Health Blog

Generic Zithromax Antibiotic 500 mg, 250 mg, 100 mg

2009-04-07T22:56:00.000-07:00

Generic Zithromax Antibiotic 500 mg, 250 mg, 100 mg

Zithromax 500 mg (Normal Dosage)
Zithromax 250 mg (Low Dosage)
Zithromax 100 mg (Extra Low Dosage)

Drug Uses
Zithromax is used for treating mild to moderate infections caused by certain bacteria. It may also be used alone or with other medicines to treat or prevent certain infections in persons with advanced HIV infection. It may also be used for other conditions as determined by your doctor.

How Taken
Use Zithromax as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Zithromax by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

Do not take an antacid that has aluminum or magnesium in it within 1 hour before or 2 hours after you take Zithromax.

Zithromax works best if it is taken at the same time each day.

To clear up your infection completely, use Zithromax for the full course of treatment. Keep using it even if you feel better in a few days.

Drug Class and Mechanism
Zithromax is a macrolide antibiotic. It slows the growth of, or sometimes kills, sensitive bacteria by reducing the production of important proteins needed by the bacteria to survive.

Zithromax (azythromycin)

2009-01-29T23:34:00.000-08:00

Zithromax (azythromycin)

Why is this medication prescribed?

Zithromax (azythromycin) is used to treat certain infections caused by bacteria, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, skin, and throat. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Antibiotics will not work for colds, flu, or other viral infections.

How should this medicine be used?
Azithromycin comes as a tablet and oral suspension (liquid) to take by mouth. It is usually taken with or without food once a day for 1-5 days. To help you remember to take azithromycin, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take azithromycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well before each use to mix the medication evenly. Use only the syringe provided to measure the correct amount of medication. Rinse the syringe with water after taking the full dose of medication.

The tablets should be taken with a full glass of water.

Take azithromycin until you finish the prescription, even if you feel better. Stopping azithromycin too soon may cause bacteria to become resistant to antibiotics.

Other uses for this medicine
Azithromycin is also used sometimes to treat H. pylori infection, early Lyme disease, and other infections. It is also used sometimes to prevent heart infection in patients having dental or other procedures and to prevent STD in victims of sexual assault. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking azithromycin,

tell your doctor and pharmacist if you are allergic to azithromycin, clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E.E.S., E-Mycin, Erythrocin), or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin); dihydroergotamine (D.H.E. 45, Migranal); ergotamine (Ergomar); medications that suppress the immune system; nelfinavir (Viracept); phenytoin (Dilantin); and terfenadine (Seldane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
if you take antacids (Mylanta, Maalox), take them 2 hours before or 4 hours after azithromycin.
tell your doctor if you have or have ever had cystic fibrosis, human immunodeficiency virus (HIV), irregular heartbeat, or kidney or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking azithromycin, call your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Azithromycin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

upset stomach
diarrhea
vomiting
stomach pain
mild skin rash

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

severe skin rash
hives
itching
difficulty breathing or swallowing
swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
hoarseness
yellowing of the skin or eyes
rapid, pounding, or irregular heartbeat

Azithromycin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Keep liquid medicine tightly closed at room temperature or in the refrigerator, and throw away any unused medication after 10 days. Do not freeze. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to azithromycin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the azithromycin, call your doctor.

Mild Erection in a Men

2008-06-20T02:28:00.000-07:00

Mild Erection in a Men

Mild erection in a men is the inability to achieve or maintain an erection that is solid enough for a man to have. It may not be possible to obtain an erection at all, or you may lose the erection during the first six ready. If the condition persists, the medical term is erectile dysfunction.

Erection problems are common to adult men. In fact, almost all men experience occasional difficulties to obtain or maintain an erection. In many cases, this is a temporary condition that will go away with little or no treatment. In other cases it may be a constant problem that can damage a man of self-esteem and harm his relationship with his partner, and therefore requires treatment.

In the past, erection problems were thought to be "all in his mind." The men were often useless advice such as "do not worry" or "just relax and that will take care of itself." Today, doctors believe that when the problem is not temporary or not go away on its own, physical factors are often the cause.

One way to know whether the cause is physical or psychologic is to determine if you have erections night. Normally, men have 3 to 5 erections per night, each lasting up to 30 minutes. Your doctor can explain a test to find out if you have the normal number of nighttime erections.

In most men, erection difficulties do not affect their sexual desire.

Ejaculation early (when the orgasm is too fast a) is not the same as impotence. Together with your partner, you should seek advice for this problem, which is usually due to psychological factors.

Male Infertility is also very different from impotence. A man who is unable to maintain an erection can be very capable of producing sperm that can fertilise an egg. Sterili of a man is usually able to maintain an erection, but he may not be able to father a child due to problems with sperm or other factors.

Un'erezione requires the interaction of the brain, nerves, hormones, and blood vessels. Anything that interferes with the normal process can become a problem. CAUSE common include:

Diseases and conditions such as diabetes, high blood pressure, heart or thyroid conditions, poor circulation, low testosterone, depression, spinal cord injury, nerve damage (for example, from a prostate surgery), or neurological disorders ( such as multiple sclerosis or Parkinson's disease)
Drugs such as blood pressure medications (particularly beta-blockers), heart medications (for example, digoxin), some peptic ulcer drugs, antidepressants and sleeping pills
Nicotine, alcohol, cocaine or
Poor communication with your partner
Stress, fear, anxiety, anger or
Orientation unrealistic expectations, which make sex a task rather than a pleasure
"Vicious circle" of doubt, failure, or negative communication that strengthens the erection problems
Erection problems tend to become more common as age, but it can affect men at any age and at any time in their lives. Natural Causes are more common in older men, while psychological causes are more common in young men.

For many men, lifestyle changes can help:

Reducing smoking, alcohol and illegal drugs.
Getting a lot of rest and take time to relax.
Exercise and eating a healthy diet to maintain good circulation.
Use safe sex practices, which reduces the fear of HIV and STDs.
Speaking openly to your partner about sex and your relationship. If you can not do this, the advice can help.
Young who can not speak to each other are unlikely to be able to make love to each other. Men who have difficulty in communicating their feelings may find it difficult to share with their partners any anxieties about their sexual performance. If you keep worries to yourself, it is more likely to lose erections. Men who can not express and resolve the feelings of anger or frustration towards their partner may hold back their erection as a weapon in the conflict. In such circumstances, advice can be very useful for both you and your partner.

There are many treatment options today. These include medicines taken by mouth, injections in the penis, vacuum devices, and surgery. In order to treat erectile dysfunction effectively, you must be aware of and comfortable, with the possible side-effects and complications that can occur with each therapy.

Bacterial infections - Urinary Tract Infections in Women

2008-04-10T08:08:00.000-07:00

Urinary Tract Infections in Women

Most urinary tract infections are caused by bacteria. Any part of your urinary tract can become infected. The urinary tract includes the kidneys, ureters, bladder and urethra. Bladder and urethra infections are the most common.

