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Nathan Goodyear

Salivary cortisol response to awakening in chronic fatigue syndrome - 0 views

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    Low morning cortisol found in those with chronic fatigue syndrome.
Nathan Goodyear

ScienceDirect - Clinical Biochemistry : Measurement of morning saliva cortisol in athletes - 0 views

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    morning saliva cortisol shown to be "highly significant correlation" with serum cortisol in athletes.
Nathan Goodyear

Testosterone for the aging male; current evidence and recommended practice - 0 views

  • Total serum testosterone consists of free testosterone (2%–3%), testosterone bound to sex hormone binding globulin (SHBG) (45%) and testosterone bound to other proteins (mainly albumin −50%)
  • Testosterone binds only loosely to albumin and so this testosterone as well as free testosterone is available to tissues and is termed bioavailable testosterone
  • Testosterone bound to SHBG is tightly bound and is biologically inactive
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  • Bioavailable and free testosterone are known to correlate better than total testosterone with clinical sequelae of androgenization such as bone mineral density and muscle strength
  • peak levels seen in the morning following sleep, which can be maintained into the seventh decade
  • Samples should always be taken in the morning before 11 am
  • The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive.
  • With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status.
  • It is advised that at least two serum testosterone measurements, taken before 11 am on different mornings, are necessary to confirm the diagnosis.
  • Patients with serum total testosterone consistently below 8 nmol/l invariably demonstrate the clinical syndrome of hypogonadism and are likely to benefit from treatment. Patients with serum total testosterone in the range 8–12 nmol/l often have symptoms attributable to hypogonadism and it may be decided to offer either a clinical trial of testosterone treatment or to make further efforts to define serum bioavailable or free testosterone and then reconsider treatment. Patients with serum total testosterone persistently above 12 nmol/l do not have hypogonadism and symptoms are likely to be due to other disease states or ageing per se so testosterone treatment is not indicated.
  • Total testosterone levels fall at an average of 1.6% per year whilst free and bioavailable levels fall by 2%–3% per year.
  • With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH
  • Metabolic clearance declines with age
  • Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced
  • There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved
  • the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis
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    Leptin inhibits male Testosterone production at the level of the hypothalamus and at the testicle level.
Nathan Goodyear

Decreased cortisol awakening respon... [Psychoneuroendocrinology. 2005] - PubMed - NCBI - 0 views

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    early life stressors shown to reduce morning cortisol on salivary testing.  This indicates an altered HPA axis.
Nathan Goodyear

A blunted cortisol awakening response and hippocampal atrophy in type 2 diabetes mellitus - 0 views

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    Individuals with type II DM, found to have blunted morning cortisol and decreased hippocampal volume.  The hippocampus is the focus of memory.  This is similar to what is found in PTSD.
Nathan Goodyear

Self-Reported Depressive Symptoms and Stress Levels in Healthy Young Men: Associations ... - 0 views

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    Elevated morning cortisol associated with depression in men. This study looked at saliva for assessment of free cortisol.
Ciara Usher

A Very Peaceful Sleep - 1 views

For the past few days, I have been suffering from stiff neck and back pains. The following morning, I am having a hard time trying to get up and it is so disappointing because I have to go through ...

Craftmatic adjustable beds

started by Ciara Usher on 06 Apr 11 no follow-up yet
Nathan Goodyear

A comparison of the use of urinary c... [J Clin Endocrinol Metab. 2013] - PubMed - NCBI - 0 views

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    night time salivary cortisol found to correlate with early morning urine samples in those with Cushing's.  This in addition to the nocturnal salivary cortisol correlation found in past studies.  The positive studies on salivary cortisol testing continues to build.
wheelchairindia9

Wrist and Forearm Splints Causes and Recovery Period | Health | Article Point - 0 views

