Dr Khush Bakht Uncategorized

Alzheimer

What Are The Causes, Signs and Symptoms of Alzheimer? | Guide For Caregivers.

Do you ever feel like you keep forgetting something, or things just keep slipping away from your mind without any reason? Have you ever felt that you went to the kitchen to grab something but struggled to remember what that was?

Well, this forgetfulness may be a part of Dementia or an early feature of Alzheimer’s Disease. But don’t get scared by these medical terms, as they are not always present. As a matter of fact, these thoughts and memories are generated, interpreted, and communicated among the brain neurons themselves, so frequent forgetfulness can give a clue about a glitch in your brain or its faulty function.

Alzheimer’s disease is a disease related to memory storage and regeneration. As scary as it sounds, it is mainly a disease of the elderly and mostly runs in families. So, if your family has no Alzheimer’s association, this article might not be for you. But wait! Even if you don’t have a family member struggling with Alzheimer, you can always help as a caregiver, so do give this article a read.

Alzheimer's Disease – A Detailed Overview:

First off, we need to know the definition of Alzheimer’s in order to understand its concept. Alzheimer’s disease is a neurodegenerative disease with the sneaky onset and progressive impairment of cognitive and behavioral functions, including comprehension, memory, reasoning, language, attention,  and judgment. (1)

Alzheimer’s disease is a vast topic that weighs heavy on the hearts and minds of the diagnosed and their families. It is a progressive brain disorder that affects millions of people worldwide, slowly deteriorating their memories, behavior, and abilities to communicate, walk in familiar surroundings, and other cognitive functions. Being a degenerating disease, it has no known cure. It profoundly impacts those who are diagnosed, as well as their families and loved ones.

While the medical community continues to explore the underlying causes and potential treatments for Alzheimer’s, it remains a formidable challenge and a deeply troubling reality for those affected.

Alzheimer's and its Relationship with Age:

Alzheimer’s disease and its association with age have always been debated among medical peers. As it is a progressive degenerative disease of the brain, it usually takes time to start its symptoms which reach their peak as the person reaches old age.

The brain function which mostly gets affected is memory storage and cognition. To actually interpret why that is so, we need to know a little bit about the anatomy of the brain and what brain part controls memory. The hippocampus is the most commonly affected part of the brain, concerned with learning and memory.

It has become increasingly clear under the light of many studies that while neuronal cell loss in the cortex and hippocampus occurs in Alzheimer’s disease, it is preceded by a previous long period of deficits in the hippocampal formation that contributes to the vulnerability of these circuits. (2)

Causes of Alzheimer's Disease:

In order to understand and better combat a disease, we must know the causes of the disease because that’s how we are going to defeat our enemy – or in this case, keep Alzheimer’s from attacking for as long as we can. With that being said, it is important to know that there is no possible cure for Alzheimer’s disease; yes a pretty bad illness to suffer from.

The exact cause of Alzheimer’s is not known, but the initial attack and its progression depend upon a variety of factors like aging, the genetic makeup of the body, lifestyle factors like poor diet and lack of exercise, chronic inflammation in the brain, and exposure to certain toxins in the environment.

If we talk about aging, not everyone in their late decades of life gets Alzheimer’s. Still, it is called the disease of old age because of the increasing risk of its development, provided that the other risk factors are also present. The reason for being prevalent in certain families is that specific genetic composition favors the development of Alzheimer’s.

But it is not always true, as Alzheimer’s is not an inherited disorder. Chronic inflammation in the brain and exposure to toxins like pesticides and heavy metals may also play a role in the development of Alzheimer’s.

If we get a little technical, Alzheimer’s disease is a chronic neurodegenerative disease, mostly affecting the medial temporal lobe and associated cortical structures. Neuritic plaques and neurofibrillary tangles show the pathological hallmarks of Alzheimer’s. (3)

Early Signs and Symptoms of Alzheimer's:

Alzheimer’s disease is a very sneaky disorder that remains unrecognized for a longer period of time. It shows some non-specific symptoms every now and then, like forgetting the names of relatives, phone numbers, and familiar places.

A layperson may not notice such discrepancies and may present to a healthcare facility at the late stages of the disease.

The initial and the most common presenting symptom is episodic short-term memory loss with relative sparing of long-term memory, which can be elicited in most patients. Short-term memory impairment is followed by impairment in:

  • problem-solving
  • judgment
  • executive functioning
  • lack of motivation
  • disorganization, leading to problems with multitasking and abstract thinking.

 In the early stages, impairment in executive functioning ranges from subtle to significant. (4)

Tips and Strategies For Caregivers:

Taking care of a patient with Alzheimer’s can be a very tiring, emotional, and challenging experience. It may require a lot of patience and dedication to fulfill this duty.

Management uses psychoeducation, shared goal setting, and patient-caregiver dyad decision-making. When combined, pharmacologic and nonpharmacologic therapies mitigate symptoms and reduce clinical progression and care burden. (5)

  • The first thing you can do is to learn thoroughly about the disease. Know the basic symptoms and management strategies to create a plan for how you will approach and take care of a patient with Alzheimer’s.
  • Establishing a routine can help reduce anxiety and confusion and help you plan for daily activities and tasks. Be patient and understanding, and avoid correcting or arguing with your loved one.
  • Make changes to the home environment to ensure their safety, such as removing tripping hazards and labeling household items. Encourage them to stay socially active and maintain connections with friends and family. Take care of your own physical and emotional well-being.
  • Don’t hesitate to seek help and support from family, friends, or support groups. Remember that caregiving is a journey, and it’s important to approach it with patience, compassion, and a willingness to learn and adapt to changing needs.
  • In addition to the above-mentioned strategies, you can help them with daily living activities, such as dressing, bathing, and grooming. You can also prepare healthy meals and snacks and encourage them to eat a balanced diet. It’s important to monitor their medication schedule and keep track of any changes in their symptoms or behavior.
  • You can also consider hiring a professional caregiver to provide additional support. Always remember that communication is the key. Try to communicate with your loved one, involve them in decision-making as much as possible, and show them love and compassion throughout their journey with Alzheimer’s disease.

Common Challenges and Concerns:

Caring for someone with Alzheimer’s can be rewarding and challenging, and caregivers may face various difficulties. One of the most challenging aspects of caring for someone with Alzheimer’s is dealing with mild to extreme behavioral changes.

People with Alzheimer’s may experience agitation, aggression, and irritability, which can be difficult to manage and require continuous supervision. Communication difficulties are also common, as the disease can affect a person’s ability to express themselves and understand others. This can be frustrating and challenging for both the patient and the caregiver.

Caregiver burnout is another difficulty faced by those caring for Alzheimer’s patients. Caregiving can be emotionally and physically tough, and caregivers, as a result, may experience exhaustion, stress, and other health problems.

The financial strain of managing Alzheimer’s disease can also be challenging, as medical bills, home modifications, and other costs can quickly add up. Caregiving responsibilities can be time-consuming and isolating, and caregivers may feel cut off from their social support networks.

Guilt and grief are also common among caregivers of Alzheimer’s patients. Caregivers may experience feelings of guilt over not being able to provide enough care or for feeling frustrated or angry with their loved one. They may also grieve for losing their loved one’s mental and physical health as the disease progresses. It becomes very emotionally exhausting for the caregiver to look at their loved one in such a deprived state.

Take Care of Yourself:

Caregivers need to seek support and resources to help them manage the challenges mentioned above. Let’s be honest; you are human too. Respite care, support groups, and counseling can provide caregivers with all the support and guidance they need to manage their caregiving responsibilities effectively.

Caregivers should also take care of their own physical and emotional well-being by exercising regularly, eating a balanced diet, getting enough sleep, and taking time for themselves. By taking care of themselves, caregivers can maintain their ability to provide quality care to their loved ones with Alzheimer’s.

References:

  1. Kumar, A., Sidhu, J., Goyal, A., & Tsao, J. W. (2022). Alzheimer Disease. In StatPearls. StatPearls Publishing.

     

  2. Lazarov, O., & Hollands, C. (2016). Hippocampal neurogenesis: Learning to remember. Progress in neurobiology, 138-140, 1–18. https://doi.org/10.1016/j.pneurobio.2015.12.006

     

  3. De-Paula, V. J., Radanovic, M., Diniz, B. S., & Forlenza, O. V. (2012). Alzheimer’s disease. Sub-cellular biochemistry, 65, 329–352. https://doi.org/10.1007/978-94-007-5416-4_14

  4. Kumar A, Sidhu J, Goyal A, et al. Alzheimer Disease. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK499922/

     

  5. Atri A. (2019). The Alzheimer’s Disease Clinical Spectrum: Diagnosis and Management. The Medical clinics of North America, 103(2), 263–293. https://doi.org/10.1016/j.mcna.2018.10.009 
Dr Khush Bakht Uncategorized

Alzheimer-1

Alzheimer's Vs Dementia | The 7 Stages of Alzheimer's & It's Risk Factors

Have you ever walked into your room and forgotten why you went in there in the first place? It is a shared experience that happens to everyone. Still, forgetfulness can become a more severe problem for some older adults. Alzheimer’s disease and Dementia are two conditions that can cause memory loss, confusion, and other cognitive problems that can make daily life challenging. While they might sound like scary diseases, the good news is that there are things you can do to reduce your risk and manage the symptoms if you or a loved one is affected.

In this article, we’ll look closer at Alzheimer’s and Dementia, including what they are, what causes them, and what you can do to stay healthy and happy as you age. We’ll also explore the different types of Dementia, their diagnosis, and the latest research on treatments and potential cures.

Whether you are a senior citizen wanting to maintain your cognitive health, a caregiver who wants to provide the best care for a loved one, or just someone curious about these conditions, this article is for you. So, let’s dive in and learn more about Alzheimer’s disease and Dementia.

Alzheimer's V/S Dementia and the differences between the two:

Alzheimer’s V/S Dementia has always been debated for a long time. Although Alzheimer’s and Dementia are terms used side by side and are often used interchangeably, there’s much difference between the two.

Dementia describes an overall decline in memory and other cognitive skills severe enough to reduce a person’s ability to perform everyday activities. The progressive and persistent deterioration of cognitive function characterizes it. Affected patients often have memory loss and a partial or significant lack of insight into their deficits. (1)

Alzheimer’s disease (AD) is the commonest type of Dementia, accounting for at least two-thirds of cases of Dementia in people aged 65 and older. Alzheimer’s is a neurodegenerative disease with insidious onset and progressive impairment of behavioral and cognitive functions, including memory, comprehension, language, attention, reasoning, and judgment. It is the 6th leading cause of death in the United States of America. So, Alzheimer’s V/S dementia is a quite an interesting topic in the healthcare field.

Factors that Increase the Likelihood of Alzheimer's and Dementia:

In order to treat or prevent a disease, we ought to know the underlying cause and the risk factors which actually lead to the disease. If you open your fridge door and forget what you wanted or you go to your room to fetch something, and you scratch your head because you cannot remember why you went there, it might not be as serious at a young age as it may be if you are old or have a positive family history for Dementia. As much as the name ‘Dementia’ is scary, it may not be as serious as it may sound.

Alzheimer’s disease is a complex condition that can tiptoe on you over time, but there are a bunch of things that make it more likely to happen. First off, the older you get, the higher the chances of developing it, especially after 65.

A positive family history of Alzheimer’s can increase your chances of getting it yourself. This is especially true if you’ve got a first-degree relative (like a parent or sibling) with the condition. But don’t freak out – having a family history of Alzheimer’s isn’t a guaranteed sentence.

Plus, if you’ve got any wobbly genes (like the APOE ones), you’re more likely to develop it too. But it’s not always out of your control – things like eating well, exercising, and getting good sleep can help. And if you’ve got high blood pressure, cholesterol, or type 2 diabetes, watch out – those can all up your chances of getting Alzheimer’s. It’s good to keep an eye out for these factors so you can lower your chances of getting hit with Alzheimer’s disease.

Is Early Diagnosis of Alzheimer's Possible?

The only definitive and conclusive way to diagnose Alzheimer’s is to carry out a brain autopsy of the patient’s brain tissue and ascertain whether the subject has Alzheimer’s or any other form of Dementia. However, due to the non-feasibility of such methods, to diagnose and conclude the conditions, medical practitioners use tests that examine a patient’s mental ability. (2)

Another way Alzheimer’s or Dementia can be assessed is by taking a history of the patient’s memory. To diagnose Alzheimer’s disease early, doctors often speak with both the patient and their relatives and friends to get a full picture of what’s going on. This is because Alzheimer’s can show up in many ways, like changes in behavior, irritability, getting lost in familiar places, becoming more aggressive, silent, or withdrawn, and having trouble with tasks that used to be easy or forgetting learned motor skills. It can also cause memory loss and trouble with communication, leading to problems with independence and self-care. By talking to everyone involved, doctors can better understand what’s happening and whether Alzheimer’s might cause these symptoms.

There is no cure for Alzheimer’s, although treatments available may improve some symptoms. (3)

Alzheimer's Stages:

For reaching a proper diagnosis and initiating a fruitful treatment or preventing the progression of forgetfulness or Dementia, it is important to note the patient’s symptoms. However, as Alzheimer’s affects each individual differently, the diversity of symptoms may sometimes be misleading.

