How Dental Health Affects Overall Health

How Dental Health Affects Overall Health

How Dental Health Affects Overall Health

In this episode, we would like to talk about dental health. Many people don’t know that dental health provides valuable information on someone’s overall health.

Today we know that most chronic illnesses are not down to coincidence, bad luck, or bad genes. Instead, they are the result of constant, silent inflammation in the body and the resulting chronic stress. This kind of inflammation often occurs in the mouth.

It can be found hiding in the tips of inflamed tooth roots, gingival pockets, around implants, in dead teeth, or in the cavities that are left behind whenever a tooth has to be removed.

Although research is constantly revealing new relationships between teeth and the body, doctors and dentists work in two different spheres, our medical care system is structured such that we can’t see the forest for the trees.

Importance of Dental Health

Looking inside someone’s mouth gives clues to their overall health. Did you know that many problems can stem from poor oral health? Good oral health gives a person the ability to speak, smile, smell, taste, touch, chew, swallow, and impacts facial expressions to show feelings and emotions.

Just like in other parts of the body, the mouth houses a lot of beneficial bacteria. But remember that the mouth is the initial entry point into the rest of your body and sometimes these bacteria make a home elsewhere where they can cause damage.  Proper oral hygiene keeps these bacteria in stable conditions.

What Contributes to Poor Dental Health

Untreated tooth decay. More than 1 in 4 (26%) adults in the United States have untreated tooth decay. Gum disease. Nearly half (46%) of all adults aged 30 years or older show signs of gum disease; severe gum disease affects about 9% of adults [1].

The main factors that cause oral health are:

  • Poor hygiene
  • Diet high in sugar
    • Sugar changes the acidity in your mouth.
      • There are 2 bacteria, streptococcus mutants, and streptococcus sobrinus. These bacteria feed on sugar and create plaque on your teeth. When you get your teeth cleaned your dentist removes this plaque. If left unchecked this plaque will eat away at your enamel.
      • Sugar also attracts bacteria that eat away at your gums and cause gingivitis and gum disease [2].
  • Alcohol use
    • Alcohol drinks are usually high in sugar like beer, liquor, and mixed drinks. This leads to the breakdown of enamel, long-term tooth decay, and gum disease.
    • Alcohol also decreases the amount of natural saliva that acts as a natural antibacterial agent. 
    • Depending on what alcohol you consume it can stain your teeth. 
    • Normal Saliva PH: 6.2-7.6
  • Smoking 
    • Smoking weakens your body’s infection fighters (your immune system). This makes it harder to fight off a gum infection. Once you have gum damage, smoking also makes it harder for your gums to heal.
      • You have twice the risk for gum disease compared with a nonsmoker.
      • The more cigarettes you smoke, the greater your risk for gum disease.
      • The longer you smoke, the greater your risk for gum disease.
      • Treatments for gum disease may not work as well for people who smoke.

Prevention

  • Proper oral hygiene
  • A well-balanced diet low in free sugars and high in fruit and vegetables, and water as the main drink;
  • Stopping the use of all forms of tobacco, including chewing
  • Reducing alcohol consumption
  • encouraging the use of protective equipment when doing sports.

What Conditions are Linked to Oral Health

Your oral health might contribute to various diseases and conditions, including:

Endocarditis

This infection of the inner lining of your heart chambers or valves (endocardium) typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to certain areas in your heart.

  • The study looked at 94 participants where participant’s portal hygiene, gingivitis, and periodontitis statuses were evaluated. 
  • The authors found that oral hygiene and gingival disease indexes were associated significantly with IE-related bacteremia after toothbrushing.
  • Participants with a mean plaque and calculus scores of 2 or greater were at a 3.78- and 4.43-fold increased risk of developing bacteremia, respectively.
  • The presence of generalized bleeding after toothbrushing was associated with an almost eightfold increase in the risk of developing bacteremia [3]. 

Cardiovascular Disease

 Although the connection is not fully understood, some research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections that oral bacteria can cause.

There are a few theories on why this can occur, according to Harvard: 

  • The bacteria that infect the gums and cause gingivitis and periodontitis also travel to blood vessels elsewhere in the body where they cause blood vessel inflammation and damage; tiny blood clots, heart attack, and stroke may follow.
  • Supporting this idea is the finding of remnants of oral bacteria within atherosclerotic blood vessels far from the mouth.
  • Rather than bacteria causing the problem, it’s the body’s immune response – inflammation – that sets off a cascade of vascular damage throughout the body, including the heart and brain.
  • There may be no direct connection between gum disease and cardiovascular disease; the reason they may occur together is that there is a 3rd factor (such as smoking) that’s a risk factor for both conditions.
  • Other potential “confounders” include poor access to healthcare and lack of exercise – perhaps people without health insurance or who don’t take good care of their overall health are more likely to have poor oral health and heart disease [4].

Pregnancy and birth complications

Periodontitis has been linked to premature birth and low birth weight.

  • Nearly 60 to 75% of pregnant women have gingivitis, an early stage of periodontal disease that occurs when the gums become red and swollen from inflammation that may be aggravated by changing hormones during pregnancy.
  • If gingivitis is not treated, the bone that supports the teeth can be lost, and the gums can become infected. Teeth with little bone support can become loose and may eventually have to be extracted.
  • Periodontitis has also been associated with poor pregnancy outcomes, including preterm birth and low birth weight. However, how periodontitis may lead to adverse pregnancy outcomes is not yet fully understood [5].
  • One systematic review looked at periodontal status looked at 22 totaling about 17,00 subjects and concluded that “The present systematic review reported a low but existing association between periodontitis and adverse pregnancy outcomes.” [6].

Pneumonia

Certain bacteria in your mouth can be pulled into your lungs, causing pneumonia and other respiratory diseases.

  • A study looked at over 122,000 participants with no history of pneumonia with a median age of 52.4.
  • The mean systolic blood pressure and fasting glucose were 125.5 mmHg and 96.7 mg/dL. While 49.6% of participants had periodontal disease, 2.7% and 6.0% had five or more dental caries and missing teeth, respectively. 
  • According to the self-reported questionnaires, 45.0% of participants brushed their teeth three times or more per day, and 26.0% replied having professional dental cleaning at least once per year.

It concluded that:

The risk of pneumonia was higher in groups with more dental caries and missing teeth. In contrast, the risk of pneumonia was lower in the frequent tooth brushing group and the regular professional dental cleaning group. 

  • There was no significant difference in the risk of pneumonia between groups with and without periodontal disease. 
  • A number of dental caries and missing teeth, and the frequency of tooth brushing and professional dental cleaning, were associated with the incidence of pneumonia. 
  • The risk of pneumonia was significantly higher in the group with a higher number of dental caries and the group with more missing teeth. 
  • Risks of pneumonia decreased significantly in the frequent tooth brushing group and the regular professional dental cleaning group [7].

Fluoride: Is it the best means of fighting tooth decay?

Fluoride is considered an essential part of dental care. Almost all toothpaste contains it. Roughly 73.0% of the U.S. population with public water access in 2018 received water fortified with fluoride. In Germany, however, no fluoride is added to drinking water—and yet rates of tooth decay have dropped.

Fluoride can store and lock calcium and other minerals in tooth enamel, which sounds like a beautiful, helpful attribute. But just like many things, it also comes with unwanted side effects.

There are ongoing studies linking fluoride to chromosomal changes, bone cancer, and impairments to intelligence, while many other studies declare its innocence of these allegations.

