Stemming the spread of common — and potentially deadly — infections

Germs, bacteria and viruses surround us, but fortunately, the human immune system is typically well equipped to fight many common bugs. For those that we can’t fight on our own, there are effective countermeasures to help us contain or prevent infections that range in intensity from inconvenient to deadly. Yet with all the medications and interventions available, education, awareness and common sense remain the best prescription for staying healthy and avoiding infections.

This month, Wellness Matters focuses on dangerous infections; next month (July), we’ll examine common contagious and infectious diseases.

It’s critical to not underestimate the severity and danger associated with infections. Regardless of how they’re contracted, if left untreated, infections that spread through insect, animal or human bites, cuts, punctures, or the sharing of toothbrushes, razors and other personal items can turn deadly quickly.

Signs and symptoms vary depending on the organism causing the infection, but often include fever and fatigue, or discomfort at the wound site. Mild maladies may respond to rest and home remedies, but some infections are life-threatening, need medical intervention and may require hospitalization.

Here are a few common infections that everyone should be aware of and which require medical attention:

Staph infections are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections.

Skin infections caused by staph bacteria include:

  • The most common type of staph infection is the boil, a pocket of pus that develops in a hair follicle or oil gland. The skin over the infected area usually becomes red and swollen. If a boil breaks open, it will probably drain pus. Boils occur most often under the arms or around the groin or buttocks.
  • This contagious, often painful rash can be caused by staph bacteria. Impetigo usually features large blisters that may ooze fluid and develop a honey-colored crust.
  • This infection of the deeper layers of skin causes skin redness and swelling on the surface of your skin. Sores (ulcers) or areas of oozing discharge may develop, too. Cellulitis occurs most often in the lower legs and feet and can be life threatening if left untreated.

Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a strain of staph bacteria that’s become resistant to the antibiotics commonly used to treat ordinary staph infections.

Most MRSA infections occur in people who’ve been in hospitals or other healthcare settings, such as nursing homes and dialysis centers. When it occurs in these settings, it’s known as health care-associated MRSA (HA-MRSA). HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints.

Another type of MRSA infection has occurred in the wider community — among healthy people. This form, community-associated MRSA (CA-MRSA), often begins as a painful skin boil. It’s spread by skin-to-skin contact. At-risk populations include groups such as high school wrestlers, child care workers and people who live in crowded conditions.

Treating dangerous infections

Antibiotics are the most effective course of treatment for fighting infections. Your doctor may perform tests to identify what type of staph bacteria is behind your infection, and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs or vancomycin.

Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines. But vancomycin and some other antibiotics have to be given intravenously.

If you’re given an oral antibiotic, be sure to take it as directed, and to finish all of the medication prescribed by your doctor. Ask your doctor what signs and symptoms you should watch for that might indicate your infection is worsening.

These common-sense precautions can help prevent or reduce the likelihood of developing infections such as staph:

  • Wash your hands. Careful hand-washing is our best defense against germs. Wash hands briskly for at least 15 to 30 seconds, then dry them with a disposable towel and use another towel to turn off the faucet. If your hands aren’t visibly dirty, you can use a hand sanitizer containing at least 62 percent alcohol.
  • Clean a wound, puncture or bite, and use an astringent, alcohol or antibiotic cream or pad. Oftentimes, simply washing the affected area with soap and water is enough. Even better, use one of the many available antibacterial creams or wipes for treating the area as soon as possible.
  • Keep wounds covered. Keep cuts and abrasions clean and covered with sterile, dry bandages until they heal. The pus from infected sores often contains staph bacteria, and keeping wounds covered will help keep the bacteria from spreading.
  • Reduce tampon risks. Toxic shock syndrome is caused by staph bacteria. Since tampons left in for long periods can be a breeding ground for staph bacteria, you can reduce your chances of getting toxic shock syndrome by changing your tampon frequently, at least every four to eight hours. Use the lowest absorbency tampon you can, and try to alternate using tampons and sanitary napkins whenever possible.
  • Keep personal items personal. Avoid sharing personal items such as towels, sheets, razors, clothing and athletic equipment. Staph infections can spread on objects, as well as from person to person.
  • Wash clothing and bedding in hot water. Staph bacteria can survive on clothing and bedding that isn’t properly washed. To get bacteria off clothing and sheets, wash them in hot water whenever possible. Also, use bleach on any bleach-safe materials. Drying in the dryer is better than air-drying, but staph bacteria may survive the clothes dryer.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Welcome to Lyme Disease central

It’s nice to brag about Connecticut’s shoreline, rolling hills, beautiful rivers and scenic vistas. We’re among the leaders in quality of life, have a highly skilled workforce, and a history rich in innovation, invention and discovery. Unfortunately, we’re also the national poster child for Lyme Disease, which — literally and figuratively — has made the nutmeg state its bull’s eye.

Lyme Disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, joint pain and in many, but not all cases, that characteristic “bull’s-eye-like” skin rash called erythema migrans. It’s estimated to affect 300,000 Americans a year and 65,000 in Europe, typically in the spring and early summer.

