Nutritional Aspects of Vitamin A and Carotenoids Historical

Nutritional Aspects of Vitamin A and Carotenoids Historical

Vitamin A was discovered in the early 1900s by McCollum and colleagues at the University of Wisconsin and independently by Osborne and Mendel at Yale. Both groups were studying the effects of diets made from purified protein and carbohydrate sources, such as casein and rice flour, on the growth and survival of young rats. They observed that growth ceased and the animals died unless the diet was supplemented with butter, fish oils, or a quantitatively minor ether soluble fraction extracted from these substances, from milk, or from meats. The unknown substance was then called ‘‘fat-soluble A.’’ Not long thereafter, it was recognized that the yellow carotenes present in plant extracts had similar nutritional properties, and it was postulated that this carotenoid fraction could give rise through metabolism to the bioactive form of fat-soluble A, now called vitamin A, in animal tissues.

This was shown to be correct after b-carotene and retinol were isolated and characterized, and it was shown that dietary b-carotene gives rise to retinol in animal tissues. Within the first few decades of vitamin A research, vitamin A deficiency was shown to cause several specific disease conditions, including xerophthalmia; squamous metaplasia of epithelial and mucosal tissues increased susceptibility to infections; and abnormalities of reproduction. Each of these seminal discoveries paved the way for many subsequent investigations that have greatly expanded our knowledge about vitamin A. Although the discoveries made in the early 1900s may now seem long ago, it is interesting to note, as reviewed by Wolf [2], that physicians in ancient Egypt, around 1500 BC, were already using the liver of ox, a very rich source of vitamin A, to cure what is now referred to as night blindness.

Definition of Vitamin A , Retinoids, and Carotenoids Vitamin A is a generic term that refers to compounds with the iological activity of retinol. These include the provitamin A carotenoids, principally b-carotene, a-carotene, and b-cryptoxanthin, which are provided in the diet by green and yellow or orange vegetables and some fruits and preformed vitamin A, namely retinyl esters and retinol itself, present in foods of animal origin, mainly in organ meats such as liver, other meats, eggs, and dairy products.

The term retinoid was coined to describe synthetically produced structural analogs of the naturally occurring vitamin A family, but the term is now used for natural as well as synthetic compounds [3]. Retinoids and carotenoids are defined based on molecular structure. According to the Joint Commission on Biochemical Nomenclature of the International Union of Pure and Applied Chemistry and International Union of Biochemistry and Molecular Biology (IUPAC–IUB), retinoids are ‘‘a class of compounds consisting of four isoprenoid units joined in a head-to-tail manner’’ [4]. All-trans-retinol is the parent molecule of this family.

The retinoid molecule can be divided into three parts: a trimethylated cyclohexene ring, a conjugated tetraene side chain, and a polar carbon–oxygen functional group. Additional examples of key retinoids and structural subgroups, a history of the naming of these compounds, and current nomenclature of retinoids are available online [4]. The IUPAC–IUB defines carotenoids [5] as ‘‘a class of hydrocarbons (carotenes) and their oxygenated derivatives (xanthophylls) consisting of eight isoprenoid units joined in such a manner that the arrangement of isoprenoid units is reversed at the center of the molecule.’’ All carotenoids may be formally derived from the acyclic C40H56 structure that has a long central chain of conjugated double bonds, by (i) hydrogenation, (ii) dehydrogenation, (iii) cyclization, or (iv) oxidation, or any combination of these processes.

Ways to Help You Enjoy Your Detox Plan

Ways to Help You Enjoy Your Detox Plan

Be a Bookworm

First think first: make sure you have a good supply of magazines, newspaper and book to keep your mind occupied. Your detox plan could be the big chance to catch up on all the reading you have been desperate to do.

Pen a Note

Is there someone out there you have not written to in a long time? Now is the moment to put pen to paper, when your head is clear and nothing else is pressing.

Phone Home

If a letter's too much. why not give an old friend a ring and persuade them to try out a detox plan!


Get out some film you haven't seen yet, or catch up on television programs you've had on tape for months.

Go Walkout

You shouldn't do too much strenuous exercise while on a juice detox plan, but there's nothing wrong with a short stroll in the park or by the river. Full-scale shopping is a bit too taxing. but browsing around your favourite junk stall is find.

Hot and Steamy

when you venture out of the house, why not make for your local sauna or turkish bath - both are wonderful companiments to a detox plan. The dry heat of sauna quickly open the pores in your skin and allows the toxin to work their way out. The steamy, jungle-type atmosphere of a Turkish bath is just as good and probably more interesting because there is a selection of steam rooms to try out.

The Marvel and Message

What better way to truly relax, tone up your muscles and improve circulation than to have a whole body massage. With or without aromatherapy oils, an hour's session is pampering but health-giving, refreshing yet relaxing, and is the ideal way to encourage a restful nap.

Feet Hands and Face

Have you looked at your feet recently? The chances are that they could do with a bit of attention, especially if they have been stuck inside tights and shoes all winter. A pedicure is the ultimate in pampering and goes well with a manicure. To make your self feel even more special, have a wonderfully relaxing facial to bring the roses back into your cheeks.

Home Health Club

In addition to all these activities are the equally beneficial health and beauty treatments that you can do in your own home. Daily body brushing stimulates the circulation and helps remove toxins, as do breathing exercises, hot and cold showers, salt rubs, mud packs and Epsom salt baths. Just shut your self away in the bathroom and indulge,
with so much to do, a detox plan isn't really that daunting is it? It's fun as well as therapeutic. Anyway, it would be hard to find a better excuse to curl up with a good book and be pampered. So. it's feet up and let yourself unwind. Go on you deserve it!

A Word of Warning

Unsupervised juice and cleansing plans as outlined in this article are nit suitable for children, pregnant women, those recovering from serious illness, or those with hypoglycaemia, diabetes or severe candidiasis. Dietary treatment including the use of juices can benefit the elderly and those recovering from ill health if properly supervised by your naturopath and/or General Practitioner.

Is you come under any of these categories and remain interested in following a fast or cleansing plan, seek professional advice and guidance first from your local GP, and then from a qualified naturopath or nutrition consultant.

Diabetes Insipidus

Diabetes Insipidus

Diabetes insipidus is a condition in which the kidneys are unable to conserve water.

Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

Treatment :The cause of the underlying condition should be treated when possible.
Central diabetes insipidus may be controlled with vasopressin (desmopressin, DDAVP). You take vasopressin as either a nasal spray or tablets.

If nephrogenic DI is caused by medication (for example, lithium), stopping the medication may help restore normal kidney function. However, after many years of lithium use, the nephrogenic DI may be permanent.
Hereditary nephrogenic DI and lithium-induced nephrogenic DI are treated by drinking enough fluids to match urine output and with drugs that lower urine output. Drugs used to treat nephrogenic DI include:
  • Anti-inflammatory medication (indomethacin)
  • Diuretics (hydrochlorothiazide (HCTZ) and amiloride)

CausesDiabetes insipidus (DI) is an uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The amount of water conserved is controlled by antidiuretic hormone (ADH), also called vasopressin.
ADH is a hormone produced in a region of the brain called the hypothalamus. It is then stored and released from the pituitary gland, a small gland at the base of the brain.
DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus.
Central diabetes insipidus is caused by damage to the hypothalamus or pituitary gland as a result of:
  • Head Injury
  • Infection
  • Surgery
  • Tumor
Nephrogenic DI involves a defect in the parts of the kidneys that reabsorb water back into the bloodstream. It occurs less often than central DI. Nephrogenic DI may occur as an inherited disorder in which male children receive the abnormal gene that causes the disease from their mothers.
Nephrogenic DI may also be caused by:
  • MRI of the head
  • Urinalysis
  • Urine output

Prognosis:The outcome depends on the underlying disorder. If treated, diabetes insipidus does not cause severe problems or reduce life expectancy.
If thirst mechanisms are normal and you drink enough fluids, there are no significant effects on body fluid or salt balance.
Not drinking enough fluids can lead to the following complications:

  • Dehydration
    • Dry skin
    • Dry mucus membranes
    • Fever
    • Rapid heart rate
    • Sunken appearance to eyes
    • Sunken fontanelles (soft spot) in infants
    • Unintentional weight loss

  • Electrolyte imbalance
    • Fatigue, lethargy
    • Headache
    • Irritability
    • Muscle pains
When to Contact a DoctorCall your health care provider if you develop symptoms of diabetes insipidus.If you have diabetes insipidus, contact your health care provider if frequent urination or extreme thirst return.

