Tired? Check your thyroid
Your Health
DR GITA MATHAI
Body temperature and weight, heart rate, skin texture, muscle and bone function, reproduction, bowel movements, sleep patterns and mental acuity are all controlled by a master computer in the brain — the pituitary gland, which sends its signals to a small gland in the neck called the thyroid. The 10-30gm gland cannot be felt by hand and its presence is unnoticed until it begins to malfunction.
One out of 4,000 children is born either without the thyroid or with one which functions sub optimally. Within a few months, parents notice that the child fails to grow as fast as his or her peers, does not feed satisfactorily, becomes constipated, has dry skin and a tongue that protrudes like that of a lizard. What is worse, mental development too is slower.
It is essential that the symptoms are recognised early on and a correct diagnosis reached because if such children do not get early and appropriate treatment they suffer physical and mental retardation.
In fact, thyroid problems can be diagnosed at birth by testing the cord blood TSH (thyroid stimulating hormone) level. This is routinely done in many hospitals. If the value is higher than normal (more than 20), the child is evaluated and treatment with thyroid hormones is started in time.
In adults, a thyroid that has been functioning normally can start malfunctioning (usually a drop in the production of thyroid hormones). This problem affects about 100 million Indians. The average age of such patients is 50 years, a majority of whom are women.
The initial symptoms are so vague that they are easy to miss — a tendency to put on weight, periods being heavier than normal, skin becoming dry, nails and hair brittle, constipation, muscle aches, lethargy and depression.
Such symptoms are often ignored and untreated. A feeling of “being tired all the time” is easy to dismiss. These symptoms can be mistaken for a normal part of perimenopause or depression or “the empty nest” syndrome. Patients may unsuccessfully try to counter the problems with nutritional supplements and multivitamin capsules. As the symptoms progress, the gland gets over-stimulated by the pituitary in an attempt to produce the required amount of hormone. It responds by increasing in size. A swelling called a goitre may then appear in the front of the neck.
At an advanced stage, the disease can be potentially fatal. As the symptoms progress, body temperature eventually drops, breathing decreases and depression and inactivity set in. The person may cease to respond, slip into a coma and die.
The body requires iodine to manufacture thyroid hormones. Adults require 150 micrograms of iodine a day. Pregnant and lactating women require 200 micrograms. Since the body cannot store iodine, it has to be taken every day. This iodine comes directly or indirectly from plants, fish and seaweed. Sea water does not contain sufficient iodine.
The amount of iodine obtained from the diet is insufficient in most cases. The government has asked salt manufacturers to fortify salt with iodine. Usually 30gm is added per kilo. Although the potency decreases with moisture, storage and cooking, usually 10-15gm of salt is consumed every day, and this provides most people with sufficient iodine.
Iodine deficiency is not the only cause of thyroid malfunction. The gland may be absent since birth, removed during surgery or destroyed by radiation. Some medications like lithium may interfere with hormone production. Stimulation of the gland may be insufficient because of pituitary disease.
The only way to treat thyroid hormone deficiency is through replacement therapy. The tablet has to be taken every day on an empty stomach first thing in the morning, otherwise it is not absorbed. The dosage has to be titrated for each patient as the response varies. Tablets should not be discontinued without a doctor’s advice. Usually, patients have to keep taking the pills all their life.
Thyroid hormones increase the BMR (basal metabolic rate). The heart rate increases, there is sweating, fine tremors and weight loss. Inappropriate administration can be dangerous. Many unscrupulous non ISI (Indian Standards Institute) pharmaceutical companies add iodine or thyroid hormone to their multimineral polyvitamin formulations. Sometimes they use thyroid gland extract from other animals as then the formulation can be labelled a “natural” product. Such supplements decrease fatigue and increase the appetite. Parents are happy as the child seems to eat more. Eventually, however side effects may appear. The natural function of the gland is suppressed. When the “tonic” is stopped, hypothyroidism sets in.
Remember:
Always use iodised salt
Read the fine print on any nutritional supplement, health drink or tonic that you and your family may have be taking
Do thyroid function tests as part of your master health check up
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Friday, December 9, 2011
Thursday, December 1, 2011
first aid
ox of help
YOUR HEALTH
DR GITA MATHAI
Cuts, bruises, electrical shocks, insect bites, earache — everyone has faced an acute medical emergency at some time in their life, often at night when neither helpful neighbours nor transportation is easily available. Emergencies seem to have a knack of occurring only at night or during a bandh when professional help is just not available.
The first step to tackling emergencies successfully is to fabricate a first aid box and keep it in an easy-to-find place, which incidentally, should be out of the reach of children.
The box should contain:
• a pair of scissors,
• a writing pad and pen,
• a torch (that works),
• copies of medical insurance papers or cash less cards,
• contact address and phone number of hospitals where such treatment is available,
• a roll of gauze bandage,
• a roll of cotton,
• some band aid strips,
• a tube of pain relieving ointment,
• an antiseptic ointment like povidone-iodine,
• an antibiotic ointment (bacitracin, polymixcin),
• eye drops, nose drops and analgesic ear drops
• Medications such as tablets of aspirin, paracetemol (for adults and children), an antispasmodic, and anti histamines like chlorpheniramine maleate (Avil) or diphendydramine (Benedryl), and an antacid liquid.
Chest pain always causes panic — in the sufferer and in family members — with visions of sudden death. Remember, in a heart attack the pain is present for 15 minutes or longer. It radiates up the neck, down the arm, moves to the back and is associated with sweating, fainting and pallor. There is no localised area of tenderness. If your pain ticks all these boxes, get medical help urgently. Before heading to the hospital, however, taking a tablet of aspirin (325mg) may save your life like it has saved that of innumerable others.
A toothache can often start in the middle of the night. Sucking on an ice cube may help. Also, take a painkiller like aspirin or paracetamol and contact a dentist as soon as possible.
Electrical short circuits, fires and shocks are other common emergencies. Always switch off the electricity mains first. Use a non-conducting material such as a wooden spoon or plastic stick to separate the person from the live wire. Do not touch the person with your bare hands. Although the actual burn caused by an electric shock appears small, the damage can extend deep into the body. It can cause the heart to stop beating. Violent jerking can cause dislocations and fractures.
