Skin/respiratory health and fertility Flashcards
1
Q
Explain the narrowing of airways in asthma (3 points):
A
- bronchial smooth muscle spasm
- swelling of bronchial mucosa
- excess viscous mucus secretion
2
Q
Hallmark asthma symptoms
A
- wheezing on out breath
- intermittent shortness of breath
- tight chest
- dry cough
3
Q
Which immunoglobulin is asthma usually mediated by?
A
IgE
4
Q
Which inflammatory mediators are released due to IgE in ashtma?
A
- histamine
- leukotrines
- prostaglandins
5
Q
If asthma is untreated, which cells migrate to the airways?
A
- eosinophils
- T helper cells
- mast cells
6
Q
what causes airway remodelling?
A
chronic inflammation causes small muscle hytrophy, formation of new vessels and interstitial collagen deposition, which results in persistent airflow obstruction
7
Q
What does excessive T2 cause?
A
increased inflammation and excess IgE
8
Q
Why is obesity a risk for asthma?
A
- lung function
- increased systemic inflammation
- microbiome (increased SCFA which increase allergic airway disease
9
Q
Name some risk factors for asthma
A
- preservatives
- Molybdenum deficiency (sulphite sensitivity)
- food colourings
- low vitamin D and Mg
- aspirin and NSAIDS
10
Q
How can female sex hormone fluctuation cause asthma?
A
- oestrogen dominance favours Th2
- HRT
11
Q
List some natural approaches to asthma
A
- fresh whole organic foods
- dietary exclusion (milk, eggs, chocolate, soy, apples)
- Salicylate sensitivity
- avoid sulphates (alcohol, dried fruits, bagged salads)
- avoid very cold drinks
- reduce red meat, sugar, dairy, processed foods
- keep hydrated
- reduce salt
12
Q
What are the best antioxidants to reduce oxidative stress in asthma, and how do they do this?
A
- vitamins A, C and E
- quercitin
- carotenes
- cofactors such as zinc, selenium, copper and flavonoids
- increase selenium for glutathione
inhibit leukotrine formation and histamine release, increase epithelial lining integrity and protect lungs against free radicals
13
Q
How can a vitamin B complex supplement help with asthma? RD?
A
- B3: decreases histamine release
- B5: reduces cortisol during stress
- B6: reduces severity and frequency of ashtma
- B12: helps with detoxification and metabolism of sulphites. Helps inflammatory reactions and methylation.
RD: 100-150mg per day
14
Q
How can a vitamin C help with asthma? RD?
A
- antioxidant
- antihistamine
- stimulates neutrophils
- increases lymphocytes
- increases interferon production
- lowers release of arachidonic acid which impedes PGE-2 synthesis
RD: 2/3g per day
15
Q
How can a vitamin D help with asthma?
A
modulates genes for asthma/allergy, and inhibits eosinophils
16
Q
How can a CoQ10 help with asthma? RD?
A
- antioxidant (lowers oxidative stress and asthma symptoms)
- may lower LTSE of glucocoritoid steroids
RD: 150mg /day
17
Q
What are the symptoms for bronchitis?
A
- unproductive cough that becomes productive with thick yellow mucus
- fever
- sore throat
- SOB
- runny nose
- muscle aches
18
Q
What is the natural approach to bronchitis?
A
- stop smoking
- look into environmental irritants
- reduce sugar, red meat, salt, diary, processed foods
- avoid histamine foods
19
Q
Which foods are mucolytic?
A
- garlic
- onion
- ginger
20
Q
Which enzyme reduces airway inflammation?
A
Bromelain
21
Q
What is emphysema?
A
dilation of the alveolar sacks by destruction of the alveolar wall, leading to collapse of the alveolar during expiration
22
Q
Why is cigarette smoking so bad for COPD?
A
Cigarette toxins activate NF-Kb pathway leading to inflammatory cascade in the airway epithelial cells and recruitment of macrophages and neutrophils
23
Q
How does N-acetyl cysteine help with COPD? RD?
A
- mucolytic, making it easier for the expulsion of mucus
- increases glutathione lowering oxidative damage
RD: 400-1200mg /day
24
Q
How do fish oils help with COPD? RD?
A
- decreases inflammation
- reduces COPD morbidity, fewer symptoms
RD: 800mg of EPA, 300mg of DHA
25
How does shiitake help with COPD? RD?
- increases phagocytes, T and B-lymphocytes, and NK cells.
- enhances interferon synthesis (anti-viral proteins)
- Increases secretory IgA
RD: 1.5-10g /day
26
How does Thyme help with COPD?
- mucolytic and anti-bacterial
- antioxidant properties
- down-regulates activated NF-Kb
27
Which hormones are increased and cause acne?
