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Can your sodium level be too low?

Symptoms of a low sodium level include nausea, vomiting, headache, confusion, feeling weak or tired, restlessness, muscle weakness, spasms or cramps and seizures or passing out.

Most Americans eat much more sodium than their bodies require. Too much sodium can worsen high blood pressure and heart failure. For these reasons, many Americans are advised to reduce the amount of sodium they eat. Because there is so much sodium in most foods, it is very difficult to eat too little.

But can sodium in the blood be low even if the amount of sodium in the body is too high? It can.

Low blood sodium is called “hyponatremia.” Although an underlying health condition usually causes low blood sodium levels, there are still signs that indicate if your levels are low.

What causes low blood sodium levels?

A low blood sodium level is a problem for many people.

“It usually happens with other ongoing problems,” said Dr. Kelley Anderson, a Marshfield Clinic cardiologist. “Low blood sodium rarely occurs in healthy people.”

The blood’s sodium reflects how diluted the blood is, not how much sodium is in the body.

One of the common causes of low blood sodium is heart failure. “Heart failure” means the heart is unable to supply your body with the blood flow it needs. The body tries to maintain blood flow by releasing certain hormones. Vasopressin is one of those hormones.

“When vasopressin increases, your kidneys retain pure water,” Dr. Anderson said. “That dilutes your blood, resulting in low sodium levels.”

Other causes include some mental disorders or cirrhosis of liver.

Symptoms of low blood sodium

The signs and symptoms of hyponatremia are common for a lot of other conditions. Some symptoms include nausea, vomiting, headache, confusion, feeling weak or tired, restlessness, muscle weakness, spasms or cramps and seizures or passing out.

“It can be tricky because a vast majority of people who have these symptoms may not have low sodium,” Dr. Anderson said. “Just because they have these symptoms, it doesn’t mean they have to run and get their sodium checked. So always check with your doctor first.”

A normal blood sodium level is around 140 mEq/L (milliequivalents per Liter). If it’s less than 135, it is considered low. When the level is below 130 or lower, more problems can occur.

How to treat low blood sodium levels

Blood levels of electrolytes are usually done to find out if sodium levels are low. Patients with conditions that cause hyponatremia usually have their blood checked regularly.

Dr. Anderson says most people don’t need to monitor their own sodium levels.

“In a healthy person, the body automatically maintains normal blood sodium.” Dr. Anderson said. “On the other hand, the body does not always do a good job of maintaining normal total body sodium. So people should remember sodium in your blood does not always reflect sodium in the body.”

The treatment of hyponatremia depends on how low the blood sodium is, the individual’s medical problems and their medications and dietary habits.

If you are experiencing symptoms that can be associated with low blood sodium, contact your provider.

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Hyponatremia – Symptoms and causes

Overview

Hyponatremia occurs when the concentration of sodium in your blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that’s in and around your cells.

In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water — cause the sodium in your body to become diluted. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening.

Hyponatremia treatment is aimed at resolving the underlying condition. Depending on the cause of hyponatremia, you may simply need to cut back on how much you drink. In other cases of hyponatremia, you may need intravenous electrolyte solutions and medications.

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Symptoms

Hyponatremia signs and symptoms may include:

  • Nausea and vomiting
  • Headache
  • Confusion
  • Loss of energy, drowsiness and fatigue
  • Restlessness and irritability
  • Muscle weakness, spasms or cramps
  • Seizures
  • Coma

When to see a doctor

Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness.

Call your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headaches, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care.

Causes

Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.

A normal blood sodium level is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

Many possible conditions and lifestyle factors can lead to hyponatremia, including:

  • Certain medications. Some medications, such as some water pills (diuretics), antidepressants and pain medications, can interfere with the normal hormonal and kidney processes that keep sodium concentrations within the healthy normal range.
  • Heart, kidney and liver problems. Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in your body, which dilutes the sodium in your body, lowering the overall level.
  • Syndrome of inappropriate anti-diuretic hormone (SIADH). In this condition, high levels of the anti-diuretic hormone (ADH) are produced, causing your body to retain water instead of excreting it normally in your urine.
  • Chronic, severe vomiting or diarrhea and other causes of dehydration. This causes your body to lose electrolytes, such as sodium, and also increases ADH levels.
  • Drinking too much water. Drinking excessive amounts of water can cause low sodium by overwhelming the kidneys’ ability to excrete water. Because you lose sodium through sweat, drinking too much water during endurance activities, such as marathons and triathlons, can also dilute the sodium content of your blood.
  • Hormonal changes. Adrenal gland insufficiency (Addison’s disease) affects your adrenal glands’ ability to produce hormones that help maintain your body’s balance of sodium, potassium and water. Low levels of thyroid hormone also can cause a low blood-sodium level.
  • The recreational drug Ecstasy. This amphetamine increases the risk of severe and even fatal cases of hyponatremia.

Risk factors

The following factors may increase your risk of hyponatremia:

  • Age. Older adults may have more contributing factors for hyponatremia, including age-related changes, taking certain medications and a greater likelihood of developing a chronic disease that alters the body’s sodium balance.
  • Certain drugs. Medications that increase your risk of hyponatremia include thiazide diuretics as well as some antidepressants and pain medications. In addition, the recreational drug Ecstasy has been linked to fatal cases of hyponatremia.
  • Conditions that decrease your body’s water excretion. Medical conditions that may increase your risk of hyponatremia include kidney disease, syndrome of inappropriate anti-diuretic hormone (SIADH) and heart failure, among others.
  • Intensive physical activities. People who drink too much water while taking part in marathons, ultramarathons, triathlons and other long-distance, high-intensity activities are at an increased risk of hyponatremia.

Complications

In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer — and symptoms and complications are typically more moderate.

In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death.

Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage. This may be related to the effect of women’s sex hormones on the body’s ability to balance sodium levels.

Prevention

The following measures may help you prevent hyponatremia:

  • Treat associated conditions. Getting treatment for conditions that contribute to hyponatremia, such as adrenal gland insufficiency, can help prevent low blood sodium.
  • Educate yourself. If you have a medical condition that increases your risk of hyponatremia or you take diuretic medications, be aware of the signs and symptoms of low blood sodium. Always talk with your doctor about the risks of a new medication.
  • Take precautions during high-intensity activities. Athletes should drink only as much fluid as they lose due to sweating during a race. Thirst is generally a good guide to how much water or other fluids you need.
  • Consider drinking sports beverages during demanding activities. Ask your doctor about replacing water with sports beverages that contain electrolytes when participating in endurance events such as marathons, triathlons and other demanding activities.
  • Drink water in moderation. Drinking water is vital for your health, so make sure you drink enough fluids. But don’t overdo it. Thirst and the color of your urine are usually the best indications of how much water you need. If you’re not thirsty and your urine is pale yellow, you are likely getting enough water.

Results From the Trial of Nonpharmacologic Interventions in the Elderly

Am J Public Health. 2016 July; 106(7): 1270–1275.

Liwei Chen, MD, PhD,Zhenzhen Zhang, PhD, Wen Chen, MD, Paul K. Whelton, MD, and Lawrence J. Appel, MD

Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.

Corresponding author.Correspondence should be sent to Liwei Chen, Assistant Professor, Department of Public Health Sciences, Clemson University, 511 Edwards Hall, Clemson, SC 29631 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.CONTRIBUTORS

L. Chen wrote the first draft of the article. L. Chen, Z. Zhang, and W. Chen conducted the statistical analyses. P. K. Whelton and L. J. Appel acquired the data. All authors conceptualized and designed the study, interpreted the results, and revised the article.

Peer Reviewed

Accepted February 15, 2016.

Copyright © American Public Health Association 2016This article has been cited by other articles in PMC.

Abstract

Objectives. To determine the effect of sodium (Na) reduction on occurrence of headaches.

Methods. In the Trial of Nonpharmacologic Interventions in the Elderly, 975 men and woman (aged 60–80 years) with hypertension were randomized to a Na-reduction intervention or control group and were followed for up to 36 months. The study was conducted between 1992 and 1995 at 4 clinical centers (Johns Hopkins University, Wake Forest University School of Medicine, Robert Wood Johnson Medical School, and the University of Tennessee).

Results. Mean difference in Na excretion between the Na-reduction intervention and control group was significant at each follow-up visit (P < .001) with an average difference of 38.8 millimoles per 24 hours. The occurrence of headaches was significantly lower in the Na-reduction intervention group (10.5%) compared with control (14.3%) with a hazard ratio of 0.59 (95% confidence interval = 0.40, 0.88; P = .009). The risk of headaches was significantly associated with average level of Na excretion during follow-up, independent of most recent blood pressure. The relationship appeared to be nonlinear with a spline relationship and a knot at 150 millimoles per 24 hours.

Conclusions. Reduced sodium intake, currently recommended for blood pressure control, may also reduce the occurrence of headaches in older persons with hypertension.

Headache is a common health problem in adults, resulting in approximately 18 million physician visits in the United States each year.1 Globally, the estimated lifetime prevalence of headaches in adults is 66%.2 The most common types of headaches are nonvascular and are commonly termed “tension headaches.”1 Tension headaches have been attributed to muscle spasm in the head, neck, and shoulders in response to stress, fatigue or environmental factors like noise or bright lights.3 However, the pathophysiology of tension headaches is uncertain.

Headaches have been associated with elevated blood pressure (BP), including sustained severe hypertension, malignant hypertension, and paroxysmal hypertension. 4 In the Hypertension Optimal Treatment trial, in which participants were randomized to 1 of 3 diastolic BP goals, headaches were reduced in all treatment groups, independent of BP goal and type of antihypertensive drug.5

High sodium intake is associated with elevated BP, and clinical trials have demonstrated that sodium-reduction (NaD) lowers BP in individuals with or without hypertension.6–13 A high intake of sodium potentially leads to headaches through a direct effect on BP or indirectly through a BP-independent mechanism. However, few studies have investigated the relationship of sodium intake to the occurrence of headaches. In preliminary observations from the Trial of Nonpharmacologic Interventions in the Elderly (TONE), we reported that individuals who were assigned to the NaD intervention had a lower incidence of headaches.13 A more recent analysis using data collected from the Dietary Approaches to Stop Hypertension (DASH)-sodium trial reported that NaD was associated with a lower risk of headaches,14 replicating the earlier observation from the TONE study. We aimed to expand on the original observation from TONE by examining the relationship between sodium intake and headaches, with a particular focus on assessing dose–response relationship.

METHODS

TONE was a multicenter, randomized controlled trial designed to test the efficacy of nonpharmacologic interventions as a means to control hypertension in the elderly. A detailed description of the design and methods of this trial has been published elsewhere.15 Eligible individuals were aged 60 to 80 years, were community dwelling, and had hypertension controlled on single antihypertensive medication. Major exclusion criteria included history of a heart attack or stroke within the preceding 6 months, current angina pectoris, congestive heart failure, insulin-dependent diabetes mellitus, serious mental or physical illness, unexplained or involuntary weight loss of 4.5 kilograms or greater during the previous year, hypercreatinemia (> 2.0 mg/dL), hyperkalemia (> 5.5 mmol/L), and anemia (hemoglobin level < 11 g/dL).

We randomly assigned overweight persons (body mass index [BMI; defined as weight in kilograms divided by the square of height in meters] > 27.3 kg/m2 in men, > 27.8 kg/m2 in women) to 1 of 4 groups in a 2 × 2 factorial design (usual care, weight loss alone, reduced sodium alone, or combined weight loss and reduced sodium). We assigned nonoverweight persons to usual care or reduced sodium intake. The NaD goal for the reduced sodium groups, both NaD alone and NaD combined with weight loss, was to achieve and maintain a 24-hour dietary sodium intake of 80 millimoles (1800 mg) or less. Three months after the start of intervention, we employed a standardized protocol to gradually taper and withdraw antihypertensive medication in participants whose BP remained less than 150/90 millimeters of mercury.

The primary trial outcome was a composite endpoint that included recurrence of high BP, resumption of antihypertensive medication, or a clinical cardiovascular event. During follow-up, we restarted antihypertensive medication if (1) systolic BP was 190 millimeter of mercury or more or diastolic BP was 110 millimeters of mercury or more at a single visit (average of 3 BP measurements), (2) mean systolic BP was 170 millimeters of mercury or more or diastolic BP was 100 millimeters of mercury or more over 2 consecutive visits (average of 6 BP measurements), or (3) mean systolic BP was 150 millimeters of mercury or more or diastolic BP rose to 90 millimeters of mercury or more at 3 consecutive visits (average of 9 BP measurements).

We enrolled participants between August 30, 1992, and June 27, 1994. We collected TONE data at 2 screening visits to establish study eligibility, a randomization visit, drug withdrawal visits (90 days after the start of intervention), and 11 subsequent quarterly follow-up visits (beginning 6 months after randomization). Closeout visits occurred between July and December 1995. The median follow-up in TONE was 29 months (range = 1–36 months). We conducted the study at 4 clinical centers (Johns Hopkins University, Wake Forest University School of Medicine, Robert Wood Johnson Medical School, and the University of Tennessee).13 Staff members, who were blinded to the participant’s randomized treatment assignment, obtained outcome information.

Variables

We estimated dietary sodium intake by measurement of carefully collected 24-hour urinary sodium excretion. We analyzed urinary sodium levels by flame photometry.13 In TONE we ascertained headaches by participant self-report of an adverse event at any follow-up visit. At each follow-up visit, participants completed a brief self-reported medical history and adverse events questionnaire. A study nurse evaluated any participant who reported an intercurrent health-related concern. If a participant reported a medical problem that was potentially serious (e.g., angina) or a symptom that was severe (e.g., headache or chest pain) the nurse completed an adverse event form. A physician then reviewed and coded the adverse event by type (e. g., stroke, myocardial infarction, headache). We also collected and coded the date of the event. Both the nurse and physician were unaware on the participant’s treatment assignment.

Trained observers who were masked to intervention assignment measured BP. At each visit, we obtained 3 BP measurements while participants rested in the seated position. We collected detailed demographic and socioeconomic information including age, gender, race, physical activity, smoking habits, and alcohol intake at baseline.15 We also collected interval medical information, medication use, and body weight measurement at each visit.

Statistical Analyses

We expressed descriptive data for identification of baseline characteristics as well as urinary sodium excretion at each visit as means (SD) for continuous variables and counts (%) for categorical variables. We used the Student t test and χ2 test to compare continuous variables and discrete variables, respectively. For all the analyses, the primary outcome was headache, which we identified by means of adverse event reports.

First, we compared incidence of headaches between those in the NaD intervention group (i.e., the NaD alone plus combined weight loss and NaD interventions) and their counterparts in the control group (i.e., usual care plus weight loss alone interventions). We used Kaplan-Meier plots to explore temporal patterns for cumulative incidence of headaches and Cox proportional hazard regressions to estimate the hazard ratio (HR) and 95% confidence interval (CI) for comparison of first occurrence of a headache between the 2 groups. Because this comparison was on the basis of randomized assignments, we only adjusted for variables that were significantly different between the NaD intervention and control groups (i.e., time-varying drug withdraw status and BPs). Although we conducted the main analyses between the NaD and control groups, we also performed a sensitivity analysis to compare headaches among the 4 original group assignments of the factorial design (i.e., usual care, weight loss alone, NaD alone, and combined weight loss and NaD interventions).

Second, we examined whether there were a dose–response relationship and threshold effect between sodium intake and the occurrence of headaches. The exposure was 24-hour urinary sodium excretion, measured as the average level during follow-up. We used Cox proportional hazard regressions to investigate the frequency of new onset headaches, assessed as an adverse event (incident headaches postrandomization). In these models, we combined participants from all intervention groups and we included potential confounders such as age, gender, race, physical activity, smoking, alcohol intake, headaches at baseline, average weight loss during follow-up, and drug withdraw status (time-varying variable) in the adjusted analyses. To explore whether the relationship of headaches with sodium intake was independent of BP, we additionally adjusted for the most recent BP. We performed all statistical analyses using SAS version 9.4 (SAS Institute, Cary, NC). We considered a P value of less than . 05 (2 sides) statistically significant.

RESULTS

displays the baseline characteristics of all TONE study participants by assignment to the NaD intervention or control. Of the 975 individuals, 52% were men, 76% were White, and the mean (SD) age was 65.8 (4.6) years. Mean (SD) 24-hour urinary sodium excretion at baseline was 148.5 (54) millimoles per 24 hours. Overall, there was no statistically significant difference in baseline characteristics by group (NaD vs control).

TABLE 1—

Baseline Characteristics of Participants by Randomly Assigned Group: Trial of Nonpharmacologic Interventions in the Elderly, United States, 1992–1995

Characteristic Control (n = 488), Mean (SD) or % Sodium Reduction (n = 487), Mean (SD) or % Alla (n = 975), Mean (SD) or %
Age, y 65. 8 (4.5) 65.8 (4.7) 65.8 (4.6)
Male 51.8 52.6 52.2
White 74.8 77.2 76.0
SBP, mmHg 128.1 (9.3) 128.4 (9.4) 128.2 (9.3)
DBP, mmHg 71.3 (7.4) 71.4 (7.2) 71.4 (7.3)
Urine sodium, mmol/24 h 148. 6 (54.9) 148.4 (53.4) 148.5 (54.2)
Weight, lb 180.0 (26.3) 180.7 (28.4) 180.3 (27.4)
BMI, kg/m2 28.9 (3.5) 28.9 (3.6) 28.9 (3.5)
Alcohol user 34.8 35.5 35.2
Currently smokes 4.9 5.7 5. 3

Participant attendance rates were 90%, 86%, and 86% at the 9-, 18-, and 30-month follow-up visits. BP measurements were available for 100% of the visits. We collected 24-hour urine samples in 867 (88.9%), 804 (82.5%), and 421 (82.1%) participants at the 9-, 18-, and 30-month visits, respectively.

Urinary Sodium Excretion and Headache Occurrence

Baseline urinary sodium excretion did not differ between the NaD and control groups (Table A, available as a supplement to the online version of this article at http://www.ajph.org). We observed significantly greater reductions in urinary sodium from baseline in the NaD group compared with the control group at the 9-, 18-, and 30-month follow-up visits. The mean changes in urinary sodium excretion in the NaD group were −40.9, −43.2, and −45.3 millimoles per 24 hours at the 9-, 18-, and 30-month follow-up visits, respectively. Corresponding mean changes in the control group were 0.4, −3.1, and −4.5 millimoles per 24 hours, respectively. During follow-up, the mean between-group difference in average urinary sodium excretion was 38.8 millimoles per 24 hours.

During follow-up, 126 participants reported headache as an adverse event, and 13 (10.3%) reported headache twice as an adverse event. We used the first reported headache as our study outcome. displays the cumulative incidence of headaches during follow-up by randomized assignment. In the control group, 14.3% reported headaches during follow-up. By contrast, only 10.5% reported headaches in the NaD group (log-rank test, P = .012).

Cumulative Incidence of Headaches by Intervention Group (Reduced Sodium vs Control): Trial of Nonpharmacologic Interventions in the Elderly, United States, 1992–1995

Note. We used the log-rank test to compare the group difference (P = .012).

The HR for headaches in the NaD group compared with control was 0.56 (95% CI = 0.38, 0.83; P = .01) after adjustment for clinical center, time-varying drug withdrawal status, and average weight loss during follow-up (model 2). After further adjustment for most recent systolic and diastolic BP before the occurrence of headaches (model 3), the HR was essentially unchanged (HR = 0.59; 95% CI = 0.40, 0.88; P = .02). In the sensitivity analysis, the HR for headaches (model 3) was 0.83 (95% CI = 0.49, 1.40; P = .48) in the weight loos alone intervention, 0.61 (95% CI = 0.39, 0.95; P = .03) in the NaD alone intervention, and 0.47 (95% CI = 0.25, 0.92; P = .03) in the combined weight loos and NaD intervention compared with the control group.