The concept of holistic dentistry is based on avoiding overburdening the body with artificial substances as far as possible. If we eat well and get all the nutrients we need, there is no need for additional fluoride. Saliva’s job is to store minerals in teeth. That is its natural function, and it does not require extra fluoride to get the job done.

Tough Foods Make You Tougher 

Chewing food is easier to digest. But did you know that adequately chewing our food can protect us from infections? Researchers recently discovered this when they took a closer look at what is known as Th17 cells in our mouths.

These cells are part of the immune system and can ward off harmful bacteria to our health while leaving friendly bacteria in peace.

Furthermore, Th17 cells form in the mouth, so the more we chew, the more cells are produced. In addition to this, eating foods with a more rigid consistency, or simply chewing well, ensures a better immune defense in the mouth.

Good Dental Hygiene Practices

Taking care of your oral health may take a lot of effort. However, if you add them to your daily routine and practice them daily, it will not feel like a chore but more of a natural habit. Here’s how you can practice good dental hygiene:

  1. Brush your teeth twice a day
  2. Use mouthwash daily
  3. Floss daily
  4. Drink more water
  5. Eat more crunch fruits and vegetables
  6. See your dentist twice a year

Watch the full episode on this by clicking here:

TIME STAMPS:

0:00 Introduction
1:00 Sponsor Ads
2:15 Cup of Nurses Introduction
4:04 Episode Introduction
6:36 Importance of Dental Health
10:44 Statistics About Gum Disease
13:28 What Contributes To Poor Dental Health
13:39 Sugar changes the acidity in your mouth!
15:42 How Alcohol Affects Dental Health
18:08 How Smoking Affects Dental Health
21:59 How to Prevent Poor Dental Health
22:45 Conditions Linked to Bad Oral Health: Endocarditis
23:23 Study About People with Endocarditis
25:13 Conditions Linked to Bad Oral Health: Cardiovascular Disease
28:24 Conditions Linked to Bad Oral Health: Pregnancy & Birth Complications
31:51 Conditions Linked to Bad Oral Health: Pneumonia
37:36 Fluoride: The best means of fighting tooth decay?
44:13 Tough Foods Make You Tougher

Heart Health – #1 Killer in America

Heart Health – #1 Killer in America

Heart Health – the No. 1 Killer in America

What is Cardiovascular Disease?

Taking care of your heart health is essential so you can avoid developing cardiovascular diseases. Cardiovascular disease can refer to a number of conditions. These are the following [1]:

Heart Disease

Heart and blood vessel disease (also called heart disease). It includes many problems, many related to atherosclerosis.
 
Atherosclerosis is when plaque builds up in the walls of the arteries. Also, the buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow, which can cause a heart attack or stroke.

Heart Attack

A heart attack occurs when a blood clot blocks the blood flow to a part of the heart. If this clot cuts off the blood flow completely, the role of the heart muscle supplied by that artery begins to die.
 
Most people survive their first heart attack and return to their everyday lives. But experiencing a heart attack does mean that you need to make some changes.
 
The medications and lifestyle changes that your doctor recommends may vary. This depends on the damage to your heart and to what degree heart disease caused the attack.
 
A complete blockage of a coronary artery means you suffered a “STEMI” heart attack. It is also known as ST-elevation myocardial infarction. Partial blockage is an “NSTEMI” heart attack or a non-ST-elevation myocardial infarction.
  • Angioplasty: Special tubing with an attached deflated balloon is threaded up to the coronary arteries.
  • Angioplasty, Laser: Similar to angioplasty except that the catheter has a laser tip that opens the blocked artery.
  • Artificial heart valve surgery: Replaces an abnormal or diseased heart valve with a healthy one.
  • Atherectomy: Similar to angioplasty except that the catheter has a rotating shaver on its tip to cut away plaque from the artery.
  • Bypass surgery: Treats blocked heart arteries by creating new passages for blood to flow to your heart muscle.
  • Cardiomyoplasty: An experimental procedure in which skeletal muscles are taken from a patient’s back or abdomen.
  • Heart transplant: Removes a diseased heart and replaces it with a donated healthy human heart.
  • Radiofrequency ablation: A catheter with an electrode at its tip is guided through the veins to the heart muscle to destroy carefully selected heart muscle cells in a very small area.
  • Stent procedure: A stent is a wire mesh tube used to prop open an artery during angioplasty.
  • Transmyocardial revascularization (TMR): A laser is used to drill a series of holes from the outside of the heart into the heart’s pumping chamber.

Stroke

An ischemic stroke (the most common type) occurs when a blood vessel that feeds the brain gets blocked. It is usually from a blood clot.
 
When the blood supply to a part of the brain is cut off, some brain cells will begin to die. It can lose functions controlled by that part of the brain, such as walking or talking.
 
A hemorrhagic stroke occurs when a blood vessel within the brain bursts. It is most often caused by uncontrolled hypertension (high blood pressure).
 
Some effects of stroke are permanent if too many brain cells die after lacking oxygen. These cells are never replaced.
 
The good news is that sometimes brain cells don’t die during the stroke — instead, the damage is temporary. Over time, as injured cells repair themselves, impaired function improves. (In other cases, intact brain cells nearby may take over for the damaged brain areas.)
 
Either way, strength may return, speech may improve, and memory may improve. This recovery process is what stroke rehabilitation is all about.
 

Treatment

Gold standard treatment is tissue plasminogen activator, r-tPA (alteplase). It is given 3 hrs after the last normal some situations allow for 4.5 hrs.
 
Another treatment is called an endovascular procedure or a mechanical thrombectomy. It is a recommended option that can help remove a clot in eligible patients. Those with a large vessel occlusion or LVO are usually prioritized.
 
In this procedure, doctors use a wire-cage device called a stent retriever. They thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot. Special suction tubes may also remove the clot.

Heart Failure

Heart failure is sometimes called congestive heart failure. It means the heart isn’t pumping blood as well as it should. But, heart failure does not mean that the heart stops beating — that’s a common misperception.
 
Instead, the heart keeps working, but the body’s need for blood and oxygen isn’t met. Heart failure can get worse if left untreated. If your loved one has heart failure, it’s vital to follow the doctor’s orders.

Treatments

  • Coronary bypass surgery. Blocked arteries can cause heart failure. To clear this, your doctor may recommend coronary artery bypass surgery. The procedure involves taking a healthy blood vessel from your leg, arm, or chest. The blood vessel is then connected below and above the blocked arteries Omit heart. This new pathway improves blood flow to your heart muscle.
  • Heart valve repair or replacement. If a faulty heart valve causes your heart failure, the valve needs to be repaired or replaced. Surgeons can repair the valve by reconnecting valve flaps. It can also be by removing excess valve tissue so that the leaflet closes. Sometimes, fixing the valve includes tightening or replacing the ring around the valve.
  • Implantable cardioverter-defibrillators (ICDs). An ICD is used to prevent complications of heart failure. It isn’t a treatment for heart failure itself, but it is like a pacemaker. It is implanted under the skin in your chest with wires leading through your veins and into your heart.
  • The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if the heart stops. When the heart stops, this device will try to pace your heart or shock it back into normal rhythm. An ICD can also work as a pacemaker and speed your heart up if it is going too slow.
  • Cardiac resynchronization therapy (CRT). Also called biventricular pacing. CRT is a treatment for heart failure in people whose lower heart chambers (ventricles) aren’t pumping in sync. A biventricular pacemaker sends electrical signals to the ventricles. It signals your ventricles to contract. This will trigger the ventricles to contract in a more coordinated way. It improves blood pumping out of your heart, and CRT may be used with an ICD.
  • Ventricular assist devices (VADs). — also known as a mechanical circulatory support device. It is a device that helps pump blood from the lower chambers of your heart (ventricles) to the rest of your body. Although a VAD can be placed in one or both ventricles of your heart, it is most implanted in the left ventricle.
    • The doctor may recommend a VAD if you wait for a heart transplant. In some cases, VAD is used as a permanent treatment for people who have heart failure. But those who aren’t good candidates for a heart transplant are first in line.
  • Heart transplant. Some people have severe heart failure, that surgery or medications don’t help. These people may need to have their hearts replaced with a healthy donor heart.
 