Burns and scalds are very common. If a person is on fire, roll them on the ground or wrap them in a heavy sheet to smother the fire. Hold the affected area under cold water or apply a cold compress. Placing ice directly on the burnt area is not advisable as can cause frostbite. If there is a blister, wipe it and the area around it with a solution of povidone iodine to sterilise it. Then poke it in three areas, taking care to keep the overlying skin intact. This makes the skin collapse on the blister and the area is no longer raw. Apply an antibiotic ointment and cover it with a gauze bandage.
Fainting is usually harmless. First, position the person on their back. Elevate the legs above the head with cushions or anything else available. If the person is in the sitting position, place the head between the knees. People faint because of a sudden decrease in blood flowing to the brain. By elevating the legs above the head, the venous return is increased, rectifying this problem.
Anything can precipitate an allergic reaction, pollen, chemicals in the air, dust, latex from gloves or shoes, or additives and colouring agents in food. There may be itching, the throat may swell, lips may become red and swollen and there may be difficulty in breathing. Mild reactions can be treated with oral tablets of an antihistamine such as chlorpheniramine (Avil) or diphenhydramine (Bendryl). Difficulty in breathing or swelling of the throat is an emergency and the person should be rushed to hospital.
If an insect has entered the ear, place the ear against a bright light. The insect may fly out. Otherwise, pour a little paraffin oil or baby oil into the ear. The insect will float up. Do not attempt to pry the insect loose with an ear bud as you may damage the ear.
A blocked nose may not be an emergency but it is very uncomfortable. Tilt the head back, put a couple of drops of a nasal drop into each nostril and then take a steam inhalation. This will clear up both an allergic block or one due to a cold. If there is a foreign body in the nose, try to blow it out gently while closing the opposite nostril. Do not suck in air as it will move the object upwards.
You can usually stop a nose bleed by using decongestant nose drops and then pinching the nostrils together. Frequent nosebleeds require evaluation.
Injury around the eye causes discolouration — a “black eye”. This is usually not serious. It will subside spontaneously with a cold compress. Bilateral black eyes may be due to head injury and is a dangerous sign. A foreign body in the eye can cause damage to the cornea. Immediately wash the eye with running water and apply antibiotic eye drops.
Learning basic first aid will bring peace of mind and, maybe, even help you save a life.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
Cuts, bruises, electrical shocks, insect bites, earache — everyone has faced an acute medical emergency at some time in their life, often at night when neither helpful neighbours nor transportation is easily available. Emergencies seem to have a knack of occurring only at night or during a bandh when professional help is just not available.
The first step to tackling emergencies successfully is to fabricate a first aid box and keep it in an easy-to-find place, which incidentally, should be out of the reach of children.
The box should contain:
• a pair of scissors,
• a writing pad and pen,
• a torch (that works),
• copies of medical insurance papers or cash less cards,
• contact address and phone number of hospitals where such treatment is available,
• a roll of gauze bandage,
• a roll of cotton,
• some band aid strips,
• a tube of pain relieving ointment,
• an antiseptic ointment like povidone-iodine,
• an antibiotic ointment (bacitracin, polymixcin),
• eye drops, nose drops and analgesic ear drops
• Medications such as tablets of aspirin, paracetemol (for adults and children), an antispasmodic, and anti histamines like chlorpheniramine maleate (Avil) or diphendydramine (Benedryl), and an antacid liquid.
Chest pain always causes panic — in the sufferer and in family members — with visions of sudden death. Remember, in a heart attack the pain is present for 15 minutes or longer. It radiates up the neck, down the arm, moves to the back and is associated with sweating, fainting and pallor. There is no localised area of tenderness. If your pain ticks all these boxes, get medical help urgently. Before heading to the hospital, however, taking a tablet of aspirin (325mg) may save your life like it has saved that of innumerable others.
A toothache can often start in the middle of the night. Sucking on an ice cube may help. Also, take a painkiller like aspirin or paracetamol and contact a dentist as soon as possible.
Electrical short circuits, fires and shocks are other common emergencies. Always switch off the electricity mains first. Use a non-conducting material such as a wooden spoon or plastic stick to separate the person from the live wire. Do not touch the person with your bare hands. Although the actual burn caused by an electric shock appears small, the damage can extend deep into the body. It can cause the heart to stop beating. Violent jerking can cause dislocations and fractures.
Burns and scalds are very common. If a person is on fire, roll them on the ground or wrap them in a heavy sheet to smother the fire. Hold the affected area under cold water or apply a cold compress. Placing ice directly on the burnt area is not advisable as can cause frostbite. If there is a blister, wipe it and the area around it with a solution of povidone iodine to sterilise it. Then poke it in three areas, taking care to keep the overlying skin intact. This makes the skin collapse on the blister and the area is no longer raw. Apply an antibiotic ointment and cover it with a gauze bandage.
Fainting is usually harmless. First, position the person on their back. Elevate the legs above the head with cushions or anything else available. If the person is in the sitting position, place the head between the knees. People faint because of a sudden decrease in blood flowing to the brain. By elevating the legs above the head, the venous return is increased, rectifying this problem.
Anything can precipitate an allergic reaction, pollen, chemicals in the air, dust, latex from gloves or shoes, or additives and colouring agents in food. There may be itching, the throat may swell, lips may become red and swollen and there may be difficulty in breathing. Mild reactions can be treated with oral tablets of an antihistamine such as chlorpheniramine (Avil) or diphenhydramine (Bendryl). Difficulty in breathing or swelling of the throat is an emergency and the person should be rushed to hospital.
If an insect has entered the ear, place the ear against a bright light. The insect may fly out. Otherwise, pour a little paraffin oil or baby oil into the ear. The insect will float up. Do not attempt to pry the insect loose with an ear bud as you may damage the ear.
A blocked nose may not be an emergency but it is very uncomfortable. Tilt the head back, put a couple of drops of a nasal drop into each nostril and then take a steam inhalation. This will clear up both an allergic block or one due to a cold. If there is a foreign body in the nose, try to blow it out gently while closing the opposite nostril. Do not suck in air as it will move the object upwards.
You can usually stop a nose bleed by using decongestant nose drops and then pinching the nostrils together. Frequent nosebleeds require evaluation.
Injury around the eye causes discolouration — a “black eye”. This is usually not serious. It will subside spontaneously with a cold compress. Bilateral black eyes may be due to head injury and is a dangerous sign. A foreign body in the eye can cause damage to the cornea. Immediately wash the eye with running water and apply antibiotic eye drops.