Observational Analyses and Dose–Response Relationship

summarizes results from the Cox proportion hazard models using average urinary sodium excretion during follow-up as the primary exposure. We identified a statistically significant direct association of headaches with average urinary sodium excretion. After adjustment for clinical center, age, smoking, race, gender, alcohol use, physical activity, average weight loss during follow-up, and drug withdrawal status (model 2), a 10 millimoles per 24 hour higher level of urinary sodium excretion was associated with a hazard of headaches that was 7. 0% higher (95% CI = 4%, 11%, P ≤ .001). The association between urinary sodium excretion and risk of headaches persisted after further adjustment for most recent systolic BP and diastolic BP in model 3. Because headaches were more common in women (17.0%) than in men (8.8%), we further stratified our analyses by gender. The magnitude of the associations was similar in both gender; the HR of headaches associated with a 10 millimoles per 24 hours higher level of urinary sodium excretion was 1.09 (95% CI = 1.03, 1.15) for men and 1.07 (95% CI = 1.02, 1.12) for women.

TABLE 2—

HR (95% CI) of Headaches by Level of Urinary Sodium Excretion During Follow-Up: Trial of Nonpharmacologic Interventions in the Elderly, United States, 1992–1995

Average Urinary Sodium as Categorical Variableb


Model Average Urinary Sodium Excretion as a Continuous Variable,a HR (95% CI) 120–150 mmol/24 h, HR (95% CI) > 150 mmol/24 h, HR (95% CI)
Model 1c 1. 04 (1.00, 1.07) 1.01 (0.62, 1.66) 1.65 (1.11, 2.46)
Model 2d 1.07 (1.04, 1.11) 1.15 (0.67, 1.95) 2.27 (1.45, 3.55)
Model 3e 1.07 (1.04, 1.11) 1.26 (0.74, 2.16) 2.32 (1.48, 3.65)

In exploratory analyses, the relationship between headaches and absolute urinary sodium level appeared to be nonlinear, with a threshold between 120 to 150 millimoles per 24 hours. We noted the greatest evidence for an association between urinary sodium excretion and occurrence of headaches above this threshold. For this reason, we categorized the participants into 3 groups on the basis of their average urinary sodium excretion during follow-up: (1) less than 120 millimoles per 24 hours (below the threshold, lower sodium intake), (2) 120–150 millimoles per 24 hours (close to threshold, moderate sodium intake), and (3) more than 150 millimoles per 24 hours (above threshold, higher sodium intake). Compared with the category of lower sodium intake, individuals with moderate sodium intake did not exhibit a significantly higher risk of headaches (HR = 1.26; 95% CI = 0.74, 2.16; P = .39). However, individuals in the higher sodium intake category had a significantly higher risk of headaches than did those in the lower sodium intake category (HR = 2.32; 95% CI = 1.48, 3.65; P ≤ .001).

During spline interpolation, we identified knots at 120 millimoles per 24 hours and 150 millimoles per 24 hours. Above the 150 millimoles per 24 hours knot, an increase of 10 millimoles per 24 hours in urinary sodium excretion was associated with an increase of 9.7% in the hazard of headaches (95% CI = 3.4%, 16.9%; P = .002) after adjusting for age, smoking, race, gender, alcohol use, physical activity, average weight loss during follow-up, and drug withdrawal status. This positive association remained significant with further adjustment for most recent BPs in model 3 (HR = 1. 09; 95% CI = 1.02, 1.18; P = .004). The risk of headaches increased dramatically and significantly as the urinary sodium excretion level was above the 150 millimoles per 24 hours (Figure A, available as a supplement to the online version of this article at http://www.ajph.org).

DISCUSSION

In this analysis of 975 persons, aged 60 to 80 years who participated in the TONE trial, we found that NaD was associated with a lower risk of headaches over the course of 36 months of follow-up. Specifically, individuals who were randomly assigned to a NaD intervention had a lower cumulative incidence of headaches than did their counterparts in the control group. In an observational analysis, urinary sodium excretion, measured as an average level during follow-up, was associated with occurrence of incident headaches, independent of other risk factors, baseline headaches, use of BP lowering medications, and most recent level of BP. We observed an apparent threshold effect, with the risk of headaches increasing progressively above a urinary sodium excretion of 150 millimoles per 24 hours. Above the sodium excretion threshold of 150 millimoles per 24 hours, risk of incident headaches was higher by 7.8% for every 10 millimoles average increase in 24-hour urinary sodium; below this threshold, there was no significant relationship.

Although numerous studies have assessed the effects of a reduced sodium intake on BP6,7,11–13 and several studies have assessed the relationship between headaches and BP,4,5,16,17 the relationship between sodium intake and the occurrence of headaches has received scant attention. The most relevant study is the DASH-Sodium trial, a randomized, controlled feeding study that tested the effects of 3 levels of sodium intake (50, 100, and 150 mmol/24 hr) in 2 different diets (the DASH diet and a typical American diet). In a recent secondary analysis of this trial, a reduced sodium intake was associated with significantly lower risk of headache (odds ratio[OR] = 0.69; P = .05, among those consuming a typical American diet, and OR = 0.69; P = . 04, among those consuming the DASH diet) in adults with prehypertension and stage 1 hypertension.14

By contrast to TONE, study participants in the DASH-Sodium trial tended to be younger, with a mean (SD) age of 48 years.10 Also, the 2 trial designs and duration of follow-up were different (a cross-over trial with approximately 30 days of follow-up for each period of intervention in the DASH-Sodium trial and a parallel arm trial with a median follow-up of 29 months in the TONE trial), the extent of NaD was almost twofold greater in the DASH-Sodium trial than in the TONE trial, and the methods used to ascertain headaches were different in the 2 studies (symptom check list in the DASH-Sodium trial and adverse event reporting in the TONE trial). Overall, the findings from our analysis and the corresponding DASH-Sodium report provide consistent evidence regarding the apparent effect of sodium intake on the occurrence of headaches. Because of the use of adverse events reporting as the method of ascertainment for headaches in the TONE trial, it seems likely that the results from this trial may have highlighted the relationship between NaD and more severe headaches.

The mechanisms underlying an association between sodium intake and headaches are uncertain. Sodium intake may be related to headaches through a direct effect on BP or indirectly through other BP-independent mechanisms. Excessive intake of sodium is a well-established risk factor for high BP, and NaD can lower BP in hypertensive and nonhypertensive individuals.6–13 Elevated BP has been associated with headaches independent of weight status and antihypertensive drug therapy.4,5 Therefore, it is possible that a high intake of sodium may lead to headaches through a direct effect on BP. However, controlling for recent BP in the Cox regression models did not attenuate the association between sodium and headaches in our analyses, suggesting that the effect of sodium on headaches might be independent of BP.

One proposed BP-independent mechanism relates to changes in vascular smooth muscle tone. Sodium intake is an important determinant of smooth muscle cell reactivity, which is in part mediated by changes in extracellular volume and perhaps by changes in intracellular calcium. A high sodium intake increases the reactivity of arterioles and the BP response to stress or sympathetic simulation.18 In a study of patients with asthma, a moderate reduction in sodium intake led to an improvement in asthma symptoms, potentially related to changes in bronchial smooth muscle tone.19 Such findings suggest that nonvascular headaches might be part of a continuum with vascular headaches at 1 extreme.20 Still, we cannot totally rule out an effect of BP in our study because we measured BP at prespecified follow-up visits, not at the time of the headaches.

Strengths and Limitations

Our study has several strengths. First, the sample size of TONE trial was relatively large (n = 975), and the duration of follow-up was relatively long (up to 3 years). Second, we collected information on potential adverse events at each study visit; a study clinician who was blinded to the participant’s treatment allocation verified these. Third, we estimated sodium intake by means of carefully collected 24-hour urine samples, with averaging of several samples for the observational analyses: twice before randomization and once at the 9-month, 18-month, and 30-month follow-up visits. Of the available methods, mean 24-hour urinary excretion of sodium collected from multiple occasions provides the most accurate estimate of dietary sodium intake for observational analyses.21 Study limitations include a lack of specific information regarding participant headaches severity and duration and prior history of headaches.

Nevertheless, headaches reported as an adverse event in TONE were associated with baseline headache experience,22 and we adjusted for baseline headaches in our observational analyses. Again, because we did not measured BP at the time of the event, inferences about the relationship between BP and headaches are uncertain. However, there were no differences when we compared BP measured at the study visit closest to the adverse event and the average BP during the follow-ups for study participants. The average time between most recent BP measurement and occurrence of adverse event headache was 12.3 days for those who had adverse event headache, which is relative short. Although the assortment of headaches in this study is probably not subject to reporting bias or directly related to the intervention assignments, we were unable to rule out the possibility that the observed improvement in occurrence of headaches in the NaD group could be a surrogate of improving general well-being.

Conclusions

Our findings suggest that reducing sodium intake lowers the risk of headaches in older persons with hypertension. Our findings are consistent with results from the DASH-Sodium trial, which enrolled a middle-aged study population and used a different approach to ascertainment. Whether a reduced sodium intake lowers the risk of headaches in other populations (e.g., persons with migraine headaches) is unknown. From a policy perspective, these data provide an additional rationale in support of recommendations by the American Heart Association, US federal government, Institute of Medicine, World Health Organization, and others to reduce dietary sodium intake. 23

ACKNOWLEDGMENTS

The Trial of Nonpharmacologic Interventions in the Elderly (TONE) trial was supported by the National Institutes of Health (grants R01 AG-09799, R01 H-48642, R01 AG-09771, R01 AG-09773, P60 AG-10484, and K08 HLO2642).

We thank the TONE participants and staff for their contributions to the study.

HUMAN PARTICIPANT PROTECTION

The institutional review boards at Johns Hopkins University, Wake Forest University School of Medicine, Robert Wood Johnson Medical School, and the University of Tennessee approved the trial protocol. Oversight of the trial was also provided by an external data and safety monitoring board appointed by staff at the National Institute on Aging and the National Heart, Long, and Blood Institute. All potential study participants provided written informed consent. Clinical Trial Registration: clinicaltrials.gov identifier {“type”:”clinical-trial”,”attrs”:{“text”:”NCT00000535″,”term_id”:”NCT00000535″}}NCT00000535.

REFERENCES

1. DuBose CD, Cutlip AC, Cutlip WD., 2nd Migraines and other headaches: an approach to diagnosis and classification. Am Fam Physician. 1995;51(6):1498–1504. 1507–1509. [PubMed] [Google Scholar]2. Stovner L, Hagen K, Jensen R et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193–210. [PubMed] [Google Scholar]3. Rasmussen BK, Olesen J. Epidemiology of migraine and tension-type headache. Curr Opin Neurol. 1994;7(3):264–271. [PubMed] [Google Scholar]4. Cirillo M, Stellato D, Lombardi C, De Santo NG, Covelli V. Headache and cardiovascular risk factors: positive association with hypertension. Headache. 1999;39(6):409–416. [PubMed] [Google Scholar]5. Wiklund I, Halling K, Ryden-Bergsten T. [What is the effect of lowering the arterial blood pressure on the quality of life? An auxiliary study to the HOT (Hypertension Optimal Treatment) trial] Arch Mal Coeur Vaiss. 1999;92(8):1079–1082. [PubMed] [Google Scholar]6. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the Trials of Hypertension Prevention, phase I. JAMA. 1992;267(9):1213–1220. [Erratum JAMA 1992;267(17):2330] [PubMed] [Google Scholar]7. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. The Trials of Hypertension Prevention Collaborative Research Group. Arch Intern Med. 1997;157(6):657–667. [PubMed] [Google Scholar]8. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013;346:f1326. [PMC free article] [PubMed] [Google Scholar]9. Appel LJ American Society of Hypertension Writing Group. ASH position paper: dietary approaches to lower blood pressure. J Clin Hypertens. 2009;11(7):358–368. [PubMed] [Google Scholar]10. Mozaffarian D, Fahimi S, Singh GM et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014;371(7):624–634. [PubMed] [Google Scholar]11. Sacks FM, Svetkey LP, Vollmer WM et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344(1):3–10. [PubMed] [Google Scholar]12. Stamler R, Stamler J, Grimm R et al. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial—the Hypertension Control Program. JAMA. 1987;257(11):1484–1491. [PubMed] [Google Scholar]13. Whelton PK, Appel LJ, Espeland MA et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998;279(11):839–846. [PubMed] [Google Scholar]14. Amer M, Woodward M, Appel LJ. Effects of dietary sodium and the DASH diet on the occurrence of headaches: results from randomised multicentre DASH-sodium clinical trial. BMJ Open. 2014;4(12):e006671. [PMC free article] [PubMed] [Google Scholar]15. Appel LJ, Espeland M, Whelton PK et al. Trial of Nonpharmacologic Intervention in the Elderly (TONE). Design and rationale of a blood pressure control trial. Ann Epidemiol. 1995;5(2):119–129. [PubMed] [Google Scholar]16. Cooper WD, Glover DR, Hormbrey JM, Kimber GR. Headache and blood pressure: evidence of a close relationship. J Hum Hypertens. 1989;3(1):41–44. [PubMed] [Google Scholar]17. Mathew NT. Migraine and hypertension. Cephalalgia. 1999;19(suppl 25):17–19. [PubMed] [Google Scholar]18. Burney P. A diet rich in sodium may potentiate asthma. Epidemiologic evidence for a new hypothesis. Chest. 1987;91(6 suppl):143S–148S. [PubMed] [Google Scholar]19. Carey OJ, Locke C, Cookson JB. Effect of alterations of dietary sodium on the severity of asthma in men. Thorax. 1993;48(7):714–718. [PMC free article] [PubMed] [Google Scholar]20. Merikangas KR, Fenton BT, Cheng SH, Stolar MJ, Risch N. Association between migraine and stroke in a large-scale epidemiological study of the United States. Arch Neurol. 1997;54(4):362–368. [PubMed] [Google Scholar]21. Whelton PK, Appel LJ, Sacco RL et al. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation. 2012;126(24):2880–2889. [PubMed] [Google Scholar]22. Lipton RB, Pfeffer D, Newman LC, Solomon S. Headaches in the elderly. J Pain Symptom Manage. 1993;8(2):87–97. [PubMed] [Google Scholar]23. Whelton PK. Sodium, potassium, blood pressure, and cardiovascular disease in humans. Curr Hypertens Rep. 2014;16(8):465. [PubMed] [Google Scholar]

Hyponatremia: Symptoms, Causes, Treatments

Overview

What is hyponatremia?

Hyponatremia is usually discovered on laboratory tests as a lower than normal sodium level in the blood. It will appear as sodium or Na+ in your lab results. Actually, the main problem in the vast number of situations is too much water that dilutes the Na+ value rather than too much sodium. As a result, water moves into body cells, causing them to swell. This swelling causes the major problem, which is a change in mental status that can progress to seizures or coma.

Hyponatremia can result from multiple diseases that often are affecting the lungs, liver or brain, heart problems like congestive heart failure, or medications. Most people recover fully with their doctor’s help.

Who is most at risk for hyponatremia?

Anyone can develop hyponatremia. Hyponatremia is more likely in people living with certain diseases, like kidney failure, congestive heart failure, and diseases affecting the lungs, liver or brain. It often occurs with pain after surgery. Also, people taking medications like diuretics and some antidepressants are more at risk for this condition.

How common is hyponatremia?

Hyponatremia is very common. Hyponatremia is the most common chemical abnormality seen among patients in the hospital. Rates of hyponatremia are higher among people admitted to inpatient hospital care units or with the medical conditions mentioned above.

Symptoms and Causes

What causes hyponatremia?

In general, too much water in your body is usually the main problem and this dilutes the sodium levels. Much less frequently, hyponatremia is due to significant sodium loss from your body.

Too much water in your body causes your blood to become “watered down.” A good example is people who run in long races or run on hot days. They lose both salt and water in their sweat and often replace these losses with mostly water. This combination can be deadly because it dilutes the remaining sodium in the body.

It’s also possible to lose too much sodium from your body. Medications, like diuretics, can cause your kidneys to increase the amount of sodium excreted in urine. Medical problems like diarrhea may cause excessive sodium loss if left untreated. Chronic or binge alcohol consumption can cause people to lose too much sodium through increased urination and vomiting. You can have hyponatremia without feeling dehydrated or volume depleted. This is most often the case in hospitalized patients.

What are the symptoms of hyponatremia?

Hyponatremia causes neurologic symptoms ranging from confusion to seizures to coma. The severity of the symptoms depends on how low the sodium levels are in the bloodstream and how quickly they fall. In many cases, blood sodium levels fall gradually, producing only mild symptoms as the body has time to make adjustments. Symptoms are more serious when blood sodium levels fall quickly.

Other symptoms of moderate to severe hyponatremia include:

Diagnosis and Tests

How is hyponatremia diagnosed?

The only way your doctor can know that hyponatremia is present is with blood tests that measure the amount of sodium (Na+) in the bloodstream. Your doctor will also perform a physical examination to detect the severity and cause(s) of hyponatremia.

Management and Treatment

How is hyponatremia treated?

Treatment for hyponatremia depends on the underlying cause and the severity of your symptoms. If you have mild symptoms, your doctor makes small adjustments to your therapy to correct the problem. This usually involves restricting water intake, adjusting medications and removing or treating the causes. Therapy may be short-term or long-term. For the short-term, we may restrict water intake, adjust or stop medications, and treat any underlying problems. For the long-term, we may continue the short-term treatments and add salt to your diet or try some newer medications.

People with moderate to severe hyponatremia require thorough medical evaluation and treatment, usually in the hospital. For the sickest patients, we may replace sodium intravenously (straight into a vein) and really limit water consumption. Certain newer medications, like tolvaptan (Samsca®), may be used to correct blood sodium levels.

Treatment to correct any underlying medical problems – like congestive heart failure (when poor heart function causes fluid to build up in the body) – is also used to improve hyponatremia.

What complications are associated with hyponatremia?

In many cases, hyponatremia causes extra water to move out of the bloodstream and into body cells, including brain cells. Severe hyponatremia causes this to occur quickly, resulting in swollen brain tissue. If left untreated, complications can include:

  • Mental status changes
  • Seizures
  • Coma
  • Death

Prevention

Can hyponatremia be prevented?

If you have certain underlying medical conditions, particularly involving the kidneys, heart, lung, liver or brain, hyponatremia is more likely. You can lower your risk for hyponatremia by following your treatment plan and restricting your water intake to levels recommended by your doctor. Also, notify your doctor of any new symptoms immediately. Monitoring must include blood tests.

Outlook / Prognosis

What are the outcomes after treatment for hyponatremia?

With treatment, many people recover fully from hyponatremia. Even long-term hyponatremia can be managed and problems prevented.

Living With

When should I call my doctor?

If you develop any symptoms of hyponatremia, contact your doctor immediately. Hyponatremia can become an emergency if your sodium level falls too much or too quickly.

Headaches & Migraines Philadelphia | Dental Excellence of Blue Bell

Could TMD Be Causing Your Headaches?

Headaches are complicated, and it can be hard to track them down to their true causes. If you have regular headaches, you should suspect that TMD could be causing them or triggering them when:

  • Headaches occur or worsen after intense jaw activity
  • You have other TMD symptoms
  • Typical migraine treatments give little or no relief

One reason to suspect that TMD is linked to your headaches is that jaw activity seems to set them off. You might notice that your headache seems to flare up after you talk a lot, laugh a lot, chew hard food, or even yawn wide. However, people are more likely to overlook teeth clenching and grinding or doing hard labor with the upper body as potentially stressing the jaw.

Another way to see if TMD might be responsible for your migraines is to see if you have other TMD symptoms. There are dozens of potential TMD symptoms, but the most common are jaw pain, jaw immobility, and ringing or pain in the ears.

Unfortunately, our understanding of migraines is not as advanced as some areas of medicine. This means that migraine treatment is often done with a guess-and-test method. If you’ve tried a few different migraine treatments and haven’t gotten good results, it might be time to consider that TMD could be to blame for your headaches.

How TMD Could Cause Migraines

It’s hard to explain the link between TMD and migraines in part because we don’t fully understand what causes migraines. However, there are four good models for why TMD might cause migraines:

  • Headache confusion
  • Pinched or pressured nerves
  • Trigger pain
  • Overloaded trigeminal nerve

One of the simplest explanations for the TMD-Migraine link is that many headaches diagnosed as “migraines” are actually TMD headaches. These headaches are caused by tension and soreness in the jaw and jaw muscles, which stretch up the sides of the head to your temples. It’s not uncommon for people to have misdiagnosed migraines.

