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3 Medicines That Could Save Your Life Following a Nuclear Blast

As the Russian-Ukraine war escalates, with no end in sight, the threat of nuclear war is ever present. At different times both sides have brought up the possibility of a “limited nuclear war.

We have never been so close to nuclear war- even during the cold war we weren’t this close.

The number of nuclear warheads in use is staggering. It is estimated that there are 12,705 nuclear warheads worldwide. These warheads are spread out between only 9 countries- U.S., Russia, France, China, the UK, Pakistan, India, Israel, and North Korea, Hopefully, cooler heads will prevail, and we will soon see a de escalation of tensions.

Preventing exposure-be prepared

Unfortunately, if a nuclear war is fought in Ukraine the radioactive fallout will travel through wind currents and eventually reach the United States. Some of the radioactivity will have dissipated, but a lot wont.

It is always better to prevent exposure to radioactive materials and fallout than to have to deal with the health effects of radiation exposure.  In previous posts I outlined precautions and preparation tips to help you mitigate and decrease your exposure to radioactive fallout.

In this post, we will discuss three of the more common medicines available in the event of a nuclear blast. Whether the drug is over the counter or prescription, it is highly advised to only take as directed by health officials and in the proper amount. Even OTC meds have serious side effects if not taken as directed.

The three we will discuss are: Potassium iodide, Prussian Blue and EDTA.

Potassium iodide (KI)

(Over the counter, however, seek care provider guidance on how and when to take)

The thyroid gland cannot tell the difference between stable and radioactive iodine.  KI acts to block radioactive iodine from being taken into the thyroid gland, it can help protect this gland from injury. Ingesting iodide tablets (KI) flood the thyroid gland and can protect the thyroid gland from absorbing the radioactive iodine from a nuclear incident.

It is also important to know what KI cannot do. KI cannot protect parts of the body other than the thyroid from radioactive iodine. KI cannot protect the body from any radioactive elements other than iodine. If radioactive iodine is not present, then taking KI is not protective.

How to take potassium iodide

Only take potassium iodide if state or local health authorities suggest you do so. During an emergency, health officials will send out an announcement. Your health department will then tell you when it’s OK to take potassium iodide. They’ll also tell you when you can stop the medication.

Excerpt from FDA recommendations:

How much potassium iodide (KI) should I take?

The FDA has approved two different forms of KI—tablets and liquid—that people can take by mouth after a nuclear radiation emergency. Tablets come in two strengths, 130 milligram (mg) and 65 mg. The tablets are scored so they may be cut into smaller pieces for lower doses. Each milliliter (mL) of the oral liquid solution contains 65 mg of KI.  According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

  • Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
  • Women who are breastfeeding should take the adult dose of 130 mg.
  • Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution).
  • Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non­nursing infants and children.
  • Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non­nursing newborn infants.
  • NOTE: Newborn infants should only be given potassium iodide under the direction of a healthcare provider. Their underdeveloped thyroid is at risk for developing low thyroid. Thyroid function tests are indicated after iodide has been administered and the radioactive event has passed.

Medical conditions in which taking potassium iodide may be harmful:

Taking KI may be harmful for some people because of the high levels of iodine in this medicine.

You should not take KI if:

  • you know you are allergic to iodine (If you are unsure about this, consult your doctor.
  • A Seafood or shellfish allergy does not necessarily mean that you are allergic to iodine.
  • Certain skin disorders (such as dermatitis herpetiformis or urticaria vasculitis).
  • People with thyroid disease (for example, multinodular goiter, Graves’ disease, or autoimmune thyroiditis)

Food and Drug interactions

There are no known food or drug interactions when taking potassium iodide

Side Effects of potassium iodide

When taken as directed KI has few side effects.

Some of the more common side effects are:

  • Skin rashes
  • Inflammation of the salivary glands
  • GI upset

Prussian Blue (COMMON BRAND NAME(S): Radiogardase

(By prescription only)

Note- Do NOT ingest Prussian blue pigment sold commercially, this practice is dangerous and potentially harmful.

Prussian blue is a pill that may be used in a radiation emergency to help remove radioactive cesium and thallium from the body. Prussian blue traps radioactive cesium and thallium in the intestines and keeps them from being reabsorbed by the body. Prussian blue decreases the half-life of cesium by 33% and from 3.8 to 2.2 days for thallium, The rate of cesium and thallium elimination is proportional to the dose and duration of Prussian blue.

Prussian blue comes in capsule form, and can be taken with or without food, however it is advised to take with food to stimulate secretion of cesium or thallium.

Treatment should be initiated as soon as possible after contamination is suspected. Even when delayed, treatment is effective and should not be withheld.

