Let it Flow, Let it Flow, Let if Flow!

Those of us in the Biomedical Sciences Master’s Program recently read a paper by Dr. Campisi on the disadvantages women experience when exercising in their luteal phase of their menstrual cycle. This got me thinking about how many athletes, especially elite runners, don’t have their menses due to the intense training plan and what impact that suppression could have on their health.

As everyone knows puberty for young females is marked by their first menses (period), which for most people will continue to occur monthly unless otherwise prompted. In normal puberty, gonadotropin-releasing hormone (GnRH) is released by the hypothalamus in a pulsatile fashion, and stimulates both the synthesis and secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the anterior pituitary (Golden and Carlson, 2008). FSH and LH are important because when they are released they promote ovulation, which then stimulates the ovaries to release estradiol and progesterone. Amenorrhea, the absence of a menstrual cycle, is caused by the suppression of the hypothalamus secreting GnRH. This leads to no release of LH or FSH, no stimulation to the ovaries, no release of estradiol or progesterone, and no menses. It has been found that long term amenorrhea, especially in adolescents, can lead to cardiovascular, bone density, and psychiatric issues in the future. 

One of the most important hormonal factors responsible for bone health is estradiol. By stimulating osteoblast (bone-building) activity, estrogen promotes the formation of certain growth factors including transforming growth factor beta (TGF-β), insulin-like growth factor 1 (IGF-1), and bone morphogenetic protein 6 (BMP6) (Meczekalski, et al, 2010). But if estrogen is never being released then bone formation and growth can’t continue. So, those who experience absence of a menstrual cycle for an extended amount of time are at increased risk for bone disorders like osteoporosis or osteopenia.

At the vascular level, estrogen-mediates inflammation, oxidative stress and over long-term estrogen increases endothelial-cell growth and inhibits smooth muscle cell proliferation (Shufelt, et al 2017). A study done on monkeys found that those who had low levels of FSH, LH, estradiol, and progesterone were at higher risk for cardiovascular disease. But when they were supplemented with oral estradiol their risks decreased. Further supporting the importance of having regular menses.

The presence of estrogen influences many areas of the brain including to the hypothalamus, cerebellum, nigrostriatal and mesolimbic system, amygdala, hippocampus, cerebral cortex, and brainstem (McEwen, et al, 2012). It has been found that estradiol is linked with levels of serotonin and dopamine, which is related to depression. Women with amenorrhea have significantly higher depression scores, greater anxiety, and increased difficulty coping with daily stress as compared to healthy controls (Shufelt, et al 2017). While there are many factors that can influence one’s mental health, it appears that one of the easiest ways to maintain it is by having regular menses. 

While it may be advantageous to not have a menses when exercising, it is not advisable to suppress it long term, especially in adolescence. Many females start birth control in adolescence, which could lead to an ethical discussion involving the principals of beneficence and non malfeasance, as birth control has been known to suppress mensuration.

References

Golden NH, Carlson JL. The pathophysiology of amenorrhea in the adolescent. Ann N Y Acad Sci. 2008;1135:163-78. doi: 10.1196/annals.1429.014. PMID: 18574222.

Meczekalski B, Podfigurna-Stopa A, Genazzani AR. Hypoestrogenism in young women and its influence on bone mass density. Gynecol Endocrinol. 2010 Sep;26(9):652-7. doi: 10.3109/09513590.2010.486452. PMID: 20504098.

McEwen, B. S., Akama, K. T., Spencer-Segal, J. L., Milner, T. A., & Waters, E. M. (2012). Estrogen effects on the brain: actions beyond the hypothalamus via novel mechanisms. Behavioral neuroscience, 126(1), 4–16. https://doi.org/10.1037/a0026708

Shufelt, C. L., Torbati, T., & Dutra, E. (2017). Hypothalamic Amenorrhea and the Long-Term Health Consequences. Seminars in reproductive medicine, 35(3), 256–262. https://doi.org/10.1055/s-0037-1603581

Is Caffeine Worth the Risks in Athletes?

       Take a step into any college athletic team locker room and I guarantee you will find a plethora of powders, cans, and bottles of caffeinated drinks. Caffeine is a very popular drink for athletes and non-athletes, but I wanted to learn why caffeine is highly consumed in the athlete population. 

Caffeine has very little, if any, nutritional value. Caffeine stimulates the vasodilation of blood vessels, neural activation of muscle contraction, blood filtration in the kidneys as well as many other things. It targets many different systems in the body within the sympathetic nervous system such as the central nervous system (increases mood and alertness, decreases feelings of pain and fatigue), muscular system (increases endurance and speed), cardiovascular system (increases heart rate). It also increases the level of oxygen uptake, ventilation, levels of epinephrine, and lowers the threshold for exercise-induces cortisol and B-endorphin release (2008, Sökmen et al.). From what I found, it seems as if caffeine heightens the body’s ability to react in a similar way that stress responses do naturally. 

It is unclear if caffeine enhances performance for a long period of time. In the study I looked at, caffeine improved strength and performance for sprints and power workouts that were less than 10 seconds. In repeated maximum exercise exertions that lasted 15 seconds to 3 minutes, caffeine had little to negative effect for sprint and power performance (2008, Sökmen et al.). Over time, it is common to see athletes become tolerant to caffeine and need higher doses of caffeine to feel the same alertness and observe the same effects. This is problematic because higher doses of caffeine can increase tremors, insomnia, and heart rate (2019, Pickering & Kiely). It is also common for athletes to experience caffeine withdrawal in the form of constant headaches due to the vasodilation of cerebral blood vessels in response to the body’s newly formed dependency on the drug.

Even though caffeine can improve the performance of athletes, there are negative side effects to it as well. Caffeine can pass through all biological membranes because it is both hydrophilic (can distribute freely into the intracellular tissue) and lipophilic (can readily cross the blood-brain barrier) (2001, Institute of Medicine Committee on Military Nutrition Research). Due to its ability to spread throughout the entire body, effects such as decreased sleep, increased anxiety, dehydration, restlessness, and rapid heart rate all come from ingesting caffeine (2011, Snel & Lorist). 