However, TMD can legitimately cause migraines by pinching or pressuring nerves in the head or face. Several branches of the trigeminal nerve–the trigger point for migraines–run near, under, or even through the jaw muscles. When these muscles are unbalanced or overworked, they can put pressure on the nerve branches, which triggers the migraine.

On the other hand, you might develop migraines in part because you are experiencing jaw pain or another headache. It’s not uncommon to have one type of headache that then triggers a migraine.

We mentioned above that the trigeminal nerve is the trigger point for migraines. However, this large nerve is also the nerve that carries commands from your brain to your jaw muscles and pain signals back from the jaw muscles to the brain. It’s possible that the excess of signals associated with an unbalanced jaw can overload the trigeminal nerve, which can trigger migraines.

Let Dr. Siegel Help Your Headache

People with TMD often get poor treatment results from their regular doctor. That’s because doctors often have little or no training in how to deal with the problem. That’s why you should seek out a professional with the training and experience necessary to diagnose and treat your TMD. Dr. Siegel completed the level VII training in TMD and other dental skills at LVI, the worldwide leader in TMD education for dentists.

He will start with a careful examination to see if you have TMD. If he identifies TMD, he might recommend a multi-stage treatment that first eliminates your pain, then stabilizes your jaw. Long-term treatments might involve restorative dentistry to undo the damage done by clenching and grinding.

Dr. Siegel also knows that often the best treatments for TMD-related migraines and headaches are interdisciplinary. He can work with your doctor or team of doctors to get the best results for you. Check out true stories from patients who now enjoy better lives thanks to Dr. Siegel.

Then call (610) 272-0828 today for an appointment to talk to Dr. Siegel about your headaches and get a primary evaluation at Dental Excellence of Blue Bell, serving patients across the Montgomery County area.

Hyponatremia: Symptoms, Causes, and Treatments

What Is Hyponatremia?

Hyponatremia (low blood sodium) is a condition that means you don’t have enough sodium in your blood. You need some sodium in your bloodstream to control how much water is in and around the cells in your body.

It can happen because of certain medical conditions, some medicines you might be taking, or if you drink too much water.

Because of the low sodium, the amount of water in your body rises and causes your cells to swell. This can lead to many problems. Some are mild, but others can be serious and even life-threatening.

How low is too low? Your blood sodium level is normal if it’s 135 to 145 milliequivalents per liter (mEq/L). If it’s below 135 mEq/L, it’s hyponatremia. Your doctor will be able to tell you whether your level is too low.

Hyponatremia Symptoms

You may not have any symptoms if your hyponatremia is very mild. Symptoms usually appear when your level of sodium suddenly rises or drops.

Signs of hyponatremia may include:

If you know you are at risk of hyponatremia and start seeing symptoms, call your doctor. If your symptoms are severe, you may need immediate care. Seek emergency care if you have:

Hyponatremia Causes

There are a lot of reasons your sodium level might get too low. These include:

  • Medications. Water pills (diuretics) and some antidepressants and pain medications can make you pee or sweat more. That can affect your sodium level.

  • Health problems. Heart failure and kidney or liver disease can affect the amount of fluids in your body, and in turn, your level of sodium.

  • Bouts of chronic, severe diarrhea or vomiting can deplete your body of fluids and sodium. 

  • Hormone imbalances. Some hormones affect your sodium levels. A condition called SIADH (syndrome of inappropriate antidiuretic hormone) can make you retain water. And a condition called Addison’s disease can affect the hormones that help keep your electrolytes in check. If your thyroid hormone is too low, it can also affect your sodium level.

  • Drinking too much water. It can dilute the amount of sodium in your blood. It usually happens when people drink too much during endurance events like marathons or triathlons, and also lose sodium through their sweat.

  • Ecstasy/molly (MDMA). This illegal amphetamine has been linked to serious cases of hyponatremia.

Hyponatremia Risk Factors

Since older adults are usually more likely to take certain medications or develop chronic diseases, they’re generally more likely to get hyponatremia. But at any age, you’re more likely to get it if you have certain conditions, including:

  • Kidney disease

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

  • Heart failure

  • Diabetes insipidus

  • Cushing’s syndrome

  • Primary polydipsia, a psychiatric condition that makes you want to drink lots of water 

It can also happen if you take the drugs that make the condition more likely.

If you drink too much water when you do something that’s physically very hard — like a marathon — you may be more likely to develop hyponatremia.

Hyponatremia Diagnosis

Because the symptoms of hyponatremia can vary so much from person to person, your doctor will probably order blood and urine tests to confirm the diagnosis. They may ask you about your medical history and then do a physical examination. But they’ll need to see your test results to make sure you have hyponatremia.

Hyponatremia Treatments

Since so many different things can cause hyponatremia, your treatment depends on the cause.

If your doctor thinks you drink too much water, you may need to cut back. If you take diuretics, your doctor may make a change in your treatment so the sodium in your blood can go back to a normal level.

If your hyponatremia came on suddenly and it’s severe, you’ll need emergency treatment to boost your sodium level and monitoring to make sure that it happens safely. You may need to stay in the hospital and have:

  • IV infusion with a sodium solution to slowly raise levels in your blood over a few days

  • Prescription medications to control problems like headaches, nausea, or seizures

Hyponatremia Complications

 

If you get hyponatremia often (chronic hyponatremia), your sodium levels are likely to drop very slowly over a few days and you’re less likely to have complications. But with acute hyponatremia, your sodium levels drop very quickly. This can cause:

  • Rapid brain swelling

  • Coma

  • Death

You’re at higher risk of getting brain damage from hyponatremia if you’re a woman who hasn’t gone through menopause. Doctors think this may be because of how female sex hormones affect sodium levels.  

Hyponatremia Prevention

There are several ways you may be able to prevent hyponatremia:

  • If you have a condition that can lead to low blood sodium, like adrenal gland insufficiency, make sure you get it treated.

  • Know the symptoms of hyponatremia. Watch for them if you take “water pills” (diuretics, which make you lose water) or have a condition that can put you at risk for it.

  • Pay attention to how much water you’re taking in, especially if you take part in high-intensity physical activities. There are two reliable ways to know how much water you should have: your thirst and the color of your urine. You’re probably getting enough water if you don’t feel thirsty and your urine is a pale yellow color.

Ask your doctor if you should drink sports beverages instead of water while doing intense physical activities. These drinks have electrolytes that include sodium. But if you’re not working out really hard or for a long period of time, you might not need them.

This Is What Happens When Your Sodium Levels Are Too Low
– SaltStick

When sodium levels are too low, the body responds with painful symptoms. But what exactly causes those nasty headaches, high levels of fatigue and painful muscular cramps? SaltStick is founded on the understanding that adequate sodium levels (along with other key electrolytes such as potassium, calcium and magnesium) are fundamental to endurance success. For an athlete to perform optimally, he or she will need to replace calories, water and electrolytes lost during exercise. Otherwise, the body will be forced to slow down. It is the “be forced to slow down” part of that last sentence that we cover in this week’s blog. Sodium is crucial to a wide swath of physiological processes, from muscle contraction to the management of blood pressure. Thus, an inadequate supply has equally far-reaching consequences. If levels fall outside the optimal range, the body mainly compensates by shifting water reserves around to avoid further sodium dilution. This results in painful side effects, such as nausea, fatigue and headache, which we explore further below. The list below is not comprehensive, but these are the most common symptoms of hyponatremia, along with their causes.

 

Headache

(Caused by swelling of the brain) When a person is fully hydrated, the concentration of sodium inside the cells (intracellular sodium) is balanced with the concentration of sodium in the plasma outside the cells (extracellular sodium), maintained by normal homeostasis. During a bout of hyponatremia, the concentration of extracellular sodium becomes too low, creating an imbalance. To resolve the difference, the cells absorb excess water causing them to swell in size. For most of the body, this is not a problem, because the skin is flexible enough to accommodate the increase in volume. However, the brain is surrounded by the skull, which does not expand. Thus, when the brain absorbs extra water, it creates pressure by pushing against the skull, which results in an often severe headache. Notably, it is the swelling of the brain that also causes some of the most extreme symptoms of hyponatremia, including personality changes and loss of consciousness. The fix: Seek to balance out sodium and water levels immediately. Do not continue to drink plain water; instead, ensure that you consume sufficient levels of sodium, either through broth, supplements or other means. Only by rebalancing the levels of sodium in the plasma surrounding the cells will the brain return to normal and relieve the pressure causing a headache.

 

Muscular cramps

(Caused by too little sodium to conduct electrical impulses) While low sodium levels are not the only cause of muscular cramps, painful twitches and cramps, especially in the legs, are a common symptom of hyponatremia. Sodium is an electrolyte, a family of minerals that get their name from their ability to conduct electrical charges. These charges help the neural system send signals throughout the body that tell the muscles to contract. Low sodium interrupts the body’s ability to send these signals, and as a result, the brain overcompensates and sends a higher-than-normal amount of electrical impulses. Eventually, these signals overwhelm the muscle, preventing it from relaxing and manifesting in a cramp. While less extreme, muscular twitches can also be a result. The fix: Stop or slow down activity until electrolyte levels return to normal. Without adequate levels of sodium, the brain has lost its ability to communicate efficiently with the muscles. Until sodium levels are restored, the brain will continue to overcompensate, and the athlete is at risk for cramping.

 

Nausea

(Caused by excess water in the gut) As mentioned above, when sodium levels are too low, the body reacts by preventing further dilution. In addition to moving water inside the cells, the body prevents any excess water from being consumed through the digestive system. Thus, absorption of water out of the gut is severely restricted, no matter how much the athlete swallows. The result is a stomach full of water that will not digest. If an athlete is in the process of exercise, this can result in nausea. The extreme headaches caused by the swelling of the brain can also result in stomach discomfort. The fix: Do not rely entirely on plain water or sports drink, as neither provides a sufficient amount of electrolytes to replace that which is lost through sweat. Instead, consume a concentrated source of electrolytes that will allow the body to begin absorbing water again.

 

Who is most susceptible

The following people are most susceptible to hyponatremia:

  • People with chronic diseases such as Addison’s disease, dysautonomia or chronic fatigue syndrome
  • The elderly
  • People who take part in long endurance exercise, especially in the heat

Performance suffers when sodium levels are too low

As an athlete, it can be tempting to avoid neglect electrolyte replacement and instead rely on sports drinks or water alone. However, this can lead to hyponatremia, because neither option provides enough sodium to replace what is lost through sweating. If you need more scientific proof that electrolytes can enhance athletic performance, consider the results of a 2016 study conducted by researchers at UCJC in Spain, who divided 26 triathletes into two groups. The first group completed a medium-distance triathlon (the distances totaled to approximately a 2K swim, 90K bike and 21K run) consuming sports drink as they usually would, but also consuming SaltStick Caps in order to replace sodium lost through sweat. The second group completed the same distance while consuming sports drink as they usually would, but they received a placebo capsule with no extra sodium. When the triathletes completed the race, researchers tallied up finishing times and found that the triathletes who consumed the sodium tablets finished in an average of 26 minutes faster. That is a 7 percent decrease in speed! The increase in speed usually came from improved cycling and running times, which come later in the race after electrolyte levels begin to decline.

 

How to prevent low sodium levels

Proper electrolyte supplementation prior to, and throughout your event, along with appropriate fluid intake, is key to avoiding cramps and performing your best. A balanced supply of absorbable sodium, potassium, calcium and magnesium is your best weapon against cramping. With those electrolytes lost in a 220-63-16-8 ratio for the average athlete, it is in the athlete’s best interest to ensure that replacement of the full spectrum of electrolytes is replaced, and in a form and quantity the body can absorb. If you want to learn about how SaltStick can help you achieve an optimal replacement of electrolytes lost through sweat, click here. Disclaimer: Contact your physician before starting any exercise program or if you are taking any medication. Individuals with high blood pressure should also consult their physician prior to taking an electrolyte supplement. Overdose of electrolytes is possible, with symptoms such as vomiting and feeling ill, and care should be taken not to overdose on any electrolyte supplement.

Sodium in serum

Sodium is a mineral element that is an important part of the tissues of the human body. It is the main extracellular cation that maintains osmotic pressure and regulates the acid-base state, neuromuscular excitability and transmission of electrical impulses.

Russian synonyms

Sodium ions, sodium in the blood.

English synonyms

Sodium, Na, Sodium serum.

Research method

Ion selective electrodes.

Units

Mmol / L (millimol per liter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

  1. Do not eat for 12 hours before testing.
  2. Do not smoke within 30 minutes prior to examination.

General information about the study

Sodium is a vital trace element that is necessary for the transmission of impulses in the nervous system and muscle contractions.The sodium ion interacts with other electrolytes (potassium, chlorine, carbonate anion) and regulates the body’s water-salt balance. Together they ensure the normal functioning of nerve endings – the transmission of weak electrical impulses and, as a result, muscle contraction.

Sodium is present in all body fluids and tissues, but in the highest concentration – in the blood and in the extracellular fluid. Extracellular sodium is controlled by the kidneys.

For humans, the source of sodium is table salt.Most receive the daily rate of this element.

The absorption of sodium in the intestine is influenced by gastrin, secretin, cholecystokinin, prostaglandins. The body takes a part of the supplied sodium for its own needs, and the kidneys excrete the rest, maintaining the electrolyte concentration in a very narrow range.

Sodium maintenance mechanisms:

  • production of hormones that increase or decrease urinary sodium loss (natriuretic peptide and aldosterone),
  • production of a hormone that prevents the loss of fluid in the urine (antidiuretic hormone),
  • Thirst control (antidiuretic hormone).

An abnormal blood sodium concentration is usually associated with one of these mechanisms. When the level of sodium in the blood changes, so does the amount of fluid in the tissues of the body. Most often, this leads to dehydration or swelling (especially in the legs).

Of all the electrolytes sodium in the human body is the most. It plays a major role in the distribution of fluid between the extracellular and intracellular spaces. In addition, it is involved in the transmission of nerve impulses and contraction of the heart muscle.Without a certain amount of sodium, the body is unable to function, which is why it is so important that its level is stable and not subject to significant fluctuations.

Sodium is excreted by the kidneys, and its concentration is regulated by the hormone aldosterone, which is synthesized in the adrenal glands. Other factors that maintain sodium at a constant level are the activity of the enzyme carbonic anhydrase, the action of hormones from the anterior pituitary gland, the secretion of the enzyme renin, ADH, and vasopressin.

What is the research used for?

  • To determine the degree of hyponatremia and hypernatremia, often associated with dehydration, edema and other diseases.
  • For the diagnosis of pathology of the brain, lungs, liver, heart, kidneys, thyroid gland, adrenal glands, which is a consequence or cause of sodium deficiency or excess.
  • To monitor the effectiveness of treatment in patients with electrolyte disturbances, for example, when taking diuretics.

When is the study scheduled?

  • With a standard laboratory examination as part of a biochemical blood test in most people (together with a group of other electrolytes: chlorine, potassium, magnesium).
  • For non-specific complaints, to monitor the results of treatment of arterial hypertension, heart failure, kidney and / or liver diseases.
  • If dehydration is suspected.
  • With symptoms of hyponatremia (weakness, lethargy, confusion) and hypernatremia (thirst, decreased urine output, convulsions, agitation).

With a sharp drop in sodium levels, a person may feel weakness and fatigue, in some cases there is confusion of consciousness up to a coma.If the sodium concentration is reduced more slowly, there may be no symptoms at all, so the level is still checked even if there are no symptoms.

What do the results mean?

Reference values: 136 – 145 mmol / l.

Decreased sodium levels indicate hyponatremia due to excessive electrolyte loss, excess fluid intake or fluid retention, with or without edema.

Hyponatremia rarely occurs when there is a lack of electrolyte intake from the outside.Most often it is a consequence of increased loss (due to Addison’s disease, diarrhea, increased sweating, diuretic use, or kidney disease). Sodium levels may decrease in response to an increase in total body fluid (with excessive water intake, heart failure, cirrhosis, kidney disease that causes excessive protein loss in the urine, such as nephrotic syndrome). Sometimes (especially with diseases of the brain and lungs, many cancers and with the use of certain medications) the body produces a lot of antidiuretic hormone, which retains fluid in the body.

High sodium levels imply hypernatremia, in most cases due to dehydration with insufficient fluid intake. Symptoms include dryness of the mucous membranes, thirst, restlessness, erratic movements, convulsions and coma. In rare cases, hypernatremia is caused by Cushing’s syndrome or a condition with low ADH levels (diabetes insipidus).

The causes of high sodium levels can be ketoacidosis, Cushing’s syndrome, dehydration, kidney disease, diabetes insipidus, high sodium intake, hyperaldosteronism, etc., low – constant thirst, heart failure, vomiting, diarrhea, diabetes insipidus, cirrhosis, kidney disease.

A decrease in sodium levels is more likely to indicate an excess of fluid than a lack of sodium. It can be caused by:

  • congestive heart failure (edema of the lower extremities and accumulation of fluid in the natural cavities of the body),
  • excessive fluid loss (severe diarrhea, vomiting, heavy sweating),
  • the introduction of a hypertonic glucose solution (accumulation of fluid in the bloodstream to dilute the resulting blood composition),
  • Heavy Jade,
  • obstruction of the pyloric stomach (vomiting of gastric contents with a high electrolyte content),
  • by malabsorption – violation of the primary absorption of sodium from food, and the adsorption of sodium released into the lumen of the gastrointestinal tract,
  • diabetic acidosis,
  • Overdose of drugs, such as diuretics (increased excretion of electrolyte in urine),
  • edema,
  • high fluid intake,
  • hypothyroidism,
  • increased production of ADH (fluid retention in the body),
  • adrenal insufficiency (lack of aldosterone, which is responsible for the reabsorption of sodium in the kidneys),
  • burn disease (dilution of blood due to intercellular fluid).

Sodium levels increase in the following conditions:

  • dehydration,
  • Cushing’s syndrome and disease (overproduction of corticosteroids that increase sodium in the body),
  • primary and secondary hyperaldosteronism,
  • coma,
  • diabetes insipidus (lack of antidiuretic hormone production),
  • tracheobronchitis.

What can influence the result?

  • Recent trauma, surgery, and shock all contribute to an increase in sodium concentration.
  • Many medications affect sodium levels. It is increased by anabolic steroids, corticosteroids, calcium, fluoride compounds, androgen, estrogens, methyldopa, laxatives, oral contraceptives, sodium bicarbonate, lower – heparin, sulfates, diuretics, carbamazepine, tricyclic antidepressants.

Download an example of the result

Important notes

Infants who are bottle-fed often suffer from hypernatremia, since formula milk contains much more sodium than breast milk.Sodium is excreted from the body of children worse than from the body of adults, therefore, large amounts of sodium in baby food products are dangerous for the child and can lead to dehydration.

Also recommended

Who orders the study?

Therapist, urologist, nephrologist, infectious disease specialist, endocrinologist, cardiologist, gastroenterologist, nutritionist, traumatologist, oncologist, neurologist.

Ito Clinic

Primary hyperparathyroidism

What is primary hyperparathyroidism?

Primary hyperparathyroidism is a condition in which parathyroid hormone is secreted in excess amounts due to abnormalities in the parathyroid glands themselves.Parathyroid hormone, like other hormones, is necessary for the body, but excessive production of the hormone has a detrimental effect.
Since in primary hyperparathyroidism, parathyroid hormone is released in excess amounts due to the pathological condition of the parathyroid glands, including adenoma, cancer and other tumors, as well as hyperplasia, and the level of calcium in the blood rises abnormally, this can cause a variety of symptoms. Hyperparathyroidism is diagnosed in about 1 in 4,000 to 5,000 people, while parathyroid cancer accounts for about 1-5% of all cases, so we can say that it is rarely associated with cancer.
Hyperparathyroidism can be caused not only by abnormalities in the parathyroid glands, but also by other diseases, including renal failure, etc. The disease caused by abnormalities in the parathyroid glands themselves is called “primary” hyperparathyroidism, a disease caused by other causes – “secondary” hyperparathyroidism.