- free testosterone (DHT)
- DHEA
- DHEAS
- 5-alpha-reductase
28
How does DHT and free testosterone cause acne?
- stimulates hyperkeritinisation of follicles
- increases sebum production
- stimulates acne lesions
29
How does hyperinsulinemia cause increased free testosterone?
hyperinsulinemia decreases Sex Hormone Binding Globulin (SHBG) causing higher free testosterone
30
High levels of 5-alpha-reductase is linked to what conditions/deficiencies?
obesity, hyperinsulinaemia and low zinc
31
How does insulin resistance cause acne?
- increased proliferation of keratinocytes
- stimulates synthesis of androgens
- increases sebum production
32
How does IGF-1 cause acne?
Downregulates Fox01 (a protein that influences glucose metabolism and insulin signalling). This leads to activation of mTORC1.
33
What is the role of mTORC1 in acne?
Mediates sebaceous gland hyper-proliferation, lipid synthesis and hyperplasia of keratinocytes
34
According to TCM, what is the cause of acne?
damp and heat in the body rising to the head
35
How can we change the diet to help with ance?
- low GI diet
- high fibre
- omega-3 to increase IGF-1
- flaxseeds can decrease free androgens, and helps with the conversion of DHT to testosterone
36
How does EPA help with acne?
- reduces inflammation
- inhibits mTORC1 activation
37
How can we naturally decrease mTORC1?
with polyphenols in green tea, turmeric and berries
38
How would vitamin A supplementation help with acne? RD?
- plays a role in collagen synthesis and supports the skin barrier
- reduces sebum and hyperkeratosis of follicles
- Inhibits growth of C. Acnes
RD: 5000 iu/day
39
How would vitamin B3 (niacinamide) supplementation help with acne? RD?
- works alongside chromium in insulin resistant
- reduces histamine release
- anti-inflammatory
- inhibits c-acnes induces IL-8 production of keratinocytes through NF-Kb and MAPK pathways
RD: 20-50mg /day in B complex
40
How would zinc supplementation help with acne? RD?
- modulates immune and inflammatory process
- inhibits 5-a-reductase, causing lower DHT
- antimicrobial against C. acnes
-
41
name some risks/causes for rosacea?
- H. Pylori
- SIBO
- Vascular hyperactivity
- food allergy/intolerances
42
List some natural approaches to rosacea:
- identify and avoid dietary triggers
- Reduce high histamine foods
- Focus on detoxification
- support gut health (H. Pylori)
- increase omega-3, for skin integrity and reduce inflammation
43
Which foods can be helpful in rosacea?
vitamin C and proanthocyanidin containing foods such as red grapes, blueberries and cranberries.
44
Which gene mutation is linked to atopic dermatitis, and what does it cause?
Fillagrin gene mutation, cause aggregation of keratin filaments
45
Why might people with atopic dermatitis have low levels of EFAs?
- FADS2 SNP
- deficiency in Mg, Zn or B6
- IR
- alcohol
- high stress
46
What blood results would you be looking for atopic dermatitis?
- FBC (eosinophils)
- Serum IgE
- genetic testing (FADS2 and VDR)
47
What is the allopathic treatment for AD?
- topical corticosteroids
- antihistamines
- immunosuppressants
48
Which dietary inclusions would you recommend for someone with AD?
- ow histamine diet
- anti-inflammatory diet
- daily sources of omega-3 (wild fish)
- quercetin rich foods (apple, kale, blueberries, spinach, red onion)
49
How does vitamin A help with atopic dermatitis? RD?
- skin cell homeostasis
- collagen synthesis
RD: 5000 iu/day
50
How does vitamin C help with atopic dermatitis? RD?
- overall barrier function
- collagen synthesis
- ceramide production in keratinocytes
RD: 1-2g/day
51
How does zinc help with atopic dermatitis? RD?
- maintains skin homeostasis
- reduces pro-inflammatory actions of keratinocytes
RD: 15-30mg /day
52
How does vitamin E help with atopic dermatitis? RD?
- helps maintain the skin water barrier
- lowers oxidative stress
- can help with itchiness topically
RD: 600iu /day
53
How does quercitin help with atopic dermatitis? RD?
- bioactive effect in inflammation, oxidative stress and wound healing.
- inhibits cytokines via NF-Kb
- stabilises mast cells
RD: 3g /day
54
How does vitamin D help with atopic dermatitis? RD?
- normalises the effect on Th1 and Th2 on cytokines
- reduces IgE production
- dampens IgE-mediated mast activation
- reduces immune allergic response
RD: optimise
55
How do EFAs help with atopic dermatitis?