Overall, caffeine physiologically does increase various systems that can help an athlete’s overall performance. I am not convinced that it greatly improves their ability to perform, but as long as dependency does not set in it is not bad for the body; however, there are negative effects to it such as sleep deprivation and increased anxiety that are arguably worse for an athlete than performing without caffeine. At the end of the day, athletes are going to do what makes them feel their best, and consuming reasonable amounts of caffeine is not a terrible choice. 

Snel, J., Lorist, M. (2011). Effects of Caffeine on Sleep and Cognition. 190 105-117. https://www-sciencedirectcom.dml.regis.edu/science/article/pii/B9780444538178000062. 

Graham, T.E., Hibbert, E., & Sathasivam, P. (1998). Metabolic and Exercise Endurance Effects of Coffee and Caffeine Ingestion. https://journals.physiology.org/doi/full/10.1152/jappl.1998.85.3.883. 

Institute of Medicine (US) Committee on Military Nutrition Research.(2001). National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK223808/. 

Sökmen, B. et al. (2008). Caffeine Use in Sports: Considerations for the Athlete. Journal of Strength and Conditioning Research. 22(3) 978-986. https://journals.lww.com/nsca-jscr/Fulltext/2008/05000/Caffeine_Use_in_Sports__Considerations_for_the.47.aspx. 

Kiely, J. Pickering, C. (2019). What Should We Do About Habitual Caffeine Use in Athletes? Sports Medicine. 49 (833-842). 

It’s Bird… It’s A Plane… It’s A… Superfood?

Blueberries, sweet potatoes, salmon, oh my! 

It has become increasingly prevalent in our society to hear about “superfoods”. They are in our smoothies and salads and yogurt cups. But, does anyone know what they actually are? What do they do? Why are they called superfoods? Furthermore, do they do “super” things for our body, like decrease stress levels? 

Colloquially speaking, a superfood is a food that is nutrient rich with compounds like antioxidants, fiber, and or fatty acids. They are said to be beneficial for health and well being. Scientifically speaking, there is no true definition of a super food; the term was created by a banana company in the early 20th  century to sell more bananas. Scientists do recognize that certain foods offer high levels of desirable nutrients and are linked to promoting personal health and wellness or preventing disease and sickness, but the actual term carries very little scientific meaning (Staab 2021). The actual term “superfood” is a marketing term for food companies, and a lucrative one at that. Many consumers are looking for healthy, nutritious options, and when they see the word “superfood” on a label they are much more likely to buy the product, even though there is no real scientific meaning behind the word (Staab 2021). 

That being said, some foods are still just really good for you, even though calling them a superfood is not necessarily scientifically accurate. My favorite example of a “superfood” is sweet potatoes (Diederichs 2009). Sweet potatoes are a great source of vitamin A and fiber. Another great example of a “superfood” are blueberries. These little guys are packed with antioxidants and fiber; there is a lot of research coming out saying they might aid in memory function and aging (Diederichs 2009). 

Another thing eating these “superfoods” can do for you is lower stress. Unhealthy eating can add to the stress your body experiences, and affects the way your body is able to respond to stressful situations. High stress can leave you depleted of nutrients, as being in a flight or fight mode requires you to use a lot of energy. Stress can also cause inflammatory responses. In a book called Stress in Health and Disease, An Issue of Psychiatric Clinics of North America, a study is discussed in which individuals with high perceived stress levels consumed either fish oil high in omega-3 fatty acids, or a placebo. At the end of six weeks, their stress levels were measured again. They found that the group that had consumed fish oil every day had stress levels significantly lower than when they started (Kirsch 2014) . This supports the hypothesis that consuming food high in omega-3 fatty acids, like salmon, will lower perceived stress over a prolonged period of time. The article discussed other ways in which healthy eating affects the way your body handles stress, including lowering inflammation, improving cognition, and an overall lower perceived stress level (Kirsch 2014). 

So what does this mean for us? Probably that we all need to have better, more balanced diets. This is something that I am continuously working at; some weeks I do better than others. Mostly, I think I feel more encouraged to eat better now that I know it not only affects my physical health, but also my mental and emotional health through the increase (or decrease) of stress.

Staab, J. (2021). What makes Superfood so Super? UC Davis. 

from https://www.ucdavis.edu/food/what-makes-superfood-so-super. 

Diederichs, Katie (2009) "Superfoods," Ethos: Vol. 2009 , Article 4. 

http://lib.dr.iastate.edu/ethos/vol2009/iss4/4. 

Kirsch, Daniel L. (2014) Stress in Health and Disease, An Issue of Psychiatric Clinics of North

America. 

In-SALT to injury

What is a Mukbang:

    The term Mukbang is a Korean term for 'eating show', originating from South Korea has in recent years become a popular trend/challenge to eat copious amounts of food while filming yourself. In 2020 during the midst of the COVID-19 pandemic, the 1-gallon pickle jar challenge became prevalent on the internet mukbang community. 

The 1-gallon Pickle challenge:

    The average jar of pickles contains 210mg of sodium per serving. In a 1-gallon jar of pickles, there are approximately 70 servings, equating to 14,700 mg of sodium. To maintain the homeostasis in the human water-salt balance we only need 500mg of sodium, Americans on average ingest 3400mg of sodium. In October of 2021, a popular YouTuber posted a video reenacting a case study that he had encountered the previous year concerning the challenge causing nearly fatal hypernatremia.   

Overview: A mukbang fanatic watched the pickle challage done previously expressing the health benefits of pickles, and how there was only health benefits concerning the challange. Excited the woman went to the grocery store bought her gallon jar of pickles and began to set up her camera. In the course of an hour the woman injested all of the pickles withen the jar, and finished the video off by drinking the juice. My previous calculations dont concider the sodium amount in the brine, so it is safe to estimate that this particular indevidual consummed well over 1500mg of sodium. The patient in question becan to experience extreme diarrhea, her muscles began to cramp and her head started hurting. Shortly after being delivered to the hospital began so experience sesures. The salt intake was too much an effectively caused her kideys to fail as water was leeched from her body. Thankfully, doctors were able to reestablish salt water balance via intervenous fluids. 