How do I know if I have a urinary tract infection?
The box below lists possible signs of a urinary tract infection. Nausea, lower back pain and fever may be signs of a kidney infection. Call your doctor if you have any of these symptoms.

Possible signs of a urinary tract infection
A burning sensation when you urinate
Feeling like you need to urinate more often than usual
Feeling the urge to urinate but not being able to
Leaking a little urine
Cloudy, dark, smelly or bloody urine

Why do women get urinary tract infections more often than men?
Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

The urethra is also located near the rectum in women. Bacteria from the rectum can easily travel up the urethra and cause infections.

Having sex may also cause urinary tract infections in women because bacteria can be pushed into the urethra. Using a diaphragm can lead to infections because diaphragms push against the urethra and make it harder to completely empty the bladder. The urine that stays in the bladder is more likely to grow bacteria and cause infections.

How are urinary tract infections treated?
If your family doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. Your doctor will then prescribe an antibiotic for you if you have an infection. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine. Make sure you take all the medicine, even if you are feeling better.

Your doctor may also suggest a medicine to numb your urinary tract and make you feel better while the antibiotic starts to work. The medicine makes your urine turn bright orange, so don't be alarmed by the color when you urinate.

What can I do if I have frequent infections?
If you have urinary tract infections often, you can try some of the suggestions in the box below. Talk with your family doctor about what changes would be helpful for you.

Your doctor also may give you a low dose of medicine for several months or longer to prevent infections from coming back.

If having sex seems to cause your infections, your doctor may suggest that you take a single low dose antibiotic pill after you have sex to prevent urinary tract infections.

Bacterial infections - Tonsillitis

2008-04-10T07:46:00.000-07:00

Bacterial infections - Tonsillitis

Open your mouth wide in front of a mirror. Do you see your tonsils? They're located on each side of your throat, just behind and above your tongue.

Years ago, many young children had their tonsils removed. In fact, surgery was once the standard treatment for recurrent tonsillitis — inflammation of the tonsils caused by a viral or bacterial infection.

Today, tonsils are recognized for their role in filtering harmful bacteria and viruses that could cause more serious infections. When tonsillitis strikes, the first line of treatment is typically self-care or antibiotics. Surgery is seldom necessary, unless tonsillitis recurs often or it interferes with breathing or swallowing.

Signs and symptoms
Tonsillitis is characterized by red, swollen tonsils. You may also notice white patches on the tonsils. Other signs and symptoms of tonsillitis include:

Severe sore throat
Difficult or painful swallowing
Headache
Fever and chills
Enlarged, tender glands (lymph nodes) in the jaw and neck
Loss of voice

Causes
When bacteria and viruses enter your body through your nose or mouth, your tonsils act as a filter — engulfing the offending organisms in white blood cells. This may cause a low-grade infection in your tonsils, which stimulates your immune system to form antibodies against future infections. But sometimes the tonsils are overwhelmed by a bacterial or viral infection. The result is tonsillitis.

Various viruses and bacteria can cause tonsillitis, including the virus that causes mononucleosis (the Epstein-Barr virus) and the bacterium that causes strep throat (Streptococcus pyogenes).

Risk factors
Tonsillitis is a common condition, especially in children. Viruses and bacteria tend to flourish where people are in close contact, such as schools and child care facilities.

When to seek medical advice
Although tonsillitis itself usually isn't serious, it can lead to complications if left untreated. Call your doctor if your sore throat:

Lasts more than 48 hours
Gets worse
Is accompanied by other signs or symptoms
Seek emergency care if you're:

Drooling
Unable to eat or drink
Having trouble breathing
Screening and diagnosis
The doctor will check your tonsils and the back of your throat for signs of infection, such as redness and pus. If your tonsils appear to be infected and you have other signs and symptoms of strep throat, you'll need a throat swab. With this simple test, the doctor rubs a sterile swab over the back of your throat to get a sample of the secretions. It doesn't hurt, but it may cause momentary gagging.

The sample will be checked in the lab for the presence of streptococcal bacteria. Test results are available within minutes to hours, depending on the testing method. If the strep test is positive, you'll need antibiotics to treat the infection.

Complications
Left untreated, tonsillitis can lead to a collection of pus between a tonsil and the soft tissues around it. This is known as an abscess. The abscess may cover a large part of the soft area at the back of the roof of the mouth (soft palate). Sometimes the swelling can be so severe that the roof of the mouth and tongue meet, blocking airflow and making swallowing extremely difficult. Rarely, the abscess may spread into the bloodstream or into the neck or chest.

Some strains of streptococcal bacteria that cause tonsillitis can also cause kidney inflammation (nephritis) or rheumatic fever, a serious condition that can affect the heart, joints, nervous system and skin.

Treatment
Tonsillitis is typically treated with self-care or antibiotics. Although surgery is no longer the standard treatment for tonsillitis, it may be recommended in some cases.

Self-care
If tonsillitis is caused by a viral infection, you'll need to let the virus run its course. Recovery may take a week or two. In the meantime, get plenty of rest. Drink warm, soothing liquids — such as soup, broth and tea — and gargle with warm salt water. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) can help reduce fever and decrease pain. Because of the risk of Reye's syndrome — a potentially life-threatening illness — don't give aspirin to children younger than age 12.
If tonsillitis is caused by a bacterial infection, your doctor will prescribe antibiotics. Oral antibiotics typically need to be taken for at least 10 days. Although you'll probably feel better in a day or two, it's important to finish the full course of antibiotics. Stopping medication early may cause the infection to come back — which can lead to potentially serious complications.

If your child has a positive strep test, he or she needs to complete at least 24 hours of antibiotic treatment before returning to school or child care. If your child has difficulty swallowing, antibiotics may be given by injection.

Surgery
Surgical removal of the tonsils (tonsillectomy) is rarely needed for adults. During childhood, surgery may be recommended if:

Your child has seven or more episodes of tonsillitis in one year
Your child has five or more episodes of tonsillitis a year for two years
Swollen tonsils interfere with your child's breathing or swallowing
An abscess develops in the tonsils
Tonsillectomy is usually done on an outpatient basis. That means your child will be able to go home the day of the surgery. A complete recovery may take up to two weeks, however.

After surgery, your child's throat will be sore. He or she may have ear pain as well. Encourage your child to suck on ice cubes or frozen fruit pops, eat ice cream or sherbet, and drink cold liquids. You may want to use a cool-mist humidifier in your child's bedroom. While your child is recovering, keep in mind that he or she will be more susceptible to infection than usual. Avoid crowds and exposure to anyone who may be ill. If your child begins to bleed from the mouth, report it to the doctor immediately.

Prevention
Frequent hand washing is the best way to prevent all kinds of infections, including tonsillitis. Wash your hands often, and encourage your children to do the same.

Self-care
A sore throat can make you miserable. These tips can help.

