Promoting Thyroid Health during September
August 27, 2013
September is Thyroid Cancer Awareness Month, and survivors, caregivers, friends, and organizations everywhere will be urging everyone to “Find It Early” through neck checks, reports the sponsoring nonprofit organization ThyCa: Thyroid Cancer Survivors’ Association, Inc.
Thyroid cancer is the fastest increasing cancer among both men and women, affecting people from young children through seniors. It is estimated that more than 60,000 people will be newly diagnosed this year in the United States alone, and more than 200,000 worldwide. Thyroid cancer is usually treatable when detected early.
ThyCa, sponsor of Thyroid Cancer Awareness Month since initiating the observance in 2000, encourages people to ask for a neck check each time they visit their doctor.
“Signs to discuss with the physician include:
- A lump or fullness in the neck
- Lymph node swelling
- Difficulty breathing or swallowing
- Voice changes,”
says ThyCa Executive Director Gary Bloom, himself a thyroid cancer survivor. “These are signs of a possible thyroid nodule. Most thyroid nodules are benign, but some are cancer. Healtcare professionals are essential to the detection of thyroid cancer.”
HealthFair’s TSH Test, also known as a thyroid stimulating hormone test, evaluates the function of your thyroid and pituitary glands with a simple finger prick blood test.
According to the National Institute of Health, a TSH test evaluates:
- If your thyroid gland is working properly:
- If you have an underactive thyroid gland (hypothyroidism), you may experience symptoms such as weight gain, fatigue, dry skin, and constipation, a feeling of being too cold, or frequent menstrual periods.
- If you have an overactive thyroid (hyperthyroidism), you may experience symptoms such as weight loss, a rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.
- TSH levels can help determine whether hypothyroidism is due to a damaged thyroid gland or another cause.
- Monitor treatment of thyroid replacement medicine for those who have hypothyroidism or hyperthyroidism.
Additional symptoms of a thyroid abnormality include:
- Difficulty sleeping
- Tremors in the hands
- Puffy Skin
- Hair Loss
- Light sensitivity, visual disturbances
- The eyes may be affected: puffiness around the eyes, dryness, irritation, and, in some cases, bulging of the eyes
Normal TSH Levels
Normal values can range from 0.4 – 4.0 mIU/L (milli-international units per liter). If you are being treated for a thyroid disorder, your TSH level should be between 0.5 and 2.0 mIU/L.
Abnormal TSH Levels
A thyroid level that exceeds the normal range is typically associated with an underactive thyroid gland, or hypothyroidism.
A thyroid level that is below the normal range is typically associated with an overactive thyroid gland, or hyperthyroidism.
For resources from Thyca, please visit their website at thyca.org.
HealthFair Upgrades Mobile Clinics to Enhance Services
August 22, 2013
HealthFair is upgrading all of their ultrasound equipment aboard their mobile clinics to enhance the quality and efficiency of their potentially life-saving screening tests. They selected Biosound technology because the MyLab 5 ultrasound machines are faster, offer better image quality, and enable HealthFair to offer a new screening test.
Research proved, “the machines operate faster, so it makes the job easier for the technicians so they can focus on the patient instead of waiting for results. We also believe the image quality is better than the previous manufacturer we were utilizing, and the enhanced equipment allows us to offer IMT screenings in the near future,” states Chris Bevan, Network Systems Administrator.
HealthFair’s focus has always been on improving cardiovascular health by identifying life-threatening risks of a heart attack, stroke, aneurysm, cancer and more, before an incident occurs. The ability to add Carotid Intima Media Thickness Screening (IMT screening) in the near future further enhances the spectrum of convenient, life-saving tests they provide at an affordable rate. IMT screenings measure the thickness of the intimal and medial layers of the carotid artery which indicate a patient’s risk of heart disease, stroke, and other vascular diseases.
Overall, their mobile clinics are equipped with the latest technology; delivering the same advanced technology as premier hospitals directly to your community. In addition to a professional environment, they offer comfort and privacy with two private exam rooms and a relaxing waiting room. Being proactive about your health doesn’t have to take away from your family, productivity, or finances.