If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings and the possibility of exposure to infected ticks.  Laboratory testing is helpful but not always conclusive, and Lyme Disease often is misdiagnosed. It is the most commonly reported vector-borne illness (meaning transmitted via organisms such as ticks or mosquitoes) in the United States, even though it does not occur nationwide and is heavily concentrated in the northeast and upper Midwest.

Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. It is not contagious and cannot be spread from person to person. But there are certain precautions we can take to prevent the spread of the illness, including using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat, especially since the ticks that transmit Lyme Disease can occasionally transmit other tick-borne diseases as well.

While it is a good idea to take preventive measures against ticks year-round, we should be extra vigilant in warmer months (April through September) when ticks are most active. And in summer, when we’re out hiking, biking, camping, and spending a lot more time in and around grass and woods, there are several steps we can take to limit bites from ticks, mosquitoes and other disease-bearing insects.

Avoid direct contact with ticks and mosquitoes when possible. If you can, avoid wooded and bushy areas with high grass and leaf litter. When hiking, picnicking or walking, try to remain in the center of trails.

Wear long pants and protective clothing, and when you’re done recreating or working outdoors, check your clothing for ticks, since they can migrate once in the car or home.

Use appropriate repellants. We can repel ticks and mosquitoes with DEET or Permethrin. Here are some useful hints for maximizing our use of tick repellant:

  • Use repellents that contain 20 percent or more DEET (N, N-diethyl-m-toluamide) on the exposed skin for protection that lasts up to several hours. Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents. It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings.
  • If you’re using other repellents, go to the Environmental Protection Agency (EPA) website for safety information.

Find and remove ticks from our bodies. Finding and removing ticks embedded in our skin can be gross, but painless. The best bet is to keep them at bay. But if they do find us, here are tips for dealing with them easily and effectively:

  • Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on us.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of the body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.
  • Consult a doctor or a nurse (or check on the Internet) to determine the best method for removing the tick; it’s important to remove the entire tick, or it can leave parts embedded in our skin.

Should you or a family member develop a bull’s-eye-type red rash near the bite site, or exhibit other side effects such as a fever, lethargy or extreme exhaustion, consult a doctor and ask to be tested for Lyme Disease.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Time to don your sunscreen and hats

After a long, cold winter, little feels better than being outdoors in the mild weather. Sunshine beckons, motivates us, and seems to physically and mentally replenish our spirits. And while those bountiful beams help stimulate chemical and physical reactions in our bodies and contribute to our health, it’s important to remember that as we savor the sun’s warmth and work on our tans, we’re also soaking up damaging ultraviolet (UV) rays.

May is UV and Skin Cancer Awareness Month. Skin cancer is the most common form of cancer in the United States. Unprotected exposure to UV radiation is the most preventable risk factor for skin cancer. In fact, UV radiation from the sun is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization. Each year, more new cases of skin cancer are diagnosed in the U.S. than new cases of breast, prostate, lung, and colon cancer combined. One in five Americans will develop skin cancer in their lifetime, and one American dies from skin cancer every hour.

Chronic exposure to the sun suppresses our natural immune system and also causes premature aging, which over time can make the skin become thick, wrinkled and leathery. Since it occurs gradually, often manifesting itself many years after the majority of a person’s sun exposure, premature aging is often regarded as an unavoidable, normal part of growing older. However, up to 90 percent of the visible skin changes commonly attributed to aging are caused by the sun. With proper protection from UV radiation, many forms of skin cancer and most premature aging of the skin can be avoided.

How to protect ourselves from extra UV exposure

The best way to lower our risk of skin cancer is to protect our skin from the sun and ultraviolet light. Using sunscreen and avoiding the sun helps reduce the chance of many aging skin changes, including some skin cancers. However, it is important not to rely too much on sunscreen alone. Also, we should also not use sunscreen as an excuse to increase the amount of time we spend in the sun – remaining outside too long during peak sunlight hours is very dangerous, and UV rays penetrate our clothes and skin.

When possible, avoid sun exposure during the peak hours of 10 am to 4 pm, when UV rays are the strongest. Clouds and haze do not protect you from the sun, so use sun protection even on cloudy days. Use sunscreens that block out both UVA and UVB radiation. Products that contain either zinc oxide or titanium oxide offer the best protection.

Less expensive products that have the same ingredients work as well as expensive ones. Older children and adults (even those with darker skin) benefit from using SPFs (sun protection factor) of 15 and over. Many experts recommend that most people use SPF 30 or higher on the face and 15 or higher on the body, and people who burn easily or have risk factors for skin cancer should use SPF 50+.

Here are helpful tips on when and how to use sunscreen:

  • Adults and children should wear sunscreen every day, even if they go outdoors for only a short time.
  • Apply sunscreen 30 minutes before going outdoors for best results. This allows time for the sunscreen to be absorbed.
  • Remember to use sunscreen during the winter when snow and sun are both present.
  • Reapply at least every two hours while you are out in the sunlight.
  • Reapply after swimming or sweating. Waterproof formulas last for about 40 minutes in the water, and water-resistant formulas last half as long.

