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Vitamins

Vitamin A

Vitamin A can be obtained in two forms:

• preformed retinol (retinyl esters) found in animal derived foods
• carotenoids which are mainly plant derived (beta carotene being the most abundant carotenoid), some of which can be converted to retinol in the body; 6mg of beta carotene is equivalent to 1mg of retinol.

The total vitamin A content of the diet (from both animal and plant sources) is normally expressed as retinol equivalents (RE).

Vitamin A is essential to the normal structure and function of the skin and mucous membranes such as in the eyes, lungs and digestive system. Therefore, it is vital for vision, embryonic development, growth and cellular differentiation, and the immune system.

Deficiency

Vitamin A deficiency is a serious public health problem worldwide,. It can lead to night blindness (impaired adaptation to low-intensity light) and an eye condition called xerophthalmia (dryness of the conjunctiva and cornea) and eventually total blindness. Marginal deficiency contributes to childhood susceptibility to infection, and therefore morbidity and mortality, in both developing and developed countries. Vitamin A deficiency is common in many developing countries especially among young children.

In the UK, frank deficiency is rare but low intakes are relatively common. For example, depending on age and sex between 6% and 20% of children have intakes that are unlikely to be adequate (below the Lower Reference Nutrient intake, LRNI). In adults, intakes tend to be higher although 16% of men aged 19-24 have intakes below the LRNI. In the UK, supplements containing 233µg of vitamin A are recommended for infants and young children from age 1 to 5 years (from 6 months for infants that receive breast milk as their main drink).

Toxicity

Excess retinol during pregnancy can increase the risk of birth defects. As a precautionary measure, women who are pregnant, or who might become pregnant, are advised not to consume high dose vitamin A supplements (>2800-3300 μg/day). Liver and liver products may contain a large amount of vitamin A, so these should also be avoided in pregnancy.

Large amounts of retinol can also cause liver and bone damage. To prevent adverse effects on bones, intakes above 1500 µgrams of retinol equivalents from food or supplements should be avoided. The Food Standards Agency advises that, as a precaution, regular consumers of liver (once a week or more) should not increase their intake of liver or take supplements containing retinol (for example, cod liver oil).

Food sources

Liver, whole milk, cheese, butter, margarine and many reduced fat spreads are dietary sources of retinol. Carrots, dark green leafy vegetables and orange-coloured fruits, e.g. mangoes and apricots are dietary sources of carotenoids. In the UK, the law states that margarine must be fortified with vitamin A (and vitamin D). Vitamin A is also often voluntarily added to reduced fat spreads, as is vitamin D.

Vitamin D

Dietary vitamin D exists as either ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3). Ergocalciferol (D2) is derived from the UV irradiation of the plant sterol ergosterol, which is widely distributed in plants and fungi. (D3 ) is formed from the action of UV irradiation on 7-dehydrocholesterol in the skin of animals including humans.

Dietary sources are relatively insignificant, compared with the synthesis in the skin from exposure to sunlight or ultraviolet rays, because there are not many rich food sources of vitamin D.

Vitamin D is not classically a vitamin but a pro-hormone, acting as a precursor to one of the hormones involved in calcium homeostasis. Cholecalciferol is metabolised to the active steroid hormone 1,25-dihydroxyvitamin D3 in the liver and kidney. In this form it works as a hormone regulating the amount of calcium absorbed in the intestine. It is also essential for the absorption of phosphorus and for normal bone mineralisation. Vitamin D is also involved in the regulation of cell proliferation and differentiation. Vitamin D is also an activator of insulin-like growth factor (IGF-1) and, associated with this, poor vitamin D status is linked to sarcopenia (age related loss of skeletal muscle) which affects up to 25% of those over the age of 65 years and more than half of those over 85.

Deficiency

Deficiency of vitamin D results in poor calcification of the skeleton and hence skeletal deformity in children (rickets) and it leads to pain and bone fragility in adults (osteomalacia). Osteoporosis is not due to vitamin D deficiency but vitamin D may be beneficial in treatment. In the UK some groups of people such as Asian, black, older, institutionalised and housebound people and those who habitually cover the skin are vulnerable to vitamin D deficiency as a result of limited exposure to sunlight. Poor vitamin D status and rickets in children used to be commonplace in the UK but fortification and supplementation policies following the Second World War made rickets a thing of the past. However, in recent years, cases are again being reported, particularly in some ethnic minority groups from the Middle East and Indian subcontinent. Poor vitamin D status (a blood level of 25hydroxyitaminD below 25nmol/L – judged to be sufficient to prevent rickets) is also commonplace in the white population of the UK, emphasising the importance of balancing the need for sun exposure with the use of sun screen. For example, 36% of men and 38% of women aged 65-84 and living in institutions had low status in the NDNS for this age group. Amongst other age groups, the worst statistics were for young adults aged 19-24 years; 24% males and 28% of females. As sunlight is the major source, status tends to be lower in the winter/ spring than summer/autumn. Many young women enter pregnancy with poor stores of the vitamin.

It is recommended that pregnant and lactating women and people aged 65 years and over take vitamin D supplements (10µg per day). For other ‘at risk’ groups, for example ethnic groups that have limited sun exposure because of their style of dress, supplements may also be necessary. Infants are recommended to receive supplements containing 7.5µg of vitamin D; and these are available under the Healthy Start Scheme.