Symptoms of Alzheimer’s, most importantly Dementia, can occur in various patterns or may be present on and off. There are seven Alzheimer’s stages that help diagnosticians better cope with the patient’s health. These seven stages are as follows:

Stage of No Symptoms:

This is a Grade One disease when the patient does not show any symptoms, and the cognitive abilities of the brain are normal.

Stage of Mild Forgetfulness:

This early stage almost completely resembles normal age-related forgetfulness. A person may forget the names of his relatives or car keys in the room but can still have a normal social life.

Stage of Noticeable Memory Deficit:

At this stage, the individual may have difficulty remembering recent events, planning and organizing tasks, and concentrating on complex activities. They may also experience difficulties with articulation and language, such as finding the right words to express.

Figure 1: Stages of Alzheimer's Disease. (6)

Stage of More than Memory Loss:

This stage can last for many years, and your loved one may experience major difficulties with memory. However, they may still be able to recall important details about their life, such as their spouse’s name or where they live. There are also changes in behavior, sleep patterns, and an increased tendency to get lost.

Stage of Decreased Independence:

In this stage, your loved one will likely have trouble remembering people that are important to them, such as close family and friends. They become dependent on others, so you might have to check up on them occasionally.

Stage of Severe Symptoms:

At this stage, the individual’s cognitive deficits become even more pronounced, and they may no longer be able to communicate effectively or recognize familiar faces. They may also experience physical limitations, such as difficulty with walking or standing. They increasingly depend on others.

Stage of Decline of Physical Control:

At this final stage, the individual is completely dependent on others for all activities of daily living and may no longer be able to swallow, speak, or control bodily functions. Your loved one’s body may begin to shut down as their mind struggles to communicate and delegate tasks effectively.

Relationship Between Dementia and Alzheimer's Disease:

Dementia, or more commonly forgetfulness, isn’t a normal part of getting old. It happens when brain cells get messed up and have trouble communicating with each other. This can make thinking, acting, and feeling different.

Alzheimer’s disease is the most common type of Dementia and is by no means an inevitable consequence of aging (4). Alzheimer’s is a slowly progressing brain disease that worsens over time, messing up more cells and causing more memory problems. One of the first things to go is the ability to remember new stuff since the part of the brain that learns new things is usually the first to get hit.

Figure 2: Dementia and its Types (8)

Early Signs and Symptoms of Dementia and Alzheimer’s:

Memory loss is among the commonest early signs of Alzheimer’s and Dementia. However, it is only significant when memory loss becomes a consistent problem that it should be a cause for concern.

Another early sign of Dementia and Alzheimer’s disease is difficulty with everyday tasks, like cooking or cleaning. You may notice that your loved one is struggling with things that used to come easily to them. 

Confusion is another common early sign of Dementia and Alzheimer’s disease. Mood changes are also a common early sign of Dementia and Alzheimer’s disease. Your loved one may become more agitated or anxious than usual.

Finally, poor judgment is another early sign of Dementia and Alzheimer’s disease. You may notice your loved one making decisions out of character or putting themselves in dangerous situations.

Apathy and depression are the most common overall. Apathy is associated with high symptom severity, likely because of its greater persistence. Symptoms such as agitation, aggression, hallucinations, and delusions may be especially distressing and dangerous to patients and caregivers. (5)

Final Verdict:

After all, is said, It is absolutely crucial to know the basics about Alzheimer’s and Dementia as these are inevitable, progressive, deteriorating brain disorders mainly affecting older adults. You must speak with their doctor if you notice any of these early signs in your loved one. Early detection and treatment can make a big difference in slowing the progression of the disease and improving quality of life.

References:

  1. Emmady PD, Schoo C, Tadi P. Major Neurocognitive Disorder (Dementia) [Updated 2022 Nov 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557444/                      
  2. Khan, S., Barve, K. H., & Kumar, M. S. (2020). Recent Advancements in Pathogenesis, Diagnostics and Treatment of Alzheimer’s Disease. Current neuropharmacology, 18(11), 1106–1125. https://doi.org/10.2174/1570159X18666200528142429                                                  
  3. Kumar, A., Sidhu, J., Goyal, A., & Tsao, J. W. (2022). Alzheimer Disease. In StatPearls. StatPearls Publishing.                                                                              
  4. De la Rosa, A., Olaso-Gonzalez, G., Arc-Chagnaud, C., Millan, F., Salvador-Pascual, A., García-Lucerga, C., Blasco-Lafarga, C., Garcia-Dominguez, E., Carretero, A., Correas, A. G., Viña, J., & Gomez-Cabrera, M. C. (2020). Physical exercise in the prevention and treatment of Alzheimer’s disease. Journal of sport and health science, 9(5), 394–404. https://doi.org/10.1016/j.jshs.2020.01.004                               
  5. Deardorff, W. J., & Grossberg, G. T. (2019). Behavioral and psychological symptoms in Alzheimer’s Dementia and vascular Dementia. Handbook of clinical neurology, 165, 5–32. https://doi.org/10.1016/B978-0-444-64012-3.00002-2                
  6. Image from https://villagegreenalzheimerscare.com/alzheimers-disease-stages/          
  7. Image from https://medicine.umich.edu/dept/mneuronet/news/archive/201907/early-alzheimer%E2%80%99s-disease-detection-may-benefit-new-stem-cell-therapy             
  8. Images from https://hhs.iowa.gov/chronic-disease-prevention/alzheimers-and-related-dementias/Dementia                                                                                           
  9. Image from https://www.theoldish.com/stages-of-alzheimers-disease/ 
Dr Khush Bakht Uncategorized

Skin Aging-2

5 Most Common Signs of Skin Aging What are the Effects of Skin Aging?

It is important to recognize and identify the signs of skin aging as recognition is essential for finding ways to slow the aging process, researching the mechanisms of aging, and devising new treatment techniques. Identifying the signs of aging also helps one make the proper lifestyle modifications for healthy and youthful skin. Understanding skin aging and its signs can help in promoting healthy skin. People should be aware of the harmful effects of sun exposure without sunscreens and the impact of poor nutrition and a lousy lifestyle on their skin.

Visible signs of aging

As we age, the signs get apparent on our skin. It is important to identify signs of aging to dodge harmful effects like fragile skin, sunburns, bruising, and even skin cancer. Significant signs of aging have been identified and are described in this article.

Fine lines and wrinkles:

Fine lines and wrinkles are among the first manifestations of aging. Due to the decline in collagen and elastin, the skin loses its elasticity and ability to recoil and gradually wrinkles. Fine lines start appearing at the areas where most of the facial movements occur during expressions like around the mouth and eyes. Crow’s feet appear around the eyes, and smile lines are evident in some people. Although smile lines are a sign of a happy life and not something to be conscious of, there are topical and cosmetic treatments to reduce the appearance. In the epidermis, due to fewer keratinocytes (cells that produce keratin protein) with age, wrinkles appear on the skin. If a wrinkle is studied under a microscope, atrophy is observed at each layer of skin. The early appearance of fine lines and wrinkles is also due to photoaging induced by unprotected sun exposure.

Skin sagging:

There are many theories describing skin sagging with age. The more involuntary gravitational theory was first proposed, which explains a steep decline of soft tissues secondary to a progressive weakening of their ligament attachment. Attrition of the ligaments that anchor the dermis to the deep osteo-fibrous structures of the face is indicated to be due to the repeated muscle activity due to facial movements such as the smile, resulting in the descent of the soft tissue and the falling element of the face (8). The other theory is the decrease in fat mass and structural components (collagen, elastin, and hyaluronic acid) with age. In conclusion, the hybrid of the two processes: alteration of skin mechanical properties and reduction of fat masses, would be responsible for facial sagging.

Age spots:

As melanocytes decrease with age, the remaining pigment-producing cells cluster and gather in specific areas and form pigment spots known as age spots or liver spots. Sun-exposed areas of the skin are more vulnerable to developing age spots. Age spots are caused by overactive pigment-producing cells. An age spot might look like a freckle and is frequently confused with it.

Dryness and itching:

With increasing age, the skin has fewer sebaceous and sweat glands, which keep the skin moist and maintain the skin barrier. Aged skin is more prone to dryness which worsens the appearance of other signs of aging, like wrinkles and fine lines. Dryness also causes itching due to a lack of hydration, and constant itching further irritates the skin. Dryness mostly occurs on the lower legs, lower arms, and elbows, forming dry and scaly patches. Men go through a minimal decrease, most frequently after age eighty. Women slowly produce less oily secretions beginning after menopause. Loss of pily secretions can make it difficult to keep the skin moist, resulting in dryness and itchiness.

Loss of plump texture:

With atrophy at the level of each skin layer, decrease in collagen and elastin production, loss of intercellular cushion, and decrease in the secretions of sebaceous glands, the skin cannot maintain its usual plump texture and becomes excessively dry leading to rough looking skin.

Effects of skin aging

The skin comprises three layers; the epidermis is the outermost layer, the dermis is the middle, and the hypodermis is the innermost layer. Each layer undergoes structural and functional changes as the skin ages. Significant changes in the skin structure and physiological function will be explained in this article.

Loss of skin barrier:

From the age of fifty, the quality of the dermis gradually deteriorates. Its Thickness decreases in correspondence with developed attenuation and loss of dermal-epidermal functional connections, which make the skin barrier (1). A weakened skin barrier makes the skin more vulnerable to damage caused by extrinsic aging. A defective skin barrier also leads to dehydration, making the skin more prone to aging. Chronological aging is accompanied by an increase in glucocorticoid production and secretion along with increased cortisol content in the skin, which can induce epidermal dysfunction (2)

Loss of skin elasticity:

When you are in your thirties, your skin starts to decrease the production of collagen and elastin, which are the proteins that maintain skin elasticity and flexibility. Collagen is produced by the most abundant cells in the dermis layer of the skin, I.e., fibroblasts. Reduced synthesis of collagen types I and III is characteristic of aged skin. The present research provides evidence that both cellular fibroblasts aging and inadequate mechanical incitation in the aged tissue contribute to reduced collagen synthesis (3). 


Collagen breakdown, a reduction in total collagen, and lessened cell-collagen fiber interactions also characterize chronologically aged skin. The collagen breakdown and degradation enzymes accumulate gradually over time in the skin. Collagen synthesis may also decline progressively, but the fall-off in new collagen production is most evident when skin damage is clinically apparent (4)

Skin thinning:

The top layer of skin, the epidermis, contains pigment-producing cells called melanocytes, and when the epidermis starts thinning with age, melanocytes are also decreased, which makes the skin more sensitive to sun-induced damage. The next layer, the dermis, contains fibroblasts that produce collagen and elastin, and its thinning causes skin elasticity loss. The most constant structural change in aged skin is a flattening of the dermo-epidermal junction by more than a third due to the loss of dermal papillae and a decreased interdigitating between skin layers. This flattening, noticeable by scanning electron microscopy commencing in the sixth decade of life, results in less opposition to shearing forces and an increased vulnerability to insult (6). Skin thinning makes the skin fragile and transparent.

Fragile blood vessels:

The dermis contains the blood vessels of the skin, and when the dermis starts thinning with age, the blood vessels also become weak. Due to the fragility of blood vessels, aged people tend to bruise easily. The fatty tissue layer beneath the dermis supports the blood vessels, and the blood vessels tend to bleed easily with the loss of fat under the skin. Collagen also forms the lining of blood vessels, and as collagen production is decreased with age, the lining of blood vessels also becomes thinner.

Reduced cell turnover:

The top layer of skin, the epidermis, sheds old skin cells and regenerates new ones. In young adults, the skin undergoes resurfacing almost every twenty days, while in older people, this process takes about thirty days and is much less effective. The healing mechanism depends on skin cell turnover and is reduced with age. The natural process of skin desquamation keeps the skin fresh looking, and plump, which is why the skin looks dull and worn out as we age.

Dehydration:

The ground substance that holds collagen and elastin proteins together in the skin structure change with age. Hyaluronic acid (HA) makes up most of the intercellular glue or ground substance and is significantly reduced with age. In our forties, hyaluronic acid starts getting scanty and causing loss of hyaluronic acid, associated with loss of skin barrier and decreased hydration as the skin cannot hold up the hydration. There is also a reduction in the lipid content of the top layer of the skin, which it cannot hold moisture leading to dehydration.

Functional dysfunction:

Normal skin function is also compromised with increasing age. The normal functions of the skin are thermoregulation and defense (first-line). Due to the loss of melanocytes, the skin becomes sensitive to heat and sun exposure and cannot perform thermoregulation. Due to the loss of collagen, elastin, and other structural components, the skin’s defensive function is compromised. Skin becomes thin and gets injured easily. The fragility of blood vessels is increased with age, which causes older individuals to bruise easily. Skin becomes less elastic and saggy and loses its flexibility. The body’s natural healing mechanism is also crippled due to slowed cell turnover.

