TresSugar

Dear Poll: Do You Feel Comfortable Asking For What You Want?

DearSugar — Tue, 13 Jan 2009 15:00:00 -0800

The only way to get what you want is to ask for it, but when sexpert Dr. Laura Berman explains her second tip for living your best sex life on Oprah.com, she makes it seem a lot easier said than done.

Talking about sex, your body parts, his body parts, and what feels good can be incredibly intimidating for a lot of people, including myself from time to time. Not only can it be difficult to talk explicitly about what turns you on, but it's easy for the other person to become insecure if they don't think they're already pleasing you in that way. Communication is crucial in every relationship but tell me, do you feel comfortable asking your partner for what you want in the bedroom?

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Relationship Protocol: Do You Fake it?

DearSugar — Fri, 09 Jan 2009 09:30:00 -0800

In case you missed it, Oprah dedicated her first week back from holiday vacation to living your best life. She covered diet, money, spirituality, and of course, sex! Dr. Laura Berman is back on today's show with tips on how we can all have a better sex life in 2009. One thing she focus' on is faking an orgasms. According to Dr. Berman, 70 percent of women have faked orgasms on a regular basis, if not once or twice, but if he thinks he's doing everything right, and if he continues to think you're getting pleasure by it, he'll never know how to really please you. In other words, you're doing yourself a huge disservice by "mercy faking" it!

So to those of you in a committed, long-term relationship, tell me, do you fake it when you're having sex with your significant other, and if so, how often? Don't worry, your secrets are safe here!

Dear Exam: What Other Organ, Besides Our Lady Business, Is Self-Cleaning?

DearSugar — Mon, 24 Nov 2008 09:00:00 -0800

I learned something new on Friday while watching Oprah's second installment of sex therapy with Dr. Berman. While I knew that our lady business is a self-cleaning organ, I learned that there is only one other organ that has that same ability. Do you know what it is? Test your body trivia below!

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Take the quiz

Did You Ever Talk to Your Mom About Masturbation?

DearSugar — Fri, 10 Apr 2009 10:30:00 -0700

Dr. Laura Berman was back on Oprah yesterday talking about - what else? - sex. Only this time she was teaching the importance of talking to your kids about sex. Having the birds and the bees talk is definitely an uncomfortable and scary thing to do, but Dr. Berman feels that if you haven't already broached the subject with your teen, you could be making a huge mistake.

Through diagrams and open dialog, she helped mothers break the ice about sex and sexual pleasure, but one controversial thing she recommends parents do is talk and teach their kids about masturbation. It seemed like everyone in the audience was extremely uncomfortable with the idea of this and I have to agree - I don't recall my mother ever talking to me about pleasuring myself! Now I might be in the minority here, so tell me ladies, did you talk about masturbation with your parents when you were a kid? And do you plan on talking with your children about it?

Dear Poll: Do You Kiss For 10 Seconds Daily?

DearSugar — Thu, 09 Apr 2009 06:00:00 -0700

Finding ways to de-stress, especially during times like these, is critical for your health and your happiness, and according to Dr. Laura Berman, kissing can really help in that crusade. Of course kissing and cuddling makes us feel close to our significant other, but it turns out that couples who engage in that connectedness are actually eight times less likely to be stressed and depressed than couples who don't take that time for each other. She also says that kissing for a minimum of a 10 seconds every day is crucial for our happiness - not just a peck ladies, but a real kiss!

I know that we all have busy schedules so tell me, do you have time to kiss your special someone for at least 10 seconds every single day?

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Myocardial infarction

FitSugar — Wed, 08 Oct 2008 17:34:55 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Myocardial infarction is the technical name for a heart attack. The heart is responsible for pumping blood, which carries oxygen, to every organ in the body – including the heart itself. A heart attack occurs when an artery leading to the heart becomes completely blocked and the heart doesn’t get enough blood or oxygen. Cells in that area of the heart start to die (called an infarct).

A heart attack is a medical emergency. If you or someone you know has any of the symptoms below, call 911 immediately. Waiting even 15 minutes can be fatal. But if you get prompt medical treatment, you can limit damage to your heart. Although heart attack is the leading cause of death in the United States, up to 95% of people who are hospitalized with a heart attack survive.

