FUNCTIONAL MEDICINE BLOG 

Includes over 800 monographs reporting on emerging studies in the medical and scientific literature of practical clinical importance, easily searched for content.

Calcium supplementation and abnormal calcium in blood and urine

Calcium supplementation is often recommended without careful determination of individual need and tolerance. Conflicting studies have raised the suspicion of an increase in cardiovascular risk associated with calcium (which may occur when the anti-inflammatory effects of magnesium are opposed). A study just published in the journal Menopause offers evidence that for a significant percentage of women modest calcium supplementation produces abnormally high levels in blood (hypercalcemia) and urine (hypercalciuria).

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Antioxidants in excess can increase inflammation and blunt benefits of exercise

Antioxidants, even glutathione, taken in excess can increase rather than ameliorate harmful inflammation...The use of antioxidants must be calibrated with careful consideration of the balance between protective and suppressive effects according to the needs of the individual patient.

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Magnesium: insulin, brain, heart and inflammation

Magnesium may be the critical nutrient most commonly drained by modern environmental stress to suboptimal levels... Recent studies add evidence to its indication for insulin resistance, diabetes, cognitive impairment, atrial fibrillation, cardiovascular disease, and neurogenic inflammation.

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Wine and histamine intolerance

Wine and histamine intolerance can be associated with an array of symptoms depending the degree of impairment of DAO (diamine oxidase) activity and the characteristics of the wine... For patients whose presentation suggests histamine intolerance aggravated by wine, consider assessing DAO activity and compensating with supplemented DAO for impaired production if indicated; the use of flavonoid compounds, notably quercitin; and a suggestion to seek wines higher in polyphenolic and flavonoid compounds.

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Metabolic health status and aging determined by inflammation, not weight

Metabolic health is not reliably determined by weight or BMI (body mass index). Lean individuals can suffer from cardiovascular and other diseases involving metabolism, and evidence has been mounting that supports the notion of a subtype of obesity that is metabolically healthy. Inflammation can determine metabolic health in both obese and non-obese populations.

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Histamine intolerance

Histamine intolerance is a widespread phenomenon that can mimic allergy. It plays a role in many diverse conditions including IBS and inflammatory bowel diseases, asthma, postural orthostatic tachycardia syndrome (POTS), complications of pregnancy, drug hypersensitivity, and intestinal permeability (by means of which it contributes to autoimmunity). It can be objectively evaluated with serum DAO activity. HI can be ameliorated by supplementation with DAO. Practitioners need to be astute in its diagnosis and management.

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Food allergy testing with IgG4 is not recommended

"...food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints."

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Hepatitis C antibody-postive patients need but often don't get confirmatory testing

Hepatitis C infection needs to be confirmed by PCR (RNA or DNA amplification) because antibody levels can remain high for many years after the infection is completely cleared by antimicrobial therapy or innate immunity. This is true for numerous other pathogens as well including Borrelia b. (Lyme disease). A paper just published in The American Journal of Medicine documents that RNA testing for hepatitis C is often not done.

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Iodine deficiency, pregnancy, and autoimmunity

Iodine deficiency is still a serious concern, especially for pregnant women in North America, as reported in a review just published in the journal Thyroid. Despite global improvements since 1990, iodine sufficiency has actually been declining in US adults. Iodine deficiency can be detected with a 24-hour urine collection. Even when supplementation is indicated it must be done cautiously to avoid triggering autoimmune thyroiditis.

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Vagal nerve activity moderates brain-immune relationships and is measured by heart rate variability

An exciting study with tremendous practical significance was just published in the Journal of Neuroimmunology that shows how vagal nerve activity, which can be measured in the clinic by heart rate variability analysis (HRV), is a key moderator of the brain-immune web and determines the immune and physiological responses to acute stress.

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