Bottom line:

The signs of aging, mainly wrinkles, fine lines, and sagginess, are natural. The problem starts when they appear due to premature aging. That is when you know you must correct your lifestyle and consult your dermatologist. Your dermatologist can guide you towards a healthy lifestyle for healthy and youthful skin. Several topical and cosmetic treatments are available nowadays for treating premature aging.

References:

1. Haydont V, Bernard BA, Fortunel NO. Age-related evolutions of the dermis: Clinical signs, fibroblast and extracellular matrix dynamics. Mech Ageing Dev. 2019 Jan;177:150-156. doi: 10.1016/j.mad.2018.03.006. Epub 2018 Mar 13. PMID: 29548941.

 

2. Wang Z, Man MQ, Li T, Elias PM, Mauro TM. Aging-associated alterations in epidermal function and their clinical significance. Aging (Albany NY). 2020 Mar 27;12(6):5551-5565. doi: 10.18632/aging.102946. Epub 2020 Mar 27. PMID: 32217811; PMCID: PMC7138575.

 

3. Varani J, Dame MK, Rittie L, Fligiel SE, Kang S, Fisher GJ, Voorhees JJ. Decreased collagen production in chronologically aged skin: roles of age-dependent alteration in fibroblast function and defective mechanical stimulation. Am J Pathol. 2006 Jun;168(6):1861-8. doi: 10.2353/ajpath.2006.051302. PMID: 16723701; PMCID: PMC1606623.

 

4. Varani J, Warner RL, Gharaee-Kermani M, Phan SH, Kang S, Chung JH, Wang ZQ, Datta SC, Fisher GJ, Voorhees JJ. Vitamin a antagonizes decreased cell growth and elevated collagen-degrading matrix metalloproteinases and stimulates collagen accumulation in naturally aged human skin. J Invest Dermatol. 2000;114:480–486. 

 

5. M.A. Farage, K.W. Miller, P. Elsner, H.I. Maibach Characteristics of the aging skin Adv. Wound Care (New Rochelle), 2 (2013), pp. 5-10

 

6. Waller JM. Maibach HI. Age and skin structure and function, a quantitative approach (I): blood flow, pH, thickness, and ultrasound echogenicity. Skin Res Technol. 2005;11:221

 

7. Farage MA, Miller KW, Elsner P, Maibach HI. Structural characteristics of the aging skin: a review. Cutan Ocul Toxicol. 2007;26(4):343-57. doi: 10.1080/15569520701622951. PMID: 18058308.

 

8. J.M. Stuzin, T.J. Baker, H.L. Gordon The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging Plast. Reconstr. Surg., 89 (March (3)) (1992), pp. 441-449

Dr Khush Bakht Uncategorized

Skin Aging 1-b

How to Achieve Youthful Skin? Here’s the Top Lifestyle Choices to Make

Conserving youthful and healthy skin is a concern for many people, unusually as they age. While genetics can play a part in skin health, lifestyle preferences can also significantly impact it. Making particular lifestyle modifications can help to maintain and facilitate youthful-looking skin. Healthy lifestyle choices can also help you to dodge premature skin aging and its signs. As the body’s most extensive organ, the skin demonstrates evident and visible signs of both intrinsic and extrinsic aging when one becomes older (1).

It’s impossible to change the natural or intrinsic aging process at the cellular level in the body. Still, we can control aging by modifying the harmful impact of extrinsic factors like sun exposure, low physical activity, and poor diet. Although nowadays, several cosmetic treatments are available to prevent skin aging. Most people go under the knife to keep their skin as young as possible, but these treatments are expensive; not all people can have them, and the chances of these procedures going wrong are also very high. You may have heard of cosmetic procedures going wrong frequently.

Ways to achieve a younger looking skin

Skin aging is a process in which skin integrity deteriorates with age due to the combined effects of chronological aging, photoaging, hormonal imbalance, and environmental factors like pollution. Over time, the main environmental culprits have been recognized, and you can adopt ways to minimize their exposure.

Wear your SPF:

Premature skin aging is caused by environmental factors, such as ultraviolet (UV) radiation, leading to photoaging (2). UV radiation causes skin damage due to the production of reactive oxygen species and increases the risk of genetic mutations leading to cancer. Photoaging is an additive process that depends on UV radiation’s intensity and exposure duration. Long-term exposure to low intensity doesn’t cause much damage as short-term exposure to high intensity. UV radiation also causes a collagen deficit by diverting the balance from production and deposition to degradation. Loss of collagen shows up as wrinkles skin.

Therefore, it is advisable to wear sunscreen, having a higher spf (sun protection factor). Sunscreens have been on the market for decades to protect against ultraviolet-induced skin damage. Most broad-spectrum sunscreens protect against UVB and short-wavelength UVA radiation (3). The skin’s top layer (epidermis) chiefly absorbs UVB, whereas UVA has a longer wavelength and, therefore, deeper skin penetration, making it the preliminary driver of photoaging (4)

For optimum sun protection, one should use the two-finger sunscreen application method, equivalent to approximately one-fourth of a teaspoon, and reapply every two hours if you sweat a lot. The choice of sunscreen should be made based on skin type. Your sunscreen should have SPF 30 or higher.

Stop smoking:

People who smoke show early signs of aging, mainly wrinkles, compared to non-smokers. Tobacco smoking introduces toxins into the body; these toxins cause free radical formation, which causes damage to the skin’s integrity. In addition to the free radical formation, smoking interferes with the normal blood supply causing the skin to become dull and dry. Dry skin ages faster than skin with proper hydration, which is decreased in smokers.

According to a study, smoking affects several physical characteristics of the skin. Mainly the thickness of the epidermis and dermis was higher, the density of these layers was lower, and the skin was less elastic in smokers. Also, nasolabial folds were more prominent in smokers (5). Smoking can deteriorate the skin’s repair mechanisms and affects skin turnover by down-regulating collagen and elastin synthesis.

Cut down on alcohol:

Alcohol is a diuretic that makes you urinate more after you drink it. It dehydrates your body, and skin dehydration cause premature aging. Alcohol also decreases collagen production in the body. Loss of collagen makes your skin lose elasticity, and it makes fine lines and wrinkles more visible. Alcohol also dilates the blood vessels giving the skin a flushed appearance which can contribute to other skin disorders like rosacea. Alcohol causes extrinsic aging and ages you at the cellular level. It tends to damage the DNA protective caps, known as telomeres, shortening them progressively and causing the cells to age faster.

Fortunately, alcohol-induced skin damage is reversible. Most of the superficial damage is caused by dehydration. Cutting out alcohol or reducing your intake to moderate or acceptable levels should make a big difference. It is crucial to stay healthily hydrated, so whether you are cutting alcohol out completely or simply cutting down, you should drink plenty of water to regulate your fluids properly.

Manage your stress:

One of the least researched topics about extrinsic skin aging is the consequence of psychological stress. The maladaptive reaction of human tissues to chronic stress impacts gene regulation. Chronic stress is important in determining an individual’s vulnerability to aging and age-related comorbidities (6).

Stress can show up on your face in two ways. First is the production of stress hormones, causing a hormonal imbalance that can lead to acne, wrinkles, and dullness. Stress hormones, mainly cortisol, decrease collagen production in the body contributing to wrinkles and loss of skin elasticity. Secondly, stress can lead to a poor sleep schedule and other deteriorating habits like low physical activity and eating junk food more often.

Excessive stress is an avoidable aging factor. You can schedule your appointments or daily tasks so that you don’t have anxiety regarding them. You can adopt a new hobby or spend some time from your day doing what you love. You can also seek professional help if your stress is not manageable.

Eat good:

They say you are what you eat, and we couldn’t agree more. Refined sugar and processed foods cause inflammation in the body due to the release of certain toxins when the body tries to break them down. Fried foods do not have enough nutrients that your skin needs for its proper structural and functional integrity.

Antioxidants like vitamin C are essential for your skin to fight the free radical damage caused by sun exposure or other factors. Your skin also needs vitamin C to synthesize collagen protein to maintain skin elasticity. Fruits and vegetables should be incorporated into the diet as they are rich in antioxidants. Avoid sugary and processed foods as they contribute to the aging process. Fish is also a healthy choice for omega-3 fats to fight inflammation. Lentils, beans, oats, nuts, and seeds are healthy food choices. Nutritional supplements that promote a youthful appearance include essential fatty acids, Coenzyme Q collagen peptides, polyphenols, flavanoids, probiotics, and vitamins A, C, D, and E, which are also encouraged (7).

Exercise regularly:

Research has shown that telomeres are usually lengthened in some people who exercise regularly compared to people who don’t. Lengthened telomeres are linked to the delayed aging process. A study concluded that higher physical activity improves skin hydration, and hydration is a key element in anti-aging (8). Regular exercise can counter hormonal imbalance, especially cortisol (stress hormone) levels, and contribute to stress management. Resistance training or exercises like running, bicycling, and jogging are helpful.

Improve your sleep:

Poor sleep schedule or inadequate sleep can lead to premature signs of aging. Not only the hours of sleep but also the position in which you sleep is important. Changing your sleep position occasionally is crucial because the earliest signs of aging appear around temples due to a common sleep position. Use silk pillow covers to avoid unnecessary friction with the skin.

Proper hydration:

Skin hydration is the key to preventing aging. Hydration should be both external and internal. Internal hydration comes from drinking plenty of water and fluids. In contrast, external hydration comes from using a good moisturizer, having ceramides and peptides to keep the skin plump and avoid fine lines and wrinkles.

Retinoids:

Start using topical retinoids at the recommendation of your dermatologist. Most people highly benefit from them if they start using them in their mid-twenties or early thirties, but they are helpful at any age you start. They are vitamin A derivatives and increase cell turnover, maintaining skin elasticity and integrity.

Bottom line:

Aging is a natural process, and no one can avoid it, but it is possible to dodge its premature signs and slow its progress by making healthy lifestyle choices. Always consult a dermatologist if you need clarification about choosing an appropriate sunscreen or discuss any cosmetic treatment and its possible side effects. If you are concerned about skin aging, you should book an appointment with your dermatologist for the proper treatment plan and consultation.

References:

1. Zhang S, Duan E. Fighting against Skin Aging: The Way from Bench to Bedside. Cell Transplant. 2018 May;27(5):729-738. doi: 10.1177/0963689717725755. Epub 2018 Apr 25. PMID: 29692196; PMCID: PMC6047276.

2. Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review. Int J Cosmet Sci 2008;30(2):87–95.

3. Guan LL, Lim HW, Mohammad TF. Sunscreens and Photoaging: A Review of Current Literature. Am J Clin Dermatol. 2021 Nov;22(6):819-828. doi: 10.1007/s40257-021-00632-5. Epub 2021 Aug 13. PMID: 34387824; PMCID: PMC8361399.

4. Battie C, Jitsukawa S, Bernerd F, Bino SD, Marionnet C, Verschoore M. New insights in photoaging, UVA induced damage and skin types. Exp Dermatol. 2014;23:7–12. doi: 10.1111/exd.12388.

5. Yazdanparast T, Hassanzadeh H, Nasrollahi SA, Seyedmehdi SM, Jamaati H, Naimian A, Karimi M, Roozbahani R, Firooz A. Cigarettes Smoking and Skin: A Comparison Study of the Biophysical Properties of Skin in Smokers and Non-Smokers. Tanaffos. 2019 Feb;18(2):163-168. PMID: 32440305; PMCID: PMC7230126.

6. Lee CM, Watson REB, Kleyn CE. The impact of perceived stress on skin ageing. J Eur Acad Dermatol Venereol. 2020 Jan;34(1):54-58. doi: 10.1111/jdv.15865. Epub 2019 Sep 16. PMID: 31407395.

7. Sonal Muzumdar, Katalin Ferenczi, Nutrition and youthful skin, Clinics in Dermatology, Volume 39, Issue 5, 2021, Pages 796-808, ISSN 0738-081X, https://doi.org/10.1016/j.clindermatol.2021.05.007.

8. Ryosuke O, Yoshie S, Hiromi A. The association between activity levels and skin moisturising function in adults. Dermatol Reports. 2021 Mar 17;13(1):8811. doi: 10.4081/dr.2021.8811. PMID: 33824705; PMCID: PMC8018252.

Dr Khush Bakht Uncategorized

Skin Aging 1-a

Top 8 Causes of Skin Aging: Why it’s Important to Know?

Skin is the largest body organ. As the most voluminous body organ revealed to the outer environment, the skin suffers from intrinsic and extrinsic aging factors. Skin aging is characterized by wrinkling, loss of elasticity, laxity, and rough-textured appearance (1).

Process of skin aging

How your skin ages will rely on various factors like your lifestyle, diet, genetics, and other personal habits.

Natural Aging Process

Aging is a cycle defined as the time-dependent continuous change in functionality and reproducibility of all higher organisms related to an inflated possibility of morbidity and mortality. Human skin is always exposed to the external environment and shows signs of aging with time. During the normal replication process of human genes, the genes get shortened with each replication cycle, and they cannot divide further after reaching a specific length. That’s when a cell attains the stage of senescence (2). Senescent cells resist the body’s normal programmed cell death (apoptosis), which removes harmful substances. These cells persist, releasing chemicals that promote inflammation and cause age-related skin changes (3).