Drink more fluids. Warm liquids — such as soup, broth and tea — are good choices.
Gargle with warm salt water. Mix 1/2 teaspoon of salt in 8 ounces of warm water, gargle, and then spit out the water.
Use honey and lemon. Stir honey and lemon to taste into a glass of hot water. Allow it to cool to room temperature before you sip it. The honey coats and soothes your throat, and the lemon helps reduce mucus. Note: Don't use honey or corn syrup in a drink for children younger than age 1.
Suck on a throat lozenge or hard candy. This stimulates saliva production, which bathes and cleanses your throat.
Humidify the air. Adding moisture to the air can reduce throat irritation and make it easier to sleep. Be sure to change the water in a room humidifier daily and clean the unit at least once every three days to help prevent the growth of harmful molds and bacteria.
Avoid smoke and other air pollutants. Smoke irritates a sore throat.
Rest your voice. Talking may lead to more throat irritation and temporary loss of your voice (laryngitis).
Think about others, too. If you're not feeling well, take a few days off to avoid spreading your germs.

Bacterial infections - Pneumonia

2008-04-10T06:39:00.000-07:00

Bacterial infections - "Pneumonia"

Pneumonia (pronounced: noo-mow-nyuh) is an infection of the lungs. When a person has pneumonia, lung tissue can fill with pus and other fluid, which makes it difficult for oxygen in the lung's air sacs to reach the bloodstream. With pneumonia, a person may have difficulty breathing and have a cough and fever. Sometimes a person may have chest or abdominal pain and vomiting, too.

Pneumonia is commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such as Streptococcus pneumoniae can cause pneumonia, too. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.

You may have heard the terms "double pneumonia" or "walking pneumonia." Double pneumonia simply means that the infection is in both lungs. It's common for pneumonia to affect both lungs, so don't worry if your doctor says this is what you have — it doesn't mean you're twice as sick.

Walking pneumonia refers to pneumonia that is mild enough that you may not even know you have it. Walking pneumonia, which has also been called atypical pneumonia because it's different from the typical bacterial pneumonia, is common in teens and is often caused by a tiny microorganism known as Mycoplasma pneumoniae. Like the typical bacterial pneumonia, walking pneumonia can also be treated with antibiotics.

What Are the Signs and Symptoms?
There are many symptoms of pneumonia, and some of them, like a cough or a sore throat, are associated with many other common infections. Often, people get pneumonia after they've had an upper respiratory tract infection like a cold.

Symptoms of pneumonia can include:

fever
chills
cough
unusually rapid breathing
wheezing
difficulty breathing
chest or abdominal pain
loss of appetite
exhaustion
vomiting
The symptoms of pneumonia vary from person to person, and few people get all of them.

When pneumonia is caused by bacteria, the person tends to become sick quickly and develops a high fever and has difficulty breathing. When it's caused by a virus, symptoms generally appear more gradually and may be less severe.

A person's symptoms can help the doctor identify the type of pneumonia. Mycoplasma pneumoniae, for example, often causes headaches and sore throats in addition to the symptoms listed above.

Can I Prevent Pneumonia?
The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received additional vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria. People who have diseases that affect their immune system (like diabetes, HIV infection, or cancer), are 65 or older, or are in other high-risk groups should receive a pneumococcal vaccination.

People with immune system problems may also receive antibiotics to prevent pneumonia that may be caused by organisms they are especially susceptible to. In some cases, antiviral medication may be used to prevent viral pneumonia or to lessen its effects.

Influenza vaccination is also recommended since pneumonia often occurs as a complication of the flu. Because pneumonia is often caused by contagious germs, a good way to prevent pneumonia is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils, wash your hands frequently with warm, soapy water, and avoid touching used tissues and paper towels.

You can also stay strong and help avoid some of the illnesses that may lead to pneumonia by eating as healthily as possible, getting plenty of rest, and avoiding smoking.

How Long Does It Last?
The length of time between exposure and feeling sick depends on many factors, particularly the type of pneumonia a person has.

With influenza pneumonia, for example, someone may become sick in as few as 12 hours or as long as 3 days after exposure to the flu virus. But with walking pneumonia, a person may not have symptoms until 2 to 3 weeks after becoming infected.

Most types of pneumonia resolve within a week or two, although a cough may linger for several weeks more. In severe cases, it may take longer to completely recover.

When Should I Call My Doctor?
If you think you may have pneumonia, tell a parent or other adult and be sure you get an appointment with a doctor. Be especially aware of your breathing; if you have chest pain or trouble breathing or if your lips or fingers look blue, you should go to a doctor's office or to a hospital emergency department right away.

How Is Pneumonia Treated?
If a doctor suspects pneumonia, he or she will perform a physical exam and may order a chest X-ray and blood tests. People who have bacterial or atypical pneumonia will probably be given antibiotics to take at home. A doctor will also recommend that a person gets lots of rest and drinks plenty of fluids.

Some people with pneumonia need to be hospitalized to get better — usually babies and young children and people older than 65. However, hospital care may be need for a teen who:

already has immune system problems
is dangerously dehydrated or is vomiting a lot and can't keep fluids and medicine down
has had pneumonia frequently
has skin that's blue or pale in color, which reflects a lack of oxygen
When pneumonia patients are hospitalized, treatment may include intravenous (IV) antibiotics (antibiotics that are delivered through a needle inserted into a vein) and respiratory therapy (breathing treatments).

Antiviral medications approved for adults and teens can reduce the severity of flu infections if taken in the first 1 to 2 days after symptoms begin. If you have been exposed to influenza and you begin to develop symptoms of pneumonia, call a doctor.

What Can I Do to Help Myself Feel Better?
If your doctor has prescribed medicine, be sure to follow the directions carefully.

You may feel better in a room with a humidifier, which increases the moisture in the air and soothes irritated lungs. Make sure you drink plenty of fluids, especially if you have a fever. If you have a fever, ask the doctor whether you can take over-the-counter medicine such as acetaminophen or ibuprofen to bring it down. But don't take any medicine without checking first with your doctor — a cough suppressant, for example, may not allow your lungs to clear themselves of mucus.

And finally, be sure to rest. This is a good time to sleep, watch TV, read, and lay low. If you treat your body right, it will repair itself and you'll be back to normal in no time.

Hypothyroidism

2008-04-05T11:20:00.000-07:00

Hypothyroidism (underactive thyroid gland)
Your thyroid is a small, butterfly-shaped gland located at the base of your neck, just below your Adam's apple. Hormones produced by the thyroid gland have an enormous impact on your health, affecting all aspects of your metabolism — from the rate at which your heart beats to how quickly you burn calories.

As long as your thyroid releases the proper amounts of these hormones, your system functions normally. But sometimes your thyroid doesn't produce enough hormones, upsetting the balance of chemical reactions in your body. This condition is known as hypothyroidism, or underactive thyroid disease.

Women, especially those older than 50, are more likely to have hypothyroidism than men are. Hypothyroidism seldom causes symptoms in the early stages, but over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.

