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Secondary Amenorrhea

Hives. Courtesy wikimedia.
Hives. Courtesy wikimedia.

What Is Chronic Urticaria?

U rticaria is an immune based skin disorder characterized by multiple eruptions of well-demarcated edematous, intensely pruritic (itchy) plaques that may be small or reach the diameter of many centimeters with surrounding erythema (redness) each lasting less than 24 hours.1

Q: What is the immune reaction in hives?

A: Hives form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Histamine is a chemical released from specialized cells along the skin’s blood vessels. Allergic reactions, chemicals in certain foods, insect stings, sunlight exposure, or medications can all cause histamine release.2

In many patients, in spite of extensive investigations, the cause remains elusive. The term idiopathic is often used to denote this category. Now it is known that autoimmunity is the cause of chronic urticaria in 50% of cases.

Treatment is generally started with nonsedating antihistamine in the daytime and sedating antihistamine in the night.3

What Is Chronic Urti caria In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Scala E, Giani M, Pirrotta L, Guerra EC, DePita O, Puddu P. Urticaria and adult celiac disease. Allergy. 1999;54:1008-9. [↩]
  2. www.webmd.com [↩]
  3. Godse KV. Chronic urticaria and treatment options. Indian J Dermatol. 2009 Oct-Dec; 54(4): 310–312. [↩]

Low Plasma Proteins

Image of a protein molecule.
Image of a protein molecule.

What Are Low Plasma Proteins?

Low plasma proteins found in blood indicates an abnormal blood level.

Plasma proteins are any of the proteins that constitute about 6% to 7% of the blood plasma in the body. They include albumin, fibrinogen, prothrombin, and the gamma globulins. All plasma proteins except the gamma globulins are produced in the liver.1

Q: Which protein is most abundant in blood?

A: Of the dozens of plasma proteins, albumin makes up more than half. Albumin level is the most frequently tested in the presence of weight loss and other signs of poor nutrition. Albumin helps maintain water balance that affects osmotic pressure, increase blood viscosity, and helps maintain blood pressure.1

Other commonly tested blood proteins are globulins which make up about a third of plasma proteins. Lab reports show the ratio between albumin and globulin, as well as, their individual values. Fibrinogen, essential for clot formation, makes 7% of plasma proteins while regulatory proteins, which include enzymes and hormones, make up 1%.

What Are Low Plasma Proteins In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier. [↩] [↩]

Copper Deficiency

mmm...copper is in chocolate!
mmm…copper is in chocolate and nuts!

What Is Copper Deficiency?

Copper is an essential trace element that is required for a number of enzymes which are necessary for normal metabolic function.

In the body almost all the copper is present as a component of copper proteins which are produced and controlled by the liver.

Q: How does the liver control copper?

A: The liver maintains proper copper balance by binding free copper to proteins and by excreting excess copper as part of bile that is then emptied into the intestinal tract and excreted in stool.

Metabolic balance studies have demonstrated that daily copper losses are approximately 1.3 mg/day.1

Among its specific functions listed below, copper is essential for energy production, blood and nerve functions, blood components, immunity, and collagen tissue. The copper enzyme, lysyl oxidase, is involved in the cross-linking of collagen in forming the framework for depositing calcium and other minerals to build and repair bone.

Animal studies suggest that adequate copper levels during pregnancy are critical to development of higher brain function in the offspring.2

What Is Copper Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Williams DM. Copper deficiency in humans. Semin Hematol. 1983 Apr; 20(2):118-28. [↩]
  2. Fisgin T, Yarali N, Duru F, Usta B, Kara A. Hematologic manifestation of childhood celiac disease. Acta Haematol. 2004;111(4):211-4. [↩]

Chromium Deficiency

Broccoli is a Good Source of Natural Chromium.
Broccoli is a Good Source of Natural Chromium.

What Is Chromium?