The information provided on this page should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
Call 911 for all medical emergencies. Links to other sites are provided for information only – they do not constitute endorsements of those other sites.

The Wonder of Detoxing

The Wonder of Detoxing

If an alien landed on earth and wanted to know all about the latest health and beauty trends, the worlds 'detox' would be on everybody's lips. It's the all natural way to look and feel healthy without having to spend a fortune. Gone are the days when only face lift would do - now we've got better options and eternal you this not the only goal.

Many people think that detoxing - that is, either going on no-foods fast, or a diet plan which recommends only simple, cleaning foods - is anew whole range of reasons, for the thousands of year. Fasting is commonplace in the Bible and some religions still use the denial of food as a way of focusing the mind and cleansing the body in preparation for worship. In more modern times, detox programs have become widespread in addiction clinics, where they help people come off drugs or alcohol, and now many ordinary people, in the prime of their health, have found that a simple detox can benefit them too.

So what's all the fuss? Won't a holiday by the sea or in the mountains do just as much good? It's true that there's nothing like breathing in fresh air to bring your body back to life and you will certainly return from a holiday looking rested and relaxed. But had you followed the detox program too the benefits would have been even greater.
The beauty of a detox plans is that it cleanses and renews the parts that you don't normally see: your digestive system, your blood, the tiny cells that make up your body, it encourages stored toxins to be removed and rests all the digestive organs that are often so overworked. Why did not give your stomach a holiday, it deserves one just as much as you do.

Ask anyone who's been on a detox diet plan how they felt afterwards and most would agree that it left them feeling sparkling and healthier. They may have had a couple of headaches or felt a bit moody to begin with, but the end results were worth it. Just a few days on a juice fast or detox plan can result in clearer skin, brighter eyes and shiner hair and an overall feeling of extra energy, and it's all achieved in a completely natural way inside your own home.

We often feel less that perfect - tired, and suffering from poor skin, cellulite bags under our eyes, wrinkles, muscles aches indigestion, constipation, bunged up noses, and so on. But how many of us are prepare to sit down and consider just why these things occur could part of the answer be that we are putting our bodies under to much strain? We may be eating too much of the wrong foods, burning the candle at both ends, smoking, drinking, supporting a family and doing a job all at once with the result that our bodies are being denied that rest and recuperation they need to be in top form. You would have no problem justifying a household spring clean, so not do the same for your body? Good Health is so valuable, and essential if we are to enjoy life to the full.

The detox plans in this article are different from anything else you may have tried because they focus on fresh fruit and vegetable juice. Juices are nature's cleansers, and also happen to be bursting with vitamins and minerals. Drunk on their own, or combined with plain foods, they can make noticeable difference to the way you feel.
The very word 'detox' sounds quite rigorous and perhaps a little off putting. There's no doubt that you do need to be fairly disciplined when following a juice detox plan, otherwise there is little point in doing it. But it is also the ideal time to pamper yourself and to give yourself treats that make the whole things easier to contemplate! The best time to follow a juice detox plan is over a weekend or when you have some time off and can take it easy. Try to avoid too many social engagements during the plan, or you can use up your precious energy on other people instead of yourself.

If you know that you can't eat all day, your hunger pangs are bound to tempt you to snack om something like a pizza or chocolate. There's no point getting upset if you do because lots of people find it difficult to stick to the plan to begin with. They key to avoiding such temptation and also enjoying a juice detox plan is to try and keep your mind occupied with other things, a sauna perhaps, a massage, a facial or even a steamy Turkish bath. There are simply masses of fun but therapeutic activities you can do which will take your mind of that noisy stomach.



Humor and laughter are a universal aspect of human experience, occurring in all cultures and virtually all individuals throughout the world (Apte, 1985; Lefcourt, 2001). Laughter is a distinctive, stereotyped pattern of vocalization that is easily recognized and quite unmistakable (Provine and Yong, 1991). Although different cultures have their own norms concerning the suitable subject matter of humor and the types of situations in which laughter is considered appropriate, the sounds of laughter are indistinguishable from one culture to another. Developmentally, laughter is one of the first social vocalizations (after crying) emitted by human infants (McGhee, 1979).

Infants begin to laugh in response to the actions of other people at about four months of age, and cases of gelastic (i.e., laughter-producing) epilepsy in newborns indicate that the brain mechanisms for laughter are already present at birth (Sher and Brown, 1976). The innateness of laughter is further demonstrated by the fact that even children born deaf and blind have been reported to laugh appropriately without ever having perceived the laughter of others (Provine, 2000). Indeed, there is evidence of specialized brain circuits for humor and laughter in humans, which researchers are beginning to identify by means of neural imaging studies. Thus, being able to enjoy humor and express it through laughter seems to be an essential part of what it means to be human.

Interestingly, though, humans are not the only animal that laughs. Primatologists have studied in some detail a form of laughter emitted by young chimpanzees, which was first described by Charles Darwin (1872). Similar types of laughter have also been observed in other apes, including bonobos, orangutans, and gorillas (Preuschoft and van Hooff, 1997; van Hooff and Preuschoft, 2003). Ape laughter is described as a staccato,

throaty, panting vocalization that accompanies the relaxed open-mouth or "play face," and is emitted during playful rough-and-tumble social activities such as wrestling, tickling, and chasing games (see Figure 1). Although it sounds somewhat different from human laughter, it is quite recognizable as such, occurring in similar social contexts as laughter in human infants and young children. Indeed, there is good reason to believe that human and chimpanzee laughter have the same evolutionary origins and many of the same functions.

In addition to laughter, there is evidence that apes may even have the capacity for a rudimentary sense of humor. Chimpanzees and gorillas that have been taught to communicate by means of sign language have been observed to use language in playful ways that are very reminiscent of humor, such as punning, humorous insults, and incongruous word use (Gamble, 2001). Interestingly, these humorous uses of linguistic signs are sometimes also accompanied by laughter and the play face, indicating a close link between humor, play, and laughter even in apes.
All of these lines of evidence suggest that humor and laughter in humans are a product of natural selection (Gervais and Wilson, 2005). Laughter appears to have originated in social play and to be derived from primate play signals. It is viewed by evolutionary researchers as part of the nonverbal "gesture-call" system, which has a long evolutionary history, predating the development of language (Burling, 1993).

With the evolution of greater intellectual and linguistic abilities, humans have adapted the laughter-generating play activities of their primate ancestors to the mental play with words and ideas that we now call humor (Caron, 2002). Thus, although they usually do not chase and tickle one another in rough-and-tumble play, human adults, by means of humor, continue to engage in frequent social play. These evolutionary origins of humor and laughter suggest that they likely have important social emotional functions that have contributed to our survival as a species. Although humor has a biological basis rooted in our genes, it is also evident that cultural norms and learning play an important role in determining how it is used in social interactions, and what topics are considered appropriate for it. In addition, although all forms of humor seem to originate in a basic play structure, the complexity of human language and imagination enables us to create humor in a seemingly endless variety of forms.