The good news is that accurate thyroid function tests are available to diagnose hypothyroidism, and treatment of hypothyroidism with synthetic thyroid hormone is usually simple and effective once the proper dosage is established.

The signs and symptoms of hypothyroidism vary widely, depending on the severity of the hormone deficiency. But in general, any problems you do have tend to develop slowly, often over a number of years.

At first, you may barely notice symptoms such as fatigue and sluggishness, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms, including:

Increased sensitivity to cold
Constipation
Pale, dry skin
A puffy face
Hoarse voice
An elevated blood cholesterol level
Unexplained weight gain
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Muscle weakness
Heavier than normal menstrual periods
Depression
When hypothyroidism isn't treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow or you may feel depressed.

Advanced hypothyroidism, known as myxedema, is rare, but when it occurs it can be life-threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma. In some cases, myxedema can be fatal.

Hypothyroidism in children and teens
Although hypothyroidism most often affects middle-aged and older women, anyone can develop the condition, including infants and teenagers. Initially, babies born without a thyroid gland or with a gland that doesn't work properly may have few signs and symptoms. When newborns do have problems with hypothyroidism, they may include:

Yellowing of the skin and whites of the eyes (jaundice). In most cases, this occurs when a baby's liver can't metabolize a molecule called bilirubin, which normally forms when the body recycles old or damaged red blood cells.
Frequent choking.
A large, protruding tongue.
As the disease progresses, infants are likely to have trouble feeding and may fail to grow and develop normally. They may also have:

Constipation
Poor muscle tone
Excessive sleepiness
When hypothyroidism in infants isn't treated, even mild cases can lead to severe physical and mental retardation.

In general, children and teens who develop hypothyroidism have the same signs and symptoms as adults do, but they may also experience:

Poor growth, resulting in short stature
Delayed development of permanent teeth
Delayed puberty
Poor mental development
Causes
Your thyroid gland produces two main hormones, thyroxine (T-4) and triiodothyronine (T-3), that influence every cell in your body. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate and help regulate the production of protein. Your thyroid gland also produces calcitonin, a hormone that regulates the amount of calcium in your blood.

The rate at which thyroxine and triiodothyronine are released is controlled by your pituitary gland and your hypothalamus — an area at the base of your brain that acts as a thermostat for your whole system. The hypothalamus signals your pituitary gland to make a hormone called thyroid-stimulating hormone (TSH). Your pituitary gland then releases TSH — the amount depends on how much thyroxine and triiodothyronine are in your blood. Finally, your thyroid gland regulates its production of hormones based on the amount of TSH it receives.

Although this process usually works well, the thyroid sometimes fails to produce enough hormones. This may be due to a number of different factors, including:

Autoimmune disease (Hashimoto's thyroiditis). Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues. Sometimes this process occurs within the thyroid gland. Scientists aren't sure why the body produces antibodies against itself. Some think a virus or bacteria might trigger the response, while others believe a genetic flaw may be involved. Most likely, autoimmune diseases result from more than one factor. But however it happens, these antibodies affect the thyroid's ability to produce hormones.
Treatment for hyperthyroidism. People who produce too much thyroid hormone (hyperthyroidism) are often treated with radioactive iodine or anti-thyroid medications to reduce their thyroid function. However, function can be reduced too much, resulting in hypothyroidism.
Radiation therapy. Radiation used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.
Thyroid surgery. Removing all or a large portion of your thyroid can diminish or halt hormone production. In that case, you'll need to take thyroid hormones for life.
Medications. A number of medications can contribute to hypothyroidism. Less often, hypothyroidism may result from one of the following:

Congenital disease. Approximately one in 3,000 babies in the United States is born with a defective thyroid gland or no thyroid gland at all. In most cases, the thyroid gland didn't develop normally for unknown reasons, but some children have an inherited form of the disorder. Often, infants with congenital hypothyroidism appear normal at birth. That's one reason why most states now require newborn thyroid screening.
Pituitary disorder. A relatively rare cause of hypothyroidism is the failure of the pituitary gland to produce enough TSH — usually due to a benign tumor of the pituitary gland.
Pregnancy. Some women develop hypothyroidism during or after pregnancy (postpartum hypothyroidism), often because they produce antibodies to their own thyroid gland. Left untreated, hypothyroidism increases the risk of miscarriage, premature delivery and preeclampsia — a condition that causes a significant rise in a woman's blood pressure during the last three months of pregnancy. It can also seriously affect the developing fetus.
Iodine deficiency. The trace mineral iodine — found primarily in seafood, seaweed, plants grown in iodine-rich soil and iodized salt — is essential for the production of thyroid hormones. In some parts of the world, iodine deficiency is common, but the addition of iodine to table salt has virtually eliminated this problem in the United States.
Risk factors
Although anyone can develop hypothyroidism, it occurs mainly in women older than 50, and the risk of developing the disorder increases with age. You also have an increased risk if you:

Have a close relative, such as a parent or grandparent, with an autoimmune disease
Have been treated with radioactive iodine or anti-thyroid medications
Received radiation to your neck or upper chest
Have had thyroid surgery (partial thyroidectomy)
When to seek medical advice
See your doctor if you're feeling tired for no reason or have any of the other symptoms of hypothyroidism, such as dry skin, a pale, puffy face, constipation or a hoarse voice.

You'll also need to see your doctor for periodic testing of your thyroid function if you've had previous thyroid surgery, treatment with radioactive iodine or anti-thyroid medications, or radiation therapy to your head, neck or upper chest. However, it may take years or even decades before any of these therapies or procedures result in hypothyroidism.

If you have high blood cholesterol, talk to your doctor about whether hypothyroidism may be a cause. And if you're receiving hormone therapy for hypothyroidism, schedule follow-up visits as often as your doctor recommends. Initially, it's important to make sure you're receiving the correct dose of medicine. And over time, the dose you need to keep your thyroid functioning normally may change.

Screening and diagnosis
Because hypothyroidism is more prevalent in older women, some doctors recommend that older women be screened for the disorder during routine annual physical examinations. Some doctors also recommend that pregnant women or women thinking about becoming pregnant be tested for hypothyroidism.

In general, your doctor may test for an underactive thyroid if you're feeling increasingly tired or sluggish, have dry skin, constipation and a hoarse voice, or have had previous thyroid problems or goiter.

Blood tests
Diagnosis of hypothyroidism is based on your symptoms and the results of blood tests that measure the level of TSH and sometimes the level of the thyroid hormone thyroxine. A low level of thyroxine and high level of TSH indicate an underactive thyroid. That's because your pituitary produces more TSH in an effort to stimulate your thyroid gland into producing more thyroid hormone.

In the past, doctors weren't able to detect hypothyroidism until symptoms were fairly advanced. But by using the sensitive TSH test, doctors are able to diagnose thyroid disorders much earlier — often before you ever experience symptoms. Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. They help your doctor determine the right dosage of medication, both initially and over time.

