Supplements For Soft Tissue Injuries

Many of you know I had surgery 2 weeks ago to remove varicose veins in my leg.  The pain, bruising and swelling were of epic proportions but they are subsiding slowly.  As a very active and busy person it has been very difficult for me to exercise patience to allow my body to heal at its own pace.

This week I decided to do some research on supplements to help my leg heal faster.  As expected, I found that a good multivitamin and plenty of protein are essential for healing.  However, I was surprised to find evidence of efficacy of a certain type of supplements for soft tissue injuries.

Proteolytic enzymes are chemically active protein substances that act to break down other proteins.  Those who remember their Biology 101 will remember that enzymes are proteins that make chemical reactions happen faster than they would on their own.

Why are proteolytic enzymes helpful in wound healing and in repairing other types of tissue damage?  Well blood is protein, and in order to get all the blood broken down and cleaned up by macrophages in the tissues you need enzymes to break down the hemoglobin and other blood proteins.

Those familiar with Chip and Joanna Gaines on the show “Fixer Upper” will remember Chip’s joy on Demo Day.  The first part of a major remodel is breaking up and taking out the cabinets, appliances, drywall and other bits and pieces that need to be gotten rid of.  The first step in healing a soft tissue injury is a similar process to Demo Day.  Damaged proteins like collagen and hemoglobin must be cleaned up in order to make way for new healthy proteins to be put in place.

So what’s the evidence that proteolytic enzymes are helpful for soft tissue healing?  I found articles published in the 1960s that showed supplementing with proteolytic enzymes produced remarkable healing of athletic injuries from a wide variety of sports.  There is more recent evidence too.

  1. In 2009 researchers showed that a protease preparation containing fungal enzymes, papain and bromelain made a significant difference in muscle strength recovery after running downhill for 45 minutes.
  2. It was also shown that protease supplementation (containing bromelain, papain, trypsin, chymotrypsin and several other enzymes) improved recovery of leg muscle strength and soreness after running downhill.
  3. A small study showed statistically significant improvement in fatigue and markers of muscle damage and inflammation with supplementation of bromelain in competitive bicycle racers.
  4. A list of surgically relevant herbal preparations listed bromelain as helpful in accelerating wound healing.
  5. A very extensive discussion of the effect of supplements on surgical wound healing mentions bromelain as effective at reducing swelling, pain and healing time.

To summarize, if you have a sports injury or a surgical wound, it would be reasonable and safe to add a proteolytic enzyme supplement to reduce swelling, bruising and time to heal the injury.  Make sure anything you choose contains bromelain because it seems to have the best research data to support its use.  As always, be sure to tell your surgeon what supplements you take or are planning to take that may affect your surgery.

Before you ask, yes, I started taking a supplement containing bromelain (among other enzymes) a few days ago.  And I’m taking some research articles to my follow up appointment with my surgeon for him to review!  I wish I had known about bromelain before my surgery, I might have had less pain and swelling to deal with.

QUESTION: Are you surprised that taking enzymes orally helps healing injuries and surgical wounds?  Would you take them yourself?

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Money And Health

With all the wrangling and fighting in Washington over the federal budget and also over the future of the Affordable Care Act, I’m feeling philosophical today about the connection between money and health.

What is the connection between money and health?  Can money buy health?  Can lack of money keep you from being healthy?  Well, yes and no.  It has been shown pretty convincingly that, in general, poor people are not as healthy as those who are better off financially.  Whether that is due to educational disparities, differences in access to health care, different diet quality, or other factors isn’t really clear.

Does being better off financially equal better health?  No, of course not.  Look at movie stars and celebrities.  Every week it seems there is another celebrity drug overdose or story about a movie star committing suicide in the depths of mental illness.  Wealthy celebrities struggle with obesity just like everyone else does.  Even access to infinite health resources does not guarantee one will be healthy.

What is money anyway?  Why do we need it?  Money is an artificial construct that makes it easier to engage in trade.  It is a symbol that everyone has agreed in advance has a certain value.  It is easier to trade coins or paper money for foodstuffs than to take a goat or bales of wool or stacks of animal furs to the grocery store.