Wearing sunscreen is critical, but only half the battle. Here are additional safety tips and information for protecting yourself from harmful UV radiation:

  • Adults and children should wear hats with wide brims to shield from the sun’s rays.
  • Wear protective clothing. Look for loose-fitting, unbleached, tightly woven fabrics. The tighter the weave, the more protective the garment.
  • Buy clothing and swimwear that block out UV rays. This clothing is rated using SPF (as used with sunscreen) or a system called the ultraviolet protection factor (UPF) index.
  • Avoid surfaces that reflect light, such as water, sand, concrete, snow, and white-painted areas.
  • Beware that at higher altitudes you burn more quickly.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Who’s got time for sleep?!

It’s April. We’ve already sprung forward an hour, and can now enjoy the lengthening days and milder temperatures. With the longer daylight hours, though, come increased outdoor activity and often a quickening life pace. If you’re already tired, it’s just going to get worse, and that hour of sleep you lost a few weeks ago is one of several elements potentially wreaking havoc silently.

When we’re tired, we become irritable. Productivity, service and quality of work often suffer. Being fatigued tests the patience of everyone around us, increases chances of accidents or mistakes, and aggravates chronic health conditions. It also reduces our natural immune system, making us more susceptible to illness.

Humans have a 24-hour internal clock called circadian rhythm that controls our eating and sleeping patterns, internal bodily functions and the timing of hormone secretions. We might have trouble falling asleep at night or waking up in the morning if our internal clock gets out of sync with the external day-night cycle. This happens with multi-time zone travel and is the basis for jet lag. With the daylight savings time shift, the external time has shifted while the internal clock has not, and even though it’s been weeks, there’s still a lag.

The more stable and consistent our circadian rhythm is, the better our sleep. This cycle also may be altered by the timing of various factors including naps, bedtime, exercise, diet, and especially exposure to light.

Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change and we have many more nocturnal awakenings than in our younger years. These not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, functioning like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more times we awake at night, the more likely we will feel unrefreshed and unrestored in the morning.

Psychological stressors like deadlines, exams, marital conflict and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to “turn off” all the noise from the day. No way around it. If you work right up to the time you turn out the lights, or are reviewing all the day’s events and planning tomorrow, you simply can’t just “flip a switch” and drop off to a blissful night’s sleep.

What we can do to sleep better

You’d think that because we all sleep, we’d be good at it by now . . . but of course, that isn’t the case. Millions of Americans suffer from fatigue caused by poor sleep habits. And while chemical imbalances and chronic conditions such as sleep apnea — where the body doesn’t get enough oxygen during sleep — can be affecting you, there are many simple solutions you can try before turning to medications or running off to get a sleep study.

The most important sleep hygiene measure is to maintain a regular sleep and wake pattern seven days a week. It’s also important to spend an appropriate amount of time in bed — not too little, or too much. This may vary by individual; for example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed, but if they have difficulty sleeping at night, they should limit themselves to seven hours in bed in order to keep the sleep pattern consolidated.

Here are 10 good sleep hygiene practices to consider:

  • Avoid napping during the day; it can disturb the normal pattern of sleep and wakefulness.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal.
  • Exercise can promote good sleep. Vigorous exercise should be practiced in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night’s sleep, but avoid exercise close to bedtime.
  • Food can be disruptive right before sleep; stay away from large meals, spicy foods which increase metabolism, sweets or unhealthy snacking. And, remember, chocolate contains caffeine, though it has many helpful properties, as well.
  • Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle, though try to avoid too much light exposure in the evening if you’ve been having trouble sleeping.
  • Establish a regular, relaxing bedtime routine, and try to wake up at the same time every day.
  • Limit stimulating activities, electronic games and TV shows before trying to go to sleep.
  • Don’t dwell on, or bring your problems to bed, and try to avoid emotionally upsetting conversations when it’s time to relax.
  • Associate your bed with sleep. It’s not a good idea to use your bed to watch TV, listen to the radio, or work.
  • Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, and the room should not be too hot or cold, or too bright.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

When it comes to vitamins, C it all clearly

Spring is only weeks away, and the worst of cold and flu season, hopefully, is behind us. But we still can’t let down our guards. It’s a germ jungle out there, and we have to stay on our toes when it comes to nutrition, exercise and general health.

Chances are many of us aren’t eating the right foods to help strengthen our immune systems. We also may be inclined to take supplements to prevent illness, or larger doses of vitamins to fight cold and bugs once they have us in their grasps. If you fall into either of these categories, you’re not alone – supplements are a multi-million-dollar industry. But it’s important to separate fact from fiction, and to understand what works best, why and how.

To start, nothing we take as a supplement beats the benefits of eating healthfully and obtaining the vitamins and minerals we need through our diet. One of the best-known and most-studied examples is Vitamin C, which we get naturally through fruits and vegetables.