Figure 2: Effects of senescent cells on the skin (4)

Like other body organs, skin aging is characterized by a continuous loss of functionality and regenerative ability. It is a multi-factorial process that impacts nearly every aspect of the skin’s configuration and function. The skin, our mechanically defensive and elastic barrier organ, is the most visible organ, where all changes, including aging, are very noticeable. The aging process of skin can be described as intrinsic (due to events happening inside the body) and extrinsic (due to events happening outside the body). Intrinsic skin aging is an unavoidable process of chronological and functional alterations. Intrinsic factors that navigate skin aging are span, genetics, and hormones.


In this article, we will explore various causes of skin aging related to both the human body and the external environment that the skin is exposed to.

Causes of Skin Aging

The external environment intensifies the natural aging process of the body. The skin bears the harmful effects of the environment extensively as it is the largest and the most exposed organ to the environment. Some of the causes of skin aging are:

1) Sun exposure:

Apart from the intrinsic aging process, sun exposure is a primary factor that causes aging. Excessive exposure of the skin to sunlight can direct to many ill and deleterious effects, such as sunburn, photoaging, and skin cancer development. The assistance of solar UV exposure to skin aging, resulting in a photo aging phenotype, has been designated (5). Sun exposure is measured in terms of some units like, hours per day, recreational sun exposure, and occasional sun exposure.

Apart from the intrinsic aging process, sun exposure is a primary factor that causes aging. Excessive exposure of the skin to sunlight can direct to many ill and deleterious effects, such as sunburn, photoaging, and skin cancer development. The assistance of solar UV exposure to skin aging, resulting in a photo aging phenotype, has been designated (5). Sun exposure is measured in terms of some units like, hours per day, recreational sun exposure, and occasional sun exposure

2) Genetics:

Genetic makeup plays an important role in the integrity of skin and skin aging process. Several genetically transmitted conditions cause the skin to age faster. These genetic conditions are progeria or progeroid syndromes, like Hutchinson-Gilford progeria, Werner’s syndrome (WS), Rothmund-Thomson syndrome, Cockayne syndrome, Ataxia telangiectasia, and Down syndrome (6). Most syndromes display DNA replication, recombination, repair, and transcription defects.

3) Smoking:

Cigarette smoking releases toxic substances in the body, which add to the oxidative stress responsible for aging. In a study conducted to assess the harmful effects of smoking on the skin, smoking was associated with the premature manifestation of skin wrinkling (7). Smoking decreases collagen synthesis, a protein responsible for maintaining skin elasticity. Decreased collagen causes the premature appearance of wrinkles. Smoking also increases the chances of skin cancer development.

4) Alcohol consumption:

Alcohol impairs the skin’s antioxidant defense mechanism, leaving it more predisposed to sunburn and the aging effects of ultraviolet light. Disproportionate alcohol consumption impacts the body in many ways (e.g., vitamin depletion, tissue damage, disturbance of inflammatory responses, and lessened ability of skin fibroblasts to produce type I collagen) that add to the aging process (8). Alcohol also causes the skin to lose hydration, making it prone to dehydration and dryness, which increase the appearance of fine lines, wrinkles, and signs of premature aging.

5) Stress and hormones:

Stress is inevitable, but excessive stress can lead to premature aging and the appearance of its signs on the skin. Stress causes the body to release stress hormones, I.e., cortisol and adrenaline, which weaken the body in the long run. Stress affects the body on the cellular level as well. It causes early shortening of telomeres and, thus, early accumulation of senescent cells, which continue to release toxins to promote inflammation.

Decreased hormone levels with age also contribute to aging. Aging is linked with the loss of sex hormones in both men and women (10). Testosterone in men and estrogen in women promote longevity and skin elasticity. These hormones are responsible for young-looking skin. With increasing age, there is a loss of sex hormones in both genders, which causes loss of skin elasticity and other manifestations of aging, like loss of muscle mass and decreased physical activity due to a decline in bone mass.

6) Poor sleep habits:

The popular belief of “beauty sleep” is true. During sleep, our body rejuvenates by repairing or replacing damaged cells with new ones. Sleep also manages and lowers the level of cortisol hormone, which causes oxidative skin damage. Sleep-induced collagen production is also interrupted if one is not getting enough sleep. A study found that chronic poor sleep quality is associated with increased signs of intrinsic aging, subsided skin barrier function, and lower satisfaction with appearance (11). Sleep-deprived women show signs of premature skin aging and a reduction in their skin’s ability to heal after sun exposure.

7) Diet:

Many studies have found that a diet high in refined sugar and carbohydrates induces premature aging. Refined sugar is called white poison for a reason. High intake of processed foods having hydrogenated oils cause chronic inflammation and hasten to age by accumulating aged cells.

8) Polluted environment:

Traffic-related air pollution exposure (particulate matter, soot, and nitrogen dioxide) has been linked with premature skin aging in several independent types of research. Traffic pollution is a main concern in an urban environment. The alliance between traffic-related air pollution and skin aging has been well-established. Air pollution is prematurely aging the skin of city dwellers by speeding up the appearance of wrinkles and age spots.

Bottom line

Aging is an inevitable, natural, and irreversible process. It happens all the time at the cellular level. The added extrinsic factors like sun exposure, unhealthy diet, and pollution cause unhealthy and premature skin aging. These extrinsic factors are modifiable by making healthy lifestyle choices. It is possible to age gracefully and naturally by improving your lifestyle. You can slow the appearance of signs of aging on your skin by living a healthy life.

References:

1. Zhang S, Duan E. Fighting against Skin Aging: The Way from Bench to Bedside. Cell Transplant. 2018 May;27(5):729-738. doi: 10.1177/0963689717725755. Epub 2018 Apr 25. PMID: 29692196; PMCID: PMC6047276.

 

2. Höhn A., Weber D., Jung T., Ott C., Hugo M., Kochlik B., Kehm R., König J., Grune T., Castro J.P. Happily (n)ever after: Aging in the context of oxidative stress, proteostasis loss and cellular senescence. Redox Biol. 2017;11:482–501. doi: 10.1016/j.redox.2016.12.001.

3. Thomas K., Chrysiis M., Wolter J.M., Daniel S.P. The essence of senescence. Genes Dev. 2010;24:2463–2479. doi: 10.1101/gad.1971610.by.

 

4. JOUR, Boyajian, Jacqueline, Ghebretatios, Merry, Schaly, Sabrina, Islam, Paromita, Prakash, Satya, 2021/12/18   – 4550 Microbiome and Human Aging: Probiotic and Prebiotic Potentials in Longevity, Skin Health and Cellular Senescence 13,10.3390/nu13124550 Nutrients

 

5. Wong QYA, Chew FT. Defining skin aging and its risk factors: a systematic review and meta-analysis. Sci Rep. 2021 Nov 11;11(1):22075. doi: 10.1038/s41598-021-01573-z. PMID: 34764376; PMCID: PMC8586245.

 

6. Makrantonaki E, Bekou V, Zouboulis CC. Genetics and skin aging. Dermatoendocrinol. 2012 Jul 1;4(3):280-4. doi: 10.4161/derm.22372. PMID: 23467395; PMCID: PMC3583889.

 

7. Wong QYA, Chew FT. Defining skin aging and its risk factors: a systematic review and meta-analysis. Sci Rep. 2021 Nov 11;11(1):22075. doi: 10.1038/s41598-021-01573-z. PMID: 34764376; PMCID: PMC8586245.

 

8. Hoyumpa AM. Mechanisms of vitamin deficiencies in alcoholism. Alcohol Clin Exp Res. 1986;10(6):573–581.

 

9. Goodman GD, Kaufman J, Day D, Weiss R, Kawata AK, Garcia JK, Santangelo S, Gallagher CJ. Impact of Smoking and Alcohol Use on Facial Aging in Women: Results of a Large Multinational, Multiracial, Cross-sectional Survey. J Clin Aesthet Dermatol. 2019 Aug;12(8):28-39. Epub 2019 Aug 1. PMID: 31531169; PMCID: PMC6715121.

 

10. Astrid M. Horstman, E. Lichar Dillon, Randall J. Urban, Melinda Sheffield-Moore, The Role of Androgens and Estrogens on Healthy Aging and Longevity, The Journals of Gerontology: Series A, Volume 67, Issue 11, November 2012, Pages 1140–1152, https://doi.org/10.1093/gerona/gls068

 

11. Oyetakin-White P, Suggs A, Koo B, Matsui MS, Yarosh D, Cooper KD, Baron ED. Does poor sleep quality affect skin ageing? Clin Exp Dermatol. 2015 Jan;40(1):17-22. doi: 10.1111/ced.12455. Epub 2014 Sep 30. PMID: 25266053.

 

Dr Khush Bakht Hypertensions

The Obesity Dilemma

Obesity | Causes and its socioeconomic effects

 

Obesity Dilemma Blog

Everyone is familiar with obesity, a significant health concern affecting almost 41.9% of Americans in 2017, previously 30.5% back in 2000. (1) In 2014, about 30% of the world’s population was obese. Research says that if the incidence of obesity remains at the same rate, half of the world population suffers from obesity until the end of 2030. (2)

According to WHO, 11% of people were obese worldwide in 2016, and its prevalence among females is more than among males. (3) Some people mix the terms obesity and overweight, but there exists a difference between these terms. Being overweight is the first step toward obesity. It is the accumulation of excessive fat leading to several health issues.

Figure 1 Shows increased waist due to abdominal obesity

Body Mass Index (BMI)

The screening test, which helps define whether a person is overweight or obese, is called Body Mass Index. It is calculated according to the following formula(4)

 

     

 

Interpretation of BMI

For an adult individual, the value of BMI determines whether he has an average weight or not. Everyone must check for their BMI regularly because a high BMI is health hazardous, and a low BMI has serious health consequences.

Figure 2 shows different categories of weight according to BMI

The average BMI ranges from 18.5 to 24.9 kgm-2. Below this range, it is underweighted, and above it is overweight. When someone has BMI ranging from 25 to 29.9 kgm-2, he/she stands in the category of overweight. When BMI becomes more than 30 kgm-2, then a person becomes obese. There exists a direct relation between BMI and the percentage of body fat content. A person with a high BMI is most likely to have high body fat content. Here are some interesting facts which you have to consider while understanding BMI.

  • For children, BMI mainly depends upon age and sex.
  • For the same BMI, females tend to have more body fat.
  • For the same BMI, there exists a difference in body fat content depending on racial differences
  • For the same BMI, Athletes and those who do exercise regularly have lower body fat content compared to non-athletes

The main concern here is whether a bodybuilder with having BMI higher than 25 falls under the overweight category or not. So, according to BMI, anyone having BMI greater than 25 is overweight and is at risk of suffering from the harmful consequences of a higher BMI. (5)

Causes of obesity in the modern world

When talking about the causes of obesity in the modern world, we know that the busy lifestyle is a significant reason behind it. People worldwide have less time for themselves and suffer from harmful consequences because they fail to balance their hectic daily routine and health maintenance.

As there are many reasons behind your becoming obese in addition to hectic daily life in the modern world, and these are as follows:

Figure 3 shows the hectic Lifestyle of today’s individual

High caloric intake:

The energy we get from the intake o food is measured in the form of calories. The average caloric need of an adult male is 2500 calories, and for a female, it is 2000 calories as determined by WHO. Any caloric intake greater than this value is responsible for increasing an individual’s weight; over time, it is responsible for obesity. Similarly, sedentary individuals with the recommended caloric intake and no physical activity are also at risk of developing obesity. (6)

Poor diet:

A poor diet does not mean that a person has less food to eat, but it indicates an imbalance in the consumption of different eatables. It includes excessive consumption of processed food items enriched in low-weight carbohydrates and fat, alcohol, and fizzy drinks. However, a state of depression and stressful life also serves as a risk for a person having a poor diet. (6)

Figure 4 shows the consumption of different foods by American according to the American Institute for cancer research in 2017 (7)

In addition, it is seen that unhealthy eating habits are common in some families.

Sedentary lifestyle

The absence of physical activity in daily life is one of the main culprits behind the development of obesity in most individuals all around the globe. People, after excessive food intake and performing their daily tasks, think that they have done enough to live a healthy life. But contrary to it, they have done nothing. So, in addition to daily activities, a proper time for physical activity in the form of any outdoor game is necessary for a healthy lifestyle. A moderate-intensity aerobic exercise for 150 minutes per week is recommended for having healthy life by the Health and Social Care Department. (6)

Figure 5 shows an example of a Sedentary Lifestyle

Genetical basis

In most cases, obesity is related to environmental factors. But there is a rare genetic disorder in which a person has increased appetite and is unable to lose weight. One such genetic disorder is Prader-Willi syndrome. The major gene involved in increased appetite or hyperphagia is the MC4R gene responsible for encoding melanocortin 4 receptors. (8)

Metabolic disorders

Different metabolic conditions also lead to obesity, such as.