In addition, TSH tests are used to help diagnose a condition called subclinical hypothyroidism, which usually causes no outward signs or symptoms. In this condition, you have normal blood levels of T-3 and T-4, but higher than normal levels of TSH.

Complications
Untreated hypothyroidism can lead to a number of health problems:

Goiter. Constant stimulation of your thyroid to release more hormones may cause the gland to become larger — a condition known as goiter. Hashimoto's thyroiditis is one of the most common causes of a goiter. Although generally not uncomfortable, a large goiter can affect your appearance and may interfere with swallowing or breathing.
Heart problems. Hypothyroidism may also be associated with an increased risk of heart disease, primarily because high levels of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — can occur in people with an underactive thyroid. Even subclinical hypothyroidism, a more benign condition than true hypothyroidism, can cause an increase in total cholesterol levels and impair the pumping ability of your heart. Hypothyroidism can also lead to an enlarged heart and heart failure.
Mental health issues. Depression may occur early in hypothyroidism and may become more severe over time. Hypothyroidism can also cause slowed mental functioning.
Myxedema. This rare, life-threatening condition is the result of long-term, undiagnosed hypothyroidism. Its symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by sedatives, infection or other stress on your body. If you have symptoms of myxedema, you need immediate emergency medical treatment.
Birth defects. Babies born to women with untreated thyroid disease may have a higher risk of birth defects than do babies born to healthy mothers. These children are more prone to serious intellectual and developmental problems.

Infants with untreated hypothyroidism present at birth are also at risk of serious problems with both physical and mental development. But if the condition is diagnosed within the first few months of life, the chances of normal development are excellent.

Treatment
Standard treatment for an underactive thyroid involves daily use of the synthetic thyroid hormone levothyroxine (Synthroid). The oral medication restores adequate hormone levels, shifting your body back into normal gear.

Soon after starting treatment, you'll notice that you're feeling less fatigued. The medication also gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine (Synthroid) is usually lifelong, but because the dosage you need may change, your doctor is likely to check your TSH level every year or so.

To determine the right dosage of levothyroxine (Synthroid) initially, your doctor generally checks your level of TSH after two to three months. Excessive amounts of the hormone can cause side effects, such as increased appetite, insomnia, heart palpitations and shakiness.

If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually increase the dosage. Progressive hormone replacement allows your heart to adjust to the increase in metabolism.

Levothyroxine (Synthroid) causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you're still receiving the right dosage. Also, don't skip doses or stop taking the drug because you're feeling better. If you do, the symptoms of hypothyroidism will gradually return. People with hypothyroidism need to take medication for the rest of their lives.

Proper absorption of levothyroxine
Certain medications, supplements and even some foods may affect your ability to absorb levothyroxine.

Major depression

2008-03-31T01:28:00.000-07:00

Major depression

is when five or more symptoms of depression are present for at least 2 weeks. These symptoms include feeling sad, hopeless, worthless, or pessimistic. In addition, people with major depression often have behavior changes, such as new eating and sleeping patterns. Major depression increases a person's risk of suicide.

Causes

The exact cause of depression is not known. Many researchers believe it is caused by chemical imbalances in the brain, which may be hereditary or caused by events in a person's life.

Some types of depression seem to run in families, but depression can also occur in people who have no family history of the illness. Stressful life changes or events can trigger depression in some people. Usually, a combination of factors is involved.

Each year, more than 18 million Americans -- men and women of all ages, races, and economic levels -- have depression. It occurs more often in women.

Women are especially vulnerable to depression after giving birth. This is a result of the hormonal and physical changes. While new mothers commonly experience temporary "blues," depression that lasts longer than 2-3 weeks is not normal and requires treatment.

Adolescent depression

Symptoms

Trouble sleeping or excessive sleeping
A dramatic change in appetite, often with weight gain or loss
Fatigue and lack of energy
Feelings of worthlessness, self-hate, and inappropriate guilt
Extreme difficulty concentrating
Agitation, restlessness, and irritability
Inactivity and withdrawal from usual activities, a loss of interest or pleasure in activities that were once enjoyed (such sex)
Feelings of hopelessness and helplessness
Thoughts of death or suicide
Depression can appear as anger and discouragement rather than feelings of hopelessness and helplessness. If depression is very severe, it may be accompanied by psychotic symptoms, such as hallucinations and delusions. These are usually consistent with the depressed mood, and may focus on themes of guilt, personal inadequacy, or disease.

Exams and Tests

Major depression is diagnosed if the person reports having five or more depressive symptoms for at least 2 weeks. Beck's Depression Scale Inventory or other screening tests for depression can be helpful in diagnosing depression.

Medical causes that can cause symptoms of depression should also be ruled out before making the diagnosis of depression.

Treatment

Depression can be treated in a variety of ways, particularly with medications and counseling. Most people benefit from a combination of the two. Some studies have shown that antidepressant drug therapy combined with psychotherapy appears to have better results than either therapy alone.

Medications include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors (SSRIs), and some newer antidepressant drugs. While antidepressant medications can be very effective, some may not be appropriate for everyone. For example, in September, 2004 the FDA began considering a warning that some antidepressants may increase the risk of suicidal tendencies in children. In 2007, the FDA proposed that all antidepressant medicines should warn of the risk of suicidal behavior in young adults ages 18 - 24 years.

Lithium and thyroid supplements may be needed to enhance the effectiveness of antidepressants. For persons with psychotic symptoms, such as delusions or hallucinations, antipsychotic medications may be needed.

Electroconvulsive therapy (ECT) is a treatment that causes a seizure by means of an electrical current. ECT may improve the mood of severely depressed or suicidal people who don't respond to other treatments.

Research is now being conducted on transcranial magnetic stimulation (TMS), which alters brain functioning in a way similar to ECT, but with fewer side effects. Use of light therapy for depressive symptoms in the winter months and interventions to restore a normal sleep cycle may be effective in relieving depression.

As treatment takes effect, negative thinking diminishes. It takes time to feel better, but there are usually day-to-day improvements. It is important to maintain a healthy lifestyle. Eat well-balanced meals, avoid alcohol and drugs (which make depression worse and may interfere with medications), get regular exercise and sleep, and seek supportive interpersonal relationships.

Many consumers try herbal products for depression. St. John's wort has a long history of use in Germany and has gained popularity as an herbal antidepressant in the United States. Most of the German studies indicated that St. John's wort was comparable to some antidepressants. However, a large study conducted by the National Center for Complementary and Alternative Medicine found that St. John's wort was NOT effective for treating major depression.

Because herbal products can have side effects, always tell your doctor if you are using them.

Support Groups

For more information and resources, see depression support group.

Outlook (Prognosis)

The outcome is usually good with treatment. Although most depressive episodes can be effectively treated with either medication, psychotherapy, or both, depression is a recurring problem for many people. For people who have experienced repeated episodes of depression, maintenance treatment may be needed to prevent future recurrences.