Learning basic first aid will bring peace of mind and, maybe, even help you save a life.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Tuesday, November 15, 2011
bony spurs
Feel it in your bones
Your Health
DR GITA MATHAI
When babies are born, they have about 350 bones. Many of these eventually fuse and adults are left with 208 bones. Locomotion and movement are possible because the bones form joints, which “articulate” with each other. Carpenters have taken a leaf out of God’s book and based the joints in their trade on this. Like us, they too have metal and plastic sliding, hinged and ball and socket joints. Just like in mechanical joints, in human joints too mechanical failure, slipping and degeneration can occur with age, overuse, lack of proper lubrication and misalignment.
Unlike carpentry joints, human joints are protected from injury by muscles and tendons. Wear and tear and overuse can cause microscopic tears in these. Calcium gets deposited in the tears, forming bony projections called spurs, which are meant to actually protect the joint.
The symptoms caused by spurs depend on their location. Spurs are usually too deep to be felt. They can be asymptomatic and be discovered accidently in an X-ray taken for some other reason. But they can cause discomfort if they press on nerves.
One of the commonest locations for spurs is the heel. If you feel a severe shooting pain, especially while placing the foot on the ground first thing in the morning, be sure it is a spur. It affects 10 per cent of the population at some point in their life.
Spurs are common in women, especially if you have gained weight. It is yet another symptom brought on by the “middle aged spread”. Feet have to bear the weight of the entire body, and an increase in weight tends to increase the pressure on the heels. Other factors that can bring on a spur are a faulty gait with the foot turned too far inwards or prolonged use of footwear with hard unyielding soles.
Heel pain and spurs can also occur if the calf muscle becomes tight and contracted. These muscles are attached to the heel. If they are not adequately stretched before and after exercise, they can pull on the heel, causing pain.
The heel is attached to the front of the foot by thick tissue called plantar fascia. Shortening or injury of this fascia can also cause strain on the back of the heel and result in spurs.
In the neck vertebrae, spur formation can press on nerves, leading to dizziness and giddiness, especially with a change in posture. It can press on the oesophagus, causing difficulty in swallowing.
Further down in the lumbar vertebra, osteophytes can press on the nerves going to the leg. They can cause pain, weakness in the legs, loss of sensation and difficulty in sitting and squatting.
Osteoarthritic changes in the fingers cause spurs to develop. The fingers appear disfigured and knotted. The range of movement is restricted. Sudden incapacitating shooting pains can also develop.
The shoulder needs to move in a full circle. Spurs restrict this so that the hand can be lifted only to 90 degrees. Combing hair and dressing become difficult.
Spur formation and degenerative changes are not a disease of old people alone. They can form in athletes and people who exercise. It tends to occur when proper stretching techniques before and after exercise are not followed.
Sometimes the extra bone formed breaks off and enters the joint space. It can suddenly make the joint painfully stuck and “locked” in an awkward position.
Symptomatic spurs require treatment. In 95 per cent of cases, simple remedial measures are sufficient and the pain disappears in six months. Ice packs alternating with hot compresses relieve pain rapidly. This may need to be combined with physiotherapy. Active and passive exercises to improve the range of motion and strengthen the muscles around the joint are essential for quick improvement. Shock wave therapy using ultrasound is also very effective.
A short course of NSAIDs (non steroidal anti inflammatory agents) will help to relieve pain in the acute phase. They should not be taken for longer than two weeks continuously as they have side effects.
Corticosteroid can be injected into the joints. The relief is significant and may last four to six months. But it can cause further degeneration of the joint if given too frequently.
Loose bodies that get stuck have to be surgically removed. Endoscopic minimally invasive surgery means hospital stay is minimal. Surgery is also indicated if there is compression on a nerve, resulting in wasting and weakness in addition to pain.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Gita Mathai
Your Health
DR GITA MATHAI
When babies are born, they have about 350 bones. Many of these eventually fuse and adults are left with 208 bones. Locomotion and movement are possible because the bones form joints, which “articulate” with each other. Carpenters have taken a leaf out of God’s book and based the joints in their trade on this. Like us, they too have metal and plastic sliding, hinged and ball and socket joints. Just like in mechanical joints, in human joints too mechanical failure, slipping and degeneration can occur with age, overuse, lack of proper lubrication and misalignment.
Unlike carpentry joints, human joints are protected from injury by muscles and tendons. Wear and tear and overuse can cause microscopic tears in these. Calcium gets deposited in the tears, forming bony projections called spurs, which are meant to actually protect the joint.
The symptoms caused by spurs depend on their location. Spurs are usually too deep to be felt. They can be asymptomatic and be discovered accidently in an X-ray taken for some other reason. But they can cause discomfort if they press on nerves.
One of the commonest locations for spurs is the heel. If you feel a severe shooting pain, especially while placing the foot on the ground first thing in the morning, be sure it is a spur. It affects 10 per cent of the population at some point in their life.
Spurs are common in women, especially if you have gained weight. It is yet another symptom brought on by the “middle aged spread”. Feet have to bear the weight of the entire body, and an increase in weight tends to increase the pressure on the heels. Other factors that can bring on a spur are a faulty gait with the foot turned too far inwards or prolonged use of footwear with hard unyielding soles.
Heel pain and spurs can also occur if the calf muscle becomes tight and contracted. These muscles are attached to the heel. If they are not adequately stretched before and after exercise, they can pull on the heel, causing pain.
The heel is attached to the front of the foot by thick tissue called plantar fascia. Shortening or injury of this fascia can also cause strain on the back of the heel and result in spurs.
In the neck vertebrae, spur formation can press on nerves, leading to dizziness and giddiness, especially with a change in posture. It can press on the oesophagus, causing difficulty in swallowing.
Further down in the lumbar vertebra, osteophytes can press on the nerves going to the leg. They can cause pain, weakness in the legs, loss of sensation and difficulty in sitting and squatting.
Osteoarthritic changes in the fingers cause spurs to develop. The fingers appear disfigured and knotted. The range of movement is restricted. Sudden incapacitating shooting pains can also develop.
The shoulder needs to move in a full circle. Spurs restrict this so that the hand can be lifted only to 90 degrees. Combing hair and dressing become difficult.