Toxicity

Excessive dietary vitamin D intake may lead to hypercalaemia (high calcium level in the blood), and some infants are especially sensitive to hypercalcaemia resulting from vitamin D toxicity. It is thought that skin synthesis is self-regulating.

Sources

Oily fish, eggs, fortified cereals and margarine are the main dietary sources of vitamin D. In the UK, the law states that margarine must be fortified with vitamin D (and vitamin A). Vitamin D is also often voluntarily added to reduced fat spreads, as is vitamin A. Human milk contains low levels of vitamin D, but infant formula is fortified with 0.001-0.0025 mg/100kcal.

Most vitamin D is obtained through the action of sunlight on our skin during the summer months. The latitude and strength of the sun in the UK means that the skin can only make vitamin D between 11am and 3pm, during the months of April to October.

Vitamin E

Vitamin E is a group of eight lipid-soluble compounds synthesised by plants, tocopherols and tocotrienols. Alpha-tocopherol accounts for 90% of the vitamin E in human tissues. Vitamin E acts as an antioxidant and is required to protect cells against oxidative damage from free radicals, for example oxidation of the lipids in cell membranes. Vitamin E content in food is expressed in terms of mg equivalents based on the biological activities of the tocopherols present.

Deficiency

Existence of dietary vitamin E deficiency is not considered to be a problem even in people consuming a relatively poor diet. Deficiency only occurs in people with severe fat malabsorption and rare genetic disorders.

Toxicity

Vitamin E has very low toxicity and humans appear to be able to tolerate high levels of the vitamin without untoward effects (e.g. between 540-970 mg/day). However, at very high doses vitamin E may have negative effects on other fat-soluble vitamins; it exacerbates the effects of vitamin K deficiency and interferes with the absorption of vitamin A.

Food sources

Foods containing large amount of polyunsaturated fatty acids will generally contain large amounts of vitamin E, therefore the richest sources of vitamin E are vegetable oils, nuts and seeds. Since vegetable oils are the richest source, deficiency is rare.

Vitamin K

Vitamin K is required for the synthesis of several of proteins required for normal blood clotting and bone structure. Vitamin K is synthesised by bacteria in the large bowel and is also present in both plant and animal foods.

Deficiency

Deficiency is rare as vitamin K is widely available from the diet and is also provided by gut bacteria. Thus, deficiency is generally secondary to conditions such as malabsorption or impaired gut synthesis. However, there is growing interest in the role of vitamin K in optimising bone health. Newborn babies up to six weeks old have low levels of vitamin K, which puts them at risk of potentially fatal ‘haemorrhage disease of the newborn’, and is known as vitamin K deficiency bleeding in infancy. Therefore, is it usual to give all newborn infants prophylactic vitamin K.

Toxicity

Few toxic reactions to Vitamin K have been identified.

Food sources

Dietary vitamin K is obtained from green leafy vegetables, dairy products and meat.

Water soluble vitamins

The B vitamins

Thiamin (vitamin B1)

Thiamin is a co-enzyme for several central energy-yielding metabolic pathways, and therefore is required to release energy from carbohydrate. As a result thiamin requirement is related to the amount of energy consumed. Thiamin is also involved in the normal function of the nervous system and other excitable tissues, such as skeletal muscles and the heart.

Deficiency

Deficiency of thiamin causes the peripheral nervous system disease beri-beri. This became a public health issue in the Far East in the nineteenth century with the introduction of highly milled (polished) rice. While beriberi is now rare, it remains a problem in some parts of the world where rice is the staple food. A different condition due to thiamin deficiency, affecting the central nervous system rather than the peripheral is sometimes seen in alcoholics and people with HIV, known as Wernicke-Korsakoff syndrome. This is caused by a combination of low intake and impairment of absorption and utilisation of the vitamin.

Toxicity

There is no evidence of any toxic effect of high doses of thiamin as the body excretes any excess.

Food sources

Whole grains, nuts, meat (especially pork), fruit and vegetables and fortified breakfast cereals are sources of thiamin in the diet. In the UK, white and brown bread flour are fortified with thiamin by law (and also with calcium, iron and niacin).

Riboflavin (vitamin B2)

Riboflavin functions as a coenzyme in a wide variety of reactions that take place in the body. Riboflavin is required to release energy from protein, carbohydrate and fat. It is also involved in the transport and metabolism of iron in the body and is needed for the normal structure and function of mucous membranes and the skin.

Deficiency

According to UK surveys, intakes of riboflavin are low in a number of population subgroups, in particular teenage girls (over 20% have intakes below the LRNI), young women (15% of 19-24 year olds below the LRNI) and women over 65 years living at home (10% of those 65-84, 15% of those over 85 years with intakes below the LRNI). A low status of riboflavin is also common but there is no clear deficiency disease because there is very efficient conservation and reutilisation of riboflavin in tissues; therefore deficiency is never fatal. Deficiency is characterised by dryness and cracking of the skin around the mouth and nose and a painful tongue that is red and dry (magenta tongue).

