Yearly Archives: 2015

Insulin is not bad [Show Notes]

 in Diabetes / Podcasts  tagged Diabetes / diets / fat / glucose / insulin by

An image of a hand underling the word "DIABETES" in red marker. All Type 1 diabetics and many Type 2 diabetics depend on insulin to stay alive.

The Bottom Line

Without insulin, you would die!

Some Basics

Sugar scrub = sugar + water (+/- essential oils)
– a good exfoliant to remove dead skin

Your tiniest capillaries are so small that red blood cells can barely squeeze through one at a time.  So, if the fluid around the red blood cell is full of sugar, it’s like that sugar scrub on your skin.

And that extra sugar can damage the capillaries in your eyes, finger tips, toes, and organs.

The cells in your body require glucose to do their jobs.  

Insulin

Insulin is the only key that will let the glucose in.  No key means no glucose.  No glucose means no energy.  And no energy eventually means death.

Insulin is also responsible for fat storage.

If you don’t eat the sugars, the body will use the fat stores on your body for energy.  But if you don’t consume energy sources (by being on a specific diet) AND your energy stores are depleted, your body will break down the proteins (aka muscles of your body) to make energy.  Your brain (and other organs in your body don’t want you to die).

Sugars and fats you eat gets turned into glucose.  Insulin opens the doors to allow the cells to use the glucose.  If there’s extra glucose around, insulin tells the liver to link it together to form glycogen and store it for later.  If the glycogen storage is full, insulin tells the liver to turn the glucose into triglycerides (think clogged arteries and growing fat deposits).

Free glucose is the easiest and fastest to use.  But during times that you’re not actively consuming sugars (like when you’re sleeping), your body is still working and that’s when glycogen can be used to provide glucose.

How much sugar in a day?  

It’s always different for different people.  The goal is having a level blood sugar as much of the day as possible.  The rule of complex carbs being better than simple carbs is true, because it takes your body longer to break down and use complex carbs.  While simple carbs usually dump a whole log of glucose in your blood stream at one time.  And natural sugars are better than processed sugars because processed sugars tend to be more concentrated.

Your body has an easier time utilizing nutrients and supplements that look more like itself over ones that are synthesized in lab.

Holla!

Rachel Mayo is my diabetes hero!

Find her at:

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T1D vs T2D

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Boy Buys Vaginal Cream [Show Notes]

 in Podcasts  tagged boys / fungus / girls / vaginal cream / yeast by

Basics

Yeast infection = fungal infection

Miconazole = -azole antifungal

Miconazole = Monistat

Yeast, or fungus, can affect any part of your skin.

Take Away

The medicine in the tube doesn’t care what body part you put it on, but the product manufacturer’s try to convince you that it does by changing the labeling on the package.

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Liver Lesson #6: Immunity [Show Notes]

 in Podcasts  tagged bacteria / immunity / Liver / lobule / recycle / red blood cells by

Let’s Review

Liver contributes to:

1. Digesting your food

2. Metabolizing the energy from your food

3. Storage of Vitamins

4. Detoxing waste and toxins from your blood

5. Production of factors involved in blood clotting

Lastly, your liver keeps your healthy by aiding your immune system.

This is the last time we get to see this guy! *sad*

A colored sketch of a liver lobule with labeled parts.

Sinusoids of Immunity

The last part of the lobule to be discussed is the sinusoids.  Sinuses and sinusoids describe the space between (think about the sinuses in your your face – they are actually just holes and tubes through the bones of your face and skull that allow for empty space).

Sinusoids are lined with Kupffer cells (actually pronounced “Coop-fur”; I said it wrong on the broadcast – blame it on the accent).  Kupffer cells are a part of your immune system (remember that your immune cells flow through the lymph system that parallels your blood vessels).  Some of the cells involved in your immune system are called macrophages (big eater).  When they find something that’s not supposed to be there, they gobble it up and carry it off to be disposed of or dissolve it into it’s basic parts and makes it safe.

Summary

Kupffer cells are macrophages that are stationed in the sinusoids of your lobules of your liver.

