Diseases

Stones at the Wrong Place

April 4, 2021 by Esther Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Stones can really be in the wrong place. But today we are not concerned with stumbling blocks, but with stones deep in our body. Often they do not cause us any complaints and are only discovered by chance. But they can also cause painful colics. We are talking about kidney stones. Two to five percent of the total population collects such stones.

Formation

Kidney stones develop when substances accumulate in the urine that are capable of stone formation. The most common are calcium oxalate stones, followed by uric acid stones. The struvite stones are composed of magnesium ammonium phosphate. The rare cystine stones are formed at elevated excretion of the amino acid cystine in the urine.

Increased concentrations of such urine components can result from a lack of fluids, especially in hot areas and in case of long-lasting diarrhea. Diet also plays a role. Eating plenty of dairy products causes an excess of calcium in the urine. If large quantities of meat and sausage is eaten, a lot of purines are produced which are broken down into uric acid. This is precipitated if the fluid intake is too low and, in addition to gout, it can lead to uric acid stones. Drinking plenty of green and black tea increases the absorption of oxalic acid, and calcium oxalate stones will be formed in the presence of calcium.

Lack of exercise in the case of prolonged bed rest or old age can lead to an increased breakdown of calcium from the bones, which in turn promotes stone formation.

Certain metabolic diseases promote stone formation. If the parathyroid gland is overactive (hyperparathyroidism), too much calcium is excreted.

In the case of primary hyperoxaluria, a congenital enzyme disorder, more oxalic acid is found in the urine. This can lead to stone formation.

Diagnosis

A clinical distinction is made between kidney, ureter and bladder stones. If the stones remain in place in the kidney, the patients are usually symptom-free and the stones are discovered only by chance during an X-ray or ultrasound examination. But if they migrate into the ureter, a renal colic occurs. The pain comes like a bolt of lightning out of the blue, with strong labor-like pains, radiating in the lower abdomen, the groin and the genitals. It is accompanied by nausea and vomiting. The patients are very restless and throw themselves around or wander up and down. Large renal pelvis limb stones that cannot be excreted do not cause colics, but only unspecific pain that is interpreted as lumbago. Irritation of the mucous membrane can lead to small amounts of blood in the urine.

Ultrasound and X-ray examinations are used for diagnosis. Stones show up as white reflections with a shadow. At the same time, an elimination urogram is carried out. A radiopaque contrast agent makes the entire urinary system visible, shows the extent of a urinary obstruction and provides information about the type of stones.

Kidney stones in an X-Ray - Source: Flickr.com - Arrow was added.

Laboratory exams are also used to differentiate the diagnosis. Uric acid, electrolytes (especially calcium) and creatinine are measured in the blood and a hemogram is performed. The pH value of urine is measured. In acidic urine (pH 5) uric acid or urate crystals precipitate, in alkaline (pH 7) phosphate crystals. If the stones injure the mucous membrane, blood is found in the urine.

Complications

When the urinary tract is blocked, bacteria can migrate into the urinary tract. The urine is an ideal breeding ground for bacteria. If the kidneys are infected, urination problems, fever and chills occur. If the bacteria enter the bloodstream, this can lead to blood poisoning. Urinary stasis can cause the renal pelvis to expand.

Therapy

In the case of stones less than 5 mm in size with a smooth surface and no signs of infection, spontaneous elimination can be awaited under the control of ultrasound, urine sediment and hemogram. You should drink plenty of water and exercise a lot, especially climbing stairs and hopping.

Renal pelvic stones are now treated with ESWL (extracorporeal shock wave lithotripsy). The urinary stone is located with X-rays or ultrasound in order to bring it into the focal point of the shock waves. The waves are generated outside the body and the radiation bundled onto the stone. It is smashed by pressure and tension waves. The intensity and number of strokes of the wave are precisely matched to the size and hardness of the stones. This creates stones or sand that can be eliminated spontaneously. The disposal must be controlled. Urine is collected and examined. It is not always possible to smash the stones in one sitting. Sometimes ESWL needs to be repeated or resorted to other treatments.

MIL (minimally invasive percutaneous nephrolitholapaxy) is often the therapy of choice. A small incision is made in the skin under anesthesia, a puncture canal is widened and an endoscope is inserted into the kidney. Kidney stones and smaller fragments can be removed with grasping forceps.

Open surgical interventions for kidney or bladder stones are rarely performed today. For example, if the procedures listed above are unsuccessful or if other complications occur, such as bleeding or injuries to neighboring organs.

Drug dissolution of the stones is used for cystine and uric acid stones. With allopurinol the uric acid level can be lowered.

Follow-up Care for Kidney Stone Patients

Around every fifth patient treated for kidney or bladder stones will have a relapse. That is why the urine must be sieved during treatment and the excreted particles analyzed, so that the patient can be advised precisely according to the type of his stones. Adequate hydration is very important for all kidney stone patients. In addition, special measures apply to the different types of stones.

With calcium oxalate stones, the consumption of dairy products, cheese, chocolate, spinach, as well as black and green tea should be restricted. Orange juice helps to reduce stone formation.
In the case of calcium phosphate stones, the consumption of milk, cheese and citrus fruits must be restricted. Currant juice is the preferred drink.
In the case of uric acid stones, it is important to ensure that the urine is alkalized. This can be achieved by taking K citrate. The patient adjusts the pH of the urine himself with test strips to 6.2 to 6.8. The diet should be low in purine, i.e. contain little meat, sausage and legumes.
For cystine stones, the urine needs to be adjusted to around 7.5 to 7.8 pH. With a good supply of vitamin C, the cystine can be converted into the more easily soluble cysteine, thus preventing stone formation.