Dosage:

For oral dosage form (capsules):

For cesium poisoning:

  • Adults and teenagers—3 grams (6 capsules) three times a day.
  • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
  • Children younger than 2 years of age—Use and dose must be determined by your doctor.

For thallium poisoning:

  • Adults and teenagers—3 grams (6 capsules) three times a day.
  • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
  • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Notify your care provider before taking if:

  • You are pregnant or nursing.
  • Have any allergic reactions to Prussian blue coloring in foods or medications.
  • Arrhythmia (heart rhythm problem) or
  • Electrolyte imbalance—Use with caution. May make these conditions worse.
  • Blockage of the intestines or constipation
  • Stomach or bowel problems—May increase risk for constipation.
  • Liver disease—May not work properly in patients with this condition

Treatment may last 30 days or longer.

Food and Drug interactions

There are no known food interactions.

The absorption of many drugs decreases when Prussian blue is added. Some of these are:

Side effects that you should report to your doctor or health care professional as soon as possible:

  • Skin rash, itching or hives, swelling of the face, lips, or tongue
  • Fast, irregular heartbeat
  • Muscle pain or weakness, cramps

Mild side effects:

  • blue colored stools
  • constipation
  • upset stomach

EDTA

A prescription medicine, given by injection into the vein (intravenously) or into the muscle (intramuscularly) when used to treat radiation and lead poisoning. It is also found in pill form.

In addition to treating poisonings by radioactive materials such as plutonium, thorium, uranium, and strontium, EDTA is used to treat lead poisoning and brain damage caused by lead poisoning.

EDTA has many other uses, from treating calcium deposits in the eye (eyedrops) to high calcium levels in the blood (hypercalcemia) and treating heart rhythm problems.

Drug and food interactions

Allergy to EDTA has been reported, however no interactions with food

Drugs: There are 21 known drug interactions with EDTA

Side effects

  • EDTA is safe when used as a prescription medicine, as eye drops, and in small amounts as a preservative in foods.
  • EDTA can cause abdominal cramps, nausea, vomiting, diarrhea, headache, low blood pressure, skin problems, and fever.
  • It is UNSAFE to use more than 3 grams of EDTA per day, or to take it longer than 5 to 7 days. Too much can cause kidney damage, dangerously low calcium levels, and death.

Special Precautions and Warnings(From RX List website):

  • Pregnancy and breast-feeding: EDTA seems to be safe when used in food amounts. The safety of larger amounts is unknown.
  • Asthma: Nebulizer solutions containing disodium EDTA as a preservative can cause the breathing tubes to narrow in some people with asthma. The size of the dose determines the amount of the narrowing.
  • Heart rhythm problems: EDTA might make heart rhythm problems worse.
  • Diabetes: EDTA might interfere with blood sugar control because it can interact with insulin.
  • Low calcium levels in the blood (hypocalcemia): EDTA can decrease serum calcium levels, making hypocalcemia worse.
  • Low potassium (hypokalemia): EDTA can bind with potassium and increase the amount of potassium that is flushed out in the urine. This might cause potassium levels to drop too low, especially in people who have low levels to begin with. If you have this problem, don’t use EDTA.
  • Low magnesium levels in the blood (hypomagnesemia): EDTA can bind with magnesium and increase the amount of magnesium that is flushed out in the urine. This might cause magnesium levels to drop too low, especially in people who have low levels to begin with. If you have this problem, don’t use EDTA.
  • Liver problems and hepatitis: EDTA might make liver disease worse. Avoid using EDTA if you have a liver condition.
  • Kidney problems: EDTA can harm the kidney and might make kidney disease worse. EDTA doses should be reduced in patients with kidney disease. Avoid using EDTA if you have severe kidney disease or kidney failure.
  • Seizures (epilepsy): There is some concern that EDTA might increase the risk of seizure in people with epilepsy or in people who tend to have seizures. EDTA can cause severe decreases in blood levels of calcium, and this can cause a seizure.

 

- Brooke Lounsbury, RN

Medical Content Writer

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Pediatric Pain: Remedies and Treatments

Safe Remedies and Treatments to Help Manage Your Child’s Pain

Studies have shown that 40% of adolescents and children complain of pain that occurs at least once a week. Chronic pain also affects 15% to 20% of children. When your child’s pain is left untreated, it can cause them to be more sensitive to pain as they age.

Below are safe remedies and treatments to help manage your child’s pain:

Nonprescription (Over-the-Counter) Pain Medicine

Medicine such as ibuprofen (Motrin or Advil) treats pain and fever. Since ibuprofen is also an anti-inflammatory medicine, it’s a good option when managing pain in injuries with swelling.

