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.
Thyroid hormone conversion affects hypothyroid treatment
Dosing strategies solely based on a TSH definition of euthyroidism neglect the important role of FT3, which has recently emerged as an equally significant parameter in defining thyroid physiology... in cases where an FT3–FT4 dissociation becomes increasingly apparent following dose escalation of l-T4, an alternate treatment modality, possibly T3/T4 combination therapy, should be considered.
Nitric oxide is essential for red blood cells to deliver oxygen
Nitric oxide built into hemoglobin as βCys93 is required for RBC-mediated vasodilation. Without sufficient nitric oxide, vasodilation and thus oxygen delivery to tissues is impaired.
Increasing calcium intake does not prevent fractures
"Collectively, these results suggest that clinicians, advocacy organisations, and health policymakers should not recommend increasing calcium intake for fracture prevention, either with calcium supplements or through dietary sources."
Adrenal suppression by inhaled steroids is common
A clinical study just published in the European Journal of Endocrinology offers evidence that inhaled steroids...frequently cause serious adrenal suppression. They also show that simply measuring morning cortisol can help indicate whether adrenal insufficiency is occurring.
Stunning discovery links brain and immune system
Investigators report in the prestigious journal Nature the stunning discovery of a central nervous system lymphatic system connecting the brain and immune system.
Insulin resistance indicated by neutrophil-lymphocyte ratio
We recommend that the NLR values of diabetic patients be calculated as NLR is a cheap, predictive, and prognostic marker for IR. High NLR values were independently related to IR.
CKD (chronic kidney disease) expected for 50% over age 30
Chronic kidney disease incidence is rising steeply and projected to affect half the population aged 30 to 64. Key causal factors are metabolic syndrome with insulin resistance and hypertension. These are made worse by added sugars than by salt.
Zoledronic acid ups bone density but doesn't reduce fractures
Zoledronic acid (Zometa®, Zomera®, Reclast®, Aclasta®), like other bisphosphonate drugs, slows bone resorption by binding to bone and inducing apoptosis (killing) osteoclasts, the bone cells that clear old bone to make room for new. A study just published in JAMA Internal Medicine adds to the evidence that this strategy, while improving bone mineral density, may not reduce and may even worsen fractures.
Fatigue: inflammation and autoimmunity
Severe fatigue, associated with chronic fatigue syndrome (CFS) or another disorder, has as a core underlying cause chronic inflammation...there are sufficient robust multiple lines of evidence to support the proposition that the severe fatigue and profound disability experienced by people with the neurodegenerative, neuro-immune and autoimmune diseases discussed here is largely driven by peripheral immune activation and systemic inflammation either directly or indirectly by inducing mitochondrial damage.
Calcium supplementation may increase macular degeneration
Calcium supplementation has previously been associated with cardiovascular risk (search 'calcium' for earlier posts), most likely by opposing the anti-inflammatory activity of magnesium. A study just published in JAMA Ophthalmology offers evidence that calcium supplementation may similarly promote age-related macular degeneration (AMD).
Blood donation? Great. Take some iron after.
According to a clinical trial recently published in JAMA, iron supplementation after blood donation may prevent you from becoming anemic and very likely greatly reduce the time it takes to recover a normal ferritin level.
Flu vaccination: worthwhile for most?
For each healthy adult, a Cochrane review found that vaccination saved an average of just 0.04 days off work and concluded that no evidence supported it as a routine public health measure.
Subclinical hypothyroidism in pregnancy
Subclinical hypothyroidism has been associated with multiple adverse maternal, fetal, and neonatal outcomes...On the basis of current evidence, we believe it is reasonable to recommend treating women with new onset subclinical hypothyroidism during pregnancy.
Overactive bladder: urine is not sterile
Overactive bladder, and the often more painful condition interstitial cystitis (IC) and painful bladder syndrome (PBS) occur in the absence of infection and should be investigated for an autoimmune basis...A fascinating paper just published in the Journal of Clinical Microbiology demolishes the dogma that urine is sterile by using advanced methods to prove that the urinary bladder has its own microbiome.
Fatigue commonly caused by iron deficiency without anemia
Fatigue, often accompanied by depression and anxiety, frequently has iron deficiency shown by suboptimal levels of serum ferritin but occurring without anemia. This often goes unrecognized in clinical practice.
Nuts reduce inflammation and all-cause mortality
In the absence of allergy, the evidence supports the consumption of nuts as wholesome foods with anti-inflammatory and metabolic benefits, exactly what paleo diets intend to accomplish.
Gout: updates in diagnosis and treatment
Gout diagnosis is rendered less invasive and more practical in the general clinical setting and treatment more sustainable by recent advances.
Nigella sativa, a true 'wonder medicine'?
Nigella sativa, also known as black cumin, produces seeds with a mind-boggling wealth of medicinal virtues. For colleagues and others who may not be familiar with the abundance of scientific evidence for the use of Nigella sativa seed extract in clinical practice, this selection of citations serves as an introduction to its wide range of indications.
Acne, a disorder of dysregulated inflammation
Acne vulgaris case management with sustainable, functional methods requires its recognition as a disorder of inflammation associated with loss of immune tolerance for a commensal skin bacteria.