Symptoms

There are 3 typical symptoms:
(1) Bone abnormalities (bones become brittle and prone to fracture.In severe cases, there may be a decrease in height)
(2) Urinary stones: (kidney stones)
(3) Hypercalcemia (headache, thirst, heartburn, nausea, loss of appetite, constipation and other gastrointestinal disorders, irritability, fatigue, decreased muscle tone, etc.)

Recently, a growing number of examples of accidental detection of hypercalcemia during clinical examination, etc. even before the onset of typical symptoms.
In this disease, a slightly elevated level of calcium in the blood, especially at the initial stage of the disease, often does not cause any obvious symptoms.However, if blood calcium levels rise significantly, these symptoms may worsen.
Cancer of the parathyroid gland often causes excessively high levels of calcium, so the above 3 symptoms are prominent.

Survey

Since this is a rare condition, symptoms such as lethargy, etc. can be assessed as psychological, leaving the problem unrecognized for a long time. These symptoms can of course also be caused by other causes, and the presence of such symptoms does not necessarily mean that the person is suffering from the disease.However, since recently in most hospitals it is possible to test the level of calcium and parathyroid hormone in the blood, the disease has become more efficiently diagnosed.

(1) Tests for diagnosing disease: blood test / urinalysis
Increased serum calcium (Ca), increased parathyroid hormone (i-PTH, total PTH), change in urine calcium (Ca), etc.
(2) Tests to determine the location of tumors in the parathyroid glands
Ultrasound examination (ultrasound), radioisotope examination (parathyroid scintigraphy (MIBI-scintigraphy)), CT of the cervical spine, etc.d.
Parathyroid cancer is difficult to diagnose before treatment. The diagnosis must be made after a comprehensive assessment of all symptoms, the results of the above examinations and the results of histopathological examination after surgery.

Treatment

The indication for treatment is an accurate diagnosis of hypercalcemia, an increased level of parathyroid hormone and confirmation of the presence of a hypertrophied area of ​​the parathyroid glands as a result of examinations.There are treatments such as percutaneous ethanol injection (PIE) and drug therapy, but the main treatment is to remove the affected area of ​​the parathyroid gland. (The concept of asymptomatic hyperparathyroidism was announced at the NIH * conference, and when the conditions are met, the choice of monitoring the patient’s condition is possible).
※ National Institute of Health

Transaction method (transaction type)
Adenoma Removal of hypertrophied parathyroid glands
Hyperplasia Total resection of the parathyroid glands followed by
autologous transplant (in the forearm, etc.)etc.)
Cancer Partial resection of the thyroid gland, including lymph nodes

Daily life

In case of extremely high blood calcium levels and severe symptoms, urgent hospitalization is required. In addition, if the bones are fragile, bed rest must be observed.
In this case, urgent treatment may not be required if the patient has only a slight increase in the level of calcium in the blood and there are no obvious symptoms.The person can maintain a normal lifestyle, as well as continue to work until the date of hospitalization is determined.
Patients can eat normal food. In the absence of appropriate medical advice, there is no need to limit yourself to calcium-rich foods such as milk or small fish.

90,000 Arterial hypertension (hypertension), essential hypertension

ARTERIAL HYPERTENSION

Arterial hypertension (hypertension) – persistent increase in blood pressure above 140/90 mm.Hg

What is high blood pressure?

Disruption of the complex system of blood pressure regulation leads to an increase in pressure in the arteries. When blood pressure is constantly elevated, we are talking about high blood pressure. In medicine, this condition is called hypertension and means increased tension in the walls of the arteries. Hypertension does not mean stress, as many people think. You can be a calm, balanced person and have high blood pressure.

Blood pressure is considered high if the systolic pressure is predominantly at or above 140 mmHg, the diastolic pressure is 90 mmHg or higher, or the increase affects both systolic and diastolic pressure. It used to be that diastolic pressure — that is, the pressure in the arteries between beats — was a more accurate indicator of health risk than the systolic pressure that builds up in the arteries during a heartbeat.However, it has now become apparent that this is not the case. Scientific studies have shown that high systolic blood pressure is a more significant health risk factor, especially in the elderly. In older patients, successful control of systolic blood pressure gives very good results in terms of maintaining health.

Arterial hypertension usually develops slowly. In most cases, normal blood pressure gradually turns into prehypertension, and then, possibly, into the first stage of hypertension

If hypertension is left untreated, high blood pressure can damage many organs and tissues of the body.The higher the blood pressure, and the longer the hypertension is left untreated, the greater the likelihood of injury. Hypertension can cause changes in the body that functions under conditions of high blood pressure over several months or years. If arterial hypertension is combined with other adverse factors such as diabetes, obesity, tobacco smoking, the risk of organ and tissue damage increases.

You can sometimes hear that the ideal systolic pressure is 100 plus age.This is not true. If you follow this formula, you will inevitably come to the erroneous conclusion that high blood pressure is a variant of the age norm.

Causes of arterial hypertension

In any disease, it is natural to ask about its cause. Why do some people get sick while others do not? Unfortunately, most patients with high blood pressure will not be able to get an answer to this question: the exact cause of their disease remains unknown.

Arterial hypertension has two forms – essential (primary) and secondary. Essential hypertension (or essential hypertension) is much more common. About 90-95% of patients with high blood pressure suffer from the essential form of the disease.

Essential hypertension differs from the secondary in the absence of an obvious cause. In the vast majority of patients with high blood pressure, it is not possible to accurately determine the starting moment of the disease. However, a number of factors are well known that increase the likelihood of developing arterial hypertension.In order to minimize the risk of the disease or even prevent its development, the first thing to do is to know these factors.

Studies have revealed a hereditary predisposition to the development of arterial hypertension. In addition, factors including body weight, salt intake and physical activity appear to interact with genetic factors. Therefore, it seems doubtful that scientists will ever be able to find a connection between a specific genetic defect and the development of all cases of essential hypertension.

Blood pressure regulation

The body has several systems that control the level of blood pressure and protect it from an excessive fall or rise. These are the heart, arteries, kidneys, a number of hormones and enzymes, as well as the nervous system.

HEART. The required amount of force to eject blood from the left ventricle into the aorta is generated by the pumping action of the heart muscle. The more pumping power the heart creates, the greater the force acting on the walls of the arteries.

ARTERIES. The walls of the arteries are equipped with smooth muscle fibers, which are involved in the expansion and contraction of the lumen of the vessel when a wave of blood passes through it. The more elastic the arteries, the less the resistance of the arterial bed, which is present in the path of blood flow and, therefore, the less the force that acts on the walls of the arteries. If the arteries lose their elasticity or are damaged for any reason, this causes an increase in resistance to blood flow and requires an increase in the force necessary to “push” blood through the vessels.This increases blood pressure.

KIDNEYS. The kidneys regulate the amount of sodium and water in the body. The rule of thumb is that sodium “holds” water. Thus, the more sodium there is in the body, the more fluid circulates with the blood. Excess fluid can increase blood pressure. In addition, too much sodium can cause vascular damage.

OTHER FACTORS. The central nervous system together with hormones, enzymes and other chemicals can affect blood pressure levels.

Baroreceptors There are tiny nodular structures in the walls of the heart and in some blood vessels called baroreceptors. These structures work like a room thermometer in your home. Baroreceptors continuously monitor the level of blood pressure in the arteries and veins.If a signal is received about a change in pressure, baroreceptors transmit it to the brain, from where in response are commands to decrease or increase the heart rate, as well as expand or narrow the lumen of the arteries to maintain normal blood pressure levels.

Adrenaline . The brain responds to impulses from baroreceptors by stimulating the release of hormones and enzymes that affect the functioning of the heart, blood vessels, and kidneys.One of the main hormones involved in blood pressure control is adrenaline, also called epinephrine. Adrenaline is released into the bloodstream under conditions of stress or tension, for example, in case of anxiety and haste when completing a task.

Adrenaline causes narrowing of blood vessels, makes the heart contract with greater force and speed, which leads to an increase in blood pressure. People often associate the feeling of high blood pressure with the release of adrenaline.

Renin-angiotensin-aldosterone system .There are other hormones in the body that regulate blood pressure levels. Among them – renin, which is formed in the kidneys, it is able to convert to angiotensin I. Once in the bloodstream, angiotensin I is converted to angiotensin II. The effect of angiotensin II is to constrict blood vessels and stimulate the release of the hormone aldosterone, which is synthesized in the adrenal glands. As a result of an increase in the concentration of aldosterone, the kidneys begin to retain more water and salts in the body.

According to scientists, some people with high blood pressure have a special type of gene responsible for the synthesis of angiotensin. As a result, the body produces too much angiotensin.

Endothelium . The lumen of the arteries is lined with a thin layer of cells called the endothelium. Experiments have shown that this layer plays a very important role in the regulation of blood pressure – for example, the release of chemicals that cause blood vessels to contract and relax.

Nitric oxide . A gas called nitric oxide found in the blood can affect blood pressure. This gas helps to relax the blood vessel wall and expand its lumen. Nitric oxide levels can be raised by the action of nitroglycerin, a drug used to treat certain cardiovascular diseases.

Endothelin . The opposite effect of nitric oxide on the vessel wall is exerted by a protein called endothelin . It causes the blood vessels to contract. Endothelin-1, a form of this protein, may play a crucial role in the development of high blood pressure.

Blood pressure measurement

Target blood pressure values ​​
(for all age groups):
• For people with arterial hypertension
– below 139/89 mm Hg.
• For people who also have diabetes mellitus
and / or kidney disease
– below 129 / 79mm Hg.

Blood pressure is determined by measuring the pressure in the arteries.The measurement is done using a device called a sphygmomanometer or tonometer. It consists of an inflatable cuff that wraps around the forearm, an air pump (manual or electronic), and a pressure gauge.

For home measurements, it is better to choose an automatic blood pressure monitor with a shoulder cuff – this device provides the most accurate and fastest measurement. It is not recommended to monitor blood pressure with devices with a sensor on the wrist or finger.

Blood pressure is measured in millimeters of mercury (mmHg).Art.). The measurement result depends on how much the pressure in the arteries is able to raise the column of mercury in the sphygmomanometer.

Two pressure readings

The level of blood pressure is characterized by two indicators. Both are equally important. The first is the level systolic pressure . This is the level of blood pressure at the time the heart is contracting – this period is called systole and throws blood into the aorta .

The second indicator is diastolic pressure .It shows how much pressure is created in the arteries during a period of time called diastole, when the heart is relaxed and filled with blood. The heart needs to completely relax before the next heartbeat, at which time the pressure in the arteries decreases. The two indicators described above are written as a fraction. The numerator (to the left of the fractional sign) indicates the systolic pressure value , , and the denominator (to the right of the fractional sign) indicates the diastolic pressure value.Out loud, these figures are divided by the preposition by . For example, if when measuring the levels of systolic and diastolic pressure were respectively 115 mm Hg. Art. and 82 mm Hg. Art., then blood pressure in this case is equal to 115/82 or 115 to 82.

Normal blood pressure readings

In the first months after birth, the child’s blood pressure is on average 100/65 mm Hg. Art. or 100 to 65. During childhood, it grows slowly.Since adolescence, normal blood pressure values ​​are 119/79 mm Hg. Art. or below. Systolic pressure is between 120 and 139 mm Hg. Art. and diastolic pressure between 80 and 89 mm Hg. Art. classified as prehypertension.

If you have prehypertension , this means that your blood pressure is above normal, but does not reach the numbers when a diagnosis of a condition called arterial hypertension is made. The presence of prehypertension should be regarded as a signal for a change in lifestyle in order to lower blood pressure.Pre-hypertension indicates that you have an increased risk of heart disease, kidney disease, and stroke.

Ideal or normal blood pressure for adults of all ages is 119/79 or below. This is the level to which, if possible, you need to strive. However, some patients with arterial hypertension do not tolerate pressure below 119/79, which must be taken into account when choosing a drug treatment.

Rules for measuring blood pressure
at home
(Harvard Medical School recommendations)

• DO NOT drink alcoholic
or caffeinated beverages and
DO NOT smoke 30 minutes before the test
• For 5 minutes quietly
sit with your back resting
on the back of the chair and your feet
on the floor

so that your elbow is
approximately at the same level as your heart
• Remove the clothing from your shoulder
and apply the cuff
• After the first measurement
, remove the cuff, wait
minute and repeat the measurement.If the
values ​​are close, average them; if not, measure
a third time and average
3 values ​​obtained
• If you get high
digits, don’t panic! Sit quietly
for a few minutes and repeat
measurement
• Compare the results of your
measurements with the time of day

Systolic pressure above 140 and / or diastolic pressure above 90 are classified as hypertension.

Patients with systolic hypertension, especially in old age, are at high risk of cardiovascular complications, despite the fact that their diastolic pressure is normal.

Pressure fluctuations during the day

The result of blood pressure measurement characterizes its level directly at the time of measurement. Blood pressure changes throughout the day. It grows during periods of activity, during intense work of the heart, for example, during physical exertion. The decrease occurs at rest, in sleep. Blood pressure also changes with different positions of the body, for example, when moving from a lying or sitting position to a standing position.

Eating food, alcohol, pain, stress and intense experiences lead to an increase in pressure. Even dreams can cause your blood pressure to rise. All these fluctuations are perfectly normal.

Blood pressure levels may vary depending on the time of day. Arterial pressure fluctuates naturally over a 24-hour period. It is usually at its highest in the morning hours, after you move into a state of wakefulness and physical activity. Further, it remains approximately at the same level throughout the day and begins to decrease only late in the evening.The pressure reaches its minimum figures in the early morning hours, while you are still sleeping. This 24-hour schedule is called a circadian rhythm. In our body, more than 100 different functions are subject to circadian fluctuations.

Diagrams of the circadian rhythm of blood pressure of workers in the day and night shifts are different, that is, they depend more on the alternation of periods of work and rest (sleep) than on the time of day. This is why blood pressure and many other body functions that are subject to circadian fluctuations change when the daily activity schedule is disrupted.

Regular monitoring of blood pressure
at home should be:

• People with diagnosed
arterial hypertension or
prehypertension
• Pregnant women
• Overweight people
body
• Smokers
• People with a hereditary
predisposition to arterial hypertension

Ensuring accurate measurements

To understand what your true average blood pressure is, the best time to change is during the daytime, when several hours have passed since getting out of bed.If you exercise in the morning, then you need to measure your blood pressure before you start exercising. After vigorous physical activity, the pressure may remain relatively low for a while and not reflect your average level.

It is also not recommended to eat, smoke or drink coffee less than 30 minutes before blood pressure measurement. Tobacco and caffeine can temporarily raise your blood pressure and your alcohol intake can lower it. On individuals, however, alcohol has the opposite effect.Some drugs, such as anti-allergic and antipyretic drugs, and a number of dietary supplements, can lead to an increase in blood pressure within a few hours or even days from the moment of administration. Sit for about 5 minutes before taking the measurement, as it takes some time for the pressure to change according to body position and level of physical activity. Following the above rules, you will be able to estimate as accurately as possible the true level of your pressure during the day.

If you are hypertensive, your treatment plan should include regular home blood pressure measurements.

High blood pressure symptoms

Often there are no symptoms that could alert you to your illness, which is why high blood pressure is also called the silent killer.

People sometimes mistake headache, dizziness, nosebleeds for signs of high blood pressure. However, only a few can confirm the appearance of dizziness or increased frequency of nosebleeds with an increase in blood pressure.Scientific studies have shown that there is no connection between headache and high blood pressure. Thus, in most people, the disease is asymptomatic.

It is possible to live with arterial hypertension for several years and not know about it. Often this condition is detected by chance during a routine examination by a doctor. Signs and symptoms usually appear only when the disease progresses to a higher – perhaps even life-threatening – stage. However, it also happens that the disease does not manifest itself even with a very high level of blood pressure.

Other symptoms that sometimes accompany high blood pressure, such as excessive sweating, muscle tremors, excessive urination, and rapid or irregular heartbeats, are mainly caused by other conditions that can cause a rise in blood pressure.

When blood pressure may fall too low

When it comes to blood pressure numbers, the general rule of thumb is that less is better. However, there are situations of a sharp drop in pressure.This condition is called hypotension and can become life-threatening if the pressure drops to a dangerous level. Fortunately, such situations are rare.

On the contrary, constantly (chronically), but not critically low blood pressure occurs quite often. The reason may be many factors, including the use of antihypertensive drugs, diabetes mellitus, the second trimester of pregnancy.

A potentially dangerous side effect of chronically low blood pressure is postural hypotension , a condition in which a person who stands up quickly can feel dizzy and even faint.The fact is that when we get up, gravity does not allow blood to be instantly redistributed according to a change in body position: in its lower part (the vessels of the legs) there is a relatively larger volume of blood compared to the upper part, which can lead to a rapid drop in pressure. Normally, the system that regulates blood pressure counteracts a decrease in blood pressure by narrowing the lumen of the arteries and increasing the release of blood with each contraction of the heart.

If the blood pressure is constantly lowered, the time required to compensate for the effect of gravity increases.Postural hypotension is more common in older age groups, as the transmission of nerve and regulatory signals becomes slower with age. The danger is that severe dizziness or loss of consciousness can lead to falls and injury.

You can prevent situations like this if
– get up more slowly and stick to something when standing
– stand for a few seconds before walking; You will give the body time to adapt to changes in pressure
– standing, crossing your legs and pressing your hips together (like scissors) will help reduce the accumulation of blood in the vascular bed of the legs.

Some older people, especially those taking drugs to treat hypertension, are more likely to faint or fall after eating. The cause may be a drop in blood pressure. If you’ve had fainting spells after a meal, you need to take steps to prevent them. Eat slowly and slowly. Rest for an hour after eating.

See a doctor if dizziness or fainting recurs. Other medical conditions can cause these symptoms or become more pronounced.

Complications of arterial hypertension

High blood pressure requires mandatory treatment, as over time, excessive force acting on the arterial walls can lead to serious damage to many vital organs of the body. The most damaging effects of high blood pressure are arteries, heart, brain, kidneys and eyes.

Some of the complications described below may require urgent treatment.

High blood pressure can damage the arteries, heart, and other body systems.

HEART AND VESSELS

ARTERIOSCLEROSIS . Healthy arteries, like healthy muscles, need to be flexible, strong, and elastic. Their walls are smooth from the inside, not obstructing blood flow. However, over the years, high blood pressure can make them thicker and harder.

ATHEROSCLEROSIS .High blood pressure can accelerate the deposition of cholesterol within the arterial wall and between its layers. If the inner wall of an artery is damaged, blood cells called platelets are deposited there. Cholesterol also tends to be deposited in a certain part of the wall. Initially, the deposition of cholesterol is only a layer of fat-containing cells. As cholesterol accumulates, the process spreads to the deep layers of the arterial wall, causing damage.Large deposits of cholesterol are called plaques. The plaque hardens over time.

The greatest danger of cholesterol plaques is damage to the vascular wall. The organs and tissues supplied by these altered arteries do not receive enough oxygen and nutrients from the blood. To ensure adequate blood flow, the body responds by increasing blood pressure. In turn, this leads to further vascular damage.

Arteriosclerosis and atherosclerosis can develop in any arteries of the body.However, the most commonly affected arteries are the arteries of the heart, brain, kidneys, abdominal aorta, and legs.

ISCHEMIC HEART DISEASE . Ischemic heart disease is one of the main causes of death in patients with untreated arterial hypertension.

This disease affects the arteries that feed the heart muscle (coronary arteries). In patients with high blood pressure, the formation of cholesterol plaques in the coronary arteries is common.

Plaques reduce blood flow to the heart muscle, which can lead to myocardial infarction if the volume of blood flow decreases to a critical level. This condition requires immediate hospitalization for medical treatment or transluminal balloon angioplasty, a surgical procedure to remove narrowings in the coronary arteries. The normalization of blood pressure leads to a decrease in the number of myocardial infarctions by about 25 percent.

ANEURISM .When blood vessels lose their elasticity, their walls can stretch and become thinner. This place in the artery is called an aneurysm. Aneurysms most often form in the arteries of the brain and in the lower aorta, at the level of the abdomen. The greatest danger of any aneurysm is rupture, leading to life-threatening bleeding.