Ibuprofen is available in liquid form for children. Other variations include tablets and chewable tablets. When you give such medication to your child for pain, remember these things for safety:

  • Check the expiration date.
  • Ensure that your child is not taking other medications with ibuprofen in them. Overdosing on this drug can damage the intestines or stomach, so talk to your doctor before giving your child more of this medicine.
  • Give your child a dose from the cup, syringe, and dropper that came with the product, and follow the recommended dosage.
  • Don’t give your child more than four doses of ibuprofen in 24 hours.

Suppose your child spits up a dose of ibuprofen without swallowing it. Let them calm down before giving them the same dose again.

You can also use acetaminophen (Tylenol) to manage your child’s pain. It’s a nonaspirin pain reliever that soothes common aches and discomfort. Unfortunately, this drug doesn’t help with inflammation.

Acetaminophen is a safe option for children since it doesn’t cause stomach issues, unlike other medications.

Still, it’s advisable to talk to a pediatrician before giving your child any pain medication or antibiotics.

Nonpharmacological Pain Management

This type of pain management doesn’t require medicines. Instead, it uses methods to alter thinking and focus to reduce pain. Here are some examples:

  • Relaxation: You can guide your child through relaxation exercises, such as stretching and deep breathing, to reduce pain.
  • Imagery: Use an imaginary mental image of sound, sight, smell, feeling, and taste to shift your child’s attention away from the pain. The image should be a pleasant one.

Still, it’s necessary to talk with a medical expert regarding safe treatments when managing your child’s pain.

How to Know When Your Child Is in Pain

Some pain, like a bad cut, is easier to see and understand. However, there is pain caused by things you can’t see, such as joint pains and headaches.

Many children show they’re in pain through crying. Still, there are other ways children may react. For instance, infants and toddlers may act fussy. They may not move as much and become quieter than usual.

Other common signs of pain in children include the child exhibiting the following:

  • Fever
  • Heavy sweating
  • Fast heartbeat and breathing
  • Holds a painful part of their body
  • Holds hands over ears to keep out noise
  • Talks about what hurts

You know your child. If you observe, listen closely, and consider how they usually behave, you can instantly tell when something’s wrong. Unfortunately, assessing and treating your child’s pain may be difficult if they can’t describe their feelings.

Suppose your child is old enough to talk. Ask them to point to the part of their body where it hurts. You may also help them describe their discomfort by going over the list of words that express pain, such as “aching,” “itchy,” “sore,” and “burning.”

Nonverbal pain expressions, such as frowning, gasping, and wincing, can also give you clues about your child’s discomfort.

Tips to Give Your Child Medicine When They Don’t Like It

You can’t blame your child if they refuse to take medications. They may have a bad experience with a bad-tasting antibiotic, so expect some protesting from your kid when given medicine.

Remember that young children don’t understand the urgency of taking medication. So forcing them to take medicine may only lead to choking or vomiting. It’s also important to learn effective strategies for managing your child’s health.   

Below are some helpful tips to give your child medicine when they don’t like it:

1.  Use a Straw

Drinking through a straw can distract your child as it takes the focus away from swallowing their medicine. Using a straw can also create a solid force to flush the medication down your child’s throat.

2.  Use a Plastic Medication Syringe or Dropper

Some young children become cooperative when you let them hold the syringe. If this technique works for your child, have them place the syringe in their mouth. Then all you need to do is to press down the plunger to administer the medicine.

3.  Establish a Schedule

Follow a consistent medicine schedule that fits within the different set times you’ve established for other daily routines. When your child has a fixed medicine time, taking their medication won’t surprise them.

4.  Ask Your Pharmacist to Recommend a Special Flavor of Your Child’s Medicine

Adding flavors such as strawberry, bubblegum, and banana is an inexpensive way to improve your child’s cooperation when taking their medicine, especially if they choose the flavor.

5.  Talk With Your Child About the Importance of Taking Medicine

Your child must understand why they have to take medicine and what could happen if they don’t take it. Talk about the importance of taking medicine in a way that doesn’t make your child feel like they’re letting you down.