Most heart attacks are caused by blood clots, which are in turn caused by atherosclerosis (stiffening and narrowing of the arteries). High blood fats (triglycerides) and LDL or “bad” cholesterol form plaque inside arteries, narrowing the passageway and reducing the amount of blood that can flow through. Your lifestyle plays a crucial role in preventing a heart attack or recovering from one. Eating a heart-healthy diet and getting at least 30 minutes of exercise five days a week (or more) can reduce your risk of heart attack.

Signs and Symptoms

Squeezing pain, heaviness, tightness, pressure in center of chest
Pain that spreads to your back, left arm, jaw, neck
Shortness of breath
Dizziness, weakness
Nausea, vomiting
Irregular heartbeat
Sweating
Feeling of doom

Women may experience different symptoms than men. In women, along with chest pain, symptoms can include:

Heartburn or pain in the abdomen
Unusual fatigue
Clammy skin

Causes

Heart attacks happen when an artery supplying your heart with blood becomes blocked. Without blood, the heart doesn’t get enough oxygen and cells in the heart start to die.

The most common cause of blocked arteries is atherosclerosis. No one knows the exact cause of atherosclerosis, but most researchers believe it begins with an injury to the innermost layer of the artery, known as the endothelium. The following factors are thought to contribute to the damage:

High blood pressure
Elevated LDL ("bad") cholesterol
An accumulation of homocysteine (an amino acid produced by the human body, thought to be a risk factor for heart disease, stroke, osteoporosis, diabetes, and dementia)
Smoking
Diabetes
Inflammation

Once the artery is damaged, blood cells called platelets build up there to try and repair the injury. Over time, fats, cholesterol, and other substances also build up at the site, which thickens and hardens the artery wall. The amount of blood that flows through the artery is decreased, and oxygen supply to organs also decreases. Blood clots may also form, blocking the artery.

Rarely, a spasm in a coronary artery (one that supplies blood to the heart) stop blood flow and can cause a heart attack.

Risk Factors

These risk factors increase your chances of developing atherosclerosis:

Smoking
High-fat diet
High LDL “bad” cholesterol and triglycerides (fats in the blood)
Lack of exercise
Being overweight or obese
Family history of heart attack
Diabetes
High blood pressure
Being male, or a female who has gone through menopause
Stress

Also, people who have elevated homocysteine, C-reactive protein (CRP), and fibrinogen levels seem to have an increased risk of heart attack. These are markers of inflammation, but researchers aren’t sure whether they contribute to heart disease or occur when you have heart disease. High homocysteine can be treated with folic acid (see Nutrition and Supplements). More research in these areas is currently underway.

Diagnosis

If you think that you are having a heart attack, don’t wait to be sure – call 911 immediately. Treating a heart attack quickly can save your life, while delay can be fatal. In the emergency room, a doctor will ask you about your symptoms and perform a physical examination. He or she will immediately run tests to determine your heart function. They may include:

Electrocardiogram (ECG) - the first test done to check for a heart attack; you may be hooked up to a monitor even as the doctor is asking you questions. An ECG measures electrical activity of your heart.

Blood tests - Your doctor may look for certain enzymes that are released into your blood when you have a heart attack.

Other tests include:

Chest x-ray
Echocardiogram (uses sound waves to take a picture of your heart)
Coronary catheterization or angiogram (uses a liquid dye inserted through a catheter to see whether your arteries are blocked)
Stress test (involves walking on a treadmill while hooked up to a ECG machine to see how your heart responds to exercise)

Preventive Care

You can reduce your risk of heart attack by:

Stopping smoking.
Getting aerobic exercise (such as walking, biking, or swimming) for at least 30 minutes 5 days per week. If you haven't exercised much in the past, walking is a great way to start.
Reducing stress and learning stress-reduction techniques such as deep breathing and meditation. Yoga and tai chi, two forms of exercise that emphasize stretching, breathing, and meditating, can also help you reduce your stress level.
Eating a diet low in saturated fat and rich in fruits, vegetables, and whole grains.
Losing weight or maintaining a proper weight.

If you have high cholesterol, diabetes, or high blood pressure, follow your doctor’s instructions to keep these risk factors under control. You may need medications in addition to lifestyle changes. If you don't have heart disease yet or have not had a heart attack despite these risk factors, aggressive control can help prevent a heart attack. And, if you already have heart disease, aggressive control of these risk factors can prevent further heart attacks or other problems related to heart disease.

