Statin drugs have taken over mainstream media recently on the news and major network daytime talk shows… but what are they?
Statins are used to lower your cholesterol. Too much bad cholesterol in your blood can stick to the walls of your arteries causing narrowing or even blockage of proper blood flow. When exercise and diet does not reduce your levels of bad cholesterol, you may need a statin to interfere with your liver’s production of natural cholesterol.
Safe for most people, prescriptions are required and they are NOT safe for pregnant women or those with liver diseases. They can also have adverse reactions when interacting with other medications.
Always ask you pharmacist about drug interactions!
Researchers have been looking at other conditions that may be controlled or improved with the use of statins such as some cancers, bone health, diabetes, muscle diseases and more.
Staying active is a good thing, but the desire to move can be overwhelming for people with restless legs syndrome. Throbbing and other leg sensations cause the sufferer a strong desire to move around just to get relief.
About 1 in 20 people have restless legs syndrome. It is found mostly in women and more serious in those who are middle aged or older. Keeping the legs in motion helps, but this activity can be distracting and cause sleep loss.
“The cause of restless legs syndrome in most cases is unknown. Research shows that affected people often have too little or malfunctioning iron in the brain. Imaging studies show that people with restless legs syndrome have abnormalities in a movement-related brain region where dopamine is active.” According to a recent article published by NewsinHealth.Com.
The disorder appears to be genetic and currently there is no cure. Your doctor may prescribe medicine to control the symptoms.
Almost 10% of the population and three times more women than men suffer from migraine headaches. Although any head pain can be miserable, a migraine headache is often disabling. It is believed that even 50% of migraines are not diagnosed or mislabeled as tension or sinus-headache (which is rare according to experts). In some cases, migraines are preceded or accompanied by a sensory warning sign (aura), such as flashes of light, blind spots or tingling in your arm or leg. A migraine headache is also often accompanied by other signs and symptoms, such as nausea, vomiting, and extreme sensitivity to light and sound. Migraine pain can be excruciating and may incapacitate you for hours or even days. When left untreated, a migraine headache typically lasts from four to 72 hours, but the frequency with which they occur can vary from person to person. You may have migraines several times a month or just once a year.
Fortunately, management of migraine headache pain has improved dramatically in the last decade. If you’ve seen a doctor in the past and had no success, it’s time to make another appointment. Although there’s still no cure, specific life style adjustments and medications can help reduce the frequency of migraine headaches and stop the pain once it has started. Most important: You are the manager of your life and need to communicate with your doctor how to keep the migraine under control. If you ask your doctor about help with migraine and his answer is handing over a prescription, please look for another doctor. Initially medications may help, but without the right knowledge in using them they could quickly become counter effective.
Migraine headache symptoms in children
Migraines typically begin in childhood, adolescence or early adulthood and may become less frequent and intense as you grow older. Children as young as age 1 can have these headaches. In addition to physical suffering, severe headaches often mean missed school days and trips to the emergency room, as well as lost work time for anxious parents. Children’s migraines tend to last for a shorter time. But the pain can be disabling and can be accompanied by nausea, vomiting, lightheadedness and increased sensitivity to light. A migraine headache tends to occur on both sides of the head in children, and visual auras are rare. However, children often have premonition signs and symptoms, such as: · Yawning · Sleepiness or listlessness · A craving for foods such as chocolate, hot dogs, sugary snacks, yogurt and bananas
Migraine headache triggers. Migraine is a genetic neurological disease affecting the bloodvessels in the brain. Whatever the exact mechanism of migraines is, a number of things may trigger them. Common migraine headache triggers include: · Hormonal changes. Fluctuations in estrogen and progesterone seem to trigger headaches in many women with migraine headaches. Women with a history of migraines often have reported headaches immediately before or during their periods. Hormonal medications, such as contraceptives and hormone replacement therapy, also may worsen migraines but sometimes also give relief. · Foods. Certain foods appear to trigger headaches in some people. Common offenders include alcohol, especially beer and red wine; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; caffeine; monosodium glutamate — a key ingredient in some Asian foods. Skipping meals or fasting also can trigger migraines. · Stress. A period of hard work followed by relaxation may lead to a weekend migraine headache. Stress at work or home also can instigate migraines. · Sensory stimulus. Bright lights and sun glare can produce head pain. So can unusual smells — including pleasant scents, such as perfume and flowers, and unpleasant odors, such as paint thinner, secondhand smoke and my co-workers armpit. · Physical factors. Intense physical exertion, including sexual activity, may provoke migraines. Changes in sleep patterns — including too much or too little sleep — often initiate a migraine headache. It is important for migraineurs to keep a steady daily rhythm Triggers may not inevitably lead to migraine, often more triggers are needed to offset the brain i.e. lack of sleep, dehydration and alcohol. Although sensitive people might get migraine every time they drink a glass of red wine .
