:p></o:p></span></div>
862. <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
863. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">9.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">     
864. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Khyati
865. S, Anup T. A randomized double-blind placebo-controlled study of ashwagandha on
866. generalized anxiety disorder. <i>International
867. Ayurvedic Medicine Journal</i>. 2013; 1: 1–7.<o:p></o:p></span></div>
868. <br />
869. <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-left: 0.75in; text-align: left; text-indent: -0.25in;">
870. <!--[if !supportLists]--><span style="font-family: "times new roman" , serif; mso-fareast-font-family: "Times New Roman";">10.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  
871. </span></span><!--[endif]--><span style="font-family: "times new roman" , serif;">Pratte
872. MA, Nanavati KB, Young V, Morley CP. An Alternative Treatment for Anxiety: A
873. Systematic Review of Human Trial Results Reported for the Ayurvedic Herb
874. Ashwagandha (withania somnifera). <i>Journal
875. of Alternative and Complementary Medicine</i>. 2014; 20(12): 901-908. <o:p></o:p></span></div>
876. </div>
877. <div style="text-align: left;">
878. <br /></div>
879. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7140139262147053885/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/ashwagandha-overview-efficacyrisk-with.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7140139262147053885'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7140139262147053885'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/ashwagandha-overview-efficacyrisk-with.html' title=''/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6149499112047516432</id><published>2020-03-21T07:07:00.002-07:00</published><updated>2021-11-26T04:52:35.880-08:00</updated><title type='text'>Responding to the Corona Virus - a More Hopeful Approach</title><content type='html'>&lt;a href=&quot;https://images.unsplash.com/photo-1504567961542-e24d9439a724?ixlib=rb-1.2.1&amp;amp;ixid=eyJhcHBfaWQiOjEyMDd9&amp;amp;auto=format&amp;amp;fit=crop&amp;amp;w=1000&amp;amp;q=80&quot; imageanchor=&quot;1&quot; style=&quot;clear: left; float: left; margin-bottom: 1em; margin-right: 1em;&quot;&gt;&lt;img alt=&quot;closeup photo of yellow sunflowers&quot; border=&quot;0&quot; height=&quot;150&quot; src=&quot;https://images.unsplash.com/photo-1504567961542-e24d9439a724?ixlib=rb-1.2.1&amp;amp;ixid=eyJhcHBfaWQiOjEyMDd9&amp;amp;auto=format&amp;amp;fit=crop&amp;amp;w=1000&amp;amp;q=80&quot; width=&quot;200&quot; /&gt;&lt;/a&gt;There is no doubt the corona virus &quot;pandemic&quot; is enveloping every avenue of our society...our world right now. Fear is rampant, anxious thoughts inundate the minds of many, questions arise about the uncertainty and panic covers our world as if blanketing it with an eerie presence. People keep asking me what I think about all of this; is it real or is this a hoax? More questions filter in about whether or not I am afraid of contracting it or if I feel comfortable going to the grocery store. Clients ask me if I am still holding appointments in my office. Others question how to deal with the spirit of fear that is everywhere and how to effectively deal with the social isolation that is being mandated across the globe.&lt;br /&gt;
880. <br />
881. I could delve deeper into detail in terms of what I believe to be true in the midst of this - the research, the numbers, the facts - but I will leave that to another day. My point in this post is different than the usual content of this blog because it is not a referenced article. However, I believe it is of key importance in the midst of this unprecedented circumstance. This idea was prompted following a conversation with my sister earlier this week. As we were discussing all that is unfolding, my sister said "I am hopeful that something good is going to come out of this...something surprisingly good". That struck me and I began to craft what that belief might look like in practical terms.<br />
882. <br />
883. The approach I have determined to take is one that bucks the current paradigm. "I choose hope" has become my mantra in these trying days. It is a complete shift in mindset when compared to the overwhelming message of despair that is covering our world and I believe it is essential. How easy it is to get wrapped up in all that is wrong right now and if we are not intentionally focused on something else, we too will fall prey to the spreading of despair. I don't want to simply roll my eyes and say "this is crazy" (which I have been guilty of doing) but rather I want to combat this fearful mentality with actionable hope. So what does that look like in practical terms? I'd like to use this post to point out a few ways that we can all engage in, not only with a hopeful outlook but also practical ways to implement hopeful actions.<br />
884. <br />
885. <br />
886. Actionable Step #1 - Fill your mind with goodness. It likely comes as no surprise that when we fill our minds with negativity, we begin to act in a like manner. So in other words, negative input produces negative output. Intentionally seek to fill the atmosphere of your mind with uplifting content. For me, that looks like reading my Bible daily, reading articles that reflect hope, listening to news that does not solely focus on despair and negativity but rather hope in the midst of chaos, listening to uplifting music.<br />
887. <br />
888. Actionable Step #2 - Creating a "hope list". This is a list of intentionality - choosing to be hopeful in the midst of chaos and negativity. The content focuses on ways to be intentional about embracing these days and weeks and months and making them joyful, deliberately fulfilling, productive and memorable.<br />
889. <br />
890. Actionable Step #3 - Looking for every opportunity to combat the spirit of fear. I won't sit in my house, secluded from society, fearful of being in someone else's presence. I will be respectful of the views of others and will not attempt to force my beliefs on anyone but I will not isolate myself. I will go to the grocery store, I will take walks in my neighborhood, I will welcome clients into my office, I will even shake someone's hand if they extend theirs to mine.<br />
891. <br />
892. Actionable Step #4 - Being wise in everyday practices. Be mindful of those who are at great risk and steer clear (nursing home residents, frail or sickly individuals, tiny babies). Don't plan a giant party. I will not be foolhardy but I will be mindful of health-related practices. I will be a bad host for illness by washing my hands after being in public, eating food that follows a pattern of dietary excellence, drinking plenty of water and exercising daily. In short, I will continue caring for my body the way I always do.<br />
893. <br />
894. Actionable Step #5 - Willingly accepting that I am not in control of these circumstances. I do not have the ability to change any of this. Therefore, I choose to leave the outcome up to God, thankful I have not been tasked with being in control!<br />
895. <br />
896. Not so difficult really. You might notice a theme interlaced throughout each actionable step - intentionality. These things may not come naturally to you...which is actually the point. These items are not complicated and yet they will remain undone if we do not deliberately embrace them. What impact would be made if more people followed these steps as opposed to actions that perpetuate fear and anxiety?<br />
897. <br />
898. <div style="text-align: center;">
899. I would encourage you to set this as your purpose in this season:</div>
900. <div style="text-align: center;">
901. Intentionally embrace hope by filling your mind with goodness and deliberately focus on actionable steps which reflect that mindset.</div>
902. <div style="text-align: center;">
903. <br /></div>
904. <div style="text-align: center;">
905. <br /></div>
906. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/6149499112047516432/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/responding-to-corona-virus-more-hopeful.html#comment-form' title='4 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6149499112047516432'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6149499112047516432'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/responding-to-corona-virus-more-hopeful.html' title='Responding to the Corona Virus - a More Hopeful Approach'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>4</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-3835648438038102096</id><published>2020-03-09T09:00:00.000-07:00</published><updated>2021-11-26T05:00:27.388-08:00</updated><title type='text'>Interstitial Cystitis Conclusion</title><content type='html'>&lt;br /&gt;
907. <div class="MsoNormal" style="line-height: normal;">
908. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Conclusion<o:p></o:p></span></i></div>
909. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
910. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">As this review has
911. demonstrated, IC is a life-altering disease riddled with multiple uncomfortable
912. and disruptive physical symptoms. Oftentimes the disease goes undiagnosed or
913. misdiagnosed and is oftentimes referred to as a diagnosis of exclusion. The
914. rate of comorbidity is elevated in those suffering from IC, displaying the
915. additionally challenging issues that accompany the management of multiple
916. disorders. Equally distressing is the elusive nature of causality for IC,
917. leaving patients with a sense of helplessness, in addition to the inability of
918. doctors to confidently recommend preventative measures. Though multiple
919. diagnostic tests are performed, none have been specifically created for the
920. diagnosis of IC. Some are invasive or uncomfortable and oftentimes the
921. diagnosis is a result of simply eliminating a whole host of other diagnostic
922. possibilities before arriving at the IC determination. This process can be
923. frustrating, lengthy and defeating to the patients who have been suffering for
924. long periods of time. Of even great importance is the questionable validity of
925. treatment modalities. As has been observed above, pharmacological treatment is
926. oftentimes ineffective or perhaps mildly effective but carries with it the
927. significant risk of adverse side effects. More complementary and alternative methods
928. (CAM) such as yoga, physical therapy, acupuncture, probiotics, dietary
929. interventions and psychological strategies have shown benefit in a number of
930. studies. However, oftentimes sample sizes are small and the amount of credible
931. and substantial evidence is lacking, thus calling into question the
932. advisability of assuming any one of these techniques provides the curative key
933. to IC. The overarching benefit to CAM is the absence of notable risks and
934. adverse side effect profiles. Perhaps the bottom line in light of this review
935. is to focus on the issues that can be improved or solved and let further
936. research determine the direction for the unanswered questions at hand. Using a
937. variety of CAM techniques provides the potential for benefit and should perhaps
938. be considered first-line treatment, while steering clear of the riskier
939. pharmacological methods.<span style="mso-spacerun: yes;">  </span>Though this appears
940. to be a logical approach to a difficult problem, the unfortunate reality is
941. that oftentimes logic is lacking in the overall outlook on health. As always,
942. lots of work to be done.<o:p></o:p></span></div>
943. <div class="MsoNormal" style="line-height: normal;">
944. <br /></div>
945. &lt;br /&gt;</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/3835648438038102096/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-conclusion.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3835648438038102096'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3835648438038102096'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-conclusion.html' title='Interstitial Cystitis Conclusion'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-1416125066791810351</id><published>2020-03-06T12:20:00.003-08:00</published><updated>2024-02-02T03:36:33.427-08:00</updated><title type='text'>Science of Essential Oils</title><content type='html'>&lt;a href=&quot;http://rec001.freeconferencecalling.com/mp3/1334873/196059/LA3977_05022016075907644_1094569.mp3&quot;&gt;http://rec001.freeconferencecalling.com/mp3/1334873/196059/LA3977_05022016075907644_1094569.mp3&lt;/a&gt;</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/1416125066791810351/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/science-of-essential-oils.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1416125066791810351'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/1416125066791810351'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/science-of-essential-oils.html' title='Science of Essential Oils'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7835588984827643027</id><published>2020-03-02T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.967-08:00</updated><title type='text'>Interstitial Cystitis Part VI</title><content type='html'>&lt;br /&gt;
946. <div class="MsoNormal" style="line-height: normal;">
947. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
948. Modalities: Psychological Strategies<o:p></o:p></span></i></div>
949. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
950. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Though perhaps not
951. widely understood or considered, psychological strategies and techniques can
952. offer potential benefits to those suffering from pain disorders by aiding
953. patients in the development of better coping strategies and transforming
954. underlying pain beliefs.<sup>49 <o:p></o:p></sup></span></div>
955. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
956. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a study of 138
957. participants with an IC diagnosis, patients were surveyed to determine the use
958. and effectiveness of psychological self-care strategies in the management of
959. symptoms.<sup>50</sup> Following review of results, researchers concluded that
960. women suffering from IC engaged in a number of psychological self-care such as
961. downward comparison, self-validation, empowerment, information-seeking, connection
962. with others and taking personal responsibility for illness.<sup>50</sup>
963. Results demonstrated improved ability to cope depended upon the use of <span style="mso-spacerun: yes;"> </span>information-seeking, downward comparison,
964. empowerment, connection with others and self-validation.<sup>50</sup> Of most
965. significance, researchers stated that involvement in a support group was
966. perhaps the most important strategy employed.<sup>50</sup> <o:p></o:p></span></div>
967. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
968. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A study of 108
969. subjects with pain-related distress and disability participated in several
970. acceptance-based strategies to determine effectiveness in dealing with pain.<sup>51
971. </sup>Treatment tools centered around increasing patient willingness to deal
972. with uncomfortable thoughts and feelings and instead focusing attention on
973. behaviors that encourage improved functioning in the long term rather than
974. caving to a momentary feeling.<sup>51 </sup>In addition, physical exercise,
975. health habits and meaningful life directions were addressed as components of
976. therapy.<sup>51 </sup>Researchers concluded that the pain and functional
977. ability of the patients improved significantly at post-treatment and at three
978. month follow-up when compared to pre-treatment.<sup>51 </sup>More specifically,
979. improvements across participants included 41.2% improvement in depression, 25%
980. improvement in physical disability, 39.9% improvement in psychosocial disability,
981. 61.8% reduction in hours needed to rest as a result of pain during daytime
982. hours, and 48.2% improvement in the ability to repeatedly perform sit-to-stand
983. endeavors.<sup>51 </sup><span style="mso-spacerun: yes;"> </span>Researchers
984. stated that psychological methods for dealing with chronic pain have significant
985. evidence to support their effectiveness yet confirmation of<span style="mso-spacerun: yes;">  </span>particular treatment modalities that lead to
986. improvement are lacking.<sup>51</sup> Further, researchers stated that an
987. acceptance-based treatment approach challenges the pain experience overall and offers
988. a very promising avenue for further development in the management of pain.<sup>51</sup>
989. <o:p></o:p></span></div>
990. <br />
991. <br />
992. <div style="text-align: center;">
993. <div style="text-align: left;">
994. <div style="text-align: center;">
995. <i>References</i></div>
996. </div>
997. </div>
998. <div style="text-align: center;">
999. <div style="text-align: left;">
1000. 49.<span style="white-space: pre;"> </span>Atchley MD, Shah NM, Whitmore KE. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States. Translational Andrology and Urology. 2015; 4(6): 662-667. </div>
1001. </div>
1002. <div style="text-align: center;">
1003. <div style="text-align: left;">
1004. 50.<span style="white-space: pre;"> </span>Webster DC, Brennan T. Use and effectiveness of psychological self-care strategies for interstitial cystitis. Healthcare for Women International. 1995; 16(5): 463-75.</div>
1005. </div>
1006. <div style="text-align: center;">
1007. </div>
1008. <div style="text-align: center;">
1009. <div style="text-align: left;">
1010. 51.<span style="white-space: pre;"> </span>McCrackena LM, Vowlesb KE, Eccleston C. Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy. 2005; 43: 1335–1346.</div>
1011. </div>
1012. <div style="text-align: center;">
1013. <div style="text-align: left;">
1014. <br /></div>
1015. </div>
1016. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7835588984827643027/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-part-vi.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7835588984827643027'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7835588984827643027'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/03/interstitial-cystitis-part-vi.html' title='Interstitial Cystitis Part VI'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7494310461815718496</id><published>2020-02-24T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.806-08:00</updated><title type='text'> Interstitial Cystitis Part V</title><content type='html'>&lt;br /&gt;
1017. <div class="MsoNormal" style="line-height: normal;">
1018. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
1019. Modalities: Probiotics<o:p></o:p></span></i></div>
1020. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1021. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Contrary to
1022. popular belief, the bladder is not sterile, a concept relatively recently
1023. presented as truth.<sup>42 </sup>In a detailed article regarding the history
1024. and current discoveries of the urinary microbiome, authors displayed evidence
1025. for the validity of a microbiome housed in the bladder.<sup>42 </sup>Not only
1026. is the urinary microbiome in existence, but in most people, it plays a
1027. protective role much like the microbiomes found in the rest of the body.<sup>42
1028. </sup>It has been postulated that disturbances in the urinary microbiome may
1029. contribute to the symptomatology that accompanies urgency urinary incontinence.<sup>42
1030. </sup>The authors of the review stated that future work is needed to better
1031. understand the intricate world of the urinary microbiome as well as what
1032. contributes to its development and healthy maintenance.<sup>42 </sup>Though
1033. this review does not pertain directly to IC, it does bring up questions as to
1034. whether or not the use of probiotics to ensure healthy microbiota would be
1035. warranted in IC patients. <o:p></o:p></span></div>
1036. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1037. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Though not a well-referenced
1038. site, the Interstitial Cystitis Association (ICA) has presented the potential
1039. benefit of probiotics for IC patients, stating that adding this supplement may
1040. provide support for general wellness.<sup>43</sup> The ICA states that
1041. probiotics initiate growth of good bacteria that will in turn help to boost he
1042. body’s natural immune defenses, thus encouraging whole-body wellness.<sup>43 </sup>Further,
1043. the ICA site reports that some IC patients have found benefit to taking
1044. probiotics, therefore presenting the possibility of positive effect.<sup>43</sup>
1045. <o:p></o:p></span></div>
1046. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1047. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a
1048. cross-sectional study, researchers compared variance between the urinary
1049. microbiome and the cytokine levels of IC-diagnosed women and healthy controls.<sup>44</sup><span style="mso-spacerun: yes;">  </span>Results demonstrated that the urinary
1050. microbiome of IC participants was less diverse, less likely to be colonized
1051. with lactobacillus, and linked with higher levels of proinflammatory cytokines.<sup>44