Treatment Approach

The goal when treating a heart attack is to restore blood flow to the affected area of the heart immediately, to preserve as much heart muscle and heart function as possible. If your doctor has prescribed nitroglycerin, take it while you are waiting for emergency medical personnel to arrive. Once at the hospital, your doctor may use drug therapy, angioplasty (using one of several methods to clear the blocked blood vessel, such as inflating a balloon inside it or holding it open with a device called a stent), and surgery.

Once you have been treated for a heart attack, making changes in your lifestyle (especially in your diet and exercise habits) and taking medications as prescribed is very important for avoiding recurrent heart attacks and even death. Although certain herbal remedies as well as relaxation techniques may also be used, they should never be used alone to treat a heart attack. A heart attack always requires emergency medical attention.

Lifestyle

Making lifestyle changes can improve many of your risk factors for heart disease, including high cholesterol, high blood pressure, extra weight, high homocysteine, and elevated C-reactive protein. Cardiac rehabilitation programs generally involve teaching you about diet, physical activity, and relaxation techniques. To keep your risk factors low, you will need to follow the healthy habits taught in cardiac rehab, like exercise and eating properly, for the rest of your life.

Medications

Aspirin - helps stop blood from clotting. You may be given aspirin in the ambulance or as soon as you get to the hospital.

Nitroglycerin - helps dilate (widen) blood vessels. You may be given nitroglycerin in the ambulance or as soon as you get to the hospital.

Pain reliever - Morphine is often given intravenously (IV) to relieve pain.

Thrombolytics - “Clot-busting” drugs may be used, depending on the type of heart attack. They are most effective when taken within 2 hours of the heart attack, and are not given after 12 hours have elapsed. These drugs may be given with other anticoagulants (blood-thinners).

Anticoagulants (blood-thinners) - Make your blood less likely to form clots. Heparin is often given by injection while you are in the hospital.

After you recover, other drugs are used to lower your risk of having another heart attack. They include:

ACE inhibitors - widen blood vessels and make it easier on your heart to pump blood. Side effects can include chronic cough. ACE inhibitors include

Benazepril (Lotensin)
Captopril (Capoten)
Fosinopril (Monopril)
Lisinopril (Zestril)
Enlapril (Vasotec)

Beta-blockers - slows heart rate, thus lowering blood pressure. These drugs include

Acebutolol (Sectral)
Atenolol (Tenormin)
Bisoprolol (Zebeta)
Carteolol (Cartrol)
Metoprolol (Toprol XL)
Nadolol (Corgard)
Propranolol (Inderal)

Statins - help lower cholesterol. People who are pregnant or have liver disease should not take statins. They include

Lovastatin (Mevacor)
Simvastatin (Zocor)
Pravastatin (Pravachol)
Atorvastatin (Lipitor)
Fluvastatin (Lescol)
Rosuvastatin (Crestor)

Niacin (nicotinic acid) - In prescription form, is sometimes used to lower cholesterol. Dietary supplements of niacin should not be used instead of prescription niacin, as it can cause side effects. Only take niacin for high cholesterol with your doctor's supervision.

Bile acid sequestrants - lowers cholesterol; people who have high levels of triglycerides (fats in the blood) should not take bile acid sequestrants. These drugs include

Cholestyramine (Questran)
Colestipol (Colestid)
Colesevelam (Welchol)

Fibric acid derivatives - lower triglycerides and moderately lower LDL cholesterol. They include Gemfibrozil (Lopid).

Anticoagulants (blood thinners) - help keep clots from forming. Your doctor may prescribe aspirin, warfarin (Coumadin), or Clopidogrel (Plavix)

Surgical Treatments

Percutaneous coronary intervention (PCI) – In primary PCI, the doctor performs a coronary angiogram (injecting dye into the arteries) to see where the artery is blocked. The doctor then performs balloon angioplasty (widening an artery with a balloon), often with stent placement, to keep the artery open.

Coronary artery bypass graft (CABG) – This surgery bypasses the blocked arteries by using a graft of another blood vessel (usually from your arm or leg) to restore blood flow to the heart.

Nutrition and Dietary Supplements

Healthy eating habits can help reduce high cholesterol, high blood pressure, and overweight –three of the major risk factors for heart disease. The American Heart Association (AHA) has developed dietary guidelines that help lower fat and cholesterol intake and reduce the risk of heart disease and heart attack. The AHA does not recommend very low-fat diets, because new research shows that unsaturated ("good") fats, such as those found in olive oil, are good for your heart.