Prevention

Drinking water avoids kidney stones - Photo by Daria Shevtsova from Pexels

The best prevention is drinking plenty of liquids, and pure water is best suited for this. For a change, you can drink either orange or currant juice, depending on the type of stone. One should rather avoid mineral water. They could be high in calcium or even acidic. The fluid intake must be regularly distributed throughout the day so that the urine is diluted. This way we avoid oversaturation with stone-forming substances.

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Echinacea – An Old Medicinal Plant

February 21, 2021 by Esther Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

They are here again, the cold, wet days when we long for the hot summer days. And with them come colds, coughs and sore throats, the uninvited companions of the cold season. But we are not at their mercy for better or worse, we can strengthen our immune system. And if we do catch a cold, there are herbal ingredients that help us cope with it more easily. I would like to introduce you to a very pretty plant. It blooms in many of our gardens all summer long. But most of them only know it as an ornamental plant and don’t even know what kind of healing powers it contains.

Botany

Echinacea is a genus of herbaceous flowering plants in the daisy family. It has ten species, which are commonly called coneflowers. Some species can get 4 feet high (140 cm). At the top there is a single, large daisy with a conical flower base and 12 to 15 pale pink to purple-colored ray-flowers. Coneflowers are native in North America, found in moist and dry prairies and open wooded areas. They are often cultivated in gardens for their showy flowers. There are different variations of coneflowers. The Echinacea purpurea, the red coneflower, is mainly used for healing purposes.

Historical

Echinacea is an ancient medicinal plant of the Indians. They used the fresh vegetable pulp or a root pulp for burns, snake and insect bites, poorly healing wounds and fever. The first settlers soon adopted the application as a home remedy for colds. About hundred years ago the plant migrated to Europe. Today preparations of this pretty flower are among the best-selling herbal immunostimulants. And rightly so, as many studies show.

Clinical Studies

The positive effect of Echinacea purpurea extract on the duration and the course of colds is found in numerous studies. In a controlled, double-blind study, in which neither the scientist nor the participants knew who was receiving the remedy and who the placebo, it could be shown that the application could shorten the duration of a cold; the cold symptoms were less severe. Some of the patients with symptoms of a cold were given 5 ml of Echinacea purpurea pressed juice twice a day, the other part an ineffective placebo, i.e. a product that looks the same as the drug but contains no active ingredients. Echinacea reduced the time for symptoms to subside to 6 days. In the placebo group, the duration of the cold was 9 days. The severity of symptoms such as nasal congestion, runny nose and sore throat could also be reduced significantly.

Another study with 755 participants showed that 46% of the ecinacea group got a cold within a 4 month period, compared to 54% in the placebo group. The participants treated with echinacea were 2.06 days sick on average, compared to 2.44 days in the placebo group.((M. Javad et.al. Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled Trial. https://doi.org/10.1155/2012/841315))

In vitro, that means in cell cultures in the lab, an echinacea extract was able to inactivate various types of coronaviruses, those responsible for the common cold as well as for SARS-CoV-1 and SARS-CoV-2.((J Signer et.al. In vitro virucidal activity of Echinaforce®, an Echinacea purpurea preparation, against coronaviruses, including common cold coronavirus 229E and SARS-CoV-2. Virol J. 2020 Sep 9;17(1):136. DOI: 10.1186/s12985-020-01401-2)) There seem to be no clinical trials available so far to prove the efficacy of echinacea for COVID-19, but we could conclude that it most likely will give us some protective effect against the virus.

Another advantage is that the alcohol-free preparations can be used by two-year-old children. Doctors and parents confirm that the preparations are well tolerated and significantly mitigate and shorten the ordeal of a cold in children.

A child sneezing - Photo by Andrea Piacquadio from Pexels

In the literature contradicting results of the effectiveness of Echinacea are found.((M Karsch-Völk et.al. Echinacea for preventing and treating the common cold. DOI: 10.1002/14651858.CD000530.pub3)) This can be attributed to the fact that these studies were made with ill-defined products. If different species, plant parts and extraction methods are used, this leads to falsification. It also depends much on where the plant grew and how the active ingredients were extracted.

Science is still researching the exact active ingredients. Modern analytical methods have already identified a large number of ingredients, such as various essential oils, terpenes, alkamides, glycoproteins, polysaccharides and many others. But it is still not known exactly which chemical compounds are actually responsible for the known effects. It is probably just the whole plant in its diverse composition.

Mechanisms of Action

Echinacea purpurea has a phagocytosis-stimulating effect on granulocytes. Granulocytes are white blood cells. They serve to ward off microorganisms. In our case of a cold, they render the invading pathogens harmless by englobing and thus incapacitating them. The extract also increases the number of white blood cells.

The entire immune system is being fortified, increasing the body’s defenses. The formation and activity of the antibodies is stimulated. Interleukins are increasingly formed, which are communication proteins that serve to regulate the immune system. Acute-phase proteins, which also serve to ward off infection, are increasingly formed in the liver.

The number of natural killer cells is also increased. They bind to virus-infected cells and destroy them.

Echinacea products are offered as drops, ointments, gels and injection solutions. To strengthen the immune system, the drops can be swallowed on a spoonful of honey as a preventive measure during the period when the flu is suspected. If the cold has already broken out, Echinacea helps to accelerate the natural healing process in a gentle way.

An Echinacea flower - Photo by Mabel Amber from Pexels

A Healthy Immune System

Always remember that prevention is better than cure and let us strengthen our immune system. This is best done through regular sport and persistent exercise in the fresh air. Sauna sessions, alternating showers, a vitamin-rich diet and clothing that is appropriate for the season also make a significant contribution to health. Let us also try to influence our thoughts positively through contemplating beautiful things. Because a balanced mood also serves to strengthen the immune system.

If we catch a cold anyway, we have to drink a lot and ensure sufficient humidity in the air, which is often neglected during the heating season. In addition, Echinacea purpurea helps us to cope with the cold faster.