Spur formation and degenerative changes are not a disease of old people alone. They can form in athletes and people who exercise. It tends to occur when proper stretching techniques before and after exercise are not followed.
Sometimes the extra bone formed breaks off and enters the joint space. It can suddenly make the joint painfully stuck and “locked” in an awkward position.
Symptomatic spurs require treatment. In 95 per cent of cases, simple remedial measures are sufficient and the pain disappears in six months. Ice packs alternating with hot compresses relieve pain rapidly. This may need to be combined with physiotherapy. Active and passive exercises to improve the range of motion and strengthen the muscles around the joint are essential for quick improvement. Shock wave therapy using ultrasound is also very effective.
A short course of NSAIDs (non steroidal anti inflammatory agents) will help to relieve pain in the acute phase. They should not be taken for longer than two weeks continuously as they have side effects.
Corticosteroid can be injected into the joints. The relief is significant and may last four to six months. But it can cause further degeneration of the joint if given too frequently.
Loose bodies that get stuck have to be surgically removed. Endoscopic minimally invasive surgery means hospital stay is minimal. Surgery is also indicated if there is compression on a nerve, resulting in wasting and weakness in addition to pain.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Gita Mathai
Friday, November 4, 2011
memories
Why you forget
Why you forget
Your Health
DR GITA MATHAI
No matter which stage of life you are in, memory lapses will be a cause of consternation; for the young it will affect their marks, for professionals it will mean missed appointments and for the elderly the fear that it may signal Alzheimer’s or dementia. A rule of thumb is that if you are more concerned about it than the people around you, it probably isn’t serious.
Memory starts in the brain with the encoding of data. The brain scans inputs much like a computer and files it away for retrieval at a later date. This process requires chemical reactions in the brain with enzymes, vitamins and essential minerals.
Schools in India emphasise rote learning so our brains become efficient at retention and immediate recall. But often parents complain that whatever is learnt the previous day is forgotten the next morning.
These children have to be tested for anaemia, lead poisoning, thyroid functions and learning disabilities. Their eyesight and hearing need to be checked. If all is normal, the social environment should be investigated. Most often the problem is in the parenting.
Part of the problem may be that children’s lives are very full. The competitive environment makes parents enrol them in tutorial schools. At home television viewing (especially while eating) may further cut into their time. Even if they do not watch TV and only the adults do, the set is often left on permanently, creating a “white noise”. The rapidly flashing images and noise depletes chemicals in the brain. The same thing happens with electronic games on phones, computers or hand-held devices. Much of the information gathered in school and in the tutorials is not encoded properly and is lost for later recall. The areas of the brain responsible for original thought are not stimulated and do not develop to their potential.
Children need adequate sleep to function at their peak scholastically. This is because chemicals in the brain regenerate during “rest time”. Although the number of hours that a child sleeps is very individual, preteen children need around 10 hours and teenagers about eight. While sleep deprived adults become grouchy and bad tempered, children may become hyperactive and unreasonable, with delayed response time. Attentiveness, particularly in school and to homework, may be unsatisfactory. Short-term memory may decrease. Memory improves with physical exercise — an hour of activity replenishes brain chemicals.
Instead of correcting these factors, parents purchase expensive herbal products and health supplements to improve performance. But unless the home environment is corrected, there will be no improvement.
In adults, some memory loss as you age is inevitable. People are afraid they have Alzheimer’s or dementia when they forget things like names or where they left their keys. In these serious disorders you are more likely to forget how to use the key rather than where you left it.
Normal forgetfulness is aggravated by anxiety, stress and depression. Addiction to alcohol, tobacco products or recreational drugs also produces detrimental changes in brain function. Memory becomes poor if there is uncontrolled diabetes, lung, kidney or liver diseases, vitamin B12 or thiamine deficiency. It, therefore, becomes important to maintain your health and prevent and control diseases, as you grow older.
People who eat too much are at risk of lifestyle diseases, which increases their risk for strokes. These destroy small areas in the brain, causing brain ageing and memory loss. Small changes in lifestyle can slow down brain ageing — enough mental activity, physical fitness, stress reduction and a healthy diet. Also, many people miss out on the necessary amount of antioxidants as they do not eat the required 4-6 helpings a day of fruits and vegetables.
Children and adults need a healthy diet, regular and adequate exercise, social interaction and intellectual stimulation to develop a good memory and maintain it. If all else fails, you can always make notes and lists to remind yourself.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Why you forget
Your Health
DR GITA MATHAI
No matter which stage of life you are in, memory lapses will be a cause of consternation; for the young it will affect their marks, for professionals it will mean missed appointments and for the elderly the fear that it may signal Alzheimer’s or dementia. A rule of thumb is that if you are more concerned about it than the people around you, it probably isn’t serious.
Memory starts in the brain with the encoding of data. The brain scans inputs much like a computer and files it away for retrieval at a later date. This process requires chemical reactions in the brain with enzymes, vitamins and essential minerals.
Schools in India emphasise rote learning so our brains become efficient at retention and immediate recall. But often parents complain that whatever is learnt the previous day is forgotten the next morning.
These children have to be tested for anaemia, lead poisoning, thyroid functions and learning disabilities. Their eyesight and hearing need to be checked. If all is normal, the social environment should be investigated. Most often the problem is in the parenting.
Part of the problem may be that children’s lives are very full. The competitive environment makes parents enrol them in tutorial schools. At home television viewing (especially while eating) may further cut into their time. Even if they do not watch TV and only the adults do, the set is often left on permanently, creating a “white noise”. The rapidly flashing images and noise depletes chemicals in the brain. The same thing happens with electronic games on phones, computers or hand-held devices. Much of the information gathered in school and in the tutorials is not encoded properly and is lost for later recall. The areas of the brain responsible for original thought are not stimulated and do not develop to their potential.
Children need adequate sleep to function at their peak scholastically. This is because chemicals in the brain regenerate during “rest time”. Although the number of hours that a child sleeps is very individual, preteen children need around 10 hours and teenagers about eight. While sleep deprived adults become grouchy and bad tempered, children may become hyperactive and unreasonable, with delayed response time. Attentiveness, particularly in school and to homework, may be unsatisfactory. Short-term memory may decrease. Memory improves with physical exercise — an hour of activity replenishes brain chemicals.