Many fad diets are popular, but they may not help you lose weight and keep it off – and in some cases, they may not even be healthy. Any healthy diet will include a variety of foods. If a diet bans an entire food group (such as carbohydrates), it's probably not healthy.

The AHA recommends the following for healthy eating:

Grains: 6 to 8 servings per day (half should be whole grains)
Vegetables: 3 to 5 servings per day
Fruits: 4 to 5 servings per day
Fat-free or low-fat dairy: 2 to 3 servings per day
Lean meat, poultry, seafood: 3 to 6 oz. per day (about the size of a deck of cards)
Fats and oils: 2 to 3 tbsp. per day (use unsaturated fats such as olive oil or canola oil)
Nuts, seeds, legumes: 3 to 5 servings per week
Sweets, sugars: 5 or fewer servings per week (the fewer, the better)

In addition, the AHA also recommends eating 2 servings of fatty fish (such as salmon or lake trout) per week; holding sodium (salt, including salt already added to food) to 2,400 mg per day or less; and limiting alcohol intake to one drink a day for women and two for men.

Diets for People with High Blood Pressure

People with high blood pressure especially need to lower the amount of sodium in their diet. The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes a diet rich in fruits, vegetables, and low-fat or non-fat dairy products that provide high intake of potassium, magnesium, and calcium sources. Sodium intake should be between 1,500 mg to 2,400 mg per day (the lower, the better) . Weight loss, regular exercise, and limiting alcohol are also very important factors for lowering blood pressure.

Mediterranean Diet

The Mediterranean Style Diet concentrates on whole grains, fresh fruits and vegetables, fish, olive oil, and moderate, daily wine consumption. The Mediterranean Style Diet is not low-fat; it is low in saturated fat but high in monounsaturated fat. It appears to be heart-healthy: In a long-term study of 423 patients who had a heart attack, those who followed a Mediterranean Style Diet had a 50% to 70% lower risk of recurrent heart disease compared with people who received no special dietary counseling.

Vitamins and Supplements

Some supplements may help lower your risk factors for heart attacks, such as high blood pressure or high cholesterol. Most do not work as well as prescription medications, but some can be used along with prescription medications in your treatment. If you have had a heart attack or are at high risk of having on, be sure to ask your doctor before taking any supplements.

Folic acid (400 mcg per day), vitamin B6 (25 to 100 mg per day), vitamin B12 (2 to 100 mcg per day) - The B vitamins help the body break down homocysteine, an amino acid that's been linked to increased risk of heart disease and stroke. Researchers believe that homocysteine may also contribute to atherosclerosis by damaging artery walls, making it easier for blood clots to form – but so far they haven't found a definite link. Researchers also don't yet know whether taking B vitamins reduces the risk of atherosclerosis or heart attack, nor do they know how much might have an effect. Talk to your doctor about checking your homocysteine levels and whether your doctor would recommend a B complex vitamin supplement. In the meantime, be sure to get enough B vitamins through your diet by eating fruits and leafy green vegetables every day.
Omega-3 fatty acids (fish oil, 1 to 4 g per day) - There is good evidence that omega-3 fatty acids (known as EPA and DHA) found in fish oil can help treat atherosclerosis by preventing the development of plaque and blood clots. Omega-3s can also help prevent heart disease, lower blood pressure, and reduce the level of triglycerides (fats) in the blood. The AHA recommends that people eat at least two servings of fatty fish (such as salmon) per week. For people who have had a heart attack, several studies show that eating fish or taking fish oil reduces the risk of both fatal and nonfatal heart attacks, as well as lowers your risk of death from any cause. Because fish oil at high doses can increase the risk of bleeding, talk to your doctor before taking a high dose (more than 1 g per day), especially if you already take blood-thinning medication.
Beta-sitosterol (800 mg to 6g per day in divided doses about 30 minutes before meals) - Beta-sitosterol is a plant sterol, a chemical found in plants that can stop cholesterol from being absorbed by the intestines. A number of well-designed scientific studies have shown that beta-sitosterol does lower LDL ("bad") cholesterol levels in the body. Beta-sitosterol may lower the amount of vitamin E and beta-carotene absorbed by the body, so you may want to ask your doctor if you need to take extra E or carotene.
Policosanol (5 to 10 mg two times per day) - Policosanol is a mix of waxy alcohols usually derived from sugar cane and yams. Several studies have indicated it may lower LDL ('bad") cholesterol and possibly even raise HDL ("good") cholesterol. One study found that policosanol was equivalent to fluvastatin (Lescol) and simvastatin (Zocor) in lowering cholesterol levels. It may also help stop blood clots from forming. However, almost all the studies have been conducted in Cuba by a research group that uses a proprietary form of policosanol and is funded by the manufacturer, so it is hard to evaluate the evidence. Policosanol may increase the risk of bleeding, and should not be taken by people who also take blood-thinning medications.
Coenzyme Q10 (CoQ10) - Researchers believe that CoQ10 may help stop blood clots from forming and boost levels of antioxidants. One study found that people who received daily CoQ10 supplements within three days of a heart attack were much less likely to experience another heart attack and chest pain. They were also less likely to die from heart disease than those who did not receive the supplements. Statins, drugs that lower cholesterol, can actually interfere with the body’s natural ability to make CoQ10, so your doctor may recommend taking a CoQ10 supplement. Still, more research is needed to say whether CoQ10 has any role in preventing or treating atherosclerosis.
Psyllium (Plantago psyllium, 10 to 30 g per day in divided doses taken 30 to 60 minutes after meals) - Taking psyllium, a type of fiber, helps lower cholesterol levels as well as blood sugar levels. If you take medicine for diabetes, talk to your doctor before taking psyllium.
L-carnitine (4 to 6 g per day) - Studies suggest that people who take L-carnitine (an amino acid) soon after a heart attack may be less likely to have a subsequent heart attack, die of heart disease, experience chest pain and abnormal heart rhythms, or develop congestive heart failure. (Congestive heart failure occurs when the heart can’t pump blood properly and blood backs up into the lungs and legs.) Studies also suggest that people with heart disease who take carnitine may be better able to exercise. Most studies used a special form of carnitine called propionyl-L-carnitine.