The Problem: 

    

    The importance of sodium in the body's water balance and the electrochemical gradient is something biological students have gotten to know more intimately than the general public. In the history of internet trends, this isn't the first instance of danger that seems idiotic to attempt (i.e tide pods, the cinnamon challenge, the outlet challenge, Benadryl challenge, and the choking-out game), and most definitely be the last. However, is there an ethical obligation of the medical community to talk to their younger patients about these social media trends? This may seem like a very benign question to ask but there has been some backlash from parental figures wishing that their children never hear of these challenges as the best preemptive measure. 

Under biomedical ethics; non-maleficence, beneficence, autonomy, and justice can there or should there be educational standards doctors are required to inform their patients with? Lastly, consideration should also be focused on if there is anything that can be done to prevent dangerous misinformation leading to cases such as this.

Farquhar, W. B., Edwards, D. G., Jurkovitz, C. T., & Weintraub, W. S. (2015). Dietary sodium and health: more than just blood pressure. Journal of the American College of Cardiology, 65(10), 1042–1050. https://doi.org/10.1016/j.jacc.2014.12.039

KEVIN G. MODER, M.D., DANIEL L. HURLEY, M.D (1990)Fatal Hypernatremia From Exogenous Salt Intake: Report of a Case and Review of the Literature DOI:https://doi.org/10.1016/S0025-6196(12)62194-6

A Mukbanger at a 1-gallon jar of pickles: https://www.youtube.com/watch?v=gF69voHU_ys

It's not you... It's your motha... (Prenatal Stress)

The purpose of the study was to evaluate how prenatal stress affects sexual hormones, sperm quality, quantity of ovarian follicles, and fertility. The stressor was immersion in cold water of the female rats in their last week of pregnancy (day 15-21). After birth, the offspring were weaned, weighed, and isolated into males and females. The offspring were weighed at birth, weaning, and adulthood. Body weight gain was lower in male and female offspring that were exposed to stress at all evaluated stages. The HPA axis being stimulated by stress explains the lower body weight regardless of having food accessible. This could also be due to CRH, leptin, and other food-intake controlling hormones being altered. Additionally, dams’ corticosterone levels were evaluated, and the results had shown nearly three orders of magnitude higher levels of stressed dams compared to control. Offspring count did not show significance in the study, as the control and stressed group had similar numbers. However, vaginal smears of stressed female offspring compared to control offspring showed significant results of estrous cyclicity (p = 0.0001). Stressed female offspring had longer estrous cycles or had incomplete cycles. This also correlated with lower levels of estradiol, and low serum progesterone (p = 0.003). Specifically with male offspring, testicular relative weight was lower in stressed males compared to the control males (p = 0.004). This could be due to higher apoptosis index in germinal cells. Thus, sperm quality was lower in stressed male offspring as well. (P = 0.05). The sperm quality could be observed by abnormality in the head and/or tail. This ties into only 70% of stressed males impregnating control females whereas 100% of control male impregnated control females. When both stressed male and female were introduced, only 50% were impregnated (p = 0.0024). In conclusion, prenatal stress does cause alteration in females and male progeny. Alterations specifically in weight, sperm quality, testicular cell death, infertility, and lower levels of hormones.

García-Vargas D, Juárez-Rojas L, Rojas Maya S, Retana-Márquez S. Prenatal stress decreases sperm quality, mature follicles and fertility in rats. Syst Biol Reprod Med. 2019 Jun;65(3):223-235. doi: 10.1080/19396368.2019.1567870. Epub 2019 Jan 28. PMID: 30689429.

Colon In The Chest: Cadaver Case Study

 

Muscle Cramps and Pickle Juice?

        Athlete or not, you have probably had muscle cramps before. If you have not, count yourself lucky as they are not super pleasant experiences. If you have had a muscle cramp before, you might have been told to drink pickle juice, but does that actually work? Skeletal muscle cramps, or exercise-associated muscle cramps (EAMCs) are involuntary contractions and spasms that arise from extended periods of exercise (Marosek, Antharam, & Dowlatshahi, 2020). There are three theories as to why these EAMCs occur. One is dehydration which proposes that a lack of water causes tissue space around muscles to shorten which increases pressure. Another is that loses of potassium, sodium, magnesium, and calcium cause EAMCs. The last is a neuromuscular cause (Marosek, Antharam, & Dowlatshahi, 2020). Of the three propositions, the first two have been found to be unlikely causes through various studies, but the neuromuscular cause is promising. The idea is that acetic acid, which is present in pickle juice, causes, through a series of steps, an oropharyngeal reflex. This reflex possibly triggers certain neurological sensory outputs (Marosek, Antharam, & Dowlatshahi, 2020). 

        Another reason why pickle juice might work, is because acetic acid has also been found to release inhibitory amino acids in the spinal cord that might “override” the contracting fibers in the muscles (Marosek, Antharam, & Dowlatshahi, 2020). Acetic acid also produces acetylcholine which causes muscle contractions. This may seem as if acetic acid would then make muscle cramps worse, but an enzyme named acetylcholinesterase ultimately relaxes muscles by breaking down acetylcholine to impede EAMCs (Marosek, Antharam, & Dowlatshahi, 2020).

        Despite finding this study that supports pickle juice ingestion in response to EAMCs, there are concerns that pickle juice either still does nothing, or that it could dehydrate athletes due to the high sodium content causing hypertonicity (Miller, Mack, & Knight, 2009). The study by Miller, Mack, & Knight found that small amounts of pickle juice did not cause substantial changes in plasma electrolyte concentrations which may indicate that concern for dehydration-induced hypertonicity is no necessary (Miller, Mack, & Knight, 2009). As to the question of does pickle juice really work, people are still split despite physiological and biochemical support in favor of it. However, if it works for you and helps those extremely painful and debilitating muscle contractions go away, then why not take a shot of pickle juice that is full of acetic acid, if you can stomach that!