As human language, culture, and technology have evolved, we have developed new methods and styles of communicating it, from spontaneous interpersonal joking and banter to oral storytelling traditions, comedic drama and humorous literature, comedy films, radio and television shows, and jokes and cartoons disseminated over the Internet. Besides being a form of playful fun and entertainment, humor has taken on a wide range of social functions over the course of human biological and cultural evolution. Many of these interpersonal functions are contradictory and paradoxical. Humor can be a method of enhancing social cohesion within an in-group, but it can also be a way of excluding individuals from an out-group. It can be a means of reducing but also reinforcing status differences among people, expressing agreement and sociability but also disagreement and aggression, facilitating cooperation as well as resistance, and strengthening solidarity and connectedness or undermining power and status. Thus, while originating in social play, humor has evolved in humans as a universal mode of communication and social influence with a variety of functions.


The Oxford English Dictionary defines humor as "that quality of action, speech, or writing which excites amusement; oddity, jocularity, facetiousness, comicality, fun." It goes on to say that humor is also "the faculty of perceiving what is ludicrous or amusing, or of expressing it in speech, writing, or other composition; jocose imagination or treatment of a subject" (Simpson and Weiner, 1989, p. 486). It is evident from these definitions that humor is a broad term that refers to anything that people say or do that is perceived as funny and tends to make others laugh, as well as the mental processes that go into both creating and perceiving such an amusing stimulus, and also the affective response involved in the enjoyment of it. From a psychological perspective, the humor process can be divided into four essential components: (1) a social context, (2) a cognitive-perceptual process, (3) an emotional response, and (4) the vocal-behavioral expression of laughter.

Introduction to the Psychology of Humor

Introduction to the Psychology of Humor

We all know what it is like to experience humor. Someone tells a joke, relates an amusing personal anecdote, makes a witty comment or an inadvertent slip of the tongue, and we are suddenly struck by how funny it is. Depending on how amusing we perceive the stimulus to be, it might cause us to smile, to chuckle, or to burst out in peals of convulsive laughter. Our response is accompanied by pleasant feelings of emotional well-being and mirth. Most of us have this sort of experience many times during the course of a typical day. Because humor is so familiar and is such an enjoyable and playful activity, many people might think they already understand it and do not need research in psychology to explain it. However, the empirical study of humor holds many interesting surprises.

Although it is essentially a type of mental play involving a lighthearted, non serious attitude toward ideas and events, humor serves a number of "serious" social, emotional, and cognitive functions, making it a fascinating and rewarding topic of scientific investigation. The topic of humor raises a host of intriguing questions of relevance to all areas of psychology. What are the mental processes involved in "getting a joke" or perceiving something to be funny? How is humor processed in the brain, and what effect does it have on our bodies? What is laughter and why do we laugh in response to humorous things? Why is humor so enjoyable? What role does humor play in our interactions with other people? What is a sense of humor and how does it develop in children? Is a good sense of humor beneficial for mental and physical health?

As is evident from these and other related questions, humor touches on all branches of academic psychology (R. A. Martin, 2000). Researchers in the area of cognitive psychology may be interested in the mental processes involved in the perception, comprehension, appreciation, and creation of humor. The interpersonal functions of humor in dyadic interactions and group dynamics are of relevance to social psychology. Developmental psychologists may focus on the way humor and laughter develops from infancy into childhood and throughout the lifespan. Personality researchers might examine individual differences in sense of humor and their relation to other traits and behaviors.

Biological psychology can shed light on the physiological bases of laughter and the brain regions underlying the comprehension and appreciation of humor. The role of humor in mental and physical health, as well as its potential applications in psychotherapy, education, and the workplace, are of interest to applied branches of psychology such as clinical, health, educational, and industrial-organizational psychology. Thus, researchers from every branch of the discipline have potentially interesting contributions to make to the study of humor. Indeed, a complete understanding of the psychology of humor requires an integration of findings from all these areas.

Despite the obvious importance of humor in many different areas of human experience and its relevance to all branches of psychology, mainstream psychology has paid surprisingly little attention to this subject up to now. Humor research typically receives scant mention, if any at all, in undergraduate psychology texts or scholarly articles. Nonetheless, there has been a steady accumulation of research on the topic over the years, producing a sizable body of knowledge. The overall aim of this article is therefore to introduce students and academics in psychology, as well as scholars and professional practitioners from other fields, to the existing research literature, and to point out interesting avenues for further study in this fascinating topic area.

In this chapter, I will begin by summarizing evidence of the universality and evolutionary origins of humor and laughter in humans. I will then explore the question of what humor is, discussing four essential elements of the humor process and the relevance of each to an integrative psychology of humor. This will be followed by a survey of the many different forms of humor that we encounter during our daily lives, and an examination of the psychological functions of humor and laughter. Next, I will summarize the history of the concept of humor, examining the way popular conceptions and assumptions about humor and laughter have changed dramatically over the centuries. Finally, I will discuss the psychological approach to humor and then present an overview of the rest of this article.

Continue to "The Universality of Humor and Laughter”

Get more advantage by consuming your daily fruits

Get more advantage by consuming your daily fruits

The very first if you had your own idea to buy some fruit in the market, you must be picky every time you put down your selecting fruit on your basket. Make sure to see the form of the fruit closely, it will easily to notice which one is the fresh one. Do not make your own decision to buy some, make sure you bring friend or family to ask for advice. Because they really important they will be suggesting you pick the better fruit to consume.

The big one is not always good, why? There are some cases connecting to this matter, we usually pick the big one while we put them in the basket. The big one had the proportion measure of its fruit visit here for more details.

Once you get home, you are to start putting them all in the water to wash them from viruses or toxin that might be clinging around on the surface of the fruit. Wash it if necessary by using some special soap to eliminate the viruses or bacteria from its fruit. Usually it will take the fruits look cleaner and fresher.

I had been applied in my day life, you know we must extra care to buy something [daily food] from greengrocer or outdoor market, if it does not work properly at least we have already done the right procedure to serve the meal to our beloved family. Now our family saves and ready to eat the fruit, seeing smile of our family without wondering the negative side after eating the fruit that will be beautiful. The effect for us, the fruit genetically taking our body looks fresher than usually, it will make our front face look younger and friendly, make people once they look at you making a baffle face, So we do not necessarily to consume sugar that might be indicated of high grease so it will lower our chance to have diabetes, but fruits produce a natural sugar that needed to our body that is the value of how we manage and follow the health procedures.

Future of genetic engineering

Future of genetic engineering

Gene therapy, genetic engineering, gene swops. Lastest research. Animal and human science of genes. How genes are reprogrammed. How scientists use genes to cure disease or create new plants and animals. Transgenic pigs. New genes in health and medicine to cure disease. Comment by Dr Patrick Dixon, physician, Futurist, author of The Genetic Revolution and Futurewise

The Diet

The Diet

For the next six weeks, follow these six simple guidelines.

For the next six weeks, you can create any meals you like as long as you follow these six simple guideline. That’s all—there’s no need to count calories or fat grams.

1. Eat protein and fruit and/or vegetables at every meal.
To supply all the amino acids you need to maximize muscle tone, have one of the following: 3 to 4 ounces of skinless poultry, lean beef (sirloin, tenderloin, or roast), or seafood (fresh, frozen, or canned, the latter packed in water; limit albacore tuna to 6 ounces per week because it contains more mercury than other types); or one egg or two to three egg whites. (After you’ve completed the six-week plan, include a variety of vegetarian protein sources in your diet for a broader spectrum of nutrients.) Also, have one serving per meal of any kind of fresh or frozen fruits, vegetables, and/or legumes.

2. Snack on a half-cup of unsalted nuts or seeds plus fresh fruit, twice a day.
Yes, nuts are high in fat and calories. But they’re also great sources of protein, fiber, good fats, and antioxidants (to fight wrinkle-causing inflammation)—and, most importantly, they’ll fill you up. Go for lower-cal nuts like almonds over higher-cal picks like Brazil nuts. If you finish your last meal more than three hours before bedtime, eat a pre-sleep snack as well. Don’t like nuts or seeds? Try 2 tablespoons of organic nut butter instead.