In the early stages of aneurysm formation, as a rule, they do not affect well-being. As it grows, an aneurysm in an artery in the brain can cause very severe, persistent headaches.A large abdominal aortic aneurysm can cause persistent abdominal or lower back pain. Occasionally, an abdominal aortic aneurysm is found on physical examination, when light pressure on the abdomen reveals a pulsating vessel. Sometimes a blood clot lining the aneurysm cavity can break off and block branches extending from the aorta.

HYPERTROPHY OF THE LEFT VENTRICLE . Blood pressure can be compared to a load that the heart, as an athlete, must lift. When the heart “pushes” blood from the left ventricle into the aorta, its work is directed against the blood pressure inside the arteries.

The higher the blood pressure, the harder it is for the heart to work. Over time, it becomes difficult for him to cope with excessive stress and the walls of the main pumping chamber (left ventricle) begin to thicken (hypertrophy). Muscle mass is growing, which requires an increase in its blood supply. However, as we already know, high blood pressure also damages the arteries that supply the heart, so the vascular bed is often unable to provide sufficient blood flow to meet the needs of the heart muscle.Effective control of blood pressure levels can prevent the development and even reduce the development of left ventricular hypertrophy.

HEART FAILURE . In this condition, the heart is not able to pass the blood flowing to it quickly enough. The result is blood stasis, which causes fluid to accumulate in the lungs, lower limbs, and other tissues. This condition is called edema. The congestion of blood in the lungs leads to shortness of breath. Accumulation of fluid in the lower extremities – to swelling of the feet and ankles.With effective treatment of hypertension, the risk of developing heart failure is reduced by about 50 percent.

BRAIN. Arterial hypertension significantly increases the risk of STROKE.

Strokes most often occur against the background of high blood pressure. However, in those people who have received medication for high blood pressure, the risk of stroke is reduced.

Stroke, or acute cerebrovascular accident, is damage to brain tissue, which occurs either due to blockage of the lumen, or due to rupture of an artery that supplies the brain.For these reasons, there are two main types of strokes: ischemic and hemorrhagic .

Ischemic stroke . Ischemic strokes account for 70-80 percent of all strokes. Ischemic stroke usually affects the parts of the brain that control movement, speech, and the senses.

A stroke develops as a result of thrombosis of an artery that supplies the brain. The likelihood of thrombus formation increases in the presence of a cholesterol plaque, since the surface of the plaque facing the lumen of the vessel is uneven and blood flow in this place is impaired.More than half of ischemic strokes are due to the formation of a blood clot in one of the arteries that leave the aorta and supply the brain.

A less common cause of ischemic strokes is the detachment of a particle of a blood clot in an artery and the movement of this particle (embolus) through larger arteries into smaller arteries in the brain. A blood clot in the chambers of the heart can also be a source of emboli. If a moving blood clot stops in a small-diameter artery and completely blocks blood flow, then a stroke develops in the corresponding part of the brain.

Sometimes cerebral blood flow is disturbed for a short time – less than 24 hours. This condition is called transient ischemic attack (TIA) or minor stroke. A transient ischemic attack is a warning sign that a stroke may develop.

Hemorrhagic stroke . Hemorrhagic stroke develops due to rupture of the wall of the cerebral artery. In this case, the blood soaks into the surrounding brain tissue, which causes damage. Brain cells located at a distance from the source of bleeding are also damaged, since they are deprived of the flow of fresh arterial blood.One of the causes of hemorrhagic stroke is arterial aneurysm. Small tears in the arterial wall can also cause blood to seep into the surrounding tissue.

Normalization of blood pressure numbers due to effective treatment is accompanied by a significant reduction in risk. Even if you’ve already had a stroke or transient ischemic attack, lowering high blood pressure will help prevent possible recurrence.

DEMENTIA .Dementia is acquired dementia. Scientific research suggests that high blood pressure can cause memory impairment and other mental impairments over time. The risk of dementia increases significantly between the ages of 70 and older. From the moment of the diagnosis of arterial hypertension to the appearance of signs of dementia, it can take from several decades to several years.

It has now been shown that therapeutic control of high blood pressure can reduce the risk of dementia.

KIDNEY

About one fifth of the volume of blood expelled by the heart passes through the kidneys. The tiny structures of the kidneys that act as filters are called nephrons. With their help, the blood is cleansed of metabolic products of our body, which are further excreted in the urine. The function of the kidneys is to control the balance of salts, acids and water in the body. In addition, the kidneys synthesize substances that regulate the diameter of blood vessels and their function. High blood pressure can negatively affect this complex process.

If, due to arterial hypertension in the arteries supplying the kidneys (renal arteries), atherosclerosis develops, blood flow to the nephrons decreases, the efficiency of elimination of waste products from the blood decreases. Over time, the concentration of these products in the blood increases, the kidneys begin to “shrink” and lose their function.

High blood pressure and diabetes mellitus are the most common causes of kidney failure.

If kidney function is ineffective, hemodialysis or even kidney transplantation may be required. Hemodialysis is the process of removing metabolic products from the blood using special equipment.

Kidney damage can lead to the appearance or aggravation of the course of arterial hypertension, since the kidneys are involved in the control of blood pressure by regulating the amount of sodium and water contained in the blood. This situation is a vicious cycle, which ultimately leads to an increase in blood pressure and a gradual decrease in the ability of the kidneys to remove metabolic products from the body.

Normalizing high blood pressure can slow the progression of kidney disease and reduce the need for hemodialysis and kidney transplantation.

EYES.

High blood pressure leads to accelerated aging of the tiny blood vessels in the eye. In severe cases, it can even lead to loss of vision.

Sometimes the presence of arterial hypertension is detected by a simple examination of the fundus.The light directed into the eye makes visible the thin arteries located on the inner surface of the eye (retina). Already in the early stages of arterial hypertension, the walls of these arteries begin to thicken and their lumen narrows. The arteries of the eye can compress nearby veins and obstruct venous return. It is believed that the state of the fundus arteries reflects the state of the cerebral vessels.

High blood pressure can also rupture the walls of the arteries and hemorrhage into the underlying tissues of the eye.In severe cases, swelling of the optic nerve, which transmits visual signals from the retina to the brain, may develop. This can cause loss of vision. Damage to the retina can in most cases be prevented by controlling blood pressure levels.

How to control blood pressure.

On the way to normalizing blood pressure, changing habits and lifestyle is of no small importance. Simple healthy eating habits, regular physical activity, and smoking cessation can significantly lower blood pressure levels.Sometimes, in the initial stages of the disease, these conditions are enough to maintain blood pressure within normal limits.

Unfortunately, drug therapy is often required in addition to the general rules. Therapy for arterial hypertension is selected individually and serves to prevent increases in blood pressure. The drugs should be taken daily (usually 1-2 times a day). Rarely is one drug effective – more often a combination of two or sometimes three types of drugs is required.Such combinations (which are often enclosed in one tablet) allow you to achieve the desired effect with a minimum dosage of each of the components.

If blood pressure does rise above normal values, there are drugs for quick help – they help to quickly and effectively reduce blood pressure “here and now”. There should be as few such emergency appointments for hypertensive patients – daily planned antihypertensive therapy should be selected as effectively as possible . It should be remembered that arterial hypertension is a chronic disease from which it is impossible to be cured forever, therefore, normal blood pressure figures require CONSTANT medication.

Why limit salt intake?

Table salt (or sodium chloride) is the most important source of sodium for our body. Sodium is a chemical element that has a number of fundamental functions. Sodium ions are involved in the transmission of nerve impulses, contraction and relaxation of muscle tissue, maintaining water balance. No cell of the body can function without this element! For the normal functioning of all organs and systems, a strictly defined amount of sodium is required.The amount of water retained in the bloodstream also depends on it. In a healthy person, the kidneys regulate sodium and water. However, with prolonged excess intake of salt (sodium), the kidneys lose this ability. Excess sodium also leads to excessive water accumulation and, as a result, to arterial hypertension.

Some people are especially sensitive to the amount of sodium in the body – their blood pressure rises or falls in direct proportion to this.Therefore, these people have an increased risk of cardiovascular complications. However, they benefit the most from a low-salt diet.

Most salt-sensitive:
– Elderly
– African American
– People with hypertension
– People with diabetes
– People with chronic renal failure

So

If you are under 50, your blood pressure is normal (below 120 / 80mm Hg.Art.), and otherwise you are healthy , as long as you do not have to worry about the amount of salt consumed. However, try to limit yourself to 2.3 grams of sodium per day. The risk of hypertension increases with age. Therefore, if you get used to eating less salty food now, it will be easier for you later.

If you are older, obese or diabetic , you need to reduce your sodium intake to 1.5 g per day

If you have hypertension, prehypertension, heart failure, or kidney disease, You should consume no more than 1.5 g of sodium per day.

What to do if blood pressure rises from time to time?

There are frequent cases when blood pressure is not constantly increased, but only in certain situations. Some people experience the so-called “white coat hypertension” – when blood pressure is always high at a doctor’s appointment, while at home it is always normal. The opposite situations also happen. The so-called “latent hypertension” is characterized by normal blood pressure when measured by a doctor, but under other conditions – under stress, in the early morning or evening hours, blood pressure rises.

However, the question arises of what to do in such ambiguous situations – when blood pressure does not rise every day, or even a week, but only from time to time. Such a picture indicates an increased lability of your blood pressure, which can soon lead to permanent arterial hypertension. A big step towards preventing serious cardiovascular complications such as stroke, heart attack, heart failure is regular home blood pressure monitoring and lifestyle and nutritional adjustments.

You need to:
– Increase physical activity
– Reduce weight, if it is overweight
– Follow the rules of a healthy diet
– Quit smoking

Thus, it should be remembered:

– Blood pressure regulates the flow of blood through the heart and blood vessels.
– The level of both systolic and diastolic pressure is equally important.
– Arterial hypertension is said to be if the level of systolic pressure is consistently 140 mm Hg or higher, and / or the level of diastolic pressure is consistently equal to 90 mm Hg or higher.
– Arterial hypertension is called a silent killer, since in a typical case this disease is not accompanied by any characteristic symptoms, but it leads to a number of severe complications.
– Untreated, this disease can lead to stroke, myocardial infarction, heart and kidney failure, blindness and reduced mental capacity.
– Treatment of arterial hypertension significantly reduces the risk of disability and death from the above diseases.

If you have high blood pressure, work with your doctor to treat the condition and improve your overall health. Make an appointment.

90,000 Disorders of secretion and action of antidiuretic hormone

Maintaining a normal volume of extracellular fluid is essential for adequate
body cell function.Extracellular osmolarity affects cell shape and
distribution of ions on both sides of the cell membrane. Adequate ion concentrations
in extracellular environments are necessary for the normal functioning of ion channels,
formation of membrane potentials and other processes of intercellular interaction.

For the regulation of water-salt metabolism and the stability of the osmotic pressure of plasma
blood in the body meets a complex regulatory system, including endocrine,
nervous and paracrine mechanisms.
The components of this system are the axis of the hypothalamus-neurohypophysis, osmoreceptor and
baroreceptor sensory systems and kidneys.
The hypothalamic-neurohypophyseal axis and its
the key hormone is antidiuretic hormone (ADH), vasopressin.


Physiological effects of ADH

ADH at the level of the kidney increases the reabsorption of water in the distal tubules and collecting
tubules. This effect of vasopressin is mediated by its binding to
specific G-protein-associated receptors on the basolateral membrane
interstitial surface of kidney tubule cells and increase activity
adenylate cyclase, followed by the synthesis of cyclic adenosine monophosphate AMP
(cAMP).There are three types of vasopressin receptors – V1, V2, V3. Water balance
regulated by vasopressin via V2 receptors. Distal cell permeability
tubules and collecting ducts is determined by the number of water channels (aquaporins) in
apical membrane. In the absence of ADH, the number of aquaporins is small, and the epithelium
practically impervious to water, therefore a large amount of
hypotonic urine. The attachment of ADH to receptors leads to an increase in concentration
intracellular messenger – cAMP, which activates protein kinase, which provides
passive reabsorption of water, by means of water embedded in the apical membrane
channels.
The main site of V1 receptor expression leading to vasoconstriction is smooth
musculature of the vessels. At physiological concentrations, ADH does not affect blood pressure, but
the vasopressor effect is manifested when large amounts of the hormone are released against the background
a sharp drop in blood pressure (with blood loss, shock). V1 receptors are also found in the medulla
kidney, liver and brain (hippocampus, hypothalamus). In hepatocytes, ADH stimulates
glycogenolysis and gluconeogenesis. In addition, ADH, interacting with V1 receptors in the central nervous system,
enhances memory.The activation of platelet V1 receptors promotes their aggregation.
V3 receptors are localized in the corticotrophs of the adenohypophysis, their stimulation contributes to
increased secretion of adrenocorticotropic hormone.


Regulation of ADH secretion

Vasopressin is synthesized in the supraoptic and paraventricular nuclei of the hypothalamus.
Further, the hormone forms complexes with specific carrier proteins (neurophysins)
and is transported along axons through the supraopticohypophyseal tract to the neurohypophysis, where
it is released under the influence of various stimuli.
Under physiological conditions, the main factor regulating the secretion of vasopressin is
is the osmolarity of the plasma. Osmoreceptors of the hypothalamus are sensitive to fluctuations
osmolarity – a shift of only 1% leads to noticeable changes in vasopressin secretion.
With a decrease in plasma osmolarity below the threshold level (about 280 mosm / kg), secretion
the hormone is inhibited, which leads to the excretion of a large volume of maximally diluted
urine. When the osmolarity reaches approximately 295 mOsm / kg, the concentration of ADH
becomes sufficient to provide maximum antidiuretic effect (volume
urine
The secretion of ADH depends on the volume of circulating blood (BCC) and is regulated
baroreceptors of the pulmonary arteries (baroreceptors of the low pressure system), the aorta and
carotid arteries (baroreceptors of the high pressure system).
With vasovagal seizures, ketoacidosis, acute hypoxia and motion sickness, manifested
such a basic symptom as nausea, the level of ADH can increase by 100-1000 times. TO
factors that stimulate the release of ADH also include acute hypoglycemia, stress
(painful, emotional), physical activity, increased core temperature,
nicotine, some drugs (β-adrenergic receptor stimulants,
cholinomimetics, cytostatics, phenobarbital, carbamazepine, clofibrate, chlorpropamide).Decrease in body temperature, atrial natriuretic inhibit its secretion
hormone, glucocorticoids, alcohol, β-adrenergic receptor blockers, anticholinergics, morphine.


Absolute or relative ADH deficiency and diabetes insipidus

Under these names, several diseases with different etiologies are combined, for which
characterized by hypotonic polyuria – the release of a large amount of urine with low
specific gravity. This may be due to ADH deficiency (central insipidus
diabetes), kidney resistance to ADH (nephrogenic diabetes insipidus), excessive
water intake (polydipsia nervosa).
In endocrinological practice, diabetes insipidus of central origin is the main
cause of polyuria. Central (hypothalamic, neurogenic,
vasopressin-sensitive) diabetes insipidus develops with pathology of the gene structure
vasopressin, in the case of surgical damage to neurons, with congenital
anatomical defects of the hypothalamus or pituitary gland, tumors, infiltrative,
autoimmune and infectious diseases with neuronal damage, with increased
metabolism of vasopressin.In about 10% of cases of central insipidus
diabetes in children, the etiology of the disease is unclear.


Diagnostics

In the diagnosis of diabetes insipidus, anamnestic data and
complaints. So, first of all, you need to make sure whether pathological
polyuria and polydipsia (exceeding 2 l / m2 2 / day). The physician should be interested in the following
questions: what is the volume of drunk and secreted fluid per day; does it affect
polyuria / polydipsia for the patient’s usual activity; whether there is nocturnal enuresis or
nocturia; what is the volume of liquid drunk at night; have a history or
clinical examination data indicating a deficiency or excess secretion
other hormones or the presence of an intracranial tumor.
Polyuria occurs when ADH secretion becomes insufficient to provide
the concentration ability of the kidneys, i.e., it decreases by more than 75%. Hyperosmolarity
plasma caused by polyuria is compensated by polydipsia. Regardless of the severity
polyuria polydipsia can maintain normal plasma osmolarity.
Violation of the mechanism for the formation of a feeling of thirst or restriction of consumption
fluids are the causes of plasma hyperosmolarity and hypernatremia in the patient
diabetes insipidus.
Thus, the main symptoms of diabetes insipidus are polyuria and polydipsia. Volume
urine ranges from several liters per day with partial central insipidus
diabetes (with partial ADH deficiency) up to 20 liters per day with complete central
diabetes insipidus (with the absence of ADH), and polyuria occurs, as a rule,
suddenly. Patients drink a lot and usually prefer cold drinks. If
fluid intake is limited, plasma osmolarity increases rapidly and
symptoms of central nervous system damage appear (irritability, lethargy, ataxia,
hyperthermia and coma).
Neurological symptoms in hypothalamic diabetes insipidus include
headaches, vomiting, limitation of visual fields. Hypopituitarism hypothalamic
origin is often associated with diabetes insipidus. 70% of patients with insipidus
diabetes due to tumors of the pituitary gland / hypothalamus have a deficiency of growth hormone
hormone (STH) and 30% – deficiency of other hormones of the adenohypophysis.
In newborns and infants, the clinical picture of diabetes insipidus
differs significantly from that in adults and is quite difficult to diagnose: children
at an early age cannot express a desire for increased fluid intake, and if
pathology will not be diagnosed in time, the development of irreversible damage is possible
brain.Newborns with diabetes insipidus due to perinatal hypothalamic
lesions lose weight, hypernatremia develops. In infants
the leading symptoms are repeated episodes of hypernatremia and vomiting. Lethal
outcomes are associated with coma and seizures. Children grow poorly, suffer from anorexia and vomiting
when eating. Children may prefer water to milk. A common reason for contacting
the doctor becomes mental retardation. These symptoms are a consequence of chronic
hypovolemia and hyperosmolarity of blood plasma.Osmolarity of urine never happens
high. At the time of diagnosis, the child usually has a pronounced deficiency
weight, dry and pale skin, he has no perspiration and lacrimation. Polyuria
can cause enuresis, nocturia disrupts sleep, leads to fatigue. Explicit
hypertensive dehydration occurs only with a lack of drinking.
Laboratory diagnostic criteria for diabetes insipidus: large urine volume (as
usually> 3 l / day), hypostenuria, that is, the specific gravity of urine in all portions per day
less than 1008 in the absence of azotemia, low level of ADH in blood plasma, not
corresponding to its osmolarity.
MRI is essential in the diagnosis of central diabetes insipidus
brain. Normally, the neurohypophysis is an area of ​​bright glow on T1-
weighted shots. The bright spot of the neurohypophysis is absent or poorly traced when
central form of diabetes insipidus due to reduced synthesis of vasopressin.
In addition, with the help of MRI, tumors, malformations of the hypothalamic-pituitary
areas in which diabetes insipidus may occur.


Treatment

The goal of treatment is to compensate for the deficiency of ADH, most often desmopressin is used for this –
long-acting ADH drug. Its antidiuretic effect lasts 8-20
hours, the vasopressor effect is minimal. For children and adults, the drug is prescribed in the form
nasal drops or as an aerosol for intranasal administration. Better to start treatment
in the evening to find the lowest effective dose to prevent nocturia.
Usually, 5-10 mcg of desmopressin 1-2 times a day is sufficient.
Chlorpropamide can be prescribed, since it not only enhances the effect of ADH on the renal
tubules, but also stimulates the secretion of ADH. Chlorpropamide is prescribed orally in doses of 250-
500 mg / day Clofibrate and carbamazepine stimulate the secretion of ADH, the latter also
increases the sensitivity of the kidneys to ADH.