1052. </sup>These results present the assumption that the microbiome of IC patients
1053. is damaged or altered and would perhaps benefit from the introduction of
1054. probiotics as an adjunctive treatment option. <o:p></o:p></span></div>
1055. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1056. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A systematic
1057. review was performed on the topic of the microbiome in the urinary tract<span style="mso-spacerun: yes;">  </span>and the use of prebiotics and probiotics as
1058. useful treatment for various urological disprders.<sup>45 </sup>Eighty-nine
1059. studies were included in the review and focused on a variety of urologic
1060. disorders including urinary incontinence, urologic cancers, interstitial
1061. cystitis, neurogenic bladder dysfunction, sexually transmitted infections, and
1062. chronic prostatitis/chronic pelvic pain syndrome.<sup>45</sup> Following an
1063. assimilation of the data and subsequent investigation of the study outcomes,
1064. the authors concluded that the microbiome in healthy individuals likely changes
1065. from a healthy one to a damaged one with the presence of urologic disorders.<sup>45</sup>
1066. Authors posed the hypothesis that the use of prebiotics and probiotics may
1067. provide a useful modality in the treatment of urologic disorders but the need
1068. for further study is apparent.<sup>45 </sup>Again, though the accumulation of
1069. data regarding the proven benefit of using prebiotics and probiotics to treat
1070. urologic disorders has not yet been widely collected, enough evidence exists to
1071. support the assumption that this may offer a promising therapy for those
1072. suffering from these disorders.<sup> <o:p></o:p></sup></span></div>
1073. <div class="MsoNormal" style="line-height: normal;">
1074. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
1075. Modalities: Dietary Intervention<o:p></o:p></span></i></div>
1076. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1077. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Dietary
1078. intervention has been widely suggested as a possible way to reduce flare ups
1079. and symptoms of IC.<sup>3</sup> Though dietary changes do not appear to provide
1080. a curative effect, studies reveal that the elimination of certain foods may be
1081. helpful in the management of symptoms. One study on dietary triggers and IC was
1082. performed to determine which foods most exacerbated symptoms.<sup>46.</sup>Three
1083. hundred forty-four foods were considered in regard to problematic potential to
1084. effect urinary frequency, urgency and/or pelvic pain symptoms.<sup>46 </sup>Researchers
1085. discovered that out of the 598 responses submitted, 95.8% of the participants answered
1086. affirmatively that certain foods and beverages contributed to their IC symptoms.<sup>46
1087. </sup>The majority of food and beverages tested posed no effect on symptoms but
1088. the items most frequently identified as problematic were citrus fruits,
1089. tomatoes, coffee, tea, carbonated and alcoholic beverages, spicy foods,
1090. artificial sweeteners, and vitamin C.<sup>46</sup> In addition, calcium
1091. glycerophosphate (a calcium salt) and baking soda offered symptom relief in
1092. some participants.<sup>46</sup> Researchers concluded that though IC diets do
1093. not necessarily need to be significantly restricted, it would behoove patients
1094. to abstain from the above-listed foods in order to provide preventative
1095. measures as well as alleviate symptoms.<sup>46 </sup><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
1096. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1097. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a survey of 374
1098. IC patients, the affect of certain beverages was tested in regard to IC
1099. symptomatology.<sup>47 </sup>Researchers discovered that the inclusion of
1100. acidic, alcoholic or carbonated beverages, and coffee or tea caused an increase
1101. in overall pain in more than 50% of the participants, thus suggesting that the
1102. elimination of such liquids would be beneficial to IC patients.<sup>47</sup> <o:p></o:p></span></div>
1103. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1104. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a study of 104
1105. IC patients, researchers investigated the effect of 175 different foods and
1106. beverages.<sup>48</sup> Out of those surveyed, 90.2% reported that the
1107. consumption of particular foods irritated their symptoms, though no correlation
1108. was found between allergic reactions and the effect of certain foods on
1109. symptoms.<sup>48 </sup>The foods and beverages most widely identified as
1110. problematic in terms of increased symptoms were caffeinated, carbonated and
1111. alcoholic beverages, certain fruits and juices, artificial sweeteners and spicy
1112. foods.<sup>48</sup> Looking at a compilation of the data, it appears fairly
1113. apparent that certain groups of foods cause an increase in symptom presentation
1114. and IC patients have potential benefit from eliminating such foods from the
1115. diet. <o:p></o:p></span></div>
1116. <br />
1117. <br />
1118. <div style="text-align: center;">
1119. <i>References</i></div>
1120. <div style="text-align: center;">
1121. <i><br /></i></div>
1122. <div style="text-align: center;">
1123. <div style="text-align: left;">
1124. 42.<span style="white-space: pre;"> </span>Thomas-White K, Brady M, Wolfe AJ, Mueller ER. The bladder is not sterile: history and current discoveries on the urinary microbiome. Current Bladder Dysfunction Reports. 2016; 11(1): 18-24. </div>
1125. </div>
1126. <div style="text-align: center;">
1127. <div style="text-align: left;">
1128. 43.<span style="white-space: pre;"> </span>Interstitial Cystitis Association. Do probiotics work? Available at: https://www.ichelp.org/diagnosis-treatment/treatments/ic-diet-self-management/do-probiotics-help-ic/. Accessibility verified July 18, 2018.</div>
1129. </div>
1130. <div style="text-align: center;">
1131. <div style="text-align: left;">
1132. 44.<span style="white-space: pre;"> </span>Abernethy MG, Rosenfeld A, White JR, Mueller MG, Lewicky-Gaupp C, Kenton K. Urinary  microbiome and cytokine levels in women with interstitial cystitis. Obstetrics and Gynecology. 2017; 129(3): 500-506.</div>
1133. </div>
1134. <div style="text-align: center;">
1135. <div style="text-align: left;">
1136. 45.<span style="white-space: pre;"> </span>Aragón IM, Herrera-Imbroda B, Queipo-Ortuño MI, et al. The urinary tract microbiome in health and disease. European Urology Focus. 2018; 4(1): 128-138.</div>
1137. </div>
1138. <div style="text-align: center;">
1139. <div style="text-align: left;">
1140. 46.<span style="white-space: pre;"> </span>Bassaly R, Downes K, Hart S. Dietary consumption triggers in interstitial cystitis/bladder pain syndrome patients. Female Pelvic Medicine and Reconstructive Surgery. 2011; 17(1): 36-39.</div>
1141. </div>
1142. <div style="text-align: center;">
1143. <div style="text-align: left;">
1144. 47.<span style="white-space: pre;"> </span>Koziol JA, Clark DC, Gittes RF, Tan EM. The natural history of interstitial cystitis: a survey of 374 patients. The Journal of Urology. 1993; 149(3): 465-9.</div>
1145. </div>
1146. <div style="text-align: center;">
1147. </div>
1148. <div style="text-align: center;">
1149. <div style="text-align: left;">
1150. 48.<span style="white-space: pre;"> </span>Shorter B, Lesser M, Moldwin RM, Kushner L. Effect of comestibles on symptoms of interstitial cystitis. The Journal of Urology. 2007; 178(1): 145-152.</div>
1151. </div>
1152. <div style="text-align: center;">
1153. <div style="text-align: left;">
1154. <br /></div>
1155. </div>
1156. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7494310461815718496/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-v.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7494310461815718496'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7494310461815718496'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-v.html' title=' Interstitial Cystitis Part V'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-3796769172790604866</id><published>2020-02-17T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.641-08:00</updated><title type='text'> Interstitial Cystitis Part IV</title><content type='html'>&lt;br /&gt;
1157. <div class="MsoNormal" style="line-height: normal;">
1158. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
1159. Modalities: Yoga<o:p></o:p></span></i></div>
1160. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1161. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Due to the fact
1162. that IC is a disorder oftentimes associated with poor musculoskeletal, neural
1163. and myofascial function of the back and/or pelvis, yoga has been shown to be an
1164. effective tool in the amelioration of IC symptoms as well as the accompanying
1165. psychological challenges.<sup>34</sup> It has been suggested that programs
1166. formulated to sustain balance of the main contributing muscles which affect the
1167. pelvic structure and lower back should be used in IC patients to help with
1168. symptom management.<sup>34 <o:p></o:p></sup></span></div>
1169. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1170. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a small
1171. randomized controlled trial of 20 women, researchers looked at the use of
1172. mindfulness-based stress reduction (MBSR), combining the modalities of
1173. meditation and yoga, and its effect on IC.<sup>35 </sup>Researchers stated that
1174. because stress exacerbates the symptoms of IC significantly, this treatment
1175. method is highly warranted due to its strong stress-reducing effects.<sup>35 </sup>Women
1176. in the study were divided into two groups, one receiving usual care (UC) and
1177. the other receiving UC as well as engaging in MBSR.<sup>35</sup> Though the
1178. MBSR group did not exceed symptom amelioration on all measures when compared to
1179. the UC group, significant improvement was seen in the women engaged in MBSR.<sup>35
1180. </sup>More MBSR patients reported post-treatment symptom improvement when
1181. compared to the UC group (87.5% of MBSR group versus 36.4% of UC group).<sup>35</sup>
1182. Though some of the MBSR group improvement was not statistically significant, it
1183. still provides insight into the therapy method and its potential effect on IC.<sup>35</sup>
1184. Researchers concluded that the results of this study provide evidence to
1185. reinforce the role of MBSR as a significantly useful tool for the treatment of
1186. IC and should be incorporated into the care plan of IC patients.<sup>35</sup>
1187. Limitations presented by small sample size should also be taken into consideration.
1188. <o:p></o:p></span></div>
1189. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1190. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Though not
1191. specifically referring to IC, the results of a meta-analysis may shed light on
1192. the possibility of the benefit of using yoga for IC patients.<sup>36 </sup>Though
1193. small, the study further supports the use of yoga in those who suffer from
1194. prolonged pain.<sup>36 </sup>Researchers concluded that the use of yoga as a
1195. complementary approach for those suffering from pain is a useful tool that
1196. produces moderate effect sizes on pain-ridden individuals.<sup>36 </sup>This
1197. finding can indirectly be applied to the possibility of yoga providing similar
1198. benefit to those suffering from the pain associated with IC.<sup>36<o:p></o:p></sup></span></div>
1199. <div class="MsoNormal" style="line-height: normal;">
1200. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
1201. Modalities: Physical Therapy<o:p></o:p></span></i></div>
1202. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1203. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Physical therapy
1204. (PT) has been used to treat IC patients and shown benefit.<sup>26 </sup>PT for
1205. IC patients frequently centers around soft tissue manipulation and
1206. rehabilitation that can help facilitate scar reduction and pain improvement.<sup>26
1207. </sup>Exercises oftentimes focus on pelvic floor relaxation rather than
1208. strengthening pelvic floor muscles.<sup>26</sup> <o:p></o:p></span></div>
1209. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1210. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">In a randomized,
1211. multicenter clinical trial of 81 women suffering from IC, researchers looked at
1212. the benefit of myofascial physical therapy (MPT) when compared to global
1213. therapeutic massage (BTM).<sup>37</sup> Though results displayed superior
1214. benefit of the MPT when compared to the GTM (59% improvement in the MPT group
1215. versus 26% in the GTM group), both categories experienced amelioration of some
1216. symptoms.<sup>37</sup> In addition, the sample size was small, thus presenting
1217. the need for caution in regard to drawing broad conclusions.<sup>37</sup> <o:p></o:p></span></div>
1218. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1219. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A pilot study of
1220. 16 female IC-diagnosed patients who suffered from high-tone pelvic floor
1221. dysfunction were monitored following manual PT.<sup>38</sup> Therapy included
1222. several techniques including direct myofascial release, joint mobilization,
1223. muscle energy techniques, strengthening, stretching, and neuromuscular
1224. reeducation.<sup>38</sup> Patients were tested for symptoms before and after
1225. treatment to determine levels of improvement.<sup>38</sup> Greatest improvement
1226. was seen in frequency of pain and suprapubic pain, while improvement in urgency
1227. and nocturia showed smaller changes.<sup>38 </sup>Researchers concluded that manual
1228. PT may be a positive therapeutic tool in the treatment of IC.<sup>38 <o:p></o:p></sup></span></div>
1229. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1230. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Forty-five women
1231. and seven men with IC or urgency-frequency syndrome were followed in a study to
1232. determine the effects of manual PT on the symptoms of these disorders.<sup>39</sup>
1233. Researchers stated that, “The rationale was based on the hypothesis that pelvic
1234. floor myofascial trigger points are not only a source of pain and voiding
1235. symptoms, but also a trigger for neurogenic bladder inflammation via antidromic
1236. reflexes”, thus attempting to reach a deeper part of the problem.<sup>39 </sup>PT
1237. centered around the pelvic floor and was conducted one to two times per week
1238. for eight to twelve weeks.<sup>39 </sup>Results demonstrated that the specific
1239. manual PT employed was highly effective in symptom amelioration for both groups
1240. of patients.<sup>39</sup><o:p></o:p></span></div>
1241. <div class="MsoNormal" style="line-height: normal;">
1242. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Treatment
1243. Modalities: Acupuncture<o:p></o:p></span></i></div>
1244. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1245. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Acupuncture has
1246. long been known for its beneficial effect on pain. A study involving a small
1247. sample of IC-diagnosed female patients examined the usefulness of acupuncture
1248. on symptom reduction.<sup>40 </sup>All twelve participants received ten
1249. acupuncture administrations twice a week and evaluations of symptoms were
1250. completed in the 1<sup>st</sup>, 3<sup>rd</sup>, 6<sup>th</sup> and 12<sup>th</sup>
1251. months.<sup>40 </sup>Results showed a statistically significant decrease in all
1252. measures in the first month.<sup>40 </sup>Improvement scores varied at
1253. different points in the study, with positive effect demonstrated in differing
1254. areas during all evaluations.<sup>40 </sup>Despite the small sample size, based
1255. upon the study results, researchers concluded that acupuncture displays a
1256. promising, non-invasive and efficacious treatment option for those suffering
1257. with IC.<sup>40 <o:p></o:p></sup></span></div>
1258. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1259. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A systematic
1260. review of complementary therapies for bladder pain syndrome looked at 11
1261. studies, all of which were evaluated for quality based on the Cochrane risk of
1262. bias scale prior to their inclusion.<sup>41</sup> Several key interventions
1263. were discussed amongst the studies including acupuncture, relaxation therapy,
1264. physical therapy, hydrogen-rich therapy, diet and nitric oxide synthetase.<sup>41
1265. </sup>Following careful evaluation, researchers concluded that dietary
1266. management, acupuncture and physical therapy had the highest potential for
1267. providing benefit to patients with bladder pain syndrome.<sup>41</sup>
1268. Researchers advised caution in regard to these results due to the limited study
1269. sizes included in the review.<sup>41<o:p></o:p></sup></span></div>
1270. <br />
1271. <br />
1272. <div style="text-align: center;">
1273. <i>References</i></div>
1274. <div style="text-align: center;">
1275. <div style="text-align: left;">
1276. 34.<span style="white-space: pre;"> </span>Ripoll E, Mahowald D. Hatha Yoga therapy management of urologic disorders. World Journal of Urology. 2002; 20: 306–309.</div>
1277. </div>
1278. <div style="text-align: center;">
1279. <div style="text-align: left;">
1280. 35.<span style="white-space: pre;"> </span>Kanter G, Komesu YM, Qaedan F, et al. Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. International Urogynecology Journal. 2016; 27(11): 1705-1711. </div>
1281. </div>
1282. <div style="text-align: center;">
1283. <div style="text-align: left;">
1284. 36.<span style="white-space: pre;"> </span>Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. Translational Andrology and Urology. 2015 4(6); 653-661. </div>
1285. </div>
1286. <div style="text-align: center;">
1287. <div style="text-align: left;">
1288. 37.<span style="white-space: pre;"> </span>FitzGerald M, Payne C, Lukacz E, et al. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome (IC/PBS) and pelvic floor tenderness. The Journal of Urology. 2012; 187(6): 2113-2118. </div>
1289. </div>
1290. <div style="text-align: center;">
1291. <div style="text-align: left;">
1292. 38.<span style="white-space: pre;"> </span>Lukban J1, Whitmore K, Kellogg-Spadt S, Bologna R, Lesher A, Fletcher E. The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac dysfunction. Urology. 2001; 57(6)(1): 121-122.</div>
1293. </div>
1294. <div style="text-align: center;">
1295. <div style="text-align: left;">
1296. 39.<span style="white-space: pre;"> </span>Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. The Journal of Urology. 2001; 166(6): 2226-2231.</div>
1297. </div>
1298. <div style="text-align: center;">
1299. <div style="text-align: left;">
1300. 40.<span style="white-space: pre;"> </span>Sönmez MG1, Kozanhan B. Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome. Ginekologia Polska. 2017; 88(2): 61-67.</div>
1301. </div>
1302. <div style="text-align: center;">
1303. </div>
1304. <div style="text-align: center;">
1305. <div style="text-align: left;">
1306. 41.<span style="white-space: pre;"> </span>Verghese TS, Riordain RN, Champaneria R, Latthe PM. Complementary therapies for bladder pain syndrome: a systematic review. International Urogynecology Journal. 2016; 27: 1127-1136. </div>
1307. </div>
1308. <div style="text-align: center;">
1309. <div style="text-align: left;">
1310. <br /></div>
1311. </div>
1312. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/3796769172790604866/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iv.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3796769172790604866'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/3796769172790604866'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iv.html' title=' Interstitial Cystitis Part IV'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-143709308762518164</id><published>2020-02-10T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.512-08:00</updated><title type='text'>  Interstitial Cystitis Part III</title><content type='html'>&lt;br /&gt;
1313. <div class="MsoNormal" style="line-height: normal;">
1314. <i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Treatment
1315. Modalities: Medications<o:p></o:p></span></i></div>
1316. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1317. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">When it comes to
1318. treatment options for IC, the list of possibilities is lengthy. However, it is
1319. important to note the risks and benefits of the suggested treatments prior to
1320. the engagement of any one modality. Treatments range from prescribed and
1321. over-the-counter medications to so-called natural interventions, diet and
1322. lifestyle modifications.<o:p></o:p></span></div>
1323. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1324. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Nonsteroidal
1325. anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium are
1326. sometimes used for IC patients. The reasoning behind these types of prescriptions
1327. is based upon the premise that inflammation plays an integral part in the