Medications
  • Angiotensin-converting enzyme (ACE) inhibitors. These drugs relax blood vessels to lower blood pressure, improve blood flow and decrease the strain on the heart. Examples include enalapril (Vasotec, Epaned), lisinopril (Zestril, Qbrelis, Prinivil), and captopril.
  • Angiotensin II receptor blockers. These drugs, which include losartan (Cozaar), valsartan (Diovan), and candesartan (Atacand), have many of the same benefits as ACE inhibitors. They may be an option for people who can’t tolerate ACE inhibitors.
  • Beta-blockers. These drugs slow your heart rate and reduce blood pressure. Beta-blockers may reduce signs and symptoms of heart failure, improve heart function, and help you live longer. Examples include carvedilol (Coreg), metoprolol (Lopressor, Toprol-XL, Kapspargo Sprinkle), and bisoprolol.
  • Diuretics. Often called water pills, diuretics make you urinate more frequently and keep fluid from collecting in your body. Diuretics, such as furosemide (Lasix), also decrease fluid in your lungs to breathe more easily.
    • Because diuretics make your body lose potassium and magnesium, your doctor may also prescribe supplements of these minerals. If you’re taking a diuretic, your doctor will likely monitor potassium and magnesium levels in your blood through regular blood tests.
  • Aldosterone antagonists. These drugs include spironolactone (Aldactone, Carospir) and eplerenone (Inspra). They are potassium-sparing diuretics with additional properties that may help people with severe systolic heart failure live longer.
    • Diuretics like spironolactone and eplerenone can raise the potassium in your blood to dangerous levels. Talk to your doctor if this is a concern so you can modify your intake of food high in potassium.
  • Positive inotropes. These medications may be given by IV to people with certain types of severe heart failure who are in the hospital. Positive inotropes can help the heart pump blood more effectively and maintain blood pressure. Long-term use of these drugs has been linked to an increased risk of death. Talk to your health care provider about the benefits and risks of these drugs.
    • Dobutamine and milrinone are the most common. 
  • Digoxin (Lanoxin). This drug, also called digitalis, increases the strength of your heart muscle contractions. It also tends to slow the heartbeat. Digoxin reduces heart failure symptoms in systolic heart failure. It may be more likely to be given to someone with a heart rhythm problem, such as atrial fibrillation.
  • Hydralazine and isosorbide dinitrate (BiDil). This drug combination helps relax blood vessels. It may be added to your treatment plan if you have severe heart failure symptoms and ACE inhibitors or beta-blockers haven’t allowed.
  • Vericiguat (Verquvo). This newer medicine for chronic heart failure is taken once a day by mouth. It’s a type of drug called an oral soluble guanylate cyclase (sGC) stimulator. In studies, those with high-risk heart failure who took vericiguat had fewer hospital stays for heart failure and heart disease-related deaths than those who received an inactive pill (placebo).

Arrhythmia

Arrhythmia refers to an abnormal heart rhythm. There are various types of arrhythmias. The heart can beat too slow, too fast, or irregularly.

Bradycardia, or a heart rate that’s too slow, is when the heart rate is less than 60 beats per minute. Tachycardia, or a heart rate that’s too fast, refers to a heart rate of more than 100 beats per minute.

An arrhythmia can affect your heart health and how it works. With an irregular heartbeat, your heart may not be able to pump enough blood to meet your body’s needs.

Treatment

  • Vagal maneuvers. If you have a very fast heartbeat due to supraventricular tachycardia, your doctor may recommend this therapy. Vagal maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. For example, you may be able to stop an arrhythmia by holding your breath and straining, dunking your face in ice water, or coughing. Vagal maneuvers don’t work for all types of arrhythmias.
  • Cardioversion. This method to reset the heart rhythm may be done with medications or as a procedure. Your doctor may recommend this treatment if you have a certain type of arrhythmia, such as atrial fibrillation.
    • During the cardioversion procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
  • Catheter ablation. In this procedure, the doctor threads one or more catheters through the blood vessels to the heart. Electrodes at the catheter tips use heat or cold energy to create tiny scars in your heart to block abnormal electrical signals and restore a normal heartbeat.
  • Pacemaker. If slow heartbeats (bradycardias) don’t have a cause that can be corrected. Doctors often treat them with a pacemaker because there aren’t any medications that can reliably speed up the heart.
    • A pacemaker is a small device that’s usually implanted near the collarbone. One or more electrode-tipped wires run from the pacemaker through the blood vessels to the inner heart. If the heart rate is too slow or if it stops, the pacemaker sends out electrical impulses that stimulate the heart to beat at a steady rate.
  • Implantable cardioverter-defibrillator (ICD). Your doctor may recommend this device if you’re at high risk of developing a dangerously fast or irregular heartbeat in the lower heart chambers (ventricular tachycardia or ventricular fibrillation). If you have heart health issues, had a sudden cardiac arrest, or have certain heart conditions that increase your risk of sudden cardiac arrest, your doctor may also recommend an ICD.
    • An ICD is a battery-powered unit that’s implanted under the skin near the collarbone — similar to a pacemaker. One or more electrode-tipped wires from the ICD run through veins to the heart. The ICD continuously monitors your heart rhythm.
    • If the ICD detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. An ICD doesn’t prevent an irregular heart rhythm from occurring, but it treats it if it occurs.
  • Maze procedure. In the maze procedure, a surgeon makes a series of incisions in the heart tissue in the upper half of your heart (atria) to create a pattern (or maze) of scar tissue. Because scar tissue doesn’t conduct electricity, it interferes with stray electrical impulses that cause some types of arrhythmia.
    • The maze procedure is usually reserved for people who don’t get better with other treatments or who are having open-heart surgery for other reasons.
  • Coronary bypass surgery. If you have severe coronary artery disease in addition to heart arrhythmia, your doctor may perform coronary bypass surgery. This procedure may improve the blood flow to your heart. Because of this, your heart health may be compromised. 

Heart valve problems

Once your heart health goes down, problems arise. When heart valves don’t open enough to allow the blood to flow through as it should, a condition called stenosis results.

When the heart valves don’t close properly and allow blood to leak through, it’s called regurgitation. If the valve leaflets bulge or prolapse back into the upper chamber, it’s a condition called prolapse. 

Treatment

  • Heart valve repair: Patch holes in a valve. Separate valve leaflets that have fused. Replace the cords that support the valve. Remove excess valve tissue so that the valve can close tightly.
    • Surgeons often tighten or reinforce the ring around a valve (annulus) by implanting an artificial ring. In some cases, doctors use less invasive procedures to repair certain valves using long, thin tubes (catheters). These procedures can involve clips, plugs, or other devices.
  • Heart Valve Replacement: If the valve is not repaired, surgeons might remove the damaged valve and replace it with a mechanical valve. It can also be a valve made from cow, pig, or human heart tissue (biological or tissue valve).
    • If you had valve replacement with a mechanical valve, you’d need to take blood thinners to prevent blood clots for the rest of your life. Biological tissue valves break down over time and usually need to be replaced.
    • A minimally invasive procedure called transcatheter aortic valve replacement (TAVR) may be used to replace a damaged aortic valve. In this procedure, the doctor inserts a long, thin tube (catheter) into an artery in your leg or chest and guides it to the heart valve. A replacement valve is moved through this catheter to the correct position.