3. Avoid dairy, soy, and grain products for the first three to four weeks.
These are the types of foods most likely to trigger food sensitivities, which may lead to bloating, low energy levels, and dry, unhealthy skin. “Food sensitivities cause a chronic state of low-grade inflammation that can hurt every system in your body, from your heart to your bones to your skin,” Lydon explains.

Beginning with week four, you can add up to 100 calories per meal of dairy or soy products (e.g., 7 ounces of low-fat milk or 4 ounces of tofu). And starting with week five, you can also have up to 100 calories per meal of whole-grain-based foods (such as a slice of multigrain bread, 1/2 cup of oatmeal, 1/2 cup of whole-wheat pasta, or 1/3 cup of brown rice), potatoes, or sweet potatoes. If you notice symptoms like bloating after adding any of these foods, cut back again.

4. Cut out processed foods.

It’s best to do without cookies, chips, etc. for the entire six-week plan, and eat them in moderation after that. Why? Processed carbs contribute to inflammation and, thus, aging, Lydon says.

5. Drink 10 to 12 ounces of fluid every time you eat.
Go for water, sparkling water, or iced unsweetened green or herbal tea (add fresh lemon, lime, or berry juice for more flavor) instead of diet sodas. Good news: You can treat yourself to a cup or two of black coffee or tea a day.

6. Pop your vitamins.
Take a daily high-potency multivitamin for overall good health; cold-water fish oil (2 to 3 grams twice a day) to fight inflammation, reduce sun damage, and improve skin; calcium (350 to 500 milligrams twice a day) to build strong bones; and magnesium (200 to 400 milligrams twice a day) to help your body absorb the calcium. Also, be sure your multivitamin contains 5 micrograms of vitamin D to help with calcium absorption.

10 Years Thinner

10 Years Thinner

Want to reverse age-related weight gain? There’s no magic pill. But there is a magic plan. Follow this 6-week diet-and-exercise program, created by Christine Lydon, MD, and you’ll wipe out 15 pounds—and look a decade younger.

You want to lose a few pounds. And you’d love to look younger. To help you on both counts, Health teamed up with fitness-and-weight-loss expert Christine Lydon, MD, to put together this groundbreaking plan based on her new book Ten Years Thinner: 6 Weeks to a Leaner, Younger-Looking You. The program not only blasts off fat but specifically targets the zones where women tend to accumulate fat as they age (belly, butt, thighs, and upper arms). Plus, it fights inflammation, a common culprit behind dull skin, wrinkles, low energy, and flab.

To give you great results in six weeks, Lydon devised 20- to 25-minute combined cardio-and-strength routines with bursts of high-intensity activity that rev up metabolism (which naturally slows over the years).

“Those bursts are the way to maximize calorie afterburn—the number of calories your body continues to burn after you stop exercising,” Lydon says. “Plus you’re building more muscle to boost your metabolism for more around-the-clock fat-burning.” The result: A slimmer, younger-looking you … fast. Sound good? Read on.

The Perfect Pregnancy Weight

The Perfect Pregnancy Weight

No more eating for two in the new guidelines for a healthy baby.

Gaining 35 pounds during pregnancy used to be the standard. Now the American College of Obstetrics and Gynecology recommends 20 to 25 pounds at most, says Frances Crites, M.D., an OB-GYN at Presbyterian Hospital of Dallas: “Patients were getting enormous, which led to delivery problems.”

Weight gain between pregnancies can also be a problem. In a study of more than 150,000 Swedish women, Harvard and Swedish researchers found that, even in normal weight women, gaining just seven pounds between pregnancies can up the risk of high blood pressure, and stillbirth. And the chance of diabetes rose 30 percent from that small weight gain. But weight loss between pregnancies has its dangers, too. An Irish study found that women whose BMIs lowered by five or more units raised the risk of premature births.

Being overweight can up your risk for certain diseases.

Heart Diseases
If you’re 40-something and overweight—even if you have normal blood pressure and cholesterol— you’re much more likely to get heart disease as you get older. Researchers at Northwestern University studied almost 18,000 people for 32 years and found that the obese were 43 percent more likely to die of heart disease later in life than those of normal weight. Fat itself, especially abdominal fat, produces hormones and chemicals that can damage blood vessels, upping the risk of blood clots and diabetes.

Diabetes and Kidney Disease
The higher your BMI, the higher the risk for these conditions. But according to The Diabetes Prevention Program, which studied people on the verge of diabetes, losing just 7 percent of body weight can cut risk of full-blown diabetes by 60 percent.

Extra weight appears to protect women from osteoporosis and fractures by upping bone density. In fact, weight loss of ten percent or more at 50 or older can actually increase the risk of hip fracture in both men and women. “But the number of deaths due to fractures is very small, so to gain weight to prevent osteoporosis is foolish,” says Willett. “Instead, be active, get enough calcium, take vitamin D, and if needed, take medication.”

Cancer Fat, particularly tummy fat, affects levels of hormones (including estrogen) and growth factors, which in turn appear to spur the development of cancer cells. Fat also hikes the body’s inflammation level, also fanning cancer risk. In fact, this year, the American Institute for Cancer Research and the World Cancer Research Fund linked excess weight to six cancers: breast cancer in post-menopausal women, esophageal, pancreatic, colon, rectal, endometrial, and kidney cancers.



What is leprosy?

Leprosy is a bacterial disease of the skin and nervous system caused by Mycobacterium leprae. The two main types of leprosy are called lepromatous and tuberculoid. Tuberculoid leprosy is not related to tuberculosis.

Who gets leprosy?

Leprosy is usually found in South Asia, Southeast Asia, tropical Africa and some areas of Latin America. Although it is occasionally found in the southern part of the United States, most persons diagnosed with leprosy in this country are immigrants or refugees who were infected in their native countries.

What are the symptoms of leprosy?

In lepromatous leprosy, the skin lesions are many and widespread. Infection in the nose may cause crusting, bleeding and blockage; infection in the eye may cause inflammation of the iris and cornea. In tuberculoid leprosy, the skin lesions are fewer and have little or no feeling. There may also be numbness in the hands, feet or other parts of the body. Lepromatous leprosy is much more contagious than tuberculoid leprosy.

How soon after exposure do symptoms appear?

The range is from 9 months to 20 years. It usually takes 4 years from the time of exposure for symptoms of tuberculoid leprosy to appear and 8 years for symptoms of lepromatous leprosy to appear.

How is leprosy spread?

Although not clearly understood, leprosy is thought to spread through prolonged close contact (as may occur in a household) with an untreated lepromatous patient. The bacteria enter the air from the patient's nose (by nose blowing, for example) and probably spread to others by being breathed in or coming into contact with broken skin. Untreated mothers may pass the infection to their unborn children.

When and for how long is a person able to spread leprosy?

Usually, after three months of treatment with dapsone or clofazimine, or after three days of treatment with rifampin, a person will no longer be infectious to others. No restrictions in employment or school attendance are indicated for persons whose disease is determined to be noninfectious.

How can leprosy be prevented?

Household contacts of persons with leprosy, especially children, should be examined yearly for at least five years after their last contact with an infectious person. Household contacts of patients with lepromatous leprosy who are less than 25 years old may be considered for preventive treatment.

Information provided by the
Wisconsin Department of Health and Family Services

How to set up a healthy sleep environment

How to set up a healthy sleep environment

Insomnia is a common condition. Most people will have an occasional bout of sleeplessness due to temporary stress, worry, or irregular schedule. However, when the inability to sleep well continues for weeks or months, it can become a health problem.

If you have chronic insomnia, it may be caused by an underlying factor such as depression, anxiety, or pain. Your insomnia will probably improve or disappear when the cause is treated successfully. Sometimes poor sleep becomes a problem of its own. Dwelling on it only makes it worse. Simply changing your beliefs about sleep and your everyday behaviors can improve your sleep dramatically.