1328. pathophysiology of IC.<sup>23</sup> With the use of these drugs, prostaglandin
1329. production is blocked and reportedly leads to control of inflammatory pain.<sup>23
1330. </sup>Challenges may arise, however, due to the increased risk of serious
1331. gastrointestinal and cardiovascular adverse effects with NSAID use.<sup>23</sup>
1332. Some researchers go so far as to say that IC can be caused by NSAID use, a
1333. condition known as drug-induced interstitial cystitis (DIC).<sup>24</sup> In a
1334. review on DIC and the effects of particular drugs on the development or exacerbation
1335. of symptoms, researchers found that NSAIDs may contribute to the initiation or
1336. worsening of symptoms.<sup>24</sup> Authors were bold enough to state:<o:p></o:p></span></div>
1337. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
1338. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">“Although there is
1339. no clear association between other NSAIDs and cystitis, there is sufficient
1340. evidence to suspect strongly that they do occasionally induce cystitis…Unless
1341. drugs are essential and cannot be replaced by suitable alternatives, they
1342. should be stopped in sequence, starting with obvious candidates such as
1343. NSAIDs…New drugs are being introduced all the time and as urologists, we need
1344. to raise our level of awareness. It seems that many urologists do not read <i style="mso-bidi-font-style: normal;">Current Problems in Pharmacovigilance </i>or
1345. <i style="mso-bidi-font-style: normal;">The British Medical Journal.”</i><sup>24<o:p></o:p></sup></span></div>
1346. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1347. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Tricyclic
1348. antidepressants are another class of drug frequently prescribed for IC. These
1349. drugs such as amitriptyline or imipramine work by aiding in the relaxation of
1350. the bladder which in turn facilitates blockage of pain.<sup>3 </sup>The
1351. mechanism of action lies in the drug’s ability to inhibit the reuptake of
1352. norepinephrine and serotonin from the brainstem to the spinal cord.<sup>25</sup>
1353. However, though in theory these drugs may suggest benefit, some research has
1354. shown that this class of drugs is useless for pain unless the patients taking
1355. them are simultaneously suffering from depression.<sup>25 </sup>Therefore,
1356. researchers conclude that in regard to pain, “if the patient is not depressed,
1357. the SSRIs are virtually useless”.<sup>25</sup> <o:p></o:p></span></div>
1358. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1359. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">According to
1360. Harvard Health, tricyclic antidepressants have the ability to relax the
1361. bladder, slow the release of neurochemicals that initiate bladder pain and
1362. inflammation and may also enhance sleep.<sup>26</sup> With most medications,
1363. however, these drugs also carry with them side effect profiles that are less
1364. than desirable.<sup>26<o:p></o:p></sup></span></div>
1365. <div class="MsoNormal" style="line-height: normal;">
1366. <sup><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;">                   </span></span></sup><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">In a study of 94
1367. patients, the long term use of tricyclic antidepressants was examined to
1368. determine safety and efficacy.<sup>27 </sup>Though the researchers concluded
1369. that patient satisfaction overall was highly positive (46% of patients),
1370. several limitations are of note.<sup>27 </sup>Not only did 84% of the patients
1371. experience negative side effects, but the dropout rate was 31%, a fairly large
1372. percentage of the original group.<sup>27 </sup>Perhaps of even greater
1373. significance was the fact that nonresponse to treatment was the leading
1374. explanation for dropout with side effects contributing to 86% of those who
1375. exited the study.<sup>27</sup> With these factors in mind, the so-called
1376. “feasible, safe and effective” use of tricyclic antidepressants as a treatment
1377. for IC is questionable.<sup>27<o:p></o:p></sup></span></div>
1378. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1379. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Antihistamines are
1380. another class of frequently prescribed medication in the management of IC. The
1381. assumption is that these drugs will reduce issues of urgency and frequency and
1382. in turn, relieve additional symptoms.<sup>3</sup> In a study of 90
1383. participants, researchers observed the effects of using hydroxyzine as a
1384. treatment for IC.<sup>28 </sup>Results demonstrated a positive and useful
1385. effect of the drug for IC patients.<sup>28</sup> <span style="mso-spacerun: yes;"> </span>Side effects such as sedation, increased
1386. appetite, urinary retention and nightmares were reported.<sup>28</sup> Further,
1387. researchers commented that the reasoning as to why hydroxyzine shows positive
1388. effect remains unclear, stating that the antihistamine action is not enough to
1389. explain positive action.<sup>28 </sup>Some postulate that since hydroxyzine is
1390. a histamine antagonist and inhibits mast cell (found in connective tissue,
1391. responsible for releasing histamine and contributing to inflammatory and
1392. allergic reactions) degranulation, a reduction in the release of histamine
1393. occurs.<sup>29 </sup>As histamine release is decreased, there may be a benefit
1394. for IC patients due to the assumption that increased histamine release appears
1395. to be present in the pathophysiology of IC.<sup>29 <o:p></o:p></sup></span></div>
1396. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1397. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">In a prospective,
1398. randomized, double-blind placebo-controlled trial, researchers looked at the
1399. effectiveness of cimetidine, an oral histamine antagonist, for IC patients.<sup>30
1400. </sup>Of the 34 patients who completed the study,<span style="mso-spacerun: yes;">  </span>significant improvement of symptoms, pain and
1401. sleep disturbance due to voiding urgency was observed<span style="mso-spacerun: yes;">  </span>in those taking the cimetidine.<sup>30</sup>
1402. However, researchers also noted that no qualitative change was observed in the
1403. bladder mucosa as a result of treatment and further, the mechanism of action
1404. for symptom relief was unidentifiable.<sup>30<o:p></o:p></sup></span></div>
1405. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1406. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Pentosan
1407. polysulfate sodium (PPS), marketed as Elmiron and approved specifically for the
1408. amelioration of IC symptoms, is also frequently used in the treatment regimen
1409. of IC.<sup>3</sup> However, the mechanism of action is unknown.<sup>3</sup>
1410. Another factor worthy of mention is the reality that pain reduction may take
1411. two to four months and improvement in urinary frequency may take up to six
1412. months, creating a significant challenge for many patients who have lived with
1413. the disorder for extended periods of time.<sup>3</sup> <span style="mso-spacerun: yes;"> </span>In a randomized, double-blind, placebo
1414. controlled study, researchers examined the efficacy of using a third of the
1415. recommended daily dose of PPS in IC patients.<sup>31 </sup>When compared to a
1416. placebo, results demonstrated that there was no statistically significant
1417. improvement between the study group and the placebo group.<sup>31 </sup>Further,
1418. researchers concluded that despite the broad population of symptomatic patients
1419. involved in the study, no treatment effect was revealed.<sup>31 <o:p></o:p></sup></span></div>
1420. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1421. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Retrospectively
1422. reviewing the charts of 260 IC patients, authors of another study evaluated the
1423. efficacy and safety of PPS.<sup>32</sup> Observations demonstrated that
1424. symptoms of both groups improved over time but symptom improvement was greater
1425. in terms of statistical significance in the treatment group compared to the
1426. control group.<sup>32 </sup>Nocturia was unchanged in the treatment group when
1427. compared with the control group.<sup>32 </sup>Authors concluded that though
1428. some areas of symptomatology were unchanged between groups and 15% of patients
1429. experienced negative side effects, that PPS remains an efficacious option for
1430. symptom reduction in IC patients.<sup>32 </sup>A systematic review of
1431. pharmacologic treatment of IC was performed to determine efficacy of the wide
1432. variety of medication options. <o:p></o:p></span></div>
1433. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1434. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">Researchers looked
1435. at randomized controlled trials in regard to pharmacological options for IC
1436. patients with the intention of evaluating the efficacy of medications, examine
1437. the effect size of the trials and to begin to develop a clinical consensus in
1438. terms of efficacious treatment options.<sup>33</sup> Twenty-one randomized
1439. controlled trials were used in the review, including 1470 patients.<sup>33 </sup>Though
1440. PPS showed modest treatment benefit, researchers concluded that there is an
1441. insufficient amount of evidence available for any other pharmacological
1442. treatments.<sup>33 </sup>Authors stated, “ A consensus on standardized outcome
1443. measures is urgently needed”.<sup>33<o:p></o:p></sup></span></div>
1444. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1445. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">It is clear that
1446. many questions and limitations remain in terms of pharmacological treatment
1447. options. Challenges such as unknown mechanisms of action, significant side
1448. effects, and lengthy waits for symptom reduction all point to the use of
1449. caution prior to the utilization of these medications. It would perhaps be
1450. useful to examine what alternatives exist for those suffering from this
1451. debilitating issue.<o:p></o:p></span></div>
1452. <br /><br />
1453. <br />
1454. <div class="MsoNormal" style="line-height: normal; text-align: center;">
1455. <i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">References<o:p></o:p></span></i></div>
1456. <div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
1457. <br /></div>
1458. <div style="text-align: center; text-indent: -24px;">
1459. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1460. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">23. Gardella B, Porru
1461. D, Allegri M, et al. Pharmacokinetic considerations for therapies used to treat
1462. interstitial cystitis. <i style="mso-bidi-font-style: normal;">Expert Opinion on
1463. Drug Metabolism and Toxicology.<sup> </sup></i>2014; 10(5): 673-684.<o:p></o:p></span></div>
1464. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1465. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">24. Bramble FJ, Morley
1466. R. Drug-induced cystitis: the need for vigilance. <i style="mso-bidi-font-style: normal;">British Journal of Urology.</i> 1997; 79: 3-7.<o:p></o:p></span></div>
1467. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1468. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">25. Medscape.
1469. Symptomatic treatment of neuropathic pain: a focus on the role of anticonvulsants:
1470. tricyclic antidepressants (TCAs) for the treatment of neuropathic pain.
1471. Available at: </span><a href="https://www.medscape.org/viewarticle/413110_3"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">https://www.medscape.org/viewarticle/413110_3</span></a><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">. Accessibility
1472. verified July 17, 2018.<o:p></o:p></span></div>
1473. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1474. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">26. Harvard Health
1475. Publishing. Diagnosing and treating interstitial cystitis. Available at: </span><a href="https://www.health.harvard.edu/diseases-and-conditions/diagnosing-and-treating-interstitial-cystitis"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">https://www.health.harvard.edu/diseases-and-conditions/diagnosing-and-treating-interstitial-cystitis</span></a><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">. Accessibility
1476. verified July 17, 2018. <o:p></o:p></span></div>
1477. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1478. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">27. van Ophoven A,
1479. Hertle L. Long-term results of amitriptyline treatment for interstitial
1480. cystitis. <i style="mso-bidi-font-style: normal;">The Journal of Urology. </i>2005;174(5):
1481. 1837-1840.<o:p></o:p></span></div>
1482. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1483. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">28. Theoharides TC,
1484. Sant GR. Hydroxyzine for interstitial cystitis. <i style="mso-bidi-font-style: normal;">Urology. </i>1997; 49(5): 108-110.<o:p></o:p></span></div>
1485. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1486. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">29. Association of
1487. Reproductive Health Professionals. Screening, treatment, and management of
1488. IC/PBS. Available at: </span><a href="http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Management"><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Management</span></a><span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">. Accessibility
1489. verified July 18, 2018.<o:p></o:p></span></div>
1490. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1491. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">30. Thilagarajah R,
1492. Witherow ON, Walker MM. Oral cimetidine gives effective symptom relief in
1493. painful bladder disease: a prospective, randomized, double‐blind
1494. placebo‐controlled trial. <i style="mso-bidi-font-style: normal;">BJU
1495. International. </i>2001; 87(3): 207-212.<o:p></o:p></span></div>
1496. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1497. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">31. Nickel JC,
1498. Herschorn S, Whitmore KE, et al. Pentosan polysulfate sodium for treatment of
1499. interstitial cystitis/bladder pain syndrome: insights from a randomized,
1500. double-blind, placebo-controlled study. <i style="mso-bidi-font-style: normal;">The
1501. Journal of Urology.</i> 2015; 193(3): 857-62. <o:p></o:p></span></div>
1502. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1503. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">32. Waters MG,
1504. Suleskey JF, Finkelstein LJ, Van Overbeke ME, Zizza VJ, Stommel M. Interstitial
1505. cystitis: a retrospective analysis of treatment with pentosan polysulfate and
1506. follow-up patient survey. <i style="mso-bidi-font-style: normal;">The Journal of
1507. the Osteopathic Association.</i> 2000; 100(3): S13-8.<o:p></o:p></span></div>
1508. <div class="MsoNormal" style="line-height: normal; margin-left: .25in;">
1509. <span style="font-family: "Times New Roman",serif; font-size: 12.0pt;">33. Dimitrakov J,
1510. Kroenke K, Steers WD, et al. Pharmacological management of painful bladder syndrome/interstitial
1511. cystitis: a systematic review. <i style="mso-bidi-font-style: normal;">Archives
1512. of Internal Medicine</i>. 2007; 167(18): 1922-1929. <o:p></o:p></span></div>
1513. </div>
1514. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/143709308762518164/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iii.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/143709308762518164'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/143709308762518164'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-iii.html' title='  Interstitial Cystitis Part III'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5310357276656770283</id><published>2020-02-03T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.725-08:00</updated><title type='text'>Interstitial Cystitis Part II</title><content type='html'>&lt;br /&gt;
1515. <div class="MsoNormal" style="line-height: normal;">
1516. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Comorbidities<o:p></o:p></span></i></div>
1517. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1518. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Those suffering
1519. from IC frequently present with multiple other maladies, creating an even more
1520. challenging set of symptoms to manage. In a population-based study of 9,269 IC
1521. patients and 46,345 randomly selected comparison subjects, researchers examined
1522. the prevalence of 32 comorbidities ranging from cardiovascular, pulmonary and neurological
1523. conditions to rheumatological, gastrointestinal and psychological conditions.<sup>9
1524. </sup>Results displayed a significantly higher prevalence of all comorbidities
1525. when compared to the control group, with the exception of metastatic cancer.<sup>9
1526. <o:p></o:p></sup></span></div>
1527. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1528. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A small
1529. cross-sectional study of 132 subjects was studied in regard to interstitial
1530. cystitis and comorbidities.<sup>10</sup> Researchers determined that multiple
1531. comorbidities existed in physician and questionnaire diagnosed patients.<sup>10
1532. </sup>Findings coincided with previous outcomes that showed comorbidities with
1533. conditions such as migraines, irritable bowel syndrome, and overall bodily
1534. pain.<sup>10</sup> However, results also showed several new apparent
1535. comorbidities such as symptoms related to dyspepsia as well as orthostatic
1536. intolerance (disorders with symptoms emerging during periods of standing
1537. upright that are alleviated when reclining).<sup>10</sup><o:p></o:p></span></div>
1538. <div class="MsoNormal" style="line-height: normal;">
1539. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Etiology<o:p></o:p></span></i></div>
1540. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1541. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">It is widely
1542. accepted that the specific cause of IC is still unknown, though several factors
1543. appear to be influential. Some researchers state that furtherance of knowledge
1544. in regard to the causes of IC may be limited due to the central focus on the
1545. bladder and lower urinary tract as the genesis of symptoms without examining
1546. other pelvic influences and systemic factors.<sup>11 </sup>Research has also
1547. shown the possible influence of other illnesses on the contraction of IC (rather
1548. than simply a comorbidity as discussed above) such as fibromyalgia, irritable
1549. bowel syndrome and chronic fatigue syndrome, suggesting that IC may entail
1550. systemic pathophysiology.<sup>11</sup> Therefore, researchers hypothesize that
1551. a plethora of causes and contributing factors are likely involved in IC symptoms
1552. which in turn lead to many sub-types of the disease.<sup>11</sup> Likewise,
1553. additional sources infer that multiple components are involved in the
1554. development of IC such as an autoimmune reaction, hereditary factors, infection
1555. or allergies.<sup>3 </sup>However, these possible instigating factors have
1556. remained unproven.<sup>3<span style="mso-spacerun: yes;">  </span></sup>Similarly,
1557. in a review of the literature, researchers studied possible causes of IC and
1558. came up with a multitude of potential contributing factors including the
1559. suggestion of infection and autoimmune response.<sup>12</sup> Certain studies
1560. have shown a connection between bacterial infection in the bladder and IC as a
1561. causal factor, but recent research contradicts this finding and no longer
1562. assumes that infection is the main etiology from which IC stems.<sup>12, 13, 14</sup>
1563. In regard to the autoimmune connection, results have been contradictory. <o:p></o:p></span></div>
1564. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1565. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Researchers
1566. evaluating lymphocyte populations in the blood and bladder tissue of IC
1567. patients discovered that lymphocyte populations were normal and thus not
1568. supportive of the theory that autoimmune disorders are an initiating factor.<sup>15
1569. </sup>In a different review of the literature, researchers looked at the
1570. intertwining of IC and systemic autoimmune disease and postulated that there is
1571. a possible association between IC patients and autoimmune diseases.<sup>16</sup>
1572. However, researchers stated “direct evidence clearly showing autoimmune
1573. mechanisms is lacking”.<sup>16 </sup>A connection between IC and Sjogren’s
1574. syndrome has shown a more significant connection, according to the researchers
1575. involved, and may warrant additional studies.<sup>16</sup> Questions still
1576. remain as to the causal or reactionary effect of autoimmune response in regard
1577. to the etiology of IC and further research is necessary in this area.<sup>15</sup><o:p></o:p></span></div>
1578. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1579. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Research in some
1580. studies has pointed to the hereditary nature of IC as a causal variable.