Marosek, S., Antharam, V., & Dowlatshahi, K. (2020). Quantitative analysis of the acetic acid content in substances used by athletes for the possible prevention and alleviation of exercise-associated muscle cramps. National Strength and Conditioning Association. 34(61) 1539-1546. https://pubmed.ncbi.nlm.nih.gov/32459412/. 

Miller, K., Mack, G., & Knight, K. (2009). Electrolyte and plasma changes after ingestion of pickle juice, water, and a common carbohydrate-electrolyte solution. Journal of Athletic Training. 44(5) 454-461. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742453/. 

Do T-Cells Need Friends?

 When reading scientific articles, it is tempting to scan over the abstract, synthesize the results, and extract relevant information to you; however, more is necessary. Working in the Exercise Immunology Lab at Creighton University revealed that the nuances of research matter and demand attention. My lab's goal was to study the effects of exercise on HIV patients and to understand how T-cell expression changes depending on people's body composition. While preparing for these studies, I found major inconsistencies in other exercise immunology results. Assessing the ambiguity of methods behind these differences became the foundation for my Honors Research Project. Where some groups of researchers used cell samples comprised of only one type of cell (homogenous) others used a full blood sample (heterogenous). The problem with this difference is that our T-cells and other cells do not live in isolation. Rather, the interconnected and communicative nature of cells (clearly shown in physiology and immunology) is what drives physiological changes, differentiation, proliferation, and signaling.  In the lab, my comparison of methods that mimicked the ambiguity of the literature showed just this. Depending on the concentration of cells and the type of cell sample, proliferation vastly changed. The fact that T-cells (relevant to the newer field of exercise immunology) and other cells respond differently depending on their surrounding culture has a few implications worth mentioning. The first is that without a centralized methodology, much of the research done in exercise immunology is difficult to use for comparison and may even need to be re-researched in a consistent manner. As the field expands, something like methods quickly alters the credibility of our current immunocompetence knowledge. In application, the theories of T-cell activation such as the Danger Theorem or Quorum Activation Hypothesis greatly differ based on methodology and leave us with less than clear understanding. Next, while this situation is just as applicable to other research fields. As students and aspiring professionals, paying attention to methodology and how well it mimics physiological conditions may change the validity of results. While we often consider ethics and validity of the experiment, we need to also consider methodology. Finally, new understandings--such as the fact that T-cells do need friends for proper proliferation--is not foreign to careers in science. Giving greater level of attention to research gives us a better critical eye for legit results and hopefully will also translate to appropriate patient care.

Siedlik JA, Benedict SH, Landes EJ, Weir JP, Vardiman JP, and Gallagher PM. Acute bouts of exercise induce a suppressive effect on lymphocyte proliferation in human subjects: A meta-analysis. Brain, behavior, and immunity 56: 343-351, 2016. 

Al-Yassin, Ghassan A. and Bretscher, Peter A.. Does T Cell Activation Require a Quorum of Lymphocytes? The Journal of Immunology. 201 (10) 2855-2861, 2018. 3. 

Got Oxygen?

In genetics we have been talking about human adaptations, which are biological adaptations we have made due to our environment. One of the adaptations that we discussed was the adaptation of a larger spleen. This was found in the Sea Nomads of Southeast Asia. These people live at sea on small boats and due to this way of life they get food mostly through diving. So, being able to hold their breath for long periods of time is quite advantageous. Over the years they have developed a genetic mutation that allows them to have a larger spleen. The spleen holds oxygenated red blood cells, so presumably an enlarged spleen – those of the sea nomads, or Bajau people, are about 50 percent larger than the spleens of unrelated, non-diving neighboring groups – injects more blood cells into the circulation and makes more oxygen available for basic body functions during prolonged dives (Sanders, 2018). 

What is even more interesting is the physiological mechanism that is believed to be contributing to this adaptation. Levels of the thyroid hormone T4 have been shown to dramatically affect spleen size in mice, suggesting that the observed large spleens of the Bajau result from modulation of thyroid hormone regulation. (Illardo and Nielsen, 2018). 

In physiology we learned that there are three types of thyroid hormones including thyroid stimulating hormone (TSH), triiodothyronine (T3), and tetraiodo-thyronine (T4). Thyroid releasing hormone (TRH) is produced in the hypothalamus. When it is released it activates the anterior pituitary gland to release TSH. This then stimulates the thyroid gland to secrete T3 and T4. All three of these thyroid hormones are important for regulating metabolism, growing tissues, ATP consumption, and increasing CV, respiratory, and renal activity (Campisi, 2021). A common medical issue that can arise from elevated thyroid levels is hyperthyroidism, which is when your thyroid gland produces too much of the hormone T4. This can lead to a host of issues including weight loss, irregular heartbeat, fatigue, issues sleeping, and tremors (Pruthi, et al, 2020). While significant research still needs to be done to evaluate what is causing these enlarged spleens, the survival benefit is quite evident. However, as a health care provider how do you treat this population? Do you treat their hyperthyroidism due to all the issues elevated thyroid levels can cause, or do you let it go so that they can have the added benefit of being able to hold their breath longer thus allowing for their survival? Either way, evaluating the biomedical principles of nonmaleficence, beneficence, and autonomy will have to be taken into account. 

Campisi, J. 2021, October 6. NS Organization of Endocrine

Ilardo, M., & Nielsen, R. (2018). Human adaptation to extreme environmental conditions. Current opinion in genetics & development, 53, 77–82. https://doi.org/10.1016/j.gde.2018.07.003

Pruthi , S., Acosta, A., Arora, A., Bakkum-Gamez, J., Bakri , S., Baughn , J., Bhatti , M., Gogle , J., Bower , J., Burnett , T., Butler Tobah , Y., Castro , R., Chang-Miller, A., Chebib , F., Creagan , E., Cutsforth-Gregory , J., D'Andre , S., DeSimone, D., David Dingli, … Zhou, M. X. (2020, November 14). Hyperthyroidism (overactive thyroid). Mayo Clinic. Retrieved October 21, 2021, from https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659. 

