Medical | GOQii

March 27, 2018 By Dr Darshana Salve 2 Comments

Snooze off fatigue!

fatigue

The alarm is set for 6 am to go for a morning walk, filled with determination to start on a routine walk from the next morning, she went to sleep early. But, like any other day, the alarm went off but, as usual, she couldn’t get out of bed. With each passing day, it got difficult even to get up for work. This happened almost for 2-3 months when Ananya realized this was not just laziness but something beyond and decided to see the doctor.

Ananya described that she had no energy to wake up in the morning and felt tired and exhausted by the end of the day. Sounds familiar??!! Yes, this happens to many around us or even to us. This Syndrome is called fatigue.

Fatigue is generally defined as a feeling of lack of energy and motivation that can be physical, mental or both. Fatigue is very common. Fatigue can be caused by Physical (around 60%) as well as Mental causes (40%). Unfortunately, it can also occur in normal individuals that experience intense physical or mental activity (or both).

However, in contrast to fatigue that occurs with some diseases and syndromes, normal fatigue in healthy individuals is quickly relieved in few hours to about a day when the physical or mental activity is reduced and adequate rest is taken.

So what are the most common causes of fatigue??

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Sleep Problems-Sleep Apnea, insomnia working in shifts or work shift changes, pregnancy, extra night hours at “work”, gadget time. For such problems, including foods like nuts or milk that are rich in tryptophan (sleep inducing hormone) can help get better sleep.
Dysglycemia – Skipping Breakfast, long gaps between meals is known to cause irregular fluctuations in sugar levels. To avoid such irregularities one must have a healthy breakfast every day preferably within one hour of waking up. Always plan for a mid-meal snack especially when the gap exceeds 5 hours.
Nutritional deficiency – Eating a healthy, balanced diet (proteins, carbohydrates, fats and fibre) is an important part of maintaining good health, and can help you feel your best. Include fruits, whole grains, and protein rich foods and avoid junk food, processed/packaged food.
Gut disturbances – An acidic body doesn’t allow oxygen to be absorbed and in turn causes fatigue. Gastric issues like bloating, constipation, food sensitivity/allergy, leaky gut (gastric reflux) all create havoc in our body resulting in physical and mental fatigue. Including adequate quantity of fibre, probiotics like curd and a good intake of water keep your gut happy and healthy.
Caffeine overload – Limit tea/coffee/green tea to 2 cups/day. Avoid having it post sunset and near bed time.
Dehydration – When dehydrated, the fluid loss causes a drop in blood volume, which makes the heart work harder to push oxygen and nutrients through the bloodstream to the brain, skin, and muscles. Maintaining a water intake to 2.5-3 litre is adequate for the majority of the population.
Metabolic/endocrine causes – Vitamin D deficiency, Hypothyroidism, Diabetes, Electrolyte abnormalities, kidney disease, Liver disease can all cause varying degrees of fatigue.
Anemia (Iron deficiency, Vitamin B12 deficiency) – It is one of the most common reasons of fatigue or tiredness in India and especially common amongst the women.
Infectious diseases -Viral infections, Hepatitis, Tuberculosis, cytomegalovirus (CMV), HIV infection, Influenza (flu), Malaria and many other infectious diseases.
Medications –It might come as a surprise to you but many drugs like antidepressants, anti-anxiety medications, sedatives, antihistamines, steroids and even some blood pressure medications can cause fatigue.
Mental Health (psychiatric) –Stress, Depression, Anxiety, Drug abuse, Alcohol abuse, eating disorders, (for example bulimia/anorexia), Grief and Bereavement are all few of the most ignored causes of fatigue. Awareness and proactive management of mental disorders is a must for living healthy.

Depending on the above reasons, the right treatment must be decided as it is important that the root cause of fatigue be treated and not just the symptom.

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In the case of Ananya, on taking a proper history and some blood tests, she was found to have nutritional and Vitamin D deficiency. Once these were corrected she felt strong and active enough to start with her healthy regime.

Fatigue is a natural part of all our lives, because of which we tend to ignore it and instead learn to live with it which in the long run causes more trouble. We must look out for tell-tale signs of things we could do earlier but can’t do anymore, unrelated aches and pains or headaches and if found positive we must seek the right help. Don’t let feeling tired today ruin your attempt to feel healthy tomorrow!