Instead of correcting these factors, parents purchase expensive herbal products and health supplements to improve performance. But unless the home environment is corrected, there will be no improvement.
In adults, some memory loss as you age is inevitable. People are afraid they have Alzheimer’s or dementia when they forget things like names or where they left their keys. In these serious disorders you are more likely to forget how to use the key rather than where you left it.
Normal forgetfulness is aggravated by anxiety, stress and depression. Addiction to alcohol, tobacco products or recreational drugs also produces detrimental changes in brain function. Memory becomes poor if there is uncontrolled diabetes, lung, kidney or liver diseases, vitamin B12 or thiamine deficiency. It, therefore, becomes important to maintain your health and prevent and control diseases, as you grow older.
People who eat too much are at risk of lifestyle diseases, which increases their risk for strokes. These destroy small areas in the brain, causing brain ageing and memory loss. Small changes in lifestyle can slow down brain ageing — enough mental activity, physical fitness, stress reduction and a healthy diet. Also, many people miss out on the necessary amount of antioxidants as they do not eat the required 4-6 helpings a day of fruits and vegetables.
Children and adults need a healthy diet, regular and adequate exercise, social interaction and intellectual stimulation to develop a good memory and maintain it. If all else fails, you can always make notes and lists to remind yourself.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Tuesday, October 25, 2011
panacea for all illnesses
An aspirin a day keeps the doc away
Your Health
DR GITA MATHAI
No one likes to be ill, and once the inevitable occurs, one does not want to swallow a large number of multicoloured tablets of all shapes and sizes.
Can you not reduce the number of tablets? I am sure if I take all these I will suffer side effects! Can I not alter the disease process with diet alone? Can I switch to a different system of medicine?
Common queries that busy physicians seldom address patiently.
Anyone who does not wish to have a chronic disease (and swallow tablets for the rest of his or her life) has to take care of his or her health from an early age.
Today, lifestyle diseases such as obesity, diabetes, hypertension and heart disease are rampant. Unfortunately, these diseases usually occur in combination. One of the diseases, say hypertension or diabetes, may start alone as a result of obesity and abnormal lipid profiles, which are often due to inactivity and an improper diet. Then there is a cascading effect — obesity leads to an abnormal lipid profile to diabetes or hypertension to heart disease.
So a person ends up taking tablets several times a day to keep the sugar under control, the blood pressure within limits and the lipids in check. Add a B complex and calcium supplement and you are looking at around 5-6 tablets a day.
The pharmaceutical industry has been working overtime to make life easier for such patients. They have come up with fixed drug combinations so that patients can take one tablet instead of two or three. The idea is good but combination medicines often fail to live up to their potential. This is because the dosage ratios are fixed; so too much or too little of one or more of the medications may be taken. Drugs that need to be taken before and after food may also be inappropriately administered. Sometimes combinations are irrational, with two antagonistic drugs being combined. Occasionally, both medications compete for the same site in the intestine for absorption so that eventually neither works! In fact, if you are prescribed combination tablets, ask your doctor if it is possible to take the tablets individually.
The combination tablets are a response to people’s demand for a “magic bullet”, a single medication that at a low dose, with a wide margin of safety, and few or no side effects, will cure all their ailments. Actually centuries ago, ancient cultures like that of the Indians, the American Indians, the Chinese, the Egyptians and the Greeks did have something like a magic bullet. Medicine men or healers brewed infusions or teas with the petals of a flowering plant — the Spiraea ulmaria — which relieved pain caused by injury, toothache, headache, and arthritis. Hippocrates even successfully administered it to ease the pain of childbirth. Eventually, about a hundred years ago, Felix Hoffmann, a chemist working for Bayer, synthesised the active ingredient in Spiraea ulmaria — salicylic acid. And that has evolved into the aspirin we use today.
Aspirin reduces pain, fever and headaches. It can be used to prevent clotting of blood, which helps prevent strokes, heart attacks and miscarriage. Aspirin also retards the onset and progress of Alzheimer’s and dementia. And it has been shown to reduce the incidence of many types of adenocarcinomas, especially that of the colon. That does make it magic but aspirin can’t cure a lifestyle disease. An aspirin a day, however, can keep lifestyle diseases away.
The other thing that can prevent them is maintaining ideal body weight, which is calculated by measuring the body mass index or BMI (weight in kilograms divided by height in meter squared). Values up to 24 are normal, 25-29 is defined as overweight, 30-34 obese and anything above that as extremely obese.
A person’s weight starts the upward climb because of an imbalance between food intake and physical activity. Environmental factors are important as both these factors are strongly influenced by habits learnt in childhood. Families that enjoy excessive amounts of calorie-dense food with refined sugars and oil and inadequate amounts (less than the recommended 400mg) of pulses, vegetables and fruits tend to have overweight children who grow up to be obese. To avoid addiction to high-calorie foods, stock fruits and vegetables as snacks. Have plain water instead of carbonated drinks and pack home-cooked food for school lunches instead of the packaged variety.
In addition, exercise is essential. It conditions the body, improves immunity, and delays, and sometimes prevents, the onset of lifestyle diseases and some cancers. Adults require an hour of aerobic activity (walking, jogging, running or swimming) followed by 20 minutes of flexion, core strengthening or yoga a day.
In short, a balanced diet, exercise and 75mg of aspirin a day should keep you healthy!
Before popping an aspirin, however, remember that it is contraindicated in children, people with bleeding disorders and those with gastric or duodenal ulcer. Aspirin is available without a prescription but please check with your doctor before you start taking it.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
No one likes to be ill, and once the inevitable occurs, one does not want to swallow a large number of multicoloured tablets of all shapes and sizes.
Can you not reduce the number of tablets? I am sure if I take all these I will suffer side effects! Can I not alter the disease process with diet alone? Can I switch to a different system of medicine?
Common queries that busy physicians seldom address patiently.
Anyone who does not wish to have a chronic disease (and swallow tablets for the rest of his or her life) has to take care of his or her health from an early age.
Today, lifestyle diseases such as obesity, diabetes, hypertension and heart disease are rampant. Unfortunately, these diseases usually occur in combination. One of the diseases, say hypertension or diabetes, may start alone as a result of obesity and abnormal lipid profiles, which are often due to inactivity and an improper diet. Then there is a cascading effect — obesity leads to an abnormal lipid profile to diabetes or hypertension to heart disease.
