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The importance of sleep

The importance of sleep   Getting sufficient sleep is crucial for maintaining good health. Our bodies devote about one-third of our lives to sleeping. During this time, our bodies enter a state of reduced awareness and responsiveness to the environment, allowing for much-needed rest and repair. Sleep consists of two main types: Non-rapid eye movement sleep (NREM) and Rapid eye movement sleep (REM). While we sleep, our bodies undergo various physiological changes that differ from when we are awake. These changes include:   Restoring and repairing damaged tissues by accelerating protein synthesis for use in the future (Restoration of tissue) Regulating hormones to maintain normal bodily functions (Hormonal control) Developing and regulating the nervous system, emotions, and memory (Neural maturation, regulation of emotions and memory) Eliminating abnormal proteins from the brain (Protein misfolding clearance)   Frequent Sleep Problems:   1. Sleep apnea, which has two types:   Obstructive sleep apnea (OSA), where the tissue around the throat, particularly the base of the tongue, collapses and blocks the airway during sleep, making it difficult for the patient to breathe, even when attempting to do so. If there is some airflow, snoring may be heard. When air is severely restricted, the brain may trigger the patient to wake up slightly, but not fully, which is known as an arousal. Central sleep apnea (CSA) occurs when the brain fails to signal breathing during sleep. As a result, there is no movement of the respiratory muscles during the apneic period. Patients with CSA may need to wake up multiple times to breathe, resulting in poor quality sleep. Furthermore, frequent arousal from sleep due to either OSA or CSA can result in high blood pressure, as the autonomic nervous system is not able to rest, and the alternating periods of oxygen deprivation and reoxygenation can produce harmful free radicals that can lead to atherosclerosis, a condition that narrows and hardens the arteries, and can lead to heart disease and stroke.   2. Sleep-related abnormal movement and parasomnia include Restless Leg Syndrome (RLS), Periodic Limb Movement in Sleep (PLMS), Bruxism, and Sleepwalking.   Restless Leg Syndrome causes significant distress for patients, as many describe feelings of discomfort in their legs, such as an urge to move or a crawling sensation that persists even after movement. Symptoms often occur when the patient is still or before bedtime, and can severely disrupt sleep, leading to frustration and affecting mental well-being. RLS is often associated with iron deficiency in the brain.   Periodic Limb Movement in Sleep is characterized by jerking movements of the legs during sleep that the patient is often unaware of. These movements can disrupt sleep, resulting in shallow and insufficient sleep, and leaving the patient feeling tired and unrefreshed. Without proper diagnosis, PLMS can go unnoticed.   Bruxism is the habit of grinding or clenching teeth during sleep, often resulting in symptoms such as jaw pain, headaches, or tooth sensitivity. Bed partners may also hear grinding or gnashing sounds during the night.   Sleepwalking is a parasomnia that is commonly seen in children but may persist into adulthood. It is important to investigate the underlying cause of sleepwalking if it occurs in adults. Severe parasomnias, such as REM Sleep Behavior Disorder (RBD), where the patient acts out dreams and may cause harm to themselves or others, may be indicative of a neurodegenerative disorder such as Parkinson's disease.   3. Circadian rhythm disorder refers to a condition where the body's internal clock is disrupted, beyond just insufficient sleep and poor sleep quality. Sleeping at appropriate times can ensure efficient functioning of various organs in the body.   Symptoms of sleep disorders may include:   Insomnia Waking up feeling tired Morning headaches Lack of concentration Excessive daytime sleepiness, falling asleep in public places, during meetings, or while driving Dependence on coffee to stay awake Difficulty falling asleep or frequent nighttime awakenings   Diagnosis of sleep disorders can be done using a standard method called Polysomnography. This involves placing several biological sensors on the body to monitor various bodily functions during sleep, such as brain waves, eye movements, muscle activity, breathing, heart rate, sleep position, and video recording. Trained specialists observe the sleep study to detect any abnormalities and provide appropriate treatment.   10 Ways to Improve Sleep Hygiene   Go to bed and wake up at the same time every day, whether it's a workday or a day off. Make sure your bedroom is quiet, comfortable, and at a suitable temperature with no disturbing sounds or lights while you sleep. Use your bed solely for sleeping and avoid doing other activities such as using your phone, eating, or reading on it. This helps train your body to associate the bed with sleep, enabling you to fall asleep more quickly. Avoid napping during the day. If you cannot avoid it, limit your nap to no more than 30 minutes and do not nap after 3 pm. Avoid beverages containing caffeine (such as tea, coffee, soda), alcohol, smoking, and heavy meals at least four hours before bedtime. Exercise regularly, but avoid exercising within two hours before bedtime. Avoid exposure to bright light, especially blue light from devices such as smartphones and tablets before bed as it triggers the release of the hormone melatonin, making it harder to fall asleep. Avoid negative emotions such as anger, excitement, and fear, such as having arguments or watching exciting horror movies before bedtime. If you do not fall asleep within 20 minutes, do not worry or watch the clock. Instead, get up and engage in other activities such as reading, listening to music, or praying, and return to bed only when you feel sleepy. Get enough sunlight in the morning for at least 30 minutes each day as it plays a crucial role in regulating the body's internal clock. By following these ten tips, you can significantly improve your sleep hygiene and enjoy better quality sleep.