Management and Medical Advice
Migraines are a chronic disorder, but they’re often undiagnosed and untreated, often waived as incidental headaches. If you experience signs and symptoms of migraine, track and record your attacks and how you treated them including (or especially) the over the counter medication you took. Then make an appointment with your doctor to discuss your migraines and decide on a treatment plan.
· If you don’t have a treatment plan when a migraine headache strikes, try over-the-counter (OTC) medications such as ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve) or paracetamol, or other self-care measures for a day or two. Keep in mind that soluble formulations in a high starting dose often work the best and can be combined with i.e. domperidon or metoclopramide to promote absorption if the migraine is accompanied with nausea . If you don’t get relief, see your doctor.
Sometimes your efforts to control your pain cause problems. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) and aspirin, may cause side effects such as abdominal pain, bleeding and ulcers, especially if taken in large doses or for a long period of time. In addition, if you take over-the-counter (OTC) or prescription headache medications more than two or three times a week or in excessive amounts, you may be setting yourself up for a serious complication known as rebound headaches. Although these drugs can give you temporary relief, they not only stop relieving pain, but actually begin to cause headaches. You then use more pain medication, which traps you in a vicious cycle. If you’re caught in the rebound headache trap, talk to your doctor.
At one time, aspirin was almost the only available treatment for headaches. Now there are drugs specifically designed to treat migraines. Several drugs commonly used to treat other conditions also may help relieve migraines in some people. All of these medications fall into two classes:
· Pain-relieving medications. These stop pain once it has started. · Preventive medications. These reduce or prevent a migraine headache.
Pain-relieving medications For best results, take pain-relieving drugs as soon as you experience signs or symptoms of a migraine headache. It may help if you rest or sleep in a dark room after taking them:
· Nonsteroidal anti-inflammatory drugs (NSAIDs). (Ibuprofen, Naproxen, Diclofenac, others) may help relieve mild migraines. Drugs marketed specifically for migraine, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraines, but aren’t effective alone for severe migraines. Combination drugs are suspected to have a higher incidence of initiating medication induced (rebound) headache.
· Triptans. Sumatriptan (Imigran) was the first drug specifically developed to treat migraines. It mimics the action of serotonin by binding to serotonin receptors and causing blood vessels to constrict. Sumatriptan is available in oral, nasal and injection form. Injected sumatriptan works faster than any other migraine-specific medication — in as little as 15 minutes — and is effective in most cases. A number of similar drugs have become available, including rizatriptan (Maxalt), zolmitriptan (Zomig) and eletriptan (Relpax). Experience has shown that sometimes people have to try 3-5 different triptans before they find the one that suits them best. A look at the different durations of effect and relative strengths might be helpfull. Dispersable tablets (wafers) do not have a quicker onset of effect or additional advantage with nausea. In fact the highest concentration in the blood is reached even at a later time then with conventional tablets. Taking triptans during the aura has no effect and might reduce the effect due to earlier elimination. Taking them when the pain becomes unbearable has no use either, they will not work anymore.