March 21, 2018 By Trishala Chopra 3 Comments

All that a women needs to know about –MENOPAUSE!

Menopause simply means marking the end of a female’s reproductive period. This is something women experience as they age. It does not occur overnight! It is a gradual process.

This gradual process is usually known as Perimenopausal phase which is a completely different transition for every woman. It is a very challenging phase for every woman, a woman might get irritated, and mood swings are the most common thing! Emotional breakdowns also occur. Earlier, the ideal age for menopause was around 45-50 years but, if a woman has attained early puberty, menopause occurs early too!

Menopause comes with many complications and the most common complication is osteoporosis and heart disease.
The bone mineral density gradually goes down during menopausal transition which may result in osteoporosis however, these symptoms vary in different women.
Hot flashes occur very frequently.
The entire menopause is divided into 3 phases which are Perimenopause, Menopause and Post Menopause.
Out of these 3 phases, Perimenopause phase which can also be called as “time around menopause” lasts for the maximum time which involves all symptoms.
Menopause and post menopause phase lasts for a shorter period.
Apart from hot flashes and mood swings, women in menopausal stage also face excess stress, tiredness, fatigue and sometimes vaginal itchiness and drying.
The main sign of menopause is irregular vaginal bleeding.
Menopause is a part of every woman’s life and it is not a disease which can be treated. However, menopause can be managed and tackled if handled properly.
Nutrition and physical exercise plays a key role in managing the menopausal symptoms

FOODS which help managing Menopausal Symptoms:-

(1) Include more fruits and vegetables in your diet

(2) Eat more beans

(3) Eat more of good fats and Omega 3 rich foods such as avocado, fish-Salmon, walnuts flaxseeds etc rather than saturated fatty acids.

(4) Consume good beverages; avoid consuming carbonated beverages and caffeine. Caffeine is a diuretic which puts load on kidneys to remove more amount of water than required which results in dehydration. Focus more on herbal teas which helps in relieving hot flashes.

(5) Balance your meals: – heavy breakfast, moderate lunch and light dinner should always

(6) Consume more of calcium containing foods as this mineral is very important for women after the age of 30. Adequate amount of calcium in diet decreases the risk of osteoporosis. Some of the natural foods high in Calcium are dairy products, ragi, sesame seeds etc

(7) Say no to high fat and high sugar foods!

(8) Add functional foods to your diet such as flaxseeds which is a super food! Raw Flaxseed should be ground and 1 tsp should be had and drink a glass of water over it.

(9) Exercise! It is a key to life a healthy life! 30 minutes of walk also acts as a stress buster!

Ladies out there at this stage of your life take care of yourself.

March 6, 2018 By Komilla Pareek 11 Comments

Simple guide to Protein-Uric Acid Connection

When Rohit came to me for consultation, he was suffering from hyperuricemia- a condition which is associated with high levels of uric acid in the blood. Increased levels of blood uric acid predispose to gouts and very high levels may lead to kidney failure. Uric acid is produced from the natural breakdown of body’s cells and from the foods rich in purines. Thus, in hyperuricemia, purine rich foods are avoided.

Though purines are present in all living things (and food) as they provide part of the chemical structure of our genes, some foods contain concentrated amounts of purines. For the most part, these high-purine foods are also high-protein foods and thus purine restriction gets wrongly translated as protein restriction in most cases.

A detailed discussion around Rohit’s food intake revealed that his diet was very low in protein. He was avoiding all pulses, milk and milk products and meat & eggs. In addition, to that, he was doing one hour of intense workout to reduce weight. He reported muscle soreness, weakness, and cramping which I could easily relate to his visible signs of protein deficiency – sparse hair, pot belly, and swollen hands.

Contrary to the notion that protein is necessary only in growing age, we need protein at every age for normal wear and tear of tissues. Most of the enzymes involved in important metabolic processes are proteins. Thus, like everyone, hyperuricemia patients too need this nutrient in adequate quantities.

Let’s make this complex protein -uric acid connection simpler through this guide on what to include and what not –

Dairy products – Not only do they provide good quality proteins, scientific studies have demonstrated that milk when taken in moderate quantities actually help in reducing and managing gouts. However, fermented milk products such as yogurt, buttermilk, curds and aged cheese have purines from the nucleic acids of the bacterial cells that proliferate during fermentation. They should be avoided. Non-fermented milk products such as cottage cheese, paneer, whey protein can be taken.