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Gastritis: get treatment and relief

Gastritis: get treatment and relief   Persistent stomach ulcers could be caused by stress or certain pain relievers. The stomach and small intestine are organs that release strong digestive enzymes and acids, which are used to digest food. Therefore, the walls of the stomach and small intestine have mechanisms protect and tolerate the acidity and digestive enzymes. This prevents the formation of ulcers under normal conditions.   The cause of gastritis and peptic ulcers is often due to a bacterial infection called H. pylori, which can cause chronic gastritis and/or peptic ulcers.   Certain pain relievers or NSAIDs can also cause stomach ulcers or sores as they destroy the lining of the stomach. Drinking alcohol, smoking, and consuming spicy foods regularly can also lead to erosion and damage of the stomach or small intestine lining, as they increase the acidity level in the stomach.   Stress is also a contributing factor as it triggers the secretion of stomach acid.     Symptoms of stomach ulcers include: Stomach pain and discomfort around the esophagus or chest area Bloating Frequent belching Nausea and vomiting Other symptoms may include black stool, vomiting blood, perforation of the stomach or small intestine, loss of appetite, and weight loss.     Treatment:   Antacids have been used for a long time as the first-line medication to alleviate symptoms and prevent acid reflux by reducing the acidity in the stomach. They can be taken at any time and provide short-term relief.   Histamine receptor antagonists can help to suppress acid secretion and are effective when taken for approximately one month.   Proton pump inhibitors are popularly used nowadays, but they are relatively expensive. They inhibit acid production and help ulcers in the stomach and duodenum heal more quickly.   Mucosal protective agents coat the ulcer and promote faster healing, preventing irritation of the gastrointestinal lining.   In cases where H. pylori is detected, treatment will be prescribed according to the doctor's treatment plan.     Lifestyle modifications:   Eating small, frequent meals of soft, well-chewed food is recommended. Chewing food slowly and thoroughly is also advised.   Eating between meals is fine, but going to bed immediately after eating should be avoided as it increases acid reflux at night.   Avoiding milk is recommended, as it may cause bloating or increased gas in the stomach.   Smoking and alcohol consumption should be limited or avoided to reduce stress.

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Diagnosing muscular and nerve conditions

