By A. Armon. Marist College. 2018.
Therapeutic Considerations Reducing the size as well as the symptoms of uterine ﬁbroids with natural medicines is easily accomplished in most cases discount bactroban 5 gm without a prescription acne 22 years old. Unfortunately purchase 5gm bactroban visa skin care oils, this statement is supported more by the clinical experiences of naturopathic physicians than by scientiﬁc evidence cheap bactroban 5 gm skin care 8 year old, though the approach is scientiﬁcally rational—that is, if uterine ﬁbroids are caused by an excess of estrogen produced in the body as well as the effects of xenoestrogens, it makes sense that reducing estrogenic inﬂuences should shrink uterine ﬁbroids. Keep in mind that as women pass through menopause there is less estrogen and so there will also be a tendency for the fibroid to shrink on its own. Diet The most important dietary recommendations are to eat a high-ﬁber diet rich in phytoestrogens (plant estrogens) and to avoid saturated fat, sugar, and caffeine. These simple changes can dramatically reduce circulating estrogen levels and reduce estrogen’s inﬂuence on the ﬁbroid. One study looked at what happened when women switched from the standard American diet (40% of calories from fat; only 12 g ﬁber per day) to a healthier diet (25% of calories from fat; 40 g ﬁber). That’s a good thing, because when phytoestrogens occupy the receptors, estrogen can’t affect cells. By competing with estrogen, phytoestrogens cause a drop in estrogen effects, and are thus sometimes called antiestrogens. Great sources of phytoestrogens include soy and soy foods, ground ﬂaxseed, and nuts and seeds. These dietary recommendations have extreme signiﬁcance not only in treating uterine ﬁbroids but also in reducing endometrial cancer. Women with uterine ﬁbroids have a fourfold increase in the risk of endometrial cancer. In a case-control study of a multiethnic population (Japanese, white, Native Hawaiian, Filipino, and Chinese) examining the role of dietary soy, ﬁber, and related foods and nutrients in the risk of endometrial cancer, 332 women with endometrial cancer were compared with women in the general multiethnic population, and all women were interviewed by means of a dietary questionnaire. Similar reductions in risk were found for greater consumption of other sources of phytoestrogens, such as whole grains, vegetables, fruits, and seaweed. The researchers concluded that plant-based diets low in calories from fat, high in ﬁber, and rich in legumes (especially soybeans), whole grain foods, vegetables, and fruits reduce the risk of endometrial cancer. These dietary associations may explain at least in part the lower rates of uterine cancer in Asian countries than in the United States. Soy isoﬂavones appear to be selective in terms of the tissues in which they have an estrogenic effect and the tissues in which their effect is antiestrogenic. Soy phytoestrogens do not appear to have an estrogenic effect on the human uterus and may in fact help shrink uterine ﬁbroids due to an antiestrogenic effect. We recommend moderate but not excessive soy consumption in the range of 45 to 90 mg soy isoﬂavones per day. See the chapter “Menopause” for more information on the isoflavone content of soy foods. Nutritional Supplements Historically, naturopaths have used lipotropic factors such as inositol and choline to support the healthy detoxiﬁcation of estrogen. Lipotropic supplements usually are a combination of vitamins and herbs designed to support the liver’s function in removing fat, detoxifying the body’s wastes, detoxifying external harmful substances (pesticides, ﬂame retardants, plastics, etc. These lipotropic products vary in their formulations depending on the manufacturer, but they are all similar and are meant for the same uses. Many now contain anticancer phytonutrients found in vegetables from the brassica family, such as indole-3-carbinol, di-indoylmethane, and sulforaphane. Research has shown that these compounds help to break down cancer-causing forms of estrogens to nontoxic forms, making them especially important for women with uterine fibroids. However, their activity is certainly less than the effects of dietary phytoestrogens such as soy and ﬂax. Newer, nonsurgical techniques such as high-intensity focused ultrasound are also now available. In addition to causing physical discomfort and embarrassment, vaginitis is medically important for several reasons: (1) it may be a symptom of a more serious underlying problem, such as chronic inﬂammation of the cervix (cervicitis) or a sexually transmitted disease; (2) the infection may travel into the uterus and lead to pelvic inﬂammatory disease, a serious situation that can result in infertility due to scarring of the fallopian tubes; and (3) chronic vaginal infections are often the underlying cause of recurrent urinary tract infections because they serve as a reservoir of the infectious bacteria. Causes Vaginitis may be sexually transmitted or may arise from a disturbance to the delicate ecology of the healthy vagina. In many instances, vaginal infections involve an overgrowth of common organisms normally found in the vagina of many healthy women. In normal situations these microbes do not cause any problems, but when there is a disturbance in the vaginal environment a normally present microbe can overgrow and produce an infection. Factors inﬂuencing the vaginal environment include pH, tissue sugar (glycogen) content, blood sugar (glucose) level, presence of “friendly” organisms (particularly Lactobacillus acidophilus), natural ﬂushing action of vaginal secretions, presence of blood (menstruation), spermicides and lubricants, and presence of antibodies and other compounds in the vaginal secretions. These factors are, in turn, affected by such things as low immune function as a result of nutritional deﬁciencies, medications (e. In fact, vaginal yeast infections are three times more prevalent in women wearing panty hose than those wearing cotton underwear. Approximately 90% of cases of vulvovaginitis will be associated with one of three organisms, Trichomonas vaginalis, Candida albicans, or Gardnerella vaginalis. The relative frequency of each form varies with the population studied, as well as with sexual activity levels. Less frequent causes of vaginitis include Neisseria gonorrhea, herpesvirus, and Chlamydia trachomatis. The preceding table summarizes the diagnostic differentiation of the most common causes of infectious vaginitis.