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    Wrist and forearm splints may be suggested for people with weak wrists or for those that have been previously injured, for tendonitis wrist support and even as a preventative for those who awaken in the morning with pain or numbness after sleeping on their hands at night. The best orthopedic wrist braces for carpal tunnel syndrome, occupational stabilization and relief from the pain of wrist strains and sprains. This Right hand wrist and forearm splint from tynor is meant to be used among patients suffering from any injury or sprain in these regions. The splint is meant to provide controlled compression in various orthopaedic conditions. The splint immobilizes the area that helps in a speedier recovery. It has anatomical thumb opening that allows free movement of the thumb. It provides a lot of comfort and is easily breathable. Forearm splint is the term used to describe the forearm pain similarly the pain of lower leg over the shin is known as shin splints. Forearm splint describes the painful disease of elbow or wrist joint. Continuous pain in forearm is often caused by tendonitis, joint injury or hairline fracture of forearm bones (proximal radius or ulna near elbow joint). Overstretching of the elbow joint often causes forearm injury. Symptoms consist of a dull pain in the forearm. Pain is minor initially but increases as activity continues. Often pin-pointed to the dorsal or back of the hand side of the forearm, mid-way between the wrist and elbow. The patient may experience weakness in the wrist extensor muscles and tenderness deep in the forearm. Pain may be reproduced by attempting to bend the wrist backwards against resistance. They provided wrist splints are used in different medical institutions and hospitals for management of hand fractures. Our offered wrist splints are manufactured by skilled professionals using optimum quality basic material and advanced technology as per the set norms of market. As well, these wrist splints can be availed in v
fnfdoc

Nausea: Causes, Symptoms And Treatment | Health Blog - 0 views

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    What causes nausea and how can you avoid/treat it at home? You feel nauseous when your stomach either stops contracting or... Ever wonder why you feel so uneasy while driving across a rough, bumpy road? How does nervousness lead to nausea? Patients with nausea make up 6.7% of all cases treated...
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    Today was an exceptionally bright day. At least the morning. The rest of the day was marred by Kate throwing up on me nonstop. She felt a strong sensation of nausea and dizziness. But why does she eat at that weird Mexican place when she knows it makes her stomach sick? Every time she goes there, she feels a gut-wrenching, stomach-turning urge to release all that her belly holds. I mean, the stomach is an elastic bag made of muscular walls containing acid. We read that in science once. But why does Kate's stomach hold a serious grudge against Mexican food?
Nathan Goodyear

Coffee and cancer risk: a summary overview - 0 views

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    2017 meta-analysis finds no increase relative risk (RR) of cancer with coffee consumption.  First, this must consider all the "other" junk put in coffee these days.  Second, and most important, this study looked at RR which tells us nothing about risk.  Studies like this don't do much more than confuse the general public, doctors, and judges--recent judge ruling in California that coffee needs a carcinogenic lable.  Third, epigenetis will tell us about individual risk.  I am growing more concerned that the majority of studies published today are merely statistical dances to ensure publication.  Is it good that no RR was found? yes, does that give any indication of absolute risk?  No.  Take home: enjoy your morning cup of joe as nature prescribed--no additives.
Stanley Bishop

Save Me From Snoring - 1 views

started by Stanley Bishop on 16 Jan 13 no follow-up yet
Nathan Goodyear

Endocrinology of the Aging Male - 0 views

  • All steps beyond the formation of pregnenolone take place in the smooth endoplasmic reticulum
  • Cytochrome P450 enzyme, CYP11A is located on the inner mitochondrial membrane and catalyses the rate limiting step of pregnenolone synthesis
  • Estrogen and related steroids, thyroid hormone and insulin increase SHBG levels.
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  • SHBG decreases in response to androgens, and in the presence of hypothyroidism, and insulin resistance.
  • Plasma SHBG levels tend to increase with increasing age
  • The apparent metabolic clearance rate of testosterone is decreased in elderly as compared to younger men
  • Testosterone circulates predominantly bound to the plasma proteins SHBG and albumin, with high and low affinity respectively
  • Testosterone is secreted in a pulsatile fashion
  • Current clinical guidelines suggest at least two measurements
  • In adult men, there is a well-documented diurnal variation (particularly in younger subjects) in testosterone levels, which are highest in the early morning and progressively decline throughout the day to a nadir in the evening
  • In older men, the diurnal variation is blunted
  • it is standard practice for samples to be obtained between 0800 and 1100 h.
  • Testosterone and DHEA decline, whereas LH, FSH, and SHBG rise
  • DHT remains constant despite the decline of its precursor testosterone
  • Longitudinal studies show an average annual decline of 1–2% total testosterone levels, with decline in free testosterone more rapid because of increases in SHBG with aging
  • Massachusetts Male Aging Study (MMAS) data show DHEA, DHEAS, and Ae declining at 2–3% per year
  • DHT showed no cross-sectional age trend
  • Androstanediol glucuronide (AAG) declined cross-sectionally with age in the MMAS sample, at 0.6% per year
  • The EMAS data show that, consistent with the longitudinal findings of MMAS (Figure 1), the core hormonal pattern with increasing age is suggestive of incipient primary testicular dysfunction with maintained total testosterone and progressively blunted free testosterone associated with higher LH
    • Nathan Goodyear
       