Diagnosing muscular and nerve conditions   The Electrodiagnosis (EDX) method, which involves Electromyography (EMG) and Nerve Conduction Studies (NCS), is utilized to diagnose muscular and nerve conditions.   EMG is a tool utilized in electrodiagnosis to assist in the diagnosis of muscular and nerve conditions and to detect abnormalities in nerve conduction. It aids in the accurate and precise treatment of conditions such as numbness in hands and feet, muscle weakness, and soft muscle tone.   So, what exactly is an EMG machine, and what are its principles and methods of operation? In general, the Electrodiagnosis method, which involves the utilization of electrical knowledge, is used to diagnose illnesses, and typically has three distinct examination techniques.   The Nerve Conduction Study is a diagnostic test that safely stimulates the nerves throughout different parts of the body using a controlled electrical current. Its purpose is to detect any abnormalities in the nerves, such as when they are functioning improperly due to conditions like diabetes or compression at the wrist or elbow.   The Needle Electromyographic Study is a diagnostic test that uses small needles to examine the muscles and nerves for any abnormalities. It is used to detect conditions such as nerve compression in the neck or back, nerve injuries, or muscle abnormalities.   The Evoked Potential test is a diagnostic test that uses electrical, light, or sound stimulation to generate electrical signals that travel along the nerves to the brain and spinal cord. This test is used to detect abnormalities in specific areas of the brain and spinal cord.   In what way is this examination beneficial?   The aforementioned examination will assist in achieving a more accurate and precise diagnosis of the disease, as well as provide information for future treatment planning.   To what extent is this examination safe?   This examination is safe for both children and adults. Although some individuals may feel a slight electric shock or discomfort when the needle is inserted into the muscle.   As for the potential complications that may occur, they include:   Hematoma from the needle, which typically resolves within 2-3 days. In cases where muscle examination is required with a needle in the chest area, there may be a chance of pneumothorax, which can cause chest tightness and difficulty breathing. However, such complications are rare and can be treated.   If you have any of the following issues, please notify your physician before the examination:   A history of easy bleeding or taking medication that may cause bleeding (in cases where a needle is required). Having a pacemaker. Having inflamed or infected skin in the area that needs to be examined. Note: Patients taking Mestinon (a medication for Myasthenia Gravis) should refrain from taking the medication one day prior to the examination. Drinking water and eating food is not prohibited.   For further inquiries, please contact the Rehabilitation Medicine Department at Vibhavadi Hospital at 02-561-1111 ext. 1118-9.

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Muscle stretches to improve blood circulation and reduce pain

Muscle stretches to improve blood circulation and reduce pain   The benefits of stretching:   Stretching is a treatment method that helps elongate tense or shortened tissues, making muscles more relaxed and flexible. This leads to improved blood circulation, reduced waste buildup in tissues, and better muscle elasticity, reducing pain and allowing for normal movement. Stretching can be used to prepare muscles before and after exercise to prevent injury.   Principles of self-stretching:   Movement should be slow and steady. Force used to stretch should be light and gradual, held when feeling tension to avoid jerking, as this can cause muscle stiffness and injury. Each stretch should be held for 5-10 seconds. Release from the stretch should be gradual, reducing the force used.   Muscle stretching for various body parts:   1. Neck-shoulder muscles stretching:   • Neck muscles stretching: Sit on a chair and place one hand behind your head, gently press your head down towards your chest and hold the tension for 10 seconds. Then slowly raise your head up. • Shoulder muscles stretching: Sit on a chair and hold onto the armrest with one hand. Place your other hand on the side of your head and gently pull your head towards your opposite shoulder, hold the tension for 10 seconds, then repeat on the other side.   2. Arm and shoulder blade muscles stretching:   • Shoulder blade muscles stretching: Raise one arm to the opposite shoulder and use the other hand to push the elbow backwards, hold the tension for 10 seconds. • Arm muscles stretching: Raise one arm and kick the opposite shoulder with the other hand. Apply pressure on the elbow and push it towards the opposite side, hold the tension for 10 seconds.   • Arm and hand muscles stretching: • Wrist muscles stretching: Turn your arm backwards and use the other hand to pull your wrist outwards, hold the tension for 10 seconds. • Forearm muscles stretching: Clasp your hands behind your back and straighten your arms, hold the tension for 10 seconds. • Upper arm muscles stretching: Raise both arms above your head and hold the tension for 10 seconds. Then, bend and straighten your wrist to stretch the muscles, hold the tension for 10 seconds.   3. Exercises for Back and Hips Muscles:   • Lie on your back with knees bent and pull them towards your chest on both sides, holding for 10 seconds. • Lie on your back with one knee bent and foot on the ground, cross the other leg over and place your hand on the bed frame while lifting your hip off the ground, alternating sides. • Lie on your back with knees bent and arms tucked under your thighs, pulling them towards your chest and feeling the tension in your hips and back, holding for 10 seconds. • Sit and meditate with your hands on the floor and arms straight, sliding your hands forward until your head touches the floor. If you cannot sit in meditation, sit with your legs straight. • Raise one arm over your head and tilt your torso to the side, holding for a few seconds.   4. Exercises for Leg and Foot Muscles:   • Stretch your calf and thigh muscles by lying on your back with one knee bent and a long cloth wrapped around your foot. Pull the cloth towards you to stretch your foot, feeling the tension in your calf and thigh muscles. • Stand facing a wall and take a step forward, keeping your back leg straight and foot flat on the ground, holding for a few seconds. Repeat with the other leg. • Sit with the soles of your feet touching and grab your toes with your hands, bending forward until your head touches the floor and feeling the tension in your inner thigh muscles. • Sit with one knee bent and foot flat on the ground, and lean forward until you feel the tension in your front thigh muscles, holding for a few seconds. Repeat with the other leg. Hold each stretch for 10 seconds and repeat each exercise 10-15 times.  