Possible Complications

Suicide (up to 15% of people with major depressive disorder die by suicide)
Increased risk of alcohol- and drug-related problems
Increased risk of tobacco dependence
Increased risk of problems with physical health and premature death due to medical illness
When to Contact a Medical Professional

Call 911, a suicide hotline, or get safely to a nearby emergency room if you have thoughts of suicide, a suicidal plan, or thoughts of harming yourself or others.

Call your doctor right away if:

You hear voices that are not there.
You have frequent crying spells with little or no provocation.
You have had feelings of depression that disrupt work, school, or family life for longer than 2 weeks.
You think that one of your current medications may be making you feel depressed. DO NOT change or stop any medications without consulting your doctor.
You believe that you should cut back on drinking, a family member or friend has asked you to cut back, you feel guilty about the amount of alcohol you drink, or you drink alcohol first thing in the morning.
Prevention

Some episodes of depression can be avoided by:

Learning how to relax and manage stress
Avoiding alcohol, drugs, and caffeine
Exercising regularly
Maintaining good sleep habits
Counseling may help you through times of grief, stress, or low mood. Family therapy may be particularly important for teens who feel blue.

For elderly or others who feel socially isolated or lonely, try volunteering or getting involved in group activities.

Medications and psychiatric counseling may prevent recurrences. Some episodes of depression are not preventable.

Influenza (Flu)

2008-03-19T02:57:00.000-07:00

Flu; Influenza A; Influenza B
The flu is a contagious infection of the nose, throat, and lungs caused by the influenza virus.
Causes
The flu usually begins abruptly, with a fever between 102 and 106°F. (An adult typically has a lower fever than a child.) Other common symptoms include a flushed face, body aches, chills, headache, nausea, and lack of energy. Some people have dizziness or vomiting. The fever usually lasts for a day or two, but can last 5 days.

Somewhere between day 2 and day 4 of the illness, the "whole body" symptoms begin to subside, and respiratory symptoms begin to increase. The flu virus can settle anywhere in the respiratory tract, producing symptoms of a cold, croup, sore throat, bronchiolitis, ear infection, or pneumonia.

The most prominent of the respiratory symptoms is usually a dry, hacking cough. Most people also develop a sore throat and headache. Nasal discharge (runny nose) and sneezing are common. These symptoms (except the cough) usually disappear within 4-7 days. Sometimes, the fever returns. Cough and tiredness usually last for weeks after the rest of the illness is over.

Influenza A usually arrives in the late winter or early spring. Influenza B can appear at any time of the year.

The most common way to catch the flu is by breathing in droplets from coughs or sneezes. Less often, it is spread when you touch a surface such as a faucet handle or phone that has the virus on it, and then touch your own mouth, nose, or eyes.

Symptoms appear 1-7 days later (usually within 2-3 days). Because the flu spreads through the air and is very contagious, it often strikes a community all at once. This creates a cluster of school and work absences. Many students become sick within 2 or 3 weeks of the flu's arrival in a school.

Tens of millions of people in the United States get the flu each year. Most get better within a week or two, but thousands become sick enough to be hospitalized. About 36,000 people die each year from complications of the flu.

Anyone at any age can have serious complications from the flu, but those at highest risk include:

People over 50
Children between 6 months and 2 years
Women more than 3 months pregnant during the flu season
Anyone living in a long-term care facility
Anyone with chronic heart, lung, or kidney conditions, diabetes, or weakened immune system
Sometimes people confuse cold and flu, which share some of the same symptoms and typically occur at the same time of the year. However, the two diseases are very different. Most people get a cold several times each year, and the flu only once every several years.

People often use the term "stomach flu" to describe a viral illness where vomiting or diarrhea are the main symptoms. This is incorrect, as the stomach symptoms are not caused by the flu virus. Flu infections are primarily respiratory infections.

Symptoms

Fever - may be high
Headache
Tiredness
Dry cough
Sore throat
Stuffy, congested nose
Muscle aches and stiffness
Other symptoms may include:

Nasal discharge
Shortness of breath
Wheezing
Croupy cough
Chills
Fatigue
Malaise
Sweating
Loss of appetite
Vomiting
Dizziness
Worsening of underlying illness, such as asthma or heart failure
Exams and Tests

The evaluation of an individual with flu symptoms should include a thorough physical exam and, in cases where pneumonia is suspected, a chest x-ray.

Additional blood work may be needed. They may include a complete blood count, blood cultures, and sputum cultures.

The most common method for diagnosing the flu is an antigen detection test, which is done by swabbing the nose and throat, then sending a sample to the laboratory for testing.

The results of these tests can be available rapidly, and can help decide if specific treatment is appropriate. However, when flu is widespread in the community the diagnosis can often be made by simply identifying symptoms without further testing.

Treatment

If you have mild illness and are not at high-risk, take these steps:
Rest
Take medicines that relieve symptoms and help you rest
Drink plenty of liquids
Avoid aspirin (especially teens and children)
Avoid alcohol and tobacco
Avoid antibiotics (unless necessary for another illness)
If the flu is diagnosed within 48 hours of when symptoms begin, especially if you are at high risk for complications, antiviral medications may help shorten the length of symptoms by about one day.

The U.S. Centers for Disease Control and Prevention recommends using oseltamivir (Tamiflu) or zanamivir (Relenza), which are active against both influenza A and B for patients who need to be treated. These medicines affect different viruses. Each of these medicines has different routes of administration and different side effects. Talk to your doctor about whether one of these drugs is right for you.

Treatment is usually not necessary for children, but if the illness is diagnosed early and the patient is at risk of developing a severe case, it can be started. Oseltamivir (Tamiflu) is the best choice for children age 12 and older. Zanamivir (Relenza) is not FDA-approved for children under age 7.

Treatment will only help if started early and only if the illness is actually influenza. It will not help treat a regular cold.

Outlook (Prognosis)

In most individuals who are otherwise healthy, the flu goes away within 7 to 10 days.

Possible Complications

Possible complications, especially for those at high risk, include:
Pneumonia
Encephalitis (infection of the brain)
Bronchitis
Sinus infections
Ear infections
Call your health care provider if someone in a high-risk category develops symptoms of the flu.

Migraine Protect Your Memory?

2008-03-16T08:46:00.000-07:00

ScienceDaily (Apr. 24, 2007) — Women with a lifetime history of migraine showed less of a performance decline over time on cognitive tests than women who didn't have migraines. Researchers say medications for migraine, diet and behavior changes may play a role in helping women with migraine protect their memory.

For the community based study, 1,448 women, of which 204 had migraine, underwent a series of cognitive tests beginning in 1993 and again approximately 12 years later.

The study found while women with migraine performed worse on cognitive tests, such as word recall, at the beginning of the study, their performance declined 17 percent less over time than women without migraine. Women over age 50 with migraine showed the least amount of cognitive decline on a test used to assess cognitive functioning.

"Some medications for migraine headaches, such as ibuprofen, which may have a protective effect on memory, may be partially responsible for our findings, but it's unlikely to explain this association given we adjusted for this possibility in our study and the medications showed no indication of a significant protective effect," said study author Amanda Kalaydjian, PhD, MS, of Johns Hopkins University in Baltimore, MD.