      This author proves the point in the review of these two studies, that TT may remain constant in aging men, however, FT drops.
  • obesity impairs hypothalamic/pituitary function
  • Androgen deprivation in men with prostate cancer has been associated with increased insulin resistance, worse glycemic control, and a significant increase in risk of incident diabetes
  • Low serum testosterone is associated with the development of metabolic syndrome 116, 117 and type 2 diabetes. 118 SHBG has been inversely correlated with type 2 diabetes
  • Improvement in insulin sensitivity with testosterone treatment has been reported in healthy 121 and diabetic 122 adult men
  • In studies conducted in men with central adiposity, testosterone has been shown to inhibit lipoprotein lipase activity in abdominal adipose tissue leading to decreased triglyceride uptake in central fat depots. 123
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    great review of hormone changes associated with aging in men.
wheelchairindia9

Tynor Wrist and Forearm Splint Right-Left - 0 views

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    Tynor Wrist and Forearm Splint Right-Left Wrist and Forearm Splint is designed to immobilize and provide firm and comfortable support to hand and wrist in various orthopedic conditions. It maintains the wrist in the functional position. Aesthetically appealing. Customizable splint. Perfect immobilization. Controlled compression. Anatomical thumb opening. Tynor Wrist and Forearm Splint Right-Left Features Made out of PUF fused Matty fabric Breathable Excellent aesthetics Improved comfort Enhanced life. Removable, Aluminum Splints Customized fitting Required degree of dorsi-flexion can be achieved Very good grip and immobilization Design features Long length of the brace, ensures enhanced immobilization Brace abuts the Palmer crease , allows free finger movement. Elegant tabs , allow easy application and removal Elegant tabs, also enhance the aesthetics of the product. Black Color, enhances the aethetics Hook loop closures Easy to apply and remove Ensures optimal compression , Built in opening for thumb abduction Better pain relief and healing. Thumb remains relaxed, no fatigue Improves comfort Tynor Wrist and Forearm Splint Right-Left Measurements Measure the Circumference at a distance 6" from the wrist along the arm
Nathan Goodyear

ScienceDirect - Clinical Biochemistry : Advantage of salivary cortisol measurements in ... - 1 views

  • nighttime salivary cortisol is more adequate than serum in the screening of Cushing's syndrome
  • Morning salivary cortisol is as good as serum as screening test for patients with Addison's disease
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    salivary cortisol is shown to be reliable for both Addison's and Cushing's Syndrome
Nathan Goodyear

Low early morning plasma cortisol in posttraumatic stress disorder is associated with c... - 0 views

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    Low cortisol found in those with PTSD.  This study suggest the high ACTH/cortisol ratio is not due to enhanced peripheral sensitization to glucocorticoids.
Nathan Goodyear

Elevated morning serum inte... [Psychoneuroendocrinology. 2007 Sep-Nov] - PubMed - NCBI - 0 views

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    elevated pm saliva cortisol and increased IL-6 is predictive of PTSD in children and adolescents.  
Craftmatic Beds

The Perfect Bed for My Nana - 1 views

My grandnana always complain about waking up in the morning with muscle pains and backaches. She is already 86 years old and it pains me to hear that she is not having a good night sleep. So I deci...

craftmatic adjustable beds

started by Craftmatic Beds on 23 Nov 11 no follow-up yet
Nathan Goodyear

Morning free and total testosterone in HIV-infected men: implications for the assessmen... - 0 views

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    low T is found in 20-70% of men with HIV.  What is interesting about this article is that Total Testosterone was found to be a poor assessment of biological active Testosterone.  Free Testosterone assessed in the am was shown to be a better functional assessment in these men.  Serum is a poor choice though.  The process of equilibrium dialysis to calculate free Testosterone is filled with variables that will effect reliability.  Increases SHBG was found associated.
Nathan Goodyear

Branched Chain Amino Acid Supplementation for Patients with Cirrhosis | Clinical Correl... - 0 views