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Maintaining physical fitness in old age: How to exercise appropriately

Maintaining physical fitness in old age: How to exercise appropriately   To stay strong and healthy in old age, exercise is crucial. However, it's important to know how to exercise properly. The general principles to follow are:   Exercise slowly and take breaks between sessions. Avoid excessive weight lifting. Rest when feeling tired; those who are not very fit can reduce their speed or take a break and start again. Exercise regularly. Maintain a consistent pace. If exercising with a group, make sure to exercise with peers of the same age.   Precautions for elderly people during exercise:   Elderly people should stop exercising if they experience:   Dizziness, blurred vision, or ringing in the ears. Difficulty breathing or shortness of breath. Loss of balance. A rapid heartbeat, i.e., around 120-130 beats per minute.   Prohibited activities for elderly people during exercise:   Exercising while feeling unwell. Exercising after a recent fever. Exercising in extremely hot environments. Exercising immediately after eating a meal.   Exercises for the elderly while lying down:   Lie on your back with your arms raised and extended above your head. Lie on your stomach with your arms bent, touching your shoulders, and then straighten them out. Lift your right hand and touch your left shoulder, then straighten your elbow and lower it. Alternate sides and repeat. Flick your wrist up and down, then make a full fist and release. Lie on your stomach with your knees bent and your arms resting at your sides. Take a deep breath and expand your abdomen, then exhale slowly and contract your abdomen. This is a lung exercise. Lie on your side with both knees bent. Straighten your left knee and then bend it back to its original position. Straighten your right knee and then bend it back to its original position. Repeat on the opposite side. Lie on your side with both knees bent. Straighten your right knee and lift your leg straight up, then return to the starting position. Alternate with your left leg straightening and lifting. Lie on your back with your legs spread apart and alternate between left and right. Point and flex your feet up and down. Rotate your feet inward and outward.     Sitting Postures:   Sit with your head down and chin tucked, then slowly raise your face up. Tilt your head to the left and right, and rotate it to the left and right without bending your neck. Sit upright, place your hands on your waist and lean slowly to the left until fully stretched, then switch to the right. Sit upright, twist your waist to the left and switch to the right. Sit upright, straighten your left knee, and flex your foot for 5 seconds before lowering it, then switch and straighten your right knee.   Standing Postures:   Stand close to the table or chair with knees apart, lean forward and stand up straight. Stand close to the table or chair, take a step forward with your left foot, bend your left knee, keep your right leg straight, and hold for 1-3 seconds, then switch. Each posture should be done 15-20 times per day. If you don't feel tired, gradually increase the exercise each day. It is recommended to do the exercise in the morning after waking up as the body is fully rested and the air is fresh and clear.