So, if you’ve had an infection and you start to get better, where do all the dead bacteria go?  They end up floating around in your blood and the Kupffer cells will gobble them up.  Kuppfer cells will do this for bacteria, fungi, and micro-parasites that they encounter.  They also gobble up dead red blood cells and get them out of circulation.  Other types of cells in your body die periodically and they, too, get gobbled up by Kupffer cells and have their parts recycled.

Dying cells and bacteria can release toxins if you had to wait on them to break down and dissolve on your own.

The liver is very efficient at all the things it does. Without your liver, processes that help your body thrive would take too long for you to reap the benefits. 

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Liver Lesson #5: Production [Show Notes]

 in Podcasts  tagged albumin / amino acids / blood / clotting / Factor X / fibrin / Liver / production by

Basics

Most of the liver’s jobs have to do with taking things away from your blood supply or taking them apart.

Your liver produces 3 important components found in your blood.  Two of them are involved in helping your blood clot.  The third is involved in keeping your blood watery.

Prothrombin

The prefix “pro-“ means “starter” or “before”.  Like “prologue” or “prodrugs”.  In medicine, it usually means that it’s the starter piece but something has to happen to it (metabolism) for it to become useable.

Not Prozac…brand names of medications are developed by highly paid branding and marketing professionals.

Prothrombin gets activated into Thrombin when your body gets hurt and sends a signal that it needs help to stop the bleeding.

Fibrinogen

The suffix “-gen” means “creating” or “starter”.  Fibrinogen gets activated into Fibrin.

So…. you get cut…. *ouch*

“I’m bleeding!”

The clotting cascade starts (way too complicated for this discussion).

When it gets to clotting factor X (ten).

CF X activates Prothrombin into Thrombin

Thrombin activates Fibrinogen into Fibrin

Fibrin – sounds like “fiber”.  Fibrin is a protein.  Some proteins are globular proteins – they are balled up in globs.  Fibrous proteins are nice and stringy like fibers.  So, Fibrin is fibrous.

Fibrin lays down a matrix over the wound and then the platelets that are floating around in your blood collect on the Fibrin and plugs the hole.

You want the blood in your body to stay liquid. You need the blood flowing out of your body to harden and stop.

Albumin (also found in the white parts of eggs).

It helps maintain the watery-ness of your blood.  They maintain the osmotic pressure of your blood (there’s a big enough difference from the inside of a cell and the outside of the cell to allow the fluid to push through the membrane without needing a portal).  If the pressure on both sides is the same, nutrients and chemicals will not transfer.

Albumin also helps the blood stay isotonic (same saltiness).  You don’t want the fluid in your blood to be more salty than the fluid in your cells because the water will flow out of the cells into the blood to try and dilute it.  But you don’t want the cells to be more salty either because the water will flow the other way and you won’t have enough liquid in your blood.

So, your liver takes the building blocks (amino acids) and puts them together to build these proteins.

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Liver Lesson #4: Detoxification [Show Notes]

 in Podcasts  tagged alcohol / detox / detoxification / drugs / enzymes / Hepatocytes / hormones / Liver by

100,000’s – get counting!

A colored sketch of a liver lobule with labeled parts.

Enzymes

The hepatocytes contains enzymes.  Enzymes are catalysts.  While a lot of processes would probably happen naturally, they would be too slow to do us any good.  Enzymes make those natural changes happen faster.

Think of an assembly line worker that does they same action over and over again on each piece being made.  That’s how enzymes work.

Things that have floated around your body and done their job (i.e. drugs, hormones), the liver brings them back in and breaks them apart into inactive parts so they can be disposed of in one of your waste systems (urine or poo).

A lot of drugs go through the liver to become active and sent out to do a job, or to be deactivated after the job is done.  You don’t want those things to stay around forever because they can become toxic.

Your liver also detoxes your body of used up hormones.  Your body produces fresh ones as you need them, so the old ones need to be gotten rid of.

The most popular job that your liver does is filtering out alcohol.  Science says an average liver can process 1 standard alcoholic drink per hour (for some people that’s longer – up to 4 hours).

Thus you have to be careful with cocktails and mixed drinks due to the different types of alcohol that get added together.  1 drink DOES NOT equal 1 glass!