Vitamin C, also known as ascorbic acid, is a water-soluble nutrient that acts as an antioxidant, helping to protect cells from damage caused by free radicals, compounds that are formed when our bodies break down food or when we are exposed to tobacco smoke or radiation and air pollution. Vitamin C is also needed for the growth and repair of tissues in all parts of the body, and it helps the immune system work to protect the body from disease. 

Sufficient quantities of Vitamin C must be consumed every day. Unlike fat-soluble vitamins, vitamin C is not stored in the body. That is why eating at least a few servings a day of citrus fruits and other vitamin C-rich food is so important. Luckily, getting the recommended daily amount of Vitamin C is not difficult, since a single orange contains 150 percent of the government’s recommended daily allowance of Vitamin C.

Vitamin C is cited as effective for fighting infections including gum disease, acne and other skin infections, bronchitis, and human immunodeficiency virus (HIV) disease. It is used for infections of the bladder and prostate, and people also put vitamin C on their skin to protect it against the sun, pollutants, and other environmental hazards. Vitamin C is also applied to the skin to help with damage from radiation therapy.

Additionally, Vitamin C is used for fighting depression, dementia, Alzheimer’s disease, physical and mental stress, fatigue, and attention deficit-hyperactivity disorder (ADHD). It’s also believed that Vitamin C might help the heart and blood vessels. It is used for hardening of the arteries, preventing clots in veins and arteries, heart attack, stroke, high blood pressure, and high cholesterol. Other uses include improving physical endurance and slowing aging, as well as counteracting the side effects of cortisone and related drugs, and aiding drug withdrawal in addiction.

Where to find it, and where not

Most experts recommend getting Vitamin C from a diet high in fruits and vegetables rather than taking supplements. Fresh-squeezed orange juice or fresh-frozen concentrate is a better pick than ready-to-drink orange juice. The fresh juice contains more active Vitamin C. Drink fresh-frozen orange juice within one week after reconstituting it for the most benefit. It you prefer ready-to-drink orange juice, buy it three to four weeks before the expiration date, and drink it within one week of opening.

People may view supplements such as Airborne and Emergen-C as quick and easy fixes; each contains 1,000 milligrams (mg) of Vitamin C along with other vitamins and minerals. And while Vitamin C has been seen as a potential remedy for the common cold, research shows that for most people, Vitamin C supplements or Vitamin-C- rich foods do not reduce the risk of getting a cold. And once you have a cold, rest, fluids and a healthy diet stimulate recovery. However, people who take Vitamin C supplements regularly might have slightly shorter colds or somewhat milder symptoms when they do have a cold.

The minimum daily requirement of Vitamin C for adults is 75 mg for women and 90 mg for men, with an extra 35 mg needed by smokers.  Citrus fruits, such as oranges and grapefruit, along with their juices, have high amounts of Vitamin C. Five servings a day of fruits and vegetables – or about 2 1/2 cups – averages out to between 200 mg to 250 mg of Vitamin C. Besides citrus, the fruits that have high amounts of Vitamin C include: 

  • Cantaloupe
  • Kiwi fruit
  • Mango
  • Papaya
  • Pineapple
  • Strawberries, raspberries, blueberries, cranberries
  • Watermelon

Vegetables that have the highest amounts of Vitamin C include: 

  • Broccoli, Brussels sprouts, cauliflower
  • Green and red peppers
  • Spinach and other leafy greens
  • Sweet and white potatoes
  • Tomatoes and tomato juice
  • Winter squash

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Spring into action on your personal health plan

It’s hard to believe March is already here . . . which means spring, warmer weather and a return to outdoor activities aren’t far behind.  As many of us shed heavy jackets and winter clothes, we also may need to shed winter pounds or consider other healthy behaviors that may have gone by the wayside during our winter hibernation. Fortunately, March is a great time to renew our personal wellness resolutions and goals, well before we start to unpack our bathing suits, tank tops and shorts.

At least half of Americans make New Year’s resolutions. Maybe we intended to lose weight, or exercise more, or quit smoking. But the vast majority of Americans who made such resolutions won’t meet their goals. Polls have found that by springtime, 68 percent of Americans who made a New Year’s resolution have broken it.  After one year, only 15 percent claim success.

But that’s okay – as philosophers and quality gurus remind us, it’s the journey not the destination! The secret to self-improvement is persistence, not perfection.  Now is our opportunity to see what we’ve done or haven’t done, set new goals and get started – or started again.

A more feasible strategy might be to set goals we can measure – and achieve – on a quarterly basis. For example, losing 10 pounds between April and June, cutting back coffee, smoking or alcohol consumption by a certain percentage, getting to the gym three times a week, consciously reducing sugar and fat intake every time we eat, walking on the weekends . . . whatever works for you.

Additionally, this is a good time to think about walks, runs and other charitable or competitive events that traditionally take place in the late spring. If you set a goal to walk or run in a 5k coming up in a few months, you can begin your training now. Or you can adjust your diet by eliminating pasta and bread from one or more meals a day and substituting more fruit and vegetables. The trick is to modify your strategy – especially if you haven’t been successful at meeting your goals over the past few months.