Are you stressed? Maybe you should have your heart checked.
August 14, 2013
People who think stress is affecting their health may be setting themselves up for a heart attack, a new study contends.
The researchers found that these people had double the risk of a heart attack compared with people who didn’t think stress was harming their health.
“People’s perceptions about the impact of stress on their health are likely to be correct,” said study author Hermann Nabi, a senior research associate at the Centre for Research in Epidemiology and Population Health at INSERM in Villejuif, France.
“They may need to take actions when they feel that it is the case,” he added.
These findings have both clinical and theoretical implications, Nabi said.
“From a clinical perspective, they suggest that complaints of adverse impact of stress on health should not be ignored in clinical settings as they may indicate increased risk of developing coronary heart disease,” he said.
From a theoretical perspective, the findings imply that the perceived impact of stress on health is a valid concept that should be considered in future studies aimed at examining the association between stress and health outcomes, Nabi added.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that “stress and reactions to stressful situations have been associated with increased risk of cardiovascular disease in many studies.”
However, few studies have looked at whether an individual’s perception of stress is associated with cardiovascular outcomes, he said.
And it’s not clear if reducing stress would affect the risk for heart attack, Fonarow said.
“Further studies are needed to determine whether stress reduction or other risk reduction strategies can reduce cardiovascular events in men and women who perceive they are under stress that is adversely impacting their health,” he said.
For the study, Nabi’s team collected data on more than 7,000 men and women who took part in the Whitehall II study, which has followed London-based civil servants since 1985.
Participants were asked how much they felt that stress or pressure in their lives had affected their health. Based on their answers, they were placed into one of three groups: “not at all,” “slightly or moderately,” or “a lot or extremely.”
Participants were also asked about their levels of stress and other lifestyle factors such as smoking, drinking, diet and physical activity.
The researchers also collected medical information, such as blood pressure, diabetes status and weight, and other data, including marital status, age, sex, ethnicity and socioeconomic status.
Over 18 years of follow-up, there were 352 heart attacks or deaths from heart attack.
After taking all of these factors into account, the investigators found those who said their health was a “lot or extremely” affected by stress had more than double the risk of a heart attack compared with those who said stress had no effect on their health.
After further adjustments for biological, behavioral and other psychological risk factors — including stress levels and measures of social support — the risk wasn’t as high. But it was still a lot higher (49 percent higher) than among those who said stress didn’t affect their health, the researchers noted.
While the study found an association between perceived levels of stress and heart attack, it did not prove cause-and-effect.
Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, offered some tips on dealing with stress.
The stress response is not only a mental reaction to a situation, but a physiological reaction, she explained.
“Acute and chronic stress over time can make us sick. Our perception of how that stress affects our health may be an additional stressor biochemically, psychologically and physiologically, creating a feedback loop that results in increased physical distress and disease,” Heller said.
Managing stress does not mean ignoring it, she said. “Working with a qualified mental health professional who specializes in cognitive behavioral therapy can be very helpful. In lieu of that, there are some things you can do on your own.”
- Take several slow deep breaths periodically throughout the day. Deep breathing can shift the body out of the fight-or-flight response.
- Exercise regularly. Cardiovascular exercise teaches the body how to handle the physiological effects of stress. It also helps reduce anxiety and depression.
- Eat as healthfully as possible. Chronic or acute stress may trigger the desire to dive into high-calorie comfort foods. However, after an initial flash of relief, you will tend to feel lethargic, fatigued and possibly worse than you did before.
- Identify stressful triggers, and create a plan to help you cope.
- Instead of stressing about your health, be proactive and find ways to improve it. If you have high blood pressure, learn how to lower the sodium in your diet. Start walking a few days a week to strengthen your heart and help manage weight.
For more on stress and your heart, visit the American Heart Association.