- good levels of GLA inhibits PG1, which inhibits arachadonic acid metabolites
- good levels of EPA increases the production of anti-inflammatory prostaglandin PG3
56
If someone has atopic dermatitis, what herbal baths could you recommend?
- calendula
- chickweed
- oatseed
57
How can a calendula herbal bath help someone with AD?
- inhibits inflammatory cytokines / COX2 production
- inhibits NO in several skin cells
- anti-microbial
58
Explain the autoimmune pathogenesis of psoriasis
deregulated T-call mediated inflammatory process, which leads to keratinocyte proliferation and dysfunctional differentiation
59
Explain the pathogenesis of the initiation phase of psoriasis
1. keratinocytes respond to a trigger
2. stimulate dendritic cells
3. stimulates cytokine production
4. leads to Th-cell differentiation
60
Explain the pathogenesis of the maintenance phase of psoriasis
1. Th-cells release cytokines
2. Keratinocyte proliferation
3. more inflammation
61
List some causes/triggers for psoriasis
- genetics (PSORS1)
- trauma
- vaccination
- air pollution
- medication
- alcohol
62
How does alcohol cause/worsen psoriasis
ethanol increases TNF-a, which causes lymphocyte proliferation and mast cell histamine release
63
How does vitamin A help with psoriasis? RD?
- epithelial cell differentiation
- collagen synthesis
- intracellular adhesion
RD: 5000IU /day
64
How does vitamin D help with psoriasis?
- downregulates TNF-a and IL-1, -6 and -8.
- anti-inflammatory
- immunomodulatory effects
65
How does vitamin E help with psoriasis? RD?
- lowers pro-inflammatory cytokines
- lowers monocyte adhesion to endothelial tissue
RD: 400-800IU /day
66
How does omega-3 help with psoriasis? RD?
Arachadonic acid is found in high levels in psoriasis along with it’s metabolite leukotrine B4. EPA supplementation specifically targets leukotrine B4 via the COX and LOX inflammatory pathways.
RD: 6g daily
67
How does alcohol increase oestrogen?
by promoting production of aromatase and inhibiting hepatic oestrogen metabolism.
68
What is the minimum semen volume for it to work? and what is the right pH?
1.5ml, pH 7.2 or higher
69
What is hypogonadism? and what are the causes?
low functioning gonads and low production of sex hormones.
- tumor
- illegal drugs
- Klinefelter syndrome
70
Which bacteria should be dominant in the seminal microbiome?
Lactobacillus
71
What is the seminal microbiome negatively impacted by?
- anti-fungals
- antibiotics
- prostatitis
- lubricants
- smoking
- alcohol
- obesity
- STIs
72
Which 2 bacteria have been linked to miscarriage, along with the presence of low lactobacillus and a higher pH?
ureaplasma and gardenerella
73
Name some high folate foods
- dark leafy greens
- asparagus
- avocado
- legumes
- poltury
74
Name some high B12 foods
- eggs
- meat
- liver
- fish
- chlorella
- nutritional yeast
75
Name some high B6 foods
- wholegrains
- green veggies
- sunflower seeds
- pistachios
- fish
76
Name some high B2 foods
- mushroom
- spinach
- almonds
- avocado
- eggs
77
Name some foods high in methionine
- brazil nuts
- sunflower seeds
- wholegrains
- fish
- beans
-chicken
78
Where is AMH released from?
immature ovarian follicles
79
What could overly high levels of AMH indicate?
PCOS
80
What functional test could you do for a women struggling with infertility?
- blood test for folate and homocysteine; if folate is low and homocysteine is high, this could indicate poor methylation. This can effect oestrogen detoxification
81
What are some risks associated with IVF?
- cancer
- ectopic pregnancy
- low birth weight
- ovarian hyper stimulation syndrome
- multiple births
82
Why might caffeine be causing infertility?
caffeine increase cortisol, which down-regulates the production of COMT. COMT detoxifies oestrogen, so this could lead to oestrogen dominance. Associated with early miscarriage and longer conception time
83
What should be avoided in step 1 of natural fertility?
- processed foods
- caffeine
- alcohol
- unnecessary medications
84
Which foods should you be focussing on for fertility?
- antioxidant rich
- beans and legumes for fibre
- organic eggs for cholesterol
- fish and seafood for protein and zinc
- organic liver
- high quality fats
-
85
Why are cruciferous veg good for female fertility?
They help with phase1 detoxification of oestrogen
86
What is the optimal BMI for fertility?
20-25
87
How does selenium help with fertility? RD?
sperm motility and structural motility
RD: 100mcg /day
88
How does Zinc help with male fertility? RD?
