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Saturday, October 25, 2008

Wild Yam Relieves Menstrual Cramps and Morning Sickness

Overview:

In the 18th and 19th centuries, wild yam (Dioscorea villosa ) was used by herbalists to treat menstrual cramps and problems related to childbirth, as well as for stomach upset and coughs. In the 1950s, scientists discovered that the roots of wild yam (not to be confused with the sweet potato yam) contain diosgenin, a phyto (derived from plants) estrogen that can be chemically converted into progesterone, a hormone. Diosgenin was used to make the first birth control pills in the 1960s.

Although wild yam continues to be used for treating menstrual cramps, nausea, and morning sickness associated with pregnancy, inflammation, osteoporosis, menopausal symptoms, and other health conditions, there is no evidence that it works. Indeed, several studies have found that it has no effect at all. That is because the body cannot change diosgenin into progesterone; it has to be done in a lab. Wild yam, by itself, does not contain progesterone.

General

Early Americans used wild yam to treat colic; another name for the plant is colic root. Traditionally, it has been used to treat inflammation, muscle spasms, and a range of disorders, including asthma. However, there is no scientific evidence that it works.

Menopause and Osteoporosis

Although wild yam is often touted as a natural source of estrogen, there is essentially no scientific evidence of wild yam's effectiveness in treating menopausal symptoms or osteoporosis. In fact, several studies have found that wild yam does not reduce the symptoms of menopause (such as hot flashes) or increase levels of estrogen or progesterone in the body. Some preparations of wild yam may contain progesterone, but only because a synthetic version of progesterone (medroxyprogesterone acetate or MPA) has been added to the herb.

High Cholesterol

Researchers have theorized that taking wild yam may help reduce levels of cholesterol in the blood, although studies have shown mixed results. Diosgenin seems to block the body from absorbing cholesterol, at least in animal studies. But in studies of people, cholesterol levels have not gone down (although fats -- triglycerides -- in the blood have decreased). More research is needed to say whether wild yam is beneficial for people with high cholesterol.

Plant Description:

Also known as colic root, wild yam is a twining, tuberous vine. One species is native to North America; another is native to China. Both contain diosgenin and have similar medicinal properties. There are an estimated 600 species of yam in the genus Dioscorea, many of them wild species that flourish in damp woodlands and thickets, and not all contain diosgenin. Wild yam is a perennial vine with pale brown, knotty, woody cylindrical rootstocks, or tubers. Unlike sweet potato yams, the roots are not fleshy. Instead they are dry, narrow, and crooked, and bear horizontal branches of long creeping runners. The thin reddish-brown stems grow to a length of over 30 feet. The roots initially taste starchy, but soon after taste bitter and acrid.

The wild yam plant has clusters of small, greenish-white and greenish-yellow flowers. The heart-shaped leaves are long and broad and long-stemmed. The upper surface of the leaves is smooth while the underside is downy.

What's it Made of?:

The dried root, or rhizome, is used in commercial preparations. It contains diosgenin, a phytoestrogen that can be chemically converted to the hormone progesterone; however, diosgenin on its own does not seem to act like estrogen in the body.

Available Forms:

Wild yam is available as liquid extract and as a powder. The powdered form may be purchased in capsules or compressed tablets. The fluid extract can be made into tea. Creams containing wild yam are also available.

How to Take It:

Pediatric

It is not known whether wild yam is safe for pediatric use, so it should not be given to children.

Adult

The following are recommended adult doses for wild yam:

  • Dried herb to make tea: 1 - 2 tsp dried root to 1 cup water. Pour boiling water over dried root, steep 3 - 5 minutes. Drink three times a day
  • Tincture: 40 - 120 drops, three times a day
  • Fluid extract: 10 - 40 drops, three to four times per day
  • Creams: Contain 12% of wild yam extract; use as directed

Note: Wild yam is often combined with other herbs said to have estrogen-like effects, such as black cohosh. Creams containing wild yam, as well as tablets and powders, may contain synthetic hormones. Check the ingredients carefully.

Precautions:

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care practitioner.

Although it does not appear to have hormone-like effects in the body, there is a slight risk that wild yam could produce effects similar to estrogen. Because of that risk, anyone with a personal or family history of hormone-related cancer should check with their doctor before using any form of "natural” hormone replacement, including wild yam.

Pregnant women and nursing mothers should avoid wild yam.

