Alzheimers diseasea progressive mental deterioration that can occur in middle or old ageis what experts call a complex medical condition. It isnt caused by one singular factor, like a caffeine-induced headache or a broken bone caused by an injury. Complex diseases involve multiple genes and environmental factors. In other words, its complicatedvery complicated, which has long hindered our understanding of the disease.

Further complicating matters is the fact that Alzheimers disease affects upwards of 5 million Americanstwo-thirds of whom are women, per the Womens Alzheimers Movement (WAM). While the disproportionate effect of Alzheimers on women has long been known, scientists and doctors are only relatively recently starting to understand why. Answering the why just may change the course of action in terms of both prevention and treatment.

But what do you focus on when it comes to a disease that has myriad risk factors, including genes, hormones, diet, stress, and environmental factors? For some of the leading experts in Alzheimers research, theyre choosing to focus on the gut.

Alzheimers is a deterioration of the brain, so it can be a little confusing to know why exactly the gut is taking center stage. As with seemingly everything else in health these days, it all comes down to the microbiome.

The microbiome is all the bacteria, fungi, and viruses that live in the gut, says Laura Cox, PhD, an instructor at the Ann Romney Center for Neurologic Diseases at Brigham and Womens Hospital and Harvard Medical School. (She received a grant from WAM in 2020 to fund her research.) Its important to have a high population of certain good bacteria strains and fungi in the gut. The good guys are linked to a variety of health benefits, including thriving brain health, while bad bacteria is linked to (amongst other health problems) deteriorating brain health.

Heres why: What happens is that as we age, everything starts to break down. This is normal and natural, and we try to fight it, Dr. Cox says. This is called inflamm-aging, aka inflammation due to age. The gut barrier (which lines the inside of the gut and prevents harmful substances from being absorbed by the body) and the blood-brain barrier (the protective blood vessels surrounding the central nervous system) are included in this gradual systemic breakdown.

This is problematic for two reasons. One, these barriers become less able to block harmful microbes, pathogens, and other substances from circulating through your system. Second, since inflamm-aging impairs the immune system, the body is less able to kill harmful bacteria and pathogens that escape through the gut. So you could have increased exposure to microbial products that are getting from the gut to the brain, Dr. Cox says. Both of these factors can lead to further bodily inflammationand experts believe that inflammation in the brain lays the groundwork for Alzheimers.Given that the majority of your immune function happens in the gutand that your microbiome supports said immune function as well as the integrity of the gut barrierand you can see why researchers are interested in the relationship between the brain and the gut.

Hemraj Dodiya, PhD has been studying the differences between the microbiome-brain connection as it relates to Alzheimers in women versus men for three years at the University of Chicago. He says that sex hormones and physiology in men and women affect the gut bacteria in the microbiome. The main question Dr. Dodiya and his team are working to answer is what bacteria strains in the gut are linked to amyloid deposits, which are buildups of plaque in the brain increasing the risk of Alzheimersand what strains are linked to reducing these deposits.

One study showed that a cocktail of five different antibiotics worked to reduce amyloid deposits in male mice, but not female mice. We can attribute this to the male mice having a protective bacteria in the gut, while the female mice could potentially have a pro-inflammatory type of bacteria in the gut, Dr. Dodiya says. Male and female mice have completely different reactions to antibiotic treatment that allows colonization or growth of certain bacterial species.

Dr. Dodiya says hes now exploring in several different experiments exploring how reproductive hormones interact with the bacteria in the gut and immune cells, in order to see if that explains the above-mentioned sex differences in the guts of mice. [This communication] could then modulate what bacteria live and what bacteria die, he says. One experiment involves castrating male mice and studying how that changes their microbiomes. In another experiment, testosterone supplements are given to female mice to see how that affects their microbiome. One experiment that Im working on is taking good bacteria from male [mice] and giving it to female mice, Dr. Dodiya says.