We have a special opportunity just for you. If you want to receive practical and up to date advice on how to implement an immunity-boosting lifestyle, simply join the Coronavirus Immunity Challenge and prepare yourself to face the pandemic with a bullet-proof immune system.

Coronavirus Immunity Challenge

Can Vitamin D Prevent COVID-19?

February 13, 2021 by Martin Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

In the beginning of last year, I was reading the news that a Chinese hospital in Shanghai was successful in treating COVID-19 patients with high doses of vitamin C. Not much attention was given to the subject, but evidence is increasing recently that vitamin D supplementation could be crucial in the prevention and treatment of COVID-19.

Vitamins are substances that you need to ingest with your food in order to live. They are vital to your health. Vitamin D is different. There are small amounts present in your food, but the bulk part is actually produced by your body. Your skin is able to metabolize it under sun exposure. If you do not get enough sun, then you need to supplement it, since the dietary intake is not sufficient to cover your needs.

Vitamin D is also different from other vitamins in the way it works in your body. In a certain sense, it almost works like a hormone, being able to regulate several essential body functions. It is able to bind to a receptor on the cell membrane and enter even into the nucleus, this way affecting how the genes express themselves in relation to cell function.((Vitamin D and COVID 19: The Evidence for Prevention and Treatment of Coronavirus (SARS CoV 2) Youtube)) Numerous cells have receptors for Vitamin D. This includes immune cells, an important fact for our subject of COVID-19 prevention. It was shown that vitamin D is essential for the proper functioning of the immune system.((F Sassi et.al. Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients2018, 10(11), 1656; https://doi.org/10.3390/nu10111656
Xu, Y., Baylink, D.J., Chen, CS. et al. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. J Transl Med 18, 322 (2020). https://doi.org/10.1186/s12967-020-02488-5))

Vitamin D and Immunity

The flu season is peaking exactly at the end of the winter, when sun exposure is limited and the Vitamin D storage is depleted. Studies have shown that children with rickets caused by Vitamin D deficiency, are also more susceptible to tuberculosis. Also, the relationship between respiratory diseases and vitamin D deficiency is well established.((H Brenner et.al. Vitamin D Insufficiency and Deficiency and Mortality from Respiratory Diseases in a Cohort of Older Adults: Potential for Limiting the Death Toll during and beyond the COVID-19 Pandemic? Nutrients 2020, 12(8), 2488; https://doi.org/10.3390/nu12082488
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.i6583
M Urashima et.al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60. DOI: 10.3945/ajcn.2009.29094))

On average we spend only 7.6% of the day being outdoors,((N. Klepeis et.al. The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. Journal of Exposure Analysis and Environmental Epidemiology (2001) 11, 231-252)) which means our sun exposure is very limited. Living above the 35th degree of latitude you do not have sufficient Vitamin D production in the winter. That includes any location of Tennessee and above. Europe is included entirely.

Indoor Light in a Metro -
Photo by cottonbro from Pexels

Studies have shown that people in the age of 77 to 82 years had less than half the capacity to produce Vitamin D in the skin compared to teenagers.((J MacLaughlin, M F Holick. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985 Oct;76(4):1536-8. DOI: 10.1172/JCI112134)) Darker skin colors have significantly less absorption of vitamin D as well.((O. M. Gutiérrez et.al. Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int. 2011 Jun; 22(6): 1745–1753. doi: 10.1007/s00198-010-1383-2))

Vitamin D is a fat-soluble vitamin. It is therefore stored in the fat tissues, and the more fat reserves you have, the more Vitamin D you will need. For that reason, individuals with a BMI higher than 35 are more likely to be Vitamin D deficient, and larger doses will be needed for supplementation.((J Wortsman et.al. Decreased bioavailability of vitamin D in obesity. The American Journal of Clinical Nutrition, Volume 72, Issue 3, September 2000, Pages 690–693, https://doi.org/10.1093/ajcn/72.3.690))

It is interesting to notice that people with higher age, dark skin color and increased BMI are having an increased risk of dying from COVID-19. Those are exactly the same risk factors for Vitamin D deficiency. Is that coincidental, or is there a causative relationship?

Vitamin D and COVID-19 Infections

Before we start, one note about unit conversion. Some countries are measuring blood levels of vitamin D in nmol/l. In the US the commonly used unit is ng/ml, and we are using this unit throughout the article. If you want to convert to nmol/l, you need to multiply those values by 2.5.

Some scientists analyzed the COVID-19 cases compared to the latitude of each country. They found out that all the countries with higher mortality rates were located above the 35th-degree latitude, thus having insufficient sun exposure in the winter.((J M Rhodes et.al. Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity. Aliment Pharmacol Ther. 2020 Jun;51(12):1434-1437. DOI: 10.1111/apt.15777)) Another research looked at the mean vitamin D level of each country and found that those with higher vitamin D levels had significantly lower numbers for COVID-19 cases and deaths.((P C Ilie et.al. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020 May 6 : 1–4. doi: 10.1007/s40520-020-01570-8))

In a research among elderly hospital patients was found that the mean vitamin D level of COVID-19 positive patient was 11 ng/ml compared to 21 ng/ml in the group who tested negative.((V Baktash et.al. Vitamin D status and outcomes for hospitalised older patients with COVID-19. Postgraduate Medical Journal Published Online First: 27 August 2020. doi: 10.1136/postgradmedj-2020-138712)) A study in Switzerland compared the vitamin D level of hospitalized patients and found that those who were hospitalized for COVID-19 infection had significantly lower vitamin D levels than those who were tested negative for COVID-19.((A D’Avolio. 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2. Nutrients 2020, 12(5), 1359; https://doi.org/10.3390/nu12051359))

That study was able to show a correlation between those two factors, but a correlation is not always causative. Some scientists found out that during an infection the serum vitamin D levels tend to drop, and stipulated the possibility that COVID-19 infection caused the vitamin D levels to drop, and not that the vitamin D deficiency has caused COVID-19.((J Smolders et.al. Letter to the Editor: Vitamin D deficiency in COVID-19: Mixing up cause and consequence. Metabolism. 2021 Feb; 115: 154434. doi: 10.1016/j.metabol.2020.154434)) Although the drop in vitamin D levels could be proven, it is though very moderate, and does not fully explain the drastic difference in vitamin D levels between those two groups.