So a person ends up taking tablets several times a day to keep the sugar under control, the blood pressure within limits and the lipids in check. Add a B complex and calcium supplement and you are looking at around 5-6 tablets a day.
The pharmaceutical industry has been working overtime to make life easier for such patients. They have come up with fixed drug combinations so that patients can take one tablet instead of two or three. The idea is good but combination medicines often fail to live up to their potential. This is because the dosage ratios are fixed; so too much or too little of one or more of the medications may be taken. Drugs that need to be taken before and after food may also be inappropriately administered. Sometimes combinations are irrational, with two antagonistic drugs being combined. Occasionally, both medications compete for the same site in the intestine for absorption so that eventually neither works! In fact, if you are prescribed combination tablets, ask your doctor if it is possible to take the tablets individually.
The combination tablets are a response to people’s demand for a “magic bullet”, a single medication that at a low dose, with a wide margin of safety, and few or no side effects, will cure all their ailments. Actually centuries ago, ancient cultures like that of the Indians, the American Indians, the Chinese, the Egyptians and the Greeks did have something like a magic bullet. Medicine men or healers brewed infusions or teas with the petals of a flowering plant — the Spiraea ulmaria — which relieved pain caused by injury, toothache, headache, and arthritis. Hippocrates even successfully administered it to ease the pain of childbirth. Eventually, about a hundred years ago, Felix Hoffmann, a chemist working for Bayer, synthesised the active ingredient in Spiraea ulmaria — salicylic acid. And that has evolved into the aspirin we use today.
Aspirin reduces pain, fever and headaches. It can be used to prevent clotting of blood, which helps prevent strokes, heart attacks and miscarriage. Aspirin also retards the onset and progress of Alzheimer’s and dementia. And it has been shown to reduce the incidence of many types of adenocarcinomas, especially that of the colon. That does make it magic but aspirin can’t cure a lifestyle disease. An aspirin a day, however, can keep lifestyle diseases away.
The other thing that can prevent them is maintaining ideal body weight, which is calculated by measuring the body mass index or BMI (weight in kilograms divided by height in meter squared). Values up to 24 are normal, 25-29 is defined as overweight, 30-34 obese and anything above that as extremely obese.
A person’s weight starts the upward climb because of an imbalance between food intake and physical activity. Environmental factors are important as both these factors are strongly influenced by habits learnt in childhood. Families that enjoy excessive amounts of calorie-dense food with refined sugars and oil and inadequate amounts (less than the recommended 400mg) of pulses, vegetables and fruits tend to have overweight children who grow up to be obese. To avoid addiction to high-calorie foods, stock fruits and vegetables as snacks. Have plain water instead of carbonated drinks and pack home-cooked food for school lunches instead of the packaged variety.
In addition, exercise is essential. It conditions the body, improves immunity, and delays, and sometimes prevents, the onset of lifestyle diseases and some cancers. Adults require an hour of aerobic activity (walking, jogging, running or swimming) followed by 20 minutes of flexion, core strengthening or yoga a day.
In short, a balanced diet, exercise and 75mg of aspirin a day should keep you healthy!
Before popping an aspirin, however, remember that it is contraindicated in children, people with bleeding disorders and those with gastric or duodenal ulcer. Aspirin is available without a prescription but please check with your doctor before you start taking it.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, October 10, 2011
schizophrenia
Let’s talk about schizophrenia
Your Health
DR GITA MATHAI
People sometimes change inexplicably in their late teens – they behave bizarrely, argue unnecessarily with everyone, imagine events, become suspicious or withdraw into a shell. This is actually a disease called schizophrenia and these forms are classic, delusional, paranoid and catanonic. The word itself means "split mind " in Greek as it was confused with a multiple personality disorder by earlier physicians. Today, these two illnesses are classified separately.
Schizophrenia is a serious mental illness that is likely to affect one in 100 men and women (0.5-0.7 per cent respectively). It strikes people usually in their late teens and twenties. It is rare for schizophrenia to set in after the age of 40 and children are rarely diagnosed with it. They can, however, go on to develop it as adults if they have some other mental illness such as autism.
The onset of schizophrenia is so gradual that it mostly goes unrecognised and untreated, especially in developing countries with inadequate healthcare. In addition, people baulk at the idea of admitting they or a loved one is suffering from schizophrenia though no one has a problem saying they have an incurable chronic illness like diabetes or hypertension.
Schizophrenic patients may be delusional or hallucinate — that is see and hear things that are not real. Their speech may be disconnected, dressing and behaviour may be socially inappropriate and they may cry and laugh for no reason at all. Sometimes the person may be “catatonic” or unresponsive to any external stimulus.
Unreasonable behaviour and a quarrelsome nature may affect relations with friends, family and colleagues. The person may be unable to keep a job. Insomnia and morning drowsiness affect efficiency. The appetite may be poor.
The diagnosis of schizophrenia is difficult as the symptoms evolve gradually over a period of months or years. It is often difficult to pinpoint the exact date at which the changes were noticeable. The symptoms should be present for a month for schizophrenia to be suspected and remain for six months for the diagnosis to be established. The patient or a caretaker can report the symptoms. They should be substantiated by evaluation by a qualified medical professional.
PET scans also do not strictly conform to normal parameters. The brains in schizophrenics have smaller temporal and frontal lobes. The levels and ratios of certain brain chemicals like serotonin, dopamine and glutamine are altered.
The exact reason for these behaviour altering brain changes is not known. However, seven per cent of persons with schizophrenia have a family member who suffers from a similar disease. Many have been born to mothers who suffered several viral illnesses during pregnancy. Environmental factors also play a role — the incidence of the disease increases in persons who are financially insecure or from dysfunctional families with a history of childhood abuse.
Schizophrenics tend to gain weight because their lifestyle is sedentary. Patients also have a predilection for addiction — to tobacco products, alcohol and drugs like cannabis. They are often unwilling to check the addictions to control lifestyle diseases like diabetes or hypertension. Also, they do not adhere to diet modifications or medications needed to keep their disease in check; so this shortens lifespan. They eventually die 10-15 years earlier than their peers. They are also 15 per cent more likely to commit suicide.