Nephrogenic diabetes insipidus

This is a syndrome of hypotonic polyuria due to renal resistance to
antidiuretic action of ADH.Polyuria occurs when the kidneys are sensitive to
ADH decreases so much that physiological concentrations of vasopressin cannot
to ensure the concentration of urine. The main signs are as follows:
1. Normal rate of glomerular filtration and tubular excretion.
2. Hypostenuria.
3. Normal or elevated ADH levels.
4. Treatment with ADH drugs does not increase osmolarity and does not decrease urine volume.
Like central diabetes insipidus, nephrogenic diabetes insipidus can be
hereditary or acquired.The hereditary form of the disease manifests itself as
usually already in infants. Possible causes of acquired nephrogenic
diabetes insipidus: hypokalemia, hypercalcemia, sickle cell anemia,
obstruction of the urinary tract, as well as taking medications (for example, lithium,
demeclocycline or methoxyflurane).
The main feature of nephrogenic diabetes insipidus is passive reabsorption of water in
distal tubules and collecting ducts does not increase under the influence of ADH, which
leads to hypostenuria.Nephrogenic diabetes insipidus may be due to
impaired binding of ADH to type V2 receptors, impaired signal transmission from
receptors or both defects.
In hereditary nephrogenic diabetes insipidus, signal transmission from
ADH receptors to adenylate cyclase, cAMP production in response to ADH is reduced,
the number of water channels in the cells of the distal tubules and collecting ducts is not
increases under the influence of ADH. Hypercalcemia and hypokalemia also impair
concentration ability of the kidneys.Hypokalemia stimulates education
prostaglandin E2 and thus prevents the activation of adenylate cyclase. Hypercalcemia
reduces the content of solutes in the medulla of the kidneys and blocks
interaction of ADH receptors with adenylate cyclase. Demeclocycline and lithium inhibit
cAMP formation stimulated by ADH.
In nephrogenic diabetes insipidus, neither ADH drugs (vasopressin,
argipressin, lipressin, desmopressin), nor drugs that stimulate the secretion of ADH
or enhance its effect on the kidneys.The most effective method of treatment is prescribing
thiazide diuretics and moderate salt restriction. Thiazide diuretics
can also be used for central diabetes insipidus. These drugs block
reabsorption of chloride in the distal convoluted tubules and thereby reduce the content
sodium in the blood. In response to a decrease in sodium concentration, the reabsorption of water into
proximal parts of the nephron increases, and the volume of fluid entering
collecting ducts decreases.Limiting salt intake increases the effect
thiazide diuretics.
Inhibitors of prostaglandin synthesis (ibuprofen, indomethacin, aspirin) reduce
the flow of solutes into the distal nephron, thereby reducing the volume
and increasing the osmolarity of urine. These drugs can be used as an additional
a remedy for the treatment of nephrogenic diabetes insipidus.


Diabetes insipidus in pregnant women

This is a transient condition due to the destruction of ADH in the blood by placental
enzymes, such as cystinylaminopeptidase.Diabetes insipidus in pregnant women
signs of both central and nephrogenic diabetes insipidus are characteristic. Polyuria
usually occurs in the third trimester, and after childbirth passes without treatment. ADH level
reduced. Polyuria is not relieved by treatment with vasopressin or argipressin, but
is treatable with desmopressin.


Nervous polydipsia

This disease is also called primary polydipsia, or dipsogenous insipidus.
diabetes.
The disease can be caused by both organic and functional
disorders of the central nervous system departments that control the secretion of ADH and quench thirst.
Polydipsia occurs when the thirst-quenching plasma osmolarity threshold becomes
lower than the osmolarity threshold for triggering ADH secretion (normal threshold
plasma osmolarity for thirst quenching is higher than for ADH secretion). Such a perversion
the normal ratio between thirst and secretion of ADH causes a persistent
polydipsia and polyuria.
Diagnostic criteria for nervous polydipsia: hypoosmolarity of plasma, urine,
reduced plasma ADH levels.
For the treatment of polydipsia nervosa, ADH preparations and thiazide diuretics cannot be used,
since they limit the excretion of water without reducing its consumption, and therefore can
cause severe water intoxication. The main efforts of the doctor should be directed
to correct the behavior and psyche of the patient in order to reduce fluid intake.


Differential diagnosis of polyuric syndromes

It is difficult to determine the cause of polyuria without special tests, but some symptoms are still
help to establish a preliminary diagnosis.Large urine volume, hypoosmolarity
plasma (
Restricted fluid test is the most common and reliable method
differential diagnosis of polyuric syndromes. Limiting consumption
fluid leads to dehydration, which normally stimulates maximum secretion
ADH, which, in turn, determines the maximum concentration of urine. That’s why
the introduction of ADH does not increase the osmolarity of urine.
Normally and with polydipsia nervosa against the background of dehydration, the osmolarity of urine exceeds
plasma osmolarity.After the introduction of ADH, the osmolarity of urine increases slightly
(less than 10%). If the osmolarity of urine, despite obvious dehydration, is not
exceeds plasma osmolarity, polydipsia nervosa can be excluded. Under the central
or nephrogenic diabetes insipidus urine osmolarity in the presence of dehydration is not
exceeds plasma osmolarity. After the introduction of ADH in healthy people and patients with
with polydipsia nervosa, urine osmolarity increases by less than 10%, in patients with
central diabetes insipidus – more than 50%, and in patients with nephrogenic
diabetes insipidus – less than 50%.
If central diabetes insipidus is diagnosed, CT is mandatory or
MRI of the hypothalamic-pituitary region to exclude craniopharyngioma, meningioma, and
infiltrative process.


ADH hypersecretion syndrome

Other names: syndrome of inadequate production of ADH, hyperhydropexy syndrome,
Parhon’s syndrome, anti-diabetes insipidus.
This syndrome is characterized by hyponatremia, plasma hypoosmolarity, and elimination
sufficiently concentrated urine (urine osmolarity usually> 300 mosmol / kg).The syndrome may be due to excessive unregulated secretion of ADH or
enhancement of its action on the cells of the distal nephron. Judging by the results
determination of ADH in plasma of patients with hyponatremia, ADH hypersecretion syndrome is the most
a common cause of hyponatremia. Indeed, the level of ADH is increased in 95% of patients with
hyponatremia.
Constant secretion of ADH or an increase in the sensitivity of kidney cells to ADH causes
fluid retention, hyponatremia, and some volume increase
extracellular fluid, which leads to inhibition of sodium absorption in
proximal renal tubules and natriuresis.In addition, an increase in BCC
stimulates the secretion of atrial natriuretic hormone, which also
promotes natriuresis. The excretion of uric acid increases, as a result of which
hypouricemia develops, often observed in ADH hypersecretion syndrome.
The cause of the syndrome can be any lesions of the central nervous system, including volumetric processes,
infections, vascular and metabolic disorders. ADH hypersecretion syndrome can
be due to increased physiological non-osmotic stimuli of ADH secretion
(for example, in acute psychosis, stress and pain).
The ability of the kidneys to excrete water is impaired in almost 66% of patients with small cell carcinoma
lung. Tumor cells secrete ADH or ADH-like peptides (possessing
immunological and biological properties of ADH), as well as neurophysin. Breathing under
constant positive pressure, activating the baroreceptors of the low
pressure, can also cause ADH hypersecretion syndrome.
In the clinical picture, the symptoms of water intoxication are in the foreground. Expressiveness
symptoms depend on the degree and rate of development of hyponatremia and overhydration.At
acute hyponatremia, when the serum sodium concentration falls below 120 mmol / L,
ADH hypersecretion syndrome is manifested by drowsiness, seizures, coma and often
ends in death. Water content in the brain in chronic hyponatremia
increases not as significantly as in acute hyponatremia (with a decrease
concentration of sodium to the same level), therefore chronic hyponatremia
characterized by lower mortality than acute. With chronic hyponatremia, even
if the sodium concentration does not reach 125 mmol / l, half of the patients have symptoms
are absent, and the frequency of deaths is very low.When the sodium concentration of such
patients decreases to 115-120 mmol / l, there is nausea, vomiting, headache and pain in
stomach, appetite disappears.
The diagnosis of ADH hypersecretion syndrome is established if the patient has
hyponatremia against the background of dilution of urine below the maximum. Exclude hypovolemia,
diseases of the thyroid gland, adrenal glands, liver, heart and kidneys. In patients with severe
heart, renal failure and cirrhosis of the liver with ascites, as well as after
the introduction of large volumes of hypotonic solutions usually develops hyponatremia
breeding.Hyponatremia is also observed in conditions accompanied by loss of
salts such as diarrhea, kidney disease, diabetes mellitus. However, in these cases (for
excluding kidney disease), there are usually signs of dehydration and a decrease in
excretion of sodium in the urine. With ADH hypersecretion syndrome and renal failure
urinary sodium levels exceed 20 mEq / L and their excretion is above 1%. In patients with
ADH hypersecretion syndrome, fluid restriction to 600-800 ml / day for 2-3
days should lead to a weight loss of 1.8-2.7 kg, the disappearance of hyponatremia and
stopping the loss of sodium in the urine.At the same time, with salt-wasting forms of renal
deficiency, fluid restriction does not eliminate either hyponatremia or salt loss with
urine.
The goal of treatment for ADH hypersecretion syndrome is to normalize plasma osmolarity and
elimination of overhydration. Treatment tactics depend on the rate of development of hyponatremia
(acute or chronic), serum sodium concentration and patient condition.
In acute hyponatremia or exacerbation of chronic hyponatremia (concentration
serum sodium
Limiting fluid intake is the best way to treat chronic syndrome
hypersecretion of ADH, which normalizes serum sodium concentration
in almost all patients with an initial sodium concentration> 120 mmol / L.Volume
the fluid consumed should be equal to the sum of the volume of excreted urine and hidden
fluid loss. If it is difficult for the patient to withstand such a regime, you can prescribe
demeclocycline or lithium. Both drugs block the effect of ADH on collective
tubules, but lithium is rarely used to treat ADH hypersecretion syndrome, since
it has many side effects. Demeclocycline is safer, but with its use
it is necessary to pay special attention to the function of the liver, since with hepatic
deficiency, the drug accumulates in the body and has a nephrotoxic
action.It should be emphasized that it is necessary to treat the underlying disease that causes
hyponatremia.

TOPIC STATTS

10/07/2021

Oncology and hematology

Lykar-oncologist about the difficult specialties of diagnostics of oncological illnesses

Cancer – tse zhvoryuvannya, like current medicine in diagnostics, lіkuvati and control.The emergence of ailments at an early stage allows one to recognize a type of therapy, and at the same time, when we are happy with it. The very fact is timely diagnostics of the vital role in the successful detection of oncological illnesses. About the specialties of diagnostics of oncological pathology of the development of the leader directly oncology, surgeon-oncologist of the Dobrobut medical hedgehog Kostyantin Volodimirovich Kopchak ….

07.10.2021

Pediatrics

Pachydermodactylia is an unseen diagnosis in the case of the suglobovy syndrome

Speak, if the patient has a symmetrical increase in the diameter of the midphalangeal lobes of the hands, the diagnosis of arthritis is most often established. Allegedly, there are some symptoms, not associated with ignition processes in cich troughs.Pahіdermodaktiliya (from the walnut pachy – tovsty, dermos – shkіra, dactylos – fingers) – one of them, children develop a little, so don’t expect the right diagnosis …

Properties of lycopene in the prevention of cancer and heart disease

Lycopene – what is it?

Do you like tomatoes? If not, after learning about the amazing properties of the antioxidant lycopene, be sure to fall in love.

Lycopene is an anti-cancer phytonutrient, an antioxidant with many properties. It is found in high concentration in tomatoes, but it can also be found in other vegetables and fruits. For all its uniqueness, it is still somewhat similar to beta-carotene.

Acting as a pigment, lycopene turns tomatoes red, although not all red fruits and vegetables contain this antioxidant. Lycopene is insoluble in water and is responsible for orange stains on kitchen utensils, for example after making tomato sauce.

Despite this unpleasant feature, the substance should be included in your diet, as it is incredibly useful.

What is lycopene?

This amazing molecule was first extracted in 1910, and the complete molecular structure was discovered in 1931.

So what is it? First, lycopene is a phytonutrient, which is an antioxidant found in plants. The human body cannot produce these substances; plants need them to protect them from the external environment, for example, parasites, toxins, UV rays.Antioxidants create various substances in plants to protect against free radicals.

Like plants, we are influenced by the environment. Thus, prolonged exposure to sunlight can lead to cell damage by free radicals, which is why it is so important to “eat a rainbow”. With the regular consumption of plant foods of all colors, you will get enough phytonutrients to protect your health.

There are over 25,000 different phytonutrients, and one of the most important is the carotenoid class.Carotenoids help plants absorb sunlight and protect chlorophyll from harmful UV exposure. And lycopene is in that class.

Like other carotenoids, lycopene is fat-soluble, meaning it is absorbed better when paired with fat such as avocado, olive oil and seeds.

Of course, a dietary supplement with lycopene cannot cure all diseases, but it certainly can bring some benefits. Some molecular compounds similar to lycopene may be mistakenly referred to as lycopene supplements, but since they differ in the substances present in foods, they may not be as effective.

Health Benefits

1. One of the most powerful antioxidants in the world

Antioxidants are important for many reasons, especially in a world where processed foods are replacing those that can boost our immune system.

Have you ever wondered what pesticides are in the foods you eat? Dichlorvos and atrazine are often used to protect plants from insects. However, they can have a toxic effect on humans.

Fortunately, the antioxidant lycopene can protect the body from pesticide damage. Research shows that it can protect the liver from the effects of dichlorvos and stop or protect the adrenal cortex from being destroyed by atrazine.

Also, the human body is affected by a chemical called monosodium glutamate. We’ve all heard of him. But do you know why you should avoid it? The Mayo Clinic in the United States states that side effects from MSG use include headaches, flushing, sweating, numbness, nausea, and weakness.

These symptoms are neurological in nature, since monosodium glutamate acts as an excitotoxin for the brain, accelerating the reaction of cells so strongly that this leads to their death, or apoptosis. However, a 2016 study found that lycopene protects cells and slows down apoptosis when MSG sends a signal to the brain.

This phytonutrient may also be effective in treating candidiasis (fungal infections). In the same way that lycopene affects the toxic monosodium glutamate, it induces apoptosis in fungal cells.The substance can be effective in both oral candidiasis and vaginal yeast infection.

Lycopene can fight not only infections, the antioxidant properties contribute to the restoration of the blood-brain barrier in spinal cord injuries. This finding is extremely important, as damage to this barrier may be one of the causes of paralysis after a spinal injury.

2. Helps prevent cancer

Due to its antioxidant properties, lycopene plays an important role in preventing and slowing down the development of certain types of cancer, which means that foods containing this substance are anti-cancer.

Scientists at the University of Portsmouth have studied the ability of lycopene to slow the growth of breast and prostate cancers by blocking the signaling pathways that tend to cause neoplasm to grow. Another study involving 46,000 people showed a strong relationship between high lycopene intakes and a reduced risk of prostate cancer. This work, published in American Journal of Clinical Nutrition , noted that the consumption of tomato paste plays an important role in this process.

Like its effects on breast and prostate cancer, lycopene also stops the spread of renal cell carcinoma, the most common type of kidney cancer. It also suggests that the substance plays a critical role in preventing disease.

Lycopene may also be effective in treating HPV infection, the main cause of uterine cancer. An additional intake of lycopene helps to quickly cope with this problem and prevent the occurrence of cancer.

Surprisingly, these studies have focused almost exclusively on obtaining lycopene from food, and not from dietary supplements. The combination of lycopene and other nutrients naturally found in foods is so powerful that nutritional supplements cannot substitute.

3. Keeps the eyes healthy

Lycopene protects the eyes from oxidative stress, which is the cause of common diseases.In an experiment with the development of cataracts, conducted by the Department of Pharmacology of the All India Institute of Medical Sciences, it was found that lycopene has the ability to prevent or slow down cataracts in the vast majority of cases.

Lycopene has a significant effect on the chemical processes leading to age-related macular degeneration, which can cause blindness in the elderly. A study from Taiwan and published in Life Sciences suggests that due to its antioxidant and anti-inflammatory properties, lycopene is able to slow down and / or stop a variety of reactions in eye cells that are caused by or lead to macular degeneration.

4. Relieves neuropathic pain

Neuropathy, or neuropathic pain, is a complex of pain conditions caused by nerve damage and often accompanied by soft tissue damage. The causes of neuropathy can be many, from alcoholism to limb amputation and diabetes. It can even come on idiopathically, that is, for no apparent reason.

There are several effective treatments for neuropathy, although it is worth noting that in some cases, treating a comorbid condition (eg, diabetes, HIV / AIDS) can also relieve pain.Many doctors tend to prescribe conventional anti-inflammatory drugs to treat pain that may not always be able to cope with the problem.

In one study published in the European Journal of Pain , testing lycopene for diabetes-related neuropathy, scientists concluded that the substance was able to exert antinociceptive effects (pain inhibition) and reduce the overall weight of the subject. This experiment proved that increased consumption of lycopene helps to reduce neuropathic pain.

Lycopene – which diseases can heal?

5. Improves brain function

Lycopene is also capable of solving neurological problems. For example, lycopene therapy has been studied as a possible way to delay the onset and slow the progression of Alzheimer’s disease by repairing damaged cells and protecting healthy ones. In patients suffering from this disease, lycopene is able to prevent possible damage and death of brain cells by participating in certain mitochondrial interactions that (not yet fully understood) lead to permanent brain degradation.

In similar processes, this phytonutrient also exhibits restorative properties in epileptic seizures. This is very important because a seizure restricts the supply of oxygen to the brain and can damage the brain if the seizure lasts a long time. In 2016, scientists discovered that lycopene can not only prevent future seizures, but also repair neuronal damage to the brain as a result of those that have already happened.

In addition to neurological problems, there are also many diseases associated with high intake of unhealthy fats and their effects on cognitive function.Not all fats are created equal, and not all are bad for your health.

Given the link between Western diets and neurological impairment, scientists in China have found that lycopene prevents memory impairment and learning impairment from high-fat diets.

6. Strengthens the heart

Of course, lycopene effectively protects the heart from many problems.

It is one of the substances recommended for lowering blood pressure.It prevents the development of various cardiovascular diseases, such as coronary heart disease, coronary artery disease (decreased blood flow to the heart caused by blocked arteries), and atherosclerosis. In a study for coronary heart disease, tomato nutrients were identified as a determining factor in prevention.

High levels of lycopene in the blood are associated with a reduced risk of death in people with metabolic syndrome, a combination of disorders that lead to heart disease.

7. Strengthens bones

Vitamin K and calcium are not the only substances that keep bones strong. Lycopene helps deal with oxidative stress in bones that can lead to fragility. It slows down apoptosis (cell death), preventing bones from weakening, and restores the cellular structure of bones, making them stronger and healthier.

Lycopene and beta-carotene

Other carotenoids are often involved in human health research.One of them, beta-carotene, is somewhat similar to lycopene.

  • Both substances are antioxidants.
  • Beta-carotene is a precursor of vitamin A. Lycopene is not associated with any vitamins.
  • At the moment, there is no data confirming the occurrence of side effects with an excess of lycopene in the body. Whereas vitamin A from beta-carotene is toxic when supplemented excessively.
  • When you consume lycopene and beta-carotene from food, the body is able to remove excess amounts of them.
  • Both substances have anti-inflammatory and anti-cancer properties.
  • They protect eye health and prevent the development of cognitive disorders.
  • The highest concentration of lycopene is found in tomatoes, peppers contain a large amount of beta-carotene.
  • Beta-carotene supplements may interact with drugs such as statins, orlistat, blood cholesterol lowering drugs, and mineral oil.Lycopene can cause negative reactions when it interacts with blood thinners, fertility medications, nicotine, and other classes of dangerous drugs.
  • Possible relationship between high beta-carotene levels and smoking-related cancer. There is no evidence of the effect of lycopene on the risk of cancer.

Top Products

Most of the research has focused on lycopene, which is present in tomatoes.However, other foods also contain this nutrient.

  • Tomatoes
  • Gak (Vietnamese fruit)
  • Watermelon
  • Grapefruit
  • Guava
  • Papaya
  • Asparagus
  • Red cabbage
  • Mango
  • Carrot

Risks and side effects

There have been rare cases of skin discoloration called “lycopinoderma” in people who consumed a very large amount of tomatoes and dishes from them.This is a non-toxic reaction that resolves after a few weeks with a diet low in or without lycopene. Cases of diarrhea, nausea, abdominal pain and cramps, gas formation, vomiting, and loss of appetite have also been reported with high lycopene intake.