Dr. Cox has seen promise with female mice going a different route: reducing carbohydrate intake. What was surprising about the study was that reducing carbs [to less than 30 percent of the overall diet] showed to be effective in reducing amyloid deposits in female mice, but not male mice, Dr. Cox says. Another surprise from the study is that the microbiomes of the female mice aged faster than the males (meaning they started to break down sooner). But restricting carbs helped slow that aging process in the female mice, she says.

All these mice experiments have some big takeaways for the future of Alzheimers prevention and treatment, particularly in women. Dr. Dodiya says that he could see it leading to the development of probiotic supplements formulated to prevent Alzheimers, with different stains for women than men. This is an outcome Dr. Cox says she could see too; designer probiotics that work as different drug therapies for men and women. But she emphasizes that more research needs to be done to pinpoint exactly what bacteria strains can cause Alzheimers, as well as which strains could play a role in prevention. Were still several years off from that knowledge.

Another possible treatment method could lie in fecal transplants, pending how the experiment taking good bacteria from male mice and giving it to female mice turns out. (Yes, the idea of it may take some getting used to, but fecal transplants are already showing success when it comes to improving someones microbiome.)

In terms of the carb reduction study, thats something Dr. Cox says women can consider putting into practice now with doctor supervision, though she emphasizes that the takeaway shouldnt be confused with reducing calories to an unhealthy level. After all, your brain needs sufficient vitamins and nutrients to function properlyand carbohydrates are the brains preferred source of fuel. Malnutrition in the elderly is already a problem, so its important to be mindful of this, she says. Its more about eating fewer carbs and enough other beneficial macronutrients like protein, fat, and fiber.

Whats clear is that while all of this research is promising, more needs to be doneespecially on humans, not just mice. But whats encouraging is that researchers are really honing in on the differences between what causes Alzheimers in men versus women, something that was long ignored. And addressing those differences lies a prevention plan that could be affective for everyone.

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Alzheimers Disease Affects More Women Than Menand Some Experts Think The Reason Why Lies in the Gut - Well+Good

As SARS-CoV-2 virus spread throughout the globe and caused the largest amount of COVID-19 cases and deaths in the US, there is hardly a person on this planet who is unaware of the coronavirus.

While ending the lockdowns across the country with safety precautions and making sure hospitals are not overwhelmed, public officials and physicians alike are waiting to see the way coronavirus behaves in the next several months. Will we see a substantial increase in the cases during the summer or will the hot weather keep it at bay? Rising number of cases in Florida and Arizona despite the heat is certainly concerning and our eyes are on them, waiting to see how the situation progresses. Will SARS-CoV-2 return in the fall and winter months causing another spike in cases in New York and New Jersey?

With each day we learn more about the virus and about the ways to treat it.

Doctors gain experience, share knowledge and are now better prepared to treat the sick. There are many treatment protocols used in various countries, different hospitals, medical wards and intensive care units, although uniformed guidelines are still lacking.

The controversy about the Hydroxychloroquine, the drug to treat malaria and rheumatoid arthritis, continues, with some randomized studies about it withdrawn from the most respected medical journals (NEJM and Lancet), but some others still ongoing. New medication Remdesivir recently received emergency use authorization by FDA. Old medicine Dexamethasone (a familiar glucocorticoid) was recently shown in a UK-based trial to improve survival of hospitalized patients on mechanical ventilation by 30% and of hospitalized patients on oxygen by 20%. Some other off-label medications include Ivermectin, colchicine, antibiotics, antiretrovirals, immunoglobulins, convalescent plasma, and Toclizumab (an IL-6 inhibitor which can prevent the cytokine storm).