Possible Interactions:

If you are currently being treated with any of the following medications, you should not use wild yam without first talking to your healthcare provider.

Hormone Replacement Therapy or Birth Control Pills -- An animal study indicated that the active component of wild yam, diosgenin, may interact with estradiol, a hormone that occurs naturally in the body and also is used in some birth control medications and certain hormone replacement therapies.

Alternative Names:

Dioscorea villosa

  • Reviewed last on: 6/15/2007
  • Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

Supporting Research

Accatino L, Pizarro M, Solis N, Koenig C. Effects of diosgenin, a plant derived steroid, on bile secretion and hepatocellular cholestasis induced by estrogens in the rat. Hepatology. 1998;28(1):129-140.

Boban PT, Nambisan B, Sudhakaran PR. Hypolipidaemic effect of chemically different mucilages in rats: a comparative study. Br J Nutr. 2006 Dec;96(6):1021-9.

Bone K, Mill S, eds. Principles and Practices of Phytotherapy, Modern Herbal Medicine. London: Churchill Livingstone; 2000.

British Herbal Pharmacopoeia. 4th ed. Great Britain: Biddles Ltd, Guildford and King's Lynn; 1996:187.

Carroll DG. Nonhormonal therapies for hot flashes in menopause. Am Fam Physician. 2006 Feb 1;73(3):457-64. Review.

Chang WC, Yu YM, Wu CH, Tseng YH, Wu KY. Reduction of oxidative stress and atherosclerosis in hyperlipidemic rabbits by Dioscorea rhizome. Can J Physiol Pharmacol. 2005 May;83(5):423-30.

Foster S, Tyler VE. Tyler's Honest Herbal. Binghamton, NY: The Haworth Herbal Press; 2000:381-382.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company; 2000:817-818.

Komesaroff PA, Black CV, Cable V, Sudhir K. Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women. Climacteric. 2001;4(2):144-150.

Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press;1999:187-188.

Taylor M. Alternatives to conventional hormone replacement therapy. Compr Ther. 1997;23(8):514-532.

Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices.Proc Soc Exp Biol Med. 1998;217:369-378.


SOURCE:

University of Maryland Medical Center

Wild Yam Root

Wild Yam Root (Dioscorea villosa) is a species of a twining tuberous vine that is native to and found growing wild in North America. Its fame is based on its steroid-like saponins which can be chemically converted to progesterone contraceptives; and cortisone.

Wild Yam is believed to be helpful to the liver and endocrine system. It regulates the female system, particularly during menstrual distress and menopause,as well as used in treating infertility. Used with chaste berry and dandelion it is an effective treatment for morning sickness.
Usually found wild in the eastern half of North America, it is a perennial plant that is a low creeper, and occupies average to poor soils and full sun.

It has been hypothesized that wild yam (Dioscorea villosa and other Dioscorea species) possesses dehydroepiandrosterone (DHEA)-like properties and acts as a precursor to human sex hormones such as estrogen and progesterone. Based on this proposed mechanism, extracts of the plant have been used to treat painful menstruation, hot flashes, and headaches associated with menopause. However, these uses are based on a misconception that wild yam contains hormones or hormonal precursors - largely due to the historical fact that progesterone, androgens, and cortisone were chemically manufactured from Mexican wild yam in the 1960s.

It is unlikely that this chemical conversion to progesterone occurs in the human body. The hormonal activity of some topical wild yam preparations has been attributed to adulteration with synthetic progesterone by manufacturers, although there is limited evidence in this area.


The effects of the wild yam saponin constituent "diosgenin" on lipid metabolism are well documented in animal models and are possibly due to impaired intestinal cholesterol absorption. However, its purported hypocholesterolemic effect in humans and the feasibility of long-term use warrant further investigation.


There are few reported contra-indications to the use of wild yam in adults. However, there are no reliable safety or toxicity studies during pregnancy, lactation, or childhood.

SOURCE: Wikipedia

Monday, October 13, 2008

How To Remedy Urinary Tract Infections in Adults?

Introduction

Urinary tract infections are a serious health problem affecting millions of people each year.

Infections of the urinary tract are the second most common type of infection in the body. Urinary tract infections (UTIs) account for about 8.3 million doctor visits each year. Women are especially prone to UTIs for reasons that are not yet well understood. One woman in five develops a UTI during her

 lifetime. UTIs in men are not as common as in women but can be very serious when they do occur.