· Ergots. Drugs such as ergotamine (cafergot) and dihydroergotamine help relieve pain. Due to the fact they have more side effects than triptans, they are less prescribed and reserved when the patient is resistant to other drug therapies. Most used is DHE as injectable.
· Medications for nausea. Metoclopramide (Primperan) or domperidon are useful for relieving the nausea and vomiting associated with migraines, not the migraine pain itself. It also improves gastric emptying, which leads to better absorption and more rapid action of many oral drugs. It’s most effective when taken early in the course of your migraine or even during the aura before your headache begins. Morfine like medications like vicodin, oxycodone etc. are very effective painkillers as long as they last. Due to their highly addictive properties, drug dependency and weaning of effect they should be avoided for treatment of headaches.
Preventive medications can reduce the frequency, severity and length of migraines and may increase the effectiveness of pain-relieving medicines used during migraine attacks. In most cases, preventive medications don’t eliminate headaches completely, and some can have serious side effects. They are considered an option with more than 2 attacks per month.
· Cardiovascular drugs. Beta blockers — which are commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines. These drugs are considered among first-line treatment agents. Calcium channel blockers and certain RAAS drugs (atacand) are also used. Consider these medication as choice if you suffer from high bloodpressure as well.
· Antidepressants. Certain antidepressants are good at helping prevent several types of headaches, including migraines. Most effective are tricyclic antidepressants, such as amitriptyline, taken in low dosage at night) Newer antidepressants (SRNI’s), however, generally aren’t as effective for migraine prevention. Effect has been measured with ie venlafaxine. In some people these drugs may cause headaches.
· Anti-seizure drugs. Some anti-seizure drugs, such as valproic acid (Depakin) and topiramate (Topamax), which are used to treat epilepsy and bipolar disease, seem to prevent migraines. Gabapentin (Neurontin), another anti-seizure medication, is considered a second-line treatment agent. They might stabilize the nerve cells that trigger migraines.
· Cyproheptadine. This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure. Preventive medications are normally tried when suffering more then 2 x monthly from migraines. It may take 3 month of slowly increasing dosage before the effect can be evaluated.
Whether or not you take preventive medications, you may benefit from lifestyle changes that can help reduce the number and severity of migraines. One or more of these suggestions may be helpful for you:
· Avoid triggers. If certain foods seem to have triggered your headaches in the past, eat something else. If certain scents are a problem, try to avoid them. In general, try to establish a daily routine with regular sleep patterns and regular meals. To detect triggers it is important to keep a daily diary in which you keep note of daily life events and medications taken and effect on possible migraine as well. Most smartphones have apps for migraine diaries.
· Exercise regularly. Regular aerobic exercise reduces tension and can help prevent migraines. If your doctor agrees, choose any aerobic exercise you enjoy, including walking, swimming and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches.
· Reduce the effects of estrogen. If you’re a woman with migraines and estrogen seems to trigger or make your headaches worse, or if you have a family history of stroke or high blood pressure, you may want to avoid or reduce the amount of medications you take that contain estrogen. These medications include birth control pills and hormone replacement therapy. Women that experience migraines during the stopweek might consider continuous treatment. Talk with your doctor about the best alternatives or dosages for you.
· Quit smoking. If you smoke, talk to your doctor about quitting. Smoking can trigger headaches or make headaches worse.
· Supplements to consider. Additional Vitamin B2 (riboflavin) Magnesium and CoQ10 , have shown effect in several studies
· Relaxation techniques, massage, physical therapy, yoga etc. can all have a beneficial effect.
A Diary is important to evaluate if you use your medication the right way. The right time, dosage form, rate of effectiveness and if you are not using to much or maybe to less. It is also important to identify possible triggers for the migraine. A 2 month period of recording would give your doctor (and yourself) a good assessment tool.