We discovered that COVID-19 not only affects the immune system, gastrointestinal and respiratory systems, causing bronchitis, pneumonia, and acute respiratory distress syndrome. It also produces hematological complications causing widespread blood clotting. Specifically, COVID-19 has been shown to cause dysfunction in the inner lining of the arteries (endothelium) and the treatment for blood clots (anti-coagulants) is now used to avoid life threatening complications. An important observation, shared by many physicians across several states, has been that in the newly diagnosed cases of the last several weeks, including June of 2020, we see that patients are not as sick, outcomes are better even with hospitalized patients. We also observe better survival rates. It is too early to say if the reason behind it is mutation and weakening of the virus or if there are other factors contributing to improved outcomes. Infection fatality rate (defined as deaths among all diagnosed, undiagnosed and asymptomatic individuals) seems to be between 0.4-1% according to various epidemiological reports. While it is still higher than influenza which carries about 0.1% death rate, the risk of dying from COVID-19 turns out to be much less than initially feared and estimated in March-April of 2020 when the case mortality rate (defined as deaths among those who were diagnosed with disease) was thought to be up to 5%.

Traditional medicine still does not recommend much for mild to moderate disease, as the majority of people will recover from COVID-19 without intervention. However, learning that there are delayed complications, such as prolonged fatigue, lingering cough, blood clots, and rashes, maybe we should be paying more attention even to the seemingly mild and moderate cases, those which do not require hospitalization. It is not uncommon for the patients to have persistently elevated levels of inflammatory and blood clotting markers and develop depressed mood and anxiety. The latter two can happen with any serious medical illness. Some physicians treat mild and moderate cases with off-label medications and supplements based on experiences with MERS and SARS and anecdotal reports from colleagues all over the world. We have observed a lot of positive progress with the use of off-label medications and natural supplements based on collective experience of many physicians, but without a gold standard randomized control trial it is impossible to definitely state whether these patients would have recovered by themselves without any intervention.

It is currently believed based on epidemiological models, that during the pandemic, the novel virus will continue to infect the world's population until about 70-80% of people are infected and herd immunity is achieved. Short of a rapidly produced vaccine or natural weakening of the SARS-CoV-2, it will mean that most of us will be exposed to the coronavirus at some point, regardless of the length of the quarantine. If and when that happens, one of two things will take place. If our immune system is stronger than the virus, we will be able to inactivate it with our own immune cells. Those people may become infected but be asymptomatic or have very mild symptoms. If our immune system is weaker than the virus's ability to enter our cells and replicate can overwhelm our defenses, leaving a person very sick, possibly progressing to life threatening complications. Research on hospitalized patients with COVID-19 revealed that older individuals, people with pre-existing conditions, such as hypertension, obesity, diabetes and cancer develop more severe disease and are at higher risk of death.

In the absence of a vaccine or a proven cure, strengthening one's immune system and practicing social distancing may be the only preventative strategies we have while the pandemic runs its course. Much like people have been preparing and stocking up on groceries and household supplies, we should be taking care of our immune system and prepare now. Our immune system is very complex and the process of becoming the healthiest version of yourself is not overnight, but simple steps can be employed right away to start the journey.

Getting adequate sleep, about 7-8 hours, will improve the body's response to illness. Decreased sleep duration has been linked to increased inflammation. Even mild sleep deprivation can cause elevation in pro-inflammatory markers, such as c-reactive protein, and cause immunodeficiency, thus decreasing the response of our body to several antigens. For example, only six days of restricted sleep tends to decrease immunity against influenza vaccination and enhances susceptibility to the common cold.Getting adequate sleep improves not only our cellular function and immunity but also helps to eliminate toxins from our body.

Eating a diet rich in fruits, vegetables, lean proteins, which constitute a healthy antiinflammatory diet, provides minerals, nutrients, and vitamins for proper cellular function. Studies show that only one meal full of refined sugars and trans-fats produces abnormal insulin response which, in turn, decreases function of macrophages. Targeted supplementation with vitamins and minerals which may specifically improve immunity can also be helpful. Zinc helps decrease viral replication, Vitamin D helps immunity, Vitamin C works as an antiviral and an antioxidant, Vitamin A helps the cells in the respiratory tree, flavonoid quercetin is also a potent antioxidant. Prior studies have shown the efficacy of Zinc in reducing colds caused by other coronaviruses. Antioxidant, antimicrobial and antiviral roles of Vitamin C are also well documented. Many of these supplements can be taken orally and some can be given intravenously, such as Vitamin C, which has decades of research showing its safety and efficacy. Higher doses of vitamin C have been given by doctors in Wuhan when the outbreak started and some hospitals and clinics in the US have also followed suit. Longer term preparedness would include seeing your doctor for a check up, getting routine blood work done, including immune markers, microbiome markers and micronutrients in order to target supplementation for deficiencies appropriately and to monitor optimal levels for the future.