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The dangers of PM2.5

The dangers of PM2.5   Airborne particulate matter, specifically PM2.5, poses a health risk that should be avoided by susceptible groups. PM2.5 refers to tiny particles with an average diameter less than 2.5 micrometers that float in the air alongside water vapor, smoke, gases, and other pollutants, notably sulfates, nitrates, and polycyclic aromatic hydrocarbons (PAHs). The World Health Organization (WHO) classifies PM2.5 as a Group 1 carcinogenic substance since it is a hazardous dust regardless of its chemical composition, including praseodymium, cadmium, arsenic, and polycyclic aromatic hydrocarbons (PAHs). Due to its small size, PM2.5 can accumulate into larger masses, enabling it to transport various substances in the air around us, forming haze and smog.   PM2.5 and its associated pollutants are toxic to human health and are a significant public health concern, according to the WHO.   How does the problem of PM2.5 dust particles affect human health?   Due to the small size of PM2.5 particles, when humans inhale them, they can penetrate deep into the alveoli, the tiny air sacs at the end of our lungs, and react with the bronchial tubes and alveoli in our lungs. Some particles escape the walls of the alveoli and seep into the bloodstream, spreading throughout our bodies. The harmful effects of PM2.5 on our lungs result from triggering the production of free radicals, reducing our antioxidant system, disrupting calcium balance, causing inflammation, and triggering genes associated with inflammation that are dangerous to our own tissue. The major consequences of this problem are as follows:   In the short term, sudden symptoms occur, leading to respiratory irritation, inflammation, and increased susceptibility to infections. Diseases include chronic respiratory diseases such as sinusitis, allergies, asthma, emphysema, coughing, wheezing, and skin and eye irritation.   PM2.5 can cause acute exacerbation in people with chronic heart and vascular diseases, especially myocardial ischemia.   Long-term exposure to small-sized dust particles can lead to their entry not only into the lungs but also into small blood vessels, causing inflammation and chronic diseases such as chronic obstructive pulmonary disease (COPD). This can also increase the risk of developing pulmonary fibrosis, a condition where lung tissue becomes damaged and scarred, leading to difficulty breathing even without smoking. Additionally, it may contribute to an increased risk of developing lung cancer and a higher rate of hospitalization and mortality.   Which groups are at risk for particulate matter pollution from dust?   Small children because their lungs are still developing and their bodies are not fully grown. Elderly people who may have undiagnosed lung or heart disease. Pregnant women. Patients with respiratory diseases, allergies, asthma, chronic obstructive pulmonary disease (COPD), and heart disease because dust particles may exacerbate these conditions. People who exercise or work outdoors such as street vendors and motorcycle drivers because they breathe faster and deeper.   Recently, many provinces in Thailand have experienced high levels of particulate matter pollution in the air. How can we take care of ourselves in this situation?   Avoid outdoor activities in areas with smog and dust. Avoid exercising outdoors. If it's unavoidable to be outdoors, wear a mask or N-95 respirator to cover your nose and mouth.   How can we reduce the amount of PM2.5 particulate matter in the air?   We can work together to control the sources of pollution by:   Reducing the use of personal vehicles and promoting the use of public transportation. Using engines that burn fuel completely and have particle-trapping devices. Controlling construction processes to minimize dust. Properly demolishing and removing unused buildings. Avoiding forest burning and land clearing for agriculture.  

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12 Amazing Benefits of ‘oranges’

12 Amazing Benefits of ‘oranges’   Oranges are a type of fruit with high Vitamin C content, and has numerous benefits that help to significantly reduce the risk of various health issues. Oranges have a sweet and sour taste and can be used to make refreshing drinks that are beneficial to the body. In addition, oranges have several nutritional benefits and advantages that make them a highly beneficial fruit. Let us explore the 12 benefits of oranges in more detail:   Relieves constipation:   Oranges are one of the fruits that help relieve constipation, as they are high in fiber, which aids in digestion and bowel movements. Eating one large orange provides approximately 2.0 grams of dietary fiber.   Boosts immune system:   Oranges are rich in Vitamin C, which makes them a fruit that boosts the immune system and helps to prevent sickness, including serious illnesses. A strong immune system helps the body to resist bacteria, viruses and other pathogens, thereby reducing the risk of infection.   Regulates blood sugar levels:   The fructose in orange flesh helps to regulate blood sugar levels and prevent spikes after consumption. Additionally, the fiber in oranges also helps the body to control blood sugar levels. Thus, oranges are considered as one of the fruits that help to control blood sugar levels.   Lowers blood pressure:   Oranges are rich in potassium and low in sodium, which aids in blood circulation and helps the body to regulate blood pressure. This fruit also helps to reduce blood pressure in people with high blood pressure.   Lowering Cholesterol in the Bloodstream:   Oranges themselves do not contain cholesterol, while vitamin C and antioxidants present in oranges can also help reduce cholesterol levels in the blood. Antioxidants prevent free radicals from sticking to blood vessels and causing a build-up of fatty deposits over time, which can lead to chronic diseases such as coronary artery disease and heart disease.   Nourishing the Heart:   Potassium in oranges is a vital component that helps the heart function more efficiently. Additionally, oranges contain various vitamins and minerals that are beneficial to heart health. They help regulate the heartbeat and improve blood circulation, making it more efficient.   Reducing the Risk of Kidney Stones:   Studies have shown that orange juice has components that help reduce the occurrence of kidney stones. Potassium in oranges helps inhibit the formation of various types of kidney stones and facilitates their elimination from the body, reducing the risk of kidney stones and stones in other organs.   Wound healing:   In a study published in the American College of Nutrition journal, it was found that individuals with higher levels of vitamin C in their bodies are less likely to develop wounds and sores compared to those who do not receive enough vitamin C to meet their needs. Oranges are a fruit that is rich in vitamin C, containing up to 89% of the daily recommended amount that the body needs.   Stroke prevention:   Strokes occur due to blood vessels becoming constricted, bursting, or rupturing. A study conducted by the American Heart Association found that consuming citrus fruits like oranges and grapefruits can help reduce the risk of stroke in women by up to 19% when compared to volunteers who consumed less citrus fruits.   Cancer prevention:   Oranges contain high levels of a type of antioxidant called flavonoids, which help protect against colorectal cancer. Additionally, the fiber in oranges helps to eliminate waste materials from the colon, further reducing the risk of developing colorectal cancer. Studies have also shown that the compounds found in oranges can help prevent oral, skin, lung, breast, and stomach cancers.   Protection from macular degeneration:   Consuming oranges can help reduce the risk of developing age-related macular degeneration, a disease that affects the central portion of the retina and can cause vision loss   Benefits for the skin:   Oranges are beneficial for skin nourishment. The antioxidants in oranges, combined with the power of vitamin C, help protect skin cells from damage caused by sunlight and toxins, reduce the appearance of wrinkles, and promote stronger skin cells. This results in a firmer and tighter-looking skin, as vitamin C is a key component in collagen production.   Furthermore, it's not just the flesh and juice of oranges that are beneficial to our health. As mentioned earlier, even the peel of oranges has its own set of benefits.