To help us establish the causative effect, there were two studies done in Israel, that checked out people who had a prior Vitamin D test on record, and they found that those who had adequate Vitamin D levels before being exposed to COVID-19 were less likely to get infected.((A Israel et.al. The link between vitamin D deficiency and Covid-19 in a large population. https://doi.org/10.1101/2020.09.04.20188268)) The second study found that those who had Vitamin D levels below 30 ng/ml, were almost twice as much needing hospitalization compared to those with normal levels.((E Merzon et.al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J. 2020 Sep;287(17):3693-3702. DOI: 10.1111/febs.15495)) A study in the US found that persons with vitamin D level below 25 ng/ml had twice as many COVID-19 infections compared to those above 55 ng/ml.((H W Kaufman et.al. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. https://doi.org/10.1371/journal.pone.0239252))

Vitamin D for COVID-19 Treatment

Another research done in Spain went some further to find out whether vitamin D is an effective treatment option. They gave vitamin D injections to patients that were hospitalized for COVID-19 treatment. For those in the placebo group, 50% were submitted to the intensive care unit, while in the group treated with vitamin D, only 2% needed intensive care.((M E Castillo et.al. “Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study” J Steroid Biochem Mol Biol. 2020 Oct; 203: 105751. doi: 10.1016/j.jsbmb.2020.105751)) This is quite a significant improvement! As a result of the study, the hospital started wheeling out COVID-19 patients in recovery to the seaside.((Coronavirus: Barcelona beach trip for recovering patients. BBC News, 3 June 2020))

In a clinical trial done in India, they gave a dose of 60.000 UI of vitamin D3 for 7 days to patients being hospitalized for COVID-19. After 3 weeks 62.5% of those who received Vitamin D were cured compared to 20.8% in the control group.((A Rastogi et.al. Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study). Postgraduate Medical Journal Published Online First: 12 November 2020. doi: 10.1136/postgradmedj-2020-139065)) A meta analysis concluded that vitamin D supplementation can cut COVID-19 mortality in half.((L Nikniaz et.al. The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients: A systematic review and meta-analysis. https://doi.org/10.1101/2021.01.04.21249219))

COVID-19 Emergency Hospital - Photo by CDC from Pexels

Scientists start to explain the many different mechanisms in which Vitamin D shows so much benefit in COVID-19 treatment. One major problem in severe patient is an overreaction of the immune system, leading to a cytokine storm. This exaggerated inflammatory response can cause multiple organ damage. Vitamin D seems to be capable of regulating the immune system to minimize cytokine storm in severe patients.((Xu, Y., Baylink, D.J., Chen, CS. et al. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. J Transl Med 18, 322 (2020). https://doi.org/10.1186/s12967-020-02488-5))

Vitamin D Supplementation

There is no consensus on which levels of vitamin D are ideal for supplementation. In 2010 the Institue of Medicine raised the recommended daily allowance from 200UI to 600UI per day. The Endocrine Society recommends supplementation of 1500 to 2000UI per day in order to raise blood levels consistently above 30 ng/ml. They deem it safe to supplement up to 4,000 UI per day without medical supervision.((M F Holick et.al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 7, 1 July 2011, Pages 1911–1930, https://doi.org/10.1210/jc.2011-0385))

Vitamin D toxicity is though very rare. The first negative side effect of high doses is increased calcium uptake, which can cause calcium deposits in the arteries and other organs. This effect is starting to be observed only in persons with Vitamin D blood levels above 150 ng/ml. Vitamin D is considered the least toxic among the fat-soluble vitamins, so there is no concern about toxicity doing a short term application of high doses of vitamin D. Some specialists like Michael Holick suggest that supplementation of up to 10.000 UI per day is perfectly safe.((„Vitamin D – State of the art“ – Dr. Michael F. Holick in Vienna (English) https://www.youtube.com/watch?v=NuWC2d0mTbo))

It is possible to produce up to 10,000 UI of vitamin D just with a few minutes of sun exposure. This will work though only between 10 am and 3 pm, using no sunscreen and having large parts of the skin exposed to the sun. Latitude, season, age and skin color are factors that can significantly influence the amount of vitamin D production. In order to find out the ideal sun exposure for you, download the app Dminder that is found in Google Play and the App Store alike.

Now what levels of vitamin D in the blood are adequate? Here again, most recommendations are way lower than they are supposed to be. If you are below 30 ng/ml (75 nmol/l) consider yourself deficient. An ideal level for a well-functioning immune system would be between 50 and 100 ng/ml (125-250 nmol/l).

There are many who advocate a wider use of Vitamin D supplementation to help control the COVID-19 pandemic. In an initiative, 200 scientists and doctors have called on governments around the world to recommend a widespread supplementation of at least 4,000UI per day.((Over 200 Scientists & Doctors Call For Increased Vitamin D Use To Combat COVID-19. VitaminDforAll)) For those who did not do any supplementation so far, they recommend taking 10,000UI daily for 2-3 weeks in order to raise the levels, and then maintain with 4,000UI per day. Most governments that far have ignored this call, but individuals are able to do their part to protect themselves. And the message is reaching the consumers. Vitamin D supplement sales increased by more than 30% during the last year.((J Grebow. Vitamin D made headlines over COVID-19 studies last year. Sales of vitamin D were also up in 2020. What will 2021 look like? 2021 Ingredient trends to watch for food, drinks, and dietary supplements. Nutritional Outlook, February 10, 2021)) And even Dr. Fauci has stated that supplementing vitamin D may be beneficial, and takes supplements for himself.((Dr. Fauci says to take vitamin D if you’re deficient — here’s how to know. CNBC. September 26, 2020))

We have stated already that obese people need higher intakes of vitamin D, since it gets absorbed by the fat tissue. Overweight person with a BMI between 26 and 30 should take 1.5x the dose of normal weight individuals, and obese persons with a BMI above 30 should triple the dose of vitamin D supplementation. Age, should be taken into consideration as well when establishing the correct dose of supplementation. Individuals above 70 years of age should consider doubling the dose of supplementation.