Keeping mental health a priority is another important aspect of our daily activities during pandemic. With pandemic and economic uncertainties, physicians are seeing more complaints of anxiety and depression. In addition, breaking daily news around the country and the world creates negative emotions that impact hormones, releasing adrenaline and cortisol which can impair immune cells. Taking control of the information overload and limiting TV and social media to a daily minimum of 20-30 minutes can help balance our thoughts, increase parasympathetic nervous system response which will, in turn, improve mood, sleep and health.

Breaking the tradition of making health resolutions for the New Year's, we should take a closer look at what we can do this summer to help nurture our emotional resilience and strengthen our immune system. As we tame our anxieties, safely ending the lockdowns, these health optimizing strategies, whether holistic or medically supervised, can prove to be lifesaving. Going outside for a walk, normalizing sleep hygiene, enjoying the sun for a natural dose of Vitamin D, practicing mindfulness, swimming in the ocean or going for a hike for a minimum of 150 minutes per week are tools in our wellness toolbox which can allow us to ride the wave of COVID-19.

This post is an advertorial piece contributed by a Patch Community Partner, a local sponsor. The views expressed in this post are the author's own.

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COVID - 19: Is There Healthily Thereafter? - Patch.com

So, 2020 has really been a shit year.

It has been for nearly everyone, of course, and when the stuff stops hitting the fan, we all need to take a collective breath, pat ourselves on the back, and celebrate.

I had a busy year planned for 2020: Im a gynecologic surgeon seeing patients and trying to build a badly needed menopause clinic in a local hospital here in Seattle. Im editing a book, and consulting and providing telemedicine care for women in menopause as Chief Medical Officer at Gennev.

Then in January, I got a diagnosis of breast cancer, and suddenly I was making new plans. Somehow I had to carve out five weeks from this life to recover from a double mastectomy, then more time later for recovery from reconstruction. I managed it, barely, to have my first surgery in March.

I thought I had it pretty much under control. My patients were scheduled with other physicians, meetings were on hold, a bunch of work up-front meant I could relax and heal. In February, I went on a vacation to Mexico, where I spent a lot of time crying on beaches and into margaritas with friends. It helped. I came back ready to move forward.

And then COVID-19 hit, and it hit right here at home: epicenter, Seattle.

Suddenly the chaos and noise of my own life have expanded to a global level, and all of us in health care are scrambling to find answers, help others stay calm and safe, keep ourselves as safe as possible on the front lines, and meanwhile Im trying desperately to ignore the little voice inside thats saying, What about me?

As a physician and surgeon, I know what cancer looks like. I have an idea how it progresses and how bad treatment can be. I wanted to get on with it, have the surgery and whatever treatment so I could recover and get back to my life. But with my first surgery scheduled for mid-March, now it looked like those carefully extracted five weeks werent mine anymore.

Oh, and did I mention, suddenly my kids were home all the time? Theyre pretty much grown, so I have it easier than many, but the advanced clusterf*ck of trying to home school an attention-deficit high schooler while sympathizing with my college kid who was missing out on some pretty important stuff in her education and future career (shes a dancer) deflated any zen I managed to scrape together in a hurry.

Story continues

This is a tough time for teens and young adults who rely on their social structures more than ever, and suddenly mine were stuck with a sick mom and Zoom.

Despite being a pretty practical person, I havent always approached my health practically. It wasnt until I was diagnosed as pre-diabetic at 42 that I finally started taking some things seriously. Perimenopause had added some belly fat and bumped up my bad cholesterol, so I at last started exercising regularly and taking medication, since eating better wasnt enough anymore.

However, as someone with a family history of cancers, Im a huge advocate of screening and started annual mammograms at 40.

Now thats irony, Alanis.