- Stanley Clark

Guest Article

 
References
  1. How do you assess pain in children who can’t express themselves?

https://www.sciencedaily.com/releases/2018/08/180802115645.htm

2. Pain in Children: Neglected, Unaddressed and Mismanaged

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140088/

3. Managing pain in children

https://myhealth.alberta.ca/Alberta/Pages/managing-pain-in-children.aspx

4. How to Safely Give Ibuprofen

https://kidshealth.org/en/parents/ibuprofen.html

5. Over-the-counter pain relievers

https://medlineplus.gov/ency/article/002123.htm

6. Pain Management and Children

https://www.stanfordchildrens.org/en/topic/default?id=pain-management-and-children-90-P02740

7. How to know when a child is in pain

https://en.hesperian.org/hhg/Helping_Children_Live_with_HIV:How_to_know_when_a_child_is_in_pain

8. Medicine – Refusal to Take

https://www.seattlechildrens.org/conditions/a-z/medicine-refusal-to-take/

9. 6 Tips That Will Take the Strain Out of Giving Your Child Medication

https://www.chla.org/blog/health-and-safety-tips/6-tips-will-take-the-strain-out-giving-your-child-medication

10. Does Your Child Refuse to Take Medicine? Some Helpful Tips

https://www.safemedication.com/pharmacist-insights/2021/04/26/does-your-child-refuse-to-take-medicine-some-helpful-tips

11. Tips to help your child to take medicine

https://www.ouh.nhs.uk/patient-guide/leaflets/files/11990Pmedicine.pdf

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The Silent Killer (Part 3)

5 Ways to Reduce Blood Pressure Naturally

The silent killer, aka hypertension can be controlled, even prevented by making some simple lifestyle changes. Below are some of the most effective ways to increase your health while decreasing your blood pressure.  This may reduce or eliminate your need for medication, along with reducing your r

  1. Nutrition

 

There are many nutritional approaches to reduce blood pressure, probably the most famous, is the DASH diet (Dietary approaches to stop hypertension) promoted by the National Heart, Lung and Blood institute, a branch of the National Institute of health, this diet plan has a proven track record of lowering blood pressure. According to the NHLBI website:

“The DASH eating plan requires no special foods and instead provides daily and weekly nutritional goals. This plan recommends:

  • Eating vegetables, fruits, and whole grains
  • Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
  • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils
  • Limiting sugar-sweetened beverages and sweets
  • When combined with a low sodium diet, the DASH diet was even more effective at lowering blood pressure. For more information on the Dash diet, check our this website.
  • Add citrus, especially grapefruits, lemons, limes, and oranges. They also fight cancer. A recent study revealed that when grapefruit and beetroot juice are combined, they provide a synergistic effect on systolic (top number, when blood is pumped through the system) which lowered blood pressure. Beetroot juice contains nitrites, Nitrites are widely known to relax blood vessels, which lowers blood pressure. Grapefruit juice contains an ingredient that allows nitrite to be more available for the body in a complex process that inhibits reoxidation of nitrite to nitrate.

2. Lose weight, if needed

Being overweight puts you at a substantially higher risk of cardiovascular disease, and especially hypertension.

Portion size and calorie reduction are effective weight loss strategies. In addition, there are many online and in person programs that can help with your weight loss journey. Some popular ones are:

  • Noom- This is an online interactive weight loss program that deals with psychology of eating along with health food choices. It is highly rated (9.8/10)and has earned the top weight loss plan off 2023 by
  • Weight watchers has in person and online programs. This time-tested program is still effective and popular.
  • Premade delivered to your door meals. Premade delivered meals have blossomed into a very popular way to combine the convenience of healthy foods with portion control. Meal delivery services offer diet and heart healthy menus. Some of the more popular meal delivery services are Factor, Hello Fresh, and Nutri System.

3. Get a dog – or any pet

Spending time with a pet, whether is a dog, cat or any other animal can help alleviate stress (one leading cause of hypertension) and promote improved mental wellbeing.

4. Community involvement

Being part of an active community has proven health benefits, including lower blood pressure, increased heart, and emotional health.

Friends, family, neighbors, social clubs, volunteer, and religious communities can offer the connectiveness and belonging, bringing meaning to our lives. Having a strong support system- having someone to call when in need- alleviates stress, which in turn lowers blood pressure.

5. Breathe – and meditate

 One of the most underrated ways to reduce blood pressure that is free and anyone can do are breathing and meditation exercises.

  • A study done out of University of Colorado, Boulder revealed that a 5 minute, 6 days a week breathing program lowered systolic blood pressure by 9mm hg, This technique, called High-Resistance Inspiratory Muscle Strength Training (IMST) was originated in the 1980s way to help critically ill respiratory disease patients strengthen their diaphragm and other inspiratory (breathing) muscles, IMST involves inhaling vigorously through a hand-held device which provides resistance. Imagine sucking hard through a tube that sucks back. In addition to lowered blood pressure, this 30-breath technique could also improve cognitive function as well.
  • Meditate- 20 minutes once a day has also been a time honored and proven method to improve both systolic and diastolic blood pressure markers. Mindfulness based meditation , has been shown to have a temporary effect on both systolic and diastolic blood pressure.