Gone are the days when schizophrenics were locked up, immersed in cold baths or given electrical shock therapy. Today there are a plethora of drugs that can be used singly or in combination to control the symptoms of schizophrenia and help the person function fairly normally. These drugs act by correcting the enzyme and chemical imbalances in the brain. Response to medication may be slow and this may be frustrating for the patient as well as caregivers but medication can be increased only gradually to optimal levels. Drugs, combinations and dosages have to be individualised and vary from person to person.
The side effects of medication are weight gain, menstrual irregularities and drowsiness. Some people become very stiff and have abnormal smacking movements or grimaces but doctors are able to tackle this with other medications.
Rehabilitation is important. Once the symptoms are controlled, patients can function in society and even hold down jobs. They need to be trained to handle money and in personal care and hygiene. Medication needs to be continued even when the symptoms have disappeared. The involvement of the whole family helps as the person is then more likely to follow medical treatment and less likely to relapse.
People often ask for a “miracle drug” — a single tablet to treat all diseases. The only universal ingredient to improve health in all diseases (even mental problems) is physical exercise. So go take a walk.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
People sometimes change inexplicably in their late teens – they behave bizarrely, argue unnecessarily with everyone, imagine events, become suspicious or withdraw into a shell. This is actually a disease called schizophrenia and these forms are classic, delusional, paranoid and catanonic. The word itself means "split mind " in Greek as it was confused with a multiple personality disorder by earlier physicians. Today, these two illnesses are classified separately.
Schizophrenia is a serious mental illness that is likely to affect one in 100 men and women (0.5-0.7 per cent respectively). It strikes people usually in their late teens and twenties. It is rare for schizophrenia to set in after the age of 40 and children are rarely diagnosed with it. They can, however, go on to develop it as adults if they have some other mental illness such as autism.
The onset of schizophrenia is so gradual that it mostly goes unrecognised and untreated, especially in developing countries with inadequate healthcare. In addition, people baulk at the idea of admitting they or a loved one is suffering from schizophrenia though no one has a problem saying they have an incurable chronic illness like diabetes or hypertension.
Schizophrenic patients may be delusional or hallucinate — that is see and hear things that are not real. Their speech may be disconnected, dressing and behaviour may be socially inappropriate and they may cry and laugh for no reason at all. Sometimes the person may be “catatonic” or unresponsive to any external stimulus.
Unreasonable behaviour and a quarrelsome nature may affect relations with friends, family and colleagues. The person may be unable to keep a job. Insomnia and morning drowsiness affect efficiency. The appetite may be poor.
The diagnosis of schizophrenia is difficult as the symptoms evolve gradually over a period of months or years. It is often difficult to pinpoint the exact date at which the changes were noticeable. The symptoms should be present for a month for schizophrenia to be suspected and remain for six months for the diagnosis to be established. The patient or a caretaker can report the symptoms. They should be substantiated by evaluation by a qualified medical professional.
PET scans also do not strictly conform to normal parameters. The brains in schizophrenics have smaller temporal and frontal lobes. The levels and ratios of certain brain chemicals like serotonin, dopamine and glutamine are altered.
The exact reason for these behaviour altering brain changes is not known. However, seven per cent of persons with schizophrenia have a family member who suffers from a similar disease. Many have been born to mothers who suffered several viral illnesses during pregnancy. Environmental factors also play a role — the incidence of the disease increases in persons who are financially insecure or from dysfunctional families with a history of childhood abuse.
Schizophrenics tend to gain weight because their lifestyle is sedentary. Patients also have a predilection for addiction — to tobacco products, alcohol and drugs like cannabis. They are often unwilling to check the addictions to control lifestyle diseases like diabetes or hypertension. Also, they do not adhere to diet modifications or medications needed to keep their disease in check; so this shortens lifespan. They eventually die 10-15 years earlier than their peers. They are also 15 per cent more likely to commit suicide.
Gone are the days when schizophrenics were locked up, immersed in cold baths or given electrical shock therapy. Today there are a plethora of drugs that can be used singly or in combination to control the symptoms of schizophrenia and help the person function fairly normally. These drugs act by correcting the enzyme and chemical imbalances in the brain. Response to medication may be slow and this may be frustrating for the patient as well as caregivers but medication can be increased only gradually to optimal levels. Drugs, combinations and dosages have to be individualised and vary from person to person.
The side effects of medication are weight gain, menstrual irregularities and drowsiness. Some people become very stiff and have abnormal smacking movements or grimaces but doctors are able to tackle this with other medications.
Rehabilitation is important. Once the symptoms are controlled, patients can function in society and even hold down jobs. They need to be trained to handle money and in personal care and hygiene. Medication needs to be continued even when the symptoms have disappeared. The involvement of the whole family helps as the person is then more likely to follow medical treatment and less likely to relapse.
People often ask for a “miracle drug” — a single tablet to treat all diseases. The only universal ingredient to improve health in all diseases (even mental problems) is physical exercise. So go take a walk.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Thursday, October 6, 2011
heralding diabetes
A herald of diabetes
Your Health
DR GITA MATHAI
The young woman who walked in for a consultation had a scarf wound around her neck. “I came to show you this,” she said, taking it off. There was a dark patch on the back of her neck with ridges and bumps, the skin raised and velvety. “I have already tried fairness creams,” she said. “They only make it worse.”
The diagnosis was easy. She had a peculiar skin lesion known as acanthosis nigricans.
The cosmetically disfiguring and aesthetically displeasing lesions usually occur on the neck (where they are clearly visible), armpit, groin, knees or elbows, in short areas with skin folds. Very rarely, it can be found on the fingers or around the lips or in the nipple area. It can occur at any age and in both men and women. It is seen in children and even in babies. The lesions appear gradually and do not itch or pain. This means that they remain unnoticed until they have spread over a large area. Initially it looks like dirt so people try to scrub it off, damaging the skin in the process. Others try to camouflage it unsuccessfully with talcum powder and make up.
Nearly 20 per cent of the population has acanthosis nigricans and the numbers are rising rapidly because obesity is the commonest risk factor. More and more people are becoming overweight in India and the world.
An inactive lifestyle causes weight gain and these two factors together cause relative insulin resistance, which results in elevated glucose levels, an abnormal lipid profile and high blood pressure. These changes are grouped together as the “metabolic syndrome X”. Acanthosis nigricans is one of the early markers of this syndrome. The American diabetic association classified it as a risk factor for the development of diabetes in 2000. In children and adolescents, symptoms of syndrome X or frank diabetes begin to appear within two years of the appearance of acanthosis nigricans.