Toxicity

No toxic or adverse reactions to riboflavin in humans have been reported. The body excretes excess riboflavin in urine.

Food sources

Milk, eggs, fortified breakfast cereals, liver, legumes, mushrooms and green vegetables are all sources of riboflavin.

Niacin (nicotinic acid)

Niacin is required for the release of energy from food (it is the precursor to the coezymes NAD and NADP which are fundamental to key reactions in carbohydrate metabolism). As a result niacin requirement is related to the amount of energy consumed. Niacin is also required for the normal function of the skin and mucous membranes and for normal functioning of the nervous system.

Niacin can be synthesised from the essential amino acid tryptophan to meet daily requirements and dietary intake is only necessary when tryptophan metabolism is disturbed or intake of this amino acid is inadequate.

Deficiency

Deficiency of niacin results in the disease pellagra. It is characterized by sun-sensitive skin producing effects similar to severe sunburn. Advanced pellagra also results in dementia and if untreated is fatal. Pellagra is now rare but was a major public health problem in the early part of the last century up until the 1980s in some parts of the world. It was usually seen in communities where maize forms the staple diet as maize contains little tryptophan and the niacin that is present is in an unavailable form.

Toxicity

Reports of niacin/nicotinic acid toxicity in humans have been observed from its use as a treatment of hyperlipidaemia (high blood lipid levels). Adverse effects are dose related and generally subside with a reduction in dose or the cessation of treatment. Acute toxic symptoms include flushing, itching of the skin, nausea and gastrointestinal disturbances.

Food sources

Meat, wheat and maize flour, eggs, dairy products and yeast are all dietary sources of niacin.

Vitamin B(Pyridoxine)

Vitamin B6 comprises 3 forms (vitamers): pyridoxine, pyridoxal and pyridoxamine, and has a central role in the metabolism of amino acids. It is involved in breaking down glycogen and has a role in the modification of steroid hormone action. It is also essential for the formation of red blood cells and the metabolism and transport of iron. Together with folate and vitamin B12, vitamin B6 is required for maintenance of normal blood homocysteine levels. Raised homocysteine is a risk factor for cardiovascular disease.

Deficiency

Deficiency of vitamin B6 is rare because it is widely distributed in foods and is synthesised by the body’s gut flora. Deficiency may only occur as a complication of disease or prolonged administration of certain drugs.

Toxicity

Long-term intake of high dose vitamin B6 from supplements (typically >200mg/day) has been reported to result in sensory nerve damage.

Food sources

Poultry, white fish, milk, eggs, whole grains, soya beans, peanuts and some vegetables are sources of vitamin B6.

Vitamin B12 (Cyanocobalamin)

Vitamin B12 serves as a cofactor for enzymes involved in the normal function of the nervous system, the formation of red blood cells and for the metabolism of folate. It is also involved in energy production. Together with folate and vitamin B6, vitamin B12 is required for maintenance of normal blood homocysteine levels. Raised homocysteine is a risk factor for cardiovascular disease.

Deficiency

Dietary deficiency is rare in younger people and only occurs among strict vegans. It is more common in older people as a result of impaired absorption, usually due to chronic inflammation of the stomach lining (atrophic gastritis) or lack of intrinsic factor (the substance required for vitamin B12 absorption). Deficiency results in the development of pernicious anaemia, in which red blood cells are enlarged (megaloblastic), and peripheral neurological damage develops.

Toxicity

There are few reports of any adverse effects of high intakes of vitamin B12.

Food sources

Vitamin B12 is found in almost all foods of animal origin. Green plants provide none but it can be synthesized by some algae and bacteria, although the bioavailability of such forms has been disputed. Meat, fish, milk, cheese, eggs, yeast extract and fortified breakfast cereals are all dietary sources.

Folate/folic acid

The term folate describes a group of derivatives of pteryl glutamic acid. Folic acid is the synthetic form of folate. It is used in supplements and for food fortification.

Folate functions together with vitamin B12 to form healthy red blood cells. It is also required for normal cell division, the normal structure of the nervous system and specifically in the development of the neural tube (which develops into the spinal cord and skull) in the embryo.

There is conclusive evidence that supplements of 400μg/day of folic acid taken before conception and during the first 12 weeks of pregnancy prevent the majority of neural tube defects (e.g. spina bifida) in babies. It is recommended that all women of childbearing age who are planning a pregnancy take a daily supplement as it is difficult to achieve 400μg/day from diet alone.

Together with vitamins B6 and B12, folate is involved with the maintenance of normal blood homocysteine levels. The amino acid homocysteine is an intermediate in folate metabolism and evidence suggests that raised blood homocysteine (hyperhomocysteinemia) is an independent risk factor for cardiovascular disease. High intakes of folate have been found to lower the blood concentration of homocysteine in people genetically at risk of hyperhomocysteinemia and, as a result it has been proposed that folic acid supplementation might reduce the risk of cardiovascular disease. However, a recent meta-analysis of a number of large trials failed to demonstrate an effect of folic acid on either coronary heart disease or stroke risk.