The only thing that will motivate a person to open their wallet or pull out a credit card (another artificial construct, BTW) is the belief that the thing they are buying will make their life better.  Whether it’s underwear, carrots, legal advice, prescription medication, or a Ducati motorcycle, the thing being purchased will make the buyer’s life better in some way.

(BTW the government is selling you something in return for the taxes you pay – the right to stay out of prison.  There is an interesting thought, right?)

OK.  So if you need money to buy the things YOU need for food, shelter, clothing, etc, you have to have something to trade for that money.  The things we possess to trade for money all fall into three broad categories:  goods, time and expertise.

So what brings money into your household?  We spend an awful lot of time doing whatever we do to earn money.  Shouldn’t it be something that gives us pride and pleasure?

Too many people sacrifice their health in the pursuit of money.  There is a sweet spot where your career and your health are balanced.  Your stress is enough to keep you motivated and energized but not so much that you are at risk of getting sick from it.

Money cannot buy health.  You don’t have to have a lot of money to do the things you need to do to be healthy.

  • Eat a balanced diet with plenty of fresh fruits and veggies in season, whole grains, nuts and seeds with limited amounts of meat and dairy.
  • Move your body every day in a way that you enjoy.
  • Get plenty of sleep
  • Drink plenty of fresh, clean water
  • Play and laugh and spend time with people who make you feel good

We all need money, but we DON’T need to be so focused on it that we make ourselves sick in the pursuit of it.  Take a moment today to examine whether your career and health are in balance or whether you need to reevaluate the relationship between money and health in your life.

QUESTION: Do you think you are sacrificing your health in order to earn money?  Why or why not?

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Should You Have A Coronary CT?

There has been a lot of buzz in the news recently about coronary CT, also known as CT Coronary Angiography (CTCA).  This is a noninvasive scan done to check for blockages in the heart’s coronary arteries.

Why would someone get a coronary CT?  There are 3 main reasons.

Chest pain

There are many reasons someone would have chest pain.  Coronary CT can help distinguish true angina from other sources of chest pain like GERD, asthma and anxiety.  Because it is noninvasive and doesn’t require IV medication or running on a treadmill, for some patients a coronary CT can be a good diagnostic option.

Management decisions

When someone has high cholesterol, we manage it based on their risk of having a heart attack in the next 10 years.  Our current model of estimating risk is actually not that great, unfortunately.  Knowing whether or not a person already has blockages in their coronary arteries can clarify heart risk and help decide whether they need medication to bring down their cholesterol.

Knowledge is power!

If a person has a family history of heart disease and is concerned about their personal risk, a coronary CT can help clarify things.  Similar to Lifeline screenings, a coronary CT is often available at low cost and sometimes is offered without a prescription.

Before you get a coronary CT, consider what you will do with the information.  If you find that you have some hardening of the arteries in your heart, are you ready to get serious about diet, exercise and weight control?  Are you ready to start taking a statin drug?  Will you work hard to get your blood pressure under control?

If you get a coronary CT and it is clean, that’s great, and very reassuring.  However, what will you do if it is NOT clean?  Are you ready to do what you need to do to reduce your heart risk?

Before you get your coronary CT, think about what you will do with the results.

QUESTION: Have you thought about getting a coronary CT?

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Hair Loss

Carolyn is a lovely lady who came to my office recently complaining that her hair was falling out.  This is a common problem that primary care doctors see.  Most of the patients are women, and often it is difficult to figure out why hair loss is happening.

If you’re a woman and you’re losing your hair, it can be terrifying!  Many of our standards of beauty in America, right or wrong, center on thick glossy healthy hair.  When we see a woman who has hair loss, we think of chemotherapy and assume she is unhealthy when that may be completely inaccurate.

What are the causes of hair loss?  In general, they can be broken down into 5 main categories.