SOURCES: Hermann Nabi, Ph.D., senior research associate, Centre for Research in Epidemiology and Population Health, INSERM, Villejuif, France; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Samantha Heller, M.S., R.D., senior clinical nutritionist, NYU Langone Medical Center, New York City; June 27, 2013, European Heart Journal, online
New medication could drop cholesterol to extreme lows
July 31, 2013
A new class of cholesterol-fighting drugs could be coming to patients in the not-so-distant future, and experts say they could be a real game-changer in Americans’ battle to lower artery-clogging LDL, or “bad,” cholesterol.
The drugs, known as PCSK9 inhibitors, work to suppress a particular gene that regulates how much cholesterol the liver can filter out of the body. In early phase 3 trials, the inhibitors have shown to be safe and to work in reducing LDL cholesterol levels to previously unknown lows.
As interesting as the drugs themselves is the process by which they were discovered. Ten years ago, researchers found a family in Paris with a long history of extremely high levels of LDL, incidents of cardiovascular disease and early deaths, says Dr. Jay Edelberg, global head of PCSK9 development for Sanofi, a pharmaceutical company working on a PCSK9 inhibitor in partnership with Regeneron. Tests revealed that the family had a rare mutation on the gene called PCSK9.
Additional studies showed that individuals with underactive PCSK9 genes had low levels of LDL and, much more important, low levels of cardiovascular disease.
“That became the most exciting potential target in cardiovascular medicine,” Edelberg said.
It’s this discovery that has Sanofi and two other major drug companies, Amgen and Pfizer, racing to develop a drug that mimics the gene’s effects.
The best approach, experts say, will be through monoclonal antibodies: antibodies that are created in a lab and help your immune system fight a disease or, in this case, fight cholesterol.
“PCSK9 inhibitors could offer an important treatment option for patients, particularly for those who are in need of greater LDL-C reductions beyond what the current standards of care can offer,” said MacKay Jimeson, a spokesman for Pfizer, one of the companies working on this new type of drug.
“This is not to replace statin therapy,” said Joe Miletich, senior vice president of research and development at Amgen. “This is actually to get patients to (their) goal who can’t get there.”
Normal LDL levels hover somewhere in the 100 to 130 mg/dL range, according to the American Heart Association. Anything above that, your doctor starts to get concerned.
“With a statin medication, you can often get somebody’s cholesterol between 70 and 100 mg/dL,” said Dr. Elliott Antman, president-elect of the American Heart Association and a dean at Harvard Medical School. “If you use these monoclonal antibodies, you could see a number way less than 50.”
This excites doctors like Antman, who is not connected to the research but often sees patients with cholesterol numbers in the hundreds.
“I would say this is a game changer.”
But is there such a thing as cholesterol levels being too low? We don’t really know, Antman says, but he believes the lower, the better.
“Infants, when they’re less than a year old, have smooth arteries, and their LDL is 40 or less,” he said.
The initial research into the PCSK9 gene also found people with virtually no PCSK9 activity who lived their entire lives with extremely low cholesterol. Researchers observed no ill effects in those patients.
The safety data from the clinical trials are good, and experts say these drugs could help patients who can’t tolerate or do not respond to traditional cholesterol-lowering drugs.
“Monoclonals were generally well-tolerated,” Antman said. “Although the studies weren’t comprised of millions of patients and duration of follow-up wasn’t as long as we’d like, the signals we’re seeing are all very positive.”
As excited as the pharmaceutical giants are about this new discovery, this isn’t ready for prime time. For one thing, the drugs are not approved by the FDA, although Antman said it probably won’t be long.
“These drugs are of such great interest that there will likely be an aggressive approach to conducting large-scale trials for FDA approval and perhaps expedited review,” he said. “It’s hard to know exactly when these drugs will be available, but I’m guessing it’ll be less than two years.”
Another issue with the drugs is that they can’t be taken orally.
“You can’t swallow this, because the digestive enzymes in your stomach would break up the protein,” Antman said. “It’s given by subcutaneous injections (into a lower level of skin), but this can be done with very small needles.”
Researchers say patients would need to give themselves injections only every two to four weeks, which, depending on how often they’re taking pills to lower cholesterol, may be a less cumbersome option.