The disease can also be hereditary and in typical inherited acanthosis nigricans, skin lesions are confined to one half of the body. They spread and increase till a certain age and then remain stationery or regress. In other families the lesions, though present in almost all family members, are not really hereditary. The biggest difference is that they are present on both sides of the body. The family usually has an inactive lifestyle, members are obese and go on to develop diabetes.
Medications can also cause these skin changes as a side effect. The most common offenders are hormones — like oral contraceptive pills (OCP), hormone replacement therapy (HRT), insulin, pituitary extract, growth hormone or systemic corticosteroids. Unfortunately, pituitary extract or steroids may be added to unregulated “natural herbal supplements” or “tonics” so the person may not even know that he or she is ingesting such substances. Sulpha drugs (antibiotic)and nicotinic acid (for high cholesterol) can also cause these.
Certain types of acanthosis nigricans are peculiar to women. It is associated with the polycystic ovary syndrome and appears at adolescence. Such girls are obese and have irregular periods and facial hair.
If you develop acanthosis nigricans, it is worthwhile consulting a physician. Although you may be obese, and that is the commonest cause of these skin changes, some investigations and tests need to be done. This is because the skin changes can (though this is rare) be associated with cancer, particularly in the abdomen. It can appear before any other obvious sign of a tumour. It can also be a part of the spectrum of autoimmune diseases like systemic lupus erythematosus, scleroderma, Sjögren syndrome, or Hashimoto thyroiditis.
There really is no specific treatment for the skin changes in acanthosis nigricans. The disease itself is harmless. The main danger lies in the complications associated with obesity and insulin resistance. Tackling the underlying problem makes the skin lesions fade. Here is what you can do to tackle it:
• If it is due to medication or health supplements, stop taking them.
• Reduce your weight with diet and exercise. Try to reach your ideal body weight (height in meter squared multiplied by 23).
• Eat more protein, fresh fruits and vegetables. Starches and sugars provide empty calories and aggravate insulin resistance.
• Sweat trapped in the folds can make the lesions malodorous. Bathe twice a day with a medicated soap like Neko if that is the case.
• Evening primrose oil or fish oil supplements may help.
• Some prescription creams or lotions help lighten the affected areas. These contain modified vitamin A products and are often prescribed for acne.
• Fairness creams do not help.
• Surgical dermal abrasion can be done.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
The young woman who walked in for a consultation had a scarf wound around her neck. “I came to show you this,” she said, taking it off. There was a dark patch on the back of her neck with ridges and bumps, the skin raised and velvety. “I have already tried fairness creams,” she said. “They only make it worse.”
The diagnosis was easy. She had a peculiar skin lesion known as acanthosis nigricans.
The cosmetically disfiguring and aesthetically displeasing lesions usually occur on the neck (where they are clearly visible), armpit, groin, knees or elbows, in short areas with skin folds. Very rarely, it can be found on the fingers or around the lips or in the nipple area. It can occur at any age and in both men and women. It is seen in children and even in babies. The lesions appear gradually and do not itch or pain. This means that they remain unnoticed until they have spread over a large area. Initially it looks like dirt so people try to scrub it off, damaging the skin in the process. Others try to camouflage it unsuccessfully with talcum powder and make up.
Nearly 20 per cent of the population has acanthosis nigricans and the numbers are rising rapidly because obesity is the commonest risk factor. More and more people are becoming overweight in India and the world.
An inactive lifestyle causes weight gain and these two factors together cause relative insulin resistance, which results in elevated glucose levels, an abnormal lipid profile and high blood pressure. These changes are grouped together as the “metabolic syndrome X”. Acanthosis nigricans is one of the early markers of this syndrome. The American diabetic association classified it as a risk factor for the development of diabetes in 2000. In children and adolescents, symptoms of syndrome X or frank diabetes begin to appear within two years of the appearance of acanthosis nigricans.
The disease can also be hereditary and in typical inherited acanthosis nigricans, skin lesions are confined to one half of the body. They spread and increase till a certain age and then remain stationery or regress. In other families the lesions, though present in almost all family members, are not really hereditary. The biggest difference is that they are present on both sides of the body. The family usually has an inactive lifestyle, members are obese and go on to develop diabetes.
Medications can also cause these skin changes as a side effect. The most common offenders are hormones — like oral contraceptive pills (OCP), hormone replacement therapy (HRT), insulin, pituitary extract, growth hormone or systemic corticosteroids. Unfortunately, pituitary extract or steroids may be added to unregulated “natural herbal supplements” or “tonics” so the person may not even know that he or she is ingesting such substances. Sulpha drugs (antibiotic)and nicotinic acid (for high cholesterol) can also cause these.
Certain types of acanthosis nigricans are peculiar to women. It is associated with the polycystic ovary syndrome and appears at adolescence. Such girls are obese and have irregular periods and facial hair.
If you develop acanthosis nigricans, it is worthwhile consulting a physician. Although you may be obese, and that is the commonest cause of these skin changes, some investigations and tests need to be done. This is because the skin changes can (though this is rare) be associated with cancer, particularly in the abdomen. It can appear before any other obvious sign of a tumour. It can also be a part of the spectrum of autoimmune diseases like systemic lupus erythematosus, scleroderma, Sjögren syndrome, or Hashimoto thyroiditis.
There really is no specific treatment for the skin changes in acanthosis nigricans. The disease itself is harmless. The main danger lies in the complications associated with obesity and insulin resistance. Tackling the underlying problem makes the skin lesions fade. Here is what you can do to tackle it:
• If it is due to medication or health supplements, stop taking them.
• Reduce your weight with diet and exercise. Try to reach your ideal body weight (height in meter squared multiplied by 23).
• Eat more protein, fresh fruits and vegetables. Starches and sugars provide empty calories and aggravate insulin resistance.
• Sweat trapped in the folds can make the lesions malodorous. Bathe twice a day with a medicated soap like Neko if that is the case.
• Evening primrose oil or fish oil supplements may help.
• Some prescription creams or lotions help lighten the affected areas. These contain modified vitamin A products and are often prescribed for acne.
• Fairness creams do not help.
• Surgical dermal abrasion can be done.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Subscribe to:
Posts (Atom)