A study by the Mayo Clinic, USA, suggests that this antioxidant may interfere with the functioning of certain drugs and substances, including drugs that thin the blood or lower blood pressure, “agents that bind to bile acid, agents that affect the immune system, agents that affect the nervous system, agents that can increase sensitivity to sunlight, agents that can treat lung disease, agents that can treat stomach disease, alcohol (ethanol), androgens, anti-asthma agents, anti-cancer agents, anti-inflammatory agents, arsenic , cholesterol lowering agents, creatine, HMG-CoA reductase inhibitors (statins), nicotine and probucol. “

The list of drugs is quite long, while the results similar to the actions of many drugs can be achieved with the help of an appropriate diet. It is worth noting that drug interactions tend to occur with supplements rather than food.

Final conclusions

  • Lycopene is a powerful antioxidant that can protect and repair the body from damage caused by a variety of diseases.
  • You can benefit from lycopene by including foods such as tomatoes, melons and other fruits and vegetables in your diet.
  • To increase the absorption of lycopene, we recommend adding healthy fats to tomatoes, such as making tomato sauce for pasta. Heat treatment will lead to changes in the structure of the lycopene molecules (from linear to curved), which, as a rule, does not occur in commercial sauces.
  • It is better to choose foods rich in lycopene. Supplements can be of poor quality, cause side effects, interfere with other drugs, and be far less effective.

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Nutritional headaches

Eating defects are one of the most common causes of headaches. Everyone understands that our food is far from ideal. There are several reasons for the onset of nutritional headaches:

• low blood sugar levels due to dietary restriction;
• the consequences of a nervous and emotionally unstable state due to diet;
• digestive disorders due to unbalanced nutrition, such as constipation, and hence the absorption of toxins into the bloodstream and other reasons;
• the use of products containing chemicals (dyes, preservatives, seasonings, etc.)that can cause headaches.

Diagnostic Criteria for Headache Induced by Food and Supplements (International Classification of Headache, 2nd Edition). Previously used term: food headache. Diagnostic criteria:
A . Headache meeting criteria C and D and having at least one of the following characteristics:
1. bilateral
2. frontal-temporal localization
3. pulsating character
4. aggravated by physical activity
B .Consuming the smallest portion of a food or nutritional supplement.
C . The headache develops within 12 hours after consuming the product.
D . The headache stops within 72 hours after a single use of the product.
Note: Phenylethylamine, tyramine and aspartame have been discussed as the main provocateurs, but their ability to cause headaches is well established.

The most common food-borne headache provocateurs are sulfites, red wine or other alcoholic beverages (causing intoxication and, accordingly, headaches), nuts, aspartame, monosodium glutamate, which is often added to various flavoring products, caffeine (including in tea, cocoa), chocolate, tyramine, which is part of some cheeses, nitrites / nitrates (salami, sausages, sausages, all canned foods, spinach, radish, lettuce, celery, cabbage, citrus fruits) and some other products, as well often supplements, including some vitamins.

Most headache-provoking foods contain substances known as “amines,” such as tyramine and phenylethylamine, which can cause headaches. Many people react with a throbbing headache to biogenic amines found in aged cheeses, vinegar, mustard, mayonnaise, smoked pork, celery, soy, pineapple, avocado, and plums.

Some people have migraine attacks after eating certain foods. For example, the chemical tyramine, found in cheeses, yeast, and nuts, can trigger a migraine attack.Tyramine has the ability to raise blood pressure and cause throbbing headaches. “In 1970 it was found that the metabolism of tyramine in migraine patients is different from that of other people. This may explain their susceptibility to the effects of tyramine-containing foods (note that this dependence is not an allergic reaction).

The special insidiousness of tyramine lies in the fact that its amount in food increases during storage (including when freezing and eating stale food).

People who decide to limit the consumption of foods containing tyramine need to take into account the peculiarities of their body’s sensitivity to this substance: someone may have an attack after eating cheese or chocolate, while another reacts to beer and sausages. It is noted that social and cultural factors play an important role in the development of this sensitivity. For example, in French migraine sufferers, attacks are most often triggered by white wine, eggs, chocolate and almost never dairy products and citrus fruits.And in England and some other European countries, dairy products and red wine are most often “mentioned”.

Food additives that appear to contribute to headaches include sodium chloride, sodium nitrite and aspartame. In the future, it is possible that other substances responsible for the appearance of headaches will be discovered.

Sausage hot-dog headache

Some people experience headaches after eating hot-dog sandwiches or other processed meat products.Such meat contains nitrites as a preservative, which can cause dilation of blood vessels. With a high degree of probability, nitrites are found in sausages, canned meats, salami, smoked and boiled sausage, smoked fish, bacon, corned beef, ham. To prevent headaches associated with the use of the above products, it is necessary to familiarize yourself with the information indicated on the manufacturer’s label before using them (to find out if they contain nitrites).

Sodium nitrite – (E-250) – dye, seasoning and preservative. Sodium nitrite is a stabilizer for the red color of canned meat and a flavoring agent. Without it, hot dogs and bacon would be gray. Sodium nitrate is used for dry preservation of meat, such as ham, as it breaks down more slowly into nitrite. Nitrite also inhibits the growth of bacteria that cause botulism. Adding nitrite to foods can increase the effects of nitrosamines, which are cancer-causing and are abundant in fried bacon.Manufacturers nowadays add ascorbic acid to bacon to prevent the formation of nitrosamines. Sodium nitrite and sodium nitrate are thought to be responsible for the hyperexcitability of the nervous system in children. Nitrite in high concentration can lead to poisoning and even death. The fact is that, coming from the intestines into the blood, nitrites bind hemoglobin and prevent oxygen from joining. This causes hypoxia (oxygen starvation) of the body. There are known cases of severe group poisoning with sausages, which mistakenly contained very high doses of sodium nitrite.In addition, according to recent reports, nitrites reduce the amount of vitamins in the body.

in order to reduce the harmful effect of sodium nitrite and ensure its maximum removal from the body, it is necessary to eat sausage together with vegetables – this will prevent the conversion of nitrites into nitrosamines

Diagnostic criteria for headache caused by donors of nitric oxide (NO) (international classification of headache 2- edition). Previously used terms: nitroglycerin headache, dynamite headache, “hot dog” headache.Diagnostic criteria:
A . Headache meeting criteria C and D and having at least one of the following characteristics:
1. bilateral
2. frontotemporal localization
3. pulsating
4. increases with physical activity
B . Donor reception NO.
C . The headache occurs within 10 minutes after taking the NO donor.
D . The headache stops within 1 hour after the circulation of the NO donor in the blood is completed.

Delayed headache caused by nitric oxide (NO) donors. Diagnostic criteria:
A . Headache in a patient with primary headache, which has the characteristics of this pain and meets criteria C and D:
1. bilateral
2. frontotemporal localization
3. pulsating
4. increases with physical activity
B . Donor reception NO.
C . The headache occurs after the elimination of NO from the blood.
D . The headache stops within 72 hours after a single dose of NO.
Notes:
1. In healthy individuals, this form of cephalalgia develops rarely, while patients with migraine develop a migraine attack without an aura, in patients with tension headache (HDN) – an attack of HDN, in patients with bundle headache (PHB ) – an attack of PHB.
2. Attacks of migraine and HDN usually develop after an average of 5-6 hours, an attack of PHB – after 1-2 hours.

Headaches arising from the use of monosodium glutamate

The chemical monosodium glutamate is widely used as a seasoning component.It is also found in many canned foods, meat tenderers and condiments, chips, restaurant foods, salad dressings and soups, and marinades. Unfortunately, about 10-30% of people who eat monosodium glutamate have headaches. This reaction usually takes the form of a series of symptoms, starting with a burning sensation in the chest, neck and shoulders, then begins to squeeze the chest, then the feeling of squeezing covers the entire head. Why MSG has such an effect in some people remains unclear.Studies have shown that if a person eats something before consuming MSG meals, absorption is slowed down and there may be no headache. One study found that drinking alcohol with a diet containing monosodium glutamate increased the likelihood of headaches. Soy sauce also causes headaches in some people.

Monosodium glutamate – monosodium glutamate – (E-621). Glutamates create a meaty flavor. One of the most common synthetic flavors is glutamic acid and its compounds.Glutamic acid salts enhance the sense of taste by stimulating the endings of the gustatory nerves and thus producing a “feeling of satisfaction.” But, it is necessary to use glutamic acid to a limited extent, since in the human body glutamic acid is converted into gamma-aminobutyric acid, which is an inhibitory mediator of the central nervous system. For adults, the permissible daily dose is 1.5 g, for children – 0.5 g. It is forbidden to use flavorings in baby food, in the production of bread, cereals, milk, flour and pasta, butter, as well as juices, syrups, cocoa , tea, spices.Glutamate is an amino acid (protein is built from it). It is present in the human body (in the mother’s breast milk), participates in protein metabolism, it is also present in many foods rich in proteins: cheese, meat, milk and beans. However, this does not mean that this dietary supplement can be consumed in any quantity. It can play a bad joke with people whose diet contains a lot of food containing monosodium glutamate, provoking the so-called “Chinese restaurant syndrome” (monosodium glutamate is a very popular ingredient in oriental cuisine).Typical symptoms: headache, heart palpitations, nausea, chest pain, drowsiness and weakness.

Diagnostic Criteria for Glutamate Mononitrate Headache (International Classification of Headache, 2nd Edition). Diagnostic criteria:
A . Headache meeting criteria C and D and having at least one of the following characteristics:
1. bilateral
2. frontal-temporal localization
3. worse with physical activity
B .Consuming glutamate mononitrate.
C . The headache develops within 1 hour after consuming glutamate mononitrate.
D . The headache stops within 72 hours after a single dose of glutamate mononitrate.
Commentary: Glutamate mononitrate headache. usually has a dull or burning, non-pulsating character, however, in patients with migraine, the pain may be pulsating; cephalalgia is usually accompanied by other symptoms, for example.a feeling of pressure behind the breastbone, a feeling of pressure and / or constriction in the face, a burning sensation in the chest, neck or shoulder region, redness of the face, dizziness and abdominal discomfort.

Sodium Sulphite – Sodium Sulphite – (E-221) – preservative – causes headache, weakness, heavy and labored breathing, cough.

Potassium Nitrite – Potassium Nitrite – (E-249) – preservative – prohibited for use in baby food. May cause headaches, weakness, shortness of breath, carcinogen.

Sodium bicarbonate (baking soda) often causes headache associated with cerebral vasospasm.

Aspartame (Nutrasweet) is a sugar substitute that is added to some products. Headaches associated with the use of this substance affect about 8% of patients with migraine attacks. Therefore, if there is an increased sensitivity to aspartame, it is necessary to stop using products containing it.

Vitamin A-related headache .Excessive vitamin A intake can cause severe headaches, often accompanied by abdominal pain, nausea, and dizziness. This syndrome disappears as soon as further intake of vitamin A is stopped. Beware: almost all vitamins in large doses are dangerous, so avoid overdose. Tell your doctor how much vitamins you are taking each day.

Acids from citrus fruits can also lead to headaches.Oranges, grapefruits, lemons contain large amounts of vitamin C (ascorbic acid). However, in people who have allergies, excess of these acids in the body can cause headaches.

Ice cream headache . Many people know that drinking ice cream or cold drinks can cause severe and unexpected headaches. This type of headache is more likely to occur during very hot weather or if the person is overheated. Pain that seems to come from deep inside the head may appear 15 seconds after ingestion of cold foods.Ice cream cools the warm palate of the mouth and apparently triggers a certain reaction in the blood vessels that causes pain. Fortunately for the sick, the pain only lasts 1 minute. About a third of people experience this headache from time to time, however 90% of people prone to migraines have the same reaction to overly cold foods or drinks. Some people find these headaches severe enough to eliminate cold foods from their diet altogether. Others simply try to stir the ice cream before eating until it melts a little and turns into a warmer liquid form.

Caffeine (methylxanthine) – causes headaches not by its presence, but by its absence. Usually, headaches occur when you stop regularly taking your favorite caffeine-containing drink – tea, coffee, Coca-Cola. Withdrawal syndrome is expressed by throbbing headaches in the temporal regions, weakness, irritation, absent-mindedness, anxiety and fear, sleep disturbances, and nausea. The habit of drinking large amounts of coffee at work leads to the development of headaches on weekends, when the usual morning cup of this drink is not drunk in a calm home environment or the consumption of coffee during the day is drastically reduced.Lack of caffeine causes headaches usually 8-12 hours after the last “dose” of caffeine has been ingested. The pains last up to two days, but can last for weeks. A typical cup of coffee can contain between 45 mg and 175 mg of caffeine; a cup of tea from 20 mg to 60 mg (and additionally 1 mg of theophylline, a biologically active substance that acts on smooth muscle fibers of blood vessels and internal organs). A cup of cocoa contains about 5 mg of caffeine. In addition, it is included in many analgesic / pain relievers as a component.Some of them are: cofergot (100 mg of caffeine), migrenol (65 mg), quarelin (60 mg), benalgin, cofficil, pentalgin, saridone, sedalgin (50 mg), solpadein, citramone (30 mg). (See also the article “CAFFEINE” in the “Pharmacology” section of the medical portal DoctorSPB.ru)

Alcohol . The headache can be caused by alcohol breakdown products, but here the connection is clearer – alcohol promotes the expansion of the blood vessels in the brain, followed by a sharp narrowing, which causes a headache.

Diagnostic Criteria for Alcohol-Induced Headache (International Classification of Headache, 2nd Edition).Immediate alcohol-induced headache. Previously used terms: “cocktail” headache. Diagnostic criteria:
A . Headache meeting criteria C and D and having at least one of the following characteristics:
1. bilateral
2. frontal-temporal localization
3. pulsating character
4. aggravated by physical activity
B . Drinking a drink that contains alcohol.
C . the headache develops within 3 hours after drinking an alcoholic drink.
D . The headache stops within 72 hours.
Note: The dose required to induce headache has not been established.
Commentary: only in isolated cases, the headache develops directly after drinking alcohol; delayed alcohol-induced headache is much more common.

Delayed alcohol-induced headache. Previously used terms: hangover headache. Diagnostic criteria:
A .Headache meeting criteria C and D and having at least one of the following characteristics:
1. bilateral
2. frontal-temporal localization
3. pulsating character
4. aggravated by physical activity
B . Drinking a small amount of alcohol (for a patient with migraine) or an excess (causing intoxication) amount (for an individual who does not suffer from mingraine).
C . The headache develops after the blood alcohol level drops sharply or drops to zero.
D . The headache stops within 72 hours.
Comments: This is one of the most common types of headache. It remains unclear whether other components (besides alcohol) of alcoholic beverages play any role in the origin of this cephalalgia. It has also not been established whether the headache is a delayed reaction to the toxic effects of alcohol, or in this case there is a mechanism similar to that in the delayed headache with the action of NO donors.Differences in the predisposition to the development of hangover headache between patients with primary headaches and healthy individuals have not been established. In patients with migraine, a migraine attack may develop the next day after drinking a small amount of alcohol; Individuals without migraines must consume significantly more alcohol to develop delayed alcohol-related headaches.

Iron deficiency (which is sometimes the result of malnutrition) leads to oxygen starvation of the brain, causing headaches.Moreover, taking aspirin as an analgesic drug in this situation, with its prolonged use (more than 3-4 days), helps to displace iron from the body and thereby aggravate the headache.

Two factors in our diet can cause and exacerbate headaches associated with sinusitis – dairy products and simple sugars, including baked goods. They are believed to weaken the immune system. Dairy products, especially fresh milk, have a reputation for being one of the main causes of mucus and sinus congestion.Therefore, people with chronic sinusitis and headaches should first of all exclude these foods from their diet.

Fasting or malnutrition can also cause headaches due to low blood sugar. Such a phenomenon as a “hungry” headache is familiar to many of us. When we exhaust ourselves with rigid diets, fasting days, we simply do not have time to have breakfast or lunch in a hurry, we have hypoglycemia – a rapid decrease in blood sugar levels.As a result, the blood vessels responsible for the supply of glucose to the brain are narrowed (glucose is the main energy source for the brain). This can cause headaches. The same happens when we are too addicted to protein diets, lean only on meat, cheese, nuts, green leafy vegetables. But at the same time, we ignore foods containing simple sugars (honey, milk, fruit juice) and complex carbohydrates (starch – legumes, whole grains, pasta). Therefore, people suffering from headaches, it is imperative to streamline the diet, make it three times a day and avoid food in which there are too many carbohydrates.

According to endocrinologists and nutritionists, the head can also ache from elementary overeating, consumption of large amounts of food consisting of easily digestible carbohydrates (sweets, pastries, fruits), as well as too abrupt transition from a low-carb diet to a normal diet. Only in this case, unpleasant sensations will appear already due to vasodilatation, which causes an increase in glucose (its sharp jump).

Headaches can be the result of constipation and sluggish bowel movements.Constipation is often associated with the characteristics of the modern diet, which is dominated by refined foods and there is a deficiency of fiber (dietary fiber). If the transport of food in the intestine stops, then this giant excretory organ will no longer be able to fully perform its tasks. Therefore, the poisons, from which the body would like to be freed, enter again, since the time of contact with them increases. These poisons cause a wide variety of painful symptoms. People who complain of constipation often suffer from pain in the extremities, migraines, have cold hands and feet, and also feel rheumatic ailments.

all about the benefits and harms to the human body

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Against excess weight and heart disease: how green tea affects the body

Green tea: all about the benefits and harm to the human body

Against excess weight and heart disease: how green tea affects the body

Green tea is one of the most ancient and popular drinks. What are the benefits and harms of green tea for the health of women and men, how much can you drink per day, how… RIA Novosti, 16.04.2021

2021-04-13T18: 45

2021-04-13T18: 45

2021-04-16T12: 24

tea

vitamins

green tea

russia

healthy lifestyle (healthy lifestyle)

