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

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

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

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

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

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

References:

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

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

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

http://noarthritis.com/research.htm

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

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

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

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

3 Tips For When A Gluten Free Diet Does Not Work

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

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

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

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

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

References:

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

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

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

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

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

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

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

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

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

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

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

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

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

Read more at www.empowher.com

References:

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

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

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

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

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

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

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

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

Headaches: Migraines, Tension, or Sinus?

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

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

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

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

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

 

Read more at www.empowher.com

References:

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

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

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

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

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

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

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

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