1581. Researchers looked at a small group of monozygotic and dizygotic twins to
1582. determine incidence of interstitial cystitis within this population.<sup>17 <span style="mso-spacerun: yes;"> </span></sup>Results showed that in the monozygotic
1583. twin group, five out of eight monozygotic twin respondents had probable or
1584. confirmed IC as compared to the group of 26 dizygotic twin respondents who
1585. showed no signs of IC.<sup>17 </sup>Researchers concluded that based on this
1586. finding, a genetic contribution is likely.<sup>17 </sup>It appears somewhat
1587. obvious, however, that basing statements upon one finding is ill-advised. <o:p></o:p></span></div>
1588. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1589. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">A pilot study
1590. examining the prevalence of IC within groups of first-degree relatives with an
1591. IC diagnosis was performed with a total number of 2,581 respondents.<sup>18</sup>
1592. Out of those who responded, 101 participants reported an incidence of 107
1593. first-degree relatives with IC.<sup>18</sup> Researchers reported more detailed
1594. findings, stating that not only is there a genetic component involved but adult
1595. female first-degree relatives of those diagnosed with IC may have as high as 17
1596. times higher prevalence rate than that found within the general population.<sup>18
1597. </sup>Concluding comments stated that, “This, together with previously reported
1598. evidence showing a greater concordance of IC among monozygotic than dizygotic
1599. twins, suggests, but does not prove, a genetic susceptibility to IC”.<sup>18</sup>
1600. <o:p></o:p></span></div>
1601. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1602. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">The connection
1603. between allergies and IC has been examined and some studies indicate that
1604. 40-80% of patients experience allergies.<sup>19</sup> The nature of causation
1605. versus correlation is not clear, however, and could be a comorbidity as easily
1606. as it could be a predictive element. <o:p></o:p></span></div>
1607. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1608. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Several popular,
1609. but weakly referenced, IC blogs and websites suggest that leaky gut may be a
1610. causal component of IC.<sup>20, 21 </sup>However, finding credible research
1611. that points to causation, correlation or comorbidity does not appear easily
1612. accessible. Due to the fact that there seems to be a possible connection
1613. between IC and autoimmune disorders, it would make sense if leaky gut showed up
1614. in IC patients (due to the role leaky gut plays in autoimmune disorders).
1615. Despite this fact, little formal research has been done in this area. <o:p></o:p></span></div>
1616. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1617. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Several risk
1618. variables have been suggested that may contribute to the contraction of the
1619. illness. Some articles state that risk factors range from heightened stress,
1620. sex of the individual, fair skin, red hair, or having an existing chronic pain
1621. disorder.<sup>3</sup> However, most of the research in these areas is, at best,
1622. lacking. One report on the epidemiology, risk factors, and impact of
1623. interstitial cystitis clearly stated that the only decisive risk factor for IC
1624. is female gender.<sup>22</sup><o:p></o:p></span></div>
1625. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1626. <span style="font-family: "times new roman" , serif; font-size: 12.0pt;">Many other
1627. hypotheses for the causal factors of IC have been postulated, but the bottom
1628. line to the question of causation is the frustrating yet simple conclusion that
1629. the cause of IC is still unknown.<sup>3</sup> Though this does not provide
1630. concrete data on what initiates the disorder, it may provide patients with a
1631. clear understanding of the fact that a specific cause is not known, suggesting
1632. time would be better spent on the prevention and treatment of IC.<o:p></o:p></span></div>
1633. <div class="MsoNormal" style="line-height: normal; text-align: center;">
1634. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;"><br /></span></i>
1635. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times new roman" , serif; font-size: 12.0pt;">References<o:p></o:p></span></i></div>
1636. <div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
1637. <div style="text-align: left;">
1638. <br /></div>
1639. </div>
1640. <div style="text-align: center;">
1641. <br />
1642. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1643. <span style="font-family: "Times New Roman",serif;">9.     Keller
1644. JJ1, Chen YK, Lin HC. Comorbidities of bladder pain syndrome/interstitial
1645. cystitis: a population-based study. <i>BJU International.</i> 2012;
1646. 110(11): 903-909.<o:p></o:p></span></div>
1647. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1648. <span style="font-family: "Times New Roman",serif;">10.  Chelimsky G, Heller
1649. E, Buffington CAT, Rackley R, Zhang D, Chelimsky T. Co-morbidities of interstitial
1650. cystitis. <i>Frontiers in Neuroscience</i>. 2012; 6: 1-6.<o:p></o:p></span></div>
1651. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1652. <span style="font-family: "Times New Roman",serif;">11.  Mullins C, Bavendam
1653. T, Kirkali Z, Kusek JW. Novel research approaches for interstitial
1654. cystitis/bladder pain syndrome: thinking beyond the bladder. <i>Translational
1655. Andrology and Urology</i>. 2015; 4(5): 524-533.<o:p></o:p></span></div>
1656. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1657. <span style="font-family: "Times New Roman",serif;">12.  Grover S, Srivastava
1658. A, Lee R, Tewari AK, Te AE. Role of inflammation in bladder function and
1659. interstitial cystitis. <i>Therapeutic Advances in Urology</i>. 2011;3 (1):
1660. 19-33.<o:p></o:p></span></div>
1661. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1662. <span style="font-family: "Times New Roman",serif;">13.  Domingue GJ1,
1663. Ghoniem GM, Bost KL, Fermin C, Human LG. Dormant microbes in interstitial
1664. cystitis. <i>The Journal of Urology.</i> 1995; 153(4): 1321-1326.<o:p></o:p></span></div>
1665. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1666. <span style="font-family: "Times New Roman",serif;">14.  Wilkins EG1, Payne
1667. SR, Pead PJ, Moss ST, Maskell RM. Interstitial cystitis and the urethral
1668. syndrome: a possible answer. <i>British Journal of Urology. </i>1989;
1669. 64(1): 39-44.<o:p></o:p></span></div>
1670. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1671. <span style="font-family: "Times New Roman",serif;">15.  MacDermott JP1,
1672. Miller CH, Levy N, Stone AR. Cellular immunity in interstitial cystitis. <i>The
1673. Journal of Urology.</i> 1991; 145(2): 274-278.<o:p></o:p></span></div>
1674. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1675. <span style="font-family: "Times New Roman",serif;">16.  Van de Merwe JP.
1676. Interstitial cystitis and systemic autoimmune diseases. Nature Clinical
1677. Practice – Urology. 2007; 4(9): 484-91.<o:p></o:p></span></div>
1678. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1679. <span style="font-family: "Times New Roman",serif;">17.  Warren JW, Keay SK,
1680. Meyers D, Xu J. Concordance of interstitial cystitis in monozygotic and
1681. dizygotic twin pairs. <i>Urology</i>. 2001; 57(6): 22-25.<o:p></o:p></span></div>
1682. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1683. <span style="font-family: "Times New Roman",serif;">18.  Warren JW, Jackson
1684. TL, Langenberg P, Meyers DJ, Xu J. Prevalence of interstitial cystitis in
1685. first-degree relatives of patients with interstitial cystitis. <i>Urology</i>.
1686. 2004; 63(1): 17-21.<o:p></o:p></span></div>
1687. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1688. <span style="font-family: "Times New Roman",serif;">19.  Van de Merwe JP,
1689. Yamada T, Sakamoto Y. Systemic aspects of interstitial cystitis, immunology and
1690. linkage with autoimmune disorders. <i>International Journal of Urology</i>.
1691. 2003; 10: S35–S38.<o:p></o:p></span></div>
1692. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1693. <span style="font-family: "Times New Roman",serif;">20.  Stop UTI Forever.
1694. Can a leaky gut cause IC (Interstitial Cystitis)? Available at: <a href="https://www.stoputiforever.com/interview/leaky-gut-and-ic/">https://www.stoputiforever.com/interview/leaky-gut-and-ic/</a>.
1695. Accessibility verified July 13, 2018.<o:p></o:p></span></div>
1696. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1697. <span style="font-family: "Times New Roman",serif;">21.  Eat Beautiful. How I
1698. healed my interstitial cystitis. Available at: <a href="https://eatbeautiful.net/2015/10/04/how-i-healed-my-interstitial-cystitis/">https://eatbeautiful.net/2015/10/04/how-i-healed-my-interstitial-cystitis/</a>.
1699. Accessibility verified July 13, 2018.<o:p></o:p></span></div>
1700. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1701. <span style="font-family: "Times New Roman",serif;">22.  Association of
1702. Reproductive Health Professionals. Screening, Treatment, and Management of
1703. IC/PBS. Available at: <a href="http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Epidemiology">http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/Screening-Treatment-and-Management-of-ICPBS/Epidemiology</a>.
1704. Accessibility verified July 13, 2018.<o:p></o:p></span></div>
1705. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
1706. <br /></div>
1707. <br /></div>
1708. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5310357276656770283/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-ii.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5310357276656770283'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5310357276656770283'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/02/interstitial-cystitis-part-ii.html' title='Interstitial Cystitis Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7752970901507464612</id><published>2020-01-27T09:00:00.000-08:00</published><updated>2021-11-26T04:58:15.887-08:00</updated><title type='text'>Interstitial Cystitis Part I</title><content type='html'>&lt;div class=&quot;MsoNormal&quot; style=&quot;line-height: normal; text-align: center;&quot;&gt;
1709. <span style="font-family: "times" , "times new roman" , serif;">Interstitial
1710. Cystitis: A Comprehensive Overview <o:p></o:p></span></div>
1711. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1712. <span style="font-family: "times" , "times new roman" , serif;">Also known as
1713. painful bladder syndrome, Interstitial Cystitis (IC) is a chronic disorder
1714. causing pain and discomfort for many people, oftentimes impeding normal
1715. life.<span style="mso-spacerun: yes;">  </span>Though a malady affecting both
1716. sexes, females are much more likely to suffer from the condition. Recent studies
1717. report an IC incidence rate of 197 diagnoses in women per 100,000 compared to
1718. 41 diagnoses in men per 100,000.<sup>1</sup> Perhaps the numbers appear at
1719. first to be negligible in the grand scheme of things, yet this disease can be
1720. life-altering. <o:p></o:p></span></div>
1721. <div class="MsoNormal" style="line-height: normal;">
1722. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Symptomatology<o:p></o:p></span></i></div>
1723. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1724. <span style="font-family: "times" , "times new roman" , serif;">As the name
1725. implies, IC is an uncomfortable affliction, causing symptoms such as bladder
1726. pressure and pain, bladder urgency with little output, painful intercourse, as
1727. well as pelvic pain and discomfort. Ranging from mild to severe, the pain can
1728. significantly impair everyday activities such as social engagements, exercise,
1729. sleep and the ability to perform job duties.<sup>2, 3</sup> Further, many
1730. people experience flare-ups due to triggering events such as menstruation,
1731. stress, exercise and extended periods of sitting.<sup>2 </sup><o:p></o:p></span></div>
1732. <div class="MsoNormal" style="line-height: normal;">
1733. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Diagnosis
1734. <o:p></o:p></span></i></div>
1735. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1736. <span style="font-family: "times" , "times new roman" , serif;">Oftentimes
1737. difficult to diagnose, doctors frequently attempt to rule out other illnesses
1738. with similar symptom profiles such as kidney stones, bladder cancer, sexually
1739. transmitted diseases, endometriosis, inflamed prostate, chronic pelvic pain
1740. syndrome and infection before looking further into the possibility of an IC
1741. diagnosis.<sup>2</sup> Frequently, IC symptoms may mirror signs of a chronic
1742. urinary tract infection but generally no infection is present in those
1743. suffering from this condition.<sup>2, 3</sup> If, however, an IC patient does contract
1744. a urinary infection, symptoms are oftentimes heightened.<sup>3</sup> In
1745. addition, most experts agree that due to IC’s wide range of symptoms and
1746. intensity of pain and discomfort, that IC may actually be a combination of
1747. multiple diseases.<sup>2</sup> Further complicating the diagnostic process is
1748. the fact that not only are many family physicians lacking in knowledge in
1749. regard to IC but there often tend to be multiple comorbidities with it as well.<sup>4,
1750. 5 </sup>These factors oftentimes present symptom-overlap and subsequent
1751. misdiagnoses which will be discussed shortly.<sup>4, 5</sup> <o:p></o:p></span></div>
1752. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1753. <span style="font-family: "times" , "times new roman" , serif;">Though IC is
1754. predominantly observed and diagnosed during middle age (average age of onset 40
1755. years), both men and women can see the emergence of the disorder between the
1756. ages of 20 and 50.<sup>6</sup> As mentioned previously, IC is much more common
1757. in females than males due to the shorter length of the urethra in women.<sup>7</sup>
1758. Because of this difference in anatomy, bacteria has an easier method of
1759. reaching the bladder and becoming overpopulated, thus causing inflammation.<sup>2,
1760. 7</sup><o:p></o:p></span></div>
1761. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1762. <span style="font-family: "times" , "times new roman" , serif;">IC can be
1763. categorized several different ways. Oftentimes it is divided into two
1764. phenotypes, non-ulcerative and ulcerative.<sup>8 </sup>Non-ulcerative IC
1765. accounts for approximately 90% of patients with the disorder and is typically
1766. identified by the observance of pinpoint hemorrhages in the bladder wall
1767. (indicating bladder inflammation is present).<sup>8 </sup>Ulcerative IC
1768. comprises 5-10% of IC patients and is identified when patients present with
1769. Hunner’s ulcers (red, bleeding areas) on the bladder wall.<sup>8 </sup>End
1770. stage or severe IC has also been used as a classification of the disorder,
1771. referring to patients who have developed very hard bladders as well as low
1772. bladder capacity and excruciating pain.<sup>8</sup> <o:p></o:p></span></div>
1773. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1774. <span style="font-family: "times" , "times new roman" , serif;">IC is also
1775. sometimes identified as being uncomplicated and complicated in nature.<sup>7 </sup>Uncomplicated
1776. IC is characterized by symptoms contained within the lower urinary tract as
1777. well as the absence of risk factors for severe infection or long-term
1778. impairment.<sup>7</sup> Further, uncomplicated IC is typically easily treatable
1779. and eliminated without much difficulty.<sup>7 <span style="mso-spacerun: yes;"> </span></sup>In contrast, complicated IC typically
1780. does not respond to antibiotic treatment, may present an increased risk of
1781. infection, possible spreading of infection to the kidneys, and inflammation of
1782. the renal pelvis (pyelonephritis).<sup>7 </sup>Particular populations are at
1783. greater risk for complicated IC including those with compromised immune
1784. systems, kidney problems or who demonstrate anatomical abnormalities in the
1785. urinary tract.<sup>7 <o:p></o:p></sup></span></div>
1786. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1787. <span style="font-family: "times" , "times new roman" , serif;">Diagnostic tests
1788. for IC include urine samples to test for bacteria, white and red blood cells,
1789. proteins and nitrites (can be an indicator of bacteria); ultrasound to examine
1790. the kidneys and bladder; and in rare cases, cystoscopy or x-ray (only used when
1791. a woman has severe and recurrent symptoms).<sup>7</sup> Additional tests that are
1792. less common but sometimes performed include bladder and urethra biopsy, bladder
1793. stretching and in men, prostate fluid culture.<sup>2<o:p></o:p></sup></span></div>
1794. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1795. </div>
1796. <div class="MsoNormal" style="line-height: normal;">
1797. <br /></div>
1798. <div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
1799. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">References<o:p></o:p></span></i></div>
1800. <div class="MsoListParagraphCxSpFirst" style="line-height: normal; text-align: center; text-indent: -0.25in;">
1801. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
1802. <span style="font-family: "times new roman" , serif;"><br /></span></div>
1803. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1804. <span style="font-family: "times new roman" , serif;"> </span><span style="text-indent: -0.25in;">1.  Arora HC, Shoskes DA. The enigma of men with interstitial cystitis/bladder pain syndrome. </span><i style="text-indent: -0.25in;">Translational Andrology and Urology</i><span style="text-indent: -0.25in;">. 2015;4 (6): 668-676.</span><br />
1805. <div>
1806. <span style="text-indent: -0.25in;"><br /></span></div>
1807. <span style="font-family: "times new roman" , serif;">2. WebMD.