In addition, people that practice meditation-prayer on a daily basis are less likely to need blood pressure medication.

Along with the above recommendations, getting a good night’s sleep, limiting (less than 1 drink for women, 2 drinks for men per day) alcohol and stopping smoking (known to raise blood pressure) are all natural  ways to help control blood pressure.

- Brooke Lounsbury, RN

Medical Content Writer

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Surviving a Nuclear Fallout: Vital Medications

Surviving a Nuclear Fallout: Vital Medications

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The Silent Killer (Part 2)

(Part 2)

Part 2 will discuss:

  • Physiology of blood pressure regulation,
  • Medications to help control hypertension

Blood pressure regulation is a complex process involving a series of body systems, hormones and input from the nervous system all working together to achieve and maintain homeostasis.

As this is a complex topic, we will keep our focus on systems that control blood pressure: one is the RAAS system, the other is the baroreceptor reflex. Both systems rely on input from hormones, receptors, and organs to help maintain a healthy blood pressure. In addition, nervous system responses (sympathetic, parasympathetic and/or autonomic) along with vagal nerve activity help regulate blood pressure. Our focus will be primarily on the hormones, systems and organs involved in blood pressure regulation.

RAAS, the system that controls long term blood pressure

The renin-angiotensin-aldosterone system (RAAS) is a complex multi-organ endocrine (hormone) system involved in the regulation of blood pressure. It regulates sodium and water by balancing fluid and electrolyte levels and regulates sodium and water absorption in the kidney. When this system is working properly, RAAS is activated when there is a drop in blood pressure (such as reduced blood volume). Once RAAS is activated it signals systems and hormones to increase water and electrolyte absorption in the kidney. This compensates for the drop in blood volume, which increases blood pressure.

Several organs, tissues and glands are involved in the RAAS, including:

  • Kidneys
  • Adrenal glands
  • Lungs
  • Heart
  • Blood vessels
  • Pituitary gland

Note, there are several other hormones such as thyroid and corticosteroids that play a part in blood pressure control. These hormones can indirectly play a part in blood pressure regulation.

What are the steps in renin-angiotensin-aldosterone system (RAAS)?

Five minute scholar has a simple video that briefly explains the process

  1. When blood pressure falls, kidneys release renin, an enzyme into the bloodstream
  2. Once released, renin splits a protein produced by your liver called angiotensinogen. The resulting split of this protein produces the hormone called angiotensin l. This hormone is inactive.
  3. In the lungs and kidneys, angiotensin converting enzyme (ACE) converts angiotensin l to angiotensin ll, an active hormone. This hormone causes small arteries to constrict, which in turn increases blood pressure. It also causes the pituitary gland to release antidiuretic hormone (ADH), also called vasopressin, and the adrenal glands to release aldosterone (a steroid hormone).
  4. Aldosterone and ADH work together and cause the kidneys to retain sodium. In addition, aldosterone causes kidneys to excrete potassium through urine.
  5. Water retention is the result of the increase in sodium, which in turn increases blood volume and blood pressure.

Short term blood pressure control

A short video explaining baroreflex regulation

(regulated by the nervous system and neurotransmitters)

There are baroreceptors located in the walls of blood vessels and the heart. They respond to sudden changes in blood volume-which signal the cardiovascular center of the brain to adjust the change in blood pressure. If baroreceptors detect a low blood pressure, it triggers vasoconstriction (narrowing of blood vessels) to increase the blood pressure. If high blood pressure is detected, vasodilation (widening of blood vessels) lowers the blood pressure.

In addition, there are renal baroreceptors, which are located within the kidneys. When these baroreceptors sense a sudden change in blood pressure (low blood pressure), it triggers the RAAS system to activate. The immediate response from baroreceptors results in short term blood pressure control until the RAAS system can take over.

Drug classes to control blood pressure

The following are just a few of the many medications used to control high blood pressure. Many of these drugs have other uses, from treating congestive heart failure to reducing likelihood of stroke or heart attack.

Ace inhibitors Lisinopril (Prinivil, Zestril) benazepril (Lotensin), enalapril (Vasotec) and others

ACE inhibitors prevent an enzyme in the body from producing angiotensin II which narrows blood vessels.

Calcium channel blocker – Amlodipine (Norvasc), diltiazem (Cardizem, Tiazac) and others

Calcium causes the heart and arteries to squeeze (contract) more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open.

Beta blockers (Not usually a first line drug to be used) Metoprolol (Lopressor, Toprol XL), atenolol (Tenormin) and others

Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline.

They cause the heart to beat more slowly and with less force, which in turn lowers blood pressure. They also help widen veins and arteries to improve blood flow.