The challenge, of course, is that wanting to lose weight and knowing how to lose weight are different objectives, and achieving and sustaining that weight loss requires smart planning, dedication, and good information.

We can cut carbs and sugar, eat lots of raw veggies, replace a meal with a protein shake, or count calories.  Diets will take off weight, but staying healthy and not regaining the weight is another matter. Instead of simply dieting, we need to focus on nutrition, health and exercise, and to recognize that there are benefits to be gained from a healthful diet besides just weight loss.

Simplicity is a useful tool for altering your diet. Vegetables, experts stress, can be eaten raw or cooked in the microwave just as easily as heating processed food. And there is an enormous amount of self-help literature available online and in book stores, and through nutritionists, your physician and other health professionals.

It’s also important to choose high-quality foods over low-quality foods. Fast food and snack foods are low quality, which means they have a lot of calories without a lot of nutrients. And when we try to appease ourselves by adding processed cheese sauce to the broccoli or deep frying our veggies, we’re not improving our diet. 

It starts by making up our minds to eat better, and by experimenting with changes that we can sustain, unlike those offered in fad diets. Actually engaging our brains, paying attention to what we’re eating, how much and when are important first steps. Frequency and understanding the chemistry of food, what we’re putting into our bodies and how it affects us, will make a big difference. And changing our diets without adding exercise is not going to be as effective a means of losing weight or achieving improved overall health.

Success is incremental, but you can reward yourself as you make changes. Once you start substituting vegetables and fruit for heavy carbs and prepared foods high in fat, sugar and sodium, you’ll get used to the healthier eating style and smaller portions will become enough. But that doesn’t mean you can’t enjoy pizza, ice cream and fast food once in awhile – as long as it becomes the exception, not the rule.

Healthful living is a lifestyle choice, and extra weight a prime contributor to most chronic diseases. Set reasonable goals – both in terms of nutrition and exercise – track your progress, involve family members or friends in setting and sharing goals, and you’ll be amazed at how much easier it is to make simple changes that will have a profound effect on your long-term health and wellness.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

The thyroid connection

The thyroid gland is a vitally important hormonal gland that plays an essential role in metabolism, growth and maturation of the human body. The thyroid constantly releases hormones into the blood, helping to regulate many bodily functions.  Additional hormones are produced when the body needs more energy in certain situations like growth, for regulating body temperature or during pregnancy.

The thyroid is located in the front part of the neck below the voice box and has the shape of a butterfly. When working properly, hormones produced by our thyroid travel through our bloodstream and help cells get energy from the food we eat. Thyroid hormones help regulate our body temperature and blood calcium levels, help with growth and development and, during infancy, strengthen brain development.

For an estimated 27 million Americans, however, the thyroid produces either too much or too little hormone, which causes an array of health symptoms, some severe. But because thyroid disease is often misdiagnosed or simply overlooked, it’s estimated that more than half of affected Americans don’t know they have a problem.

Women are much more likely to have thyroid problems than men, and may have up to a one in five chance of developing thyroid problems during their lifetime. The risk increases with age and family history, as well as having an autoimmune disease or a close relative with one; through radiation exposure; by going through menopause or perimenopause; or following childbirth.

Hypothyroidism (underactive thyroid) accounts for the majority of thyroid disease cases — up to 80 percent according to some estimates. This condition occurs when our body produces too little thyroid hormone, leading to symptoms such as fatigue and general sluggishness; unexplained weight gain or increased sensitivity to cold; pain, stiffness or swelling in joints; muscle aches and weakness; heavy menstrual periods; depression; brittle hair and nails; and elevated blood cholesterol.

If left untreated, hypothyroidism can lead to obesity, joint pain, infertility, goiter (thyroid enlargement) and heart disease, but because the symptoms can mimic other diseases, or even be attributed to aging, many people do not realize the thyroid connection. Further, the symptoms may be mild at first, becoming increasingly severe only after a number of years, making them easy to overlook.

A blood test that measures our levels of thyroid-stimulating hormone (TSH) is typically used to diagnose hypothyroidism, and treatment usually involves taking a synthetic or natural thyroid hormone daily.

In contrast, hyperthyroidism results from an overactive thyroid. Symptoms include weight loss; nervousness, anxiety and irritability; increased perspiration; racing heart, hand tremors; difficulty sleeping; increased bowel movements; and muscle weakness, especially in the upper arms or thighs.

A TSH blood test can typically diagnose hyperthyroidism, and the condition is usually treated with anti-thyroid drugs that block the gland’s ability to produce thyroid hormone. Other treatments include surgery, or radioactive iodine, which destroys overactive thyroid cells.