Herbs

Herbs should not be used in place of emergency medical attention for a heart attack, nor should they be used by themselves to lower your risk of heart attack after you’ve had one. However, some can be used along with prescription medications in your treatment. If you have had a heart attack or are at high risk of having on, be sure to ask your doctor before taking any herbs.

Hawthorn (Crataegus monogyna, 160 to 1,800 mg per day in two or three divided doses) - Hawthorn contains the polyphenols rutin and quercetin, and was used traditionally to treat cardiovascular diseases. Animal and laboratory studies show that hawthorn has antioxidant properties that help protect against the formation of plaques and may help lower high cholesterol and high blood pressure. Talk to your doctor before taking hawthorn, as it can interact with other drugs taken for heart disease and high blood pressure.
Garlic (Allium sativum, 900 mg per day of garlic powder, standardized to 0.6% allicin) - Clinical trials have shown that fresh garlic and garlic supplements may lower cholesterol levels, prevent blood clots, and destroy plaque. However, other studies show mixed evidence. In one study, people who had a previous heart attack and then took a garlic oil extract for 3 years had fewer second heart attacks and a 50% reduction in death rate than those who did not take garlic. Garlic can increase the risk of bleeding and should not be taken if you are also taking blood-thinning medication.
Bilberry (Vaccinium myrtillus) and other flavonoids - A close relative of the cranberry, bilberry fruits contain flavonoid compounds called anthocyanidins. Flavonoids are plant pigments that have antioxidant properties, and researchers think they may help prevent a number of illnesses including heart disease and diabetes. Bilberry has been used traditionally to treat heart disease, but only animal and test-tubes studies have been done. Animal studies have found that anthocyanidins and other flavonoids may strengthen blood vessels, improve circulation, and prevent LDL ("bad") cholesterol from being damaged (which may cause blood clots to form in arteries).
Asian ginseng (Panax ginseng) – Ginseng may help reduce risk factors for heart disease, including lowering blood pressure and cholesterol, but more studies are needed to be sure. Ginseng can increase the risk of bleeding and should not be taken if you are also taking blood-thinning medication. Ginseng should not be used if you have high blood pressure unless your doctor recommends it.
Green tea (Camellia sinensis) - Population studies suggest that regularly drinking green tea may reduce the risk of heart attack from atherosclerosis. It also may help you lower your cholesterol and your weight, although more research is needed to know for sure.
Kudzu (Pueraria lobata) - Kudzu has been used traditionally to treat heart disease, including heart attack and congestive heart failure. A few studies suggest it may help relieve angina, but the studies were of poor quality. More research is needed to know whether kudzu has any benefit for heart disease.