Lifestyle is important, taking the right medications is also important. Worrying on dietary triggers is less important. It will probably take several months to get the combinations right of type and dosage. This may count for preventive and relieve medication.
Keep in mind to limit the amount of painkillers and triptans to 2-3 days per week. If not you might see a tendency of increase in the frequency of headaches and related an increase in medicine consumption and before you know it you are in a vicious circle of medication dependent headaches. You can always improve ! Do not hesitate to ask for help.
For teenagers acne is the worst four letter word. I remember looking horrified into the mirror before going to school, or worse a party, noticing a pimple on the chin or nose. Trying to make it go away ended mostly with a doublesized, glazing red one instead.
Acne is caused by inflammation of the oil glands in the skin and at the base of strands of hair. In the teenage years, hormones stimulate the growth of body hair, and the oil glands secrete more oil (sebum).
The skin pores become clogged with shedding cells and bacteria called Propionibacterium acnes (P. acnes ) growing in the clogged pores. When the body works to destroy the bacteria, the resulting inflammation forms whiteheads and blackheads in these areas. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Nearly 17 million people in the United States have acne, making it the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring, permanent scarring, which can be upsetting for people who suffer from the disorder.
The symptoms of acne are:
pimples, some filled with puss
Other troublesome acne lesions can develop, including the following:
Papules—inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
Pustules (pimples) — inflamed, pus-filled lesions that can be red at the base
Nodules—large, painful, solid lesions that are lodged deep within the skin
Cysts—deep, inflamed, pus-filled lesions that can cause pain and scarring
These skin eruptions may be painful. In severe cases, cysts (fluid-filled bumps larger than pimples) may develop under the skin.
What causes my acne?
Although cleaning the skin is a first step in controlling acne, a dirty skin is not the cause of acne. This is one of many myths blamed for originating acne. Also foods like chocolate, pig meat or French fries are not a cause of acne. You might notice a flare up but the relation is different as it might be a mild allergy to an ingredient or it might be the stress your body gets from a unbalanced diet. Fruits and vegetables are the main components to a healthy diet and thus create a balance in your body and as such will have a positive effect on acne. Other important stress factors can be school (nothing new here) and lack of sleep. Stick to a regular 8 hour sleep a night rhythm and sleep away your acne (or keep it under control).
Sexual frustration is also not a cause of acne, although it seems to be a popular myth.
The main cause is hereditary, if it is in the genes of your mom and dad you already have a 80% chance of getting it as well. Nothing you can change about that but at least: It ain’t your fault !
Because the actual process is hormonal (testosterone) related, boys will have a worse outbreak in their teens than girls. Adult women have relatively more problems in their post teens, related with their menstrual cycle or due to the use of hormonal birthcontrol.
How to treat acne.
First of all you should review the soaps and lotions you are using as well as make-up you might use. Oily makeup will probably aggravate your condition by blocking up the pores more. In a pharmacy or cosmetic center you might get advice which ones not to use. Harsh soaps have usually a negative effect on your skin because they tend to wash away your natural fatty acids who work as your skin’s disinfectant which might cause easier growth of bacteria, contrary to the effect you are expecting!
Use “Non-soap” soaps, preferably with a acidy pH i.e. like sebamed, sanex or dove.
Several products may be used to help prevent pimples or blackheads. Treatment usually begins with putting products containing benzoyl peroxide on the areas of skin with acne. Benzoylperoxide will enter the pore and kill the bacteria inside. It also opens up the pore. The strength is not very important, however starting with the lower 5% will give less irritation to the skin. Pharmacies will have a gel for sale that is economic and can be used either as a wash or left on the skin overnight. If benzoyl peroxide alone is not effective, your doctor may prescribe antibiotics to be taken by mouth or a antibiotic lotion to put on your skin. You may also need to use a skin cream or gel containing tretinoin (Retin-A, Locacid). Tretinoin is a vitamin a derivative that peels off the old skin while stimulating growth of new cells. Their action might cause a worsening of your condition at first making your skin red and irritated. The best way is to start these creams carefully like every other day before using them daily.