Supplementing thyroid health

As with virtually every bodily function, our diet plays a role in the health of our thyroid. There are some specific nutrients that the thyroid depends on and it’s important to include them in our diet:

  • Iodine: Our thyroid contains the only cells in our body that absorb iodine, which it uses to make critical hormones. Without sufficient iodine, your thyroid cannot produce adequate hormones to help your body function on an optimal level. Iodine deficiency is not that common in the United States because of the prevalent use of iodized salt. However, according to the CDC, up to 36 percent of women of childbearing age may not get enough iodine from their diets, and it’s thought that iodine deficiency is on a slow but steady rise.
    Because iodized salt is heavily processed, physicians sometimes recommend avoiding iodized salt and instead getting iodine naturally from sea vegetables (seaweed), such as hijiki, wakame, arame, dulse, nori, and kombu. Too much iodine can actually trigger thyroid problems and worsen symptoms, so it’s important to have a healthy balance.
  • Selenium: This mineral is critical for the proper functioning of our thyroid gland, and is used to produce and regulate an important hormone. Selenium can be found in foods such as shrimp, snapper, tuna, cod, halibut, calf’s liver, button and shitake mushrooms and Brazil nuts.
  • Zinc, Iron and Copper: These metals are needed in trace amounts for healthy thyroid function. Low levels of zinc have been linked to low levels of TSH, and iron deficiency has been linked to decreased thyroid efficiency. Copper is also necessary for the production of thyroid hormones. Foods such as calf’s liver, spinach, mushrooms, turnip greens and Swiss chard can help provide these trace metals in our diet.
  • Omega-3 Fats: These essential fats, which are found in fish or fish oil, play an important role in thyroid function, and many help our cells become sensitive to thyroid hormone.
  • Coconut Oil: Coconut oil is made up of mostly medium-chain fatty acids, which may help to increase metabolism and promote weight loss, along with providing other thyroid benefits. This is especially beneficial for those with hypothyroidism.
  • Antioxidants and B Vitamins: The antioxidant vitamins A, C and E can help our body neutralize oxidative stress that may damage the thyroid. In addition, B vitamins help to manufacture thyroid hormone and play an important role in healthy thyroid function.

Finally, there are certain foods that should be avoided to protect our thyroid function. These include:

Aspartame
: There is concern that the artificial sweetener aspartame, sold under the brand name Nutrasweet, may trigger Graves’ disease and other autoimmune disorders in some people. The chemical may trigger an immune reaction that causes thyroid inflammation and thyroid autoantibody production.

Non-fermented Soy: Soy is high in isoflavones, which are goitrogens, or foods that interfere with the function of our thyroid gland. Soy, including soybean oil, soy milk, soy burgers, tofu and other processed soy foods, may lead to decreased thyroid function. Fermented soy products, including miso, natto, tempeh and traditionally brewed soy sauce are safe to eat, as the fermentation process reduces the goitrogenic activity of the isoflavones.

Gluten: Gluten is a potential goitrogen and can also trigger autoimmune reactions in people who are sensitive. Gluten is found in wheat, rye and barley, along with most processed foods.

The isothiocyanates found in cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts are goitrogens as well.

While it’s true that large amounts of these vegetables, eaten raw, could interfere with thyroid function, they offer many other health benefits that make the benefits outweigh the risks for most people. If you know you have thyroid disease and want to be especially careful, steaming these vegetables will negate the goitrogenic effect, making them a healthy addition to your diet.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

With Meds, How Expired is Expired?

If you take a big swig off the milk container that’s been sitting in your fridge too long, you’re likely to get an immediate — and nasty — surprise.  When dairy and meat products exceed their expiration dates, the change is anything but subtle. However, the same aesthetic and sensory clarity typically doesn’t exist for prescription and over-the-counter (OTC) medications. They may look, feel and smell the same…but are they effective and safe after the expiration date has come and gone, and if so, for how long?

The answer to that question can vary according to the kind of drug, how it’s been stored, if it’s been opened and its intended purpose. Medications are expensive, and we hate throwing them away if it isn’t necessary. On the other hand, we don’t want to take medications that are no longer potent or effective, especially if we rely on them for life-saving purposes such as epi-pens for allergic reactions, insulin for diabetes or antibiotics for fighting infections.

Where do you draw that line, though, on all those prescription bottles cluttering up your medicine cabinet, and common drugs such as pain relievers, topical ointments for itchy skin, and cough syrup?

What does an expiration date mean?

The expiration date is the final day that the manufacturer guarantees the full potency and safety of a medication. Drug expiration dates exist on most medication labels, including prescription, over-the-counter and dietary (herbal) supplements. U.S. pharmaceutical manufacturers are required by law to place expiration dates on prescription products prior to marketing. For legal and liability reasons, manufacturers will not make recommendations about the stability of drugs past the original expiration date.

The expiration date of a drug is estimated using stability testing determined by the Food and Drug Administration (FDA). Drug products marketed in the United States typically have an expiration that extends from 12 to 60 months from the time of manufacture. Once the original container is opened, either by the patient or the health care provider who will dispense the drug, that original expiration date on the container can no longer be relied upon.  However, the actual shelf life of the drug may be much longer.