The urinary system consists of the kidneys, ureters, bladder, and urethra. The key elements in the system are the kidneys, a pair of purplish-brown organs located below the ribs toward the middle of the back.

The kidneys remove excess liquid and wastes from the blood in the form of urine, keep a stable balance of salts and other substances in the blood, and produce a hormone that aids the formation of red blood cells. Narrow tubes called ureters carry urine from the kidneys to the bladder, a sack-like organ in the lower abdomen. Urine is stored in the bladder and emptied through the urethra.

The average adult passes about a quart and a half of urine each day. The amount of urine varies, depending on the fluids and foods a person consumes. The volume formed at night is about half that formed in the daytime.

The Urinary System and How It Works


What are the causes of UTI? 

Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from thebladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.

In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. An infection limited to the urethra is called urethritis. If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis.

Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coliChlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.

The urinary system is structured in a way that helps ward off infection. The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur.

Who is at risk?

Some people are more prone to getting a UTI than others. Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection.

A common source of infection is catheters, or tubes, placed in the urethra and bladder. A person who cannot void or who is unconscious or critically ill often needs a catheter that stays in place for a long time.

Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter clean and remove it as soon as possible.

People with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection.

UTIs may occur in infants, both boys and girls, who are born with abnormalities of the urinary tract, which sometimes need to be corrected with surgery. UTIs are more rare in boys and young men. In adult women, though, the rate of UTIs gradually increases with age.

Scientists are not sure why women have more urinary infections than men. One factor may be that a woman's urethra is short, allowing bacteria quick access to the bladder.

Also, a woman's urethral opening is near sources of bacteria from the anus and vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.

According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.

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Recurrent infections

Many women suffer from frequent UTIs. Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another. Of the last group, 80 percent will have recurrences.

Usually, the latest infection stems from a strain or type of bacteria that is different from the infection before it, indicating a separate infection. Even when several UTIs in a row are due to E. coli, slight differences in the bacteria indicate distinct infections.

Research funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent UTIs may be the ability of bacteria to attach to cells lining the urinary tract.

A recent NIH-funded study found that bacteria formed a protective film on the inner lining of the bladder in mice. If a similar process can be demonstrated in humans, the discovery may lead to new treatments to prevent recurrent UT

Is. Another line of research has indicated that women who are "non-secretors" of certain blood group antigens may be more prone to recurrent UTIs because the cells lining the vagina and urethra may allow bacteria to attach more easily.

Further research will show whether this association is sound and proves useful in identifying women at high risk for UTIs.

Infections in pregnancy

Pregnant women seem no more prone to UTIs than other women.  However, when a UTI does occur in a pregnant woman, it is more likely to travel to the kidneys.  According to some reports, about 2 to 4 percent of pregnant women develop a urinary infection.

Scientists think that hormonal changes and shifts in the position of the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For this reason, many doctors recommend periodic testing of urine during pregnancy.

What are the symptoms of UTI?

Not everyone with a UTI has symptoms, but most people get at least some symptoms. These may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over -- tired, shaky, washedout -- and to feel pain even when not urinating.

Often women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. It is common for a person with a urinary infection to complain that, despite the urge to urinate, only a small amount of urine is passed. The urine itself may look milky or cloudy, even reddish if blood is present.

Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

In children, symptoms of a urinary infection may be overlooked or attributed to another disorder. A UTI should be considered when a child or infant seems irritable, is not eating normally, has an unexplained fever that does not go away, has incontinence or loose bowels, or is not thriving.

Unlike adults, children are more likely to have fever and no other symptoms.  This can happen to both boys and girls.  The child should be seen by a doctor if there are any questions about these symptoms, especially a change in the child's urinary pattern.

How is a UTI diagnosed?

To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. You will be asked to give a "clean catch" urine sample by washing the genital area and collecting a "midstream" sample of urine in a sterile container.

This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results. Usually, the sample is sent to a laboratory, although some doctors' offices are equipped to do the testing.

In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria. This last step is called a sensitivity test.

Some microbes, like Chlamydia and Mycoplasma, can be detected only with special bacterial cultures. A doctor suspects one of these infections when a person has symptoms of a UTI and pus in the urine, but a standard culture fails to grow any bacteria.

When an infection does not clear up with treatment and is traced to the same strain of bacteria, the doctor may order some tests to determine if your system is normal.