Homeopathy

Homeopathy should not be used instead of immediate medical attention for a heart attack. Homeopathy may, however, be used to help reduce your risk of heart disease. Although few studies have examined the effectiveness of specific homeopathic remedies, professional homeopaths would recommend appropriate therapy to lower high blood pressure and cholesterol. Before prescribing a remedy, homeopaths take into account your constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath would assess all of these factors when determining the most appropriate remedy for you as an individual.

Acupuncture

Acupuncture may be helpful in reducing some risk factors for heart disease. Some studies show that it can help people who want to stop smoking, and it may help some people lose weight and lower their blood pressure.

Massage and Physical Therapy

Although few studies have examined the effectiveness of massage therapy for heart disease, massage has a relaxing effect and can reduce stress-related hormone levels. Lowering stress hormone levels can lower cholesterol and blood pressure, reducing your risk of heart disease. In addition, relaxation techniques may help you make lifestyle changes such as eating healthy, quitting smoking, and exercising. At least one study found that massage can lower blood pressure.

Other Considerations

Prognosis and Complications

After a heart attack, a person’s prognosis depends on how damaged the heart is. If the person is alive 2 hours after an attack, he or she has a good chance for survival, but may experience complications such as:

Irregular heart rhythm, called an arrhythmia
Congestive heart failure
Shock
Infarct extension (extension of the amount of affected heart tissue) or recurrent heart attack(s)
Pericarditis (infection around the lining of the heart)
Pulmonary embolism (blood clot in the lungs)
Complications from treatment (for example, thrombolytic agents increases the risk of bleeding)

The good news, however, is that heart attacks are not always disabling, especially when there are no complications. In fact, a full recovery is possible that allows you to do all the tings you used to do, including sexual activity. Going through cardiac rehabilitation and sticking with lifestyle changes can help lead to a positive recovery.

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Review Date:
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adam.com

Alzheimer's disease

FitSugar — Wed, 08 Oct 2008 17:34:55 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Alzheimer's disease (AD) is a progressive, degenerative brain disease that results in impaired memory, thinking, and behavior. People with AD experience gradual memory loss as well as impaired judgement, difficulty concentrating, loss of language skills, personality changes, and a decline in the ability to learn new tasks.

The rate of progression is different for each person. If AD develops rapidly, it is likely to continue to progress rapidly. If it has been slow to progress, it will likely continue on a slow course.

There is no cure for AD, but studies suggest that medications, herbs and supplements, and lifestyle adjustments may help slow the progression and improve the symptoms of the disease.

Signs and Symptoms

The early symptoms of AD are occasionally overlooked because they resemble signs that many people attribute to "natural aging." The following are the most common signs and symptoms of AD:

Psychological Symptoms

Memory loss, including not recognizing friends and family members
Difficulty concentrating
Difficulty comprehending words, completing sentences, or finding the right words
Loss of familiarity with surroundings, wandering aimlessly
Depression
Hallucinations, delusions, and psychosis
Aggression, agitation, anxiety, restlessness
Accusatory behaviors (such as accusations of spousal infidelity)
Withdrawal, disinterest, hostility, loss of inhibitions

Physical Symptoms

Impaired movement or coordination
Muscle rigidity, shuffling or dragging feet while walking
Insomnia or disturbances in sleep patterns
Weight loss
Incontinence
Muscle twitching or seizures

Causes

The causes of AD are not entirely known but are thought to include genetics and environmental factors. New research indicates that free radicals (highly reactive molecules that can cause oxidation, or damage to cells) may play a role in the development of AD.

A gene for the protein epsilon apolipoprotein (Apo E) -- especially Apo E3 and Apo E4 varieties -- is thought to accelerate the formation of abnormal deposits (called plaques) in the brain and increase the risk for AD. Reports indicate that 50 - 90% of those with the Apo E4 gene develop AD. However, even people without inherited genes for the disease can get AD.

Scientists also believe the environment may play a part in AD because people in different regions of the world have widely varying risks of developing the disease. For example, people living in Japan and West Africa have much less risk for AD than Japanese Americans and African-Americans.

People with AD have abnormal deposits, or plaques, in their brain tissue. These plaques contain beta amyloid, a protein that releases free radicals, or highly reactive molecules, that can cause damage to cells through a process called oxidation. These free radicals are believed to lower levels of acetylcholine (a brain chemical that helps transmit impulses in the nervous system) and damage brain tissue, bringing on the symptoms of AD.