Liver cleanses your blood of:

  • Drugs
  • Hormones
    • Sex hormones
    • Adrenaline
    • Cortisol
  • Alcohol

Thank your liver!!

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Liver Lesson #3: Storage [Show Notes]

 in Podcasts  tagged eating / glucose / intestines / Liver / sleeping / storage / Vitamins by

Recap

Digestion – bile breaks down fat to be absorbed by intestines

Metabolism – breaking down food into useful pieces

Your liver helps you store those energy sources until you need them – like times when you’re not eating.

Your body does lots of processes for you while you’re sleeping.

Storage

Glucose is a main source of energy for your body.

Insulin tells your cells to let glucose in the door so it can be used immediately.  It also tells the liver to put extra glucose in long chains called Glycogen to store for future use.

Another energy source is fat or fatty acids.  When the liver doesn’t have enough space for fat, it sends it to other areas of the body.

Certain vitamins (A, D, E, K) like to hang out in fat more than water, so it goes with the fat wherever it goes.

The liver stores Vitamin B12.  B12 is usually promoted for energy boosting.  A vitamin B12 deficiency can lead to a certain type of anemia (pernicious anemia). This means not enough red blood cells are being made, thus not enough oxygen is being delivered to all the parts of your body.  Therefore your body doesn’t have the resources to utilize and create energy.  End result: you feel tired.

Iron and copper are also stored by your liver until you need them.  Low iron is another culprit of anemia.

Interesting fact:  This is why liver tastes more metallic than other red meats.

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Liver Lesson #2: Metabolism [Show Notes]

 in Podcasts  tagged athletes / Cholesterol / Diabetes / fat / gallbladder / glucose / intestines / Liver / metabolism / protein / sugar by

Review

Liver – have one.

Lobule – yep!

A colored sketch of a liver lobule with labeled parts.

Liver makes bile, helps digest fat in the intestines. Gallbladder? Holds bile until your intestines need bile.

3 main energy sources:  Carbohydrates, Fats, Proteins

Intestines absorb them into the blood and send them to the liver.

Basics of Metabolism

Metabolism = change

This type of change happens for 2 reasons:

  1. To make something useful
  2. To make something safe

What’s water got to do with it?

  • Your blood is made of water
  • Liver preforms hydrolysis on carbohydrates (using water to dissolve it into tiny bits of sugar = glucose)

Carbohydrate Metabolism

Glucose is the main form of sugar that your body uses for energy.

Sugars are the easiest to turn into energy so that gets used first.  So low carb diets force the body to go after fats, which are the next easiest.  If you’re eating low fat as well, then the body will burn the fat deposits on the body.  Weight loss!

Fat Metabolism

The liver breaks down the fatty acids to make cholesterol (which is not always bad).  Cholesterol is used in your cells walls to keep them fluid and slippery.  Cholesterol is also used to make bile (think “like dissolves like”).  If there’s any extra fatty acids the liver performs gluconeogenesis (gluco = glucose, neo = new, genesis = creation). It basically creating glucose out of anything that contains Carbon.

This is why fats are bad for Type 2 Diabetics as well as sugar.

Protein Metabolism

Protein is the hardest, but can still provide energy.  Proteins are made up of amino acids.  Amino = Nitrogen, acid = carbon.  The nitrogen is relatively useless, so the liver turns it into urea, that gets sent out and filtered by the kidneys.  The part with the carbon can be turned into glucose (gluconeogenesis again).

One of the intermediate steps of the urea production is ammonia.  There is actually a blood test that can be done to test the ammonia-urea balance (BUN = Blood Urea Nitrogen), and if this is out of balance, it indicates a problem.  This test may indicate that your body is metabolizing your own muscles.  This can also be a sign of starvation or other nutritional imbalance.  You need your muscles, you don’t want to metabolize your muscles.

Your body generally needs fully intact amino acids to build, rebuild, and heal muscles.  Proteins and amino acids have a life span, so your body is constantly rebuilding and replacing with fresh supply.  Athletes require higher protein diets than most because of this process.

Take Away

Glucose and fats aren’t inherently bad, it’s more about the amounts of each that get consumed and float around your body.

Your liver can be very efficient and metabolizing the foods you eat.