Types of Cardiac Medications for Your Heart’s Health

  • Anticoagulant – is used to treat specific blood vessel, heart, and lung conditions.
  • Antiplatelet agent – keeps blood clots from forming by preventing blood platelets from sticking together.
  • Angiotensin-converting enzyme (ACE) inhibitor – expands blood vessels and decreases resistance by lowering levels of angiotensin II. Allows blood to flow more easily and makes the heart’s work easier or more efficient.
  • Beta-blocker: Decreases the heart health rate and cardiac output, lowering blood pressure and making the heartbeat more slowly, with less force.
  • Angiotensin II receptor blocker – rather than lowering levels of angiotensin II (as ACE inhibitors do), angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This medication keeps blood pressure from rising.
  • Combined alpha and beta-blocker: Combined alpha and beta-blockers are used as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure.
  • Angiotensin receptor neprilysin inhibitor: Neprilysin is an enzyme that breaks down natural substances in the body that open narrowed arteries. By inhibiting neprilysin, those natural substances can have their usual effect. That improves artery opening and blood flow, reduces sodium (salt) retention, and decreases strain on the heart.
  • Calcium channel blocker Interrupts the movement of calcium into the heart and blood vessel cells. May decrease the heart’s pumping strength and relax the blood vessels.
  • Cholesterol-lowering medications: Various medications can lower blood cholesterol levels, but statins are the best first course of action. Other drugs may be recommended when statins prove ineffective or if a patient experiences severe side effects from statin therapy.
  • Digitalis preparation: Increases the force of the heart’s contractions, which can be beneficial in heart failure and for irregular heartbeats.
  • Diuretics: Cause the body to rid itself of excess fluids and sodium through urination. Help to relieve the heart’s workload. Diuretics also decrease fluid buildup in the lungs and other parts of the body, such as the ankles and legs. Different diuretics remove fluid at varied rates and through various methods.
  • Vasodilator: Relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload. Available as pills to be swallowed, chewable tablets, and a topical application (cream).

Fact Sheet – Heart Disease

Taking care of your heart health is essential. Remember that heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States [2].

  • There are about 3 million deaths in the US.
  • Cardiovascular disease alone accounts for almost 1/4th of the total deaths in the US. 
  • One person dies every 36 seconds in the United States from cardiovascular disease.
  • Heart disease cost the United States about $363 billion each year from 2016 to 2017. It includes the cost of heart health care services, medicines, and lost productivity due to death.

Coronary Artery Disease

  • Coronary heart disease is the most common type of heart disease, killing 360,900 people in 2019.
    • About 18.2 million adults age 20 and older have CAD (about 6.7%).
    • About 2 in 10 deaths from CAD happen in adults less than 65 years old.

Heart Attacks

In the United States, a person suffers from a heart attack every 40 seconds.

  • Every year, about 805,000 people in the United States have a heart attack. Of these,
    • 605,000 are a first heart attack
    • 200,000 happen to people who have already had a heart attack
    • About 1 in 5 heart attacks are silent—the damage is done, but the person is not aware of it.
Race of Ethnic Group % of Deaths Men, % Women, %
American Indian or Alaska Native 18.3 19.4 17.0
Asian American or Pacific Islander 21.4 22.9 19.9
Black (Non-Hispanic) 23.5 23.9 23.1
White (Non-Hispanic) 23.7 24.9 22.5
Hispanic 20.3 20.6 19.9
All 23.4 24.4 22.3

Cardiovascular Disease Beyond Death

Cardiovascular disease isn’t something that just happens one day and death follows it the next. It is a chronic heart health condition that gets worse over time. Often times it can be managed and people can live active and great lives even when they have comorbidity.

Cardiovascular disease is not a death sentence but when it is not managed properly, it can be a problem[3]. According to heart.org, almost half of the US population has some type of cardiovascular disease. 

    • According to 2017 figures, 116.4 million people had hypertension, almost half of the US population at that time, and that is just hypertension alone.
    • Cardiovascular disease is such an issue that the AHA had to lower its guidelines for what hypertension is from 140/90 to 130/80 so that people can get treated sooner.
  • 1 in 5 Americans reported having adequate aerobic exercise and muscle-strengthening activity to meet the physical activity guidelines.
  • Estimates for 2035 are showing that more than 130 million people will have some form of cardiovascular disease and the total cost to the healthcare system would be $1.1 trillion. 

Activity Guidelines for Your Heart Health

Key Guidelines for Adults

    • Adults should move more and sit less throughout the day. Some physical activity is better than none. Those people who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
  • For substantial heart health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic exercise. Preferably, aerobic activity should be spread throughout the week.
  • Additional heart health benefits are gained by engaging in physical activity beyond 300 minutes (5 hours) of moderate-intensity physical activity a week.
  • Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups two or more days a week. These activities provide additional heart health benefits.

Key Guidelines for Older Adults

The fundamental guidelines for adults also apply to older adults. In addition, the following vital guidelines are just for older adults [4]:

    • Older adults should do multicomponent physical activity as part of their weekly physical activity that includes balance training and aerobic and muscle-strengthening exercises.
    • Senior adults should determine their level of effort for physical activity relative to their fitness level.
    • Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.

Aging adults cannot do 150 minutes of moderate-intensity aerobic activity weekly because of chronic conditions. They should be as physically active as their abilities and needs allow. 

Diets Effects on Cardiovascular Disease

Trans Fats

Artificial trans fats or trans fatty acids are created in the industrial food-making process. By adding hydrogen to liquid vegetable oils, making them more solid [5]. Restaurants and certain food businesses use trans fats because they make food taste better and improve texture. The oils can be reused many times over. 
 
Although the FDA has guidelines on how much trans fats are allowed, they are not illegal to use. The FDA has stated that hydrogenated oils are not generally recognized as safe. Heart.org recommends ideal 2 grams or less, the closer to 0, the better. 

Trans Fat in Our Diet

The FDA also does not require to list trans fats if the product contains <0.5g. So, if you think about it, some of the products can have 0.4g, and through your diet, the total can add up to well over the 2g recommendation. 

Common foods that have trans fats:

  • Fast food
  • Doughnuts
  • baked goods 
  • pie crusts
  • Biscuits
  • frozen pizza
  • Cookies
  • Crackers
  • margarine and other spreads
There are naturally occurring trans fats like those in dairy and milk products. Keep in mind those are occurring and also in small amounts. There’s no research on the difference between artificial trans fats and occurring ones. 
 
One study looked at trans fat consumption in Iranian homes [6]. A study was done on 35,924 individuals and looked at their trans fat consumption. This consumption showed an association with heart health and coronary artery diseases.
 