Deficiency

Deficiency results in megaloblastic anaemia and may be due to poor diet or increased requirement, for example in pregnancy, from prolonged drug use or malabsorption. Megaloblastic anaemia is characterized by the release of immature red blood cell precursors into the circulation due to impairment of the normal process of maturation in the bone marrow. There may also be a low white cell and platelet count in the blood. Deficiency is often accompanied by insomnia, depression, forgetfulness and irritability.

Toxicity

Few adverse effects have been reported although high intakes may mask vitamin B12 deficiency and excessive intakes can cause complications if taken with certain drugs, for example anticonvulsants used in the treatment of epilepsy.

Food sources

Green leafy vegetables, brown rice, peas, oranges, bananas and fortified breakfast cereals are sources of folate.

In various parts of the world folic acid is added by law to flour and bread e.g. USA, Canada and Chile. The UK is yet to commit to this fortification, largely because of concerns that high intakes of folic acid mask vitamin B12 deficiency in older people who are particularly susceptible, and some concerns regarding the relationship between folic acid and cancer. In 2005 the Scientific Advisory Committee on Nutrition (SACN) reviewed the research to underpin potential folic acid fortification in the UK and recommended that ‘mandatory fortification’ with folic acid should be implemented. Their conclusions were considered by the Food Standards Agency’s Board and it was agreed by the Board that mandatory fortification should go ahead. But before the recommendations were finalized, it was agreed to wait for the findings of ongoing trials investigating the relationship between folic acid and cancer. These trials have now finished and have been considered by SACN: an outcome is awaited.

Vitamin C (ascorbic acid)

Vitamin C has antioxidant properties, potentially protecting cells from oxidative damage caused by free radicals. Vitamin C is also involved in the synthesis of collagen which is required for the normal structure and function of connective tissues such as skin, cartilage and bones. It is therefore an important nutrient for the healing process. It is also involved in the normal structure and function of blood vessels and neurological function. Vitamin C also increases the absorption of non-haem iron (iron from plant sources) in the gut.

Deficiency

Severe deficiency of vitamin C leads to scurvy. Signs of deficiency do not manifest until previously adequately nourished individuals have been deprived of vitamin C for 4-6 months. Deficiency is associated with fatigue, weakness, aching joints and muscles. Most of the other symptoms of scurvy are due to impaired collagen synthesis and are characterized by bleeding gums, poor wound healing and damage to bone and other tissues.

Toxicity

Acute high doses of vitamin C are occasionally associated with diarrhoea and intestinal discomfort. A significant number of people take high dose (1000mg) vitamin C supplements (the RNI for adults is 40mg/day); however there is no evidence that this either confers any benefit or presents negative health consequences.

Food sources

Fresh fruits especially citrus fruits and berries; green vegetables, peppers and tomatoes are all sources of vitamin C. It is also found in potatoes (especially new potatoes).

The bioavailability and absorption of vitamins

The bioavailability of a vitamin (i.e. how readily it can be absorbed and used by the body) may be influenced by a variety of factors. The proportion of a vitamin absorbed from the diet following consumption can vary, and will depend upon the individual person’s needs, their ability to absorb nutrients, the amount available to them and other components of the diet. For example, vitamin C can enhance the absorption of non-haem iron when foods or drink containing both vitamin C and non-haem iron are consumed in the same meal. Some vitamins, e.g. vitamin C and riboflavin, are labile and susceptible to damage by heat, light, oxygen, enzymes and minerals and these losses may occur during food processing, preparation and storage.

Vitamin supplements

Although most people are able to meet their requirements for vitamins by eating a varied diet, there are certain groups of the population who have higher than normal requirements for some nutrients, e.g. ill people, those taking certain drugs and pregnant women. Such people need to ensure they eat foods rich in particular vitamins and sometimes supplements are advised. Infants and young children are recommended to have supplements of vitamins A, C and D up to age 5 years. Vitamin D supplements are also recommended for older people and pregnant and lactating women. Some women may require additional iron if menstrual losses are high and folic acid is advised for women planning a pregnancy and for pregnant women in the first 12 weeks of pregnancy.

– See more at: https://web.archive.org/web/20160417013019/http://www.positivehomeopathy.com/vitamins/#sthash.FECXRvR0.dpuf

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Urinary tract infections in women

The urinary tract consists of various parts that produce,store and get rid of urine.It consists of two kidneys,ureters,bladder and urethra.when the blood reached to the kidneys ,it will filter the waste products,and urine passed through the ureter,bladder and into urethra.

The infection may occur in 2 ways.

  1. Either from kidneys to bladder through blood.
  2. Or from urethra to kidneys ie from downwards.

Risk factors

Female anatomy,sexual intercourse and family history.

The infections are more common in women than men as the urethra is shorter in females.

The infection in the lower urinary tract is called as cystitis.

The infection in the upper urinary tract is called as pyelonephritis.

Causes-

1.Mostly the infections are caused by bacteria like Escherichia coli,kleibsiella,proteus,pseudomonas,enterobacter.

2.spermicide use,independent of sexual frequency increase the risk of infection.

3.frequent participation in sexual intercourse.

4.infection is more common in the early marriage which is called as honeymoon cystitis.

5.use of urinary catheters.

6.hereditary.

7.constipation

8. spinal cord injury

9.anatomic,functional,metabolic abnormalities.