It is interesting to note that High Fructose Corn Syrup which is present in soft drinks and many other industrialized foods can inactivate Vitamin D.((V Douard et.al. Excessive fructose intake causes 1,25-(OH)(2)D(3)-dependent inhibition of intestinal and renal calcium transport in growing rats. Am J Physiol Endocrinol Metab. 2013 Jun 15;304(12):E1303-13. DOI: 10.1152/ajpendo.00582.2012)) The same mechanism may not apply to table sugar, but an excess of any kind of sugar will reduce the effectiveness of the immune system.

Conclusion

In summary we have seen that vitamin D has a profound impact on our immune system and is essential in the prevention of COVID-19. Based on this fact, we highly recommend to test for adequate vitamin D levels, and correct with proper sun exposure or supplementation if levels are low. In questions of doubt, consult a nutritionist to define the ideal dose for you.

Although vitamin D is essential, it is by far not the only thing you can do to strengthen your immune system. We have prepared a 10 day immunity challenge that will cover several habits that are essential to keep your immunity in top shape. Participate now to find out what you can do to have maximum protection against the coronavirus that is circulating around the entire globe.

Coronavirus Immunity Challenge

The Metabolic Syndrome

January 15, 2021 by Esther Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Obesity, high blood pressure, elevated blood sugar and increased triglycerides with simultaneously decreased HDL are the precursors of a heart attack. In the US, one third of the adult population suffer from metabolic syndrome, and in women at the age of 70 and over, the prevalence rises to about 60%((J.S.Moore et. al. Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis 2017;14:160287. DOI: http://dx.doi.org/10.5888/pcd14.160287)). Even in the so-called developing countries, obesity continues to play a greater role. For this reason, the World Health Organization is particularly concerned with the problem of metabolic syndrome.

Definition of Terms

The metabolic syndrome is a complex metabolic disorder, the main symptom of which is insulin resistance. This is an insufficient response of the muscle, fat and liver cells to the action of insulin. That means the pancreas produces enough insulin, but the cells don’t respond well enough. In 1999 the WHO suggested the following parameters to be diagnosed for metabolic syndrome: Being diabetic or having glucose intolerance/insulin resistance, together with 2 of the following factors:((R M Parikh, V Mohan. Changing definitions of metabolic syndrome. Indian J Endocrinol Metab. 2012 Jan-Feb; 16(1): 7–12. doi: 10.4103/2230-8210.91175))

Abdominal obesity with a waist/hip ration of above 0,9 in men and over 0,85 in women or Body Mass Index over 30 kg/m²
Elevated triglyceride levels above 150 mg/dl; decreased HDL, men below 35 mg/dl and women below 39 mg/dl
Elevated blood pressure above 140/90 mmHg
urinary albumin excretion rate above 20 μg/minute

Causes of Metabolic Syndrome

In recent years there has been increased research into genetic factors. The body composition, the type of muscle fibers and their blood flow, and the hormone and enzyme levels play an important role in the development of the metabolic syndrome. But the problem is only triggered by a faulty lifestyle on the part of the person himself. Alcohol, smoking and stress are important triggers, but also improper nutrition and, above all, a lack of exercise. For these reasons, we also speak of the prosperity syndrome.

As the name suggests, the syndrome involves mainly metabolic diseases such as obesity (severe overweight), diabetes, high blood pressure, blood clotting disorders and disorders of lipid metabolism. This results in organ damage such as arterial occlusive diseases, coronary heart diseases, strokes, or colloquially called hardened arteries.

Obesity

According to the WHO, obesity is already a pandemic. It is the leading cause of high blood pressure and diabetes. The absolute weight plays less of a role, but more the fat distribution. The belly fat causes much more problems than the fat on the thighs and hips. Excess fat does not just stay quiet until a fat reserve is needed. Instead, fat tissue is considered a hormonal organ. Many different substances, similar to hormones, are released from the fat cells. These in turn influence blood clotting, insulin resistance, high blood pressure and control energy expenditure, to name but a few.

Sedentary Lifestyle

Physical inactivity is a risk factor by itself. Modern technology relieves us of a lot of activities that used to be mandatory. This ranges from remote controls to electronic typewriters to cars and escalators. Many professions today are sedentary and many leisure activities are carried out while sitting. Exercise falls by the wayside, just we would urgently need it to reduce our belly fat. Fortunately, the times of famine, for which a certain fat reserve would be beneficial, are not coming at the moment. Every now and then, a fasting day or skipping dinner days should be inserted – a programmed time of famine – in order to reduce excess body fat.

Increased Lipid Levels

Elevated triglycerides are often hereditary. But diet also plays an important role. If we eat high-fat, there will be lots of triglycerides circulating in the blood. Excess carbohydrates are also converted into fat in order to be stored, and insulin is needed for this process. A high-calorie diet paves the way for Diabetes.

Fortunately, there are some foods that can lower triglycerides. These include: soybeans, legumes, avocado, onion, wheat germ, and whole grains. We should incorporate several of these foods into our daily diet. Most of them help lower blood pressure at the same time. In addition, they do not contain cholesterol and even help to lower it, since we should keep cholesterol levels low.