They should be applied at night because they are unstable to sunlight. Other modern “peeling” creams are the those that contain alpha hydroxy acids. They are found in most anti-wrinkle creams.
An oral vitamin A derivative called isotretinoin (RoAccutane) is available for severe acne. However, isotretinoin must be used very carefully because it causes birth defects in babies born to mothers who become pregnant while they are taking the drug or who have taken it several months before becoming pregnant. Sometimes a dermatologist might even use corticosteroids to prevent scarring.
Women can also take certain birthcontrol pills that will counteract the effect of testosterone and therefore dimishing acne.
How long will the effects last?
New whiteheads usually stop appearing after 4 to 6 weeks of treatment, but usually you will need to continue the treatment at least 6 to 8 weeks. Controlling treatment might be needed until you “grow over it”.If you are taking antibiotics, at some point your doctor will ask you to stop taking them to see if they are still necessary.
Many factors may make acne worsen temporarily. Thus, even if you are receiving the proper treatment, results may vary over time. Try to discover and change, when possible, the factors in your environment or lifestyle that make the acne worse.
How can I take care of myself?
Follow the full treatment prescribed by your doctor.
In addition you can:
Wash your face two times a day with a gentle soap.
Wash your hands more frequently and avoid putting your fingers and hands to your face unnecessarily. Don’t squeeze, pick, scratch, or rub your skin. Scars may form if you squeeze pimples, however a beautician may expell blackheads with a special tool to avoid any contamination.
Don’t rest your face on your hands while you read, study, or watch TV.
Watch out wearing backpacks or headbands for a long time, the pressure on your skin can cause pimples to form, pressing weights while lying on your shoulders may have the same effect.
Avoid working in hot kitchens where greasy foods are cooked.
Avoid getting sunburned.
Avoid extreme stress if possible. Practice stress reduction strategies such as exercise, meditation, and counseling if stress is extreme.
The key to understanding blood sugar control is to understand the role played by special cells in your pancreas, called Beta-Cells. These tiny cells are scattered throughout your pancreas and their job is to produce insulin, store it, and release it into the blood stream at appropriate times.
The beta-cells of a healthy person who has not eaten in a while release a small amount of insulin into the blood stream throughout the day and night in the form of very small pulses every few minutes. This is called “basal insulin release.“
Maintaining this steady supply of insulin is important. It allows the cells of the body to utilize blood sugar even if some time has passed since a meal.
The steady insulin level as another function, too. A dropping insulin level signals the liver that blood sugar is getting low and that it is time to add more glucose. When this happens, the liver converts the carbohydrate it has stored, (known as glycogen) into glucose, and dumps it into the blood stream. This raises the blood sugar back to its normal level.
Regular functioning of insulin
When a healthy person starts to eat a meal, the beta-cells kick into high gear. Their stored insulin is released immediately. Then, if the blood sugar concentration rises over 100 mg/dl, (5.5 mmol/L) the beta-cells start secreting more insulin into the blood stream. This early release of stored insulin after a meal is called “First Phase Insulin Release.” In a healthy person it keeps the blood sugar from rising to very high levels because it is available to meet most of the glucose that comes from the digestion of the current meal. After completing the first phase insulin release, the beta-cells pause. Then, if blood sugar is still not back under 100 mg/dl (5.5 mmol/L), they push out another, smaller second phase insulin response which takes effect about an hour after the meal and, in a healthy person, brings the blood sugar back down to its starting level, usually by two hours after the start of a meal.
It is this combination of a robust first phase insulin response followed by a functional second phase insulin response that keeps the blood sugar of a normal person from ever rising over 140 mg/dl(7.8 mmol/L) even after a high carbohydrate meal.