Your body gets fat deposits because the body is saturated with enough fatty acids that it needs, so any extra gets packed up and shipped around the body to be stored until later.

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Liver Lesson #1: Digestion [Show Notes]

 in Podcasts  tagged bile / Cholesterol / digestion / gallbladder / hepatocyte / intestines / Liver by

Review

Liver shaped like a triangle – check!

Lobule, hepatocytes, vessels – check!  Hundreds of thousands – got it! 

A colored sketch of a liver lobule with labeled parts.

Bile Basics

Hepatocytes make bile.

It’s colors green due to red blood cell waste (bilirubin).

Bile consists of water, salt, cholesterol, bilirubin.

Bile moves from hepatocytes in liver to the gallbladder.

When you eat fats, the intestines triggers the gallbladder to send bile to help digest fat.

The fats are used in the energy-making process.

Bilirubin makes bile green.  It also makes the skin yellow in jaundice.  Makes poop brown.

For babies, it’s because baby hangs on to extra red blood cells from mommy after birth, and the liver has to learn what to do with all of them after they die (RBC’s only liver 120 days!).  For adults with hepatitis, it’s because their liver is damaged and can’t work as efficiently as it used to.  If your poop is the wrong color, it can indicate there is a major liver problem.

If you are gallbladderless, there is no where for the bile to be stored.  So, it gets send to the intestines continuously.  Also, if you have a meal heavy in fats, the intestines will just dump the food it can’t process faster towards the exit.

High levels of bilirubin in infants can lead to cerebral palsy.  If the liver can’t handle all the bilirubin in a timely manner, the only other way to get it to breakdown is UV light. 

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How to Hear Your Liver [Show Notes]

 in Podcasts  tagged detoxification / digestion / immunity / Liver / metabolism / percussing by

Liver Basics

Your liver is shaped like a lumpy triangle.  

It is part of the digestive system, so having it close to the organs that carry your food means that blood doesn’t have to travel very far to get things to and from this organ.

During a physical exam, your doctor finds its location and size by percussing (aka tapping on it – just like a percussion instrument).  Here is a video demonstrating the technique.

Microscopic Level

Hepatocytes (liver cells) build together into Lobules.  Lobules build together into Lobes.

A colored sketch of a liver lobule with labeled parts.

6 Functions

  1. Digestion
  2. Metabolism
  3. Storage
  4. Detoxification
  5. Production
  6. Immunity

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APAP vs NSAIDs

 in Blog  tagged advil / APAP / Aspirin / fever / headache / inflammation / naproxen / NSAIDs / OTC / pain / tylenol by

FAQ

What’s the difference between acetaminophen (Tylenol) and ibuprofen (Advil/Motrin)?

APAP

Acetaminophen (A-SEET-a-men-o-fin, APAP) is in a class all by itself and science isn’t 100% sure how it works. There is a suspicion that there is an enzyme in the inflammation cascade that is only found in the central nervous system, and that enzyme is inhibited by APAP. But because it’s central, this is why APAP works on pain and fever but not swelling. APAP is metabolized by the liver, and that metabolism pathway produces a very toxic by-product if it gets into a traffic jam. This is why APAP dosing limits have been adjusted, and APAP overdoses are so dangerous, even if one does not have liver disease or consume alcohol.
Podcast Episode: Too Much Acetaminophen

NSAIDs

Ibuprofen is in a class many call NSAIDs (non-steroidal anti-inflammatory drugs – because the other medications used to treat inflammation are steroids). NSAIDs, including ibuprofen work on a specific enzyme step in the inflammation process that result in pain, swelling, and fever. That is why joint and muscle injuries respond well to NSAIDs. It is also why the inflammatory response due to viral or bacterial infections are subdued easily by NSAIDs. NSAIDs are metabolized and processed through the kidneys. An overdose can lead to kidney damage, as well as kidney disease can be worsened if these medications are used.  Aspirin is also a NSAID, as well as naproxen.

Bottom Line

In my personal experience, APAP works well on fever and overall body aches (think the flu). Ibuprofen and naproxen work well on injured joints and muscles, as well as sore throat symptoms due to viral infections.  Aspirin doesn’t get recommended for the same things as NSAIDs, mostly because it has such a big reputation as a blood thinner.