One of these tests is an intravenous pyelogram, which gives x-ray images of the bladder, kidneys, and ureters. An opaque dye visible on x-ray film is injected into a vein, and a series of x-rays is taken. The film shows an outline of the urinary tract, revealing even small changes in the structure of the tract.

If you have recurrent infections, your doctor also may recommend an ultrasound exam, which gives pictures from the echo patterns of soundwaves bounced back from internal organs. Another useful test is cystoscopy. A cystoscope is an instrument made of a hollow tube with several lenses and a light source, which allows the doctor to see inside the bladder from the urethra.

How is UTI treated?

UTIs are treated with antibacterial drugs. The choice of drug and length of treatment depend on the patient's history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug.

The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Still, many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured.

Single-dose treatment is not recommended for some groups of patients, for example, those who have delayed treatment or have signs of a kidney infection, patients with diabetes or structural abnormalities, or men who have prostate infections.

Longer treatment is also needed by patients with infections caused by Mycoplasma orChlamydia, which are usually treated with tetracycline, trimethoprim/sulfamethoxazole (TMP/SMZ), or doxycycline. A followup urinalysis helps to confirm that the urinary tract is infection-free. It is important to take the full course of treatment because symptoms may disappear before the infection is fully cleared.

Severely ill patients with kidney infections may be hospitalized until they can take fluids and needed drugs on their own. Kidney infections generally require several weeks of antibiotic treatment. Researchers at the University of Washington found that 2-week therapy with TMP/SMZ was as effective as 6 weeks of treatment with the same drug in women with kidney infections that did not involve an obstruction or nervous system disorder. In such cases, kidney infections rarely lead to kidney damage or kidney failure unless they go untreated.

Various drugs are available to relieve the pain of a UTI. A heating pad may also help. Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. During treatment, it is best to avoid coffee, alcohol, and spicy foods. And one of the best things a smoker can do for his or her bladder is to quit smoking. Smoking is the major known cause of bladder cancer.

Recurrent infections in women

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can ask her doctor about one of the following treatment options:

  • Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective. NIH-supported research at the University of Washington has shown this therapy to be effective without causing serious side effects.

  • Take a single dose of an antibiotic after sexual intercourse.

  • Take a short course (1 or 2 days) of antibiotics when symptoms appear.

Dipsticks that change color when an infection is present are now available without a prescription. The strips detect nitrite, which is formed when bacteria change nitrate in the urine to nitrite. The test can detect about 90 percent of UTIs when used with the first morning urine specimen and may be useful for women who have recurrent infections.

Doctors suggest some additional steps that a woman can take on her own to avoid an infection:

  • Drink plenty of water every day.
  • Urinate when you feel the need; don't resist the urge to urinate.

  • Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.

  • Take showers instead of tub baths.

  • Cleanse the genital area before sexual intercourse.

  • Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.

Some doctors suggest drinking cranberry juice.

Infections in pregnancy

A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her baby and other risks such as high blood pressure. Some antibiotics are not safe to take during pregnancy. In selecting the best treatments, doctors consider various factors such as the drug's effectiveness, the stage of pregnancy, the mother's health, and potential effects on the fetus.

Complicated infections

Curing infections that stem from a urinary obstruction or other systemic disorders depends on finding and correcting the underlying problem, sometimes with surgery. If the root cause goes untreated, this group of patients is at risk of kidney damage. Also, such infections tend to arise from a wider range of bacteria, and sometimes from more than one type of bacteria at a time.

Infections in men

UTIs in men are often a result of an obstruction -- for example, a urinary stone or enlargedprostate -- or from a medical procedure involving a catheter. The first step is to identify the infecting organism and the drugs to which it is sensitive. Usually, doctors recommend lengthier therapy in men than in women, in part to prevent infections of the prostate gland.

Prostate infections (chronic bacterial prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue effectively. For this reason, men with prostatitis often need long-term treatment with a carefully selected antibiotic. UTIs in older men are frequently associated with acute bacterial prostatitis, which can have serious consequences if not treated urgently.

Is there a vaccine to prevent recurrent UTIs?

In the future, scientists may develop a vaccine that can prevent UTIs from coming back. Researchers in different studies have found that children and women who tend to get UTIs repeatedly are likely to lack proteins called immunoglobulins, which fight infection. Children and women who do not get UTIs are more likely to have normal levels of immunoglobulins in their genital and urinary tracts.