When first phase release fails, or when second phase insulin response is sluggish, blood sugars start to rise to higher levels after a meal and take longer to return to normal. This condition is called “impaired glucose tolerance.” If the blood sugar rises over 200 mg/dl (11 mmol/L) after a meal the same condition is called “Diabetes.”
First and second phase insulin release may fail to do their jobs for several reasons. The most common is a condition called insulin resistance in which some receptors in the liver and the muscle cells stop responding properly to insulin. This means that though there is lots of insulin circulating in the body, the muscles and liver (but not, alas, the fat cells) don’t respond until the insulin levels rise much higher.
So when a person’s cells become insulin resistant, it will take a lot more insulin than usual to push circulating glucose into cells. Eventually the body may not be able to produce enough insulin to clear all the dietary carbohydrate from the bloodstream and blood sugars will rise to abnormal levels.
If your beta-cells are normal, and if insulin resistance at the muscles and liver is your only problem, over time you may be able to grow new pancreas islets filled with new beta-cells that can store even more insulin for use in first and second phase insulin response. In this case, though your blood sugar may continue to rise into the impaired range and take longer than normal to go back down to normal levels, your blood sugar response may never deteriorate past the impaired glucose tolerance stage to full-fledged diabetes. This is what happens to most people who have what is called “Metabolic Syndrome.” Unfortunately, if you have impaired glucose tolerance, there is no way of knowing if you fall into this group or if your rising blood sugars are caused by failing or dying beta-cells.
First phase insulin release also fails because beta-cells are dysfunctional or dying. This can happen along with insulin resistance, or without it. Studies have found that some thin, non-insulin resistant relatives of people with Type 2 Diabetes already show signs of beta cell dysfunction.
If beta-cells are dying or not working properly. The remaining beta-cells may be working full-time just to keep up with the need for a basal insulin release so they can’t store any excess in those granules for later release.
Scientists have discovered dozens of different genetic defects which cause beta-cells to fail or die in humans and animals. This means that one person’s Type 2 Diabetes can behave quite differently from that of another person, depending on what exactly is broken in their blood sugar control system. This is why drugs that work well for one person may do little for another person.
Whatever the reason for the failing first phase insulin release there’s an ugly feedback mechanism that kicks in when blood sugar levels rise because of that failing first phase insulin release: High levels of circulating glucose themselves are toxic to beta-cells, a phenomenon called “glucose toxicity”. So as blood sugars rise these high blood sugar concentrations further damage and or kill more beta-cells, making insulin release even less able to control blood sugar concentrations.
When first phase insulin release is weak or missing your blood sugar may easily rise over the 200 mg/dl (11 mmol/L) level currently defined as “diabetes.”
At that point, two bad things happen. When the concentration of glucose in your blood reaches 200 mg/dl (11 mmol/L) your cells become insulin resistant even if they weren’t insulin resistant before, so it takes a lot more insulin to lower your blood sugar from that point on.
And, even worse, the lack of a robust insulin response to the rising glucose may erroneously be interpreted by your liver as a sign that blood sugar is too low and that it is time to dump more glucose into the bloodstream. So in addition to the glucose coming in from your recent meal you also have to contend with additional glucose dumped by your poor old confused liver.
As you become more diabetic, and your second phase insulin response grows weaker, it may take four or five hours for your beta-cells to secrete enough insulin to bring your blood sugar level down to its fasting level. And, in fact, during the day your blood sugar may never get back to its fasting level because the glucose coming in from your next meal comes into the bloodstream before the glucose from the previous meal has completely cleared. Only at night, while you are sleeping, may your beta-cells finally secrete enough insulin to get your blood sugar down low enough that you wake up with a normal fasting blood sugar.
However, since it took all the insulin your beta-cells could make to get back to that normal blood sugar and they will have had no chance to store any extra insulin to take care of your breakfast. As soon as you throw that morning bagel down the hatch, blood glucose will rise, and once again your beta-cells will have to spend many hours trying to bring it back down.