Chromium is a mineral that the body absolutely requires in trace amounts for normal metabolism, meaning the physical and chemical processes by which energy is produced and used.

Chromium is especially involved in the use of glucose sugar and lipids such as cholesterol and the effectiveness of insulin hormone.

Q: How is chromium involved in the use of glucose?

A: Very small amounts of chromium are required to enable insulin to move glucose from the bloodstream into cells for use as energy.

Insulin is a hormone that controls the use and storage of glucose in two ways: 1) lowers a rise of glucose in blood after meals by moving it out of the bloodstream into body cells, especially muscle cells and 2) limits the release of glucose from the liver between meals. Insulin is produced by beta cells on the surface of the pancreas.

To date, the molecular mechanism by which chromium affects glucose and lipid metabolism is still unclear.1

What Is Chromium Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Lewicki S, Zdanowski R, Krzyżowska M, Lewicka A, Dębski B, Niemcewicz M, Goniewicz M. The role of Chromium III in the organism and its possible use in diabetes and obesity treatment. Ann Agric Environ Med. 2014 Jun 10;21(2):331-335. [↩]

Iron Deficiency

ferritinWhat Is Iron?

Iron is an essential mineral that is required for normal body function.

Almost two-thirds of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues. Smaller amounts of iron are found in myoglobin, a protein that helps supply oxygen to muscle, and in enzymes that assist biochemical reactions.

Iron is also found in proteins that store iron for future needs and that transport iron in blood.

Q: How are iron stores regulated?

A:Iron stores are regulated by intestinal iron absorption.1That is, whenever iron is needed, more iron is absorbed than when iron is sufficient. This mechanism prevents excess iron in the body which is harmful.

In the brain, iron is necessary to ensure oxygenation and to produce energy in the cerebral parenchyma (via cytochrome oxid. ase), and for the synthesis of neurotransmitters and myelin.

Iron concentrations in the umbilical artery are critical during the development of the fetus, and in relation with the IQ in the child.2

What Is Iron Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://ods.od.nih.gov/factsheets/Iron-HealthProfessional accessed 12/11/12 [↩]
  2. Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006 Sep-Oct; 10(5):377-85. [↩]

Phosphorus Deficiency

burger_21119511What Is Phosphorus?

Phosphorus is an essential mineral present in every cell of the body mostly in the form of phosphate.

About 85% of phosphorus is present in bone making up a major component of bone formation. As a component of calcium phosphate, phosphorus constitutes 45% of skeletal bone weight while calcium constitutes 40% to support the body.1.

Phosphorus is required for normal tooth development. Inadequate phosphorus in early childhood development makes for defective tooth enamel in permanent teeth.

Phosphorus is crucial for the production of ATP (adenosine triphosphate), a molecule within cells that the body uses to store energy, and is required for production of phosphocreatine to power muscles.  Functions are more fully described below.

One gram of protein in food provides approximately 15 mg of phosphorus. In an adult, the body content of phosphorus ia about 700 grams.

What Is Phosphorus Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://www.nlm.nih.gov/medlineplus/ency/article/002424.htm [↩]

Potassium Deficiency

Luscious Figs For Potassium.
Luscious Figs For Potassium.

What Is Potassium?

Potassium is a mineral that is crucial for life being essential for every cell, especially nerve and muscle function.

Most potassium is intracellular, meaning it is found within cells while sodium, its opposing mineral (both electrolytes), is found in the fluid surrounding cells.

In muscle contraction, exchange of potassium and sodium takes place so that potassium moves out of muscle cells and sodium moves into them.

With muscle relaxation, potassium moves back into the cells and sodium moves out. Functions are described below.