Central agonist class-Clonidine (Catapres)

Central-acting agents lower heart rate and reduce blood pressure. This drug blocks signals from the brain to the nervous system that increase the heart rate and narrow blood vessels. As a result, the heart doesn’t pump as hard and blood flows more easily through the body’s veins and arteries.

Diuretics- Hydrochlorothiazide (Hydrodiuril, Microzide), furosemide (Lasix) spironolactone (Aldactone)

Diuretics work by reducing the volume in liquid in the body by releasing sodium and water. This in turn lowers blood pressure.

- Brooke Lounsbury, RN

Medical Content Writer

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Surviving a Nuclear Fallout: Vital Medications

Surviving a Nuclear Fallout: Vital Medications

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The Silent Killer

Part 1

High blood pressure (HBP) has been called the silent killer and with good reason. It is estimated that at least 20 percent of the population with high blood pressure have no symptoms.

In part 1 we will discuss:

  • Symptoms of hypertension
  • Health risks of uncontrolled hypertension
  • Stages of hypertension
  • Types of hypertension
  • How to take blood pressure at home

Part 2 will discuss:

 Physiology of blood pressure regulation, lifestyle, nutrition, and medications to help control hypertension.

Symptoms associated with hypertension:

  • Ringing in ears
  • Headache
  • Dizziness
  • Confusion
  • Visual disturbances
  • Difficulty breathing
  • Chest pain
  • irregular heartbeat
  • In severe cases blood in urine

In the US alone nearly half of adults in the United States (47%, or 116 million) have hypertension, defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80.

Health risks of uncontrolled hypertension

Uncontrolled hypertension increases your risk of kidney disease, cognitive decline, heart disease and stroke and more.

Stages of hypertension

(The top number is systolic and measures the pressure in your arteries when your heart beats

The bottom number is diastolic -when the heart muscle relaxes.) 

All blood pressure measurements over 120/80 mm Hg are considered elevated in adult population

As of 2021 AHA blood pressure guidelines:

  • Normal = less than 120 and less than 80
  • Elevated = 120-129 and less than 80
  •  Stage 1 = 130-139 or 80-89
  • Stage 2 = 140 or higher or 90 or higher
  • Hypertensive Crisis (call your care provider immediately) = Higher than 180 and/or higher than 120

Types of hypertension

Primary Hypertension

Caused by one or more of the following: poor diet, smoking hereditary alcohol, lack of exercise, obesity.

  • Blood pressure is high on three or more visits to care provider.
  • May have no symptoms, but you may experience frequent headaches, tiredness, dizziness, or nose bleeds.

Secondary Hypertension. 

Caused by a medical condition or medication.

 Examples include:

  •  Airway obstruction during sleep and sleep apnea.
  • An abnormality in the arteries supplying blood to the kidneys
  • Adrenal gland tumors
  • Thyroid disease
  • Medications that can cause HPB:
  • Pseudoephedrine, (Sudafed) 
  • NSAIDS (non-steroidal anti-inflammatory drugs 
  • Select antidepressants
  • ADHD medications
  • Birth control pills
  • Decongestants
  • Steroids and immunosuppressants

Resistant Hypertension

  • Defined as 3 or more hypertension medications prescribed and blood pressure still not controlled.
  •  20-30 percent of HBP patients have resistant hypertension. 
  • May be genetic.
  • More common in obese, older female patients. 
  • Underlying cause may be diabetes or kidney disease. 

Isolated Systolic Hypertension. 

  • Blood pressure defined as systolic over 140, diastolic is normal- below 90. 
  • Most common in people over the age of 65 and is due to the loss of elasticity in the arteries.

Malignant Hypertension. 

  • Rare, occurs in less than 1 percent of patients diagnosed with high blood pressure. 
  • More common in younger adults, especially African American men.
  • This hypertension type occurs in only about 1 percent of people with hypertension.
  •  It is more common in younger adults, African American men, and women who have pregnancy toxemia.
  • Blood pressure rises rapidly and can be a medical emergency.  
  • Symptoms include numbness in the arms and legs, blurred vision, confusion, chest pain, and headache.

White coat syndrome

  • White coat syndrome is a condition in which your blood pressure is high at your healthcare provider’s office, but you get a normal reading at home.
  • Can be an underlying risk for future health problems.
  • Left untreated, patients have a 36 percent increased risk of heart disease, 33 percent increased risk of death and 109 percent increased risk of death from heart disease.
  • Previously believed this syndrome was exclusively due to anxiety from clinic visits, however closer monitoring of blood pressures taken outside clinic setting point to unstable blood pressure readings. 