  • Hypothyroidism; a state of decreased production of thyroid hormones
  • Cushing syndrome; a state of excessive steroid hormone production, mainly cortisol. (6)

Medicinal side effects

Obesity can result as a side effect of different medications such as

  • Corticosteroids
  • Antidepressants
  • Antipsychotics
  • Medication for diabetes
  • Anti-epileptics

However, a smoker can also suffer from obesity after quitting smoking. (6)

 

 

Consequences of Obesity

Obesity is the 2nd major concern after smoking in the U.S., having a significant impact on societies, nations, and individuals. In the USA, obesity is also 2nd major cause of death below 70 years of age.

 

Obesity and Society

In societies, obese people have low self-esteem as they seek disrespect and laughter from people in their surroundings. They got lower wages as people thin obese people are unable to do adequate work at the workplace. Due to obesity, they face great discrimination in society and have a poor quality of life. Let’s take an example; no one wants to give a romantic role to an obese individual to individual. Nobody wants to marry an obese partner. Most of the time, obese individual lives a lonely life as nobody wants to be their friend. (9)

In U.S. societies, the prevalence of obesity in males is more compared to females, and people whose age ranges between 40-59 are at greater risk of suffering from obesity and its consequences. (10)

Childhood Obesity

Childhood obesity has become a major concern for modern society due to the lack of outdoor activities for our children. Research conducted over the selected countries has shown that childhood obesity rate is increasing at an alarming state.

Figure 6 shows the percentages of childhood obesity in different selected countries

According to the above data, U.S. girls are the most obese, and Indian girls are the least obese. All others fall between these two extremes. (11)

Obesity and Personal Financial status

Obesity has a devastating impact on the financial status of an obese individual due to the following reasons

  • Loss of job
  • Lower wages
  • Huge medical expenditures
  • Reduced productivity at the workplace
  • Retirement at an early age
  • Co-morbidities

Obesity and Economy

Obesity is a burden on society’s economy, and the prevalence of obesity in the community is a major concern for national stakeholders. According to a systematic literature review, obesity burdens society and the health care system. (12) The global economic impact of obesity was about 2.8% of the overall GDP of the U.S. in 2014. (2) Obesity affects economic growth of the country is due to decreased productivity at work, lost working days, disability, and mortality.

Figure 7 shows the burden of obesity on the economy of different countries of the world (13)

  • The economic impact of obesity in the U.S. rose to 1.4 trillion dollars in 2020 from 976 billion dollars. (10)
  • The economic cost of an adult individual ranges from 147 to 210 billion dollars per year
  • Most of the economic expenditure is due to the cardiovascular and diabetic consequences of obesity.
  • Obese individuals have 15 times more costs than non-obese individuals.
  • Direct medical costs are related to obese males, while job-related costs such as low wages are related to obese females.
  • If there is no obesity, then there will be 8.5% Medicare and 11.8% Medicaid expenditures.

Obesity and the Healthcare system

After discussing the impacts of obesity on the society and economy, we will now discuss the most critical effect of obesity and its complications, which is on the healthcare system. According to a survey, the healthcare expenditure of obese individuals is US$ 1496 more than non-obese individuals. (14)

Obesity burdens the healthcare system all around the globe, but its impact is different in different countries of the world.

Figure 8 shows the list of countries whose healthcare systems will be most affected due to obesity from 2020 to 2050 (15)

According to the above data, the U.S. is spending most of its healthcare budget, about 14%, on the treatment of obesity which is more than any other country in the world.

Bottomline

Obesity is one of the major health issues prevailing worldwide. It not only affects the personal life of the individuals but also the economic growth of the countries. At the same time, mortality rate is increasing due to obesity and its complications, and it is burdening the healthcare system to great extent.

 

 

References:

  1. Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLoS ONE. 2021 Mar 1;16(3 March).
  2. Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic Burden of Obesity: A Systematic Literature Review. International Journal of Environmental Research and Public Health [Internet]. 2017 Apr 19 [cited 2022 Jun 27];14(4). Available from: /pmc/articles/PMC5409636/
  3. Obesity and overweight [Internet]. [cited 2022 Jun 26]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  4. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. The Lancet. 2014 Aug 30;384(9945):755–65.
  5. About Adult BMI | Healthy Weight, Nutrition, and Physical Activity | CDC [Internet]. [cited 2022 Jun 27]. Available from: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
  6. Obesity – Causes – NHS [Internet]. [cited 2022 Jun 27]. Available from: https://www.nhs.uk/conditions/obesity/causes/
  7. Martínez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: Evidence from a nationally representative cross-sectional study. Population Health Metrics. 2017 Feb 14;15(1).
  8. Genes and obesity | CDC [Internet]. [cited 2022 Jun 27]. Available from: https://www.cdc.gov/genomics/resources/diseases/obesity/obesedit.htm
  9. Obesity Consequences | Obesity Prevention Source | Harvard T.H. Chan School of Public Health [Internet]. [cited 2022 Jun 27]. Available from: https://www.hsph.harvard.edu/obesity-prevention-source/obesity-consequences/
  10. Economic Impact of Obesity increased to $1.4 Trillion [Internet]. [cited 2022 Jun 27]. Available from: https://milkeninstitute.org/article/economic-impact-obesity-increased-14-trillion-says-milken-institute
  11. China Is Now The World’s Second-Fattest Country After The U.s – Old Discussions – Andhrafriends.com [Internet]. [cited 2022 Jun 27]. Available from: http://www.andhrafriends.com/topic/515588-china-is-now-the-worlds-second-fattest-country-after-the-us/
  12. Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic Burden of Obesity: A Systematic Literature Review. International Journal of Environmental Research and Public Health [Internet]. 2017 Apr 19 [cited 2022 Jun 27];14(4). Available from: /pmc/articles/PMC5409636/
  13. Tackling obesity would boost economic and social well-being – OECD [Internet]. [cited 2022 Jun 27]. Available from: https://www.oecd.org/newsroom/tackling-obesity-would-boost-economic-and-social-well-being.htm
  14. Musich S, MacLeod S, Bhattarai GR, Wang SS, Hawkins K, Frank G. Bottone Jr, et al. The Impact of Obesity on Health Care Utilization and Expenditures in a Medicare Supplement Population. Gerontology and geriatric medicine [Internet]. 2016 Jan 1 [cited 2022 Jun 27];2:233372141562200. Available from: /pmc/articles/PMC5119873/
  15. How much obesity costs healthcare systems around the world | World Economic Forum [Internet]. [cited 2022 Jun 27]. Available from: https://www.weforum.org/agenda/2019/10/obesity-healthcare-expenditure-burden/
  16. HUNT Study: Doubled Mortality Risk From Sedentary Lifestyle for 20 Years [Internet]. [cited 2022 Jun 27]. Available from: https://scitechdaily.com/hunt-study-doubled-mortality-risk-from-sedentary-lifestyle-for-20-years/

 

Dr Khush Bakht Your Hormones Strategy

How You Can Boost Your Testosterone Levels Safely and Naturally

Testosterone | All You need to Know about Testosterone Supplements and Boosters

 

The Testosterone Blog

Testosterone boosters include a range of supplements that increase testosterone levels. There are many options, depending on the severity of the drop. You can use herbal blends if your testosterone levels are mildly lower than normal. We will tell you in detail about these herbal supplements. But if your testosterone levels are very low and you have severe symptoms, there are steroids available that must be taken under supervision. High doses of steroids can have side effects with unwanted symptoms of excessive testosterone. Some medications are also available for treating low hormone levels.

Why do we need testosterone

As we explained in our previous blog, testosterone is the male sex hormone. It is important for regulating fertility, muscle mass, red blood cell production, and fat distribution. When testosterone levels fall below normal, it can lead to infertility and other health issues. Low testosterone is becoming more and more common. In this article, you will learn the signs and symptoms of low testosterone and the supplements available to boost hormone levels.

What are the signs and symptoms of low testosterone

If your testosterone levels decline, your sex drive may reduce. You may also be unable to get and maintain an erection. A person with low testosterone may also experience low sperm count, low bone density, fatigue, weakness, anxiety, anemia, increased sweating, and enlarged or swollen breast tissue. Gradually these symptoms develop and can lead to loss of body hair, muscle bulk, increased body fat, and loss of strength. Testicular injury, infection of the testicles, certain medications, pituitary tumors, and some genetic diseases can cause chronic low testosterone. Chronic low testosterone levels may cause osteoporosis, mood swings, reduced energy, and testicular shrinkage.

How can we detect low testosterone

Blood tests can detect low testosterone levels. Hence, an imbalance of testosterone can be treated accordingly. If you are diagnosed with low testosterone, your doctor may suggest several tests and exams to determine the cause. Your doctor may suggest imaging tests such as an MRI or CT scan of the brain to see if your pituitary gland is working properly, genetic tests, or hormone tests. Your doctor will examine you to look for signs of low testosterone. He or she will look at your amount of body hair, the size of your breasts, testes, scrotum, and penis. The doctor will inquire about your medical history and your family’s medical history.

Supplements that can boost your testosterone levels

Following is a list of supplements that may help increase testosterone levels.

  • D-aspartic acid
  • Vitamin D
  • Tribulus Terrestris
  • Magnesium
  • Dehydroepiandrosterone (DHEA)
  • Ashwagandha
  • Fenugreek
  • Ginger
  • Saw palmetto extract

Vitamin D

Vitamin D is a fat-soluble vitamin that our body produces upon exposure to sunlight. People with limited exposure to sunlight may have low levels of vitamin D. You must be aware that a lack of vitamin D can cause bones to become soft and weak. Still, there is also a link between vitamin D levels and testosterone. Research has shown that sex steroid production is linked with vitamin D status. In its active form, it functions as a steroid hormone in the body. Some studies have shown a synergistic effect of activated vitamin D on sex steroid production in vitro (1). Researchers found that men with vitamin D deficiency had lower testosterone levels than those without a deficiency. This suggests that boosting vitamin D levels may help raise testosterone levels. So, if you have a deficiency of vitamin D, increase your sun exposure, eat vitamin D rich foods or use a vitamin D supplement. Vitamin D supplements come as capsules and sprays.

D-aspartic acid

D-aspartic acid is an amino acid occurring in the pituitary gland and testes. It has a role in regulating the release and synthesis of testosterone (2). Research suggests that D-aspartic acid functions in nervous system development and hormonal regulation. It also influences the hypothalamic-pituitary-gonadal axis at the hypothalamus, pituitary, and testes levels. Accumulating D-aspartic acid at these sites is associated with the upregulation of testosterone production (3).

Tribulus Terrestris

Tribulus Terrestris is a flowering plant. It is found in tropical and temperate zones throughout the world. It has been used in many traditional medical practices in various cultures. Researchers studied the effect of this herb on testosterone levels. They found that Tribulus Terrestris extract increases the body’s natural testosterone levels, improving male sexual performance and building muscles (4).

Magnesium

Just like vitamin D, magnesium deficiency has been closely associated with low testosterone levels. In a study of athletes and sedentary men, investigators found that magnesium supplements increased testosterone levels in both groups. The increase was higher in athletes. This suggests that magnesium boosts testosterone in men with normal levels.

Dehydroepiandrosterone

Dehydroepiandrostenedione is a hormone produced in the adrenal glands. It helps regulate testosterone and estrogen levels. Many people take DHEA as a supplement to boost testosterone. DHEA supplementation helps increase testosterone levels, although the magnitude differs among different subgroups (5). A study found that hormone supplementation is one direct way to increase sex steroid hormone levels (6).

Ashwagandha

Ashwagandha is a shrub. Its roots and fruit have medicinal properties. Ashwagandha is used in ayurvedic medicine (7). It acts as an adaptogen which means it helps your body handle stress and anxiety (8). Evidence suggests its beneficial effects on sperm quality in men with infertility (9). Another study showed positive effects on testosterone levels (10). Hence it is a good supplement for boosting testosterone levels.

Fenugreek

Fenugreek is another popular herb that can support healthy testosterone levels. Evidence suggests its role in increasing testosterone levels and sexual desire (11). It also improves mental alertness and mood (12).

Ginger

Ginger is a flowering medicinal plant used as a household spice that has played a role in alternative medicine for centuries. It has various potential health benefits, such as reducing cholesterol levels and inflammation. A study showed that it boosts testosterone levels (13). Several animal studies have shown that ginger positively affects testosterone levels and sexual function (14).

Saw palmetto extract

Saw palmetto is a shrub-like palm that is often used as a supplement to prevent hair loss and treat urinary symptoms. It may also increase testosterone levels by blocking the activity of a specific enzyme called 5-alpha reductase, responsible for converting testosterone into dihydrotestosterone (inactive form) (15).

How to choose a testosterone booster

It would be best to keep several key factors in mind when looking for a supplement to boost your testosterone levels.

  • Ingredients

Some ingredients have more research, so you should look for products containing researched ingredients.

  • Dose

You should choose those supplements that contain ingredients in doses shown to be effective and safe.

  • Quality

You should never settle on low quality when it involves your health. Look for products from well-known companies that follow current Good Manufacturing Practices (cGMPs) set by the Food Drug Administration.