"Sleep hygiene" measures include commonsense health practices and setting up an environment that promotes sleep.



Insomnia is the perception or complaint of inadequate or poor-quality sleep because of one or more of the following:

  • difficulty falling asleep
  • waking up frequently during the night with difficulty returning to sleep
  • waking up too early in the morning
  • unrefreshing sleep

Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability.

Insomnia can be classified as transient (short term), intermittent (on and off), and chronic (constant). Insomnia lasting from a single night to a few weeks is referred to as transient. If episodes of transient insomnia occur from time to time, the insomnia is said to be intermittent. Insomnia is considered to be chronic if it occurs on most nights and lasts a month or more.

Certain conditions seem to make individuals more likely to experience insomnia. Examples of these conditions include:

  • advanced age (insomnia occurs more frequently in those over age 60)
  • female gender
  • a history of depression

If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely.

There are many causes of insomnia. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:

  • stress
  • environmental noise
  • temperatures
  • in the surrounding environment
  • wake schedule problems such as those due to jet lag
  • side effects

Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.

In addition, the following behaviors have been shown to perpetuate insomnia in some people:

  • expecting to have difficulty sleeping and worrying about it
  • ingesting excessive amounts of caffeine
  • drinking alcohol before bedtime
  • smoking cigarettes before bedtime
  • napping in the afternoon or evening
  • or continually disrupted sleep/wake schedules

These behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping problem in the first place. Stopping these behaviors may eliminate the insomnia altogether.

Insomnia is found in males and females of all age groups, although it seems to be more common in females (especially after menopause) and in the elderly. The ability to sleep, rather than the need for sleep, appears to decrease with advancing age.

Patients with insomnia are evaluated with the help of a medical history and a sleep history. The sleep history may be obtained from a sleep diary filled out by the patient or by an interview with the patient's bed partner concerning the quantity and quality of the patient's sleep. Specialized sleep studies may be recommended, but only if there is suspicion that the patient may have a primary sleep disorder such as sleep apnea or narcolepsy.

Transient and intermittent insomnia may not require treatment since episodes last only a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the person's biological clock will often get back to normal on its own. However, for some people who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and next-day alertness. As with all drugs, there are potential side effects. The use of over-the-counter sleep medicines is not usually recommended for the treatment of insomnia.

Treatment for chronic insomnia consists of:

  • First, diagnosing and treating underlying medical or psychological problems.
  • Identifying behaviors that may worsen insomnia and stopping (or reducing) them.
  • Possibly using sleeping pills, although the long-term use of sleeping pills for chronic insomnia is controversial. A patient taking any sleeping pill should be under the supervision of a physician to closely evaluate effectiveness and minimize side effects. In general, these drugs are prescribed at the lowest dose and for the shortest duration needed to relieve the sleep-related symptoms. For some of these medicines, the dose must be gradually lowered as the medicine is discontinued because, if stopped abruptly, it can cause insomnia to occur again for a night or two.
  • Trying behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning.

Relaxation Therapy.
There are specific and effective techniques that can reduce or eliminate anxiety and body tension. As a result, the person's mind is able to stop "racing," the muscles can relax, and restful sleep can occur. It usually takes much practice to learn these techniques and to achieve effective relaxation.

Sleep Restriction.
Some people suffering from insomnia spend too much time in bed unsuccessfully trying to sleep. They may benefit from a sleep restriction program that at first allows only a few hours of sleep during the night. Gradually the time is increased until a more normal night's sleep is achieved.

Another treatment that may help some people with insomnia is to recondition them to associate the bed and bedtime with sleep. For most people, this means not using their beds for any activities other than sleep and sex. As part of the reconditioning process, the person is usually advised to go to bed only when sleepy. If unable to fall asleep, the person is told to get up, stay up until sleepy, and then return to bed. Throughout this process, the person should avoid naps and wake up and go to bed at the same time each day. Eventually the person's body will be conditioned to associate the bed and bedtime with sleep.

The Right Regiment for You

The Right Regiment for You

You've discussed your symptoms and risk factors with your doctor, you've done some research, and you've decided to take hormone therapy (HT)1. Before you take any pills, apply patches, or rub in creams, you need the answers to some questions: What should you take, how much should you take, and when should you take it?

What to Take

While there is no set combination or dosage of hormones that works for every woman, a hormone therapy regimen may commonly include a combination of:

* a form of estrogen
* a form of progesterone
* and, if needed, an androgen such as testosterone

The Estrogens: Not All Alike

While we tend to think of estrogen's relationship to our reproductive function first, this hormone actually nourishes and protects our bodies in hundreds of ways, from our hearts, to our bones, to our skin and hair. In the uterus, estrogen causes the lining (endometrium) to thicken and build up each month until it is sloughed as a menstrual period.

''Estrogen'' is often used as a general term, but it is actually a category of hormones. Of the many types of estrogen our bodies make, these are the three produced in major amounts:
  • Estradiol
is the most potent form of estrogen, and the one produced in the largest amounts by a woman's ovaries before menopause. Estradiol levels fall after menopause. The brand names Estrace®, Estraderm®, Vivelle®, Alora®, FemPatch™, Estring®, and Climara® contain estradiol.
  • Estrone
is the predominant estrogen in a woman's body after menopause. When ovarian function declines, the fat cells in a woman's body take over the role of synthesizing estrone. Premarin® and Ogen® contain estrone (Premarin also contains other estrogens derived from the urine of pregnant horses).
  • Estriol
is known as the ''weak'' or ''forgotten'' estrogen. Produced in large amounts by the placenta during pregnancy, estriol is also converted in small amounts by the liver. Estriol is not commercially available in the U.S.

You have a variety of estrogen preparations to choose from.

Commonly prescibed estrogens include:

* Estraderm® (transdermal skin patch)
* Estring® (vaginal ring)
* Climara® (transdermal skin patch)
* Vivelle® (transdermal skin patch)
* FemPatch™ (transdermal skin patch)
* Estrace® (oral tablet, vaginal cream)
* Ogen® (oral tablet, vaginal cream)
* Premarin® (oral tablet)

When taken alone as a medication, estrogen can cause the cells in the uterine lining to become crowded or malformed. Progesterone, on the other hand, controls that effect, protecting you from endometrial abnormalities. You can choose between synthetic forms of progesterone, called progestins, and natural progesterone (progesterone USP), which must be compounded by a pharmacist2.

Arriving at the right HT formulation for you can take some time and adjustment. For many women, 0.625 mg Premarin® or 1 mg Estrace® are good starting dosages of estrogen. Dosages of progesterone will vary depending on the type of progesterone you are taking, and whether you are on a continuous or cyclical regimen.

If the intitial HT dose gives you uncomfortable side effects or doesn't alleviate your symptoms, your doctor can adjust the dose, try a different form of estrogen, or low-dose natural progesterone instead of synthetic progestin, depending on your individual situation.

Patch, Pill, or Cream?

In choosing the form of hormone therapy that is best for you, there are several factors you and your healthcare provider will want to consider, including which symptoms are most important for you to manage.

Because the level of heart and bone protection differs with various forms of HT, your individual profile and family history of these conditions may come into play. Some women value convenience very highly, and choose a form of HT that is easiest for them to remember how and when to take. Finally, some women weigh the costs of various forms, and factor that into their decision.

Points you may want to keep in mind in deciding between oral (taken by mouth), transdermal (skin) patch, transdermal (skin) cream, or vaginal cream estrogen:

* The estrogen skin patch is typically more expensive than oral estrogen, and the adhesive sometimes causes skin irritation.
* The skin patch may be a good choice for you if your triglyeride levels are abnormally high. Transdermal estrogen enters the body through the skin and does not raise triglyceride levels. Oral estrogen appears to increase triglyceride levels somewhat because it passes through the liver.
* Estrogen in cream form can be very effective in treating urinary and vaginal problems. (Premarin®, Estrace®, and Ogen® are commercially available as vaginal creams; natural low-dose estrogen therapy can be compounded as a cream or suppository by a pharmacist per your healthcare provider's direction).
* Vaginal estrogen creams may not have protective benefits in regard to heart or bone health.