1808. Interstitial Cystitis. Available at: <a href="https://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis#1">https://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis#1</a>.
1809. Accessibility verified July 6, 2018.<o:p></o:p></span></div>
1810. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1811. <span style="font-family: "times new roman" , serif;">3.     Mayo
1812. Clinic. Interstitial Cystitis. Available at: <a href="https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357">https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357</a>.
1813. Accessibility verified July 6, 2018.<o:p></o:p></span></div>
1814. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1815. <span style="font-family: "times new roman" , serif;">4.     Clemens
1816. JQ, Calhoun EA, Litwin MS, et al. A survey of primary care physician practices
1817. in the diagnosis and management of women with interstitial cystitis/ painful
1818. bladder syndrome. <i>Urology</i>. 2010; 76(2): 323-328.<o:p></o:p></span></div>
1819. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1820. <span style="font-family: "times new roman" , serif;">5.     American
1821. Urological Association. First-ever clinical guidance on interstitial
1822. cystitis/bladder pain Syndrome Released: Effective treatment includes valid
1823. diagnosis, effective symptom control and focus on quality of life. Available
1824. at: <a href="http://auanet.mediaroom.com/2011-03-01-FIRST-EVER-CLINICAL-GUIDANCE-ON-INTERSTITIAL-CYSTITIS-BLADDER-PAIN-SYNDROME-RELEASED">http://auanet.mediaroom.com/2011-03-01-FIRST-EVER-CLINICAL-GUIDANCE-ON-INTERSTITIAL-CYSTITIS-BLADDER-PAIN-SYNDROME-RELEASED</a>.
1825. Accessibility verified July 6, 2018.<o:p></o:p></span></div>
1826. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1827. <span style="font-family: "times new roman" , serif;">6.     Harvard
1828. Health Publishing Harvard Medical School: Trusted Advice for a Healthier Life.
1829. Interstitial Cystitis. Available at:
1830. https://www.health.harvard.edu/diseases-and-conditions/interstitial-cystitis.
1831. Accessibility verified July 6, 2018.<o:p></o:p></span></div>
1832. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1833. <span style="font-family: "times new roman" , serif;">7.     PubMed
1834. Health. Cystitis: overview. Available at:
1835. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072587/. Accessibility verified
1836. July 6, 2018.<o:p></o:p></span></div>
1837. <br />
1838. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
1839. <br /></div>
1840. </div>
1841. &lt;span style=&quot;font-family: &amp;quot;times new roman&amp;quot; , serif; font-size: 12.0pt;&quot;&gt;&lt;sup&gt;&lt;/sup&gt;&lt;/span&gt;</content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7752970901507464612/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-i.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7752970901507464612'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7752970901507464612'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-i.html' title='Interstitial Cystitis Part I'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5281788893334810634</id><published>2020-01-18T09:00:00.000-08:00</published><updated>2021-11-26T04:58:29.775-08:00</updated><title type='text'>Diet and Exercise: Implications for Those Suffering From Rheumatoid Arthritis</title><content type='html'>&lt;br /&gt;
1842. <div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
1843. <div style="text-align: left;">
1844. <span style="font-family: "times" , "times new roman" , serif; text-indent: 0.5in;">           Though the
1845. prevalence of rheumatoid arthritis (RA) is relatively low at approximately
1846. 0.5-1% among most populations, for those suffering from the disease it can be a
1847. life-altering reality.</span><sup style="font-family: times, "times new roman", serif; text-indent: 0.5in;">1</sup><span style="font-family: "times" , "times new roman" , serif; text-indent: 0.5in;"> According to the Centers for Disease Control
1848. and Prevention (CDC), RA is an autoimmune disease and manifests itself by
1849. causing the immune system to attack healthy cells in error. This, in turn,
1850. causes painful swelling and inflammation in the affected regions of the body.</span><sup style="font-family: times, "times new roman", serif; text-indent: 0.5in;">2
1851. </sup><span style="font-family: "times" , "times new roman" , serif; text-indent: 0.5in;">Typically, RA affects joints in the hands, wrists and knees and can lead
1852. to stiffness, tenderness and swelling in the joints, weight loss, fatigue,
1853. weakness, and chronic pain.</span><sup style="font-family: times, "times new roman", serif; text-indent: 0.5in;">2</sup></div>
1854. </div>
1855. <div class="MsoNormal" style="line-height: normal;">
1856. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Pharmacological
1857. Treatment<o:p></o:p></span></i></div>
1858. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1859. <span style="font-family: "times" , "times new roman" , serif;">Treatment options
1860. vary, though pharmacologic therapies are often the first line treatment options
1861. recommended.<sup>3</sup> Nonsteroidal anti-inflammatory drugs, nonbiologic and
1862. biologic disease-modifying antirheumatic drugs, immunosuppressants, and
1863. corticosteroids are all classes used in medication-based therapies for RA.<sup>3
1864. </sup>Side effects of these drugs are disturbing at best, including upper
1865. respiratory tract infections, headache, diarrhea, inflammation of the mouth and
1866. lips, nausea, vomiting, abdominal pain, dizziness, bleeding gums, blurred
1867. vision, leukopenia, shaking fingers/hands, muscle spasms, and numbness.<sup>4,
1868. 5, 6 </sup>In addition, biologic agents that are oftentimes used for RA
1869. patients have limited long-term safety data, presenting a point of particular
1870. concern due to the possibility of enhanced risk of malignancies, more
1871. specifically, lymphoma.<sup>7</sup> Further, the cost of the newer biologic
1872. drugs is quickly escalating, presenting an obstacle for those planning to use
1873. such interventions.<sup>7 </sup>When efficacy is measured across the span of
1874. RA-specific drugs, production of positive effects show only low to moderate benefit,
1875. pulling into question the risk versus advantage argument.<sup>8</sup> In
1876. addition, pharmacological treatments carry significant risk and adverse event
1877. profiles, oftentimes causing increased drop-out rates in clinical trials.<sup>8</sup>
1878. A systematic review of multiple RA medications, such as conventional synthetic
1879. disease-modifying antirheumatic drugs, glucocorticoids and tofacitinib showed
1880. efficacy, thus suggesting their usefulness in the treatment of RA.<sup>9</sup>
1881. However, the review was funded by multiple drug companies including Astra-Zeneca,
1882. Lilly, Merck, Glaxo, Sanofi-Aventis, and Pfizer, calling into question the
1883. validity of efficacy-reporting.<sup>9 <o:p></o:p></sup></span></div>
1884. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1885. <span style="font-family: "times" , "times new roman" , serif;">With these factors
1886. in mind, alternative treatment options appear a warranted area of study in the
1887. management and treatment of this disease. Many non-pharmacologic therapies are
1888. available, including diet, exercise, physical therapy, and other
1889. lifestyle-related treatments.<sup>3 </sup>For the purposes of this paper, diet
1890. and exercise will be explored as non-pharmacologic treatment modalities in RA
1891. patients. <o:p></o:p></span></div>
1892. <div class="MsoNormal" style="line-height: normal;">
1893. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Diet<o:p></o:p></span></i></div>
1894. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1895. <span style="font-family: "times" , "times new roman" , serif;">Due to the
1896. affordability, accessibility and presence of reliable scientific evidence that
1897. display benefit, dietary interventions appear to provide a solid alternative to
1898. pharmacologic treatments of RA.<sup>10 </sup>Further, research supports a
1899. display of significant benefits from this modality in regard to reducing
1900. symptoms such as pain, joint stiffness, swelling, tenderness and associated
1901. disability with disease progression.<sup>10 </sup><o:p></o:p></span></div>
1902. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1903. <span style="font-family: "times" , "times new roman" , serif;">In a review of the
1904. research, authors deduced that the inclusion of vegetables, spices such as
1905. turmeric and ginger and fruits can provide important sources of natural
1906. antioxidants as well as anti-inflammatory effects for RA patients.<sup>10 </sup>Additionally,
1907. data suggests that RA patients should employ a reduction in processed and high
1908. fat foods as well as avoidance of foods such as oils, butter, sugar and animal
1909. products.<sup>10 </sup>Research performed with patients suffering from a
1910. variety of rheumatic diseases studied the effect of antioxidants in the diet
1911. when compared to reduction of disease symptoms and overall improvement.<sup>11 </sup>Outcome
1912. measures showed that RA subjects eating a diet consisting of berries, fruits,
1913. vegetables, roots, nuts, germinated seeds and sprouts showed a significant
1914. benefit in regard to symptoms on subjective and objective measures.<sup>11 </sup>Similarly,
1915. in a study testing the effectiveness of eating an uncooked vegan diet rich in
1916. lactobacilli, researchers determined that when compared to the control group,
1917. the intervention group experienced subjective relief from RA symptoms.<sup>12 </sup>Further,
1918. when participants returned to eating an omnivorous diet, the RA symptoms were
1919. again aggravated.<sup>12</sup> Though the intervention group showed somewhat
1920. inconsistent results on objective measures, there was an associated decrease in
1921. disease activity overall and a prevention of the need for pharmacologic
1922. intervention.<sup>12 </sup>A group of researchers took the diet restriction to
1923. a new level by studying 66 patients with active RA and randomizing them to
1924. either a gluten-free, vegan diet or a well-balanced, non-vegan diet.<sup>13 </sup>Participants
1925. were studied at three, six, and 12 months and researchers concluded that 40.5%
1926. of the gluten-free, vegan group improved while only 4% of the non-vegan group
1927. improved.<sup>13 </sup>Researchers suggested that dietary modification such as
1928. the one studied may provide a clinical benefit for RA patients.<sup>13 </sup>Outcomes
1929. of additional studies show a potential for anti-inflammatory effects as well as
1930. decreased blood lipids oxidized low-density lipoprotein levels and raised
1931. natural atheroprotective antibodies against phosphorylcholine in RA patients
1932. who consume a gluten-free, vegan diet.<sup>14 </sup>Further, in a single-blind
1933. dietary intervention study, 24 patients with RA were given a very low-fat
1934. (approximately 10% fat), vegan diet and followed for a four-week trial.<sup>15 </sup>Outcome
1935. measures demonstrated that subjects with moderate-to-severe RA experienced a
1936. significant reduction in RA symptoms when they ate a very low-fat, vegan diet.<sup>15</sup>
1937. Additional research points to the beneficial inclusion of probiotics in
1938. conjunction with a vegan or vegetarian diet, showing an improvement in symptoms
1939. with such combinations.<sup>11, 12<o:p></o:p></sup></span></div>
1940. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1941. <span style="font-family: "times" , "times new roman" , serif;">The benefit of
1942. fasting has also been studied in RA patients when coupled with dietary
1943. interventions. A systematic review examined the effect of fasting for at least
1944. three months followed by the adoption of a vegetarian diet.<sup>16 </sup>Results
1945. showed that there was a statistically and clinically significant, beneficial,
1946. long-term effect on RA patients.<sup>16 </sup>Due to the fact that the
1947. literature review was limited to four applicable studies, concrete conclusions
1948. may be premature. However, such convincing data warrants further investigation
1949. by way of additional randomized, long-term studies. In a randomized,
1950. single-blind, controlled trial, 27 patients with RA were allocated to an
1951. intervention group, while 26 RA patients were placed in a control group.<sup>17
1952. </sup>The intervention group subjects were allocated to a four-week stay at a
1953. health farm and were placed on an initial 7-10 day fast.<sup>17 </sup>Following
1954. the fasting period, subjects were put on an individually-adjusted gluten-free,
1955. vegan diet for an additional three and a half months, followed by a gradual
1956. transition to a lactovegetarian diet for a total trial period of one year.<sup>17
1957. </sup>The control group was allotted to a four-week stay at a convalescent
1958. home, eating an ordinary diet for the entirety of a year.<sup>17 </sup>Following
1959. the initial four week period, study results showed a significant improvement in
1960. symptoms for the intervention group such as number of tender and swollen
1961. joints, duration of morning stiffness, and an improvement in overall health
1962. assessment score.<sup>17 </sup>Further, the benefits in the intervention group
1963. after the completion of one year again showed significant advantages in all
1964. measured indices when compared to the control group.<sup>17 </sup><o:p></o:p></span></div>
1965. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1966. <span style="font-family: "times" , "times new roman" , serif;">It appears clearly
1967. evident that dietary interventions are beneficial in RA patients and provide a
1968. viable and effective method of treatment. Of similar importance is the fact
1969. that non-pharmacological interventions such as diet modification do not produce
1970. dangerous results or adverse side effects. <o:p></o:p></span></div>
1971. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1972. <br /></div>
1973. <div class="MsoNormal" style="line-height: normal;">
1974. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Physical
1975. Activity<o:p></o:p></span></i></div>
1976. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1977. <span style="font-family: "times" , "times new roman" , serif;">In addition to the
1978. clearly beneficial components of dietary intervention, physical activity can
1979. also be a significant factor in the management of RA. Research abounds in
1980. regard to the overall positive effect of exercise for RA patients.<o:p></o:p></span></div>
1981. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
1982. <span style="font-family: "times" , "times new roman" , serif;">In a study of 220
1983. patients with RA, subjects were divided into a class exercise group, a home
1984. exercise group and a control group.<sup>18 </sup>Subjects were measured at base
1985. line and subsequently at six and 12-week marks.<sup>18 </sup>Results displayed
1986. that in the class exercise group, grip strength, walk time and fatigue greatly
1987. improved.<sup>18 </sup>Further, overall symptoms of pain and depression were
1988. all positively affected in the class exercise group.<sup>18 </sup>Though some
1989. improvements were made in the home exercise group, they were not as significant
1990. in the class exercise group, despite the similarity of exercises completed,
1991. possibly due to the differing levels of intensity.<sup>18 </sup>Researchers
1992. concluded that exercise was a positive influence on RA symptoms.<sup>18<span style="mso-spacerun: yes;">  </span></sup>A literature review looked at the
1993. benefits of exercise for RA patients and also found a positive level of effect.<sup>19
1994. </sup>Authors deduced that exercise in general showed a clear and proven method
1995. of treatment that provided an improvement in overall function for RA patients.<sup>19
1996. </sup>An additional meta-analysis and literature review of studies looked at
1997. the effect of cardiorespiratory aerobic exercise for RA patients in regard to
1998. quality of life, function and clinical and radiologic outcomes.<sup>20 </sup>Collective
1999. results showed that cardiorespiratory aerobic exercise proved to be a safe
2000. method of treatment, providing improvement in some of the most important
2001. outcome measures for RA.<sup>20 </sup>Another meta-analysis examined the
2002. efficacy of resistance exercises in RA patients.<sup>21 </sup>Following the
2003. study of a total of 10 randomized, controlled trials with 547 patients, authors
2004. concluded that not only was resistance exercise in RA patients safe, but it
2005. also showed improvement in most outcomes and was statistically significant as
2006. well as possibly clinically significant for the outcome of RA disability
2007. measures.<sup>21</sup> Further, subgroup analysis also revealed a trend towards
2008. increased efficacy in programs with high-intensity resistance exercise.<sup>21</sup>
2009. Another literature review showed evidence that physical activity is a
2010. significant factor in the common and distressing symptom of fatigue for RA
2011. patient.<sup>22</sup> The review examined 24 studies with a total of 2,882
2012. participants with RA.<sup>22</sup> Authors concluded that physical activity had
2013. a positive effect on fatigue in RA patients.<sup>22</sup><o:p></o:p></span></div>
2014. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
2015. <span style="font-family: "times" , "times new roman" , serif;">Not only has
2016. exercise been proven as an effective method of treatment for typical RA
2017. symptoms, but it has also been shown to have a positive effect on mood for RA
2018. patients.<sup>18, 23 </sup>In a review of the literature, authors concluded
2019. that exercise improves depression for RA patients, a common yet not classic
2020. symptom of RA.<sup>23 </sup>Additionally, a systematic review with
2021. meta-analysis of 500 articles and 2,449 participants studied the effects of
2022. exercise on depressive symptoms in adults with arthritis and rheumatic
2023. conditions.<sup>24 </sup>Authors concluded that depressive symptoms were
