Dr. Curtis McElroy

Author: docmac

  • Autoimmune Hepatitis

    Autoimmune Hepatitis

    When white blood cells (lymphocytes) erroneously attack liver cells, they cause inflammation and damage to the liver. This results in the condition autoimmune hepatitis. There are two types of autoimmune hepatitis.

    Type 1 autoimmune hepatitis is the most common type of the disease. Although it can affect anyone of any age, it most commonly develops in women aged around 45.

    Type 2 autoimmune hepatitis primarily affects young girls between the ages of two and fourteen, and is much less common than type 1 hepatitis.

    In many cases of autoimmune hepatitis the symptoms develop gradually over weeks or months. Often at the time of diagnosis there are very mild symptoms, or no symptoms at all.

    How Is Autoimmune Hepatitis Diagnosed

    The presence of hepatitis is often discovered when patients are undergoing medical tests for unrelated disorders.

    Blood tests called liver function tests give a general guide as to whether the liver is inflamed and how well it is functioning. These tests are able to confirm the presence of hepatitis, but not the cause of the disease.

    Other tests and a liver biopsy are able to identify the type of cells involved in the inflammation. This can rule out other causes of the hepatitis, and help confirm the diagnosis of autoimmune hepatitis.

    Symptoms Of Autoimmune Hepatitis

    Symptoms can range from minor to severe, and can include fatigue, joint and muscle pain, feeling very unwell, vomiting and for women loss of menstruation. Jaundice can develop if inflammation is severe.

    Persistent untreated inflammation causes liver damage and may lead to scarring of the liver, a condition known as cirrhosis. This can result in serious problems and liver failure in severe cases.

    Complications Of Autoimmune Hepatitis

    Cirrhosis of the liver occurs when liver tissue is damaged, resulting in fibrosis, or scar tissue. In the early stages it rarely exhibits signs or symptoms of the disease, and worsens steadily over time. However as liver function gradually deteriorates , the problem becomes serious.

    Liver failure occurs when the extent of damage to liver cells prevents the liver from functioning adequately. A liver transplant usually becomes necessary.

    Treatment Of autoimmune Hepatitis

    With early and ongoing treatment for autoimmune hepatitis the prognosis is very good, and the disease is manageable if treatment protocols are followed.

    Early treatment helps to control inflammation and reduces the risk of complications. Long-term treatment can stop the disease from escalating and may even reverse some of the damage to the liver.

    Steroid medication (usually prednisolone) is the usual first treatment, as steroids are good at reducing inflammation. A high dose is usually needed for about the first month of treatment. To reduce the risk of side effects , the dose is gradually lowered over the next few months.

    Monitoring will allow the doctor to ultimately determine the lowest effective maintenance dose. Adding an immune system suppressor (azathioprine) also helps to avoid the side effects of prednisolone.

    Most people need to continue medication for one or two years. Even if there are periods of remission, the disease often reappears if the treatment is discontinued. Some people need to remain on medication for life.

    Causes Of Autoimmune Hepatitis

    Evidence suggests that a predisposition to autoimmune disease may run in families. Already having an autoimmune disease such as rheumatoid arthritis, Celiac or Grave’s disease could make you more likely to develop autoimmune hepatitis.

  • Alopecia (Hair Loss)

    Alopecia (Hair Loss)

    Alopecia areata is a skin condition which occurs as a result of our immune system mistakenly attacking our own healthy tissues. This creates a condition called autoimmune disease.

    Autoimmune disease can present itself in different ways, depending on which body part is affected. When the immune system damages the hair follicles the result is hair loss.

    One or more bald patches appear on the scalp. These patches are usually round in shape and the size of a large coin. Occasionally the beard, eyebrows, eyelashes or other body hair are also affected.

    Alopecia areata can occur at any age. However it usually affects children, teenagers and young adults. Research shows that the first attack of this disease usually happens before the age of 30.

    The Effect Of Alopecia Areata

    There is no scarring or physical pain associated with the condition, and the affected hair follicles are not destroyed. Often as one patch is regrowing another patch is appearing. Apart from the bald patches the scalp usually has a healthy appearance.

    Occasionally, there may be a slight redness, and a mild burning or itching feeling. The size of the bald patches and the time they last are variable.
    The condition can be embarrassing and very upsetting. The stress, especially on young boys, unable to hide the condition because of short hair, is severe.