It concluded that the average intake of trans fats was about 14g/1000 kcal. Trans fatty acids is accounted for 33% of fatty acid consumption. They concluded that 39% of coronary heart health events could have been prevented if unsaturated fatty acids had replaced them

To watch the full episode of Ep. 85, check out the whole video here 👇👇👇

TIME STAMPS:

0:00 Introduction
0:52 Sponsor Ads
2:01 Cup of Nurses Introduction
2:30 Episode Introduction
2:46 What is Cardiovascular Disease?
5:36 Heart Disease
9:50 What happens in the hospital when you get a heart attack?
26:00 What are the 2 types of stroke?
28:32 Treatments for Stroke
31:58 Heart Failure
32:20 When does heart failure happen?
34:48 Treatments for Heart Failure
48:00 Medications for Heart Failure
54:41 What is Arrhythmia?
55:03 Treatments for Arrhythmia
1:04:10 Heart Valve Problems
1:06:12 Treatments for Heart Valve Problems
1:07:01 Types of Cardiac Medications
1:11:58 Fact sheet – Heart Disease
1:14:49 Probability of Heart Attack Based on Ethnicity Group
1:17:47 Activity Guidelines for Adults
1:21:25 Diets Affecting Cardiovascular Disease

The Power of Your Mitochondria

The Power of Your Mitochondria

The Powerhouse of the Body – Mitochondria

The power of your mitochondria plays an important role in your body. You have memorized what a mitochondrion is, but do you know about the power of your mitochondria? Has anyone ever asked you, “How are you taking care of your mitochondria?” 
 
You may remember from high school biology that all human cells have a nucleus. And nucleus contains our genetic blueprint (DNA). But do you remember much about mitochondria? 
 
We can say that Humans generate and use electricity. These so-called power stations of the cell convert nutrients into energy. They are the foundational generators that provide every living cell, and ourselves. It is the energy we need to move, adapt and evolve. 
 
Chemical energy produced by the mitochondria is stored in a small molecule. These are called adenosine triphosphate (ATP). Mitochondria contain their small chromosomes.
 
Generally, mitochondria, and thus mitochondrial DNA, are inherited only from the mother.
 
Where did the mitochondria derive from? One theory behind where this small but mighty organelle came from was no further than the bacteria in our environment [1]
 
Unlike the microbes that thrive in our gut, scientists believe that we evolved a close companionship with bacteria. This bacteria could tap into a far more efficient energy production model than our far-off microscopic ancestors.
 
 
 

Facts and Functions of Mitochondria

Fun fact: 

Mitochondria is the only other organelle in the cell (outside the nucleus) to contain a copy of your genetic code. 

Scientists have been inspired to improve their knowledge about mitochondria. They have also studied its function outside energy production using that knowledge. It turns out that mitochondria are multifunctioning organelles. 

Functions:

  • ​​Play a vital role in the aging process, and most age-related diseases
  • Are vital to cell health, including regulating how nutrients get into individual cells
  • Help maintain the integrity of a cell – The energy it produces is used for growth and cell functions but is also targeted to help heal and recycle other outdated parts.
  • They help in the immune function – help activate various antiviral and anti-inflammatory pathways to help fight pathogens.
  • Regulating cell death – is an essential system designed to help destroy infected or damaged cells.

Clearly, without a healthy set of mitochondria, your ability to lead a healthy life can be significantly reduced. It is why establishing a healthy, resilient line of mitochondria is so important to optimize your well-being.

Here are a few tips you can take away to improve the power of your mitochondria [2]

1. Get active

Fun fact, you can increase the number of mitochondria within you simply through regular exercise. When your body notices a new routine in your fitness, it works to generate more energy and helps your body to adapt to changes in stress and the environment.

Abundance in the power of your mitochondria means more stamina and the more remarkable ability to allocate resources to healing after a heavy workout. 

2. Eat the right foods

Your diet is so crucial to mitochondrial health. The key is to eat enough nutrient-rich foods. Think about it this way; you’re gathering and improving natural resources used to create energy.

It provides access to antioxidants that help neutralize the toxic by-products associated with normal energy production. 

3. Decrease inflammation

Inflammation can have a very destructive effect on your mitochondria. Inflammation issues may stem from gut dysbiosis that can promote an inflamed state within your body.
 
Changing your diet can help balance your gut and adjust the inflammatory levels inside you [2]
 
Scientists found out that the mitochondria change their role during the inflammatory state. Enzymes change as the production of reactive oxygen species increases. In return, this damages the cell structures.

4. Focus on Quality Sleep

The mitochondria are such incredible organelles. They are essential in establishing healthy sleep habits. Aim for 7-8 hours of sleep and learn more about practicing good sleep hygiene. ​​
 
Less than seven hours of sleep a night can reduce so-called mitochondrial DNA copies in the participants’ blood cells. Mitochondria are like the power source of a blood cell.
 
Cells function much better when more mitochondrial DNA copies are available [3].
 
A new study based on 30 pairs of twins suggests that less than seven hours of sleep is bad for our health and leads to poor cell function.
 
 

Viome Results on Mitochondrial Health 

In May of 2021, I was able to analyze my gut and cellular health to see what is my mitochondria health. My score was 50/100. 

Reference ranges: 

  • Not Optimal
    • 0 to 40, which represents 19.0% of the Viome population
  • Average
    • 41 to 65, which means 79.0% of the Viome population
  • Good
    • 66 to 100, which represents 2.0% of the Viome population

How are the scores calculated? 

Mitochondrial Biogenesis Pathways – Mitochondrial Biogenesis Pathways score assesses the activity levels of molecular pathways needed to biologically generate and maintain the cellular functions of your mitochondria to meet your body’s energy and metabolic demands. 

It includes PGC1-alpha signaling – known as the master regulator of mitochondrial biogenesis.

If the score is not optimal, it implies insufficient activity in the mitochondria support functions. It could be due to excessive oxidative stress or a deficiency in specific nutrients.

This deficiency serves as cofactors needed for the mitochondria biogenesis pathways. 

Energy Production Pathways – The Energy Production Pathways score evaluates the efficiency of your cell’s ability to convert carbohydrates (glucose) into energy molecules that fuel our cells (otherwise known as ATP). 

If the score is low, your mitochondrial metabolic activity is sluggish. It could use a little boost from the molecular targets and vitamins. It can also come from a cofactor or coenzyme supplements like:

  • CoQ1, 
  • NAD+ precursors
  • L-Carnitine
  • Various activators of AMPK (an activator of metabolic pathways, which stimulates mitochondrial ATP production).

My Personalized Supplements to Support Mitochondrial Health 

Ashwagandha Root & Leaf Extract (263 mg/day) – these extracts can be seen in-vitro to enhance cellular energy production. It is done by increasing Succinate Dehydrogenase (SDH) levels. These levels are essential enzymes in mitochondrial energy production.
 
Curcumin (550 mg/day) – increases the translocation of Nrf2 to the cell nucleus. This enhances mitochondrial biogenesis and health via PGC-1α and p-AMPK pathways.
 
Magnesium (604 mg/day) – Magnesium is essential for all ATPase activity. It is a class of enzymes that catalyze the phosphate bond in ATP. This results in a release of energy used for other cellular reactions. It includes the movement of calcium across and within the cell membrane of cardiac and vascular tissues.
 
L-Theanine (140 mg/day) – includes neurological and cardiovascular protective effects. Through enhanced cellular antioxidant activity and mitochondrial function, these effects are mediated.
 
Vitamin B3 (Niacin) (35 mg/day) – In the body, B3 is converted into (NAD). NAD is a coenzyme found in glycolysis. It is also located in the pyruvate dehydrogenase complex. The citric acid, or TCA cycle, is seen in energy production pathways. 
 
The TCA cycle is also known as the Krebs cycle. It produces Adenosine Triphosphate (ATP), which provides energy to cells. 
 
NAD also exhibited antioxidant activity and increased NAD biosynthesis. It offers protection against DNA damage during oxidative stress.
 