10.in menopause as the oestrogen levels are decreased and loss of protective vaginal flora increase the risk of infection.

Signs and symptoms-

–         Burning while passing urine

–         Frequent urination but quantity less.

–         Pain above the pubic bone

–         Lower back pain

–         Sometimes blood or pus may pass through the urine

–         In upper UTI , fever,flank pain ,nausea,vomiting.

–         In young children, fever is the common symptom and in  infants loss of appetite,vomiting,loss of sleep and often show the signs of jaundice.

–         In older children,urinary incontinence

Diagnosis-

–         Basing on the symptoms

–         Microscopic examination of urine

–         Urine culture

Differential diagnosis

–         Cervicitis

–         Vaginitis

–         Prostaitis

–         Haemorrhagic cystitis

–         Interstitial cystitis ,in which there is chronic pain in the bladder.

 

Homeopathic approach

Whatever the severity of the infection the medicines will show effect on the presenting complaints and after that the resistance power of the patient ie immune system power will increase through the medicines.by that further recurrence or the severity of infection will completely subside.

 

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thyroid treatment in homeopathy

Thyroid Problems

Thyroid gland is largest gland in endocrine system. Thyroid gland situated in neck. Main function of thyroid gland is producing hormones – T3[tri iodothyronin]  and T4[tetraiodothyronine] which controls body metabolism, thyroid gland also produce calcitonin which plays a role in calcium homeostasis. The hormonal output from thyroid is regulated by thyroid stimulating hormone [TSH ] produced by anterior pituitary, which itself regulated by thyrotropin releasing hormone [TRH] produced by hypothalamus.

The most common problems of thyroid gland consist of an overactive thyroid gland referred to as hyperthyroidism and underactive thyroid gland referred to as hypothyroidism. When there is fluctuation in thyroid hormones which causes thyroid problems. Normal range should be-

T3 – 80-230 ng/dl in adults

83-280 ng/dl in baby and old children

32-250 ng/dl in new born

T4 – 5-14 mg/dl in adult

5.6-16.6 mg/dl in babies and older children

9.8-22.6          mg/dl in new born

TSH – 0.4-6 mg/dl

When TSH is less than 0.4 mg/dl condition is called as hyperthyroidism .when TSH is more than 6 mg/dl condition is called as hypothyroidism.

CAUSES :

  • Iodine deficiency –now days this is rare cause for thyroid problem because salt contains iodine. Other than this vitamin deficiency, magnesium deficiency etc.
  • Mental stress.
  • Hereditary.
  • During pregnancy due to hormonal fluctuation. Iodine deficiency during pregnancy can cause maternal and fetal hypothyroidism [congenital hypothyroidism] and impair neurological development of fetus.

HYPOTHYROIDISM: Underactive thyroid gland

In this condition, TSH more than 6 mg/dl, T3 is normal and T4 is decreased or normal.

SYMPTOMS OF HYPOTHYROIDISM:

Initially it may be asymptomatic

  • Cold intolerance                                       Weight gain
  • Low heart rate > 60 bpm                         Weakness
  • Decreased sweating                                 Muscle cramps and joint pain
  • Dry itchy skin, puffy face                        Brittle and thin nails
  • Depression                                               Hypotension
  • Hair loss                                                   Anemia
  • Increased sleep                                         Irritability
  • Deafness                                                  Enlarged tongue
  • Constipation, indigestion
  • Gynaecomastia-breast development in men
  • Female infertility due to hormonal imbalance which is produced from ovaries .which causes irregular menses
  • Hyperprolactinamea – prolactin level increases in blood
  • Galactorrhea – is spontaneous flow of milk unassociated with child birth
  • Serum cholesterol level increases
  • Goiter- enlargement of thyroid gland
  • Slow speech, hoarseness of voice, breaking in voice, difficulty in swallowing, shortness of breath
  • Low basal body temperature
  • Decreased libido in men, decreased sperm count

HYPERTHYROIDISM: (Overactive thyroid gland)

In this condition, TSH will be less than 0.4mg/dl, T3 and T4 increased. Hyperthyroidism may cause thyrotoxicosis. some patient may develop thyrotoxicosis as a result of inflammation of thyroid gland[ thyroiditis]

SYMPTOMS OF HYPERTHYROIDISM:

  • Heat intolerance                          Nervousness
  • Irritability                                     Increased sweating
  • Increased heart rate                      Hand tremors
  • Anxiety                                        Decreased sleep
  • Thinning of skin                           Fine, brittle hair
  • Muscular weakness                      Weight loss even though appetite is good
  • Irregular menses                           Palpitation
  • Hair loss                                        Weakness
  • Hypoglycemia                              Polyuria
  • Polydipsia-increased thirst           Delirium
  • Confusion                                     Amenorrhea-absence of menstruation
  • Nausea and vomiting                    Diarrhea
  • Gynaecomastia-development of breast in men
  • Exophthalmos- bulging of eye anteriorly out of the orbit
  • Swelling in front of the neck from enlarged thyroid gland called goite

HASHIMOTO’S THYROIDITIS:

Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes.