As with most women in their 40s, the mammograms showed that I had dense breasts, but nothing particularly concerning.

Then Gennev started working with MiraKind, an organization researching the connection between a gene defect called the KRAS variant and a greater likelihood of developing certain cancers. I got tested, and sure enough, I was a carrier. Knowing being KRAS positive could mean I was more susceptible to breast cancer, I added an MRI to my usual mammogram (remember, dense breasts).

Two days later, they called me and said, So, there are a couple of masses on your MRI. A couple of biopsies revealed invasive ductal carcinoma. More testing, more biopsies, more black and blue boobs.

Now I had a decision to make: I could get bilateral lumpectomies and sign up for a life of going in every six months and probably having to get biopsies every six months. Eventually theyd find something, and Id be right back here again. Im a doctor I knew how Id feel with these things on my chest, knowing there was cancer in them. So I decided on a bilateral mastectomy.

In the end, it was the right choice: there was more cancer that hadnt yet been detected. It was small, sure; but it wouldnt always be small.

The hospital where I would have my surgery started disallowing non-essential surgery the week before my mastectomy was planned. And surgery on anyone who was medically fragile old, ill, likely to respond poorly to anesthesia, etc. was postponed.

I wanted nothing to do with postponing the surgery. I had done everything to make taking those five weeks okay for everyone it affected patients, family, colleagues. Just the thought of redoing all that was exhausting. I had taken the time to take care of me, and dammit, I was going to take care of me!

In the end, it came down to the fact that I was young and healthy going in, so I wouldnt need an ICU bed that was needed for a COVID-19 patient. Id be out the next day. So we went ahead.

On March 19, all my breast tissue was removed.

March and April were spent alternating holding my breath and breathing sighs of relief: biopsy of sentinal nodes revealed no signs of spreading. Testing of the tumor showed it wasnt aggressive enough to require chemotherapy. Because I did what I did when I did it, the cancer was Stage 1. Ill be treated with hormone therapy; Im on Tamoxifen. They got great margins when they did the surgery, and I dont need radiation.

Ask anyone who knows me: Im pretty blunt. Im never unkind, but if a patient wants a lot of touchy-feely handholding, they should probably find another doctor. However. Telling your daughters you have breast cancer is not an occasion for blunt.

Not only was I telling them I was sick, I also knew they would watch me for signs of what was to come for them. Realistic but reassuring is a delicate dance. Fortunately, I was able to be pretty reassuring. It was Stage 1, not a particularly aggressive form, and Id be fine on the other side. But I also wanted to be honest with them about their own health and the screenings theyd need, given their family history.

I could complain about how unfair it is to have bad genetics, or how much it sucks to take care of myself and still have cancer, but I really have a shit happens approach to life, and it served me well. Yelling about how unfair it is as much as I was screaming it on the inside sometimes wasnt going to help me or my kids get through it.

COVID and being isolated together certainly didnt make it easier. This is a hard time for kids their lives are dominated by social things, the groups theyre in, who they communicate with, the things they do. Theyre missing out on things. So managing their emotions and my own is really tough; Im maybe not as patient as I would be otherwise, because Im going through some shit. I have cancer and it sucks. I dont tell them everything because it wouldnt help them. But I try to be open and honest because I know your imagination can sometimes be worse than the truth.

It could be easy to let cancer and COVID take charge and send me screaming to a safe room, but thats really not my style. I take precautions to protect myself from the coronavirus, but Im still seeing patients. I know that as a healthcare professional, Ill get it eventually. I just intend to be at full strength when it happens.

I walk every day, three to five miles with my dog. I run three days a week. Im back in physical therapy because too many hours performing surgery have caused problems with my neck. I truly think staying active has helped with my recovery.

Recovery was tough, not so much because of pain, but because COVID meant my friends and family couldnt help they way they wanted to: they couldnt come clean my house or cook meals, though many dropped meals on my doorstep, rang the bell and ran.