How to take blood pressure at home

Here is a short video on how to properly take blood pressure

Blood pressure should be taken at the same time in the same setting as often as your care provider recommends.

Excerpt from AHA

  • Don’t eat or drink anything 30 minutes before you take your blood pressure.
  • Empty your bladder before your reading.
  • Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
  • Put both feet flat on the ground and keep your legs uncrossed.
  • Rest your arm with the cuff on a table at chest height.
  • Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
  • Do not talk while your blood pressure is being measured.
  • Take 2 readings, at least 1-2 minutes apart
  • Log your results. Attached is a pdf supplied by the AHA to log your readings

- Brooke Lounsbury, RN

Medical Content Writer

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Hashimotos Thyroiditis Part 2

Tips to manage Hashimoto’s

  • Health risks of not treating Hashimoto’s adequately
  • Lifestyle/stress reduction tips to manage energy and emotional ups and downs
  • How to naturally increase biologically active T3
  • Diet strategies to help heal
  • Nutritional supplements that can aid in recovery and optimal health
  • How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Health risks of not treating Hashimoto’s adequately

  • May cause impaired carbohydrate metabolism leading to an increase in type 1 and type 2 diabetes- A study that examined hospitalized patients between the years of 2001 and 2010, the Endocrinology and Diabetology Department in Bydgoszcz concluded : “Conclusions: Carbohydrate metabolism disorders in the form of type 1 diabetes connected with an autoimmune process, as well as type 2 diabetes connected with the increase of the insulin resistance, occurred in average of half of the patients with Hashimoto’s thyroiditis.”
  • Cognitive decline/brain fog, inability to focus, – Hashimoto’s thyroiditis is an inflammatory disease (hence the “itis” at the ending of thyroiditis) This extends to brain tissue, where brain inflammation can cause a multitude of problems.
  • Fertility issues– An unregulated thyroid condition of any kind can lead to lack of or incomplete implantation or early miscarriage. Thyroid disorders in men can affect sperm quality and motility
  • Higher risk of heart disease and high cholesterol

A large study in Demark over a period of 7 years revealed that   individuals with mild hypothyroidism who were not treated had an 83% increased risk of developing heart problems as compared with individuals with normal thyroid function or hypothyroidism that was treated. 

High cholesterol – Low thyroid function negatively affects lipid metabolism, leading to an increase LDL, the “bad cholesterol.”

Lifestyle/stress reduction tips to manage energy and emotional ups and downs

Hashimoto’s disease can have you feeling great one day and totally exhausted the next. Even when optimally managed, excess stress, either emotional or physical can leave one feeling exhausted for days. It is important to maintain good diet, adequate exercise, avoid stress as much as possible and keep a consistent schedule.

  • Remove/reduce sugar from the diet as much as possible, replace with fiber rich fruits. Sugar can place a tremendous burden on the body, flooding cells with insulin to deal with excess glucose in the bloodstream. This can set off a cascade of reactions that challenge thyroid regulation and can affect fat cell receptors and metabolism.
  • Make time for exercise-Make sure you are getting at least 15 minutes of brisk walking in a day. However, don’t overdo any physical activity. This can cause adrenal fatigue, cortisol overload and other stressors that can create a cascading downward spiral resulting in an overload on thyroid function.
  • Plan your days, but don’t over plan. Make time in your schedule to eat a healthy diet, exercise and get good quality sleep. In addition, make relationships and community a priority. Healthy relationships help carry life’s burdens and reduce stress hormones.
  • Get adequate, good quality sleep- The body repairs, heals and detoxifies during sleep. Good quality sleep is vital for Hashimoto patients. Aim for at least 7 hours of shut eye.
  • Keep stress at a minimum. Overactive adrenals, cause by stress can lead to thyroid dysfunction, diabetes, heart disease and more. Nurture and maintain supportive relationships. Avoid news and media if it negatively affects you. Take up a hobby. Hobbies have proven to reduce stress and calm the mind.

How to naturally increase biologically active T3

T3, the biologically active thyroid form can be increased by:

  • Supplementing diet with selenium and zinc rich foods. A rich source of selenium can be found in Brazil nuts- you only need 1-2 a day, Zinc is found in shellfish, nuts, meats, legumes. If supplementing with either selenium or zinc consult your care provider. Selenium toxicity can cause kidney failure and heart attack or heart failure, zinc toxicity symptoms are nausea, dizziness, vomiting and can lead to copper deficiency and a decrease in HDL (good) cholesterol.
  • Adding healthy fats to your diet– flax, avocado, raw unsalted seeds, and nuts. These foods aid in helping cell receptors take up thyroid hormone.
  • Moderate exercise– Walking, jogging, swimming, tennis, biking, hiking in moderation helps overall thyroid function.
  • Liver detoxification– The liver is involved in the conversion of thyroid hormone and regulation. Some foods that can help detoxify the liver are onions, beetroot, apples, turmeric, leafy greens, tea and in moderation, coffee.
  • Add sea vegetables to your diet. Iodine is a key factor in thyroid function; however, iodine supplementation can be tricky. Too much or too little can negatively affect thyroid dysfunction. Sea salt and iodized salt in moderation along with adding kelp and seaweed powder to your meal can help provide iodine needed supplementation.
  • Drink plenty of good quality, fluoride free water- Filter your water, and if fluoridated use a filter that removes fluoride. Fluoride has an electrical affinity stronger than iodine and will bond to the tyrosine molecule (Thyroid hormone is comprised of tyrosine and iodine) This reduces the amount of thyroid hormone in the body.

 

Diet strategies to help heal

It is believed that impaired gastrointestinal tract (gut dysbiosis) and intestinal permeability are the main cause of Hashimotos. To learn more check out Dr Isabella Wentz book on Hashimotos Thyroiditis- the root cause. This book is a wealth of information to educate and empower anyone dealing with Hashimoto’s.

  • As stated above, avoid simple carbohydrates. Breakfast should include a quality high protein item and fruit or vegetable if desired. Some quality high protein foods are cold water fish (salmon, sardines, and tuna for example) grass fed and finished meats, eggs, and poultry.
  • Increase leafy greens and vegetables such as carrots, turnips,celery
  • Drink twice body weight in ounces of quality water.
  • Add healthy fats to your diet. Healthy fats include butter (no margarine) flax, raw, unsalted nuts and seeds, avocados, olive oil and cold-water fish such as salmon.
  • Add a digestive enzyme right before meals if you experience stomach issues.
  • Eat soy in moderation- Soy, if paired with iodine deficiency can inhibit thyroid function. Check ingredient labels on every packaged food item, including salad dressings, protein bars, ice cream etc. for added soy. Most nutritionists advise to limit soy, not cut it out completely.
  • Cruciferous vegetables- cabbage, broccoli, cauliflower, brussel sprouts etc. if eaten in excess can suppress thyroid function. These foods are packed with nutrition. Don’t cut them out completely, just don’t eat in excess.
  • Supplement with probiotics and fermented foods- Gut health-restoring the gut microbiome- is a large part of healing and managing Hashimoto’s
  • Do a trial run of going gluten free- It takes about 3 weeks for the body to adjust to a gluten free diet. Many report relief in digestive symptoms and less body aches after stopping gluten. In a select population, gluten consumption can trigger an immune reaction. This is because gluten contains a protein (gliadin) that resembles transglutaminase, an enzyme of the thyroid. In gluten sensitivity or celiac disease, the immune system mistakenly attacks the thyroid.
  • Some people react to casein which is found in cow milk, yogurt, some cheeses and supplements. Casein is very structurally similar to gluten(gliadin) and some people have a negative reaction to it, just like gluten.

Nutritional supplements that can aid in recovery and optimal health

Important-Check with your healthcare provider before taking supplements- many supplements can interact with medications you are currently taking

  • Selenium works in synergy with vitamin E to form active T3
  • Zinc- helps repair intestinal walls and stabilizes immune system.
  • Vitamin D with K2 (K2 aids calcium absorption to bones instead of going to arteries where calcium can build up, leading to heart attack and stroke.)
  • Vitamin C with bioflavonoids
  • Magnesium citrate
  • Iron in the form of ferritin- if iron deficient
  • Iodine
  • B complex (look for the methylated form of B12)
  • Probiotics
  • Betain with Pepsin- a natural gastric acid- many Hashimoto sufferers have low stomach acid
  • Digestive enzymes- hel break down fats, carbohydrates and protein. Many diagnosed with Hashimotos have problems digesting food.

 

How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Dealing with thyroid disorders can be a complicated and complex health issue. Many diseases mimic others- Some heart diseases may have undiagnosed thyroid function. This also is common with depression, anxiety, and other mental health disorders. Some medications can affect thyroid function. Diabetics have a higher incidence of thyroid disorders.

Educating yourself and seeking a health professional who understands  thyroid disorders is vital to overall wellbeing.

At the very minimum, request a TSH and free T4 lab if hypothyroid is suspected.

Keep a journal of food, activity, mood and physical symptoms that you have recorded for a week or so before your appointment. Include physical signs of hypothyroid you may be having. This will enable your care provider to provide the best care possible.  

- Brooke Lounsbury, RN

Medical Content Writer

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Everyone should be empowered to care for themselves and their loved ones during the unexpected.
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