SIGNS AND SYMPTOMS:

  •  Hashimoto’s thyroiditis very often results in hypothyroidism with bouts of hyperthyroidism.
  •  Symptoms of Hashimoto’s thyroiditis include myxedematous psychosis, weight gain, depression, mania, sensitivity to heat and cold, paresthesia , chronic fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia , constipation, migraines, muscle weakness, joint stiffness, menorrhagia, cramps, memory loss, vision problems, infertility and hair loss.
  •  The thyroid gland may become firm, large, and lobulated in Hashimoto’s thyroiditis, but changes in the thyroid can also be non-palpable.
  •   Enlargement of the thyroid is due to lymphocytic infiltration and fibrosis rather than tissue hypertrophy.
  •   Physiologically, antibodies against thyroid peroxidase (TPO) and/or thyroglobulin cause gradual destruction of  follicles in the thyroid gland
  •  Accordingly, the disease can be detected clinically by looking for these antibodies in the blood.

DIAGNOSING THYROID CONDITIONS:

Diagnosis of various thyroid disease and conditions involves clinical examination, blood tests, and in some cases, imaging tests and/or biopsy. There are different tests and procedures used to diagnose the following thyroid problems:

  • Hypothyroidism
  • Hashimoto’s Disease
  • Hyperthyroidism
  • Graves’ Disease
  • Goiter, Nodules
  • Thyroid Cancer

INVESTIGATIONS FOR THYROID PROBLEM:

THYROID BLOOD TESTS-The blood tests that may be done as part of a thyroid diagnosis include the following:

  • Thyroid Stimulating Hormone (TSH) Test
  • Total T4/ Total Thyroxine
  • Free T4 / Free Thyroxine
  • Total T3 / Total Triiodothyronine
  • Free T3 / Free Triiodothyronine
  • Thyroglobulin/Thyroid Binding Globulin/TBG
  • Thyroid Peroxidase Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies
  • Antithyroid Microsomal Antibodies / Antimicrosomal Antibodies
  • Thyroglobulin Antibodies / Antithyroglobulin Antibodies
  • Thyroid Receptor Antibodies (TRAb)
  • Thyroid-Stimulating Immunoglobulins (TSI)

 

Nuclear Scan / Radioactive Iodine Uptake (RAI-U) – which can tell whether a person has Graves’ disease, toxic multinodular  goiter, or thyroiditis.

CT scan – to help detect and diagnose a goiter, or larger thyroid nodules.

MRI / Magnetic Resonance Imaging – to evaluate the size and shape of the thyroid

Thyroid Ultrasound – to evaluate nodules, lumps and enlargement of your gland. Ultrasound can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue.

THYROID BIOPSY/ASPIRATION-A needle biopsy, also known as fine needle aspiration (FNA) is used to help evaluate lumps or cold nodules.

OTHER DIAGNOSTIC TESTS – Iodine Patch Tests, Saliva Testing, Urinary Testing, Basal Body Temperature Testing.

 

TREATMENT FOR THYROID PROBLEM IN POSITIVE  HOMEOPATHY:

Positive homeopathy treats Thyroid problem positively by giving constitution medicine. Homeopathic medicines make diseased man to normal state.

“Homeopathic sweet pills kills the ills”

It helps to increase immune system in body to fight against disease. Homeopathy medicine acts on hypothalamus and brings thyroid hormones to normal range.

 

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Sinusitis

A 24 years old female complains “my head feels heavy, can’t bend down, something tight feeling around the head, my nose is stuffed, and I cannot breath. I got very ill one winter, dizzy, fever, congestion, and ear infection, fatigue. My sinuses were constantly draining, green, thick mucus. Because I let it go so long thinking it was just a cold, it turned into Bronchitis and I was out of work for 2 weeks on a strong course of antibiotics.” this is what we hear most of them complaining. If we try to enquire about the past they give a history of recurrent cold or coryza. That is how a case of sinusitis presents.

So what is this sinusitis?

It’s nothing but the inflammation of the Paranasal sinuses.
What are these Paranasal sinuses then? These are the four paired structures surrounding the nasal cavities which make the skull bone feel light, provides insulation to the skull and provide Resonance for the voice.

Depending upon the location they are named as,

  • Frontal (forehead, eyebrows),
  • Maxillary (cheek bone),
  • Sphenoid (behind the eyes to vertex) and
  • Ethmoid (in between the eyes or root of nose).

Pathophysiology of Sinusitis:-

The paranasal sinuses are lined with mucus membrane that has ciliated epithelium which produces mucus. Normally, mucus does not accumulate in the sinuses, as it is cleared by the cilia. These discharges remain sterile despite their adjacency to the bacterium-filled nasal passages. But, when the sinus ostia are obstructed, however, or when ciliary clearance is impaired or absent, the secretions can be retained. This is when it can get infected with bacteria, virus or fungus producing the typical signs and symptoms of sinusitis.

Other causes are: Noninfectious causes include Allergic Rhinitis (mucosal oedema or polyp), Barotrauma (deep sea diving, air travel), chemical irritants, squamous cell carcinoma or deviated nasal septum.

These infectious agents or the irritants cause the mucus membrane to swell up and prevent draining of fluid from sinuses. Collected fluid dries up and becomes viscid and turns yellowish to green.

How does it presents?