Sanders, R. A. 19. (2018, April 20). Enlarged spleen key to diving endurance of 'sea nomads'. Berkeley News. Retrieved October 19, 2021, from https://news.berkeley.edu/2018/04/19/enlarged-spleen-key-to-diving-endurance-of-sea-nomads/.

Can facebook use decrease stress?

In an attempt to keep my phone in my pocket this week, I have decided to take a break from social media. Instagram, Facebook, Tik Tok and other social media platforms have become a major part of my life and I often feel like I am being consumed in the addicting algorithms. While I do find a lot of enjoyment in posting and viewing pictures and activities, it is very common become trapped in all of the negativity that "scrolling" brings. Studies have shown that the use of Facebook has been associated with constructs such as greater distress, induction of negative social comparison, and lower self esteem in addicted and problematic users. My "social media cleanse" led me to do a bit of research on the impacts of social media and stress and I found something interesting.

A study done by Rus and Tiemensma examined how Facebook influences reactivity to acute social stressors. They had participants use facebook before experiencing an acute social stressor. Facebook users reported lower levels of psychosocial stress, physiological stress and rated the stressor as less threatening. These results suggest that Facebook use could buffer stress if used before experiencing an acute social stressor. These findings are understandable when considering the benefits of facebook use; feelings of increased self esteem, enhanced social support, general well-being, and overall life satisfaction. 

Social media platforms have many benefits and now have been found to possibly act as a buffer for acute stress, but to what extent does social media have a positive impact? Personally, using instagram and facebook can lead to toxic thoughts of comparison, negative self talk and fear of missing out (FOMO). This study was incredibly interesting in that it offered a unique stance on social media and stress. 

Here is the study:

Rus, H. M., & Tiemensma, J. (2018). Social media as a shield: Facebook buffers acute stress. Physiology & Behavior, 185, 46–54. https://doi-org.dml.regis.edu/10.1016/j.physbeh.2017.12.021

Stretch Baby Stretch

            As a weightlifter, I depend on my body’s mobility to perform lifts correctly, and under a certain amount of weight. Without mobility and flexibility, my lifting ability diminishes. Recently, I’ve noticed that my mobility isn’t where I want it to be, and it started to hold me back from heavy lifts. I tried to figure out what I could do to fix it – do I lift more with better technique, do I just practice until it *clicks, * what could I do? The answer is simple – yoga. 

            Mobility is defined as the ability to move body structures or parts of the body through the existing range of motion for a functional activity (functional range of motion) (Vauhnik et al. 2014), and this is also strongly associated with joint integrity (Vauhnik et al. 2014). As many may or may not know, yoga tries to target imbalances in the body, and a lot of that comes from muscle imbalances/shortness. This can occur due to a result of physical inactivity and[/or] putting irregular or excessive pressure on muscles and other soft tissues crossing or surrounding joints (Vauhnik et al. 2014). You know, us athletes know this all too well – all of us are stronger on one side than the other. This shortness Vauhnik talks about can occur in the muscles responsible for maintaining our posture (or lack of it), and other muscles may respond to this imbalance by weakness under incorrect or excessive pressure (Vauhnik et al. 2014). Here, the target of yoga is to improve flexibility enabling us to easier and better use our muscles in everyday activities. For this we need appropriate flexibility of muscles that maintain posture (tonic muscles) and adequately strengthened muscles which are responsible for the movement of the distal segments of the body (phasic muscles) (Vauhnik et al. 2014). Not only is yoga important for fluid flexibility of our muscles, it also improves joint mobility as well, since this is based on gradual stretching of muscle and connective tissue around bones and joints (Vauhnik et al. 2014). Because of this, the latter provide straight-line compression and lubrication of articular cartilage by the synovial fluid, thereby bringing fresh nutrients and oxygen to those parts of joint cartilage which are rarely used in everyday activities (Vauhnik et al. 2014). This may prove to be of particular importance when looking at people with knee osteoarthritis. A study (as well as one of their reference studies) looking at this found a few things. The reference study had set-up an integrated yoga therapy program in a non-residential camp set up for one week without any physiotherapy intervention. [It] showed a 40% reduction in resting pain after yoga (Nagarathna et al. 2012), while in Nagarathna’s study, they added yoga after the standard physiotherapy which showed a reduction in resting pain scores by 33.6 and 71.8% after 15 and 90 days respectively (Nagarathna et al. 2012), also showing reduced joint stiffness ratings as well. To be able to reduce pain in a demoralizing disease such as osteoarthritis (which, in extreme cases, can reduce quality of life), is extraordinary, through something as simple as stretching. I think that’s pretty remarkable, knowing that there’s ways around degenerative diseases as well as poor mobility issues in healthy individuals, making getting older a tad bit sweeter. 

 

 

 

 

 

Nagarathna, Raghuram, et al. “Effect of Integrated Yoga Therapy on Pain, Morning Stiffness and Anxiety in Osteoarthritis of the Knee Joint: A Randomized Control Study.” International Journal of Yoga, vol. 5, no. 1, 2012, p. 28. Crossref, doi:10.4103/0973-6131.91708.

 

 

Vauhnik, Renata, et al. “The Impact of Hatha Yoga Practice on Flexibility: A Pilot Study.” Alternative & Integrative Medicine, vol. 03, no. 02, 2014. Crossref, doi:10.4172/2327-5162.1000160.

Bleeding and the Bones. Period.

            As being a female athlete, I have to deal with something that male athletes never have to deal with – a menstrual cycle. As all of my fellow females can contest to, menstrual cycles are not fun, and I think many of us ladies have imagined what it would be like to have it disappear. Not having our menses seems fantastic at first, however, the absence of the menses would set up a series of devastating consequences in the long term, affecting any female. 