Eventually, even the long hours of the night will not be enough time for your beta-cells to produce enough insulin to bring your blood sugar back to normal, and now, perhaps a decade after you achieved diabetic post-meal numbers, you will finally start seeing diabetic fasting blood sugar levels.
image – exploding-diabetes
This process explains why for many people who become diabetic–particularly middle-aged women, the fasting blood sugar level is the very last measurement to become abnormal. Only when a whole night isn’t long enough for your beta-cells to bring your blood sugar back down to normal or near-normal levels will you become diabetic by a fasting blood sugar test. That is why lately more emphasis is put on the measurement and control of post meal sugar control. It has been calculated that less then 40% of the people that have a fpg <120 and HbA1C of 7 have post meal glucose <200mg/dl. This is a scary statistic considering the amount of diabetics that have worse data and consider themselves under good control!
People whose fasting blood sugar numbers have risen along with their post-meal numbers have generally lost more beta-cell function than those who still maintain normal or near-normal fasting blood sugars. This is why as soon as you discover that your post-meal blood sugars are rising beyond a normal level, it is so important to start controlling those abnormal post-meal blood sugars immediately. By doing so, you may be able to lower any insulin resistance, preserve your remaining beta-cells and keep your fasting blood sugar from ever deteriorating.
Even after you have been diagnosed as having a type 2 diabetic fasting plasma glucose, you may still have a good number of beta-cells left–anywhere from 40 to 60%. If you can reduce your insulin resistance through weight loss, exercise, and the use of drugs that counter insulin resistance, and if you keep your carb intake low to avoid blood sugar spiking, those cells may be able to produce enough insulin to control your blood sugar.
Even more important, if you keep your blood sugar under the damage-limit of 140 mg/dl (7.8 mmol/L) at all times, you may be able to keep glucotoxicity from murdering the rest of those cells.
Some studies mostly in cell-cultures and animal models have demonstrated that giving stressed beta-cells a rest can sometimes restore function. A few studies suggest this can also be done in humans.
One way of “resting” beta-cells is to use injected insulin as soon as type 2 diabetes is diagnosed, particularly if your blood sugars are very high at the time of diagnosis. If you take the burden off your beta-cells by supplementing insulin, there’s some suggestion that they may recover some of their ability to produce insulin later on so that you can go off insulin and retain much better control. You’ll still have to limit carbs and address any problems you have with insulin resistance through weight loss, exercise, and insulin-sensitizing drugs. But you’ll have an easier time doing it.
Every Tuesday and Thursday from 10 a.m. till noon, you can come to the Philipsburg Pharmacy for a free Diabetes and Blood-pressure check-up.
To understand how diabetes leads to Erectile Dysfunction (ED), you first have to understand how erections work. Getting an erection is really a complicated process.
Anatomy of an Erection
In the shaft of the penis there are two side-by-side chambers of spongy tissue called the corpora cavernosa. They’re mainly responsible for erections. Just below them is another chamber called the corpus spongiosum. The urethra, which carries semen and urine, runs through the center of it.
The corpora cavernosa are made of small arteries and veins, smooth muscle fiber, and empty spaces. The chambers are wrapped in a sheath of thin tissue.
When you get an erection, nerve signals from your brain or from the nerve endings in your penis cause the smooth muscle of the chambers to relax and arteries to dilate, or open wider. This allows a rush of blood to fill the empty spaces.
The pressure of blood flow causes the sheath of tissue around the chambers to press on veins that normally drain blood out of the penis. That traps blood in the penis. As more blood flows in, the penis expands and stiffens, and you have an erection.
When the excitement ends, the smooth muscle contracts again, taking pressure off the veins and allowing blood to flow back out of the penis.