 

To watch the full Episode 84, check out our video below! Let’s all learn about mitochondria here 👇

TIME STAMPS:

0:00 Introduction
0:49 Cup of Nurses Introduction
2:42 Episode Introduction
2:55 The Powerhouse of the Body – Mitochondria
9:21 What are the functions of the Mitochondria?
11:58 Improve Your Mitochondria: Get Active
14:55 Improve Your Mitochondria: Eat the right foods
15:43 Improve Your Mitochondria: Decrease Inflammation
17:18 Improve Your Mitochondria: Focus on Quality Sleep
20:57 Viome Results on Mitochondrial Health
22:58 How Viome Scores are Calculated
29:20 Personalized Supplements to Support Mitochondrial Health
29:34 Supplement: Ashwagandha Root & Leaf Extract
29:47 Supplement: Curcumin
30:12 Supplement: Magnesium
31:14 Supplement: L-Theanine
33:48 Supplement: Vitamin B3

 

The Stress Response and What Foods Lower It

The Stress Response and What Foods Lower It

The Stress Response and What Foods Lower It

How we react to the stress response is important. We all deal with stress differently. Some people can get over it quickly, while others take their time.

But why is that? Is there a way to help reduce anxiety? Does food play a role in this? Find out more by reading about it in our post.

What is Stress

Stress is your mental and physical reaction to pressure from a certain situation. But remember, not all of the stress response is bad.

Certain stress helps you and gives you the strength to do more. Negative or harmful stress is referred to as distress, and on the flip side, positive or good stress is referred to as eustress. 

The Stress Response 

The stress response begins in the brain, starting with the cerebral cortex, amygdala, and hypothalamus.

When someone comes into contact with a stressful situation, the cerebral cortex identifies it and sends the information to the amygdala.

The amygdala interprets the senses, and if it perceives it as dangerous, it sends a distress signal to the hypothalamus. 

When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus.

This area of the brain functions like a command center, communicating with the rest of the body through the nervous system so that the person has the energy for fight or flight.

The hypothalamus controls such involuntary body functions as breathing, blood pressure, heartbeat, and the dilation or constriction of blood vessels and bronchioles in the lungs.

The autonomic nervous system has two components; 

  • Sympathetic nervous system: functions like a gas pedal in a car. It triggers the fight-or-flight response, providing the body with a burst of energy so that it can respond to perceived dangers.
  • Parasympathetic nervous system: acts like a brake. It promotes the “rest and digest” response that calms the body down after the danger has passed.

After the amygdala sends a distress signal, the hypothalamus activates the sympathetic nervous system by sending signals through the autonomic nerves to the adrenal glands.

These glands respond by pumping the hormone epinephrine into the bloodstream. As epinephrine circulates through the body, it brings on a number of physiological changes. 

  • The heart beats faster than normal, pushing blood to the muscles, heart, and other vital organs. 
  • Pulse rate and blood pressure go up. 
  • The person starts to breathe more rapidly. Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as possible with each breath. Extra oxygen is sent to the brain, increasing alertness. 
  • Sight, hearing, and other senses become sharper. 
  • Triggers the release of blood sugar (glucose) and fats from temporary storage sites in the body. These nutrients flood into the bloodstream, supplying energy to all parts of the body.

The Body’s Stress Response Process

All of these changes happen so quickly that you won’t be aware of them right away. The body’s wiring is so efficient that the amygdala and hypothalamus start this cascade even before the brain’s visual centers even have a chance to fully process what is happening.

That’s why people are able to jump out of the path of an oncoming car even before they think about what they are doing.

As the first surge of epinephrine subsides, the hypothalamus activates the second component of the stress response system, the HPA axis.

This process consists of the hypothalamus, the pituitary gland, and the adrenal glands. The HPA axis relies on a series of hormonal signals to keep the sympathetic nervous system going [1].

If the brain continues to perceive something as dangerous, the hypothalamus releases corticotropin-releasing hormone (CRH), which travels to the pituitary gland, triggering the release of adrenocorticotropic hormone (ACTH).

This hormone travels to the adrenal glands, prompting them to release cortisol. The body thus stays revved up and on high alert. When the threat passes, cortisol levels fall.

The parasympathetic nervous system, the brake, then dampens the stress response.

Cortisol is also responsible for:

  • Increased urea production, appetite suppression, suppression of the immune system, exacerbation of gastric irritation, an associated feeling of depression, and loss of control.

In addition to the HPA axis, some other hormones, such as Growth Hormone (GH) and thyroid hormones, also play a significant role in stress. 

  • Growth hormone is a peptide hormone released from the anterior pituitary gland. GH raises the concentration of glucose and free fatty acids.
  • Thyroid hormones, the Thyroid releases thyroxin and triiodothyronine. The main function of thyroid hormones is to increase the overall metabolic rate.

Thyroxin also increases heart rate and also the sensitivity of some tissues to catecholamines (epinephrine and norepinephrine).

Negative Effects of Stress

When you are unable to efficiently cope with stress or if the stress persists over a long period of time, it leads to negative systemic effects. Stress affects the body in many ways.

Stress affects both physical as well as mental health.

Some of the prolonged effects may be individualized, but some of the effects are common to every individual.

Most of the effects are associated with increased concentrations of corticoids and adrenaline. Some major effects on the body’s systems are [2]:

Digestion

Inconsistent eating habits, acid reflux, diarrhea, or constipation are the common symptoms seen in stressed persons. Chronic stress is also associated with obesity leading to many other negative effects.

Though there is no clear evidence that stressful life events promote the development of diabetes in children or in adults.

In addition to that, hormonal changes occurring during acute and chronic stress can also affect glucose homeostasis in both healthy people and those with diabetes.

Several studies have reported a negative effect of acute stress on the maintenance of blood glucose concentrations in patients with type 1 and type 2 diabetes.

Circulation

Both adrenaline and cortisol affect heart and blood pressure when active over long periods of time. Too much adrenaline makes blood pressure go up, which in turn affects the functioning of the heart since the heart has to pump harder and faster. 

This can produce coronary heart disease, strokes, and sudden cardiac arrest. Stress has been reported to be a predictor of incidents of Coronary Heart Disease (CHD) and hypertension.

Stress can cause increased oxygen demand on the body, spasms of the coronary blood vessels, and electrical instability in the heart’s conduction system. 

Chronic stress also leads to increased blood cholesterol levels 

The persistently high levels of cholesterol and other fatty substances in the blood may cause atherosclerosis and sometimes may be a reason for a heart attack. 

Cortisol also plays a role in the accumulation of abdominal fat, leading to obesity. Occupational stress also has a significant influence on the onset of CHD.

Schnall PL, Landsbergis PA, Baker D (1994) Job strain and cardiovascular disease. Annu Rev Public Health 15: 381-411.

Eaker ED (1998) Psychosocial risk factors for coronary heart disease in women. Cardiol Clin 16: 103-111.

Torpy JM, Cassio L, Glass RM (2007) Chronic Stress and the Heart. JAMA 298: 1722.

Fumio K (2004) Job Stress and Stroke and Coronary Heart Disease. JMAJ 47: 222-226.

Immunity 

The persistent activation of the Hypothalamic Pituitary Adrenal (HPA) axis in chronic stress response impairs the immune response leading to several types of infections.

Studies have shown that people under chronic stress are more susceptible to viral illnesses like the flu and the common cold, as well as other infections. 

Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM Jr (1997). Social ties and susceptibility to the common cold. JAMA 277: 1940-1944.

The high levels of stress hormones suppress the release of cytokines and chemicals secreted by Th cells. Cytokines regulate both cell-mediated and humoral immune responses in the body.

Chronic stress may dysregulate cytokines that can lead to suppression of both cell-mediated and humoral immune responses, as well as systemic inflammation.

Proinflammatory cytokines produce symptoms of fatigue, malaise, diminished appetite, and listlessness, which are the symptoms usually associated with depression.