            Everyone can agree that as an athlete, the health of your skeletal system is adamant for proper performance and well-being whether you’re male or female. More often than not, females are put under more extreme circumstances, forcing us to meet certain leanness and body fat percentages (Rogers 2021), and often both internal and external pressures from sports result in a female taking her body to the extremes to meet such demands, resulting in menstrual irregularities, namely amenorrhea (Rogers 2021). Amenorrhea is the absence of a regular menses. There are two types, primary and secondary. In this post, I will specifically talk about secondary amenorrhea, which is cessation of a regular menses for three months or more or the cessation of irregular menses for 6 months or more (Rogers 2021). This has some very concerning consequences on the skeletal system, because not only does this situation compromise an individual’s ability to achieve peak bone mass, it also may increase the risk of bone related injuries and potentially lead to osteoporosis in the long-term (Rogers 2021). This is honestly scary, because the female menstrual cycle juggles with a number of hormones, such as progesterone, estrogen, and estradiol, to name a few, and these hormones also have a correlation with bone health. Estrogen is an inhibitor of bone turnover and helps to maintain the balance between bone resorption and formation (Rogers 2021), while progesterone and estradiol protect against bone loss and also slows the rate of bone remodeling (Rogers 2021). When these hormones are not doing what they’re supposed to be doing, or, when they aren’t present anymore, like during amenorrhea, this is when bone complications begin to arise. And to put amenorrhea aside for a moment, it is [also] important to stress that the female sex per se is more prone to have osteopenia or osteoporosis because the optimal PBM reached by females is 25–30 % lower than in males (Meczekalski et al. 2014) in a healthy female. When such menstrual irregularities surface, it just increases the deteriorating domino effect. To finally understand some of the detrimental long-term consequences on the skeletal system from a menstrual irregularity is eye-opening, and, frankly, should be something made more public. Studies regarding menstrual irregularities and bone complications could also shed light on hormonal birth control affects, and how synthetic hormones within birth control could possibly help such dysfunctions. 

Rogers, Stacey. “Bone Health, Birth Control and the Female Athlete.” JPS Health & Fitness, 3 Feb. 2021, www.jpshealthandfitness.com.au/bone-health-birth-control-and-the-female-athlete.

 

Rogers, Stacey. “Menstrual Cycle Dysfunction in Female Athletes.” JPS Health & Fitness, 20 Jan. 2021, www.jpshealthandfitness.com.au/menstrual-cycle-dysfunction-in-female-athletes.

 

Meczekalski, B., et al. “Functional Hypothalamic Amenorrhea and Its Influence on Women’s Health.” Journal of Endocrinological Investigation, vol. 37, no. 11, 2014, pp. 1049–56. Crossref, doi:10.1007/s40618-014-0169-3.

Modere Liquid Biocell- Hydrolyzed Chicken Sternal Cartilage Extract Providing Hydrolyzed Collagen Type II Peptides

 A few years ago, I bought a bottle of Modere Liquid Biocell because I had been interested in trying collagen to improve skin health. The liquid biocell in this product is made by using chicken sternal cartilage extract. I drank the recommended amount in the morning, that night when I laid down, I felt sick to my stomach. I tried drinking it one more time a few days later but the same thing happened. I didn’t use this product again and my stomach problems went away. 

When first searching the web to see if other users experienced similar side effects, I didn’t find much considering the amount of Modere’s paid advertising. Modere pays fitness websites, influencers on YouTube and countless other people to recommend their products. It’s untruthful for someone to promote a product they claim they use regularly when their followers aren’t aware they’re being paid to promote the product. After tons of digging, I finally found a large group of people that have experienced side effects including headache, nausea, upset stomach, vomiting and diarrhea. The use of cartilage extract providing hydrolyzed collagen type II peptides can cause the body to become too acidic resulting in the body trying to reject the ingested substance.

 

 Modere has been criticized for over exaggerated claims with limited research to back those claims. Over exaggerating is necessary to increase the perceived value and to justify the expensive price. The benefits of this product are exaggerated by sales representatives to hit sales goals. Modere isn’t approved by the FDA and hasn’t had sufficient research to make such exaggerated claims. 

 

It was stated in a study by the FDA that “No animal studies have been conducted in which the toxicity of Peptan II was evaluated. However, the safety of the proposed use of Peptan II is supported by a lack of adverse effects reported in 2 animal studies of a product containing 10% hyaluronic acid, 60% type II collagen, and 20% chondroitin sulfate (BioCell® Collagen II)” (Schauss et al., 2007). “A lack of reported side effects” isn’t saying much when the testing was performed on rats who don’t have the ability to vocalize the side effects they experienced. 

There’s not enough transparency when reporting the side effects of this product. Side effects aren’t printed on the product, making it harder to track experienced side effects back to the product.

 

Modere has had over 76 complaints to the BBB in the last 12 months. (Modere, Inc.: Better Business Bureau® profile). Modere has a multi-level marketing strategy, also called a pyramid scheme which is a controversial type of business. Modere has had multiple lawsuits filed against them for unethical business practices. 

 

A key takeaway is to pay attention to anything you add or remove from your diet and take note of any changes you notice. 

 

References

 

FNS, S. B., & Rizzo, N. (2021, September 27). Modere Review. DietSpotlight. Retrieved October 7, 2021, from https://www.dietspotlight.com/modere-review/. 

Gras notice 713, hydrolyzed pork cartilage - FDA. (2017, February 23). Retrieved October 7, 2021, from https://www.fda.gov/media/110032/download. 

Johnson, M. (2021, May 5). Modere trim review: Is it really a scam or does it work ... Retrieved October 7, 2021, from https://choicesinchildbirth.org/modere-trim-review/. 

Joo, Pamela, Jenny, Branda, & Cossman, D. (2020, June 16). Is Modere a scam? ugly truth revealed. Mama's Money Tree. Retrieved October 7, 2021, from https://mamasmoneytree.com/is-modere-a-scam/. 

Liquid biocell® life. Modere. (n.d.). Retrieved October 7, 2021, from https://www.modere.com/productdetail/liquid-biocell-life-420ml. 

Modere, Inc.: Better Business Bureau® profile. BBB. (n.d.). Retrieved October 7, 2021, from https://www.bbb.org/us/ut/springville/profile/health-products/modere-inc-1166-86090006. 

Schauss AG, Merkel DJ, Glaza SM, Sorenson SR (2007). Acute and subchronic oral toxicity            studies in rats of a hydrolyzed chicken sternal cartilage preparation. Food Chem Toxicol                 45(2):315-321. DOI:10.1016/j.fct.2006.08.011. 