Dr. Kalaydjian says another factor that needs to be explored is the possibility that women with migraine may change their diet or behavior in some way that might improve cognition. "For example, alternative treatment for migraine includes adequate sleep, as well as behavioral and relaxation techniques, and a reduction in caffeine," said Dr. Kalaydjian.

"Despite these theories, it seems more likely that there may be some underlying biological mechanism, such as changes in blood vessels or underlying differences in brain activity, which results in decreased cognitive decline over time," said Dr. Kalaydjian. "More research is needed to fully understand how migraine affects cognition."

Headache migraine

2008-03-16T07:37:00.000-07:00

Headache - migraine

A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.

Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.

Causes

A lot of people get migraines -- about 11 out of 100. The headaches tend to start between the ages of 10 and 46 and may run in families. Migraines occur more often in women than men. Pregnancy may reduce the number of migraines attacks. At least 60 percent of women with a history of migraines have fewer such headaches during the last two trimesters of pregnancy.

Until the 1980s, scientists believed that migraines were due to changes in blood vessels within the brain. Today, most believe the attack actually begins in the brain itself, and involves various nerve pathways and chemicals in the brain.

A migraine attack can be triggered by stress, food, environmental changes, or some other factor. However, the exact chain of events remains unclear.

Migraine attacks may be triggered by:

Allergic reactions
Bright lights, loud noises, and certain odors or perfumes
Physical or emotional stress
Changes in sleep patterns
Smoking or exposure to smoke
Skipping meals
Alcohol
Menstrual cycle fluctuations, birth control pills
Tension headaches
Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

Symptoms

Migraine headaches, which can be dull or severe, usually:

Feel throbbing, pounding, or pulsating
Are worse on one side of the head
Last 6 to 48 hours
Symptoms accompanying migraines include:

Nausea and vomiting
Sensitivity to light or sound
Loss of appetite
Fatigue
Numbness, tingling, or weakness
Warning signs (auras) that can precede a migraine include seeing stars or zigzag lines, tunnel vision, or a temporary blind spot.

Symptoms that may linger even after the migraine has gone away include:

Feeling mentally dull, like your thinking is not clear or sharp
Increased need for sleep
Neck pain
Exams and Tests

Migraine headache may be diagnosed by your doctor based on your symptoms, history of migraines in the family, and your response to treatment. Your doctor will take a detailed history to make sure that your headaches are not due to tension, sinus inflammation, or a more serious underlying brain disorder. During the physical exam, your doctor will probably not find anything wrong with you.

Sometimes an MRI or CT scan is obtained to rule out other causes of headache like sinus inflammation or a brain mass. In the case of a complicated migraine, an EEG may be needed to exclude seizures. Rarely, a lumbar puncture (spinal tap) might be performed.

Treatment

There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or altering triggers. When you do get migraine symptoms, try to treat them right away. The headache may be less severe.

A good way to identify triggers is to keep a headache diary.

When migraine symptoms begin:

Rest in a quiet, darkened room
Drink fluids to avoid dehydration (especially if you have vomited)
Try placing a cool cloth on your head
Over-the-counter pain medications like acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. (Be aware, however, that chronic usage of such pain medications may result in rebound headaches.) If these don't help, ask your doctor about prescription medications.

Possible Complications

Migraine headaches generally represent no significant threat to your overall health. However, they can be chronic, recurrent, frustrating, and they may interfere with your day-to-day life.

Stroke is an extremely rare complication from severe migraines. This risk may be due to prolonged narrowing of the blood vessels, limiting blood flow to parts of the brain for an extended period of time.

When to Contact a Medical Professional

Call 911 if:

You have unusual symptoms not experienced with a migraine before, like speech or vision problems, loss of balance, or difficulty moving a limb
You are experiencing "the worst headache of your life"
Call your doctor immediately if:

Your headache pattern or intensity is different
Your headache gets worse when you lie down
Also, call your doctor if:

Previously effective treatments no longer help
Side effects from medication occurs (irregular heartbeat, pale or blue skin, extreme sleepiness, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain, cramps, dry mouth, extreme thirst, or others)
You are likely to become pregnant -- some medications should not be taken when pregnant
Prevention

Avoid smoking
Avoid alcohol
Exercise regularly
Get enough sleep each night
Learn to relax and reduce stress -- try progressive muscle relaxation (contracting and releasing muscles throughout your body), meditation, biofeedback, or joining a support group
If you get at least three headaches per month, your doctor may prescribe medication for you to prevent recurrent migraines.

Beta-blockers such as propranolol (Inderal)
Antidepressants, including tricyclics like amitriptyline (Elavil) or selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or sertraline (Zoloft)
Anticonvulsants such as valproic acid (Depacon, Depakene), divalproex sodium (Depakote), or topiramate (Topamax).

Asthma and Allergy

2008-03-11T06:57:00.000-07:00

Asthma and other allergic diseases are two of the most common health problems. Approximately 50 million Americans have asthma, hay fever or other allergy-related conditions.
Some allergy problems — such as a mild case of hay fever — may not need any treatment. Sometimes allergies can be controlled with the occasional use of an over-the-counter medication. However, sometimes allergies can interfere with day-to-day activities or decrease the quality of life. Allergies can even be life threatening.

An allergist is a physician who specializes in the diagnosis and treatment of asthma and other allergic diseases. The allergist is specially trained to identify the factors that trigger asthma or allergies. Allergists help people treat or prevent their allergy problems. After earning a medical degree, the allergist completes a three-year residency-training program in either internal medicine or pediatrics. Next the allergist completes two or three more years of study in the field of allergy and immunology. You can be certain that your doctor has met these requirements if he or she is certified by the American Board of Allergy and Immunology.

One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. But sometimes the defenses are too aggressive and harmless substances such as dust, molds or pollen are mistakenly identified as dangerous. The immune system then rallies its defenses, which include several chemicals to attack and destroy the supposed enemy. In the process, some unpleasant and, in extreme cases, life-threatening symptoms may be experienced in the allergy-prone individual.

Cause of Allergic Reactions
There are hundreds of ordinary substances that can trigger allergic reactions. Among the most common are plant pollens, molds, household dust (dust mites), cockroaches, pets, industrial chemicals, foods, medicines, feathers and insect stings. These triggers are called "allergens."

Asthma and allergies can affect anyone, regardless of age, gender, race or socioeconomic factors. While it's true that asthma and allergies are more common in children, they can occur for the first time at any age. Sometimes allergy symptoms start in childhood, disappear for many years and then start up again during adult life.

Although the exact genetic factors are not yet understood, there is a hereditary tendency to asthma and allergies. In susceptible people, factors such as hormones, stress, smoke, perfume or other environmental irritants also may play a role.

Types of Allergy Problems
An allergic reaction may occur anywhere in the body but usually appears in the nose, eyes, lungs, lining of the stomach, sinuses, throat and skin. These are places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.