Cholesterol is essential for life. That is why the body produces it itself. Without cholesterol, life would be bland, because it is the starting substance for sex hormones, as well as bile acid, aldosterone and cortisol. But the amount needed is very little, and any cholesterol in the diet will lead to excess. Here, too, there are foods that help to lower the cholesterol level: They are mainly nuts, avocados, flaxseed and chia, but also all fruits and vegetables.

LDL transports cholesterol to the body cells. We are used to call LDL the bad cholesterol. It’s just the taxi for the cholesterol. It only becomes dangerous when it oxidizes, i.e. reacts with oxygen and deposits as plaques in the vessel walls. This can be avoided by reducing oxidized cholesterol in the diet, not smoking, building up as little stress as possible and eating a lot of fruits and vegetables high in antioxidants, which are protecting the LDL from oxidation.

Decreased HDL

Most Metabolic Syndrome patients have low HDL levels. However, high values protect the blood vessels. HDL is the taxi for cholesterol back to the liver when it is not needed in the cells. We can increase the HDL levels by plenty of exercise. People who do regular exercise have higher levels.

High Blood Pressure

About 40% of overweight people also have high blood pressure. No wonder, because for every additional pound of fat, an extra mile of new blood vessels have to be created (3,5 km for every kg of fat). The heart therefore has to work harder. Smoking and drinking coffee, black and green tea also narrow the vessels and should be avoided. Apples, pears, grapefruits, pumpkin and celery all help lower blood pressure. They have hardly any sodium, but a lot of potassium. These two minerals are primarily that regulate blood pressure. Sausage, cheese, ham and cured meat are high in sodium, which increases blood pressure. Therefore we should avoid these foods.

Elevated Blood Sugar

This cause of Metabolic Syndrome can also be hereditary. But the trigger is again lifestyle. Lack of exercise, obesity and a high fat diet promote the development of diabetes. The resulting damage of diabetes can be very serious: blindness, kidney failure, amputation of legs and cardiovascular disease.

Diabetes test - Photo by Polina Tankilevitch from Pexels

What can you do? Here weight reduction is again called for, through exercise and a sensible diet. Olive or canola oil are positive fat sources, as well as nuts and seeds. Fruits, vegetables and whole grains provide a lot of fiber, fill you up and help that the sugar from food flows more slowly into the bloodstream.

Drug Treatment of the Metabolic Syndrome

Unfortunately, the Metabolic Syndrome delivers a whole package of metabolic disorders. The drug treatment is accordingly, and one or more drugs for each of the problems are applied. And quickly you have gathered half a pharmacy. The doctor will prescribe all essential drugs for treating the disorders. Unfortunately, a doctor rarely has time for lifestyle advice or has little experience with proper nutrition.

The far more sensible way would be a change in lifestyle and diet, as has been listed under the individual points above.

Hope on the Horizon

A group of doctors who study the Metabolic Syndrome in great detail give hope: “The Metabolic Syndrome can be treated quite effectively. If obese people having Metabolic Syndrome lose significant weight, the metabolic disorder has disappeared in most of them. Almost everyone can reduce their medication or stop it altogether.”

I would also like to encourage in this direction. Metabolic Syndrome patients need to find a way to get more exercise. Support Groups can help. If there isn’t one around, why not start one yourself? Diet and lifestyle courses bring help. Lifestyle changes are therefore undertakings in the right direction – and success is certain!

Does the Pandemic Stress You Out?

August 16, 2020 by Martin Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Almost half of the Americans report that the pandemic is affecting their mental health.((Coronavirus is harming the mental health of tens of millions of people in U.S., new poll finds. Washington Post, April 2, 2020)) A federal disaster distress hotline ha seen a more than 10x spike in incoming text messages during the pandemic.((The Health 202: Texts to federal government mental health hotline up roughly 1,000 percent. Washington Post, May 4, 2020)) In the UK a study ascertained the anxiety level of the population on a scale of 1 to 10. They found out that the average anxiety level jumped from 3 before the pandemic to 5.2 right after the lockdown.((Coronavirus and anxiety, Great Britain: 3 April 2020 to 10 May 2020. Office of National Statistics)) Especially couples and elderly people have seen a drastic rise in anxiety level.

The reasons for the steep increase of anxiety and stress are manifold. One of the more obvious ones is fear of getting infected when leaving home. News from relatives or friends who succumbed to the disease will just increase the fear of being the next victim. Although some simple protective measures are healthy, the more anxious ones are getting neurotic in their hygiene attempts. When studies were published that the virus can stay airborne for about 3 hours, this heightened the ill effects of coronaphobia in a large number of people. It is important to put the risk into a healthy perspective, and I wrote an article about the naked truth of the coronavirus that can help in that matter.

Quarantine is another source of stress. Especially those who reported being lonely have felt a greater rise in anxiety levels. As about one-third of the world’s population is put under quarantine, a number of mental health issues like low mood, irritability, stress, insomnia, anxiety, depression and others are on the rise.((Lockdown is the world’s biggest psychological experiment – and we will pay the price. World Economic Forum, April 9, 2020)) Social isolation is a big factor in that, together with feeling trapped at home and interruptions of the usual daily routines.

For families with children, the stress of schooling their children and entertaining them at home puts an extra burden on the parents that they are often not used to handle (We have some tips in the article: 15 Creative & Fun Family Activities You Can Do at Home). In some cases, a dysfunctional relationship is aggravated by the fact that the family is forced to stay together in quarantine, and having no place to escape. Domestic violence is increasing drastically during the lockdown.

Others are even more stressed with the thought of getting back to normal. After returning to work, will there be a risk for a second outbreak? What is my risk of getting infected being in touch with people again? Some risks are for real, but after doing some healthy precautions, put your worries away. And it is alright to take your time and return gradually into social life once the lockdowns are lifted.