  • low level of BCAAs in patients with cirrhosis is hypothesized to be one of multiple factors responsible for development of hepatic encephalopathy
  • supplementation of BCAAs is thought to facilitate ammonia detoxification by supporting synthesis of glutamine, one of the non-branched chain amino acids, in skeletal muscle and in the brain as well as diminishing the influx of AAAs across the blood-brain barrier
  • oral BCAA supplementation is more useful in chronic encephalopathic patients than is parenteral BCAA supplementation in patients with acute encephalopathy
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  • malnutrition progressing to cachexia is another common manifestation of cirrhosis
  • Malnutrition can be mitigated with BCAA supplementation
  • Studies show that administration of amino acid formulas enriched with BCAAs can reduce protein loss, support protein synthesis, and improve nutritional status of patients with chronic liver disease
  • Leucine has been shown to be the most effective of the BCAAs because it acts via multiple pathways to stimulate protein synthesis
  • BCAAs metabolites inhibit proteolysis
  • Patients with cirrhosis have both insulin deficiency and insulin resistance
  • BCAAs (particularly leucine) help to reverse the catabolic, hyperglucagonemic state of cirrhosis both by stimulating insulin release from the pancreatic β cells and by decreasing insulin resistance allowing for better glucose utilization
  • Coadministration of BCAAs and glucose has been found to be particularly useful
  • BCAA supplementation improves protein-energy malnutrition by improving utilization of glucose, thereby diminishing the drive for proteolysis, inhibiting protein breakdown, and stimulating protein synthesis
  • Cirrhotic patients have impaired immune defense, characterized by defective phagocytic activity and impaired intracellular killing activity
  • another effect of BCAA supplementation is improvement of phagocytic function of neutrophils and possibly improvement in natural killer T (NKT) cell lymphocyte activity
  • BCAA supplementation may reduce the risk of infection in patients with advanced cirrhosis not only through improvement in protein-energy malnutrition but also by directly improving the function of the immune cells themselves
  • BCAA administration has also been shown to have a positive effect on liver regeneration
  • A proposed mechanism for improved liver regeneration is the stimulatory effect of BCAAs (particularly leucine) on the secretion of hepatocyte growth factor by hepatic stellate cells
  • BCAAs activate rapamycin signaling pathways which promotes albumin synthesis in the liver as well as protein and glycogen synthesis in muscle tissue
  • Chemical improvement with BCAA treatment is demonstrated by recovery of serum albumin and lowering of serum bilirubin levels
  • long-term oral BCAA supplementation was useful in staving off malnutrition and improving survival by preventing end-stage fatal complications of cirrhosis such as hepatic failure and gastrointestinal bleeding
  • The incidence of death by any cause, development of liver cancer, rupture of esophageal varices, or progression to hepatic failure was decreased in the group that received BCAA supplementation
  • Patients receiving BCAA supplementation also have a lower average hospital admission rate, better nutritional status, and better liver function tests
  • patients taking BCAA supplementation report improved quality of life
  • BCAAs have been shown to mitigate hepatic encephalopathy, cachexia, and infection rates, complications associated with the progression of hepatic cirrhosis
  • BCAAs make up 20-25% of the protein content of most foods
  • Highest levels are found in casein whey protein of dairy products and vegetables, such as corn and mushrooms. Other sources include egg albumin, beans, peanuts and brown rice bran
  • In addition to BCAAs from diet, oral supplements of BCAAs can be used
  • Oral supplementation tends to provide a better hepatic supply of BCAAs for patients able to tolerate PO nutrition as compared with IV supplementation, especially when treating symptoms of hepatic encephalopathy
  • Coadministration of BCAAs with carnitine and zinc has also been shown to increase ammonia metabolism further reducing the encephalopathic symptoms
  • Cirrhotic patients benefit from eating frequent, small meals that prevent long fasts which place the patient in a catabolic state
  • the best time for BCAA supplementation is at bedtime to improve the catabolic state during starvation in early morning fasting
  • A late night nutritional snack reduces symptoms of weakness and fatigability, lowers postprandial hyperglycemia, increases skeletal muscle mass,[25] improves nitrogen balance, and increases serum albumin levels.[26] Nocturnal BCAAs even improve serum albumin in cirrhotic patients who show no improvement with daytime BCAAs
  • Protein-energy malnutrition (PEM), with low serum albumin and low muscle mass, occurs in 65-90% of cases of advanced cirrhosis
  • hyperglucagonemia results in a catabolic state eventually producing anorexia and cachexia
  • BCAAs are further depleted from the circulation due to increased uptake by skeletal muscles that use the BCAAs in the synthesis of glutamine, which is produced in order to clear the ammonia that is not cleared by the failing liver
  • patients with chronic liver disease, particularly cirrhosis, routinely have decreased BCAAs and increased aromatic amino acids (AAAs) in their circulation
  • Maintaining a higher serum albumin in patients with cirrhosis is associated with decreased mortality and improved quality of life
  • the serum BCAA concentration is strongly correlated with the serum albumin level
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    great review of cirrhosis and BCCA supplementation.
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