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The effects of high blood cholesterol level

The effects of high blood cholesterol level   If the blood cholesterol level is higher than 240 mg/dL along with individual risk factors, it may lead to various diseases such as heart disease.   Cholesterol is a crucial component of the body, present in the cell walls of all types of cells, including brain cells. It is a reserve energy source stored in the form of fat cells. Abnormal high levels of cholesterol are strongly associated with the development of heart disease.   There are two ways that the body obtains fat: fat produced by the body and fat obtained from food.   Fat obtained from food can be divided into two types: plant-based fat and animal-based fat.   Animal-based fat includes fat derived from animal food sources such as meat, animal fat, animal skin (duck skin, chicken skin), animal fat (pork fat, beef fat), egg yolk, animal organs, which contain an essential component called "cholesterol."   Plant-based fat mainly consists of "triglycerides" and is found in food such as coconut milk, flour, and sweet foods with high sugar content. This group of fats is believed to contribute to the development of heart disease, but its importance is less than that of cholesterol.   When fat-containing foods of any form are ingested, they are broken down in the small intestine with the help of bile and digestive enzymes secreted from the pancreas. The resulting small fatty acids and lipid compounds are then absorbed into the body through the small intestine, enter the bloodstream, and are transported to the liver where they are metabolized and re-formed.   These fats remain in the body as various compounds such as cholesterol, triglycerides, and lipoproteins. High levels of these compounds, particularly cholesterol and triglycerides, are associated with an increased risk of heart disease, especially when combined with other risk factors.   HDL, IDL, and LDL are the different types of lipoproteins, which are complex particles that transport cholesterol and other fats in the blood.   HDL stands for high-density lipoprotein, which is often referred to as the "good cholesterol." This lipoprotein helps to remove excess cholesterol from the bloodstream and transport it to the liver for disposal. High levels of HDL are associated with a lower risk of heart disease.   LDL stands for low-density lipoprotein, which is often referred to as the "bad cholesterol." This lipoprotein carries cholesterol from the liver to the rest of the body, but when there is too much LDL in the blood, it can accumulate in the walls of arteries and contribute to the formation of plaques, which can lead to heart disease.   IDL stands for intermediate-density lipoprotein, which is a type of lipoprotein that is intermediate in density between LDL and HDL. IDL particles are formed from the breakdown of VLDL (very-low-density lipoprotein) particles, which transport triglycerides (another type of fat) in the blood. IDL particles can be further metabolized to LDL or taken up by the liver.   About 2/3 or 60-70% of the cholesterol level detectable via blood tests are made by the body.   When should you seek treatment?   If your cholesterol level is high, such as more than 240 mg% or the total cholesterol in low-density lipoprotein is higher than normal, the doctor will check if there are risk factors for developing coronary artery disease. If you have risk factors such as having cardiovascular disease elsewhere, smoking, diabetes, high blood pressure, a family history of heart disease, postmenopausal women, or advanced age, you are considered to be at high risk and should receive full treatment.   Triglycerides are less associated with coronary artery disease than cholesterol, but if they are very high, they must be treated.   If you already have coronary artery disease, you must treat both high cholesterol and high triglycerides.   Treatment Guidelines:   For individuals with high blood lipids such as total cholesterol levels greater than 240 mg/dL and LDL cholesterol levels greater than 160-180 mg/dL, along with other risk factors for heart disease, the following steps should be taken:   Patients should control their diet for approximately 1-3 months.   After 1-3 months, if blood lipids remain high, medication to reduce blood lipids may be necessary. Currently, there are four groups of lipid-lowering drugs available on the market: fibrates, statins, resins, and ezetimibe. Statin drugs have been shown to effectively reduce the risk of heart disease in clinical trials. However, each group of lipid-lowering drugs has its own advantages and disadvantages, and a physician should be consulted before making a decision.   Efforts should be made to ensure that total cholesterol levels are below 160 mg/dL and LDL cholesterol levels are below 130 mg/dL, or reduced by 30-50% from their initial levels.   Dietary control and medication should be combined in a long-term treatment plan.     The Principles of Dietary Control:   Foods should contain less than 30% fat and cholesterol levels should be between 200-300 mg per %.   If cholesterol levels are high:   Avoid foods such as egg yolks, animal fats (pork, beef), animal organs (liver, kidneys, heart, lungs, intestines, and brain), animal oils, red meats (beef, pork), duck and chicken skin, egg yolks, large squid, and scallops. Avoid fried foods and choose to grill, bake, boil, or steam instead. Use oils that are low in saturated fat, such as soybean oil, corn oil. Unlimited intake of green vegetables. Lose weight.   If triglyceride levels are high:   Avoid foods such as coconut milk and sweet desserts that contain sugar. Exercise, which can reduce triglyceride levels. Reduce alcohol consumption, including beer. Lose weight.     Other things you should know:   To check your overall cholesterol levels, including triglycerides, it is recommended that you fast for at least 10-12 hours (not 6 hours). However, you can still drink water during the fasting period. If you only need to check your "bad" cholesterol (LDL), you do not need to fast.   Medications to lower blood cholesterol do not help reduce belly fat or weight because belly fat is a type of fat cell that accumulates in the body, which is different from the fat in the blood.   If you do not have any risk factors for heart disease, acceptable cholesterol levels are total cholesterol levels below 240 mg/dL and "bad" cholesterol (LDL) levels below 130 mg/dL.   Fish oil has the ability to reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol, but does not reduce low-density lipoprotein (LDL) cholesterol.