2024. reduced with the inclusion of exercise.<sup>24</sup> Again, though depression
2025. is not an RA-specific symptom, it is a common factor experienced in those with
2026. this disease and a symptom undeniably worth improving.<o:p></o:p></span></div>
2027. <div class="MsoNormal" style="line-height: normal;">
2028. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">Conclusion<o:p></o:p></span></i></div>
2029. <div class="MsoNormal" style="line-height: normal; text-indent: .5in;">
2030. <span style="font-family: "times" , "times new roman" , serif;">Though some of the
2031. studies cited in this paper have limitations such as measures of self-reported
2032. data, small sample sizes or confounding variables, the preponderance of the
2033. evidence clearly shows a positive effect of both dietary intervention and exercise
2034. on the symptoms and overall outcome for RA patients. Of similar importance,
2035. specific dietary interventions as well as various forms of exercise, like those
2036. reviewed in this paper, have not only proven to be safe methods of reducing
2037. overall disease markers but have also been shown to be significant factors in
2038. symptom management, both without risk of side effects or negative outcomes. <span style="mso-spacerun: yes;"> </span>RA patients would clearly benefit from dietary
2039. intervention and exercise protocols as first-line treatment options rather than
2040. the more commonly prescribed pharmacologic options. <o:p></o:p></span></div>
2041. <div class="MsoNormal" style="line-height: normal;">
2042. <br /></div>
2043. <div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
2044. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;">References</span></i><br />
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2136. <span style="font-family: "Times New Roman",serif;">20.  Baillet A, Zeboulon
2137. N, Gossec L, et al. Efficacy of cardiorespiratory aerobic exercise in
2138. rheumatoid arthritis: meta-analysis of randomized controlled trials. <i>Arthritis
2139. Care and Research.</i>2010; 62(7): 984-992.<o:p></o:p></span></div>
2140. <div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
2141. <span style="font-family: "Times New Roman",serif;">21.  Baillet A, Vaillant
2142. M, Guinot M, Juvin R, Gaudin P. Efficacy of resistance exercises in rheumatoid
2143. arthritis: meta-analysis of randomized controlled trials. <i>Rheumatology
2144. (Oxford). </i>2012; 51(3): 519-527.<o:p></o:p></span></div>
2145. <div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
2146. <span style="font-family: "Times New Roman",serif;">22.  Cramp F, Hewlett S,
2147. Almeida C, et al. Non-pharmacological interventions for fatigue in rheumatoid
2148. arthritis. <i>Cochrane Database of Systematic Reviews</i>.2013; 23(8):
2149. doi: 10.1002/14651858.CD008322.pub2.<o:p></o:p></span></div>
2150. <div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
2151. <span style="font-family: "Times New Roman",serif;">23.  Kelley GA, Kelley
2152. KS. Exercise reduces depressive symptoms in adults with arthritis: evidential
2153. value. <i>World journal of rheumatology</i>. 2016; 6(2): 23-29.<o:p></o:p></span></div>
2154. <div class="MsoNormal" style="line-height: normal; margin-left: .5in; text-align: justify;">
2155. <span style="font-family: "Times New Roman",serif;">24.  Kelley GA, Kelley
2156. KS, Hootman JM. Effects of exercise on depression in adults with arthritis: a
2157. systematic review with meta-analysis of randomized controlled trials. <i>Arthritis
2158. Research and Therapy.</i>2015; 17(21): 1-22.<o:p></o:p></span></div>
2159. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
2160. <br /></div>
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2211. </span></i><br />
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2213. <br /></div>
2214. <i style="mso-bidi-font-style: normal;"><span style="font-family: "times" , "times new roman" , serif;"><br /></span></i></div>
2215. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5281788893334810634/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/diet-and-exerciseimplications-for-those.html#comment-form' title='3 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5281788893334810634'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5281788893334810634'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/diet-and-exerciseimplications-for-those.html' title='Diet and Exercise: Implications for Those Suffering From Rheumatoid Arthritis'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>3</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-9178802235413768008</id><published>2020-01-18T04:47:00.001-08:00</published><updated>2021-11-26T04:58:38.218-08:00</updated><title type='text'>Interstitial Cystitis Part II</title><content type='html'></content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/9178802235413768008/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-ii.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/9178802235413768008'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/9178802235413768008'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2020/01/interstitial-cystitis-part-ii.html' title='Interstitial Cystitis Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-5127946837858376991</id><published>2019-12-02T08:30:00.000-08:00</published><updated>2021-11-26T04:58:41.250-08:00</updated><title type='text'>Radon Exposure and Cancer Risk: Warranted Caution or Unnecessary Hype?</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
2216. <br />
2217. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2218. <span style="font-family: "times" , "times new roman" , serif;">Concern for a
2219. multitude of chemicals, environmental elements and toxic substances has been on
2220. the increase in recent years. Clearly, being surrounded by such influential
2221. components is not preferable, yet it remains to be proven that they are the
2222. primary cause of ill-health in our world. With that being said, there can be
2223. benefit to investigating the true effects of assumed toxins to determine
2224. whether or not they pose negative implications to health. <o:p></o:p></span></div>
2225. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2226. <span style="font-family: "times" , "times new roman" , serif;">Radon, a
2227. naturally-occurring radioactive gas found typically in rocks and soil, is
2228. produced when thorium and uranium radioactively decay.<sup>1</sup> It is an
2229. odorless, colorless, inactive gas that does not chemically bond with other
2230. substances.<sup>1</sup> With a half-life as long as 3.8 days, it has the
2231. potential of remaining in the air for an extended time.<sup>2</sup> <span style="mso-spacerun: yes;"> </span>Radon has been the culprit of multiple claims
2232. suggesting its link to cancer, particularly for those exposed to it via
2233. occupational means (mining). As mentioned previously, however, it is important
2234. to review the evidence behind such hypotheses before engaging in great measures
2235. to eliminate exposure. Further, for the purposes of this analysis, focus will
2236. be given solely to indoor radon exposure rather than outdoor exposure
2237. experienced in situations such as underground mining. <o:p></o:p></span></div>
2238. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2239. <span style="font-family: "times" , "times new roman" , serif;">In a nested
2240. case-control study, researchers in Finland examined the effect of indoor radon
2241. exposure and lung cancer risk, due to the conflicting outcomes observed in
2242. other studies.<sup>3 </sup>Study participants consisted of 517 case-control
2243. pairs in the matched analysis, and 1055 case subjects and 1544 control
2244. subjects<span style="mso-spacerun: yes;">  </span>in the unmatched analysis.<sup>3</sup>
2245. All participants lived within radon-exposed homes over a period of multiple
2246. years.<sup>3 <span style="mso-spacerun: yes;"> </span></sup>Outcomes demonstrated
2247. that the odds ratio of lung cancer in the matched and unmatched analyses
2248. displayed no statistically significant indications for a heightened risk of
2249. lung cancer in relation to indoor radon concentration.<sup>3 </sup>Subsequently,
2250. researchers concluded that radon exposure did not appear to pose a causal
2251. threat to the incidence of lung cancer.<sup>3 <o:p></o:p></sup></span></div>
2252. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2253. <span style="font-family: "times" , "times new roman" , serif;">In a French
2254. hospital-based case-control study, researchers looked at the connection between
2255. radon exposure and cancer risk.<sup>4</sup> Four hundred eighty-six cases and
2256. 984 controls with radon measures in at least one dwelling were examined.<sup>4</sup>
2257. Following adjustments for age, sex, region, cigarette smoking and occupational
2258. exposure, lung cancer risk was studied in relation to indoor radon exposure.<sup>4
2259. </sup>Researchers concluded that a minimal increased lung cancer risk existed
2260. in relation to indoor radon exposure.<sup>4</sup> <o:p></o:p></span></div>
2261. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2262. <span style="font-family: "times" , "times new roman" , serif;">A meta-analysis of
2263. 17 case-controlled studies was performed to determine the relationship between residential
2264. radon exposure and risk of lung cancer, based upon the exposure rate of 150
2265. Bq/m3.<sup>5</sup> Adjusted odds ratios with 95% confidence intervals (CI) in
2266. regard to lung cancer risk and concentration of radon exposure were extracted
2267. and quality of studies was examined.<sup>5</sup> Authors noted that it was
2268. difficult to draw definitive conclusions based upon confounding variables,
2269. while also mentioning the caution that was taken to eliminate as many of these
2270. as possible to display accurate results.<sup>5</sup> Further, authors stated
2271. that despite the inability to fully predict or assume direct association
2272. between residential radon exposure and lung cancer risk, a dose-response
2273. relationship was demonstrated in the review.<sup>5</sup> Authors concluded that
2274. enough evidence was displayed to suggest the importance of developing
2275. strategies to reduce human exposure to radon.<sup>5<o:p></o:p></sup></span></div>
2276. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2277. <span style="font-family: "times" , "times new roman" , serif;">Researchers<span style="mso-spacerun: yes;">  </span>in Germany performed two case-control studies
2278. during 1990-1997 and analyzed data from 2,963 lung cancer patients and 4,232
2279. controls.<sup>6</sup> Results demonstrated a linear dose-response relationship
2280. between the level of radon exposure and lung cancer in all subjects (smokers
2281. and never-smokers alike).<sup>6</sup> Incidence of lung cancer among smokers
2282. with radon exposure showed even higher rates of lung cancer incidence.<sup>6 </sup>Researchers
2283. concluded that the risk for developing cancer as a result of radon exposure was
2284. significant.<sup>6</sup><o:p></o:p></span></div>
2285. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2286. <span style="font-family: "times" , "times new roman" , serif;">A New Jersey study
2287. was conducted amongst 433 female lung cancer cases compared to 402 control
2288. cases.<sup>7 </sup>After controlling for smoking and occupational histories, results
2289. showed a notable trend of increased risk of lung cancer in those exposed to
2290. residential radon.<sup>7</sup> Though researchers acknowledged study
2291. limitations such as differences in housing construction and ventilation, age
2292. and socioeconomic status of participants and diet and lifestyle choices of
2293. those included, evidence remained that radon exposure posed a threat for many
2294. people in regard to cancer risk.<sup>7</sup> Researchers concluded that though
2295. the study resulted in a positive correlation, limitations of the study should
2296. prompt further research, taking into account such variables before drawing firm
2297. conclusions.<sup>7</sup> <o:p></o:p></span></div>
2298. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2299. <span style="font-family: "times" , "times new roman" , serif;">Based upon the
2300. preponderance of the evidence presented here, it appears that the risk
2301. associated with radon exposure is significant enough to pay attention to.
2302. Though future research is warranted in regard to confounding variables and
2303. study design, recommendations to limit radon exposure seem wise. <o:p></o:p></span></div>
2304. <div style="line-height: 150%; text-align: center; text-indent: 0.5in;">
2305. <span style="font-family: "times" , "times new roman" , serif;"><o:p> </o:p><i style="text-align: center;">References</i></span><br />
2306. <br />
2307. <div class="MsoNormal" style="line-height: normal; margin-left: .5in;">
2308. <br /></div>
2309. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2310. <span style="font-family: "Times New Roman",serif;">1. Yoon JY, Lee JD, Joo SW,
2311. Kang DR. Indoor radon exposure and lung cancer: a review of ecological
2312. studies. <i>Annals of Occupational and  Environmental Medicine. </i>2016;28:15.
2313. doi:10.1186/s40557-016-0098-z.<o:p></o:p></span></div>
2314. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2315. <span style="font-family: "Times New Roman",serif;">2. International Commission on
2316. Radiological Protection (ICRP) Protection against radon-222 at home and at
2317. work. A report of a task group of the International Commission on Radiological
2318. Protection. Ann ICRP. 1993;23(2):1–45. doi: 10.1016/0146-6453(93)90002-P.<o:p></o:p></span></div>
2319. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2320. <span style="font-family: "Times New Roman",serif;">3. Auvinen A, Mäkeläinen I,
2321. Hakama M, et al. Indoor radon exposure and risk of lung cancer: a nested
2322. case-control study in Finland. <i>Journal of the National Cancer
2323. Institute. </i>1996;17;88(14):966-72.<o:p></o:p></span></div>
2324. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2325. <span style="font-family: "Times New Roman",serif;">4. Baysson H, Tirmarche M,
2326. Tymen G. Indoor radon and lung cancer in France. <i>Epidemiology. </i>2004
2327. Nov;15(6):709-16.<o:p></o:p></span></div>
2328. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2329. <span style="font-family: "Times New Roman",serif;">5. Pavia M, Bianco A, Pileggi
2330. C, Angelillo IF. Meta-analysis of residential exposure to radon gas and lung
2331. cancer. Bull World Health Organization. 2003;81(10):732–738.<o:p></o:p></span></div>
2332. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2333. <span style="font-family: "Times New Roman",serif;">6. Wichmann HE, Rosario AS,
2334. Heid IM, Kreuzer M, Heinrich J, Kreienbrock L. Increased lung cancer risk due
2335. to residential radon in a pooled and extended analysis of studies in
2336. Germany. <i>Health Physics.</i>  2005;88(1):71-9.<o:p></o:p></span></div>
2337. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2338. <span style="font-family: "Times New Roman",serif;">7. Schoenberg JB, Klotz JB,
2339. Wilcox HB, et al. Case-control study of residential radon and lung cancer among
2340. New Jersey women. <i>Cancer Research</i>. 1990; 50(20):6520-4.<o:p></o:p></span></div>
2341. <br /></div>
2342. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/5127946837858376991/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/12/radon-exposure-and-cancer-risk.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5127946837858376991'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/5127946837858376991'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/12/radon-exposure-and-cancer-risk.html' title='Radon Exposure and Cancer Risk: Warranted Caution or Unnecessary Hype?'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-4349469152372070125</id><published>2019-11-27T06:27:00.001-08:00</published><updated>2021-11-26T04:58:44.412-08:00</updated><title type='text'>Acupuncture for the Treatment of Tinnitus</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
2343. <br />
2344. <div class="MsoNormal" style="text-align: center;">
2345. <div align="center" class="MsoNormal">
2346. <b><span style="font-family: "times" , "times new roman" , serif; line-height: 107%;">Acupuncture
2347. for the Treatment of Tinnitus<o:p></o:p></span></b></div>
2348. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2349. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">Tinnitus,
2350. the perception of noise or ringing in the ears, is a prevalent problem in the
2351. United States, affecting approximately 45 million Americans each year.<sup>1,2 </sup>Though
2352. tinnitus is not considered a disease on its own, it is a significant symptom
2353. stemming from some kind of underlying condition.<sup>3</sup> Root causes of
2354. tinnitus range from age-related hearing loss to ear injury or circulatory
2355. disorder.<sup>1</sup> Further, tinnitus can appear in those with structural
2356. lesions or those with conditions such as Meniere’s disease and multiple
2357. sclerosis.<sup>3</sup> Pulsatile and non-pulsatile tinnitus are two ways to
2358. classify the problem, though many subtypes are frequently identified in the
2359. literature (somatic, neurological, objective, subjective). Pulsatile tinnitus
2360. involves the sensation of a rhythmic sound that resembles a heartbeat,
2361. swooshing or whooshing not externally sourced.<sup>4,5</sup> This form of
2362. tinnitus is often caused by sounds such as personal pulse, vascular problems or
2363. changes in the ear canal.<sup>5 </sup>By comparison, non-pulsatile tinnitus is
2364. attributed to problems with the nerves involved with hearing and may be experienced
2365. in one or both ears.<sup>5 </sup>This form of tinnitus is oftentimes described
2366. as originating inside the head.<sup>5<o:p></o:p></sup></span></div>
2367. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2368. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">Determining
2369. the cause of tinnitus, regardless of type, is of key importance in the terms of
2370. treatment. Clearly, if the underlying problem can be addressed and rectified or
2371. improved, the associated symptoms may be alleviated or improved as well.