Importantly, a recent study investigating the association between the metabolic syndrome and potassium intake in the general population found a significant inverse association between potassium intake and metabolic syndrome in adults. That is, the lower the potassium intake, the greater the odds of developing metabolic syndrome. After adjusting for various lifestyle and dietary confounders, subjects in the highest quartile of potassium intake had 39% lower odds for metabolic syndrome compared to those in the lowest quartile. This association was consistent for both sexes. Among the components of metabolic syndrome, potassium intake was inversely related to abdominal obesity and fasting hyperglycemia in multivariate analysis.1

What Is Potassium Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Shin D, Joh HK, Kim KH, Park SM. Benefits of potassium intake on metabolic syndrome: The fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Atherosclerosis. 2013 Sep;230(1):80-5. doi: 10.1016/j.atherosclerosis.2013.06.025. [↩]

Vitamin B3 (Niacin) Deficiency

SumptuousTuna For Niacin.
Sumptuous Tuna For Niacin.

What Is Vitamin B3 (Niacin)?

Niacin is an essential water-soluble B vitamin that is required by all cells of the body.

During digestion of food containing it, niacin (the form in food) is changed in the small intestines to the active form niacinamide (niacin plus an amide group), which is then absorbed into the bloodstream. 

Niacinamide is converted by the body into co-enzymes which are present in all cells. These are niacinimide adenine dinucleotide (NAD) and NADP. NADP is formed when the body adds a phosphate to NAD.

Q: How do these enzymes work?

A: These enzymes function in oxidation-reduction reactions essential for release of energy from carbohydrates, fats, and proteins and are needed as components for more than 200 enzymes involved in metabolism.

In addition to producing energy, niacinamide is essential for healthy skin and the mucosal lining of the digestive tract, normal functioning of the brain and nervous system, and production of steroid hormones in adrenal glands and hormones in sex glands.  Functions are more fully described below.

Urinary excretion of niacin cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, the vitamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.1

What Is Niacin Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. eCollection 2014. [↩]

Hypertension, Reversible

Grade_1_hypertension[1]What Is Reversible Hypertension?

Reversible hypertension is a pressure disorder of arteries associated with increased systemic (body wide) blood vessel resistance to blood flow due to endothelial (cell) dysfunction of arterial blood vessels that can improve with nutritional treatment.

Hypertension itself is defined as a systolic blood pressure (SBP) of 140 mm Hg (mercury) or greater and/or diastolic blood pressure (DBP) of 90 mm Hg or greater.

Q: What is blood vessel (vascular) resistance to blood flow?

A: Vascular resistance to blood flow means the arteries carrying blood away from the heart cannot relax or dilate when needed to lower blood pressure but stay constricted, which in turn, keeps the pressure high.

Here’s an analogy: if you replace your garden hose having a one inch inside diameter with one that has a smaller half inch diameter and open the water valve as usual, the result would be water shooting out with more force.

What Is Reversible Hypertension In Celiac Disease and/or Gluten Sensitivity?

Homocysteine, Elevated Blood Level (Hyperhomocysteinemia)

A 3-D model of homocysteine.
A 3-D model of homocysteine.

What Is Elevated Homocysteine?

Elevated homocysteine in blood, called hyperhomocysteinemia, indicates an abnormal blood level of this transient amino acid.

Q: How does the level of homocysteine become abnormal?

A: In metabolism, homocysteine is briefly formed in the breakdown of the amino acid methionine. It is normally converted to cystathione and then to the amino acid cysteine by means of an enzyme that requires vitamin B6.

In the reverse, conversion of homocysteine to methionine requires an enzyme dependent on adequate folic acid and vitamin B12 levels.

Insufficient methionine levels and/or inefficiency in this process results in elevated homocysteine plasma levels that are toxic to blood vessels.

Folic acid, vitamin B12 and vitamin B6 are involved in the metabolic removal of homocysteine, but folic acid deficit occurs the most often.1

What Is Elevated Homocysteine In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Lim PO, Tzemos N, Farquharson CA, et al. Reversible hypertension following coeliac disease treatment: the role of moderate hyperhomocysteinaemia and vascular endothelial dysfunction. Journal of Human Hypertension. Jun 2002;16(6):411-5. [↩]