Natural Hormone Options

Used in connection with hormones, the term ''natural'' can be confusing. When we say ''natural'' we mean molecularly identical to the hormones produced in your body. That's the key difference between the synthetic progestins and natural progesterone, for example.

The synthetic progestins (Provera® is a commonly-prescribed progestin) are similar to the progesterone your body produces, but the subtle chemical differences can significantly influence the hormone's action and side-effects in the body. Synthetic progestins can cause side-effects of irritability, nausea, depression, and water retention in some women. Natural progesterone is molecularly identical to the hormone made in the body, and many women find it easier to tolerate.

Many women call Women's Health America and the consulting pharmacists at Madison Pharmacy Associates to ask if there is a ''natural estrogen'' they can take with their natural progesterone. They are often surprised to learn that commerically manufactured and frequently-prescribed forms of estrogen (Estrace® and Estraderm® for example) are ''natural'' estrogens. Choosing among the various low-dose estrogens is a decision best made by you and your healthcare provicer based on the specific symptoms that need to be managed.

Women who are taking the hormone testosterone to alleviate lack of sex drive also have the option of taking the natural form of this hormone. Natural testosterone is not commercially available and must be compounded by a pharmacist. The section on ''Checking Testosterone After Hot Flashes'' tells more about how to decide if testosterone may be helpful for you.

When to Take It

If you're taking hormone therapy, you can choose between two types of regimens: cyclical and continuous combined. Taking HT cyclically, the most frequently prescribed regimen, mimics a menstrual pattern: you take estrogen every day and progesterone for 12-14 days of the month.

When you finish taking progesterone each month, you experience bleeding as your body ''withdraws'' from the hormone progesterone, and the endometrial lining sloughs away. Continuous combined therapy, in which women take estrogen and progesterone every day, typically eliminates the breakthrough bleeding after some initial spotting in the first one to three months. Most women report fewer side-effects with this regimen.

Evaluating Your Choices

Whatever hormone therapy regimen you choose, be aware of two very important points, says Dr. Wulf H. Utian:

1) The therapy must be evaluated at least annually by both you and your doctor, sooner if you experience side effects or problems. No hormone therapy should ever be considered permanent, although you may be taking the hormones indefinitely.

2) No single hormone ''recipe'' exists that will fit every woman. The first regimen you try may not work for you, but don't give up. Your doctor should fine-tune your hormone regimen to your individual needs -- your risk factors, your symptoms before and during therapy, and your lifestyle.

The consulting pharmacists at Madison Pharmacy Associates routinely work with women and their healthcare providers to individualize low-dose natural hormone therapy regimens, and are available to advise you. You can have your healthcare provider call 1-800-558-7046 for a comprehensive consultation with a pharmacist.

1 Some women should not take estrogen: women who have had breast or uterine cancer; women with chronic blood-clotting problems, unexplained vaginal bleeding, or serious gall bladder or liver disease; or women who are or might be pregnant.

2 Madison Pharmacy Associates P O Box 259690, Madison, WI 53717-9690, 1-800-558-7046 specializes in compounding natural hormones.

3 More reasons than ever for HT,'' T.L. Bush, R.D Gambrell, Jr., and V. Miller, Patient Care, Nov. 15, 1993, pp. 103-132.

Estrogen for Younger Looking Skin

Estrogen for Younger Looking Skin

Estrogen and Skin-Aging

Well-known for its influence on osteoporosis and mood, estrogen also appears to exert strong influence on aging of the skin. Estrogen receptors are located in the skin, and studies show that estrogen increases the activity of skin fibroblasts, cells that produce collagen. Collagen is the connective tissue that adds ''plumpness'' to skin, giving it structure, tone, and thickness. It helps keep moisture in the skin by insuring the production of hyaluronic acid and acid mucopolysaccharides.

Declining Hormone Levels Correlate With Declining Skin Integrity

During menopause, when the production of hormones in the ovaries diminishes significantly and eventually stops altogether, it is not surprising that most women notice changes in their skin, most noticeably dryness and wrinkling. Studies show declining levels of estrogen associated with menopause are linked to a decline in skin integrity and function. The skin thins out and loses its elasticity causing wrinkles to deepen, and the process of cell renewal slows down, resulting in less radiance and a duller complexion. Some estimates show that skin loses up to 30% of its collagen in the first five years after menopause, and without intervention, post-menopausal skin will continue to degenerate.

Estrogen Replacement Improves Skin

Maintaining optimal levels of estrogen, however, appears to safeguard against many of these effects. Women who use estrogen therapy after menopause have been shown to have thicker, healthier skin. A study in the British Medical Journal found that the collagen content of skin in postmenopausal women who underwent estrogen replacement therapy was 48% greater than in those who did not - suggesting that, in aging women, estrogen protects skin similar to the way it protects bones. Skin wrinkling may also diminish as a result of the effects of the hormone on the elastic fibers and collagen. The same study also showed women who take both estrogen and testosterone have skin that is 48 percent thicker (and healthier) than women who don't take either hormone.

The Benefits of Topical Estrogen Creams

For women who cannot tolerate or are not interested in estrogen replacemen, topical forms of specialized estrogen creams, using the estrogen, estriol, can produce similar beneficial effects on facial skin without raising the level of estrogen in the body.

Considered the ''weakest'' of the estrogens, research shows estriol may turn out to be the estrogen that is a good alternative for a wide array of anti-aging and hormone replacement applications, including hot flashes, insomnia, vaginal atrophy, and facial wrinkles.

In a study published in the International Journal of Dermatology, topical estrogen appeared to increase the amount of collagen in skin with marked improvement in skin elasticity and firmness after six months of treatment.

The study showed topical estrogen cream:

* Decreased wrinkle depth and pore size by 61% to 100%
* Increased skin thickness by 7% to 15%
* Increased skin lipid sebum production by 35%
* Markedly improved skin hydration

Other Benefits

In addition to its influence on skin aging, it has been suggested that estrogen also increases cutaneous wound healing by regulatind the levels of a cytokine. In fact, topical estrogen has been found to accelerate and improve wound healing in elderly men and women. The role of estrogen in scarring is unclear, but recent studies indicate that the lack of estrogen or the addition of tamoxifen may improve the quality of scarring.
Hormone Testing

As always, hormone level testing can help take the guesswork out of hormone therapy and determine a program that is just right for you.

Hormones and Aging

Hormones and Aging

Hormones are powerful chemical messengers produced by your body that tell your cells what to do, and regulate every organ and major body system. Hormones affect everything from your ability to fall asleep, to your mood, thinking ability, cholesterol level, response to stress, and the speed at which you age.

As we age, hormone levels decline, creating a severe hormone imbalance that may contribute to many of the diseases associated with aging including depression, osteoporosis, coronary artery disease, and loss of libido.


By the time a woman enters menopause, she may already have experienced two decades of hormonal imbalance. After menopause, when all her hormone levels decrease significantly, risk of major diseases increases. These include:

Heart disease - Rates of heart disease in postmenopausal women gradually climb until they equal the rates typically seen among men. According to the American Heart Association, heart disease is the leading killer of American women (American Heart Association 2004).

Osteoporosis - Hormone deficiencies are clearly associated with bone loss and osteoporosis, beginning even in the third decade of life. By the time a woman reaches 50, her risk of an osteoporotic bone fracture is significantly increased.

Alzheimer's and dementia - Loss of hormones is associated with neurodegeneration and increased risk of dementia, such as Alzheimer's disease and Parkinson's disease.