How a Tumor on an Adrenal Gland Causes High Blood Pressure

 When my mom was about fifty, she developed high blood pressure. For the next five years she would get migraines when she attempted to exercise or anytime her heart rate increased for just a few minutes. This didn't make sense because she had eaten healthy her entire life and lived an active lifestyle, in fact, she competed in triathlons well into her forties. However, she has a demanding career, tries to do everything for everyone and has many dangerous hobbies. Once during a standard checkup, her doctor wanted to rush her to the emergency room for high blood pressure but my mom explained it was typical to have blood pressure that high. It was on average around 200/120.  

My mom had seen over ten specialists including a neurologist (twice), pulmonologist, cardiologist, primary physician, two physician assistants, alternative medicine doctor, and many more. Everyone she saw assumed it must be her heart that was causing high blood pressure so they would recommend a different type of blood pressure medication or increase her existing dosage. At a party, my mom happened to start talking with an endocrinologist. He recommended getting a scan of her adrenal glands and sure enough, she had a tumor on her right adrenal gland. The surgeon planned to remove only the tumor if possible but ended up removing the entire gland due to risk factors. The surgeon said humans can live with less than half of a normal adrenal gland. It has been more than two years since her surgery and her health has returned to normal (knock on wood). 

 

Even though a person might have symptoms that point to an issue in their circulatory system, the real problem might be occurring in a different system, making it harder to pinpoint the exact issue. Therefore, even the best and most specialized doctors might miss details in a patient’s presenting symptoms resulting in the wrong diagnoses. 

 

Not only did my mom’s physician never recommended seeing an endocrinologist over the course of five years, she used my mom’s case in front of other doctors falsely claiming she caught the rare situation. I believe it would have been more ethical to admit she never landed on the correct diagnosis. 

 

There was also a chiropractor my mom was visiting who claimed she could heal my mom. I think chiropractors are amazing but, in this case, making false claims only prolonged finding the correct diagnosis. 

  

If an individual has received a diagnosis that isn’t fixing their problem, they should consider exploring other options. Such as, get more testing done, search the internet, talk to people, use apps that give the most likely diagnoses or keep meeting with health specialists.

Less Macrophage Inflammatory Protein 3alpha and β-defensin Found in Individuals with Atopic Dermatitis and Why It Matters Concerning the Vaccinia Virus

Atopic Dermatitis (AD), commonly known as eczema causes rashes on skin. The smallpox vaccine is made from the vaccinia virus (VV) which is a poxvirus closely related to smallpox but less harmful. The Smallpox vaccine has live vaccinia virus that isn’t in a weaker form like many other vaccines.  Those with AD are more likely to develop eczema vaccinatum which occurs when VV is implanted into a person’s skin though the smallpox vaccination. The VV spreads to cells causing lesions, outbreaks can occur on other parts of the skin other than the initial infected area.  

Those with AD are likely to have an allergic reaction to something coming into contact with the skin like environmental allergens or a vaccination that the immune system tries to attack causing the same outbreak that was trying to be prevented in the first place by receiving the vaccination. An individual without AD will create antibodies after receiving the smallpox vaccination that will prevent a smallpox infection if that person ever comes into contact with the smallpox virus whereas an individual with AD will have an allergic reaction to the smallpox vaccination causing rashes that have an appearance just like smallpox. This is why the Centers for Disease Control and Prevention doesn’t require individuals with AD to receive the smallpox vaccination. 

 

The results of one study suggest that Macrophage inflammatory protein 3alpha is critical in the immune response against VV. Someone with AD lacks a sufficient amount of MIP-3alpha. Increasing MIP-3alpha could help prevent severe reactions for those with AD if they receive the smallpox vaccination (Kim et al., 2007).  Another study showed that, “deficiency in HBD-3 increases the susceptibility of patients with AD to systemic VV infection after smallpox vaccination” (Howell et al., 2007).  HBD-3 is a 45 amino acid antimicrobial peptide. 

 

Although rare, there have been reported cases of a smallpox vaccinee, infecting an individual with AD though close contact. If smallpox vaccines were used again would enough screening be done to make sure those with AD do not receive the vaccine and do not come into contact with someone who has recently been vaccinated with the smallpox vaccine? Could individuals with AD increase the amount of MIP-3alpha or HBD-3 in their skin so they could still receive the smallpox vaccine? It would be a win, win situation if an individual with AD could receive the VV vaccine so they are protected against smallpox but without the vaccine creating an outbreak. Smallpox and Eczema Vaccinatum can be fatal therefore learning the role MIP-3alpha and HBD-3 play in preventing an outbreak is huge to further understand AD and possibly improve the lives of those with AD. 

 

References

Centers for Disease Control and Prevention. (2017, July 12). Vaccine basics. Centers for Disease Control and Prevention. Retrieved October 8, 2021, from https://www.cdc.gov/smallpox/vaccine-basics/index.html. 

Howell, M. D., Streib, J. E., & Leung, D. Y. (2007). Antiviral activity of human beta-defensin 3       

against vaccinia virus. The Journal of allergy and clinical immunology, 119(4), 1022–1025. https://doi.org/10.1016/j.jaci.2007.01.044

 

Jennifer L. Reed, Dorothy E. Scott, Mike Bray, Eczema Vaccinatum, Clinical Infectious 

        Diseases, Volume 54, Issue 6, 15 March 2012, Pages 832–840, 

        https://doi.org/10.1093/cid/cir952

 

Kim, B. E., Leung, D. Y., Streib, J. E., Kisich, K., Boguniewicz, M., Hamid, Q. A., & Howell, M. 

        D. (2007). Macrophage inflammatory protein 3alpha deficiency in atopic dermatitis skin 

        and role in innate immune response to vaccinia virus. The Journal of allergy and clinical 

        immunology, 119(2), 457–463. https://doi.org/10.1016/j.jaci.2006.10.005

Music vs. Massage Therapy in Labor

Balancing Autonomy and Patient Beneficence

 Jehovah’s Witnesses are known for refusing blood transfusions, even in dire situations due to their religious beliefs. Jehovah’s witnesses believe that it is not in God’s will to receive blood transfusions and often even refuse taking blood transfusions of their own blood (Medical Protection Society, 2014). This can be a difficult for some physicians because this significantly cuts back their treatment options for those who are Jehovah’s Witnesses.

