Calcium and vitamin D use in those with heart/cardiovascular disease

calcium and vitamin D in those with heart or cardiovascular disease

Why are calcium and vitamin D important?

Adequate calcium and vitamin D are very important in ensuring bone health as well as other uses.  As our bones are constantly breaking themselves down and remaking themselves it is never too late to ensure that we have sufficient intake and levels of calcium and vitamin D.  These can both be checked in a blood test by your Doctor.

Anyone who has been diagnosed with osteoporosis or the lesser osteopaenia should make sure that they have enough intake through diet or supplement of calcium and vitamin D.  They are also needed when osteoporosis medication is being used to ensure that the medication can work effectively.

 

Calcium and vitamin D in heart/cardiovascular disease patients

Over the last few years there seemed to be a link between the use of calcium supplements and increased cardiovascular disease.

Just because things occur together does not mean that one causes the other.

What is likely is that there are risk factors for osteoporosis and risk factors for cardiovascular disease that are the same.  This means that people who are more likely to get osteoporosis are advised to take calcium and these same people are also more likely to get cardiovascular disease.  Therefore just because people being diagnosed with cardiovascular disease may also take calcium does not mean calcium is the cause of this!  An analysis of several studies has shown no link between calcium and cardiovascular disease.

 

Calcium and vitamin D supplementation

The recommended daily intake of calcium is 1000mg for most people but increases to 1200mg in postmenopausal women.

The daily requirement can generally be reached through having three serves of dairy.  In those who are unable to do this a supplement can be used to make up the shortfall.

Vitamin D supplements are available if needed to bring levels above the 50nmol/L that is recommended.

 

Speak with your Doctor to find out your calcium and vitamin D levels

 

Reference Harvard Health Publishing

https://www.health.harvard.edu/heart-health/calcium-and-heart-disease-what-is-the-connection

Acne

acne

Acne

Everyone from teen age onwards knows about acne.  Even if you are one of the lucky ones who didn’t suffer much you will know someone who did.  Acne, also known as pimples, usually occur on the face but can occur on the chest and back as well.  They can appear as whiteheads, blackheads, pimples or cysts (don’t have a head).

Acne usually begins in the teenage years and lasts for the duration of these years however it can persist well into adulthood.

 

Causes of acne

Increased production of oil (sebum) by skin cells leading to blocked hair follicles is the main cause of acne.  Hormones that increase at puberty lead to a larger amount of oil.  When this oil causes a blockage in a pore it is common for bacteria that is present on our skin to then multiply in the pimple.  This leads to the pus-filled lump that we know as a pimple.

 

Prevention of acne

  • Wash the face twice a day with a non-soap cleanser and water. If you have been exercising or work in a humid environment or have just been sweating a lot you may have to wash following this also.
  • If non-soap cleansers don’t seem to be effective enough there are medicated cleansers that contain antibacterials, benzoyl peroxide or salicylic acid that are helpful.
  • It is very important not to over scrub the skin or make it too dry as this leads to irritation that may increase acne formation or dryness that leads the skin to produce more oil to compensate.
  • Picking, squeezing, touching the skin frequently with your hands and having hair hanging over your face are all things you should NOT Picking and squeezing increases the likelihood of scarring and touching with hands and hair increases the chance of pimple formation.
  • Use oil free make-up and moisturisers to avoid clogging of pores.
  • Always wash makeup off before going to bed to avoid clogging of pores overnight.

 

Treatment of acne

  • Treatment creams and gels containing benzoyl peroxide, sulphur and salicylic acid can be applied to acne to get rid of it.

Sometimes prescription treatment from your Doctor is required to treat acne.

  • Antibiotics taken orally or to be applied topically can help as they kill bacteria that is often involved in acne.
  • Azelaic acid lotion kills bacteria but also helps with inflammation.
  • Retinoids such as isotretinoin can be prescribed by a dermatologist for severe acne that is not responding to other treatment.
  • The contraceptive pill can be helpful in those females who have flare ups of acne associated with their menstrual cycle.

 

Though acne is common it should be treated seriously.  Those who suffer worst are usually teenagers who often feel self-conscious about their appearances anyway.

 

Iodine deficiency in pregnancy

iodine deficiency in pregnancy

Iodine is important in pregnancy

Most women know that it is important to take folic acid before and during pregnancy.  A recent Western Australian study found that not as many women know the importance of ensuring adequate iodine levels in pregnancy.

Almost as important as ensuring adequate levels during pregnancy is ensuring enough is being taken before pregnancy.

It was discovered that only about a quarter of women supplemented with iodine prior to pregnancy whereas 66% used an iodine supplement while pregnant.  This number is similar to other Australian states.

 

Effects of low iodine levels in pregnancy

Iodine is needed to make thyroid hormones.  Thyroid hormones are important in the development of most organs before and after birth.