Most of them present it after a viral infection or any upper respiratory tract infection.
Common presenting symptoms of sinusitis include,

  • Nasal drainage
  • Congestion
  • Facial pain or pressure
  • Headache

Start on one side and progress to both. Thick, purulent or discolored nasal discharge is often thought to indicate bacterial sinusitis, but it also occurs early in viral infections such as the common cold and is not specific to bacterial infection alone.

Other nonspecific symptoms include,

  • Cough,
  • Sneezing,
  • Fever.
  • Tooth pain, most often involving the upper molars, is associated with bacterial sinusitis,
  • Halitosis (offensive breath).

Headaches or heaviness of the head is localized to the involved sinus like frontal sinus, pain in the forehead, maxillary, pain in cheek bones etc. it can be worse when the person bends over or lying down. Sphenoid or Ethmoid sinus infection can present as severe frontal or retro-orbital pain radiating to the occiput. Presence of nasal discharge can differentiate it from toothache, tension headaches or migraine.

Complications

If these symptoms are not treated on time it will lead to chronic sinusitis. That is if it is persistent for more than 3 months or acute is recurring.
The symptoms are similar to acute but of longer duration and may lead to loss of sense of smell and taste. Due to the stuffed nose there may be difficulty in sleeping and tiredness.
Rarely may end up in severe complications like Lower Respiratory Tract infections (Bronchitis), swelling around the face, meningitis, cerebral abscess.

How will the physician diagnose??

A detailed case history can identify the cases. Depending on the symptoms or presentation it’s difficult to differentiate it as bacterial or viral.

Duration of the disease can be of help to differentiate it, less than 7 days for viral and more than 7 days for bacterial.

Tenderness: In acute cases no much investigations is required. The doctor may press on your face to check for any tender points to locate the infection. In chronic or seemingly complicated cases may require CT -Scan to be done.

A routine blood investigation will help to know the severity of infection. Few cases may require endoscopy or culture and sensitivity if the case is not clear.

Mode of Treatment

General management:

  • Quit smoking
  • Drinking plenty of fluids and getting lots of rest when needed is still the best bit of advice to ease the discomforts of the common cold. Water is the best fluid and helps lubricate the mucus membranes.
  • Ginger tea, fruit juice, and hot tea with honey and lemon may all be helpful.
  • Spicy foods that contain hot peppers or horseradish may help clear sinuses.
  • Inhaling steam 2 – 4 times a day is extremely helpful

What is the treatment available??

Most of the Sinusitis headaches are neglected in the beginning stage, that too when intensity of pain is less, even if taken care also, it will be in the form of following measures.

Antibiotics: – but it is not required in all cases. Only if the infection is serious it may be required. Taking more antibiotics may suppress the mucus discharge per nose and may lead to collection of more mucus in sinuses. Adaptation of Antibiotics may lead to higher/strong range of Antibiotics every time.
Nasal steroid spray (adverse reaction are seen), decongestant nasal drops, nasal irrigation or inhalation, steam inhalation – reduce the swelling of mucus membrane and can be soothing but later affects are worse than previous by reducing the sensitivity.

Other treatment includes
Surgery: – functional endoscopic sinus surgery (even after surgery you will need to use steroid nasal sprays, or other medication)
Balloon dilatation of the sinuses (not enough research is available)
Why Homoeopathy is safer…?
As I mentioned Common infections like common cold, repeated attack of Allergic Rhinitis are the main causes for the Sinusitis, which shows that the particular person’s immunity or body’s resistance power is poor and are much prone to diseases like this. Through Homeopathic medicines we can boost up the immunity and even it’ll reduce the recurrence (which is very common) with relief & without any side effect.
Why Positive homeopathy…?
“Homoeopathy is same but Homeopath’s approach differs”
Yes, we have very wonderful Homeopathic remedies (Like ,Allium Cepa,Hydrastis,Kali Bich ,Kali Iod, Lemna minor,Lyco, Pulsatilla, Sanguinaria, Sil, Spigelia, ,Sticta p ,Viola odarata, , etc etc.) that can open and hydrate sinuses may help in getting better in an acute conditions with severe headache.
But to get complete relief without recurrence one has to follow the Classical homeopathy which is found by our Master Samuel Hahnemann and taught by Dr.Prafull Vijaykar. Where through Theory of Suppression we can access the exact stage of disease and can decide the prognosis after giving a very well selected Constitutional remedy. By treating the root causes only one can make get rid of recurrence and from further complications.

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PSORIASIS

Introduction:

It is a greek language meaning “itching condition”(psora-itch, sis-action).

Definition:

Psoriasis is a chronic recurring skin disease characterized by red, flaky, crusty, patches of the skin covered with silvery scales.

It is an immune mediated diseases that affects the skin and it is not contagious disease.

Causes and triggering factors:

  1. Stress.
  2. Skin injury and infections (mostly streptococcal infection).
  3. Changes in season or climates.
  4. Certain medicine including lithium salt, beta blockers, antimalarial drugs.
  5. Excessive alcohol consumption.
  6. Smoking.
  7. Some hair spray, face creams, hand infections.
  8. Genetic cause- leucocyte antigen alleles.
  9. Idiopathic.