Eggs– The yolk of an egg contains the nucleic acids, but the egg white is pure protein without purines.

Nuts – Nuts are naturally low in purines and can be eaten daily by those on a low purine diet. Good sources of low-purine nuts and seeds include walnuts, almonds, flaxseeds and cashew nuts. Keep in mind that nuts are rich in calories, so eating too many of them could cause you to gain weight.

Pulses– Beans and pulses contain low to moderate amount of purines. However, researchers prove that purine from plant sources are less likely to harm and one serving of pulses per day can be safely taken by gout patients.

Meat – Meats including bacon, beef, pork, and lamb; Organ meats, such as brains, heart, kidney, liver, and sweetbreads; anchovies, sardines, herring, mackerel, and scallops are high in purine and should be avoided.

Epidemiological research has demonstrated that all purine-containing foods are not the same, and that plant purines are far safer than meat and fish purines in terms of gout risk.

Hope this information helps you meet protein requirements and lead a normal active healthy life on a low purine diet.

February 17, 2018 By Richi Seth Leave a Comment

Tennis Elbow: Symptoms, management and its prevention

How often have you heard or read in news about a sportsman suffering a tennis elbow or your friend saying I am suffering a tennis elbow? Many a time I am sure. But, are you aware of what is ‘Tennis Elbow’ and how can you prevent it.

The elbow is known as the “funny bone” but if you suffer from tennis or golfer’s elbow, the pain you undergo when you hit the elbow is unbearable.

Tennis elbow can be caused by sudden injury of the muscle and tendon area around the outside of the elbow where the muscles and tendons of the forearm attach to the outside bony area- the lateral epicondyle of the elbow. Another common term, “golfer’s elbow,” refers to the same process occurring on the inside of the elbow called as medial epicondyle. It does not happen with the sportspersons only, it’s just the term which is referred to the sport as it can be a significant problem for some tennis players.

What Are the Symptoms of Tennis Elbow?

Pain around the outside of the elbow.
Pain is worse by moving the wrist with force. Examples include lifting, using tools, opening jars, or even handling simple utensils such as rolling pin, using a toothbrush or knife and fork.

How do you manage a Tennis Elbow?

Tennis elbow is treated primarily by physiotherapy which includes some exercises of forearm and wrist along with their strengthening progressively, bracing for resting the muscles, topical anti-inflammatory gels, topical steroid gels, and steroid injections. Surgery is needed in rare cases.

Immediate line of treatment to reduce the pain and inflammation of tennis elbow should be:

Rest
Avoid any activity that causes pain.
Apply ice to the affected area. Holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day can help ease the pain.
Massaging and manipulating the affected area may help relieve the pain and stiffness, and improve the range of movement.

Exercises:

It is important to maintain the fitness levels with performing some light exercises like:

Aerobic exercises like walking, running or jogging that are good for overall fitness
Gentle stretching exercises can help in rehabilitating the elbow and some of the good exercises for tennis elbow include gentle wrist extensions, flexes and rotations, wrist curls and extensions with the help of light dumbles.
Isometric exercises such as squeezing a ball, are also a good cure for tennis elbow.

Tennis Elbow prevention through nutrition

Apart from the above-mentioned treatment options, it is also important to support the connective tissues’ health with nutrient-rich, anti-inflammatory food:

Have plenty of colourful fruits and vegetables daily in your diet.
Consumption of Pineapples is beneficial as they are rich in vitamin C that helps in building collagen. They are also rich in bromelain, which contains powerful anti-inflammatory properties that can reduce pain and swelling caused by tennis elbow.
Having good quality protein which contains a high biological value like eggs, lean meat which serves as the “building blocks” for tissue repair.
Having supplements with vitamin C, vitamin A, zinc and copper.
Having anti-inflammatory foods and supplements such as barley, ginger, curcumin, omega 3 rich foods like fish such as mackerel and salmon, walnuts, flaxseeds etc.
Limit the intake of processed and canned foods and sugar.

Precautions to be taken

To help lessen the stress and abuse on tennis elbow:

Use the proper equipment and technique in sports.
Use of a counter-force brace, an elastic band that wraps around the forearm just below the injured elbow (tendon) may help to relieve pain in some people.
Avoid tight gripping and overuse of the wrist.