Early tests indicate that a vaccine helps patients build up their own natural infection-fighting powers. The dead bacteria in the vaccine do not spread like an infection; instead, they prompt the body to produce antibodies that can later fight against live organisms. Researchers are testing injected and oral vaccines to see which works best. Another method being considered for women is to apply the vaccine directly as a suppository in the vagina.

Urinary Tract Infection in Adults At A Glance

  1. The urinary tract consists of the kidneys, ureters, bladder, and urethra.
  2. Some people are at more risk for urinary tract infections (UTIs) than others.
  3. One woman in five develops a UTI during her lifetime.
  4. Not everyone with a UTI has symptoms. Common symptoms include a frequent urge to urinate and a painful, burning when urinating.
  5. Underlying conditions that impair the normal urinary flow can lead to more complicated UTIs.

[Source:   National Institutes of Health, National Kidney and Urologic Diseases Information Clearinghouse]

Wednesday, October 8, 2008

IMMUNOL - Enhances Optimum Immune System Function

IMMUNOL  is designed as an immune-modulator to help enhance and balance the immune system.

When necessary,
IMMUNOL helps activate the body's own defense systems against viral, ba
cterial, fungal, and other harmful organisms, while providing balanced nutrition and helping to relieve stress, thus improving and achieving optimal immune function.

INGREDIENTS: 
Date Fruit B.E.E.contains maleic acid, oleanolic acid and abundant and balanced nutrients that work as an immune tonic to support the body's regulatory balance and adaptability, and strengthen the body's natural immunity and resistance to allergies and other immune imbalances.

Olive Leaves B.E.E. - contains oleuropein that can be converted into elenolic acid, which has antibiotic properties without being an actual antibiotic. It helps the immune system fight dangerous viruses, bacteria and other invaders without building antibiotic resistance and at the same time helping to strengthen the immune system.

Astragalus Root B.E.E. - contains flavonoids, polysaccharides, triterpene glycosides, amino acids, and trace minerals.  It can promote immune, liver, and cardiovascular functions through its multiple effects. 

It may increase proliferation and differentiation of bone marrow stem cells and progenitor cells.  It has antibiotic activities and increases antibody levels of IgA and IgG.  

It benefits immune function in a double-direction.  Namely, it helps increase the immune response and potentiates the effects of interferon in people with weak immune systems, thus fighting and preventing bacterial and viral infections, and other harmful factor attacks, while at the same time, decrease the immune response in people with some auto-immune disease, such as Systemic Lupus Erythematosus (SLE).

Eleuthero Root B.E.E. - is an extract from Siberian Ginseng and contains eleutherosides, and polysaccharides that play a critical role in supporting immune function. 

Also, eleuthero is an "adaptogen" (an agent that helps the body adapt to stress).  It helps support adrenal gland function when the body is challenged by stress, thus improving immune function, because stress can run the immune system down. 

In addition, it helps enhance intellectual and physical performance and promote general health.
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2 vegicaps daily for continuous support of immune system. 
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Tuesday, October 7, 2008

How To Win Against Acute Renal Failure (2)

Part 1 Part 2

Risk Factors

Conditions that increase your risk of acute kidney failure include:

  • Advanced age
  • Chronic infection
  • Diabetes
  • High blood pressure
  • Heart failure
  • Various blood disorders
  • Immune disorders, such as lupus, IgA nephropathy and scleroderma
  • Kidney diseases
  • Liver diseases
  • Prostate gland enlargement
  • Bladder outlet obstruction

Acute kidney failure almost always occurs in connection with another medical condition or event. In fact, most people who experience acute kidney failure are already in the hospital for other reasons, such as severe injury, complicated surgery or overwhelming infection.

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Tests and Diagnosis

When signs and symptoms point to acute kidney failure, blood and urine tests pin down the diagnosis. Changes associated with acute kidney failure include:

  • Daily urine output usually falls to less than 2 cups (500 milliliters).

  • Blood urea and creatinine levels rise rapidly.

  • Blood electrolyte concentrations — levels of minerals such as sodium, potassium and calcium that regulate fluid balance and muscle function, plus many other vital processes — become unstable, causing swelling (edema) and lung congestion.

  • Blood potassium, in particular, rises rapidly, often to life-threatening levels.

Ultrasound is the imaging test most commonly used in diagnosing kidney failure, but your doctor may also order an abdominal computerized tomography (CT) or magnetic resonance imaging (MRI) scan.