I have two sisters who live locally, and it was killing them not to be able to come and help. One sis is a chef and she just wanted to come and cook for me, but she couldnt come into my house. That was hard, but honestly, it was harder for them than me, since I was pretty out of it for the first two weeks after surgery.

So, yeah, 2020 is a shit year, but at least some things will get easier now. No more mammograms for me, because the reconstruction surgery scheduled for July will be done using my own abdominal tissue. From now on, a check up involves making sure the area around the reconstruction is healthy and cancer-free, including the lymph nodes and chest wall.

I know a lot about health, particularly womens health, because its my job. And I made a lot of decisions, together with my doctors, based on the knowledge I have. I wanted to share a few things that might help others have an easier time of it, COVID or no.

It might not prevent you from having health problems, but being fit can make it easier to handle the treatment and make recovery easier and faster.

Diabetes, cancer, heart disease are all in my family history. Knowing that helped me make better choices. And the KRAS test prompted me to do the MRI that revealed the cancer while it was still early-stage. Knowledge matters.

When I got that pre-diabetes diagnosis, I decided it was time to get a handle on me Ive spent my life caring for others as a doctor, wife, and mom. I was trained in residency to go until you drop. But suddenly I realized I needed to focus on my own health too. I made changes in work and home life, ate better, took meds. I wanted to feel good and I did. And when this came up, I had good endurance, strong muscles, a strong cardiovascular system, even strong legs and abs to help me get out of bed when I couldnt use my arms!

For the past few years, I had managed my sleep patterns to feel better, and through all of this, I managed to for the most part still get good sleep.

Because I made great decisions for a solid few years before this diagnosis, there was a little WTF? that I did everything right and still got this disease. But we live in a toxic world, I hadnt always made great decisions, my work has at times been really stressful, plus, I just had some bad dumb luck. Theres always been that bit of pessimism in me because my family history indicates that I have at least one cancer in my future. But, I thought, this can be dealt with, Im healthy going in, and Ill take this one day at a time.

Ive lost sensation in my chest area. I bump into things, and I dont even know it. Its weird and Im mourning the loss of sensation there, but I knew it would happen, and I was at least somewhat prepared. Make plans. Have a wedge for your bed. Know what the drain looks like coming out of your body. Know who will help you shower and who will make you laugh when your life just has so much yuck in it. Because theres a lot of yuck; youre going to need your sense of humor. And if yours is AWOL, borrow some from a friend.

Just because I knew what was coming doesnt mean I didnt have emotions around it. I had to let myself grieve the loss of my breasts even as I was taking control of the decision to have the bilateral mastectomy. I had to stop being practical and allow myself to mourn.

Living in Seattle, I am blessed with having so many amazing medical professionals in cancer treatment. But I also wanted to work with someone I was comfortable with, someone I trusted with my body, with my future. I needed to feel they were making decisions that worked for me. Please know that youre not hurting a doctors feelings if you decide to move on from them because youre not connecting well with them. It happens all the time, and docs understand how important it is that you feel comfortable. I picked people I felt great with and felt we were making decisions for the same reasons.

Hey, I get a tummy tuck out of this get lemons, make lemonade! Im not exactly going to be voluptuous, but Im good with Bs or even really big As that look nice.

Dont rely on self-breast exams even when I knew where my biggest tumor was, I couldnt feel it. Also, some people are pushing thermograms, claiming theyre safer than mammograms, but they are NOT safer, so do your research before committing. A mammogram isnt perfect, but its a good tool and has saved lives. And you wont get breast cancer from mammograms. The radiation is minimal: you get more from walking around for two weeks in the world. Be informed about your choices before you make them.

I could have put off the reconstruction until next year, when theres a chance COVID-19 will be behind us, and things will be back to whatever normal there is on the other side. But I figured, 2020 is already a hot mess of a year, I might as well shove all the shit into this one and look forward to 2021.

So thats what Im doing. May you get all your shit behind you too. Now go schedule your next screening.

See the original article on ScaryMommy.com

Link:
Im A Physician Who Had Breast Cancer, And Here Are The Knowledge-Based Decisions I Made For Myself - Yahoo Lifestyle