Segerstrom SC, Miller GE (2004) Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull 130: 601-630.

Neil S, Ironson G, Siegel SD (2008) Stress and Health: Psychological, Behavioral, and Biological Determinants. Annu Rev Clin Psychol 1: 607-628.

In some cases, stress could also be a cause of cancer. The persistent activation of the Hypothalamic Pituitary Adrenal (HPA) axis in the chronic stress response and in depression probably impairs the immune response.

It can also contribute to the development and progression of some types of cancer. Studies have indicated that stress can promote breast cancer cell colonization of bone.

Reiche EM, Nunes SO, Morimoto HK (2004) Stress, depression, the immune system, and cancer. Lancet Oncol 5: 617-625.

Reproduction

Since sex life depends on the fitness of both body and mind, chronic stress may decrease libido.

It may even cause erectile dysfunction or impotence in men. In the case of chronic stress, testosterone levels can drop to the extent that can interfere with spermatogenesis (sperm production).

In women, stress can affect the menstrual cycle. It can lead to irregular, heavier, or more painful periods [3].

2 Foods That Decrease Stress

Many foods can help you with stress. The reason many foods decrease stress is that they usually help rev down the stress response. Many common foods will help you get through your stressful times.

Chronic stress leads to poor food choices that further increase inflammation. This is why it is important to eat healthily and dial down on nutrition. 

Oatmeal

The main reason why oatmeal helps with stress and anxiety is that it boosts serotonin. Serotonin is a natural feel-good neurotransmitter. Oatmeal increases serotonin due to the fact that it is a good source of tryptophan.

Tryptophan is a precurses to serotonin, and studies are looking at whether levels of tryptophan have an impact on mood.

Oats are also a complex carb, high in fiber, and rich in vitamin B, magnesium, and potassium.

Those nutrients play a key role in blood sugar stabilization, mood, and energy. Fiber has been shown in some studies to decrease oxidative stress and inflammation.

Stable electrolyte levels help with heart function and blood pressure. 

Tea 

Tea has been around for thousands of years. There is a wide assortment of teas, but specifically, black tea has been associated with calming and relaxing properties.

There are 2 major players when it comes to tea having these beneficial effects. L-theanine and catechins are responsible for the destressing functionality of tea [4]

L-theanine is an amino acid commonly found in tea and certain mushrooms. L-theanine facilitates relaxation by boosting GABA, serotonin, and dopamine.

It also reduces the amount of cortisol in your system.

What is really interesting is that l theanine increases alpha brain waves which are associated with wakeful relaxation while promoting attention and creativity. 

According to a study shown on WebMD, tea drinkers showed a drop in cortisol levels and decreased platelet aggregation after a stressful situation [5].

Catechins are naturally occurring phenols, also known as antioxidants. It helps combat oxidative stress. It has also been linked to the inhibition of corticosteroid-induced anxiety and stress [6]. 

Learn more about stress response by watching the full Episode 82 here 👇

TIME STAMPS:

0:00 Introduction
0:45 Cup of Nurses Introduction
2:28 Episode Introduction
2:45 The Stress Response
16:33 Negative effects of stress
16:46 Effects of Stress in Digestion
19:02 Effects of Stress in Circulation
20:49 Effects of Stress on Immunity
27:12 Effects of Stress in Reproduction
33:00 2 Foods that Decrease Stress
33:25 Foods that decrease stress: Oatmeal
35:23 Foods that decrease stress: Tea

 

The Science of Blood – Nurse Edition

The Science of Blood – Nurse Edition

The Science of Blood – Nurse Edition

In this episode, we will talk about the science of blood. It is precisely what it comprises, its different types, administer it, and what to watch out for.

What is Blood?

When people think of blood, it’s usually the red liquid that comes out of your cut, or what you see in gore movies. But blood is more than just that. For one it has three different components:

  • Red Blood Cells: 44%
  • White Blood Cells and Platelets: 1%
  • Plasma: 55%

Many people are not familiar with how blood works or what it is even made of. If you are interested in blood or work in this field (blood banks, labs, etc.), this episode will teach you everything you need to know about it. 

Red Blood Cells

Red blood cells are also called erythrocytes, and they account for 44% of your blood. These cells are round, flat, and look like a donut.
 
Hospitals check for red blood cells’ size, shape, and health when a person is in the hospital. It is also the first thing that doctors look into to identify a person’s health condition.

The RBCs have two crucial functions:

  • Takes oxygen from the lungs and delivers it to the rest of the body.
  • Removes carbon dioxide from the body, breathe it out, and returns it to the lungs.
RBC works with the help of hemoglobin, maintaining acid-base balance in the body. The red blood cells can live for 120 days and produce by the bone marrow. After 120 days, the spleen breaks them down, while the liver turns them into amino acids.
 
For RBCs to function they need nutrition to stay healthy. These cells survive and stay healthy with the help of Vitamins B12, B2, B3, folate, and iron.

Anemia

The biggest problem that occurs with irregular red blood cells is anemia. This condition is when the RBC has low oxygenation. It leads to developmental delays in children. In severe cases, anemia leads to heart failure. The most common symptoms of anemia are tachycardia, lethargy, pale skin, and chills.

Common Types of Anemia:

Iron-deficiency Anemia – happens when your body does not have enough iron to produce red blood cells. It is also the most common form of anemia. The most common causes of iron deficiency are when you have:

  • A diet low in iron
  • Sudden blood loss 
  • Menstrual periods
  • Inability to absorb iron from food (ex. post-surgery)

Sickle Cell Anemia – is an inherited disease where the red blood cells look like a half-moon or sickle. This cell does not flow well in the blood vessels and causes blockage in the blood vessels. It can lead to organ damage, pain, and infection. Sickle cells also die after 20 days compared to normal RBC which is 120 days.  

Normocytic anemia – the RBC is normal in shape, but the number produced doesn’t meet the body’s needs. It usually causes long-term conditions in the body like cancer, kidney diseases, or rheumatoid arthritis.

Hemolytic Anemia – is a condition when the RBCs are destroyed even before their lifespan is over. When this happens, the body does not have enough red blood cells to function as your bone marrow cannot meet the demand. 

Fanconi Anemia – is the rarest form of anemia and is an inherited disorder like sickle cell. Anemia like this happens when the bone marrow cannot produce enough blood components. Red blood cells are also part of this blood component. Children born with this condition often develop leukemia [1].

Blood Types

There are eight blood types from the four blood groups. These are A, B, AB, and O. All red blood cells, positive or negative, have Rh factors except Type O.
 
The proteins can elicit an immune response when they contact their corresponding antibody. They stimulate the antibodies in the plasma to defend the body.
 
The antibodies in the blood protect your body from foreign invaders. Blood types have antibodies except for Type AB.
 
Type AB is in the plasma surrounding the RBCs. The recipient’s plasma antibodies must be the opposite of the antigen found on the donor’s red blood cell.