For all types of databases and retrieval systems on the Internet 5gm bactroban with mastercard acne 20s, reproduce the title for citation purposes as closely as possible to the wording that appears on the screen buy bactroban 5 gm without a prescription skin care 9, duplicating capitalization purchase 5gm bactroban free shipping skin care physicians, spacing, and punctuation. Tis may include all capital letters or all lower case letters, capital letters within words, run-together words, and symbols. When citing a database, always provide information on the latest title and publisher unless you are citing an earlier version. Continue to Citation Rules with Examples for Entire Databases/Retrieval Systems on the Internet. Continue to Examples of Citations to Entire Databases/Retrieval Systems on the Internet. Citation Rules with Examples for Entire Databases/Retrieval Systems on the Internet Components/elements are listed in the order they should appear in a reference. An R afer the component name means that it is required in the citation; an O afer the name means it is optional. Author/Editor (R) | Author Afliation (O) | Title (R) | Content Type (O) | Type of Medium (R) | Edition (R) | Editor and other Secondary Authors (O) | Place of Publication (R) | Publisher (R) | Date of Publication (R) | Date of Update/Revision (R) | Date of Citation (R) | Availability (R) | Language (R) | Notes (O) Author/Editor for Databases/Retrieval Systems on the Internet (required) General Rules for Author/Editor • If there are no authors or editors, as is ofen the case, see No author can be found below • List names in the order they appear on the title page or opening screens • Enter surname (family or last name) frst for each author/editor • Capitalize surnames and enter spaces within surnames as they appear on the assumption that the author approved the form used. Databases/Retrieval Systems on the Internet 1627 Box 10 continued from previous page. Some databases/retrieval systems on the Internet do not display a traditional title page that clearly states the names of the authors. When there is no title page: • Look at the top, bottom, or sidebar of the frst screen or the bottom of the last screen of the site • Do not assume that an individual named as Web master or contact person is the author; he or she most probably is not, especially for sites produced by large organizations • Do not assume that a name in a copyright statement, such as "copyright 1997 by John A. Place the organization in the publisher position when the organization appears to be serving as both author and publisher. Databases/Retrieval Systems on the Internet 1629 Box 3 continued from previous page. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. Names in non-roman alphabets (Cyrillic, Greek, Arabic, Hebrew, Korean) or character-based languages (Chinese, Japanese). Romanization, a form of transliteration, means using the roman (Latin) alphabet to represent the letters or characters of another alphabet. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. An organization such as a university, society, association, corporation, or governmental body may be an author. International Union of Pure and Applied Chemistry, Organic and Biomolecular Chemistry Division. American College of Surgeons, Committee on Trauma, Ad Hoc Subcommittee on Outcomes, Working Group. American Academy of Pediatrics, Committee on Pediatric Emergency Medicine; American College of Emergency Physicians, Pediatric Committee. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. Databases/Retrieval Systems on the Internet 1635 Box 9 continued from previous page. Separate the surname from the given name or initials by a comma; follow initials with a period; separate successive names by a semicolon and a space. Database/retrieval system on the Internet with editors where there is no author 9. Databases/Retrieval Systems on the Internet 1637 Box 12 continued from previous page. If you abbreviate a word in one reference in a list of references, abbreviate the same word in all references. Marubini E (Istituto di Statistica Medica e Biometria, Universita degli Studi di Milano, Milan, Italy), Rebora P, Reina G. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. Databases/Retrieval Systems on the Internet 1639 Box 14 continued from previous page. Moskva becomes Moscow Wien becomes Vienna Italia becomes Italy Espana becomes Spain Examples for Author Affiliation 10. Database/retrieval system on the Internet with author afliation Title for Databases/Retrieval Systems on the Internet (required) General Rules for Title • Reproduce the title of a database/retrieval system as closely as possible to the wording that appears on the screen, duplicating capitalization, spacing, and punctuation • Use a colon followed by a space to separate a title from a subtitle, unless another form of punctuation (such as a question mark, period, or an exclamation point) is already present • Follow non-English titles with a translation whenever possible; place the translation in square brackets • End a title with a space Specific Rules for Title • Determining the title if there is no standard title page • Titles not in English • Titles in more than one language • Titles ending in punctuation other than a period • Titles containing a Greek letter, chemical formula, or another special character 1640 Citing Medicine • No title can be found Box 16. While many databases/retrieval systems on the Internet display a traditional title page and clearly state the title, some sites do not. When there is no title page: • Look for the most prominent (usually the largest) wording on the opening screen • Look at the title bar of the Web browser (generally in the top lef corner) • Look for the title in the source code of the database/retrieval system if it is displayed by the Web browser • If a title cannot be determined, construct a title by using the frst series of words on the screen; place the constructed title in square brackets Box 17.