Another source of stress is news overload. Some are trying to catch up with all the latest news, and chasing the newest studies to try to understand a disease that even experts have a hard time to understand. Coupled with that are a number of conspiracy theories that are gaining much popularity. One example is a video of Judy Micovits who went viral, claiming that the virus was released from a Chinese lab, and that most information published is just a big scam. Fact-checking revealed that her video was the bigger scam, and most of her statements were simply made up.((Fact-checking Judy Mikovits, the controversial virologist attacking Anthony Fauci in a viral conspiracy video. Science Magazine website, May 8, 2020))

Finding a scapegoat for the pandemic seems to be attractive for many, but it may be just a way of avoiding to take their own responsibility of needing to respond to the crisis. Some others have an urgent desire to find out the truth. Yes, it is very likely that China has underreported their COVID-19 death rates since they do not correlate to the Wuhan crematory activities.((Cremation numbers reveal possible suppression of true COVID-19 data in China. News Medical, June 8, 2020)) On the other hand in the western hemisphere the death rates are more likely to be a bit overreported since financial benefits are associated with the treatment of COVID-19 patients. But finding some proof that the virus was man-made in any way would be a pretty hard task, even in the hypothetical case that it would be the truth. And at the end of the day, what difference will it make for your life?

A much more tangible stressor is the economic impact that the pandemic is causing worldwide. With a large number of people losing their job, financial difficulties are a reality in many homes. There are plenty of families out there just struggling to put food on the table, and that can be stressful.

Health profesionals who are on the frontline of the battlefield are especially vulnerable of suffering from stress during the pandemic. Those who are exposed to patients dying around them every day can suffer from post-traumatic stress disorder.

How to Stay Sane During the Pandemic

Have a Plan

Being prepared can do a lot to minimize the stress you face during this crisis. Preparation will include provisions for maintaining your food supply (stocking some food, maybe considering an own garden to help out), implementing safety precautions, things to do during the pandemic, how to protect your financial interests and more.

Manage your finances

Control your finances and savings during a pandemic

Mishandling your finances is quite easy when you are dealing with economic turmoil all around us. Hence, you need to start managing your finances wisely to avoid having regrets when the problem has passed. When you are on a tight budget, you need to be doing proper financial planning, recording all the expenses and analyzing where you can save. Then you should avoid debt wherever you can. Buy things when you can afford them, paying the full price in cash. Any debt will add extra stress during uncertain times like we are passing now.

Filter Information

Avoid bad news whenever you can. Spending time reading alarming tales of the horrors of COVID-19 will probably increase anxiety, not reduce it. Do not focus on the kind of information that will not help rectify the situation. Pay attention to material that gives advice on how you can overcome or guard against being affected by the worsening of the pandemic. Filtering information can also mean changing the subject when bad news are brought up countless times.

Keep Exercising

As you know, exercising is a great way of staying positive, staying healthy, and improving your overall physical and mental well-being. You may be tempted to cancel your workout routine while the gym is closed or severely restricted. But you can do an exercise routine right at your home, or go out for a walk with all the needed safety precautions. Exercise does a lot to eliminate stress or anxiety from your mind, and keeps your thoughts clear and focused. Therefore, keep exercising and enjoy the process.

Stay Connected with People

Stay in touch with friends and family during a pandemic lockdown.

While you are not able to meet up with friends and family the way you would like, you need to make an effort to reach out to them. Schedule some regular time to check in with those you care about. It will do a lot to keep your mind sane in a time you are restricted in what you can do. Be especially mindful about the needs of your parents, grandparents or other elderly people around you.

Find some Meaningful Activities

We all have a need to belong and to have a purpose in our life. While you are at home, find some activities that can be meaningful to you and to others. Sometimes caring for someone else is all it takes to take off the focus from yourself and see the needs of somebody else. You may be doing some remote work, so even you are not going to the office you are keeping up with your regular activities. If your job does not allow for remote work, use your chance to educate yourself and be better prepared once the pandemic is over.

Dwell on the Positive

When things are falling apart all around us, it is easy to get caught in a worry round of fears and negative thinking. Are you afraid of getting infected? Remind yourself of all the protective measures you have implemented, and dwell on all the cases that recovered already. You are weary about the restrictions? Think about what you want to do when the lockdown is over. You are worried about the future? What does it help you to get all wrapped up with your worries?

Jesus expressed it right in the Sermon of the Mount: “Therefore I tell you, do not worry about your life, what you will eat or drink, or about your body, what you will wear. Isn’t there more to life than food and more to the body than clothing? Look at the birds in the sky: They do not sow, or reap, or gather into barns, yet your heavenly Father feeds them. Aren’t you more valuable than they are? And which of you by worrying can add even one hour to his life?… So then, do not worry about tomorrow, for tomorrow will worry about itself.” Matthew 6:25-34

It is correct to properly protect yourself. You should do the part that you are able to do. But after having done your part, what does it help you to keep worrying?

Find a Save Haven of Rest

When troubles abound all around you, there seems to be plenty of reason to get worried. But stress will take hold of you if you are feeling that there is a threat to your life that you are not able to control. What you need in this moment is a fortress for your mind to find safety.

A Christian will find this save haven in a meaningful relationship with his Creator. If God was creating you, is He not able to take care of your health? And if he feeds the birds in the sky, is he not going to take care of you? Knowing that we have a Heavenly Father that takes care of us, will provide a fortress to our mind that will resist any storm that may go on around us.

The Bible is giving us lots of examples how our Heavenly Father was taking care of His children in the past. But you need to rest assured that He will do the same thing in your life, if you commit yourself into His care. In order to have this assurance, you need to have a living relationship with Him. You need to take a step of faith and experience for yourself that you can trust your Heavenly Father to take care of you.