At the pharmacy, “beyond-use” dates are often put on the prescription bottle label given to the patient. These dates often say “do not use after…” or “discard after…” and are required by the Board of Pharmacy in many states. These dates are typically one year from the date on the stock bottle. According to the manufacturer, the stability of a drug cannot be guaranteed once the original bottle is opened. Therefore, the United States Pharmacopeia (USP), the body that sets the standards for pharmaceutical quality in the U.S., recommends using “beyond use” dates. The “beyond use” date would never be later than the expiration date on the manufacturer’s bottle.

The American Medical Association (AMA) concluded more than a decade ago that the actual shelf life of some products is longer than the labeled expiration date. Over 3,000 lots, representing 122 different drug products, were assessed in a government test program. Based on stability data, expiration dates on almost 90 percent of the lots were extended beyond their original expiration date for an average of 66 months. Of these 2,652 lots, only 18 percent were terminated due to failure. Examples of common drug products that were tested with no failures included amoxicillin, ciprofloxacin, diphenhydramine, and morphine sulfate injection. Drug expiration extension dates on these products ranged from 12 to 184 months.

However, it is difficult for consumers or health care providers to know which specific products could have an extended shelf life. The ability for a drug to have an extended shelf life would be dependent upon the actual drug ingredients, presence of preservatives, temperature fluctuations, light, humidity, and other storage conditions. Additionally, the drug lots tested in the program were kept in their original packaging. Once a drug is repackaged into another container, as often happens in the pharmacy, the shelf-life might decline.

Is it safe to take expired medications?

There are no specific reports linking expired medication use to human toxicity. Solid dosage forms, such as tablets and capsules, appear to be most stable past their expiration date. Drugs that exist in solution or as a reconstituted suspension, and that require refrigeration (such as amoxicillin suspension), may not have the required potency if used when outdated. Loss of potency can be a major health concern, especially when treating an infection with an antibiotic. Additionally, antibiotic resistance may occur with sub-potent medications. Drugs that exist in solution, especially injectable drugs, should be discarded if the product forms a precipitant or looks cloudy or discolored.

EpiPen autoinjectors should not be used after the expiration date as the epinephrine has been shown to lose its potency. EpiPen’s are used in life-threatening situations like anaphylaxis, so there is a major health threat with an expired EpiPen. Expired medications that contain preservatives, such as ophthalmic (eye) drops, may be unsafe past their expiration date. Outdated preservatives may allow bacterial growth in the solution.

Insulin is used to control blood sugar in diabetes and may be susceptible to degradation after its expiration date. Oral nitroglycerin (NTG), a medication used for angina (chest pain), may lose its potency quickly once the medication bottle is opened. Vaccines, biologicals or blood products could also be subject to quick degradation once the expiration date is reached. If a patient finds a medication is powdery or crumbling, has a strong smell, or has dried up (as in the case of ointments or creams), these drugs should be discarded.

Proper storage of medications may help to extend their potency. The bathroom and medicine cabinet are not ideal places to store medications due to heat and humidity. Similarly, medications should not be left in a hot car. Medications remain most stable in dry, cool spaces away from light. Keep the prescription bottle caps tightly closed and always keep medications out of reach of children and pets.

If questions still remain about whether or not to use an old or expired medication, it is wise to speak with your pharmacist or physician, who can offer additional information and advice.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

The Eyes Have It

Our eyes, it’s said, are our windows to the world. Romantic and aesthetic benefits aside, taking care of our peepers is an important and often overlooked task, especially since we don’t think about eye health until we have a problem. But as January is National Glaucoma Awareness Month, it’s a good time to consider how best to care for our eyes, and to become aware of warning signs that may require medical care or interventions.

Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. The optic nerve is a bundle of more than 1 million nerve fibers, and it is necessary for good vision as it connects the retina to the brain. The retina is the light-sensitive tissue at the back of the eye.

Studies have shown that eye pressure is a major risk factor for optic nerve damage. In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid flows through a spongy meshwork, like a drain, and leaves the eye.

With glaucoma, the fluid passes too slowly through the meshwork drain. Since the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve. When the optic nerve is damaged from increased pressure, glaucoma — and vision loss — may result. That’s why controlling pressure inside the eye is important.

Another risk factor for optic nerve damage relates to blood pressure. It is important to make sure that your blood pressure is at a proper level. This can be determined by visiting your primary care physician.

Glaucoma has no early warning signs. However, symptoms can include blurriness or clouded vision, sensitivity to light, headaches, reduced peripheral or “side” vision, or “tunnel vision.” It’s more common in adults over 60, in African American adults over 40, or in adults with diabetes or a family history of glaucoma. It’s most often treated through medications and surgery.

Not every person with increased eye pressure will develop glaucoma. Some people can tolerate higher levels of eye pressure better than others. Also, a certain level of eye pressure may be high for one person but normal for another.

Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. That’s why a comprehensive dilated eye exam is very important. It can help your eye care professional determine what level of eye pressure is normal for you.