Allergic Rhinitis (Hay Fever). Allergic rhinitis is a general term used to describe the allergic reactions that take place in the nose. Symptoms may include sneezing, congestion, runny nose, and itching of the nose, the eyes and/or the roof of the mouth. When this problem is triggered by pollens or outdoor molds, during the Spring, Summer or Fall, the condition is often called "hay fever." When the problem is year-round, it might be caused by exposure to house dust mites, household pets, indoor molds, or allergens at school or in the workplace.

Asthma. Asthma symptoms occur when airway muscle spasms block the flow of air to the lungs and/or the linings of the bronchial tubes become inflamed. Excess mucus may clog the airways. An asthma attack is characterized by labored or restricted breathing, a tight feeling in the chest, coughing and/or wheezing. Sometimes a chronic cough is the only symptom. Asthma trouble can cause only mild discomfort or it can cause life-threatening attacks in which breathing stops altogether.

Skin Allergies. Contact dermatitis, eczema and hives are skin conditions that can be caused by allergens and other irritants. Often the reaction may take hours or days to develop, as in the case of poison ivy. The most common allergic causes of rashes are medicines, insect stings, foods, animals and chemicals used at home or work. Allergies may be aggravated by emotional stress.

Anaphylaxis. Anaphylaxis is a rare, potentially fatal allergic reaction that affects many parts of the body at the same time. The trigger may be an insect sting, a food (such as peanuts) or a medication. Symptoms may include:

Vomiting or diarrhea
A dangerous drop in blood pressure
Redness of the skin and/or hives
Difficulty breathing
Swelling of the throat and/or tongue
Loss of consciousness
Frequently these symptoms start without warning and get worse rapidly. At the first sign of an anaphylactic reaction, the affected person must go immediately to the closest Emergency Room or call 911.
When To See an Allergist

Often, the symptoms of asthma or allergies develop gradually over time.

Allergy sufferers may become used to frequent symptoms such as sneezing, nasal congestion or wheezing. With the help of an allergist, these symptoms usually can be prevented or controlled with major improvement in quality of life.

Effectively controlling asthma and allergies requires planning, skill and patience. The allergist, with his or her specialized training can develop a treatment plan for your individual condition. The goal will be to enable you to lead a life that is as normal and symptom-free as possible.

A visit to the allergist might include:

Allergy testing. The allergist will usually perform tests to determine what allergens are involved.

Prevention education. The most effective approach to treating asthma or allergies is to avoid the factors that trigger the condition in the first place. Even when it is not possible to completely avoid allergens, an allergist can help you decrease exposure to allergens.

Medication prescriptions. A number of new and effective medications are available to treat both asthma and allergies.

Allergy medications

2008-03-11T06:53:00.000-07:00

Allergy medications: Know your options
Because you can't always avoid allergy triggers, you may need medication to help alleviate allergy symptoms.

Allergy medications are available in pill, liquid, nasal spray, eyedrop and skin cream (topical) forms. Some are available over-the-counter while others are available by prescription only.

The best medication or combination of medications for you depends on your symptoms, what other health conditions you have and what other medications you take. Certain allergy medications work better for some people than others. You may need to try a few different medications to determine which ones are most effective and have the least bothersome side effects.

To choose the best allergy medications for you, learn what's available to treat your symptoms — and work with your doctor to figure out what medications is best for you.

Options for allergy medications
There are several types of medications used to treat and prevent allergy symptoms. Medications are available in pill and liquid forms, nasal sprays, eyedrops and skin creams.

Corticosteroids help prevent and treat the inflammation associated with allergic conditions.
Antihistamines block histamine, an inflammatory chemical released by your immune system during an allergic reaction.
Decongestants relieve nasal and sinus congestion.
Leukotriene modifiers block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction.
Cromolyn sodium prevents the release of histamine, an inflammatory chemical released by your immune system during an allergic reaction.

Allergy treatment

2008-03-06T13:03:00.000-08:00

Allergy treatment

For Los Angeles resident Dorit Brunner, it began with a severe bout of the flu that developed into a sinus infection. What followed were weeks of stuffiness, congestion and sneezing. "It was like I had a constant cold," remembered Dorit about the onset of her allergy problem. Her symptoms are now under control, thanks to a host of effective new agents that relieve discomfort without the traditional side-effects.

"Now I'm fine," Dorit added. "When I start getting sinus problems, I take the medication right away -- otherwise, the stuffiness can kill me."

Too many people suffer needlessly with allergies, according to Zab Mohsenifar, M.D., director of the Division of Pulmonary/Critical Care Medicine at Cedars-Sinai Medical Center. In the Los Angeles area, allergy season begins in early to mid-March when pollens produced by a proliferation of blooming flowers, grasses and weeds attack allergy sufferers.

"If you can identify the offending agent and avoid it, that's great -- but not very realistic for most people," Dr. Mohsenifar explained. "There are now medications that are very, very effective in treating the symptoms of allergies without drowsiness."

For Dorit, that means taking the prescription antihistamine Zyrtec at the first signs of congestion and using Ventolin, a bronchodilator that "relaxes" the muscles around airways to make breathing easier. Though Dorit had no personal history of allergies until three years ago, she was aware of their disabling effects because her husband, Jesse, had struggled with severe allergies for years before finding effective treatment with Dr. Mosenifar's aid.

"For several years, I'd suffered along with my allergies," said Jesse. "Whole days would be wasted when I was inundated with a histamine response. I'd take over-the-counter antihistamines, but the side-effects were terrible. I was sleepy all the time and really felt miserable."

Now Jesse relies on Zyrtec as well when spring and summer arrive. "This works beautifully without any side-effects," he added.

Dr. Mohsenifar recommends treating rhinitus, or nasal congestion, with long-acting antihistamines that are available by prescription and, increasingly, over the counter, including Allegra and Claritin. Nasal sprays with cromolyn sodium such as Nasalcrom (available over the counter) can help prevent or reduce symptoms by blocking the production of histamines. People with allergy-triggered asthma can also benefit from these medications along with prescribed cortisone sprays, which contain steroids that reduce inflammation.

Though both Dorit and Jesse had undergone extensive allergy testing in years past, Dr. Mohsenifar does not suggest this as a first line of defense, except in very severe cases. "There is such a multitude of allergens -- and people can be sensitive to so many -- that it can be difficult to identify the specific agent causing the symptoms," he explained. "It's best to explore conventional means of treating the allergy with medication first and then, if still unmanageable, allergy testing can provide a second tier of investigation."

Despite the "good news" of more and better medications, the "bad news" is that allergies are here to stay -- and possibly on the rise.

"Studies suggest that the number of people with allergies is growing," said Dr. Mohsenifar. "Allergens are complex substances and, with the cross-breeding of plants and flowers, people are exposed to an increasing variety of agents that they may result in hypersensitivity." Which is why it's even more important to be aware of the medications available to help manage the signs and symptoms of allergy season, he stressed.