In addition to binding to thyroid tissue order 5gm bactroban otc skin care with vitamin c, these antibodies may also bind to the adrenal glands discount bactroban 5 gm visa skin care juarez, pancreas buy bactroban 5gm line acne velocite, and acid-producing cells of the stomach (parietal cells). Hashimoto’s thyroiditis can be reasonably assumed to be present when there are signs of autoimmune thyroid disease. According to this criterion, subclinical hypothyroidism is a relatively common ﬁnding, affecting 2% to 7% of adults. With the growing incidence of iodine deﬁciency, we expect this last cause will become more commonly recognized. Basal Body Temperature Before the use of blood measurements, it was common to diagnose hypothyroidism on the basis of basal body temperature (the temperature of the body at rest) and Achilles reﬂex time (reﬂexes are slowed in hypothyroidism). With the advent of sophisticated laboratory measurement of thyroid hormones in the blood, these functional tests of thyroid function fell by the wayside. Yet it is affected by so many other variables, including adrenal function, body composition, activity levels, menstrual status, and immune function, that it has very little speciﬁcity for thyroid function. Nonetheless, it is a good general screening test that is easy to do and virtually without cost. The function of the thyroid gland can be determined by simply measuring your basal body temperature. Shake down the thermometer to below 95°F and place it by your bed before going to sleep at night. Record the temperature for at least three mornings (preferably at the same time of day) and give the information to your physician. Menstruating women must perform the test on the second, third, and fourth days of menstruation. Therapeutic Considerations The medical treatment of hypothyroidism, in all but its mildest forms, involves the use of desiccated thyroid or synthetic thyroid hormone. Although synthetic hormones have become popular, many physicians (particularly naturopathic physicians) still prefer the use of desiccated natural thyroid, which contains all thyroid hormones, not just thyroxine. At this time, it appears that thyroid hormone replacement is necessary in the majority of people with hypothyroidism. In particular, the use of thyroid replacement is very important in patients with Hashimoto’s thyroiditis, as it achieves two objectives: it normalizes thyroid hormone levels and also decreases autoimmune processes. We prefer desiccated thyroid, as it may stimulate blocking antibodies to antithyroid antibodies or act as a decoy for thyroid antibodies. Some patients are found to recover from Hashimoto thyroiditis after an extended treatment time with thyroid hormone and no longer need to be maintained on replacement, but the majority will require lifelong replacement therapy. The thyroid extracts sold in health food stores are required by the Food and Drug Administration to be thyroxine-free. In other words, think of health food store thyroid preparations as milder forms of desiccated natural thyroid. If you have mild hypothyroidism, these preparations may provide enough support to help you with your thyroid problem. Since it is important to nutritionally support the thyroid gland by ensuring adequate intake of key nutrients required in the body’s manufacture of thyroid hormone and avoiding goitrogens (see above), most health food stores’ thyroid products also contain supportive nutrients such as iodine, zinc, selenium, and tyrosine. Iodine and Tyrosine Thyroid hormones are made from iodine and the amino acid tyrosine. The average intake of iodine in the United States, once estimated to be more than 600 mcg per day, is now less than half that. Vegans, especially those who are pregnant, should be careful to ensure adequate iodine intake, as their levels are typically low. For this reason, and because the only function of iodine in the body is for thyroid hormone synthesis, it is recommended that dietary levels or supplementation of iodine not exceed 600 mcg per day for any length of time. Vitamins and Minerals Zinc, selenium, vitamin E, and vitamin A function together in many body processes, including the manufacture of thyroid hormone. A deﬁciency of any of these nutrients would result in production of lower levels of active thyroid hormone. Supplementation with zinc has been shown to reestablish normal thyroid function in hypothyroid patients who were zinc deﬁcient, even though they had supposedly normal serum T levels. Vitamin B2 (riboﬂavin), B3 (niacin), B6 (pyridoxine), and C are also necessary for normal thyroid hormone manufacture. Exercise Exercise is particularly important in a treatment program for hypothyroidism. Exercise stimulates thyroid gland secretion and increases tissue sensitivity to thyroid hormone. Many of the health benefits of exercise may be a result of improved thyroid function. The health beneﬁts of exercise are especially important in overweight hypothyroid individuals who are dieting. A consistent effect of dieting is a decrease in the metabolic rate as the body strives to conserve fuel. Diet The recommendations given in the chapter “A Health-Promoting Diet” are suitable, with the following caveat: the diet should be low in raw goitrogens and high in foods rich in the trace minerals needed for thyroid hormone production and activation. Goitrogens to be limited include brassica-family foods (turnips, cabbage, rutabagas, mustard greens, radishes, horseradishes), cassava root, soybeans, peanuts, pine nuts, and millet.