Are testosterone boosters safe

Though many supplements have been shown to improve testosterone levels, it is important to remember that the FDA does not assess over-the-counter (OTC) supplements. For this reason, some may not be effective for you. One study found that only 30% of people experienced increased testosterone levels after using five OTC testosterone boosters (16). You should choose high-quality products from a trusted supplier, and picking tested supplements may be beneficial. You should also be cautious while taking supplements if you are taking other medications or have an underlying health condition. Make sure to talk with a healthcare professional before using any of the supplements listed above to prevent negative side effects, especially if you are taking any medication or have an underlying health condition. They will help you choose the best supplement for your needs and warn you about any ingredients that may interact with other medications you are using.

Other ways to boost testosterone levels

There are some other natural ways to boost testosterone levels. Some of them include minimizing stress and getting high-quality sleep. Testosterone replacement therapy is also available for those whose bodies stop producing the hormone.

Testosterone replacement therapy

Besides natural testosterone supplements, there are medications available for low testosterone levels. One well-known treatment doctors give to males showing symptoms of low testosterone is testosterone replacement therapy. Taking prescription testosterone helps restore the levels in the blood and reverse the symptoms of low testosterone. People notice improvements in alertness, sexual function, energy, mood, and overall well-being. A recent study suggests that TRT provides an extra benefit for overall mortality and stroke for men whose testosterone levels have normalized with TRT. However, doctors do not usually recommend testosterone replacement therapy as the first course of action for low testosterone levels. If other conditions or medications cause testosterone levels to drop, doctors usually treat the underlying cause before recommending testosterone replacement therapy. The Endocrine Society advises that doctors should not prescribe TRT to men under 65 years, even if they have low testosterone levels.

References

  1. Holt, R., Juel Mortensen, L., Harpelunde Poulsen, K., Nielsen, J. E., Frederiksen, H., Jørgensen, N., Jørgensen, A., Juul, A., & Blomberg Jensen, M. (2020). Vitamin D and sex steroid production in men with normal or impaired Leydig cell function. The Journal of steroid biochemistry and molecular biology, 199, 105589. https://doi.org/10.1016/j.jsbmb.2020.105589
  2. Topo, E., Soricelli, A., D’Aniello, A., Ronsini, S., & D’Aniello, G. (2009). The role and molecular mechanism of D-aspartic acid in the release and synthesis of LH and testosterone in humans and rats. Reproductive biology and endocrinology: RB&E, 7, 120. https://doi.org/10.1186/1477-7827-7-120
  3. Melville, G. W., Siegler, J. C., & Marshall, P. (2017). The effects of d-aspartic acid supplementation in resistance-trained men over a three month training period: A randomized controlled trial. PloS one, 12(8), e0182630. https://doi.org/10.1371/journal.pone.0182630
  4. Singh, S., Nair, V., & Gupta, Y. K. (2012). Evaluation of the aphrodisiac activity of Tribulus Terrestris Linn. in sexually sluggish male albino rats. Journal of Pharmacology & pharmacotherapeutics, 3(1), 43–47. https://doi.org/10.4103/0976-500X.92512
  5. Li, Y., Ren, J., Li, N., Liu, J., Tan, S. C., Low, T. Y., & Ma, Z. (2020). A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials. Experimental gerontology, 141, 111110. https://doi.org/10.1016/j.exger.2020.111110
  6. Chen, W. C., Chen, Y. M., Huang, C. C., & Tzeng, Y. D. (2016). Dehydroepiandrosterone Supplementation Combined with Whole-Body Vibration Training Affects Testosterone Level and Body Composition in Mice. International journal of medical sciences, 13(10), 730–740. https://doi.org/10.7150/ijms.16132
  7. Salve, J., Pate, S., Debnath, K., & Langade, D. (2019). Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study. Cureus, 11(12), e6466. https://doi.org/10.7759/cureus.6466
  8. Liao, L. Y., He, Y. F., Li, L., Meng, H., Dong, Y. M., Yi, F., & Xiao, P. G. (2018). A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chinese medicine, 13, 57. https://doi.org/10.1186/s13020-018-0214-9
  9. Mahdi, A. A., Shukla, K. K., Ahmad, M. K., Rajender, S., Shankhwar, S. N., Singh, V., & Dalela, D. (2009). Withania somnifera Improves Semen Quality in Stress-Related Male Fertility. Evidence-based complementary and alternative medicine: eCAM, 2011, 576962. Advanced online publication. https://doi.org/10.1093/ecam/nep138
  10. Lopresti, A. L., Drummond, P. D., & Smith, S. J. (2019). A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males. American journal of men’s health, 13(2), 1557988319835985. https://doi.org/10.1177/1557988319835985
  11. Rao, A., Steels, E., Beccaria, G., Inder, W. J., & Vitetta, L. (2015). Influence of a Specialized Trigonella foenum-graecum Seed Extract (Libifem), on Testosterone, Estradiol and Sexual Function in Healthy Menstruating Women, a Randomised Placebo Controlled Study. Phytotherapy research: PTR, 29(8), 1123–1130. https://doi.org/10.1002/ptr.5355
  12. Maheshwari, A., Verma, N., Swaroop, A., Bagchi, M., Preuss, H. G., Tiwari, K., & Bagchi, D. (2017). Efficacy of FurosapTM, a novel Trigonella foenum-graecumseed extract, in Enhancing Testosterone Level and Improving Sperm Profile in Male Volunteers. International journal of medical sciences, 14(1), 58–66. https://doi.org/10.7150/ijms.17256
  13. Banihani S. A. (2018). Ginger and Testosterone. Biomolecules, 8(4), 119. https://doi.org/10.3390/biom8040119
  14. Ghlissi, Z., Atheymen, R., Boujbiha, M. A., Sahnoun, Z., Makni Ayedi, F., Zeghal, K., El Feki, A., & Hakim, A. (2013). Antioxidant and androgenic effects of dietary ginger on the reproductive function of male diabetic rats. International journal of food sciences and nutrition, 64(8), 974–978. https://doi.org/10.3109/09637486.2013.812618
  15. Pais, P., Villar, A., & Rull, S. (2016). Determination of the potency of a novel saw palmetto supercritical CO2 extract (SPSE) for 5α-reductase isoform II inhibition using a cell-free in vitro test system. Research and reports in urology, 8, 41–49. https://doi.org/10.2147/RRU.S96576
  16. Balasubramanian, A., Thirumavalavan, N., Srivatsav, A., Yu, J., Lipshultz, L. I., & Pastuszak, A. W. (2019). Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements. The journal of sexual medicine, 16(2), 203–212. https://doi.org/10.1016/j.jsxm.2018.12.008

 

 

 

 

 

 

 

Dr Khush Bakht Your Hormones Strategy

How You can Boost Testosterone Level Safely and Naturally

Testosterone | How you can boost your testosterone levels safely and naturally

 

The Testosterone Blog

You are not alone if you are looking for ways to boost your testosterone levels. Testosterone is a vital hormone for men’s health, and low testosterone can cause various problems. Fortunately, there are plenty of ways to boost your testosterone levels naturally. This article will share the best ways to boost your testosterone levels safely and effectively. Following these tips can improve your testosterone levels, and you can enjoy better health.
Testosterone is a male sex hormone also produced in females in small amounts. Testosterone is essential for men’s health. It plays several crucial roles in muscle growth, fat loss, and sexual function. Conversely, low testosterone can cause fatigue, loss of libido, erectile dysfunction, and even depression. But you don’t need to be stressed because we have your back. It would be best if you continue reading this article.


How testosterone is produced naturally in our body

Testosterone is a steroid hormone. It is produced in the testicles of men by Leydig cells and ovaries in women. (1) Most testosterone in the ovary gets converted to the female sex hormone, estradiol. Adrenal glands, located on top of each kidney, also produce testosterone in small amounts in both sexes.


Regulation of testosterone levels

Testosterone levels are tightly controlled to maintain normal levels in the blood. Hypothalamus and pituitary gland plays a role in controlling the amount of testosterone produced by the testes. In puberty, the hypothalamus produces GnRH (gonadotropin-releasing hormone), which causes the pituitary gland to produce two hormones, luteinizing hormone, and follicle-stimulating hormone. Luteinizing hormone acts on the Leydig cells to increase testosterone production. Testosterone limits its production through negative feedback. High levels of testosterone in the blood signal the hypothalamus to suppress the secretion of gonadotropin-releasing hormone. It also makes the pituitary gland less responsive to GnRH stimuli, suppressing the production of luteinizing hormone. (2) Levels of testosterone fall as a result, so negative feedback decreases, and the hypothalamus resumes secretion of gonadotropin-releasing hormone.


What role does testosterone play in our body?

While you think of testosterone as a sex hormone, you might wonder what its functions are. Let us tell you the functions of testosterone in detail.
Testosterone is responsible for primary as well as secondary sexual development. Primary sexual development includes development before puberty. It involves testicular descent during gestation, spermatogenesis, enlargement of the penis and testis, and increasing libido. (2) The secondary sexual characteristics involve those responsible for masculinity, such as male hair patterns, vocal changes, voice deepening, and anabolic effects. The anabolic effects include growth spurts in puberty and skeletal muscle growth. Testosterone increases tissue growth and stimulates protein synthesis and red blood cell production. (2)
Testosterone levels tend to drop with age. Men experience a decrease in testicular size, a drop in libido, lower bone density, mass muscle decline, increased fat production, and a decrease in red blood cells. (2)


What happens if testosterone is low in our body

Did you know the testosterone level is not constant throughout the day in a man’s body? The body produces testosterone in a pulsatile pattern. The testosterone level is highest in the morning and falls during the day. The average testosterone level ranges from 300-1000 ng/dl. A level below 300 ng/dl is considered a low testosterone level.

 

How common is low testosterone level

While it is difficult to state the prevalence of low testosterone, statistics have shown that about 2 men in every 100 may have low testosterone levels. The chances of having low testosterone increase with aging. Research has shown that unhealthy lifestyles are playing a part in this imbalance.


What conditions cause low testosterone levels

You might wonder what causes low testosterone levels; leave it to us. Researchers have found that low testosterone level is associated with metabolic syndrome (3). It is a group of diseases that occur together. The diseases include high blood pressure, excess body fat around the waist, high blood sugar, and abnormal cholesterol levels. There is a bidirectional relationship between low testosterone levels and obesity or metabolic syndrome.

 

How to boost testosterone levels naturally

There are many effective ways to boost testosterone levels. Our job is to tell you how to boost testosterone levels naturally. Your job is to follow these tips effectively. The following are the proven ways to boost testosterone levels.

 

Physical activity and exercise

Regular exercise prevents many lifestyle-related diseases. Exercise produces many systemic and endocrine changes and can boost your testosterone level. (6) Research has proven that physically active men show better hormone values than sedentary men. Similarly, practicing regular physical activity has been shown to improve overall health. (5)
You might be wondering what kind of exercise is best to boost testosterone levels. Research shows that performing strength exercises such as weight lifting leads to alterations at the hypothalamic-pituitary-testicular axis (7). As explained above, the hypothalamic-pituitary-testicular axis regulates the testosterone level in our body.
Although all types of exercise should boost testosterone levels, high-intensity interval training (HIIT) can also be efficient (8).


A diet containing proteins, fats, and carbohydrates

Your diet has a significant impact on testosterone as well as other hormone levels. It would help if you focused on eating a balanced diet that meets your body’s requirements. Also, some foods affect your hormone levels more than other foods. So including those foods in your diet can boost your testosterone levels.
Taking enough protein, healthy fats, and carbs into the diet are essential to boost testosterone levels. Evidence suggests that satisfactory function of the hypothalamic-pituitary-testicular axis requires a functional (protein) reserve as well as an energy (fat) reserve (9). Carbohydrates help optimize testosterone levels during resistance training (10). Research has shown that fat intake significantly correlates with testosterone (11). In men, a decrease in dietary fat content and an increase in unsaturated fatty acids reduce the serum concentration of testosterone (12). Hence a diet based on whole foods with a healthy balance of proteins, fats, and carbs is best. It boosts hormone levels and long-term health.


Foods that will boost your testosterone levels

Eating a healthy and balanced diet can boost testosterone levels. But there are certain foods rich in nutrients that may help boost healthy testosterone levels.


Fatty Fish and fish oil

Fatty fish and fish oil are rich in nutrients crucial for maintaining hormonal levels. Seafood contains omega-3 fatty acids, vitamin D, and zinc. However, certain high-fat foods, such as processed and fried foods, have decreased testosterone levels. Research has also shown that low-fat diets can affect testosterone levels (13). You can also boost your fatty acid levels by taking omega-3 supplements. Fish rich in omega-3 fatty acids include salmon, sardines, trout, and Atlantic mackerel. Regardless, adding healthy fat sources to your diet benefits overall health, including hormonal levels.


Oysters

Oysters contain more zinc than other food, which is necessary for reproductive health and function. Research has shown that males with zinc deficiency may develop hypogonadism, a condition in which the body produces less testosterone (14). These males experience impotence or delayed sexual maturation. Zinc is also present in foods like shellfish, red meat, poultry, beans, and nuts. So you can also take these foods to meet your requirement for zinc.