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Vitamin D and its benefits

Vitamin D and its benefits   Vitamin D is essential and should not be neglected if you want to avoid certain diseases. Did you know that research studies have found that one in three Thai workers, or approximately 36.51%, are deficient in vitamin D? This is surprising, considering that Thailand is a country that only experiences two seasons - hot and hotter.   So, where do we get our vitamin D from? Our bodies can obtain vitamin D from two sources:   1. Food There are certain foods that are rich in vitamin D, such as cooked salmon, canned tuna, and fortified foods like milk, orange juice, yogurt, and even breakfast cereals in other countries.   2. Sunlight To get vitamin D from sunlight, we need to expose our skin to the sun for at least 15 minutes every day. This can be done by wearing short-sleeved shirts and shorts.   Vitamin D3 is synthesized in our skin from UVB radiation, which has a short wavelength and is absorbed by the outermost layer of skin, the epidermis, or the dermis, which is the skin area where vitamin D is synthesized.   However, due to our working lifestyles, such as working in buildings or offices, wearing long-sleeved shirts, applying sunscreen, avoiding the sun for fear of skin darkening, driving with tinted windows to block sunlight, and exercising indoors in gyms, some of us are not getting enough vitamin D from sunlight. This is compounded by age-related decreases in vitamin D absorption from food. When these factors are combined, our bodies can become deficient in vitamin D.   The main function of vitamin D is to aid in the absorption of calcium and phosphorus, which are necessary for growth and the development of strong bones and teeth.   However, we now know that vitamin D has a structure similar to steroid hormones, making it a hormone-like substance. It is found in various organs throughout the body, including brain cells and beta cells in the liver, which are composed of VDR (Vitamin D Receptor), which affects the functioning of various cells throughout the body.   When we lack Vitamin D, it can have various impacts on our body if we have low levels or a deficiency for an extended period. It can cause Osteomalacia, a softening of bones in adults, and Rickets, a softening of bones in children.   Vitamin D deficiency is also associated with an increased risk of Osteoporosis, falls, and fractures.   Furthermore, a lack of Vitamin D can affect our overall health beyond just our bones, such as muscle weakness, and increased risk of various cancers, including colon, breast, and prostate cancer. It also stimulates our immune system and can help prevent diseases such as type 1 diabetes, MS (Multiple Sclerosis), IBD (Inflammatory Bowel Disease), infections, and insulin resistance.   To prevent Vitamin D deficiency, we should consume foods that are rich in Vitamin D and adopt healthy lifestyle habits, such as getting sunlight exposure in the morning. Additionally, taking Vitamin D supplements is another option, with the Recommended Dietary Allowance (RDA) being 600 international units (IU) per day. However, it's important to have your Vitamin D levels checked before starting any treatment.   Treatment:   To properly approach treatment, it is advisable to consult with a physician first to assess vitamin D levels in the blood before taking vitamin supplements. This is because if we take an excessive amount of vitamin D for a prolonged period, such as more than 20,000 IU per day, it may become toxic and harmful to our health rather than beneficial.   Best wishes from the Department of Anti-Aging Medicine, Vibhavadi Hospital.