Blood Groups and Types

A blood type: has only A antigens on its surface but B antibodies in the plasma

  • Donates to: A and AB
  • Recipient of: O and A

B blood type: has only B antigens on its surface but A antibodies in the plasma

  • Donates to: B and AB
  • Recipients of: O and B

AB blood type: has both A and B antigens on its surface but NO antibodies in the plasma

  • Donates to: AB
  • Recipient of: O, A, B, and AB
  • UNIVERSAL RECIPIENT

O blood type: has NO antigens on its surface but has A and B antibodies in the plasma

  • Donates to: O, A, B, AB
  • Recipient of: O
  • UNIVERSAL DONOR

Rh Factor

  • These factors are either found on the surface of a red blood cell or not. Either a person has them, or they don’t!
  • If the factors are present on the RBC, the person is Rh POSITIVE. If the elements are absent on the RBC, the person is Rh NEGATIVE.
  • Example: A+ (has factors present) or A- (no factors present)
  • IMPORTANT! If a patient is Rh-positive, they can receive either Rh+ or RH- blood. On the other hand, if a patient is Rh-negative, they can only receive Rh- blood.
The same RBC antigen and antibody cause an immune response called agglutination. This is when RBCs stick together and the donor’s red blood cells will lysis. When this happens, a reaction called hemolytic transfusion occurs. A donor’s RBC is then compared to the patient’s antibodies.

White Blood cells and Platelets

White blood cells account for 1% of your total blood. The main difference between leukocytes and RBCs or platelets is that they have a nucleus. White blood cells are responsible for your immunity.
 
You’d think there would be more than 1% of total blood for such an important role. There are also different types of blood cells with extra responsibilities [2].

Types of White Blood Cells

There are five main types of leukocytes.

  1. Neutrophils
    1. 62% of leukocytes are neutrophils. They are responsible for fighting off bacteria and fungi.
    2. They live for about 6hrs – to a few days.
  2. Lymphocytes
    1. 30% of leukocytes are lymphocytes. There are different types of lymphocytes.
      1. B cells: responsible for antibodies and activating T cells.
      2. T cells: are made in the thymus 
        1. Cytotoxic T cells: destroy infected cells (viral or cancer) through the use of granule sacs that contain digestive enzymes.
        2. Helper T cells: activate T cells, macrophages, and B cells.
        3. Regulatory T cells:  suppress the actions of B and T cells to decrease the immune response.
        4. Memory T cells protect against previously encountered antigens and provide lifetime protection against some pathogens.
        5. Natural Killer T cells: destroy infected or cancerous cells and attack cells that do not contain molecular markers that identify them as body cells.
  3. Monocytes
    1. 5.5% of leukocytes are monocytes.
      1. It is made in the bone marrow and travels through the blood to tissues in the body, where it becomes a macrophage or a dendritic cell. Macrophages surround and kill microorganisms, ingest foreign material, remove dead cells, and boost immune responses.
      2. During inflammation, dendritic cells stimulate immune responses by showing antigens on their surface to other immune system cells.
      3. A monocyte is a type of white blood cell and a type of phagocyte.
  4. Eosinophils
    1. 2% of all leukocytes are eosinophils. They are responsible for fighting off larger parasites and are part of the allergic inflammatory response. 
    2. They live for about 8-12 days.
  5. Basophils
    1. 0.5% of leukocytes are basophils. They are responsible for histamine release during inflammation. 

Platelets

Platelets are thrombocytes produced by the bone marrow. They are responsible for coagulation which is crucial to wound healing. If one of your blood vessels gets damaged, it signals platelets. The platelets then rush to the site of damage and form a plug, or clot, to repair the damage  [3].

  • An average platelet count is 150,000 to 450,000 platelets per microliter of blood.
  • The risk for bleeding develops if a platelet count falls below 10,000 to 20,000.
    • Thrombocytopenia: IIs a condition when your bone marrow makes too few platelets, or your platelets are destroyed. If the platelet count gets too low, bleeding can occur under the skin. This is seen as bruising, inside the body as internal bleeding, or outside the body through a cut that won’t stop bleeding or from a nosebleed. Thrombocytopenia can be caused by many conditions, including several medications, cancer, kidney disease, pregnancy, infections, and an abnormal immune system.

Some people make too many platelets and can have platelet counts from 500,000 to more than 1 million.

  • Thrombocythemia – is a condition when the bone marrow makes too many platelets. The symptoms can include blood clots that form and block the blood supply to the brain or the heart. However, the cause of thrombocythemia is unknown.
  • Thrombocytosis –  is a condition caused by too many platelets. But platelet counts do not get as high as thrombocythemia. It is also more common and is not caused by the abnormal bone marrow. It is often caused by another disease in the body that stimulates the bone marrow to make more platelets. Those affected with thrombocytosis often have cancer, infections, inflammation, and reactions to medications. The symptoms of thrombocytosis are not usually severe, and the platelet count becomes normal again once the underlying condition becomes better. 

Plasma

Plasma makes up 55% of the total blood volume. It contains water, protein, glucose, clotting factors, hormones, electrolytes, carbon dioxide, and oxygen. Generally, it carries nutrients, hormones, and proteins to different parts of the body. It also carries the waste products of cell metabolism away from tissues. Other than that, plasma is also the vehicle for blood cells to the blood vessels [4].

In addition, plasma is the vehicle for transporting blood cells through the blood vessels.

  • Coagulation – many essential proteins, such as fibrinogen, thrombin, and factor X, are present in plasma and play a vital role in the clotting process to stop a person from bleeding.
  • Immunity – blood plasma contains disease-fighting proteins, such as antibodies and immunoglobulins, which play a crucial role in the immune system by fighting pathogens.
  • Blood pressure and volume maintenance – a protein present in plasma called albumin helps maintain the oncotic pressure. This pressure prevents fluid from leaking into the body and skin where less water is present. It also helps ensure blood flow through blood vessels.
  • pH balance – substances present in blood plasma act as buffers, allowing plasma to maintain a pH within normal ranges, which helps to support cell function.
  • Transportation – plasma transports nutrients, electrolytes, hormones, and other essential substances all over the body. It also helps to remove waste products by transporting them to the liver, lungs, kidneys, or skin.
  • Body temperature – plasma helps maintain body temperature by balancing heat loss and heat gain in the body.

Blood Product Administration

Nurses should always follow the best standard practices when administering blood transfusions. They must also follow the standard policies and procedures of the healthcare facility.[5]

Blood transfusion consent, blood typing, and cross-matching are all needed before administering blood. But these are not required if the situation is an emergency. Checking blood products against the order and using two patient identifiers is critical. Blood must be given to patients within 30 minutes after being taken from the blood bank.

  • The patient and family members are informed about the procedure including what to expect during and after it is done.
  • Before administration, two licensed personnel must verify the correct blood product and patient. 
  • Blood products need a dedicated line for infusion and filtered intravenous tubing. Normal saline flushes the intravenous line, with no other solutions or medications. 
  • Need to take vital signs before initiating the transfusion. The nurse stays with the patient for the first 15 minutes of the transfusion. This is done to check for any immediate reaction. 
  • Vital signs are monitored for 15 minutes once the transfusion starts. It’s monitored during, after and one hour after the transfusion is complete.

Blood transfusion can create adverse reactions in the patient. The signs and symptoms of blood transfusion reactions for hemolytic and non-hemolytic reactions include:

  • Pain
  • Anxiety
  • Hematuria
  • Fever
  • Headache
  • Pruritus
  • Rash or hives
  • Nausea
  • Respiratory difficulties (common for non-hemolytic reactions)
The symptoms mentioned above, plus hypotension, bleeding, and oliguria shows hemolytic reactions. Blood transfusion should stop immediately but keep an IV line open for normal saline.
Patients are monitored by the healthcare provider and physicians must be noted immediately. The remaining blood products and tubing are then taken to the laboratory to be tested.

Want more blood? Click here 👇 to watch the full Episode 81:

SHOW NOTES:

0:00 Introduction
3:16 Episode Introduction
5:12 Red Blood Cells
11:20 Common Types of Anemia
19:50 Blood Types
26:45 Types of White Blood Cells
36:24 Platelets
47:00 Plasma
53:01 Blood Product Administration