2372. However, finding effective treatments for tinnitus have been challenging to
2373. date.<sup>3 </sup><o:p></o:p></span></div>
2374. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2375. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">Acupuncture,
2376. originating in ancient China, has been used for thousands of years to treat a
2377. variety of conditions. Due to its efficacious outcomes in treating multiple
2378. maladies, it seems appropriate to examine its usefulness when applied to those
2379. suffering from tinnitus. Research surrounding this topic is abundant, yet simultaneously
2380. inconsistent with many studies demonstrating efficacy and some  presenting its lack of usefulness. <o:p></o:p></span></div>
2381. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2382. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">In
2383. a review of 40 research studies, the efficacy of acupuncture as a treatment for
2384. tinnitus was examined.<sup>6 </sup>Eight different types of acupuncture were
2385. analyzed, some of which were tested in conjunction with additional
2386. interventions such as supplementary medicine.<sup>6 </sup> A total of 3657 subjects were included across
2387. the 40 studies.<sup>6</sup> Researchers concluded that all eight methods of
2388. acupuncture were effective in the treatment of neurological tinnitus (tinnitus
2389. caused by disease such as Meniere's disease).<sup>6</sup>  <o:p></o:p></span></div>
2390. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2391. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">Similarly,
2392. a  2019 study was performed to determine
2393. the usefulness of acupuncture as a treatment choice for patients suffering from
2394. tinnitus.<sup>7 </sup>One hundred seven tinnitus patients were examined over
2395. the course of 17-24 acupuncture treatments.<sup>7 </sup>Researchers concluded
2396. that patients experienced improvement in their tinnitus condition following the
2397. course of treatment.<sup>7 <o:p></o:p></sup></span></div>
2398. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2399. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">A
2400. clinical observation study was performed to determine the difference in outcome
2401. between acupuncture combined with the intake of an herbal formula compared with
2402. the intake of the same herbal formula alone.<sup>8</sup> Sixty patients were
2403. randomized into two groups - a combined therapy group and an herbal formula
2404. only group and treatment was administered according to a specific regimen for a
2405. total of six weeks.<sup>8</sup> Tinnitus severity score and tinnitus handicap
2406. inventory were used to determine clinical effects of the treatments over the
2407. course of the study.<sup>8</sup> Results showed an efficacy rate of 93.3% in
2408. the combined therapy group when compared to the 67.9% efficacy rate in the
2409. herbal formula only group.<sup>8</sup> Researchers concluded that acupuncture
2410. used in conjunction with an herbal formula provided improvement for tinnitus
2411. patients.<sup>8<o:p></o:p></sup></span></div>
2412. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2413. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;"> A randomized clinical trial of 50 participants
2414. tested the effectiveness of acupuncture on tinnitus when compared to no
2415. treatment.<sup>9</sup> Subjects were divided into equal groups and were
2416. evaluated for five weeks.<sup>9 </sup>Results showed a statistically
2417. significant effect between groups, leading researchers to conclude the efficacy
2418. of acupuncture to reduce tinnitus intensity and improve the quality of life of
2419. the tinnitus patients.<sup>9<o:p></o:p></sup></span></div>
2420. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2421. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">In
2422. a  systematic review of literature, tinnitus
2423. and the effect of acupuncture as a treatment modality was studied.<sup>10</sup>
2424. Six randomized controlled studies were examined and results showed positive
2425. effect in two unblinded studies and no significant effect in four blinded
2426. studies.<sup>10 </sup>Researchers concluded: “The belief that acupuncture is a
2427. specifically effective treatment for chronic tinnitus is not based on the
2428. evidence of rigorous randomized controlled trials. Further research on this
2429. subject seems to be warranted but should be conducted according to the highest
2430. methodological standards.”<sup>10<o:p></o:p></sup></span></div>
2431. <div class="MsoNormal" style="line-height: 150%; text-align: left;">
2432. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">            An additional study demonstrated the ineffective nature of
2433. acupuncture on tinnitus patients.<sup>11 </sup>The randomized, single-blind,
2434. placebo-controlled study followed 50 patients suffering from the condition and
2435. divided participants into a manual acupuncture group, an electrical acupuncture
2436. group and a placebo group.<sup>11</sup> Researchers studied frequency of
2437. tinnitus, tinnitus intensity, and reduction of life quality among patients over
2438. the course of the study.<sup>11 </sup>Patients were evaluated before treatment,
2439. following six sessions of treatment and one month following the completion of
2440. treatment.<sup>11</sup> Results demonstrated no statistically significant
2441. effect of either form of acupuncture.<sup>11 </sup>Despite the lack of statistically
2442. significant improvements, researchers noted relative advantages of electrical
2443. acupuncture when compared to the other two groups.<sup>11<o:p></o:p></sup></span></div>
2444. <span style="font-family: "times" , "times new roman" , serif;"><br /></span>
2445. <br />
2446. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2447. <span style="font-family: "times" , "times new roman" , serif; line-height: 150%;">From
2448. the preponderance of the evidence, it appears that acupuncture holds a distinct
2449. amount of possibility in terms of an effective treatment modality for those
2450. suffering from tinnitus. There are several factors to acknowledge in regard to
2451. the studies reviewed, including small sample sizes and relatively brief
2452. treatment periods. However, it is important to note that though the evidence
2453. for the efficacy of acupuncture as a treatment option is perhaps not
2454. overwhelming, it does not include extensive risk. Therefore, it likely would be
2455. wise to consider acupuncture as a treatment option for those suffering from
2456. tinnitus, particularly if other therapies have not yielded results or have
2457. created negative side effects.<o:p></o:p></span></div>
2458. </div>
2459. <div class="MsoNormal" style="text-align: center;">
2460. <div style="text-align: left;">
2461. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
2462. </div>
2463. <div align="center" class="MsoNormal" style="text-align: center;">
2464. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
2465. <div align="center" class="MsoNormal" style="text-align: center;">
2466. <span style="font-family: "times" , "times new roman" , serif;"><span style="font-family: "times new roman" , serif;"><o:p> </o:p></span><span style="font-family: "times new roman" , serif;"><i>References</i></span></span></div>
2467. <div align="center" class="MsoNormal" style="text-align: center;">
2468. <br />
2469. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2470. <span style="font-family: "Times New Roman",serif;">1.Mayo
2471. Clinic. Tinnitus. Available at:
2472. https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156.
2473. Accessibility verified November 24, 2019.<o:p></o:p></span></div>
2474. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2475. <span style="font-family: "Times New Roman",serif;">2.American
2476. Tinnitus Association. Understanding the Facts: Demographics. Available at: https://www.ata.org/understanding-facts/demographics.
2477. Accessibility verified November 24, 2019.<o:p></o:p></span></div>
2478. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2479. <span style="font-family: "Times New Roman",serif;">3.Naderinabi
2480. B, Soltanipour S, Nemati S, Saberi A, Parastesh S. Acupuncture for chronic
2481. nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018;9(1):38–45.
2482. doi:10.22088/cjim.9.1.38<o:p></o:p></span></div>
2483. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2484. <span style="font-family: "Times New Roman",serif;">4.Department
2485. of Radiology and Biomedical Imaging. Pulsatile Tinnitus Clinic. Available at:
2486. https://radiology.ucsf.edu/pulsatile-tinnitus. Accessibility verified November
2487. 24, 2019.<o:p></o:p></span></div>
2488. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2489. <span style="font-family: "Times New Roman",serif;">5.My
2490. Health Alberta. Ringing in the ears (tinnitus). Available at:
2491. https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tinit.
2492. Accessibility verified November 24, 2019.<o:p></o:p></span></div>
2493. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2494. <span style="font-family: "Times New Roman",serif;">6.
2495. Pang P, Shi Y, Xu H, et al. Acupuncture methods put to the test for a tinnitus
2496. study: A Bayesian analysis. Complementary Therapies in Medicine. 2019;
2497. 42:205-213.<o:p></o:p></span></div>
2498. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2499. <span style="font-family: "Times New Roman",serif;">7.
2500. Lin TY, Yang SW, Lee YS, et al. Analysis of Factors Influencing the Efficiency
2501. of Acupuncture in Tinnitus Patients. Evid Based Complement Alternat Med.
2502. 2019;2019:1318639. Published 2019 May 26. doi:10.1155/2019/1318639.<o:p></o:p></span></div>
2503. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2504. <span style="font-family: "Times New Roman",serif;">8.
2505. Chen S, Tan X, Fei L, Xiang X. Clinical observation on idiopathic tinnitus
2506. treated with acupuncture, buzhong yiqi tang and cizhu wan. Zhongguo Zhen Jiu.
2507. 2018;38(4):369-73. doi: 10.13703/j.0255-2930.2018.04.007.<o:p></o:p></span></div>
2508. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2509. <span style="font-family: "Times New Roman",serif;">9.
2510. Doi MY, Tano SS, Schultz AR, Borges R, Marchiori LL. Effectiveness of acupuncture
2511. therapy as treatment for tinnitus: a randomized controlled trial. Braz J
2512. Otorhinolaryngol. 2016;82(4):458-65. doi: 10.1016/j.bjorl.2016.04.002.<o:p></o:p></span></div>
2513. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2514. <span style="font-family: "Times New Roman",serif;">10.
2515. Park J, White AR, Ernst E. Efficacy of Acupuncture as a Treatment for Tinnitus:
2516. A Systematic Review. Arch Otolaryngol Head Neck Surg. 2000;126(4):489–492.
2517. doi:https://doi.org/10.1001/archotol.126.4.489.<o:p></o:p></span></div>
2518. <div class="MsoNormal" style="line-height: normal; text-align: left;">
2519. <span style="font-family: "Times New Roman",serif;">11.Wang
2520. K, Bugge J, Bugge S. A randomised, placebo-controlled trial of manual and
2521. electrical acupuncture for the treatment of tinnitus. <i>Complement Ther
2522. Med.</i> 2010;18(6):249-55. doi: 10.1016/j.ctim.2010.09.005.<o:p></o:p></span></div>
2523. <br /></div>
2524. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/4349469152372070125/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/acupuncture-for-treatment-of-tinnitus.html#comment-form' title='1 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4349469152372070125'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/4349469152372070125'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/acupuncture-for-treatment-of-tinnitus.html' title='Acupuncture for the Treatment of Tinnitus'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>1</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-7710164449604801340</id><published>2019-11-10T09:00:00.000-08:00</published><updated>2021-11-26T05:00:27.471-08:00</updated><title type='text'>Protein Needs in Compromised Populations Part II</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
2525. <br />
2526. <div class="MsoNormal" style="line-height: 150%;">
2527. <i><span style="font-family: "times" , "times new roman" , serif;">HIV Patients<o:p></o:p></span></i></div>
2528. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2529. <span style="font-family: "times" , "times new roman" , serif;">In a randomized,
2530. double-blind, multicenter trial of 59 HIV positive subjects, researchers
2531. studied the effect of high protein whey supplementation when compared to a matched
2532. isocaloric control supplement without added protein for patients with a history
2533. of weight loss (a typical and potentially dangerous factor for HIV positive
2534. patients).<sup>7 </sup>Following the 12-week study, researchers concluded that
2535. there was no observed difference in regard to increased energy intake or
2536. changes in weight/lean body mass.<sup>7 </sup>However, researchers stated that
2537. CD4 lymphocytes (white blood cells responsible for fighting bacteria, viruses
2538. and germs) did increase in the protein group, a potential benefit according to
2539. the authors.<sup>7 </sup>However, researchers also stated that gastrointestinal
2540. symptoms were more commonly reported in the high protein whey <span style="mso-spacerun: yes;"> </span>group.<sup>7</sup> It is important to note
2541. that this study was supported by the whey supplement company, drawing into
2542. question the validity of accurate findings.<sup>7 </sup><o:p></o:p></span></div>
2543. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2544. <span style="font-family: "times" , "times new roman" , serif;">A 1999 three-arm
2545. randomized controlled trial of 536 HIV patients with CD4 counts below 200
2546. looked at the impact of nutrients on the prevention of weight loss over a
2547. four-month period.<sup>8</sup> Researchers<span style="mso-spacerun: yes;"> 
2548. </span>studied the implementation of three nutritional regimens to determine
2549. their effect on the prevention of weight loss in patients.<sup>8 </sup>Therapies
2550. consisted of a <span style="mso-spacerun: yes;"> </span>500 kcal daily of caloric
2551. supplement with peptides and medium-chain triglycerides plus a multivitamin and
2552. mineral supplement, 500 kcal of a caloric supplement with whole protein and
2553. long-chain triglycerides plus a multivitamin and mineral supplement, and a
2554. multivitamin and mineral supplement only.<sup>8 </sup>At the conclusion of the
2555. four-month study, researchers concluded that no differences were observed
2556. (including the increased protein group), stating that caloric supplements did
2557. not provide a viable treatment modality for this population.<sup>8</sup><o:p></o:p></span></div>
2558. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2559. <span style="font-family: "times" , "times new roman" , serif;">In a 2003 study of
2560. 467 weight-stable HIV-infected men with CD4 counts lower than 200 were observed
2561. in regard to protein intake and body composition variables, including body cell
2562. mass (the depletion of which is a predictor of disease progression and death).<sup>9</sup>
2563. Researchers concluded that increased protein intake was related to increased
2564. body cell mass, suggesting efficacy in the use of protein to boost health
2565. variables in HIV patients.<sup>9</sup><o:p></o:p></span></div>
2566. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2567. <span style="font-family: "times" , "times new roman" , serif;">Researchers in a
2568. 2006 study of children suffering from rapidly-progressing AIDS, examined the
2569. effect of<span style="mso-spacerun: yes;">  </span>a whey protein supplement in
2570. regard to <a href="https://www.blogger.com/u/1/null" name="_Hlk23585985">erythrocyte glutathione concentration, T
2571. lymphocyte counts and occurrence of additional infections</a>.<sup>10</sup> In
2572. the prospective double-blind clinical trial, 18 HIV-infected children
2573. undergoing antiretroviral therapy were followed for four months.<sup>10</sup>
2574. The subjects were divided into three groups and given whey protein,
2575. maltodextrin or placebo, followed by an evaluation of erythrocyte glutathione
2576. concentration, T lymphocyte counts and occurrence of additional infections.<sup>10</sup>
2577. Results demonstrated<span style="mso-spacerun: yes;">  </span>that in the whey
2578. protein group, erythrocyte glutathione levels increased and co-infection
2579. occurrence decreased, while T lymphocytes remained unchanged when compared to
2580. the control group (placebo).<sup>10<span style="mso-spacerun: yes;">  </span></sup>Researchers
2581. concluded that the inclusion of a whey protein supplement was advisable for
2582. this population.<sup>10 </sup><o:p></o:p></span></div>
2583. <div class="MsoNormal" style="line-height: 150%;">
2584. <i><span style="font-family: "times" , "times new roman" , serif;">Summary of Findings and
2585. Limitations<o:p></o:p></span></i></div>
2586. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2587. <span style="font-family: "times" , "times new roman" , serif;">Though this brief
2588. review may appear to point to the overall benefits of increased protein intake
2589. and health-compromised people groups, it is important to note the existence of
2590. study limitations. Several of the studies reviewed involved very small sample sizes.
2591. Though this fact does not necessarily fully discount the findings, it does give
2592. reason to be cautious when evaluating the efficacy of information. Many of the
2593. studies reviewed also examined multiple factors combined with increased protein
2594. intake, making the definitive factor of efficacy more difficult to deduce. Further,
2595. as mentioned previously, one of the studies presented was funded by the maker
2596. of the protein supplement used in the study, thus giving reason to again be
2597. mindful of the bias potential. Length of the studies is also a factor to
2598. consider due to the fact that the relevance of data was not studied extensively
2599. in terms of long-term outcomes. Oftentimes interventions appear positive in the
2600. short-term but neutral or negative in the long-term. Further, though some
2601. benefit was shown in some of the presented studies, it is important to note
2602. that reduction in wound size or increased levels of CD4 levels for example,
2603. does not necessarily imply positive health outcomes for the individual overall.
2604. Symptom management, symptom reduction and more acceptable biomarkers do not
2605. always suggest optimal health, a point of key importance when evaluating
2606. treatment modalities.<o:p></o:p></span></div>
2607. <div class="MsoNormal" style="line-height: 150%;">
2608. <i><span style="font-family: "times" , "times new roman" , serif;">Risks<o:p></o:p></span></i></div>
2609. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2610. <span style="font-family: "times" , "times new roman" , serif;">It is always
2611. important to examine the level of risk associated with any type of intervention,
2612. even if the added measure appears to be harmless. Though protein is a necessary
2613. nutrient, an increase of consumption does not come without risk. Consuming
2614. large amounts of protein carries with it a significant amount of risk such as
2615. increased risk of cancer, diabetes and overall mortality.<sup>11</sup> Eating a
2616. high protein diet also creates excessive strain on the kidneys, causing
2617. complications such as the formation of kidney stones and other kidney-related
2618. health issues.<sup>13</sup> In addition, the inclusion of high protein
2619. supplements made from dairy products carries with it a considerable amount of
2620. risk due to the detrimental effects of dairy consumption. Higher mortality
2621. rates, cancer, fracture risk and heart disease can all be linked to the
2622. consumption of dairy, a fact that should give significant pause to the
2623. recommendation to increase the consumption of it, particularly in
2624. immune-compromised populations.<sup>,14, 15, 16<o:p></o:p></sup></span></div>
2625. <div class="MsoNormal" style="line-height: 150%;">
2626. <i><span style="font-family: "times" , "times new roman" , serif;">Conclusions and Future Research
2627. Opportunities<o:p></o:p></span></i></div>
2628. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2629. <span style="font-family: "times" , "times new roman" , serif;">As reviewed above,
2630. some evidence appears to exist in regard to increased protein intake. However,
2631. study limitations exist and multiple risks exist to the implementation of
2632. increased protein intake. Additional research into alternative methods of
2633. improvement that do not involve increased protein intake would be wise to
2634. conduct, in addition to a more extensive evaluation of the risk-benefit ratio
2635. of protein intervention and the detrimental effects of engaging in such
2636. measures.<o:p></o:p></span></div>
2637. <div class="MsoNormal" style="line-height: 150%;">
2638. <span style="font-family: "times" , "times new roman" , serif;"><br /></span></div>
2639. <div class="MsoNormal" style="line-height: 150%; text-align: left;">
2640. <div style="text-align: center;">
2641. <span style="font-family: "times" , "times new roman" , serif;"><i>References</i></span></div>
2642. </div>
2643. <div class="MsoNormal" style="line-height: 150%; text-align: center;">
2644. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2645. <span style="font-family: "times new roman" , serif;">7. Sattler FR, Rajicic N, Mulligan
2646. K, et al. Evaluation of high-protein supplementation in weight-stable
2647. HIV-positive subjects with a history of weight loss: a randomized, double-blind,
2648. multicenter trial. American Journal of Clinical Nutrition.
