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Marz final exam review lecture Nutrition IV


asthma
osteoarthritis
thyroid
digestive dz
CV dz

asthma
look at diagrams p318-19, 53-54
study cyclic amp & gmp and modulators
mast cells and degran, stabilizers
stab: antiox, sel, vit a, c, flavonoids from substance p
local lack of epi or dha?
allergies usu adrenal fatigue
tx: decr inflam and allergens
**asthma: avoid sulfites, take molybdenum IV or oral
tx: elim allergens & inflam incl high aa foods (animal)
walnuts, flax, hemp for omega 3, cold water fish, seaweed, greens
quercetin, yellow onion skin, sweet potato, egg yolk, yellow things
avoid: banana, tryptophan, foods high in calcium
phospholipase A2 frees up aa from cell membranes, know it's modulators
supps: b12 shots daily for a week for kids very effective
b6 anti allergen, for msg sensitivity, grams may cause peripheral neuropathy
b6 cofactor for delta 6 desaturase
magnesium for muscle spasm all kinds
calcium can relax smooth muscles but CI in asthma dt ?
NAC mucolytic esp for environ sensit, also chelator
quercetin stabilizes mast cells
ginkgo, lobelia, ephedra inhibit phosphodiesterase which breaks down cAMP
you want more cAMP so avoid these???
many w/ allergies have limited delta 6 desaturase and need preformed Gamma linonenic from EPA, borage, etc
**GLA sources: nuts, seeds, grains, EPO, borage, black currant oil
low in DM, alcoholism, HTN, atopy
**diff between allergies in kids and adults

osteoporosis
large protein intake-->acidity-->calcium excretion
female bone mass peaks at 35
**average ca turnover 500mg/day
RDA is high at 800mg, 1200 in preg
500mg supp may be enough to have positive calcium balance
calcium is protective vs lead intake
etio: hyper and hypothyroidism, DM, hyperadrenalism, corticosteroids, anti-clot meds (coumadin-->vit k def)

**vit K look up, rate limiting for osteocalcin manufacture, attaches ca ions to forming bone
phylloquione = vit k
must have bile to absorb K1 from dark leafies, K2 made by intestinal bacteria, K3 more toxic
most pts def in vit k, in green leafies, no RDA but adults need 70-140mcg/day per Marz
sources: turnip greens, brocc, cabbg, liver, green tea, lettuce, spinach, asparagus, oats, cheese
K needed to bind calcium into bone matrix

contributing to osteoporosis: homocysteinuria, hemochromatosis, obesity
elevated TGs can sequester vitamin d and cause def, get falsely low vit d levels
alc, smok, caffeine, immobilization, RF, acidosis, renal dz

**study page on vit D metab, skin then liver then kidney, p176
7-dehydrocholesterol-->cholecalciferol in skin after sun-->kidney, becomes either 1,25 or 24,25 depending on blood calcium level, 1,25 brings up calcium levels by 2 mechanisms, aside about chinese medicine and bone health: mb poor renal health, atherosclerosis, low boron, mg, est cause osteoporosis

malabsorption, gi inflam, parasites
sx: failure to thrive,
vit K, homocysteine
iron, acid
phos inhibits ca absorption
coffee and tea
stress, high cortisol
a condition with many related factors, trace elements with ca supp sig help
boron, molybdenum, silica, magnesium for tensile strength
dense bones may not be strong, if brittle need minerals

RA
autoimmune
family tree connection book
gluten sensitivity?
egg, soy, beef, pork
parasites?
tx: decr aa fats, veg diet, fasting, elemental or hypoallergenic diet
avoid grass
eat: omega 3's cod liver oil
anti-ox decr membr perm, promote synovial fluid secretion
**iron: CI in RA pts, elevates in synovial fluid, use liver extract if IDA
expect false elevation in acute inflam
copper salicylate more anti-inflam than aspirin p346
bromelain enz
heavy metals, trans fats incr synovial permeability
hyperthyroid-->inflam
**solanaecea know family
**tx: niacinamide. a form of b3 that is not vasodilator
**tx: boron
tx: B6 (there's a q on **carpal tunnel and pyridoxal 5 phosphate)
tx: zinc and copper **relationship, zinc w/o copper can raise LDL etc
ginger & tumeric anti-inflam
**carotenoids inhib 5 lipoxygenase, stops flow to LK4 series regulates inflam
glucosamine sulfate
s adenosyl thiamine