Although not confirmed by scientific studies, other factors that have been speculated to contribute to the development of AD include infections (such as herpesvirus type 1), exposure to metal ions (such as aluminum, mercury, zinc, copper, and iron), or prolonged exposure to electromagnetic fields.

Risk Factors

The causes and risk factors contributing to the development of AD are not entirely clear. The following all appear to have an association with AD to varying degrees.

Family history of AD
Older age -- 20 - 40% of people with AD are older than 85
Female gender -- while women tend to develop AD more than men, this may be related to the tendency for women to live longer.
Americans are more likely to get AD than Asians or Native Americans
Long-term high blood pressure
History of head trauma -- one or more serious blows to the head may put a person at an increased risk.
Down syndrome
Elevated levels of homocysteine (a body chemical that contributes to chronic illnesses such as heart disease, depression, and AD)
Aluminum or mercury poisoning
Prolonged exposure to electromagnetic fields

Diagnosis

There is no definitive test for AD. A true diagnosis can only be made after a person dies and an autopsy is performed on the brain.

However, AD usually has a characteristic pattern of symptoms. A health care provider will try to narrow down a diagnosis by ruling out other possible causes. The health care provider will ask questions about medical history and symptoms and do a physical exam (including a neurological exam).

The following tests may also be used to aid in the diagnosis:

Psychological tests assess the individual's memory and attention span. They may also reveal difficulties in problem-solving, social, and language skills.
Electroencephalograph (EEG) traces brain-wave activity. This test sometimes reveals "slow waves" in people with AD.
Blood test for the Apo E4 gene may indicate a genetic tendency for AD. The presence of the gene in the blood may suggest AD, but it does not always make an accurate diagnosis.
Imaging tests such as CT, MRI, or PET scans.

In the early stages of dementia, brain image scans may be normal. In later stages, an MRI may show a decrease in the size of certain brain areas. While the scans do not confirm the diagnosis of AD, they do exclude other causes of dementia such as stroke and tumor.

Preventive Care

Consuming a low-fat, low-calorie diet may reduce the risk for AD.
Higher intake of fatty, cold-water fish (such as tuna, salmon, and mackerel) may be associated with a lower risk of dementia. This may be due to the high level of omega-3 fatty acids found in such fish. Eating fish at least two to three times per week provides a healthy amount of omega-3 fatty acids, but dietary supplementation with capsules or liquid products is still recommended.
Reducing intake of linoleic acid (found in margarine, butter, and dairy products) may prevent cognitive decline.
Antioxidants, such as vitamins A, E, and C (found in darkly colored fruits and vegetables), may help prevent damage caused by free radicals.
Maintaining normal blood pressure levels may reduce the risk for AD.
Hormone-replacement therapy (HRT) in postmenopausal women may decrease production of chemicals that cause AD, stimulate growth of brain cells, and improve blood flow in the brain. However, the role of hormones in the prevention of AD is still controversial. HRT has also been shown to increase the risk for breast cancer, heart attacks, strokes, and blood clots.
Some studies suggest that certain medications may prevent AD, including statin drugs (such as pravastatin or lovastatin, used to lower cholesterol) and nonsteroidal anti-inflammatories (NSAIDs), with the exception of aspirin. More research is necessary, however, to determine how effective these medications are in reducing the risk of the disease.
Keeping mentally and socially active may help delay the onset or slow the progression of AD.

Treatment

The goals in managing AD are to:

Slow the progression of the disease.
Manage behavior problems, confusion, and agitation.
Modify the home environment.
Support family members and other caregivers.

There is no cure for AD. The most promising treatments include lifestyle changes, medications, and antioxidant supplements.

Lifestyle

Research indicates that the following lifestyle modifications may help improve behavior in people with AD:

Walking regularly with a caregiver or other reliable companion may improve communication skills and diminish the risk of wandering.
Bright light therapy may reduce insomnia and wandering.
Calming music may reduce wandering and restlessness, boost brain chemicals, and improve behavior.
Pet dogs can increase appropriate social behaviors.
Relaxation training and other exercises that require focused attention (often used with refreshments as rewards) can improve social interaction and the ability to perform tasks.

The Safe Return Program, implemented by the Alzheimer's Association, encourages identification bracelets, wallet cards, and clothing labels for patients with AD. Identifying information is stored in a national database and distributed to authorities when a patient is reported missing. If a registered person is found, the information is used to contact their caregiver.