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MOSCOW, Apr 13 – RIA NovostiGreen tea is one of the oldest and most popular drinks. What are the benefits and harms of green tea for the health of women and men, how much it can be drunk per day, how it affects the body, as well as how to choose, brew and how much to store – in the material RIA Novosti. History and types According to a Chinese legend, one person noticed that his goats, which ate tea shoots, were unusually playful, playful and mobile. Then the shepherd decided to brew the parts of the plant, and it turned out to be a pleasant drink. Until the 1st century BCNS. in China, they used unprocessed leaves, then they began to dry and fry them. In the 7th – 10th centuries, the drink became ceremonial. Later he gained popularity in Japan, Korea, India, the Middle East, Central Asia. It is believed that green tea was first brewed in Russia in 1618, later it became a drink of the general population. Now consumed in almost all countries of the world and appreciated for its taste and health benefits. Green tea differs from black in that it does not undergo enzymatic oxidation, as a result of which the black variety becomes astringent.The taste of green tea is more delicate, herbal. By taste, green varieties are divided into: Composition and calorie content Green tea contains antioxidants, polyphenols, carotenoids, catechins, tocopherols, kaempferol, quercetin, myricetin, thein, tannin, ascorbic acid, vitamin P, minerals – chromium, manganese, selenium, zinc and a number of others substances. There are only 2 calories in one glass of unflavored drink. Useful properties of green tea Green tea, which contains caffeine, fights lethargy, depression and depression, reduces drowsiness, and stimulates the brain.It also has a beneficial effect on the cardiovascular system, blood pressure, lowers cholesterol, the risk of myocardial infarction, inhibits the development of certain types of cancer, and promotes weight loss. Drinking the drink strengthens the immune system, increases resistance to diseases, improves eye health (including useful for the prevention of glaucoma), slows down the aging of the body due to antioxidants. According to a 2006 study, among those who drank green tea more than five times a day, the death rate dropped by 23% in women, by 12% in men.At the same time, from cardiovascular diseases – by 31% and 22%, respectively, from stroke – by 42% and 35%. It has also been found that the drink prevents the development of dementia. Harm of green tea and contraindications Because of the caffeine contained in it, green tea is contraindicated in people with nervous disorders, insomnia, which can aggravate symptoms. It is also not recommended when using blood thinning medications in combination with certain other medications. Green tea can be harmful to people with high blood pressure, kidney, stomach, and liver problems.It is better not to mix it with other stimulating drinks – coffee, energy drinks, alcohol. With a lack of iron, you should drink such tea no earlier than 30 minutes after eating. Not recommended during pregnancy and lactation. Before drinking, in case of doubt, you should consult your doctor. The benefits and harms of green tea for men For men, this drink is useful in that it reduces the risk of developing myocardial infarction, ischemic heart disease and other cardiovascular diseases. Green tea tones up well, stimulates the nervous and mental processes.According to research, it increases sperm concentration, thereby increasing fertility. At the same time, it can aggravate nervous disorders and insomnia, it is contraindicated in hypertension, gastrointestinal diseases. The benefits and harms of green tea for women Green tea is considered a beauty drink for women, it helps to lose weight, due to antioxidants, slows down the aging process of the body. The extract is found in many face care products for women. It evens out skin tone, fights inflammation, regulates sebum production, and prevents the appearance of wrinkles.One of the most important properties of green tea for women is that it reduces the risk of breast cancer by 20-30% when consumed regularly. Contraindications are diseases of the gastrointestinal tract, liver and kidneys, pregnancy and lactation. Benefits and harms of species Green tea has many beneficial properties, its use is associated with a lower probability of heart attack, stroke. Moreover, each variety differs in its taste, but is practically the same in terms of the content of microelements important for health. Green Tea with Milk Green tea contains a high amount of flavonoids – catechins, which are powerful antioxidants that prevent the first signs of aging in the body and reduce the risk of cancer.Milk added to the drink can reduce their absorption and health benefits. However, green tea with milk has diuretic properties and is often used during weight loss by boosting metabolism. Green tea with jasmine This tea contains vitamins of groups A, B, vitamins C, PP, calcium, magnesium, sodium, potassium, phosphorus, chlorine, etc. Also, the drink is rich in amino acids, which contribute to better concentration, stimulating mental activity. Green tea with jasmine protects the body from free radicals, is a prophylactic agent against multiple sclerosis and neurodegenerative diseases – Parkinson’s, Alzheimer’s, etc.e. Contraindications for it are the same as for a classic drink. Green tea bags Green tea bags generally have a lower price. Unnatural flavors are often added to it, which reduces the beneficial properties of the drink. Poor-quality raw materials can also be used, and the bags themselves consist of about a third of artificial compounds that prevent dissolution. In this case, the beverage may develop a chemical aftertaste. It is best to buy high quality loose leaf tea without harmful additives.Matcha green tea Matcha tea has become very popular lately. It is made by roasting and grinding tea tree leaves into powder. It removes toxins from the body, saturates it with antioxidants, energizes it, increases concentration, reduces the risk of cardiovascular diseases, strengthens the immune system, has a positive effect on skin health, and prolongs youth. Excessive consumption of green tea can lead to irritability, headaches, insomnia, diarrhea, and heartburn.Milk Oolong Green Tea: Often, the milky flavor of this tea is achieved through the use of flavors, so before buying, you should study the composition. Real milk oolong does not have a pronounced taste. This tea, unlike other varieties, does not strongly tone up, but it improves brain function and increases concentration. Its benefits are due to its high antioxidant content, high tannin content, essential oils, polyphenols and vitamins. They heal and strengthen the body.To avoid the negative effects of tea, you should choose only a natural, high-quality product. Green tea with ginger Ginger has a cleansing, anti-inflammatory, strengthening, warming effect, due to which it is useful during colds. When added to green tea, it produces a vitamin drink that speeds up metabolism, helps reduce pain during menstruation, arthritis, blood sugar, and appetite. In this case, after use, indigestion and heartburn may occur.Also, green tea with ginger contains salicylates, which thin the blood, so it is contraindicated in people with poor clotting. Green tea with cinnamon Cinnamon can reduce hunger, so drinking with it is useful for losing weight. It also cleanses the intestines, removes harmful substances from the body, reduces cholesterol levels, normalizes metabolism and the functioning of the gastrointestinal tract. Cinnamon green tea can be harmful to those with kidney and liver disease and is contraindicated during pregnancy and lactation.Green tea with honey and lemon As in the case of ginger, the combination of green tea with honey and lemon increases the beneficial properties of the drink and increases the concentration of substances important for the body. It strengthens the immune system well, helps to quickly recover from viral diseases. Green tea with honey and lemon has bactericidal, antiparasitic, anti-inflammatory qualities, tones up, improves brain activity, and is useful for the prevention of cardiovascular diseases. The ingredients of the drink can cause allergies, it is not recommended for people with gastrointestinal diseases.Mint Green Tea Mint is said to have a calming effect, making green tea less tonic than other varieties. It is used for inflammatory diseases of the upper respiratory tract, soothes headaches, improves appetite. It also strengthens the immune system, cleanses the body, fights oxidative stress, slows down aging, and prevents the formation of edema. The drink can cause stomach upset, diarrhea, allergic reactions, dizziness if consumed excessively.Losing weight with green tea Green tea helps you lose weight because it contains polyphenols that are involved in the processing of stored fat. Also, the drink has antioxidant properties and improves metabolism. With a balanced diet, green tea helps to lose weight, because it has a diuretic effect, mildly suppresses appetite, removes excess fluid from the body, has a minimum calorie content, but at the same time saturates with useful substances. Green tea in medicine Green tea is used in traditional Indian and Chinese medicine.They are treated for high blood pressure, in China they believe that the drink activates the mind, normalizes blood flow and nervous system, relieves tension, promotes digestion, neutralizes toxins, and improves vision. It helps to normalize weight, is good for the heart, has anti-tumor properties, and increases the body’s resistance to various radiation and free radicals. Modern science claims that green tea is suitable for the treatment of psoriasis, reduces the risk of developing type 2 diabetes, and is beneficial for the prevention of cancer, as shown by numerous scientific studies.Green tea is usually brewed, but matcha is added to bars, baked goods, drinks and even dumplings. Jasmine tea can be used as a marinade, bergamot drink is added to ice cream, muffins, soufflés, cakes, and Labsang Souchong smoked tea is included in meat seasoning. Green tea jelly is popular in Asia as well. It is best to choose a natural, leafy product.When buying by weight, you should take into account the color of the tea leaves, they must be the same size, fragrant, without tea dust and preservatives. If the product is in a pack, there should also be nothing foreign in the composition. How to brew and drink green tea To prepare a drink, water should be free of hard impurities that can spoil the taste of green tea. It must be turned off immediately after boiling and allowed to cool slightly to a temperature of 75-80 degrees. The dishes must be preheated by sprinkling them with hot water.Then pour tea leaves into it, add a little hot water and drain it. After that, you can brew the drink. How to store it properly Store green tea in a place that does not contain other odors, because it absorbs them. It must be kept in an airtight package, for example, in a tin container, a metallized bag, a tight glass jar. Sunlight, as well as a leaky container, can deprive green tea of ​​taste and smell.Can you drink green tea every day? – Green tea can be drunk every day, while the optimal amount is 3-5 cups (200 ml per serving) per day. Is it possible to brew green tea a second time? – If we are talking about leafy green tea, then it even needs to be brewed several times. It is better to use pouring kettles so that the drink does not brew too much – this adds extra bitterness and spoils the taste. There is no point in brewing tea bags a second time. What removes green tea from the body? – Green tea has many positive effects, lowering “bad” cholesterol, increasing the body’s resistance to fighting infections, and so on.But if we talk about removing, as advertised, “slags”, then no, it does not remove them, this is just a marketing ploy. Is it possible to drink green tea on an empty stomach? – Drinking green tea on an empty stomach can affect the body negatively, for example , cause indigestion, heartburn, nausea and even constipation. It is better to drink green tea between meals or after meals. How does green tea affect the heart? – Green tea helps to lower blood pressure, which is good for the health of the cardiovascular system.How much caffeine is in green tea? – On average, there is 25-40 mg of caffeine per cup (200 ml). At the same time, in the same container with black tea there will be 14-70 mg of caffeine, in 100 ml of coffee – 50-80 mg, and in espresso – 250 mg. understand that the benefits of green tea can be obtained from masks, creams and other cosmetics containing its extract. They have an anti-inflammatory effect, reduce dark circles under the eyes, even out skin tone, etc.Just drinking or washing your face with green tea has no proven benefit. What happens if you drink green tea at night? – Green tea has many beneficial properties, including improving sleep. That said, drinking green tea less than 2 hours before bed can lead to poor sleep and increased nighttime urination, which can also impair sleep. Green tea or black tea? – Two drinks are full of health benefits. At some points, one variety is in the lead, at others – the second. Black tea invigorates well, but less aggressive than coffee.Green leaf drink serves as a good antioxidant and helps to relieve swelling.

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tea, vitamins, green tea, Russia, healthy lifestyle (healthy lifestyle)

MOSCOW, April 13 – RIA Novosti. Green tea is one of the most ancient and popular drinks. What are the benefits and harms of green tea for the health of women and men, how much it can be drunk per day, how it affects the body, as well as how to choose, brew and how much to store – in the material of RIA Novosti.

History and species

According to Chinese legend, one man noticed that his goats, which ate tea shoots, were unusually playful, playful and agile. Then the shepherd decided to brew the parts of the plant, and it turned out to be a pleasant drink. Until the 1st century BC. in China, they used unprocessed leaves, then they began to dry and fry them. In the 7th – 10th centuries, the drink became ceremonial. Later he gained popularity in Japan, Korea, India, the Middle East, Central Asia.It is believed that green tea was first brewed in Russia in 1618, later it became a drink of the general population. Now it is consumed in almost all countries of the world and is appreciated for its taste and health benefits.

21 October 2020, 01:30 The taste of green tea is more delicate, herbal.

According to taste, green varieties are divided into:

  • refreshing;

  • tart;

  • Floral Spicy;

  • Floral delicate.

Composition and calorie content

Green tea contains antioxidants, polyphenols, carotenoids, catechins, tocopherols, kaempferol, quercetin, myricetin, thein, tannin, ascorbic acid, vitamin P, minerals – chromium, manganese, selenium, zinc other substances.There are only 2 calories in one glass of unflavored drink.

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Useful properties of green tea

Green tea, which contains caffeine, fights lethargy, depression and depression, reduces drowsiness, stimulates the brain … It also has a beneficial effect on the cardiovascular system, blood pressure, lowers cholesterol, the risk of myocardial infarction, inhibits the development of certain types of cancer, and promotes weight loss.Drinking the drink strengthens the immune system, increases resistance to diseases, improves eye health (including useful for the prevention of glaucoma), slows down the aging of the body due to antioxidants. According to a 2006 study, among those who drank green tea more than five times a day, the death rate dropped by 23% in women, by 12% in men. At the same time, from cardiovascular diseases – by 31% and 22%, respectively, from stroke – by 42% and 35%. It was also found that the drink prevents the development of dementia.30 July 2020, 12:00 CLEARGot itBlack or green? We ask an expert stupid questions about Fife-o-Klok tea in a London hotel, hot and bitter on the lakeside from a thermos, fruit – on a St. Petersburg roof or with sugar and lemon for a morning sandwich. What is a real tea ceremony? Can green tea be spoiled by boiling water of 100 degrees, and black tea by the tenth brew? And is there a tea “overdose”?

Harm of green tea and contraindications

Because of the caffeine contained in it, green tea is contraindicated for people with nervous disorders, insomnia, which can aggravate symptoms.It is also not recommended when using blood thinning medications in combination with certain other medications. Green tea can be harmful to people with high blood pressure, kidney, stomach, and liver problems. It is better not to mix it with other stimulating drinks – coffee, energy drinks, alcohol. With a lack of iron, you should drink such tea no earlier than 30 minutes after eating. Not recommended during pregnancy and lactation. If in doubt, consult your doctor before use.

The benefits and harms of green tea for men

For men, this drink is useful in that it reduces the risk of developing myocardial infarction, ischemic heart disease and other cardiovascular diseases. Green tea tones up well, stimulates the nervous and mental processes. According to research, it increases sperm concentration, thereby increasing fertility. In this case, it can aggravate nervous disorders and insomnia, is contraindicated in hypertension, gastrointestinal diseases.

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The benefits and harms of green tea for women

Green tea is considered a beauty drink for women, it helps to lose weight, due to antioxidants it slows down the processes aging of the body. The extract is found in many face care products for women. It evens out skin tone, fights inflammation, regulates sebum production, and prevents the appearance of wrinkles.One of the most important properties of green tea for women is that it reduces the risk of breast cancer by 20-30% when consumed regularly. Contraindications are diseases of the gastrointestinal tract, liver and kidneys, pregnancy and lactation.

Benefits and harms of species

Green tea has many beneficial properties, its use is associated with a lower likelihood of heart attack, stroke. Moreover, each variety differs in its taste, but is practically the same in terms of the content of microelements important for health.

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Green tea with milk

Green tea contains a high amount of flavonoids – catechins, which are powerful antioxidants, prevent the first signs of aging in the body and reduce the risk of developing cancer. Milk added to the drink can reduce their absorption and health benefits. However, green tea with milk has diuretic properties and is often used during weight loss by boosting metabolism.

17 February 2020, 13:26 Science Scientists have explained the anti-cancer effect of green tea

Green tea with jasmine

This tea contains vitamins of groups A, B, vitamins C, PP, calcium, magnesium, sodium, potassium, phosphorus, chlorine, etc. .d. Also, the drink is rich in amino acids, which contribute to better concentration, stimulating mental activity. Green tea with jasmine protects the body from free radicals, is a prophylactic agent against multiple sclerosis and neurodegenerative diseases – Parkinson’s, Alzheimer’s, etc.e. Contraindications for it are the same as for a classic drink.

Green tea bags

Green tea bags generally have a lower price. Unnatural flavors are often added to it, which reduces the beneficial properties of the drink. Poor-quality raw materials can also be used, and the bags themselves consist of about a third of artificial compounds that prevent dissolution. In this case, the beverage may develop a chemical aftertaste. It is best to buy high quality loose leaf tea without harmful additives.

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Matcha green tea

Matcha tea has recently become very popular. It is made by roasting and grinding tea tree leaves into powder. It removes toxins from the body, saturates it with antioxidants, energizes it, increases concentration, reduces the risk of cardiovascular diseases, strengthens the immune system, has a positive effect on skin health, and prolongs youth.Excessive consumption of green tea can lead to irritability, headaches, insomnia, diarrhea, and heartburn.

Green Milk Oolong Tea

Often the milky flavor of this tea is achieved through the use of flavors, so you should study the composition before buying. Real milk oolong does not have a pronounced taste. This tea, unlike other varieties, does not strongly tone up, but it improves brain function and increases concentration. Its benefits are due to its high antioxidant content, high tannin content, essential oils, polyphenols and vitamins.They heal and strengthen the body. To avoid the negative effects of tea, you should choose only a natural, high-quality product.

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Green tea with ginger

Ginger has a cleansing, anti-inflammatory, strengthening, warming effect, due to which it is useful during colds. When added to green tea, it produces a vitamin drink that speeds up metabolism, helps reduce pain during menstruation, arthritis, blood sugar, and appetite.In this case, after use, indigestion and heartburn may occur. Also, green tea with ginger contains salicylates, which thin the blood, so it is contraindicated in people with poor clotting.

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Green tea with cinnamon

Cinnamon can reduce hunger, so a drink with it is useful for losing weight. It also cleanses the intestines, removes harmful substances from the body, reduces cholesterol levels, normalizes metabolism and the functioning of the gastrointestinal tract.Cinnamon green tea can be harmful to those with kidney and liver disease and is contraindicated during pregnancy and lactation.

Green tea with honey and lemon

As in the case of ginger, the combination of green tea with honey and lemon increases the beneficial properties of the drink and increases the concentration of substances important for the body. It strengthens the immune system well, helps to quickly recover from viral diseases. Green tea with honey and lemon has bactericidal, antiparasitic, anti-inflammatory qualities, tones up, improves brain activity, and is useful for the prevention of cardiovascular diseases.The ingredients of the drink can cause allergies, it is not recommended for people with gastrointestinal diseases.

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Green tea with mint

It is believed that mint has a calming effect, due to which green tea with it is less tonic than other varieties. It is used for inflammatory diseases of the upper respiratory tract, soothes headaches, improves appetite. It also strengthens the immune system, cleanses the body, fights oxidative stress, slows down aging, and prevents the formation of edema.The drink can cause stomach upset, diarrhea, allergic reactions, dizziness if consumed excessively.

Slimming with green tea

Green tea helps you lose weight, because it contains polyphenols that are involved in the processing of stored fat. Also, the drink has antioxidant properties and improves metabolism. With a balanced diet, green tea helps to lose weight, because it has a diuretic effect, mildly suppresses appetite, removes excess fluid from the body, has a minimum calorie content, but at the same time saturates with useful substances.

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Green tea in medicine

Green tea is used in traditional Indian and Chinese medicine. They are treated for high blood pressure, in China they believe that the drink activates the mind, normalizes blood flow and nervous system, relieves tension, promotes digestion, neutralizes toxins, and improves vision. It helps to normalize weight, is good for the heart, has anti-tumor properties, and increases the body’s resistance to various radiation and free radicals.Modern science claims that green tea is suitable for the treatment of psoriasis, reduces the risk of developing type 2 diabetes, is useful for the prevention of cancer, as shown by numerous scientific studies. 23 October 2019, 21:00 in cooking

Usually green tea is brewed, but matcha is added to bars, pastries, drinks and even dumplings. Jasmine tea can be used as a marinade, bergamot drink is added to ice cream, muffins, soufflés, cakes, and Labsang Souchong smoked tea is included in meat seasoning.Green tea jelly is also popular in Asia.

How to choose

First of all, you should refuse packaged green tea – it often contains flavoring additives. It is best to choose a natural, leafy product. When buying by weight, you should take into account the color of the tea leaves, they must be the same size, fragrant, without tea dust and preservatives. If the product is in a package, there should also be nothing foreign in the composition.

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How to brew and drink green tea

To prepare a drink, water must be free of hard impurities that can spoil the taste of green tea.It must be turned off immediately after boiling and allowed to cool slightly to a temperature of 75-80 degrees. The dishes must be preheated by sprinkling them with hot water. Then pour tea leaves into it, add a little hot water and drain it. After that, you can brew the drink.

How to store it correctly

You need to store green tea in a place where there are no other odors, because it absorbs them. It must be kept in an airtight package, for example, in a tin container, a metallized bag, a tight glass jar.Sunlight as well as a leaky container can rob green tea of ​​its taste and smell.

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Questions

Nutritionist Veronika Khovanskaya answered the popular questions of RIA Novosti.

Can I drink green tea every day?

– Green tea can be drunk every day, with the optimal amount being 3-5 cups (200 ml per serving) per day.

Can I brew green tea a second time?

– If we are talking about leafy green tea, then it even needs to be brewed several times.It is better to use pouring kettles so that the drink does not brew too much – this adds extra bitterness and spoils the taste. There is no point in brewing tea bags a second time.

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What does green tea remove from the body?

– Green tea has many positive effects, lowering “bad” cholesterol, increasing the body’s resistance to fighting infections, and more. But if we talk about removing, as indicated in the advertisement, “slags”, then no, it does not remove them, this is just a marketing ploy.

Can green tea be drunk on an empty stomach?

– Drinking green tea on an empty stomach can negatively affect the body, such as upset stomach, heartburn, nausea and even constipation. It is best to drink green tea between meals or after meals.

How does green tea affect the heart?

– Green tea helps lower blood pressure, which is good for cardiovascular health.

March 9, 4:28 pm Science Scientists have explained how tea affects blood pressure

How much caffeine is in green tea?

– On average, there is 25-40 mg of caffeine per cup (200 ml).At the same time, in the same container with black tea there will be 14-70 mg of caffeine, in 100 ml of coffee – 50-80 mg, and in espresso – 250 mg.

How is green tea useful for the skin of the face?

– When we talk about the skin, it should be understood that the benefits of green tea can be obtained from masks, creams and other cosmetics containing its extract. They have an anti-inflammatory effect, reduce dark circles under the eyes, even out skin tone, etc. Simply drinking or washing your face with green tea has no proven benefit.

What happens if you drink green tea at night?

– Green tea has many beneficial properties, including improving sleep.