bursitis
tx with short juice fast
same for other acute inflam
no sources for arachidonic acid
vit b12 shots, not local
cts pryidoxine b6 hallmark tx, relates to paniculofibrocitis in upper back
if chronic upper back pain mb adhesions btw skin and muscle, b6 helps
avoid coffee, it's inflam
if migraine avoid coffee too

hypothyroidism
etio: mercury, radiation
tx: iodine protective
etio: goitrogens inhibit iodinization of tyrosine, activation of t3, or release of hormone
tx: found in raw foods only, cook or soak to remove
Wilson's syndrome esp in preg
low BBT mbdt hypothyroid
see list on notes: soy, peanuts etc for list of goitrogens
goitrogens affect pts less if they are replete with iodine
michigan and surrounding areas more goitrogens in water
tx: avoidgoit, rest, take iodine but not 300mg that's suppressive
tyrosine t2 t3 t4
zinc, copper, selenium needed
glandulars

esophagitis
les relaxed by foods, alc, allerg, preg (pressure & hormones), obes,
r/o bulemia in teen
candida
tx: small relaxed meals, fiber, lecithin & choline

PUD
may have low acid not hi in gastric
duod may have high acid
etio: h pylori, aspirin, nsaids, "new sorts of aspirin in disguise"
want to inhib cox 2 not cox 1 which helps PGE1 and is protective for stomach, eczea, psoriasis
tx: zinc and vit a are most imp for epithelial tissue
performed GLA (EPO, borage, etc)
etio: allergen most assoc: dairy, casein
xanthine oxidase from homog milk
chlorinated h2o
tx: raw cabbage juice
tx: glutamine for si, butyrate for li
tx: carrot juice for any ulceration, anti-inflam and a for healing epithel
comfrey, deglycyrizhated licorice root

celiac dz
flattened villi-->malabsorb
pan nutrient def esp fat sol
onset age 6mo-3yr w/ solid food intro, then sx "disappear" until adulthood
headaches, gallbladder, etc later
wheat, barley, spelt, rye,
response 2-3wks - years for full recovery
bx is allo gold standard for dx but anti-endomysial antibodies is noninvasive gold standard
supp big at first esp vit d in kids, k, e, a
calcium imp, b12 for energy

IBD
UC acute bloody d, Crohn's more chronic
etio: yeast, dysbiosis
etio: parasites, AI, food allergy,
not much seen where big fiber consumed
tx for acute: not fiber
tx: fasting, elemental diet
tx: butyrate enema
tx: 8-10gm glutamine to stabilize gi tract
tx: soluble fiber for stool bulk and chelation of endotoxins
tx: arginine conditionally essential in severe wt loss, use with glutamine
tx: glycyrrhiza anti-inflam local

constip
prevalent
mb delayed transit time with daily bm
28 hours is average US bowel transit time
incr bowel pace to prevent cancer

parasites and D
tx: ricewater after parasites are r/o
etio: clostridium, candida
tx: bromelain

polysystemic candidiasis
etio: dietary carbs or abx, cortisone inhaler, oral steroids
abs vs yeast==>complexes may cause sx
distinctive: esp worse with simple carbs
etio: estrogenic hormones
tx: like diabetic
sx: foul stool, foot fungus, thrush, vag yeast, sensitive to mold/moldy food (peanuts)
sx: skin conditions, arthralgias, environmental illness
dx: check blood sugar
tx: caprylate, undecylate, garlic (raw)

BEGIN HERE IN AM

derm
p53-54
**etio: cAMP low, cGMP high dt polyamines/endotoxins
tx: decr bowel transit time

psoriasis
vit D used as drug supp topical
**active 1,25 form is used topically to suppress cell division

acne
etio: hyperglycemia, hormones
tx: vit a and zinc, mb high doses of a
caution: too much zinc-->nausea, can raise chol in adults
drugs: retin-a oral
conventional: abx
tx: fiber to bind endotox
tx: azulaic acid for cystic, from molds
etio of adult: hypochlorhydria, sibo

migraine
vasomotor instab
**triggers: xanthines
((he thinks he made an error about tyramine containing foods, fermented cheeses and wine--may not be related to migraines so much as to MAOI-->can cause BP to incr))
tx: niacin admin early can prevent, want the flushing kind
tx: tanacetum
sx: short plt activation time, sticky plts, may find high fibrinogen, crp, ferritin
tx: fish oil to make plts less sticky, garlic, ginger, tumeric

that was 80% of exam
last 20% is cardiovasc

some general cv dz
week 10 print

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