More than 50% of Australian women studied did not know what effect the lack of iodine could have on their babies.

 

Iodine supplementation in pregnancy

Women who are considering pregnancy or who are pregnant or breastfeeding should take 150 micrograms of iodine daily.

Iodine is contained in pregnancy multivitamins.

Some of you may know that iodine has been added to non-organic bread since 2009 due to low levels of iodine in the population.

Table salt is also iodised to increase iodine intake.  Salts such as Himalayan salt and sea salt contain many minerals however table salt only contains sodium with added iodine in most cases.

 

Reference

Source: Hine, T., Zhao, Y., Begley, A., Skeaff, S. and Sherriff, J. (2018), Iodine-containing supplement use by pregnant women attending antenatal clinics in Western Australia. Aust N Z J Obstet Gynaecol. doi:10.1111/ajo.12785

Hypothyroidism

hypothyroidism

What is the thyroid?

The thyroid is a gland in the neck that releases hormones that regulate our metabolism.  Growth and energy levels are important parts of our metabolism that are controlled by thyroid hormones.

The main hormones made in the thyroid are thyroxine (T4) and tri-iodothyronine (T3).

 

What is hypothyroidism?

Hypothyroidism is where the thyroid gland does not work effectively enough and does not release enough hormones.  As these hormones are not released in to the blood stream metabolism slows down.

Hypothyroidism is more common in women than men.  Around 5-10% of women suffer with hypothyroidism which is the most type of thyroid condition.

A blood test is used to determine if someone has hypothyroidism.  An ultrasound or scan may also be used.

 

Symptoms of hypothyroidism

As hypothyroidism leads to a slowing down of metabolism symptoms are reflective of this.

  • Tiredness
  • Weight gain
  • Feeling cold
  • Constipation
  • Dry skin
  • Hair loss
  • Swollen neck due to enlarged thyroid gland

 

Causes of hypothyroidism

  • Iodine deficiency – iodine is required to make T4 and T3
  • Medicines – lithium and amiodarone can interfere with the making of T4 and T3
  • Pituitary gland disorder
  • Hypothalamus disorder
  • Hashimoto’s disease

 

Treatment of hypothyroidism

Thyroxine tablets may be prescribed by your Doctor if it is determined that you can not make enough of this yourself due to one of the disorders mentioned above.  This treatment is usually needed for the rest of your life and is monitored through blood tests and improvement in symptoms to determine the dose needed.

If it is determined that there is an iodine deficiency supplementation may be used.

Thyroid medicine can be affected by

thyroid medicine can be affected by

Thyroid medicine

The type of thyroid medicine I will be discussing is the one used for hypothyroidism where levels of thyroid hormone in the body are low and need to be increased.  There are a couple of other medical conditions where thyroid hormone medicines are taken.

The name of thyroid hormone medicine is thyroxine (sometimes called levothyroxine).  Thyroxine is best taken first thing in the morning and so other medicines should be timed around this.

 

Thyroxine and calcium/dairy products

Calcium, present as a supplement or in dairy products, can latch on to thyroxine and stop it from being taken in by your body.  This means that levels of thyroid hormone in the body will get lower.  Calcium supplements are best taken at night so if you need to take calcium take it at this time.  If you want to consume dairy in the morning you should wait until at least two hours after taking thyroxine to do this.

 

Thyroxine and iron supplements

Iron is a mineral that significantly lowers the amount of thyroxine that is absorbed if they are taken together.  It is important to take iron at lunch time or even dinner time if you also take thyroxine so that there is a gap of at least four hours between taking them.

 

Thyroxine and food

Eating at the same time as taking thyroxine lowers the amount of thyroxine absorbed.  Take thyroxine first thing in the morning and don’t eat for at least half an hour to avoid this problem.

High fibre foods such as cereal should be consumed two to three hours away from thyroxine as these can have more of an effect.

Cruciferous vegetables such as broccoli and cauliflower can lower thyroid hormone levels in the body.  It is best to keep a consistent intake of these vegetables.  That means to have a little bit each day or every second day so that the effects of these healthy foods are balanced out.

 

Thyroxine and soy (eg tofu)

Soy can decrease thyroid hormone levels in the body.  If you use soy you may need a higher dose of thyroxine.

 

Thyroxine and multimineral supplements

Essential trace minerals need to be separated from thyroxine use by four hours.  Lunch or dinner time is a good time to take these supplements which are quite commonly needed in those with a thyroid hormone deficiency.

 

 

However!

If you have been taking thyroxine for a while and have it, for example, with food and supplements don’t change what you do all of a sudden.  The dose of thyroxine that you take will be based on blood tests and the effects of interfering food and medicines will be reflected in your dose.

Speak with your Pharmacist or Doctor before you change how you take thyroxine.