Many physicians accept diminished hormone levels as an inevitable consequence of aging and dismiss the anti-aging benefits of restoring youthful hormone levels. However, research indicates that, in addition to relieving menopausal symptoms, optimizing hormone levels can benefit conditions such as osteoporosis, depression, fatigue, and excess weight. Among the most important hormones for women to monitor and balance are free estrogen, testosterone, and DHEA.

Estrogen Is Important for Osteoporosis Prevention

Strong, healthy bone is continually maintained through a process of bone resorption (removal of old bone) and bone formation (deposition of new bone). During this process, estrogen plays an important role in protecting against bone loss. Sufficient levels of progesterone and testosterone are also important. A woman's risk of bone loss and osteoporosis increases dramatically after menopause when estrogen and other hormone levels decline. The primary preventative treatment modality in the U.S. for postmenopausal osteoporosis is hormone therapy. Studies show that hormone therapy could potentially prevent 80% of vertebral fractures and reduce hip fractures by about 50%.

Testosterone Linked to Libido and Well-being

Although women produce only small quantities of testosterone, this important hormone helps women maintain muscle strength, bone mass, and sexual function. A woman's testosterone level decreases throughout her adult life, and, by menopause, is about 50% of what it was at 20.

In one study published in the New England Journal of Medicine in September 2000, testosterone patches were tested on 75 surgically menopausal women whose declining testosterone levels had resulted in a loss of libido. Study participants using testosterone patches were two to three times more likely to have an increase in sexual activity and improved overall well being than those not using patches.

Studies Suggest Hormones Affect Skin Integrity and Elasticity

During menopause, when the production of hormones in the ovaries diminishes significantly and eventually stops altogether, it is not surprising that most women notice changes in their skin, most noticeably dryness and wrinkling. Studies show the skin thins out and loses its elasticity causing wrinkles to deepen, and the process of cell renewal slows down, resulting in less radiance and a duller complexion. Some estimates show that skin loses up to 30% of its collagen in the first five years after menopause, and without intervention, post-menopausal skin may continue to degenerate.

Maintaining optimal levels of estrogen appears to exert strong influence on aging of the skin. A study in the British Medical Journal found that the collagen content of skin in postmenopausal women who underwent estrogen therapy was 48% greater than in those who did not -- suggesting that, in aging women, estrogen protects skin similar to the way it protects bones. Another study suggested that skin wrinkling may also diminish as a result of the effects of the hormone on the elastic fibers and collagen. The same study also showed women who take both estrogen and testosterone have skin that is 48 percent thicker (and healthier) than women who don't take either hormone.

Estrogen Helps Maintain Healthy Vaginal Tissue and Prevent Urinary Incontinence

Vaginal dryness and atrophy, urinary frequency, urinary incontinence, and repeat urinary tract infections are problems that many women experience during and after menopause. These symptoms occur because falling estrogen levels can lead to thinning of the vaginal and urethral tissue and weakening of the muscles around the bladder.

Supplemental low-dose estrogen has a very robust local effect on the many estrogen receptors in these tissues and can be useful in reducing vaginal dryness and thickening skin and mucosa. Studies show low-dose estrogen can also lower vaginal pH, promoting a healthy environment for the growth of protective flora, which may then help prevent urinary tract infections.

DHEA - The Fountain of Youth Hormone

DHEA, a hormone produced by the adrenal glands, has been called the ''fountain of youth'' hormone because of its widespread positive role in maintaining youthful function as we age. Levels of DHEA peak in our twenties then begin a dramatic decline, which is associated with diminishing immunity, memory, libido and energy, and lowered resistance to age-related diseases. DHEA also plays an important role in how we handle stress and in bone mineral density.

While over-the-counter DHEA supplements are widely available and may be valuable in the quest for healthy aging, too much DHEA can ''cascade'' or turn into other hormones, creating further hormone imbalance. On the other hand, DHEA levels typically increase on their own when other hormones are brought back into balance. As with all hormones, measuring your hormone levels before supplementation is critical.



This online resource guide provides information about cataracts. It answers questions about causes and symptoms, and discusses diagnosis and types of treatment

Glaucoma Defined

What is glaucoma?

Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. Glaucoma occurs when the normal fluid pressure inside the eyes slowly rises. However, with early treatment, you can often protect your eyes against serious vision loss.

What is the optic nerve?

The optic nerve is a bundle of more than 1 million nerve fibers. It connects the retina to the brain. (See diagram below.) The retina is the light-sensitive tissue at the back of the eye. A healthy optic nerve is necessary for good vision.

What are some other forms of glaucoma?

Glaucoma section

Open-angle glaucoma is the most common form. Some people have other types of the disease.

  1. Low-tension or normal-tension glaucoma. Optic nerve damage and narrowed side vision occur in people with normal eye pressure. Lowering eye pressure at least 30 percent through medicines slows the disease in some people. Glaucoma may worsen in others despite low pressures.

    A comprehensive medical history is important in identifying other potential risk factors, such as low blood pressure, that contribute to low-tension glaucoma. If no risk factors are identified, the treatment options for low-tension glaucoma are the same as for open-angle glaucoma.

  2. Angle-closure glaucoma.
    The fluid at the front of the eye cannot reach the angle and leave the eye. The angle gets blocked by part of the iris. People with this type of glaucoma have a sudden increase in eye pressure. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, you need to seek treatment immediately.

  3. This is a medical emergency.
    If your doctor is unavailable, go to the nearest hospital or clinic. Without treatment to improve the flow of fluid, the eye can become blind in as few as one or two days. Usually, prompt laser surgery and medicines can clear the blockage and protect sight.

  4. Secondary glaucomas.
    These can develop as complications of other medical conditions. These types of glaucomas are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis (eye inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Corticosteroid drugs used to treat eye inflammations and other diseases can trigger glaucoma in some people. Treatment includes medicines, laser surgery, or conventional surgery.
  5. Congenital glaucoma.
    Children are born with a defect in the angle of the eye that slows the normal drainage of fluid. These children usually have obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive tearing. Conventional surgery typically is the suggested treatment, because medicines may have unknown effects in infants and be difficult to administer. Surgery is safe and effective. If surgery is done promptly, these children usually have an excellent chance of having good vision.

  6. Secondary glaucomas.
    These can develop as complications of other medical conditions. These types of glaucomas are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis (eye inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Corticosteroid drugs used to treat eye inflammations and other diseases can trigger glaucoma in some people. Treatment includes medicines, laser surgery, or conventional surgery.

Causes and Risk Factors

How does open-angle glaucoma damage the optic nerve?

In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid leaves the chamber at the open angle where the cornea and iris meet. (See diagram below.) When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain. As the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve. When the optic nerve is damaged from increased pressure, open-angle glaucoma--and vision loss--may result. That's why controlling pressure inside the eye is important.

Glaucoma before surgery.

Does increased eye pressure mean that I have glaucoma?

Not necessarily. Increased eye pressure means you are at risk for glaucoma, but does not mean you have the disease. A person has glaucoma only if the optic nerve is damaged. If you have increased eye pressure but no damage to the optic nerve, you do not have glaucoma. However, you are at risk. Follow the advice of your eye care professional.

Can I develop glaucoma if I have increased eye pressure?

Not necessarily. Not every person with increased eye pressure will develop glaucoma. Some people can tolerate higher eye pressure better than others. Also, a certain level of eye pressure may be high for one person but normal for another.

Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. That's why a comprehensive dilated eye exam is very important. It can help your eye care professional determine what level of eye pressure is normal for you.

Can I develop glaucoma without an increase in my eye pressure?

Yes. Glaucoma can develop without increased eye pressure. This form of glaucoma is called low-tension or normal-tension glaucoma. It is not as common as open-angle glaucoma.

Who is at risk for glaucoma?

Anyone can develop glaucoma. Some people are at higher risk than others. They include:

  • African Americans over age 40.
  • Everyone over age 60, especially Mexican Americans.
  • People with a family history of glaucoma.