Would you like to have this experience? Would you like to discover the promises that your Heavenly Father has given you that He will take care of you? Do you want to discover the purpose that He has for your life? Do you want to know what more your Heavenly Father has prepared just for you? If that is your desire, you should take a guided study of the Bible to discover what your Heavenly Father has to tell you today. Use the chance and get your study guide for free.

I Want the Free Bible Study Guide

10 Tips for Aging Persons During the Pandemic

June 7, 2020 by Martin Neumann - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

The Elderly need our care at the pandemic

Most European countries are working already on easing their COVID-19 restrictions. All the US states are also gradually reopening, although with significant state by state differences. That does not mean there is no need for caution, especially for the elderly people. Once restrictions are lifted, new infections will be on the rise, and the elderly will be the first ones to suffer the consequences.

Older people face a higher risk of getting infected during a pandemic because they may have weaker immune systems, making them more susceptible to illnesses. Especially those who are suffering from a chronic disease like heart and lung diseases as well as diabetes, are more likely to suffer serious complications when conducting a COVID-19 infection.

When assessing your risk, you should consider also your overall health status. Are you consistently fatigued? Can you walk around the block? Can you climb up the stairs? When getting in this fragile zone, you should double up your caution for avoiding a coronavirus infection.

Here are other means of protecting you during a pandemic, if you or one of your loved ones form part of this more vulnerable group:

Continue taking vitamin supplements

You must continue to take vitamin supplements to support a healthy immune system. Hence, it is wise to keep up with your supplements to help your body fight infections more effectively. If you are not taking any supplements, you can get in touch with your health advisor to find out if you can start, especially if you have any chronic illnesses. Some of the supplements recommended are vitamin C and Zinc, but also consider Vitamin B12, calcium, and vitamin D. it is essential to bear in mind that not all supplements aid in supporting a healthy immune system.

Continue taking your medications

You must continue your medication while quarantined. In order to increase your protection, you need to make sure that your diabetes and blood pressure is under control. Therefore, make sure you have your regular medication readily available or well-stocked.

Thoroughly wash your hands

Washing your hands thoroughly or staying sanitized whenever you have been in contact with other people can never be overemphasized. Wash your hands thoroughly with soap and, ideally, warm water using the 20 seconds rule. Use antibacterial hand sanitizers and avoid touching your face, nose, and mouth. Keep your home and frequently touched surfaces disinfected.

Maintain a healthy diet

Being in isolation does not need to include cutting corners on your healthy diet. Making eating a healthy diet one of your priorities is advisable. Focus on foods that aid in boosting your immune system, like citrus fruits and bell peppers being high in vitamin C. Limit or avoid sugary foods, fatty foods, and alcohol. Focus on diets rich in fruits and vegetables as well as unrefined plant foods, and reduce your consumption of meat and other animal products. Increase your intake of food rich in antioxidants, which help protect your cells from damage.

Fruits are a good source of antioxidants

Avoid sharing personal items

Avoid sharing personal or hygiene items such as utensils, water bottles, food, and bathing soap with others. This small reflex can play a significant role in protecting you and your loved ones from getting infected or spreading the infection.

Get enough sleep

Getting plenty of rest is a compelling way of staying healthy and reducing your stress levels. Make sure you not only get enough sleep every night but that you get enough rest throughout the day. One of the significant reasons you may be more vulnerable to illnesses during a pandemic is due to too much stress and not getting enough rest. So make sure you reduce your stress levels by getting enough sleep, proper rest, and remaining active.

Remain active

Staying healthy and remaining active does not necessarily require you to go out, although you should go outside for a walk if you can. You can continue improving your health even if you have to stay at home by being active every day. Moving around and getting active plays a significant role in helping your body fight off infections and inflammation. You can stay active by doing non-strenuous exercises such as doing household chores. You should implement every day some stretching exercises, and complement it with cardiovascular exercise and strength exercise as far as you can. However, you should avoid any excesses to prevent fatigue.

Keep in touch with your caregiver

A lot of older people have caregivers, and some are caregivers. If you have a caregiver and he or she cannot afford to come over to your house, you can keep in touch via calls or messaging. Talk to your caregiver about who can provide you with care if he or she falls ill. If you are a caregiver, you need to make sure that you and the person you are caring for take the necessary precautions to avoid getting infected.

Stay at home

Understand that the advice to stay at home during a pandemic is good advice that is for your benefit. If you are not infected, avoid contact with strangers, as you are more vulnerable to getting infected. If you are concerned about groceries, you can do online shopping or ask a family member to do your groceries. Going outside for a walk while you take extra caution to remain distance from other people carries little risk to get infected, and can do a lot to strengthen the immune system and to lift up the mood. Some elderly people may though be saver to go out with a caregiver, so they do not forget to maintain the proper precautions.

Avoid large groups

If you are at a residential care home, make sure you avoid large groups. If you have a large family, make sure you keep a safe distance from others and avoid shaking hands or close physical contact. When receiving visitors, be sure to maintain a 6 foot or 2m distance.

Be sure though to stay in touch via regular video calls. Being connected helps a lot to ease the impacts of social distancing. We live in the technology era, which makes it possible to remain connected with people regardless of the distance. It is even possible to have group calls where the whole family can participate in different locations.

Adapting to the New Normal

Event with restrictions starting to be lifted, we still need to act with caution. The government was able to flatten the curve by implementing social distancing. These measures were effective to withhold the explosive growth of the pandemic, so that the health care system would not enter into collapse. Unfortunately, even with vigorous restrictions we are not able to completely eliminate the virus.

Once the restrictions are lifted, new surges of the pandemic will arise, which will cause additional risks for infections, and possibly the necessity for repeated lockdowns in the future. Elderly people should continue to act with some caution, even if restrictions around them get lifted. And in order to be save, it is more important than ever to work on strengthening the immune system. Implementing an immunity boosting lifestyle can go a long way to stay safe during the next few years we need to deal with the pandemic.

Coronavirus Immunity Challenge

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