Berries, cherries, and pomegranates

Berries, cherries, and pomegranates are rich in antioxidants. Antioxidants protect Leydig cells from damage and increase testosterone production (4). Pomegranate is also an age-old symbol of fertility and sexual function. Obesity-induced inflammation reduces testosterone levels (15). Berries protect against this inflammation and thus help boost testosterone levels (16).


Eggs

Egg yolks are rich in healthy fat, protein, and selenium. Selenium acts as an antioxidant in the body. It also enhances testosterone production by activating specific pathways and expressing certain genes (17). It would be best if you also remembered that whole eggs are more nutritious than plain egg white since the yolk contains most of the nutrients. You should add eggs to your diet on a priority basis because they improve overall health.

 

Avocados

Avocados provide healthy fat, which boosts hormone levels. Also, avocados contain magnesium and boron. Boron is a mineral that is known to benefit testosterone levels. It influences testosterone metabolism and protects against testosterone degradation (18).


Leafy green vegetables

Dark, leafy green vegetables are excellent sources of micronutrients, including magnesium, a mineral that is important for maintaining normal testosterone levels. Magnesium increases testosterone activity in the body by reducing oxidative stress. Oxidative stress can reduce testosterone, so introducing nutrients that combat oxidative stress will help boost testosterone levels (19). Therefore including magnesium-rich foods such as spinach, kale, and other green vegetables may help promote healthy testosterone levels.
The above-explained foods are some of the many foods which boost testosterone levels. Including these foods and others such as onion, ginger, and fortified plant milk in your diet will benefit your overall health and hormonal health.

 


References

1. Mederos, M. A., Bernie, A. M., Scovell, J. M., & Ramasamy, R. (2015). Can Serum Testosterone Be Used as a Marker of Overall Health?. Reviews in urology, 17(4), 226–230.
2. Nassar GN, Leslie SW. Physiology, Testosterone. [Updated 2022 Jan 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526128/
3. Kelly, D. M., & Jones, T. H. (2013). Testosterone: a metabolic hormone in health and disease. The Journal of endocrinology, 217(3), R25–R45. https://doi.org/10.1530/JOE-12-0455
4. Martin, L. J., & Touaibia, M. (2020). Improvement of Testicular Steroidogenesis Using Flavonoids and Isoflavonoids for Prevention of Late-Onset Male Hypogonadism. Antioxidants (Basel, Switzerland), 9(3), 237. https://doi.org/10.3390/antiox9030237
5. Vaamonde, D., Da Silva-Grigoletto, M. E., García-Manso, J. M., Barrera, N., & Vaamonde-Lemos, R. (2012). Physically active men show better semen parameters and hormone values than sedentary men. European journal of applied physiology, 112(9), 3267–3273. https://doi.org/10.1007/s00421-011-2304-6
6. Ari, Z., Kutlu, N., Uyanik, B. S., Taneli, F., Buyukyazi, G., & Tavli, T. (2004). Serum testosterone, growth hormone, and insulin-like growth factor-1 levels, mental reaction time, and maximal aerobic exercise in sedentary and long-term physically trained elderly males. The International journal of neuroscience, 114(5), 623–637. https://doi.org/10.1080/00207450490430499
7. Timón Andrada, R., Maynar Mariño, M., Muñoz Marín, D., Olcina Camacho, G. J., Caballero, M. J., & Maynar Mariño, J. I. (2007). Variations in urine excretion of steroid hormones after an acute session and after a 4-week program of strength training. European journal of applied physiology, 99(1), 65–71. https://doi.org/10.1007/s00421-006-0319-1
8. Hackney, A. C., Hosick, K. P., Myer, A., Rubin, D. A., & Battaglini, C. L. (2012). Testosterone responses to intensive interval versus steady-state endurance exercise. Journal of endocrinological investigation, 35(11), 947–950. https://doi.org/10.1007/BF03346740
9. Lado-Abeal, J., Prieto, D., Lorenzo, M., Lojo, S., Febrero, M., Camarero, E., & Cabezas-Cerrato, J. (1999). Differences between men and women as regards the effects of protein-energy malnutrition on the hypothalamic-pituitary-gonadal axis. Nutrition (Burbank, Los Angeles County, Calif.), 15(5), 351–358. https://doi.org/10.1016/s0899-9007(99)00051-9
10. Volek, J. S., Kraemer, W. J., Bush, J. A., Incledon, T., & Boetes, M. (1997). Testosterone and cortisol in relationship to dietary nutrients and resistance exercise. Journal of applied physiology (Bethesda, Md: 1985), 82(1), 49–54. https://doi.org/10.1152/jappl.1997.82.1.49
11. Bishop, D. T., Meikle, A. W., Slattery, M. L., Stringham, J. D., Ford, M. H., & West, D. W. (1988). The effect of nutritional factors on sex hormone levels in male twins. Genetic epidemiology, 5(1), 43–59. https://doi.org/10.1002/gepi.1370050105
12. Hämäläinen, E., Adlercreutz, H., Puska, P., & Pietinen, P. (1984). Diet and serum sex hormones in healthy men. Journal of steroid biochemistry, 20(1), 459–464. https://doi.org/10.1016/0022-4731(84)90254-1
13. Kurniawan, A. L., Hsu, C. Y., Chao, J. C., Paramastri, R., Lee, H. A., Lai, P. C., Hsieh, N. C., & Wu, S. V. (2021). Association of Testosterone-Related Dietary Pattern with Testicular Function among Adult Men: A Cross-Sectional Health Screening Study in Taiwan. Nutrients, 13(1), 259. https://doi.org/10.3390/nu13010259
14. Maxfield L, Shukla S, Crane JS. Zinc Deficiency. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493231/
15. Tremellen, K., McPhee, N., Pearce, K., Benson, S., Schedlowski, M., & Engler, H. (2018). Endotoxin-initiated inflammation reduces testosterone production in men of reproductive age. American journal of physiology. Endocrinology and metabolism, 314(3), E206–E213. https://doi.org/10.1152/ajpendo.00279.2017
16. Land Lail, H., Feresin, R. G., Hicks, D., Stone, B., Price, E., & Wanders, D. (2021). Berries as a Treatment for Obesity-Induced Inflammation: Evidence from Preclinical Models. Nutrients, 13(2), 334. https://doi.org/10.3390/nu13020334
17. Qazi, I. H., Angel, C., Yang, H., Zoidis, E., Pan, B., Wu, Z., Ming, Z., Zeng, C. J., Meng, Q., Han, H., & Zhou, G. (2019). Role of Selenium and Selenoproteins in Male Reproductive Function: A Review of Past and Present Evidences. Antioxidants (Basel, Switzerland), 8(8), 268. https://doi.org/10.3390/antiox8080268
18. Rondanelli, M., Faliva, M. A., Peroni, G., Infantino, V., Gasparri, C., Iannello, G., Perna, S., Riva, A., Petrangolini, G., & Tartara, A. (2020).The pivotal role of boron supplementation on bone health: A narrative review. Journal of Trace Elements in Medicine and Biology, 62, 126577. https://doi.org/10.1016/j.jtemb.2020.126577
19. Maggio, M., Ceda, G. P., Lauretani, F., Cattabiani, C., Avantaggiato, E., Morganti, S., Ablondi, F., Bandinelli, S., Dominguez, L. J., Barbagallo, M., Paolisso, G., Semba, R. D., & Ferrucci, L. (2011). Magnesium and anabolic hormones in older men. International journal of andrology, 34(6 Pt 2), e594–e600. https://doi.org/10.1111/j.1365-2605.2011.01193.x

 

Dr Khush Bakht Hypertensions

The Cholesterol Paradox VI

Cholesterol Markers | Blood Work for Cholesterol levels

 The Cholesterol Paradox Blog

A cholesterol test is a blood test that determines the amount of cholesterol and specific fats in your blood. Cholesterol is a waxy fat-like substance present in every cell of your body and blood. Cholesterol is essential for your cells and organs.

Lipid Panel

Before your serum cholesterol test, you might need to fast (without food or liquids) for nine to twelve hours. Because of this, testing is frequently conducted in the morning.

If you need to fast or if there are any other particular instructions, your provider will let you know. The blood test that measures cholesterol levels is called a lipid panel or lipid profile.

The lipid profile gives you the following numbers:

  • Total cholesterol.
  • HDL levels.
  • VLDL levels and triglycerides.
  • LDL levels.
  • Non-HDL cholesterol.
  • The ratio between cholesterol and HDL.

A lipid panel measures your risk of cardiovascular disease. Because high levels of cholesterol and triglycerides in your blood can cause their accumulation in blood vessels and arteries, damaging these structures and increasing your risk of cardiovascular complications. Due to this, healthcare professionals use lipid panel tests for children and adults to evaluate the risk of cardiovascular abnormalities like heart disease, heart attack, and stroke.

·       Estimation of total cholesterol

Total cholesterol in your blood includes low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol. In the United States, the cholesterol level in your blood is measured in milligrams of cholesterol per deciliter (mg/dL) of blood. In many European countries, cholesterol is measured in millimoles per litre (mmol/L). You can interpret your test results using the following guidelines (1).

Total cholesterol (in the U.S. and some other countries)Total cholesterol (in Canada and most of Europe)Results
Below 200 mg/dlBelow 5.2 mmol/lDesirable
200-239 mg/dl5.2-6.2 mmol/lBorderline high
240 mg/dl and aboveAbove 6.2 mmol/lHigh

Canadian and European guidelines slightly differ from the guidelines of the U.S. These conversions are according to the U.S guidelines.

·       Estimation of LDL cholesterol

It is the primary source of cholesterol accumulation and blockage in the arteries. LDL cholesterol forms plaque (waxy) on the inside wall of an artery. Excess plaque can limit blood flow through that artery. LDL levels of 190 mg/dl or greater are considered excessively high. Values between 70-189 mg/dl are considered high if you are at risk of cardiovascular disease.

LDL cholesterol (in the U.S. and some other countries)LDL cholesterol (in Canada and most of Europe)Results
Below 70 mg/dlBelow 1.8 mmol/lBest for people with coronary artery disease, a history of heart attacks, angina, or coronary bypass
Below 70 mg/dlBelow 2.6 mmol/lNormal for people with a risk of coronary artery disease or diabetes. Near normal for people with uncomplicated coronary artery disease
100-129 mg/dl2.6-3.3 mmol/lNear normal if there is no coronary disease. High if there is coronary disease.
130-159 mg/dl3.4-4.1 mmol/lBorderline high if there is no coronary disease. High if there is coronary disease.
160-189 mg/dl4.1-4.9 mmol/lHigh if there is no coronary disease. Very high if there is coronary disease.
190 mg/dl and aboveAbove 4.9 mmol/lVery high representing a genetic condition

·       Estimation of HDL cholesterol

HDL helps remove cholesterol from your arteries. You are required to have a high HDL cholesterol level. According to studies of both men and women, having higher HDL levels lowers the chance of heart attack.

HDL cholesterol (in the U.S. and some other countries)HDL cholesterol (in Canada and most of Europe)Results
Below 40 mg/dl (men)Below 1.0 mmol/l (men)Poor
Below 50 mg/dl (women)Below 1.3 mmol/l (women)Poor
40-59 mg/dl (men)1.0-1.5 mmol/l (men)Better
50-59 mg/dl (women)1.3-1.5 mmol/l (women)Better
60 mg/dl and aboveAbove 1,5 mmol/lBest

·       Estimation of triglycerides

Triglycerides are included in a lipid panel even though they are not a form of cholesterol. The optimum level of triglycerides should be under 150 mg/dl. You may require treatment if your triglyceride levels are 150-199 mg/dl (borderline high) or 200 mg/dl or higher (high).

Triglycerides (in the U.S. and some other countries)Triglycerides (in Canada and most of Europe)Results
Below 150 mg/dlBelow 1.7 mmol/lDesirable
150-199 mg/dl1.7-2.2 mmol/lBorderline high
200-499 mg/dl2.3-5.6 mmol/lHigh
500 mg/dl and aboveAbove 5.6 mmol/lVery high

Cholesterol and metabolic disease correlation

Increased cholesterol levels can be due to the presence of metabolic disease. Obesity is the leading risk factor for cholesterol, and obese individuals often have insulin resistance which, if not checked, can lead to type 2 diabetes mellitus. Hence increased cholesterol, obesity, and diabetes are interlinked. Your doctor may prescribe tests for diabetes along with the lipid profile. Following are the tests that are often prescribed to rule out diabetes.

  • HOMA-IR
  • Random blood glucose
  • Level of HbA1c
  • Blood glucose 1 hr post 50g
  • Glucose tolerance test
  • Blood glucose 1 P.C.
  • Blood glucose 2 PC

·       HOMA-IR

HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) measures insulin resistance in the body. It tells how much insulin your body needs to check blood sugar levels (2). Insulin resistance is an early stage of type 2 diabetes. It increases your risk of many chronic diseases. Different studies provide different ranges for HOMA-IR. But the professionals agree that the higher your HOMA-IR number gets, the more insulin resistant you are. Usually, if HOMA-IR is less than 1, insulin sensitivity is considered normal. On the other hand, levels above 2.9 signal significant insulin resistance.