Autoimmune

This type of hair loss is pretty obvious.  There are well-defined patches of bald skin on the scalp.  Sometimes the skin is perfectly normal, and sometimes there is scarring present.  A doctor should be able to diagnose these causes of hair loss pretty readily by discussing symptoms and doing a physical examination, and discuss treatment.

Trauma

How can you cause trauma to your HAIR?  Easy.  You pull on it.  Women who wear their hair tightly pulled back all the time will lose hair by injuring the follicles.  This is most often seen in African-American girls and women who wear their hair in cornrows and other tight braids.  It is very common to see receding hairlines in these patients as the hair follicles at the edge of the hair field are lost.

We also see hair loss from repeated pulling on the hair, a nervous habit called trichotillomania.  Treatment for anxiety will reduce the urge to pull or twirl the hair and stop the hair loss from happening.

Hormones

By far the most common cause of hair loss in America is male pattern baldness.  Everyone is familiar with the bald-spot-and-receding-hairline pattern in our fathers, grandfathers, uncles and other older male relatives.

Did you know women can get male pattern hair loss too?  It happens after menopause, when the hormone balance in the female body shifts to be more male-predominant.  Women tend to have more of an all-over-the-scalp or general thinning of the hair rather than a receding hairline or bald spot on the crown.

Most people who check with Dr. Google about their hair loss are familiar with underactive thyroid as a cause of hair loss.  It is true that hypothyroidism has hair loss as one of its symptoms.  Thyroid medication can also cause hair loss.

Another hormonal cause of hair loss is the shedding of hair after childbirth.  About 3 months after a baby is born, Mom usually starts losing the extra hair she grew in pregnancy.  Don’t worry, the new mom won’t have to worry about going bald in addition to getting back into her pre-pregnancy clothes.  The hair loss stops after a few weeks and usually her hair is the same as it was before she got pregnant.

Stress

This is an extremely common and extremely frustrating cause of hair loss.  When the body goes through a major stress, physical or mental, it can cause the hair to go into “sleeping” (called telogen) phase.  Surgery, childbirth, or the death of a close family member can trigger it.  The body just doesn’t have the resources to put into growing hair, so it conserves those resources in the most sensible way it can.

About 3 months after the stress has resolved, the hair follicles want to start growing hair again.  Unfortunately the follicle can’t start growing the same hair shaft again.  It has to shed that hair shaft and start over.  All those hair shafts being shed at the same time is what makes a person fear their hair is falling out.  Like the new mom above, the hair won’t ALL fall out, and after a few weeks looking at the hairline will show new, short, fine hairs growing.  This is reassurance that stress was the cause and that the body is back to business as usual as far as hair goes.

Nutrition

Nutritional deficiencies are another common cause of problems with the hair.  Very commonly after bariatric surgery we will see patients complaining of hair loss.  Calorie restriction from ordinary dieting, not just the super-restrictive diet after bariatric surgery, will cause some hair loss too.

Protein, vitamins and minerals are important nutrients for healthy hair growth and if you’re not getting enough your hair will suffer.  Nutrients to pay close attention to as far as hair growth goes include iron, zinc, biotin, omega-3 fats, protein, vitamin D and trace minerals like selenium.

Your doctor can check your iron and vitamin D levels.  Everyone needs an omega-3 supplement because almost nobody gets enough in their diet.  Same with a good-quality multivitamin.

If you’re having trouble with hair loss, see your doctor to make sure there isn’t a potentially serious cause for it like hypothyroidism or iron deficiency.  If no cause turns up, I invite you to consider trying a few months of Vitalizing Plan which contains your comprehensive multivitamin, Vitamin D, fish oil and probiotics to boot.  Everyone who uses Vitalizing Plan tells me their hair and nails are improved from using it.  And since it’s guaranteed, there’s no risk.

What have you got to lose, except more hair?  Give your doctor a call and check for medical causes of hair loss.  If s/he doesn’t turn up a cause, let me know and we’ll talk about nutrition!  You can email me at drjen@jenniferwurstmd.com or call 888-741-9153 to set up a time to talk.

QUESTION: Do you have problems with hair loss?

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