Take care of your eyes, and they’ll take care of you

Adults should visit with an optometrist or an ophthalmologist at least once every other year, and annually if you have bad eyesight or a family history of glaucoma, cataracts, or other congenital or age-related eye ailments. Many eye maladies develop as we get older, part of the natural aging process. Through a comprehensive eye exam that typically involves dilating your pupils and conducting a number of standard (and painless) tests, eye care professionals not only determine sight deficiencies and illnesses, but also find warning signs pointing to other dangers such as heart disease, diabetes, high blood pressure, and cancer.

Being aware of the potential damage from ultraviolet light also is important. Sunglasses and clear eyeglasses with protective coatings filter out the sun’s damaging rays, so if you work or spend a lot of time outdoors, you need that extra protection.

Dry eye syndrome also affects us as we age. If the glands in our eyes stop making enough natural lubricants, we can buy over-the-counter remedies, but should have our eyes checked for inflammation or infection. Sometimes dry eyes occur from living or working in windy, dry, or low-humidity environments, or in buildings with air-blown hot air. Doctors recommend “fake tears,” which don’t have as many chemicals as the “get the red out” eye drops. Anti-inflammation medications and vitamins or foods like fish oil, which are high in Omega-3, are often recommended.

Through comprehensive, regular eye exams, doctors can check for early warning signs of glaucoma, potential retinal detachment (which causes floaters or flashes in the eye but can be sight threatening) and other common eye diseases, and help keep those beautiful eyes of ours sparkling and healthy.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Keep Your Skin in the Game

The cold weather often means an increase in chapped lips, dry, itchy skin, rashes and a worsening of skin conditions like eczema or psoriasis. The main culprit is lack of moisture. During winter, the humidity in the outside air plunges, and thanks to indoor heating, we’re assailed by dry, warm air in our house, office, school or workplace.

During flu and cold season, we’re also washing our hands more often than ever, which saps the natural oils in our skin, leaving them dehydrated until they crack, peel and bleed.

The skin barrier is a mix of proteins, lipids and oils. It protects your skin, and how good a job it does is largely genetic, but also a measure of environmental conditions. If you have a weak barrier, you’re more prone to symptoms of sensitive skin such as itching, inflammation and eczema. Your hands are also more likely to become very dry in winter if they’re constantly exposed to cold air, water, extreme heat or other environmental factors.

One solution is to keep ourselves, and our skin, properly hydrated. But drinking water alone won’t do the trick for your skin; it also requires replenishment. Using moisturizers especially formatted for your skin is an important tool in your hydration arsenal. But putting moisturizers on once a day isn’t enough – you need to apply five or more applications daily to afford day-long protection. Coverage should include hands, fingernails, face, arms and legs and even your feet.

There are many effective hand creams and body lotions available in our local drugstores and supermarkets.  Choosing the one that’s best may require some trial and error, but focus on the two main ingredients that make the greatest difference:  emollients and humectants.

Emollients act as lubricants on the surface of the skin. They fill the crevices between cells that are ready to be shed and help the loose edges of the dead skin cells that are left behind stick together. Emollients help keep the skin soft, smooth, and pliable. Look for ingredients such as lanolin, jojoba oil, isopropyl palmitate, propylene glycol linoleate, squalene, and glycerol stearate.

Humectants draw moisture from the environment to the skin’s surface, increasing the water content of the skin’s outer layer. Scan the ingredients label for common humectants such as glycerin, hyaluronic acid, sorbitol, propylene glycerol, urea, and lactic acid.

If your hands go from just being dry and rough to having little cracks, or fissures, and are tender or bleeding, it’s time to move on to more therapeutic moisturizers. Petroleum jelly is a reliable standby. Or choose a thick, rich moisturizer in a formula that contains heavier ingredients such as dimethicone, cocoa or shea butter, or beeswax. Applying a generous coating at bedtime, and wearing a pair of cotton gloves will help retain the healing salve until it can be fully absorbed while you sleep.

If you already have sensitive skin, look for a moisturizer that contains soothing ingredients such as chamomile or aloe, and doesn’t contain potential allergens such as fragrances or dyes. Also, avoid products containing acids, which can irritate sensitive skin.

As we age, our skin tends to become drier because our oil-producing glands become less active. To keep skin soft and well hydrated, choose an oil-based moisturizer that contains petrolatum as the base, along with antioxidants or alpha hydroxy acids to combat wrinkles. These ingredients help hold in moisture and prevent flaky, scaly skin.

Hand washing, though critical for your overall health and to prevent the spread of germs, also dries out skin and hands. The best bet is to choose a mild soap, use warm — not hot — water, pat your hands dry and apply a moisturizer right away. If you have severely dry hands or you wash your hands a dozen or more times a day, substitute a hand-sanitizing gel or wipes for some soap-and-water sessions.

Other tricks for limiting dry skin is to sleep with a humidifier at night, take short, warm (not hot) showers, and to wear gloves, a hat and sunscreen when you’re outdoors. A balanced diet rich in vegetables and fruits also provides the vitamins and minerals your body needs to help it remain healthy. If redness, peeling and tenderness persist, see a dermatologist. He or she can prescribe a steroid cream to help fight inflammation, and also check on whether your dry hands may be due to a skin condition such as eczema or psoriasis.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!