One example of a difficult illness to treat due to the refusal of blood transfusions is acute leukemia. An interesting article regarding these health disparities notes that some Leukemia patients are not provided with the proper treatment and intensive chemotherapy due to concern that these individuals without blood transfusions would not have the proper support to survive myeloablation (Chaer & Ballen, 2019). Myeloablation is a form of myelosuppression in which bone marrow activity is decreased, resulting in fewer red blood cells, thus restricting the oxygen and blood circulation in an individual’s body (NCI Dictionary of Cancer Terms, 2021). This makes the treatment of acute leukemia in Jehovah’s Witness patients remarkably more complex, unique, and interesting. This also makes an interesting ethics case as physicians must respect a patient’s autonomy meanwhile while doing what is best to treat their patient.

Before diving further into the ethical concerns of a case like this, another treatment option for these patients is discussed and noted to be Hematopoietic Stem Cell Transplant. This type of stem cell transplant has been found to be successful in Jehovah’s Witness patients. This treatment protocol is a reduced intensity condition but with a longer treatment time and is less likely to require blood transfusions to keep a patient healthy (Chaer & Ballen, 2019). The treatment process, however, can pose a challenge due to prolonged suppression in the individual.  This article in particular notes this is likely the best treatment method for these patients in combination with infusion of CD34 cells, which are associated with greater platelet recovery (Chaer & Ballen, 2019).

This treatment is not the first line of treatment for leukemia though and once again brings up ethical concerns. Physicians are required to respect an individual’s bodily autonomy and their right to choosing treatment protocols that best fit with their belief. On the other hand, physicians also must look out for what the best thing to do for the patient is and exercise beneficence, taking care of all their patients equally. Understanding alternative treatment methods is essential to a physician as they can respect their patient’s bodily autonomy and right of treatment refusals but also provide their best care possible for the patient. In this case, understanding these two ethical arguments is essential in successfully treating individuals who practice the religion.

 

El Chaer, F., & Ballen, K. K. (2020). Treatment of acute leukaemia in adult Jehovah's Witnesses. British journal of haematology, 190(5), 696-707.

Mps. (2014). Medical Protection Society. Retrieved from https://www.medicalprotection.org/southafrica/casebook/casebook-may-2014/the-challenges-of-treating-jehovah's-witnesses

NCI Dictionary of Cancer Terms. (2021). Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/myeloablative-chemotherapy

Misuse of Cognitive Enhancing Drugs

     

    The misuse of Adderall, Ritalin, and other prescription stimulants is very common amongst undergraduate students. These drugs are known to increase concentration, improve academic performance, and induce euphoria. The effects of these drugs can be very appealing to overworked, sleep-deprived college students. Up to 20% of college students reported misuse of these prescription stimulants to enhance academic performance (Kennedy, 2018). Prescription stimulants are the second most used illicit drug by college students (Lakhan, Kirchgessner 2012)

    Adderall is composed of amphetamine and dextroamphetamine. The drug binds to norepinephrine and dopamine receptors in both the brain and adrenal gland, amplifying the “feel good” chemicals in the body (Lautieri, 2021). It is most often prescribed to people with Attention Deficit Hyperactivity Disorder (ADHD).  When used properly, these prescription stimulants help people feel more focused and less impulsive. However, the misuse of these drugs by people without ADHD can have very serious short and long term side-effects. Short term effects include nervousness, interruption of sleep patterns, anxiety, and restlessness (Sison, 2019). Long term side-effects include damage to the cardio-vascular system, which could result in high blood pressure, irregular heart rate, or cardiomyopathy. In some cases, long-term misuse could result in psychosis (Lautieri, 2021).

    Although these prescription drugs increase productivity and concentration, there is little evidence supporting their ability to improve knowledge application. So although a student may complete multiple assignments in one evening with a high level of focus, the quality of work is unlikely to increase (Lakhan, Kirchgessner, 2012). 

Should pharmaceutical companies produce these “cognitive enhancing” drugs for the general public? Is it ethical for people without ADHD to have access to these drugs to improve their performance at school or work? How is the recreational use of these drugs different from caffeine consumption (another enhancing substance)? I think the answer lies in the severe side-effects that come along with the misuse of these stimulants. The misuse of prescription stimulants can cause such intense damage to the body, and ultimately lead to life-altering changes in body function. People with heart conditions are more likely to endure detrimental side-effects that could lead to death (Aberg, 2021). Without extensive public education, allowing prescription stimulants to be available to the general public can be very dangerous. Additionally, allowing the general public to have access to prescription stimulants will likely increase rates of addiction. I believe the risks outweigh the benefits for allowing the general population access to drugs like Adderall and Ritalin. 

Sources:

Aberg, S. E. (2021, January 28). "study drug" abuse by college students: What you need to know. National Center for Health Research. Retrieved October 4, 2021, from https://www.center4research.org/study-drug-abuse-college-students/. 

Kennedy, S. (2018, December 15). Raising awareness about prescription and stimulant abuse in college students through on-campus community involvement projects. Journal of undergraduate neuroscience education : JUNE : a publication of FUN, Faculty for Undergraduate Neuroscience. Retrieved October 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312145/. 

Lakhan, S. E., & Kirchgessner, A. (2012, September). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: Misuse, cognitive impact, and adverse effects. Brain and behavior. Retrieved October 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/. 

Lautieri, A. (2021, September 29). Long term effects of adderall on brain, personality, and body. American Addiction Centers. Retrieved October 4, 2021, from https://americanaddictioncenters.org/adderall/long-term-effects. 

Sison, G. (2019, September 3). Adderall abuse among college students: Prescription Stimulant Addiction. American Addiction Centers. Retrieved October 4, 2021, from https://americanaddictioncenters.org/adderall/adderall-abuse-among-college-students.