Diabetes: A Perfect Storm for Erectile Dysfunction
Many common problems related to diabetes all come together to cause erectile dysfunction. That’s why various studies show that 35% to 75% of men with diabetes will develop some degree of erectile dysfunction. If you are having difficulty getting erections, there may be a number of things going on in your body.
Nitric oxide is a chemical released into the bloodstream by the lining of blood vessels. It acts as a kind of chemical messenger that tells the smooth muscles and arteries in the penis to relax and let in blood.
High blood sugar, which must be managed carefully if you have diabetes, causes blood vessel and nerve damage that affects many processes in the body. Sexual response is one of them. Damage to the blood vessels blocks the release of nitric oxide. A lack of nitric oxide results in constricted blood vessels and reduces blood flow to the penis.
What’s more, according to the American Diabetes Association, 73% of adults with diabetes have high blood pressure or take blood pressure medication. The combination of high blood pressure and diabetes also increases the risk for blood vessel damage, further reducing blood flow.
High cholesterol is also common in people with diabetes. LDL cholesterol, or what’s called “bad” cholesterol, can interfere with the ability of blood vessels to dilate. High cholesterol levels result in fatty deposits in artery walls. This buildup of fatty deposit can reduce blood flow.
Some of the choices that men with diabetes make also feed into this “perfect storm.” Smoking, especially. Smoking by itself reduces blood flow all through the body.
Last but not least, feeling badly about your health can lead to erectile dysfunction. For most men, erectile dysfunction is mainly a physical problem, but the mind always plays some part in sexual arousal.
Although having diabetes means that you may encounter problems with your sexual functioning, you really can turn it around. By living a healthy lifestyle and working with your doctor, you can get your diabetes under control and treat erectile dysfunction if it becomes a problem for you.
If you have diabetes and it has caused erectile dysfunction (ED), you still have every reason to be optimistic about the future and a healthy sex life. There are many proven treatments you can try.
A doctor’s first choice for treating erectile dysfunction is usually one of the pills called PDE5 inhibitors. First there was Viagra. Now there’s also Levitra and Cialis. All three drugs work in similar ways. They don’t increase sexual desire. They make it physically possible to get an erection when you are aroused.
No one of them has been proven to work better than the others, although there can be a different individual response. But the time they take to start working and the duration of their effects vary. That’s something you may want to consider based on your sexual habits. For example, does spontaneity matter to you, or do you usually plan sex ahead of time?
Viagra starts working in about 15 to 30 minutes and its effects last about four hours. Levitra starts working in about 30 to 60 minutes and lasts four to five hours. Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours. Take note that Viagra is most affected by slow absorption if you take it after a meal.
These drugs are not good for every man. Men who take nitrate drugs for chest pain or alpha blockers for high blood pressure or prostate problems shouldn’t take Cialis, Levitra or Viagra. Other reasons why you may not be able to take these drugs include:
High blood pressure that isn’t under control
Very low blood pressure
A heart attack or stroke in the past six months
Kidney or liver disease
Retinitis pigmentosa (an eye disease)
Other Treatments for Erectile Dysfunction
If erectile dysfunction pills are out of the question, or if they haven’t worked for you, don’t worry. There are other good options.
Alprostadil is another drug for erectile dysfunction. However, it’s not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis, allowing blood to fill the spongy tissue that makes the penis erect.
Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erection problems. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.
Next, you may want to try a vacuum device, or “penis pump.” This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.
You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It’s safe to keep the band on for up to 30 minutes.
Alternative Treatments for Erectile Dysfunction
Currently, no herb or supplements have been proven to help with erectile dysfunction. Herbs and supplements that some people believe are helpful include:
Horny goat weed
Before trying any alternative treatment, be sure to ask your doctor about it first. Herbs and supplements, whether they help with erectile dysfunction or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking.
Every Tuesday and Thursday from 10 a.m. till noon, you can come to the Philipsburg Pharmacy for a free Diabetes and Blood-pressure check-up.