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Dealing with hormones in old age

Dealing with hormones in old age   As one enters old age, the most noticeable issue is the various changes in physical health, especially the changes in hormones that are commonly referred to as "menopause" for women and "andropause" for men who are 45 years of age and older. Hormones, such as sex hormones and estrogen, gradually decrease and affect both the physical and mental changes in the body, which varies from person to person depending on their physical condition.   When the level of sex hormones decreases, generally one experiences symptoms such as fatigue, insomnia, loss of appetite, body aches, hot flashes, sweating, and shaking, as well as mental and cognitive changes, such as memory loss, short attention span, anxiety, and irritability. There are also sexual problems that may occur due to decreased hormones.   Using hormone replacement therapy depends on how much one's daily life is affected by these symptoms. Emotional fluctuations, easy stress, insomnia, or hot flashes are symptoms that can affect one's quality of life. It is not solely dependent on the decrease of hormones, but also other factors such as stress from family and work, as well as one's original mental state. Therefore, if the symptoms are not severe, hormone replacement therapy may not be necessary and should be consulted with a doctor first for safety purposes.   Hormone supplements in food:   We can enhance our hormones through natural food sources that contain components similar to hormones, such as phytoestrogen. Examples include:   Flavonoids, found in beta-carotene group, help eliminate toxins in the brain and increase oxygen supply to the brain. These can be found in colorful fruits and vegetables such as carrots, pumpkins, cantaloupes, tomatoes, cucumbers, oranges, and leafy greens such as spinach, kale, and broccoli.   Vitamin B promotes blood circulation, hormone function, and muscle strength. Vitamin B6 is abundant in wheat germ, bananas, chicken, fish, and cauliflower, while Vitamin B12 can be found in liver, beef, pork, white fish, eggs, and dairy products.   Vitamin C helps blood circulation by increasing the flexibility and dilation of blood vessels, and strengthens the immune system. This can be found in all kinds of fresh fruits and vegetables.   Vitamin E helps fight free radicals, strengthens heart and muscle tissue, and creates hormones. It also strengthens the body's immune system and can be found in nuts, seeds, and vegetable oils.   Calcium helps to strengthen bones and muscles and is involved in the nervous system's functioning related to sexual activity and emotional response. It can be found in milk, dairy products, soybeans, and green leafy vegetables such as kale and spinach.   Chromium deficiency can reduce sexual desire and can be found in apples, grapes, berries, green leafy vegetables, mushrooms, and beans.   Zinc plays a crucial role in male hormone production and the functioning of the testes. It can be found in oysters, crab meat, pumpkin seeds, onions, and red eggs.   Vitamins and minerals are all beneficial for the body, but it is important to consume them in appropriate amounts that suit your body's needs. Moreover, do not be swayed by advertisements promoting medication or herbal remedies, as they may have adverse effects on the body. It is crucial to care for the elderly, and if you have any doubts, it is always best to consult a doctor.     With best wishes from the Department of Anti-Aging Medicine, Vibhavadi Hospital.

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