    Surveys have found the suicide rate among these young sufferers higher than would be expected. This is especially tragic, considering the disease affects the appearance rather than physical health.

    Treatment For Alopecia Areata

    When there are only one or two small bald patches, no treatment is the common option. Bald patches in mild cases often regrow hair in a matter of months. When less than half of the scalp Is affected, doctors’ advice is usually to wait and see
    .
    The chances of hair regrowth within one year, without treatment, for this group is 8 out of 10. One or more recurrences of alopecia areata is common for sufferers. This is the case even if full regrowth of hair occurs after the first episode.

    When complete baldness is the result of autoimmune disease, it is called alopecia areata totalis. When the same condition causes the loss of all head hair, together with all body hair, it is called alopecia areata universalis. These types of hair loss tend to be long lasting, even permanent.

    However, with the uncertainty of this disease there is no way of predicting if the hair loss will be temporary or permanent. Regardless of how much hair is lost, follicles remain alive. Hair regrowth may occur, after many years, even without treatment.

    What Causes Alopecia Areata

    Scientists do not know what the trigger is that causes autoimmune disease to start and stop, or why the immune system suddenly disrupts the normal functioning of the hair follicles.

    They believe that heredity plays a part, but is not the only answer. Studies show there is a loose genetic correlation and that 20% of people with this condition have a close family member with the disease.

    Researcher also suggests that viruses, infections, medicines and environmental factors are all possible causes. Stress is also believed to have an impact.

    Scientists keep searching for the elusive trigger. Its discovery will allow sufferers to avoid relapses. However no dietary or lifestyle modification has yet been found.

    Current treatments do not turn alopecia areata off. Although they stimulate the hair follicles and produce hair again, treatments need to be continued until the disease turns itself off.

  • Setting Realistic Fitness Goals

    How to Know Whether Your Fitness Goals Are Unrealistic

    Setting a new fitness goal can be exciting and add a new spark to a dying fitness flame, but sometimes we get too exuberant and overestimate our abilities. We want to challenge ourselves with a new and loftier goal, but sometimes we expect more out of ourselves that we can deliver. When that happens, it is time to re-evaluate our goal and make it more realistic.

    So how do you know if your fitness goal is unrealistic? Usually if any of these three things happen, it is time to scale back and re-adjust:
    • You are not making progress toward your goal.
    • You are sore beyond expectations.
    • Your desire to workout is waning or you have stopped exercising altogether.

    Let’s look at each one of these in more detail.

    Not making progress

    If you have been sticking to your workout and eating schedule, but still not making acceptable progress toward your goal, it is time to look at your program to see what changes need to be made.

    What you do depends on your goal. For example, if you want to lose weight, then the calories you eat must be less than the number of calories you burn. Aim for a 500-calorie per day deficit. Doing so should result in about a 1-pound weight loss per week. But first, you must know how many calories you are eating and how many you’re burning.

    Read nutritional labels or search online for calorie-per-serving numbers. Calculate your AMR or Active Metabolic Rate to figure out how many calories you are burning per day based on your metabolism and workout schedule. This give you an idea of where you need to make changes.

    Sore beyond expectations

    When first starting a new workout, expect some soreness to set in around 24 to 48 hours after first exercising. The soreness should be mildly irritating. However, if you are too sore to get up off the couch or must walk down a flight of stairs sideways, it is a good indication you need to change your routine to something less demanding for now and gradually work up to the level of exercise you first set as your goal. Rome wasn’t built in a day, nor should you expect to reach a lofty fitness goal the first time out of the chute. Set up a progressive schedule and slowly work your way up to where you want to be.

    Waning desire

    If you no longer have the excitement you first had when you started working out, it could be you need a change in your end goal or the road to get you there.

    Perhaps your goal now seems too far away and unreachable. Or maybe you need some variety in your workout. Look at your goal.
    If it is still measurable, attainable and realistic, then set up milestones or “mini-goals” along the way that once reached, can be celebrated. Each smaller goal accomplished gets you closer to your end goal.

    If you suffer from any of the three unrealistic goal indicators, look to change whatever it is that is holding you back. Success can be right around the corner, if you want it bad enough.

Copyright @ 2017 DrCurtisMcElroy