In a few cases, your doctor may remove a small sample (biopsy) of kidney tissue and send it to a laboratory for microscopic examination to identify the cause of acute kidney failure.

Complications

The sooner the cause of your acute kidney failure is resolved, the more likely you'll be to recover your kidney function.

Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration system for removing toxins and waste from your body — or a kidney transplant to survive.

Acute kidney failure may be fatal. Death rates are highest when the kidneys fail after surgery or trauma or in the context of severe, chronic medical problems.

Other factors that can adversely affect the outcome of acute kidney failure include multiorgan failure, multiple blood transfusions, a recent history of stroke or heart attack, or a postoperative stroke, advanced age, infection, gastrointestinal bleeding and pre-existing malnutrition.

Treatments and Drugs

The first goal is to treat the illness or injury that originally damaged your kidneys. Once that's under control, the focus will be on preventing the accumulation of excess fluids and wastes in your blood while your kidneys heal. This is best accomplished by limiting your fluid intake and following a high-carbohydrate, low-protein, low-potassium diet.

Your doctor may prescribe calcium, glucose or sodium polystyrene sulfonate (Kayexalate) to prevent the accumulation of high levels of potassium in your blood. Too much potassium in the blood can cause dangerous irregular heartbeats (arrhythmias).

Dialysis

Most of the time, you also need to undergo temporary hemodialysis — often referred to simply as "dialysis" — to help remove toxins and excess fluids from your body while your kidneys heal. Dialysis, which is a mechanical way of filtering waste from your blood, is an imperfect but lifesaving substitute for kidney function.

In acute kidney failure, dialysis is usually done at a hospital or dialysis center, not at home. The treatment relies on an artificial kidney (dialyzer) to take over kidney function.

Blood is pumped out of your body to the artificial kidney through one of two routes — a catheter placed surgically in one of your main blood veins, or a surgically created junction between a vein and artery in your arm.

Inside the artificial kidney, your blood moves across membranes that filter out waste before being returned to your body. Less than 1 cup (237 milliliters) of blood is outside your body in the dialyzer and tubing at any one time.

Hemodialysis

Prevention

Acute kidney failure is often impossible to prevent. But you may reduce your risk by following these suggestions:

  • Don't abuse alcohol or drugs, including over-the-counter pain medications such as aspirin, acetaminophen and ibuprofen.
  • Avoid long-term exposure to heavy metals, such as lead, as well as to solvents, fuels and other toxic substances.

Carefully follow all of your doctor's recommendations for managing any chronic medical condition that increases your risk of kidney failure.

If you're at high risk of kidney damage induced by contrast dye used for certain X-rays — for example, if you have diabetes or multiple myeloma — your doctor may prescribe a dose of acetylcysteine before the procedure. This medicine can help prevent acute kidney failure under these circumstances.

[SOURCE: Mayo Clinic.com ]
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How To Win Against Acute Kidney Failure

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Renal failure may be sudden or a gradual loss of the kidney's ability to excrete wastage.  It is also known as kidney failure.  

The abrupt or rapid decline is medically termed as Acute Renal Failure (ARF) and the gradual loss as Chronic Renal Failure (CRF).



Acute Renal Failure

Definition - Acute kidney failure is the sudden loss of your kidneys' ability to perform their main function — eliminate excess fluid and electrolytes as well as waste material from your blood. When your kidneys lose their filtering ability, dangerous levels of fluid, electrolytes and waste accumulate in your body.

Acute kidney failure is most common in people who are already hospitalized, particularly people who need intensive care. Acute kidney failure tends to occur after complicated surgery, after a severe injury or when blood flow to your kidneys is disrupted.

Acute kidney failure can be serious and generally requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you can recover normal kidney function. 

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Signs and Symptoms - Signs and symptoms of acute kidney failure may include:

  • Decreased urine output, although occasionally urine output remains normal

  • Fluid retention, causing swelling in your legs, ankles or feet

  • Drowsiness

  • Shortness of breath

  • Fatigue

  • Confusion

  • Seizures or coma in severe cases

  • Chest pain related to pericarditis, an inflammation of the sac-like membrane that envelops your heart

Because acute kidney failure is usually a complication of some other serious disorder, initially the signs and symptoms may go unnoticed or be attributed to the underlying disease.