Medications

Several drugs are available to try to slow the progression of AD and possibly improve the person's mental capabilities. These include:

Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Razadyne, formerly called Reminyl)
Tacrine (Cognex)

Memantine (Namenda) is currently the only drug approved for treatment of moderate-to-severe Alzheimer’s disease.

The following medications may ease the symptoms related to AD:

Selective serotonin reuptake inhibitors (SSRIs) increase activity of a brain chemical called serotonin. They are used to treat depression.
Methylphenidate stimulates the brain to increase alertness. It is used to treat withdrawal and apathy.
Risperidone, olanzapine, and haloperidol are mood stabilizers. They help improve social interactions, and reduce delusions, paranoia, and aggression.
Carbamazepine is an anti-seizure drug that stabilizes sodium levels in the brain. It is used to treat agitation.

Nutrition and Dietary Supplements

Individuals with AD may have particular dietary concerns. People with AD often forget to eat and drink, and, as a result, often become dehydrated.

Following these nutritional tips may help improve general health and well-being:

Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell peppers).
Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables such as kelp and dulce.
Eat more high-fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.
Avoid refined foods such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.
Use healthy oils in foods, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, five days a week.

You may address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil, one to three times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources but not substitutes for supplementation.
Vitamin C, 500 - 1,000 mg one to three times daily, as an antioxidant and for immune support.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
Acetyl-L-carnitine, 500 mg daily, for antioxidant and muscle protective activity.
Probiotic supplement (containing Lactobacillus acidophilus and other species), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
L-glutamine, 500 - 1,000 mg three times daily, for support of gastrointestinal health and immunity.
L-arginine, 1 -2 gm three times daily, for blood vessel support.
SAMe (s-adenosyl-L-methionine), 100 - 200 mg before breakfast daily, for mood improvement.
Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant and immune system effects.
L-theanine, 200 mg one to three times daily, for nervous system and brain support.
Melatonin, 2 - 5 mg one hour before bedtime, for sleep and immune protection. Ask your health care provider about potential drug interactions with the use of melatonin.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.

Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for blood flow and brain health. Ginkgo is the most widely studied herb, especially for symptoms related to dementia and Alzheimer's disease.
Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support and antiviral effects.
Bacopa (Bacopa monnieri) standardized extract, 50 - 150 mg three times daily, traditionally used in India to improve mental performance.
Vinpocetine (isolated from Vina minor), 10 - 40 mg twice daily, for symptoms of Alzheimer's disease or dementia.

Acupuncture

Small studies have shown that transcutaneous electrical nerve stimulation (TENS), a technique used in physical therapy and certain types of acupuncture, may improve memory and daily living skills in people with AD. Further studies are needed to confirm whether acupuncture may be effective in the treatment of AD.

Massage and Physical Therapy

The inability to communicate normally with language increases anxiety and frustration in people with AD. Using touch, or massage, as a form of nonverbal communication has been shown to benefit those with AD. In one study, people with AD who received hand massages and were spoken to in a calming manner had a reduction in pulse rate and in inappropriate behavior. Health care professionals speculate that massage may be beneficial for people with AD not only because it is relaxing, but because it provides a form of social interaction and a moderate form of exercise.

Mind-Body Medicine

Music Therapy

Music therapy, the use of music to calm and heal an individual, cannot slow or reverse dementia, but it may improve quality of life for both a person with AD and their caregiver. Clinical reports suggest that music therapy may reduce wandering and restlessness and increase chemicals in the brain that enhance sleep and ease anxiety. For example, people with AD have been shown to experience significant increases in levels of brain chemicals such as melatonin, norepinephrine, and epinephrine after listening to live music regularly for a month. Mood also improved after listening to the music.

Support for the Caregiver

Studies suggest that caregivers who receive emotional support tend to experience an improvement in their quality of life, and those they are caring for benefit as well.

Other Considerations

A person with AD can experience the following complications:

Falls (from impaired coordination)
"Sundowning" (withdrawal or agitation in the evening)
Malnutrition and dehydration
Infection (from urinary tract infections or pneumonia)
Asphyxiation (stopped breathing)
Harmful or violent behavior toward self or others
Suicide
Poor health and support due to caregiver burnout
Physical and emotional abuse, including neglect
Heart disease

Alzheimer's disease gets worse over time. However, people with the disease can survive for many years. Those with a long-standing history of high blood pressure are more likely to get worse faster.

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Review Date:
11/8/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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