Among African Americans, studies show that glaucoma is:

  • Five times more likely to occur in African Americans than in Caucasians.
  • About four times more likely to cause blindness in African Americans than in Caucasians.
  • Fifteen times more likely to cause blindness in African Americans between the ages of 45-64 than in Caucasians of the same age group.

A comprehensive dilated eye exam can reveal more risk factors, such as high eye pressure, thinness of the cornea, and abnormal optic nerve anatomy. In some people with certain combinations of these high-risk factors, medicines in the form of eyedrops reduce the risk of developing glaucoma by about half.

Medicare covers an annual comprehensive dilated eye exam for some people at high risk for glaucoma.

What can I do to protect my vision?

Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. So, if you fall into one of the high-risk groups for the disease, make sure to have your eyes examined through dilated pupils every two years by an eye care professional.

If you are being treated for glaucoma, be sure to take your glaucoma medicine every day. See your eye care professional regularly.

You also can help protect the vision of family members and friends who may be at high risk for glaucoma--African Americans over age 40; everyone over age 60, especially Mexican Americans; and people with a family history of the disease. Encourage them to have a comprehensive dilated eye exam at least once every two years. Remember: Lowering eye pressure in glaucoma's early stages slows progression of the disease and helps save vision.

Symptoms and Detection

What are the symptoms of glaucoma?

At first, there are no symptoms. Vision stays normal, and there is no pain.

However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. That is, objects in front may still be seen clearly, but objects to the side may be missed.

As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye. Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.

Glaucoma can develop in one or both eyes.

Normal vision
Normal vision
Scene viewed by a person with glaucoma
Same scene as viewed by a person with glaucoma

How is glaucoma detected?

Glaucoma is detected through a comprehensive eye exam that includes:
  1. Visual acuity test. This eye chart test measures how well you see at various distances. A tonometer measures pressure inside the eye to detect glaucoma.
  2. Visual field test. This test measures your side (peripheral) vision. It helps your eye care professional tell if you have lost side vision, a sign of glaucoma.
  3. Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
  4. Tonometry. An instrument (right) measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
  5. Pachymetry. A numbing drop is applied to your eye. Your eye care professional uses an ultrasonic wave instrument to measure the thickness of your cornea.


Can glaucoma be treated?

Yes. Immediate treatment for early stage, open-angle glaucoma can delay progression of the disease. That's why early diagnosis is very important.

Glaucoma treatments include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these. While these treatments may save remaining vision, they do not improve sight already lost from glaucoma.

  1. Medicines. Medicines, in the form of eyedrops or pills, are the most common early treatment for glaucoma. Some medicines cause the eye to make less fluid. Others lower pressure by helping fluid drain from the eye.

    Before you begin glaucoma treatment, tell your eye care professional about other medicines you may be taking. Sometimes the drops can interfere with the way other medicines work.

    Glaucoma medicines may be taken several times a day. Most people have no problems. However, some medicines can cause headaches or other side effects. For example, drops may cause stinging, burning, and redness in the eyes. Many drugs are available to treat glaucoma. If you have problems with one medicine, tell your eye care professional. Treatment with a different dose or a new drug may be possible.

    Because glaucoma often has no symptoms, people may be tempted to stop taking, or may forget to take, their medicine. You need to use the drops or pills as long as they help control your eye pressure. Regular use is very important. Make sure your eye care professional shows you how to put the drops into your eye. See tips (hyperlink to "How should I use my glaucoma eyedrops?") on using your glaucoma eyedrops.

  2. Laser trabeculoplasty. Laser trabeculoplasty helps fluid drain out of the eye. Your doctor may suggest this step at any time. In many cases, you need to keep taking glaucoma drugs after this procedure.

    Laser trabeculoplasty is performed in your doctor's office or eye clinic. Before the surgery, numbing drops will be applied to your eye. As you sit facing the laser machine, your doctor will hold a special lens to your eye. A high-intensity beam of light is aimed at the lens and reflected onto the meshwork inside your eye. You may see flashes of bright green or red light. The laser makes several evenly spaced burns that stretch the drainage holes in the meshwork. This allows the fluid to drain better.

    Like any surgery, laser surgery can cause side effects, such as inflammation. Your doctor may give you some drops to take home for any soreness or inflammation inside the eye. You need to make several follow-up visits to have your eye pressure monitored.

    If you have glaucoma in both eyes, only one eye will be treated at a time. Laser treatments for each eye will be scheduled several days to several weeks apart.

    Studies show that laser surgery is very good at reducing the pressure in some patients. However, its effects can wear off over time. Your doctor may suggest further treatment.

  3. Conventional surgery. Conventional surgery makes a new opening for the fluid to leave the eye. (See diagram.) Your doctor may suggest this treatment at any time. Conventional surgery often is done after medicines and laser surgery have failed to control pressure.

    Glaucoma after surgery.

    Conventional surgery is performed in an eye clinic or hospital. Before the surgery, you will be given medicine to help you relax. Your doctor will make small injections around the eye to numb it. A small piece of tissue is removed to create a new channel for the fluid to drain from the eye.

    For several weeks after the surgery, you must put drops in the eye to fight infection and inflammation. These drops will be different from those you may have been using before surgery.

    As with laser surgery, conventional surgery is performed on one eye at a time. Usually the operations are four to six weeks apart. Conventional surgery is about 60 to 80 percent effective at lowering eye pressure. If the new drainage opening narrows, a second operation may be needed. Conventional surgery works best if you have not had previous eye surgery, such as a cataract operation.

    In some instances, your vision may not be as good as it was before conventional surgery. Conventional surgery can cause side effects, including cataract, problems with the cornea, and inflammation or infection inside the eye. The buildup of fluid in the back of the eye may cause some patients to see shadows in their vision. If you have any of these problems, tell your doctor so a treatment plan can be developed.

Conventional surgery makes a new opening for the fluid to leave the eye.

How should I use my glaucoma eyedrops?

If eyedrops have been prescribed for treating your glaucoma, you need to use them properly and as instructed by your eye care professional. Proper use of your glaucoma medication can improve the medicine's effectiveness and reduce your risk of side effects. To properly apply your eyedrops, follow these steps:

  • First, wash your hands.
  • Hold the bottle upside down.
  • Tilt your head back.
  • Hold the bottle in one hand and place it as close as possible to the eye.
  • With the other hand, pull down your lower eyelid. This forms a pocket.
  • Place the prescribed number of drops into the lower eyelid pocket. If you are using more than one eyedrop, be sure to wait at least five minutes before applying the second eyedrop.
  • Close your eye OR press the lower lid lightly with your finger for at least one minute. Either of these steps keeps the drops in the eye and helps prevent the drops from draining into the tear duct, which can increase your risk of side effects

What can I do if I already have lost some vision from glaucoma?

If you have lost some sight from glaucoma, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision.

Many community organizations and agencies offer information about low vision counseling, training, and other special services for people with visual impairments. A nearby school of medicine or optometry may provide low vision services.

Current Research

What research is being done?

A large amount of research is being done in the U.S. to learn what causes glaucoma and to improve its diagnosis and treatment. For instance, the National Eye Institute (NEI) is funding a number of studies to find out what causes fluid pressure to increase in the eye. By learning more about this process, doctors may be able to find the exact cause of the disease and learn better how to prevent and treat it. The NEI also supports clinical trials of new drugs and surgical techniques that show promise against glaucoma.

Eye Health Organizations
Tips on Talking to Your Doctor
How to Find an Eye Care Professional
Order Glaucoma Publications from our online catalog

Content last reviewed April 2006

This online resource guide provides information about cataracts. It answers questions about causes and symptoms, and discusses diagnosis and types of treatment. It was adapted from Don't Lose Sight of Glaucoma (NIH Publication No. 96-3251) and Glaucoma: What You Should Know (NIH Publication No. 03-651).

The National Eye Institute (NEI) conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services.

This page was last modified in October 2007

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