Causes

Acute kidney failure has many possible causes, generally grouped according to the part of kidney function they affect. All your blood flows through your kidneys, which are the key organs in the complex system that removes excess fluid and waste material from the blood.

Your kidneys receive blood through your renal arteries, which branch off the main artery (the abdominal aorta) carrying oxygenated blood away from your heart.

On entering the kidneys, blood is diffused through an intricate network of filtering structures. These structures consist of nephrons — approximately 1 million of them — each containing a tuft of capillary blood vessels and tiny lobules that lead to larger collecting tubes.

The capillary tufts (glomeruli) filter fluid from your blood, extracting both waste products and substances your body needs continuously — sugar, amino acids, calcium and salts. The filtered fluid then enters the tubules, from which the bloodstream reabsorbs these vital materials. What remains is waste, which is excreted in your urine.

Underlying causes

Three types of conditions can cause acute kidney failure: (1) Prerenal conditions, which disrupt blood flow on its way to the kidneys; (2) Renal conditions, which directly damage the structures of the kidneys; (3) Postrenal conditions, which interfere with the urinary excretion of waste from the filtering process

Pre-renal causes

Extremely low blood pressure.  --Severe bleeding, infection in the bloodstream (sepsis), dehydration or shock can all lead to a drastic drop in blood pressure that prevents an adequate amount of blood from reaching your kidneys. Dangerously low blood pressure tends to follow traumatic injury.

Poor heart function.  -- A heart attack or congestive heart failure can severely limit blood flow to your kidneys.

Low blood volume.  -- Severe dehydration diminishes the volume of blood in your body and the amount available to your kidneys.

Renal causes

Reduced blood supply within your kidneys. Your kidneys don't just process blood for the rest of your body — they depend on an adequate blood supply of their own. Reduced blood flow to the kidneys, especially to the renal tubules, can result in acute renal failure.

In atherosclerosis, for example, deposits of cholesterol on the inner walls of arteries (plaques) may break up, releasing solid fragments into the bloodstream. These fragments (emboli) can get into the kidneys' circulation and accumulate in small vessels, severely restricting the blood supply and causing acute kidney failure, also known as atheroembolic kidney disease.

Hemolytic uremic syndrome.  -- Hemolytic uremic syndrome — associated with certain strains of Escherichia coli (E. coli) bacteria — is a leading cause of acute kidney failure in children. The bacterium causes inflammation of the intestine.  It also produces a toxin that causes damage and swelling in the lining of blood vessels, especially the small blood vessels (glomerular capillaries) in the kidneys.  As red blood cells travel through the damaged blood vessels, they're often broken apart (hemolysis).  This complex condition may result in acute kidney failure. 

Inflammation in the kidneys.  -- Acute kidney failure may result from sudden inflammation of the spaces between the glomeruli and the tubules (acute interstitial nephritis) and inflammation of the glomeruli (acute glomerulonephritis). Acute interstitial nephritis is usually associated with an allergic reaction to a drug.  Examples include certain antibiotics — especially streptomycin and gentamicin — and common pain medications, such as aspirin and ibuprofen (Advil, Motrin, others). Antibiotics pose a greater risk of acute kidney failure for people who already have liver or kidney disease or who use diuretics or other drugs that affect the kidneys.

Acute glomerulonephritis may follow a bacterial or viral infection, such as strep throat or hepatitis. Immune system diseases, such as lupus or IgA nephropathy (Berger's disease), also may trigger acute glomerulonephritis.

Toxic injury.   -- Your kidneys are particularly vulnerable to toxic injury from alcohol, cocaine, heavy metals, solvents and fuels. Sometimes, these toxins can induce acute kidney failure. Some medications, including certain chemotherapy drugs and contrast dyes used in medical tests, have a similar effect in vulnerable people.

Postrenal causes

Conditions that block the passage of urine out of the body (urinary obstructions) can, without treatment, also lead to acute kidney failure.

Ureter obstruction. -- Kidney stones in both of the tubes leading from your kidneys to your bladder (ureters) — or in a single ureter if only one kidney is functioning — can prevent the passage of urine, as can tumors pushing in on the ureters.

Bladder obstruction. -- In men, prostate enlargement is a common cause of urinary retention due to obstruction at the bladder outlet. Other obstructive bladder causes, in both men and women, include a bladder stone, blood clot, tumor or a nerve disorder that prevents the bladder from contracting properly.  [SOURCEKinetics Product Guide]

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