2649. 2008;88(5):1313–1321. doi:10.3945/ajcn.2006.23583<o:p></o:p></span></div>
2650. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2651. <span style="font-family: "times new roman" , serif;">8. Gibert CL, Wheeler DA, Collins
2652. G, et al. Terry Beirn Community Programs for Clinical Research on AIDS:
2653. randomized, controlled trial of caloric supplements in HIV infection. Journal
2654. of Acquired Immune Deficiency Syndrome. 1999;22:253–259. <o:p></o:p></span></div>
2655. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2656. <span style="font-family: "times new roman" , serif;">9. Williams SB, Bartsch G,
2657. Muurahainen N, et al. Protein intake is positively associated with body cell
2658. mass in weight-stable HIV-infected men. Journal of Nutrition. 2003; 133(4):
2659. 1143-1146.<o:p></o:p></span></div>
2660. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2661. <span style="font-family: "times new roman" , serif;">10. Moreno YF,  Sgarbieri VC,
2662. da Silva MN, Toro AADC, Vilela MMS. Features of whey protein concentrate
2663. supplementation in children with rapidly progressive HIV infection. Journal of
2664. Tropical Pediatrics. 2006; 52(1): 34–38.<o:p></o:p></span></div>
2665. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2666. <span style="font-family: "times new roman" , serif;">11. Levine ME, Suarez JA,
2667. Brandhorst S, et al. Low protein intake is associated with a major reduction in
2668. IGF-1, cancer, and overall mortality in the 65 and younger but not older
2669. population. Cell Metabolism. 2014;19(3):407–417. <o:p></o:p></span></div>
2670. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2671. <span style="font-family: "times new roman" , serif;">12.  Fontana L, Klein S, O Holloszy
2672. J, Long-term low-protein, low-calorie diet and endurance exercise modulate
2673. metabolic factors associated with cancer risk. American Journal of Clinical
2674. Nutrition. 2006; 84(6):1456–1462.<o:p></o:p></span></div>
2675. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2676. <span style="font-family: "times new roman" , serif;">13. Robertson W, Heyburn P, Peacock
2677. M, Hanes F, Swaminathan R. The effect of high animal protein intake on the risk
2678. of calcium stone-formation in the urinary tract. Clinical Science. 1979;
2679. 57(3):285-288.<o:p></o:p></span></div>
2680. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2681. <span style="font-family: "times new roman" , serif;">14. Michaëlsson K, Wolk A,
2682. Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women
2683. and men: cohort studies. British Medical Journal.  2014; 349 :6015.<o:p></o:p></span></div>
2684. <div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-align: left;">
2685. <span style="font-family: "times new roman" , serif;">15. Aune D, Rosenblatt DAN, Chan
2686. DSM, et al. Dairy products, calcium, and prostate cancer risk: a systematic
2687. review and meta-analysis of cohort studies. American Journal of Clinical
2688. Nutrition. 2015;101:87-117.  <o:p></o:p></span></div>
2689. <div style="text-align: left;">
2690. <span style="font-family: "times new roman" , serif; font-size: 11.0pt; line-height: 107%;">             16. Chen M, Li Y, Sun
2691. Q, et al. Dairy fat and risk of cardiovascular disease in 3 cohorts of US
2692. adults.                 American Journal of Clinical Nutrition. 2016;104(5):1209–1217. </span></div>
2693. </div>
2694. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/7710164449604801340/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised_10.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7710164449604801340'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/7710164449604801340'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised_10.html' title='Protein Needs in Compromised Populations Part II'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8755372626436617988</id><published>2019-11-03T03:41:00.005-08:00</published><updated>2021-11-26T05:00:27.555-08:00</updated><title type='text'>Protein Needs in Compromised Populations Part I</title><content type='html'>&lt;span style=&quot;font-family: &amp;quot;times&amp;quot; , &amp;quot;times new roman&amp;quot; , serif;&quot;&gt;&lt;br /&gt;&lt;/span&gt;
2695. <br />
2696. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2697. <span style="font-family: "times" , "times new roman" , serif; text-indent: 0.5in;">There does not
2698. appear to be much debate when discussing the importance of nutrition on patients
2699. suffering from wounds and burns and likewise with people who are HIV positive. More
2700. specifically, increased intake of protein is often posed as the essential
2701. nutrient for such patients. However, as is always the case, it is of paramount
2702. importance to examine the scientific findings of such claims before making the
2703. assumption that the recommendations are sound. For the purposes of this paper,
2704. a brief review of the literature concerning the afore-mentioned populations in
2705. relation to protein intake will be presented.</span></div>
2706. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2707. <span style="font-family: "times" , "times new roman" , serif;"><o:p></o:p></span></div>
2708. <div class="MsoNormal" style="line-height: 150%;">
2709. <i><span style="font-family: "times" , "times new roman" , serif;">Wound and Burn Healing<o:p></o:p></span></i></div>
2710. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2711. <span style="font-family: "times" , "times new roman" , serif;">According to an
2712. article published in the British Journal of Nursing, author Linda Russell
2713. reported that protein deficiency poses many detriments to the healing process
2714. such as reduction in collagen formation.<sup>1 </sup>Further, Russell commented
2715. that high exudate loss has the potential to deplete protein stores by 100 grams
2716. per day, thus indicating the need for heightened intake of protein.<sup>1 </sup>It
2717. should be noted that in addition to increased protein intake, the author
2718. encouraged a comprehensive evaluation of nutrition overall, stating that a
2719. holistic approach to nutrient load is vital to wound healing.<sup>1 </sup><o:p></o:p></span></div>
2720. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2721. <span style="font-family: "times" , "times new roman" , serif;">A 2014 review of
2722. the literature looked at the necessity of nutrition, including the subset of
2723. protein, in relation to wound healing.<sup>2 </sup>Researchers stated that
2724. increased<span style="mso-spacerun: yes;">  </span>protein needs were noted as a
2725. result of protein loss due to large surface area of unhealed wounds, wound
2726. exudates, chronic wound sites, and losses in lean body mass.<sup>2, 3</sup>
2727. Further, researchers stated that in order to experience wound healing, protein
2728. losses must be accounted for and replaced by increased intake of protein.<sup>2
2729. </sup>Once again, it is noteworthy to mention that the authors recommend a
2730. comprehensive overview of nutrition and possible supplementation of various
2731. sources to enhance wound healing, rather than solely relying upon increased
2732. protein intake. <o:p></o:p></span></div>
2733. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2734. <span style="font-family: "times" , "times new roman" , serif;">In a 1993 study of
2735. 28 malnourished patients with truncal pressure ulcers, researchers examined the
2736. effect of protein on wound healing.<sup>3 </sup>Patients were divided into two
2737. groups, one receiving 24% protein (high intake) and the other receiving 14%
2738. protein (moderately high intake).<sup>3 </sup>Researchers observed a decrease
2739. in wound surface area in the higher protein group but not the moderate protein
2740. group.<sup>3 </sup>Higher caloric intake was also noted as a contributing
2741. factor to the reduction in wound surface area in the higher protein group.<sup>3
2742. </sup>Though the researchers concluded that high protein diets may improve
2743. wound healing, it is important to point out the uniqueness of the population
2744. studied (malnourished nursing home patients) and not automatically apply the
2745. findings to the general population. <o:p></o:p></span></div>
2746. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2747. <span style="font-family: "times" , "times new roman" , serif;">A 2009 review of
2748. the literature studied the connection between nutrition and wound healing and
2749. confirmed conclusions previously mentioned. Authors stated, based upon their
2750. review, <span style="mso-spacerun: yes;"> </span>that protein is a vital
2751. component to wound and burn healing.<sup>4 </sup>Skin regrowth, according to
2752. the review, is dependent upon cell proliferation and protein synthesis, both of
2753. which require increased protein consumption.<sup>4 </sup>In addition,
2754. researchers concluded that rapid protein initiation was vital in preventing
2755. protein malnourishment in patients.<sup>4 </sup>Researchers not only
2756. recommended protein intake increase but also the inclusion of anabolic hormones
2757. to heighten the body’s response to protein<sup>4 </sup><span style="mso-spacerun: yes;"> </span>Of key importance would be an additional review
2758. of the data concerning risks involved with this type of supplementation,<span style="mso-spacerun: yes;">  </span>a suggestion not examined in the current
2759. article. <o:p></o:p></span></div>
2760. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2761. <span style="font-family: "times" , "times new roman" , serif;">A literature
2762. review in the Indian Journal of Critical Care Medicine examined the importance
2763. of hydration and nutritional intake in relation to pressure ulcers.<sup>5</sup>
2764. Researchers noted that though hydration is of key importance to the
2765. regeneration of skin, nutrition is equally imperative to the wound healing
2766. process.<sup>5</sup> Protein, along with a multitude of other nutrients, was
2767. recommended<span style="mso-spacerun: yes;">  </span>as essential to the process
2768. of wound healing, stating that protein was the most important macronutrient
2769. involved in the repair of tissues.<sup>5 </sup><o:p></o:p></span></div>
2770. <div class="MsoNormal" style="line-height: 150%; text-indent: .5in;">
2771. <span style="font-family: "times" , "times new roman" , serif;">In a 2014 Cochrane
2772. Review, researchers studied a variety of factors in regard to wound healing,
2773. including increased protein intake.<sup>6 </sup>Outcome results showed a lack
2774. of efficacy in regard to the incorporation of increased protein and wound
2775. healing.<sup>6</sup> Furthermore, out of the fourteen studies reviewed, authors
2776. concluded that nutritional supplements overall showed no benefit to wound
2777. healing (with the questionable exception of arginine which showed possible but
2778. not convincing efficacy).<sup>6 </sup><o:p></o:p></span></div>
2779. <div class="MsoNormal" style="line-height: 150%; text-align: left; text-indent: 0.5in;">
2780. <div style="text-align: center;">
2781. <br />
2782. <br /></div>
2783. </div>
2784. <div style="text-align: center; text-indent: 48px;">
2785. <div class="MsoNormal" style="line-height: normal; text-align: center;">
2786. </div>
2787. <div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
2788. <i><span style="font-family: "times new roman" , serif;">References</span></i><br />
2789. <br /></div>
2790. <br />
2791. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2792. <span style="font-family: "Times New Roman", serif;">1. Russell, L. The importance of patients'
2793. nutritional status in wound healing. </span><i style="font-family: "Times New Roman", serif;">British Journal               of Nursing</i><span style="font-family: "Times New Roman", serif;">. 2013;
2794. 10(1): 44-49.</span></div>
2795. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2796. <span style="font-family: "Times New Roman", serif;">2. Molnar JA, Underdown MJ, Clark
2797. WA. Nutrition and chronic wounds. </span><i style="font-family: "Times New Roman", serif;">Advanced</i><span style="font-family: "Times New Roman", serif;"> </span><i style="font-family: "Times New Roman", serif;">Wound                  Care</i><span style="font-family: "Times New Roman", serif;"> (New
2798. Rochelle). 2014;3(11):663–681.</span></div>
2799. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2800. <span style="font-family: "Times New Roman", serif;">3. Breslow RA, Hallfrisch J, Guy
2801. DG, Crawley B, Goldberg AP. The importance of dietary                 protein in healing
2802. pressure ulcers. </span><i style="font-family: "Times New Roman", serif;">Journal of the American Geriatric Society.</i><span style="font-family: "Times New Roman", serif;"> 1993;
2803. 41(4):                   357-362.</span></div>
2804. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2805. <span style="font-family: "Times New Roman", serif;">4. Demling RH. Nutrition,
2806. anabolism, and the wound healing process: an overview. </span><i style="font-family: "Times New Roman", serif;">Eplasty</i><span style="font-family: "Times New Roman", serif;">.                2009;9:e9.</span></div>
2807. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2808. <span style="font-family: "Times New Roman", serif;">5. Saghaleini SH, Dehghan K,
2809. Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z. Pressure                    ulcer and nutrition. </span><i style="font-family: "Times New Roman", serif;">Indian
2810. Journal of Critical Care Medicine</i><span style="font-family: "Times New Roman", serif;">. 2018;22(4):283–289. </span></div>
2811. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2812. <span style="font-family: "Times New Roman", serif;">6. Langer  G, Fink  A.
2813. Nutritional interventions for preventing and treating pressure ulcers.                  </span><i style="font-family: "Times New Roman", serif;">Cochrane
2814. Database of Systematic Reviews</i><span style="font-family: "Times New Roman", serif;"> 2014, Issue 6. Art. No.:CD003216. </span></div>
2815. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2816. <span style="font-family: "Times New Roman", serif;">DOI:  10.1002/14651858.CD003216.pub2.</span></div>
2817. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2818. <br /></div>
2819. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2820. <br /></div>
2821. <br />
2822. <div class="MsoNormal" style="line-height: normal; text-align: justify;">
2823. <br /></div>
2824. <br /></div>
2825. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8755372626436617988/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8755372626436617988'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8755372626436617988'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/11/protein-needs-in-compromised.html' title='Protein Needs in Compromised Populations Part I'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-8123086630238659660</id><published>2019-09-23T08:02:00.000-07:00</published><updated>2024-02-02T03:36:38.605-08:00</updated><title type='text'>A New Take on Breast Cancer Awareness Month...</title><content type='html'>&lt;div class=&quot;&quot; data-block=&quot;true&quot; data-editor=&quot;6v26a&quot; data-offset-key=&quot;8kspd-0-0&quot; style=&quot;background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;&quot;&gt;
2826. <div class="_1mf _1mj" data-offset-key="8kspd-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2827. <span data-offset-key="8kspd-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>October is Breast Cancer Awareness Month, and it is discouraging to see misguided the “celebration” is – there are pink M&Ms, pink buckets of fried chicken, and of course the constant reminder that the best way to reduce your risk of breast cancer is to have mammograms.</b></span></span></div>
2828. </div>
2829. <div class="" data-block="true" data-editor="6v26a" data-offset-key="86c8-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
2830. <div class="_1mf _1mj" data-offset-key="86c8-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2831. <span data-offset-key="86c8-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>This year, we have a constructive alternative. Healthy on Purpose is partnering with Wellness Forum Health and the Physicians Committee for Responsible Medicine (PCRM) to promote a different awareness campaign designed to educate women and show them how to really reduce their risk of breast cancer.</b></span></span></div>
2832. </div>
2833. <div class="" data-block="true" data-editor="6v26a" data-offset-key="dgakn-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
2834. <div class="_1mf _1mj" data-offset-key="dgakn-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2835. <span data-offset-key="dgakn-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Women will be asked to sign a pledge card with 4 commitments:</b></span></span></div>
2836. </div>
2837. <div class="" data-block="true" data-editor="6v26a" data-offset-key="72g43-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
2838. <div class="_1mf _1mj" data-offset-key="72g43-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2839. <ul>
2840. <li><span data-offset-key="72g43-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Choose plant-based foods</b></span></span></li>
2841. <li><span data-offset-key="6qsn5-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Exercise regularly</b></span></span></li>
2842. <li><span data-offset-key="45a0o-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Limit alcohol</b></span></span></li>
2843. <li><span data-offset-key="1dl8e-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Maintain a healthy weight</b></span></span></li>
2844. </ul>
2845. </div>
2846. </div>
2847. <div class="" data-block="true" data-editor="6v26a" data-offset-key="f0v6p-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
2848. <div class="_1mf _1mj" data-offset-key="f0v6p-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2849. <span data-offset-key="f0v6p-0-0" style="font-family: inherit;"><span style="color: #e06666;"><b>Those who sign the pledge through Healthy on Purpose and Wellness Forum Health will receive a $100 coupon good toward one of our online educational programs, and also have access to a free lecture on breast health. We will be donating $25 to PCRM and the wonderful work this organization does for every coupon redeemed by November 15.</b></span></span></div>
2850. </div>
2851. <div class="" data-block="true" data-editor="6v26a" data-offset-key="ebkti-0-0" style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">
2852. <div class="_1mf _1mj" data-offset-key="ebkti-0-0" style="direction: ltr; font-family: inherit; position: relative;">
2853. <b style="color: #e06666; font-family: inherit;">This promotion starts October 1. If you would like to sign a pledge and/or  help by asking women to sign the pledge, please send an email to kylea.rorabaugh@gmail.com</b></div>
2854. </div>
2855. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/8123086630238659660/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/09/a-new-take-on-breast-cancer-awareness.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8123086630238659660'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/8123086630238659660'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/09/a-new-take-on-breast-cancer-awareness.html' title='A New Take on Breast Cancer Awareness Month...'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry><entry><id>tag:blogger.com,1999:blog-6366113899601223690.post-6000466500811799131</id><published>2019-01-20T18:27:00.001-08:00</published><updated>2024-02-02T03:36:37.188-08:00</updated><title type='text'>about me</title><content type='html'>&lt;span style=&quot;font-family: Georgia, serif; font-size: 16px;&quot;&gt;My name is Kylea and I am a mom and wife with a passion for maintaining a vibrant and intentional lifestyle and sharing what I have learned with others. I am also a Licensed Professional Counselor, crazy about research, and am always looking for new ways to learn. This blog is intended to showcase key components of what it means to live a life that is healthy on purpose.&lt;/span&gt;&lt;br /&gt;
2856. <div>
2857. <span style="font-family: Georgia, serif; font-size: 16px;"><br /></span></div>
2858. </content><link rel='replies' type='application/atom+xml' href='http://www.healthyonpurpose.org/feeds/6000466500811799131/comments/default' title='Post Comments'/><link rel='replies' type='text/html' href='http://www.healthyonpurpose.org/2019/01/about-me.html#comment-form' title='0 Comments'/><link rel='edit' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6000466500811799131'/><link rel='self' type='application/atom+xml' href='http://www.blogger.com/feeds/6366113899601223690/posts/default/6000466500811799131'/><link rel='alternate' type='text/html' href='http://www.healthyonpurpose.org/2019/01/about-me.html' title='about me'/><author><name>Healthy on Purpose</name><uri>http://www.blogger.com/profile/12056498754267285311</uri><email>noreply@blogger.com</email><gd:image rel='http://schemas.google.com/g/2005#thumbnail' width='16' height='16' src='https://img1.blogblog.com/img/b16-rounded.gif'/></author><thr:total>0</thr:total></entry></feed>