Finally, these types of medications are very expensive to make and difficult to store and require a much more extensive manufacturing process than a pill.
“They are heat-sensitive and open to risk of microbial contamination, so issues of shelf life and handling are always front and center,” Antman said. “This means they’re probably going to be more expensive than pills.”
But Antman believes, as the saying goes, an ounce of prevention is worth a pound of cure.
“How much is it worth to use a more expensive treatment up front to avoid downstream events that are more expensive?” he asked. “If you think prevention is expensive, try treating disease.”
This article was written by Matt Sloane and published on CNN.com
Yoga may help patients with atrial fibrillation
July 31, 2013
People with a common heart rhythm problem may be able to decrease their symptoms by adding gentle yoga to their treatment regimen, a study suggests. The research published in the Journal of the American College of Cardiology is one of the first to test the effects of yoga on the heart condition, known as atrial fibrillation. Experts cautioned that while the findings are promising, more research is needed.
Atrial fibrillation arises when the heart’s upper chambers quiver chaotically instead of contracting normally; it’s not immediately dangerous but can cause symptoms like palpitations, shortness of breath and dizziness. Over the long run, it can also raise the risk of strokes or heart failure.
The standard treatment includes drugs that control the heart’s rhythm and rate, and aspirin to prevent blood clots. However, those treatments are often not enough to fully prevent episodes. In the new study, researchers looked at whether adding gentle-style yoga classes to 49 patients’ drug therapy could help.
Lead researcher Dr. Dhanunjaya Lakkireddy said his own father was a “yoga master,” so he was familiar with the practice. But he was even more motivated by research showing that yoga can have calming effects on the nervous system, helping to lower blood pressure and heart rate. His team found that over three months of classes, patients started having fewer symptoms — an average of two episodes, versus almost four in the three months before taking up yoga.
Still, yoga is no replacement for medication, said Lakkireddy, a cardiologist at the University of Kansas Hospital and Medical Center in Kansas City. ”Just doing yoga alone is not going to cut it,” he said. “You still need to take the appropriate medications and follow your doctor’s recommendations. But this suggests that yoga can be a fantastic adjunct.”
The study involved 49 patients with paroxysmal AF — a form where symptoms arise suddenly and then end on their own, usually within 24 hours. For the first three months, patients stuck with their usual activities. Then for the next three months, they had hour-long yoga sessions with a certified teacher, at least twice a week; some people opted to come every day.
“More research is needed, but these findings are very promising,” said Goldberg, medical director of the Center for Women’s Health at NYU Langone Medical Center in New York City. But she also stressed that it’s important for people to know that there are different styles of yoga, and some may be inappropriate or even dangerous for people with a heart condition. ”This study used a mild form of yoga,” Goldberg said. “The findings do not speak to all styles of yoga.”
Specifically, study patients took classes in the Iyengar style, which moves at a slow pace and emphasizes proper alignment in the poses, breathing and relaxation. Some other styles of yoga are more strenuous, like the style known as “vinyasa.” There are also “hot yoga” classes, where the room temperature is kept as high as 105 degrees. ”We would never recommend hot yoga for a heart patient,” Goldberg stressed.
All of that said, Goldberg already suggests gentler yoga classes to some of her heart patients. Both she and Lakkireddy said that patients who are interested in yoga should get the go-ahead from their doctor first. Of course, Goldberg noted, your doctor may not be able to recommend a specific yoga program. In that case, she suggested calling your local Y or a senior center and asking about classes geared for older adults or people with heart disease.
Lakkireddy said that someone with atrial fibrillation who is relatively young and otherwise healthy could try a regular Iyengar-style class. But be sure to talk to the teacher ahead of time about your heart condition, he said.
In the United States, it’s estimated that about 2.7 million people have atrial fibrillation. Besides paroxysmal atrial fibrillation, there are two other forms: persistent and permanent. Lakkireddy said his findings cannot be assumed to apply to those types of the disorder.
Learn more about atrial fibrillation from the U.S. National Heart, Lung and Blood Institute.
This article was written by Amy Norton and published on HealthDay.com