10. Advanced effects of human immune deficiency virus.

11. Family history of psoriasis.

Mechanism:

It has two hypothesis, they are as follows:

  • The first considers the psoriasis are primarily a disorder of excessive growth and reproduction of skin cells.
  • The problem is simply seen as a fault of the epidermis and its keratinocytes
  • The second hypothesis is sees the disease as being an immune mediated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system.
  • Tcells become active and migrate to the dermis and trigger the release of cytokines, which cause inflammation and rapid production of skin cells.

General symptoms and stages:

Psoriasis can appear anywhere on the skin but its favourite location are the knee, elbow bends, arms, legs, scalp, genetial areas, and nails.

It is often symmetrical lesions have similar shapes.

Plagues may be surrounded by a rim.

There are four stages are as follows:

  1. Early stage.
  2. Progressive stage.
  3. Stationary stage.
  4. Regressive stage.

Early stage:

It begins with small pink papules with are covered with fine white scales.these papules become plagues with itching.

Progressive stage:

Here the plaques grow in to larger ones and merge with one another with itching. many patients experience the koebner phenomena.

Stationary stage:

It begins few weeks after the progressive stage. The old lesions are covered with thick white scales, be new lesions do not appear.

Regressive stage:

The plaque stops growing they flatten and turn pale. When scaling decreases the lesions decrease in size and disappear leaving the discoloration on the skin.

Classification:

There are different varities of psoriasis:

  1. Psoriasis vulgaris.
  2. Psoriatic erythroderma.
  3. Pustular psoriasis.
  4. Guttate psoriasis.
  5. Nail psoriasis.
  6. Psoriatic arthritis.
  7. Inverse psoriasis.
  8. Drug induced psoriasis.

Psoriasis vulgaris:

It is the most common form of psoriasis. It affects 80-90% of the people with psoriasis.

Plague psoriasis is typically appears as raised areas of inflamed skin covered with silvery white scaly skin.

Psoriatic erythroderma:

It involves the widespread inflammation and exfoliation of skin over most of the body surface.

It accompanied by severe itching, swelling and pain.

It is often the result of an excaberation unstable plagues psoriasis, particularly following the abrupt withdrawl of systemic treatment.

Pustular psoriasis:

It appears as raised bumps that are filled with non infections pus(pustules). The skin under and surrounding the pustules is red and tender. Pustular psoriasis can be localized, commonly to the hands and feet (palmoplantar pustulosis), or generalized with widespread patches.

Guttate psoriasis:

It is characterized by numerous small, scaly, red, pink, tear drop-shaped lesions. These numerous spots of psoriasis appear over large areas of the body, primarily the trunk, but also the limbs and scalp.

Nail psoriasis:

It produces a variety of changes in the appearance of fingers and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail.

Psoriatic arthiritis:

It involves joint and connective tissues inflammation. Psoriatic arthritis can affect any joint, but is most common in the joints of the fingers and toes. This can result in a sauage-shaped swelling of the fingers and toes known as dacylitis.

Psoriatic arthritis can also affect the hips, knees and spine (spondylitis). Between 10-30% of people who have psoriasis also have psoriatic arthritis.

Drug induced psoriasis:

There are some drugs which can induce lithium salt, beta blockers, antimalarial drugs.

 Diagnosis:

  1. 1.    Auspitz’s sign:

On peeling of the lesions of the skin, it can produce the haemorrhagic spots.

  1. 2.    Koebner’s phenomena:

This type of phenomena is first discovered by heinrich koebner in 1872. The skin injury ( tattoo pricking, cuts etc)can causes new psoriatic lesions.

  1. PSAI:

Psoriasis area severity index(PSAI) is the most widely used measurement tool for psoriasis. PSAI combines the assessment of the severity of lesions and the area affected in to a single score in the range 0 (no disease) to range72 (maximal).

Homoeopathic treatment:

Arsenicum album:

Dry rough scaly eruption, itching, burning, swelling, papular eruptions. Malignant pustules, ulcers and offensive discharge.

cold, wet, scratching.

Warmth.

Kali arsenicum:

Patches on back, arms and spreading from elbows. Scaly itching. Scaling off leaves behind red skin.

Kali bromatum:

Syphilitic psoriasis, skin is cold, blue, spotted, corrugated, large indolent painful pustules.

Thyroidinum:

It is one of the best psoriatic remedy for the chilly and anameic subjects, dry impoverished skin, cold hands  and feet.

Radium bromide:

Psoriasis of penis, itching eruption on face oozing, patch erythema on forehead

Graphitis:

Rough hard persistent dryness of skin with eruption oozing out a sticky exudation occurs in bends of limbs, groins, neck, and behind ears.

Other remedies:

There are many other remedies which includes aur.met, psorinum, selenium, hydrocotyle, mezerium, petroleum, iodum, pulsatilla, sepia, silicea, rhustox, thuja, Tuberculinum, cal carb, lyopodium,merc sol.

Conclusion:

In positive homoeopathy we are following the method of homoeopathy by          Dr. Prafull G. vijayakar.

Homoeopathic medicines act best on the genetic background, that it acts on the seven layers from them ectoderm to inner organs.  so that psoriasis is ly eradicated by our positive homoeopathy.

 

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