Higher HOMA-IR means your body is using more than regular insulin to keep your blood sugar in balance. The higher the number, the more insulin-resistant you are. Insulin resistance is one of the various symptoms of metabolic syndrome.

·       Random Blood Glucose

A random blood glucose test measures the amount of glucose circulating in a person’s blood. Your doctor may prescribe this test to determine whether you have diabetes. Random glucose test helps a doctor decide if further testing is needed. Random glucose testing measures glucose levels in the blood at any given point in the day. The blood glucose amount is measured in units of milligrams per deciliter (mg/dl). A random blood glucose level of 200 mg/dL or above indicates the presence of diabetes (3).

·       Level of HbA1c

The HbA1c test measures your average blood glucose level over the past few months. It is also called glycohemoglobin or glycated haemoglobin test. HbA1c is like a baseball player’s average season batting. One game does not tell you a player’s performance in his career. And one day’s test results do not give you complete information on how your treatment works. The blood sugar is called glucose. When it accumulates in your blood, it binds to the haemoglobin of RBCs. The HbA1c test measures how much glucose is bound. If your glucose level is high, your haemoglobin A1c test will be higher.

·       Blood glucose 1 hr post 50g

In this test, blood glucose levels are measured 1 hour after drinking a solution of 50 grams of glucose. This test is used to screen for gestational (pregnancy-related) diabetes. This test is recommended for pregnant women between the 24th and 28th weeks of gestation or earlier if the risk is high. This test is a form of the glucose tolerance test used for pregnant women that has a lower dose of sugar (50 grams instead of 75 or 100 grams), a shorter testing period (1 hour rather than 2 hours), and is more practical because there is no need to fast before this test.

A glucose level below 7.8 mmol/l is considered normal. A glucose level of more than 11.1 mmol/l indicates the presence of diabetes (4).

·       Blood glucose 1 P.C.

Blood glucose 1 hr P.C. (after a meal) is a test that is rarely prescribed but may help monitor gestational diabetes. The blood glucose 1 hour P.C. shows alteration in glucose levels in the patient’s eating habits and other lifestyle factors. It complements diabetes self-monitoring performed at home with a blood glucose monitor or monitoring in a lab.

Glucose level precisely 1 hour after the end of a balanced meal containing sufficient carbohydrates, but also other elements of the major food groups should be lower than 7.8 mmol/l and, in pregnant women, ideally over 5.0 mmol/l (5).

·       Blood glucose 2 P.C

It is a blood test recommended to check for diabetes. If you have diabetes, your body does not release enough insulin to keep your blood sugar level in balance. This means your blood glucose levels are too high, and with time it can lead to various health problems, including damage to the heart, nerves, kidneys and eyes. This test shows how your body responds to sugar after eating. As you eat a meal, your blood glucose level rises sharply. In response, your pancreas release insulin to utilize this glucose. Within 2 hours of eating a meal, your insulin and blood sugar level should return to normal. If your levels remain high, it means you may have diabetes.

References

  1. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/diagnosis-treatment/drc-20350806
  2. https://www.ncbi.nlm.nih.gov/pubmed/29120677
  3. https://www.medicalnewstoday.com/articles/323022#interpreting-results
  4. https://www.biron.com/en/glossary/blood-glucose-1-h-post-50-g/#:~:text=Measuring%20blood%20glucose%20levels%20(glycemia,if%20the%20risk%20is%20high.
  5. https://www.biron.com/en/glossary/blood-glucose-1-pc/#:~:text=Measuring%20blood%20glucose%20(glycemia)%201,risk%20of%20developing%20gestational%20diabetes.
Dr Khush Bakht Hypertensions

The Cholesterol Paradox V

Role of Dietary Cholesterol and Cholesterol Ranges

 

The Cholesterol Paradox Blog

Until now, we have discussed cholesterol, its relation with the cardiovascular system, causes, risk factors and myths, and their facts. You may find it strange that the amount of cholesterol in your diet and blood are two different things. The body tightly regulates the cholesterol level in the blood by controlling its production of cholesterol. When your dietary cholesterol intake goes down, your body makes more; when intake increases, your body makes less amount of cholesterol. Because of this, dietary cholesterol has very little impact on blood cholesterol levels in most people (1).

Some specific foods are known to raise blood cholesterol levels. We will discuss their detail in the text below.

Effect of certain foods on your blood cholesterol level

Coffee

Studies have shown that there is a chance that drinking coffee could increase a person’s blood cholesterol levels, though the brewing method may play a role. According to a more recent 2016 study, coffee drinking is associated with higher cholesterol levels, although its effects differ depending on the variety of coffee and the gender of the individual. 

Instant coffee is less likely to impact cholesterol levels than unfiltered and French press coffee. A prior study from 1997 found that the oils found naturally in coffee beans—rather than the amount of caffeine in coffee—may impact cholesterol levels. 

Figure 1 Coffee Beans

Cafestol and kahweol are two natural oils, also referred to as diterpenes, and are found in coffee. Whereas the amount of diterpenes in coffee varies depending on the brewing process, the Institute for Scientific Information on Coffee (ISIC) believes that these oils can increase total and low-density lipoprotein (LDL) cholesterol levels.

For instance, the majority of the diterpenes stay in the coffee filter when coffee is made using paper filters. Unfiltered coffee, however, allows more diterpenes to enter the coffee. One or two cups of unfiltered coffee daily are acceptable, but experts advise against drinking more than four (2).

Sugar

Sugar substitutes provide calories but no nutrition. Sugars that are added are distinct from those that are naturally present in foods like fruits and milk. The term “added sugars” refers to sweets you add to food, such as white sugar, brown sugar, honey, and artificial sweeteners. The additional calories from 22 tablespoons of added sugar daily can reach 350. 

Along with impacting your weight and increasing your risk for diabetes, these extra empty calories also affect your cholesterol levels. Additionally, sugary foods affect the production of cholesterol by your liver. When you consume too much sugar, your liver produces more LDL and less HDL.

A diet high in sugar also results in more triglycerides being produced, a blood fat type that affects your cholesterol levels. It develops when you consume more calories than your body requires to function. When your body requires additional energy between meals, triglycerides from your fat cells are released. Additionally, sugar hinders your body’s capacity to break down and eliminate triglycerides by blocking enzymes.

It’s critical to remember that your body requires cholesterol to function properly. Your body needs a crucial component to create new cells (3).

Butter

Butter contains saturated as well as trans fats. Both may increase the low-density lipoprotein (LDL) cholesterol or bad cholesterol in the blood. One tablespoon of unsalted butter is known to have 31 mg of cholesterol and 7.2 g of saturated fat. The American Heart Association (AHA) recommend that those who aim to lower their LDL cholesterol should get no more than 5-6 percent of their total calorie intake from saturated fat. On a 2000-calorie diet, this is equal to 11-13 g of saturated fat per day. Hence, two tablespoons of butter provide more saturated fat than most people should consume daily.

Evidence suggests that people should maintain a favorable ratio between LDL and HDL (high-density lipoprotein) levels (4).

Normal cholesterol ranges

Your cholesterol numbers show how much cholesterol is circulating in your blood. Good cholesterol (HDL cholesterol) is one number you would want to be high. Bad cholesterol (LDL cholesterol) should be low. Your cholesterol numbers are important because they help you know your risk for heart disease. Cholesterol helps your body perform many important functions. But too much cholesterol is bad for your health. It can accumulate in your arteries and damage their integrity, leading to atherosclerotic plaque formation.

Your provider checks your cholesterol levels through a blood test called a lipid panel or lipid profile. Your lipid panel gives you the following numbers.

Figure 2 Vial for lipid profile test

Total cholesterol

It estimates the total amount of cholesterol in your blood, including low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol. The ideal range for total cholesterol is 180–200 mg/dL (10–11.1 mmol/l) or less. Further cholesterol tests might be unnecessary if your cholesterol is within this normal range.

Levels of HDL cholesterol

HDL helps remove cholesterol from your arteries. You are required to have a high HDL cholesterol level. According to studies of both men and women, your having higher HDL levels lower the chance of heart attack. The term ‘good cholesterol’ is sometimes used.

  • Low HDL levels risk heart disease for both men and women.
  • For men, an HDL aim of 40 mg/dl or greater is considered good.
  • Women should aim for HDL levels of 50 mg/dl or above; doing so is considered positive.
  • An ideal HDL level of 60 or above is thought to offer the best defense against heart problems (5).

Levels of LDL cholesterol

It is the primary source of cholesterol buildup and blockage in the arteries. It is typically considered excessive if your LDL cholesterol is 190 mg/dL or greater. Most frequently, values between 70 and 189 mg/dL (3.9 and 10.5 mmol/l) are regarded as excessive if:

  • Your age is between 40 and 75, and you have diabetes.
  • You have diabetes and a significant risk of cardiovascular disease.
  • Your chance of developing heart disease is moderate to high.
  • You have cardiovascular disease, a stroke propensity, or impaired leg circulation.

If you are taking medication to lower your cholesterol, your health care professionals will often set a specific level for your LDL cholesterol. More recent recommendations suggest doctors no longer need to aim for a particular LDL cholesterol level. The high-risk patients are given stronger medications. However, some suggestions still urge using specific targets.

Level of triglycerides

It is another form of fat in your blood that can raise your risk for heart disease, especially in women. Triglycerides are included in a lipoprotein panel (the test that measures cholesterol levels) even though they are not a form of cholesterol. The optimum level of triglycerides should be under 150 mg/dL. You might require treatment if your triglyceride levels are borderline high (150-199 mg/dL) or high (200 mg/dL or higher).

Your blood triglyceride concentrations may be elevated if you consume more calories than you expend, particularly calories from fats and carbohydrates like sweet foods. The majority of the time, a high blood triglyceride level is symptomless, but over time, it may harm your arteries and raise your risk of heart disease. Both adults and children are more likely to develop acute pancreatitis when triglyceride levels are incredibly high.

Triglyceride tests are known by the terms TG, TRIG, lipid panel, and fasting lipoprotein panel.

  • If they are under 150 mg/dl, they are normal.
  • High enough if they are between 150 and 199.
  • If they are between 200–499, they are considered high.
  • If they reach 500 or higher, they are considered very high (6)

Level of VLDL

VLDL is a very low-density lipoprotein. It is another bad form of cholesterol that contributes to plaque buildup. VLDL carry triglycerides in your blood. VLDL can not be measured directly. Triglycerides make up around half of VLDL. Hence, you can calculate your VLDL level as a proportion of the triglyceride levels.

Non-HDL cholesterol

This is all the cholesterol in your blood that is not HDL. It can be calculated simply by subtracting HDL cholesterol from total cholesterol.

  • Total cholesterol – HDL = Non-HDL cholesterol

Ratio between total cholesterol and HDL

This is your total cholesterol divided by your HDL. The desirable ratio is below five. Your results may show a chart with more details and desirable levels.

Figure 3 Cholesterol chart

Variations in lipid profile

The normal numbers and ranges described above are not absolute. There may be variations in these numbers due to certain factors. Genetic factors may play a role in these variations. Also, there may be age-related and sex-related differences. Most normal cholesterol levels are the same regardless of your gender. But there is one key difference among adults. That’s your HDL number.

Studies have shown that serum lipid levels vary considerably within individuals over short periods due to intrinsic factors such as hormonal variations, certain illnesses, extrinsic factors such as diet, and analytical and quality control factors (7).

There may be seasonal variations. The cholesterol levels tend to be higher in the winter months and lower in the summer months (8).

An individual’s serum cholesterol values can vary about 2-3% within the same day. Cholesterol levels are also lower for shorter periods in response to severe pain, surgery, and short-term physical strain.

References

  1. Fernandez M. L. (2012). Rethinking dietary cholesterol. Current opinion in clinical nutrition and metabolic care, 15(2), 117–121. https://doi.org/10.1097/MCO.0b013e32834d2259
  2. Urgert, R. & Katan, M. B. The cholesterol-raising factor from coffee beans. Rev. Nutr. 17, 305 (1997).
  3. Faheem, M. et al. Does BMI affect cholesterol, sugar, and blood pressure in general population? Ayub Med. Coll. Abbottabad 22, 74–77 (2010).
  4. https://www.acpjournals.org/doi/10.7326/M13-1788
  5. Barter, P. et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. Engl. J. Med. 357, 1301–1310 (2007).
  6. Tirosh, A. et al. Changes in triglyceride levels and risk for coronary heart disease in young men. Intern. Med. 147, 377–385 (2007).
  7. Mark A Pereira, Rianne M Weggemans, David R Jacobs, Jr, Peter J Hannan, Peter L Zock, Jose M Ordovas, Martijn B Katan, Within-person variation in serum lipids: implications for clinical trials, International Journal of Epidemiology, Volume 33, Issue 3, June 2004, Pages 534–541, https://doi.org/10.1093/ije/dyh057
  8. Kelly G. S. (2005). Seasonal variations of selected cardiovascular risk factors. Alternative medicine review : a journal of clinical therapeutic, 10(4), 307–320.

 

 

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