- high levels of zinc in seminal fluid
- antioxidant effects
- needed for spermatogenesis
- needed for thyroid function
RD: 15-45mg /day
89
How does CoQ10 help with male fertility? RD?
- key antioxidant for sperm motility concentration
RD: 200mg /day
90
How does fish oil help with male fertility? RD?
- omega-3 is required for cell membrane fluidity
- increase sperm count
RD: 900mg DHA /day
91
How does L-carnatine help with male fertility? RD?
- needed for sperm maturation and motility
- works well with CoQ10
RD: 1000mg /day
92
How does folate, B12, B2 and B6 help with male fertility?
- needed for methylation and detoxification
93
How does vitamin A help with female fertility? RD?
- needed for progesterone
- not recommended during pregnancy, just before
RD: Cod liver oil, 1 tbs /day
94
How does CoQ10 help with female fertility? RD?
- needed for oocyte development
- improves ovarian response to IVF
RD: 200mg /day
95
How does myo-inositol help with female fertility? RD?
- promotes ovarian function
- enhances oocyte quality
- encourages regular cycle
RD: 2mg /day for 26 weeks
96
How does argenine help with female fertility? RD?
- precursor to NO
- angiogenesis
- hormone secretion
- supports cell devision and embryo development
RD: 1000 - 2000mg /day
97
How does L-carnatine help with female fertility? RD?
- increases endometrial thickness
- useful for implantation
RD: 500-1000mg /day
98
If your client was going to have IVF, what 2 supplements would you suggest and why?
- L-carnatine: increases endometrial thickness
- Alpha-lipoic acid: immunomodulating to help the body accept the pregnancy
99
How does folate help with female fertility? RD?
- required for RNA and DNA synthesis (neural tube development)
- needed if there is a MTHFR defect
RD: 400mcg /day or 800mcg /day if high risk, obese or twins
100
Which herbs are useful for female fertility?
- vitex agnus castus
- ashwadanga
- shatavari
101
When should intercourse happen in the cycle to maximise conception chances?
5 days before ovulation, during and 3 days after
102
Which day of the cycle do you start testing LH levels for ovulation?
day 9
103
How can we increase cervical mucus?
- stay hydrated
- evening primrose oil (only first half of cycle, follicular phase)
- fertility friendly lubricant
104
What should our BBT be in the folicular phase?
36.4/5 oc
105
What should our BBT be after ovulation?
37 oc (0.5 above average)
106
What can effect the BBT?
- erratic sleep
- getting up and going to the toilet before
- alcohol consumption can elevate temp
107
What are the three foetal stages?
1. Blastogenesis stage
2. Embryonic stage
3. Foetal stage
108
name some foods that should be avoided during pregnancy and why
- pate, soft and blue cheese: listeria risk (miscarriage, still birth, pre-term labour, illness, new born death)
- raw eggs: salmonella
- raw fish: parasite risk
-
109
How much does blood volume increase by during pregnancy?
30%
110
what are some emmenagoug herbs that can stimulate the uterus?
- parsley
- rosemary
- basil
- wormwood
- yarrow
111
what is toxoplasmosis
a protozoan parasite found in cat faeces, raw meat and soil on unwashed fruit and veg
112
which medications should not be taken during pregnancy and why?
- antibiotics: can cause miscarriage or birth defects
- antidepressants can cause congenital defects
113
Explain why calcium is so important during pregnancy
to support foetal, placental and maternal tissue growth. extra 6-10g per day
114
Explain why protein is so important during pregnancy
ossification of the foetal skeleton, teeth and neural development. protection of maternal bones.
1000mg per day
115
Explain why magnesium is so important during pregnancy
needed for pregnancy and breast feeding.
Deficiency has been linked to pre-eclampsia, slow foetal growth, pre-term labour, metabolic dysregulation and SIDS.
360-400mg /day
116
Explain why iron is so important during pregnancy
- increased blood volume
- support increase material production of RBC
- blood transport
- meet growth demands
117
Explain why vitamin A is so important during pregnancy
- foetal growth: vision, hearing, immune and respiratory function
- anything above 1000 IU/day of vitamin A has been shown to cause birth defects, so supplementation should be beta-carotene
- vitamin A before conception
118
Explain why vitamin D is so important during pregnancy
- crosses placenta
- fully through mother
- later part of pregnancy usually low vitamin D
- low VD can effect bone health, brain development, risk of CVD, risk of T1DM, insulin resistance, dental issues and low muscle mass
- low VD can cause pre-eclampsia
RD: 2000 IU/day during pregnancy
119
Which probiotic supplements would you suggest to a pregnant woman in her last trimester and why?
- Lactobicillus rhamnosus GG
- Biffidobacterium lactus
protective against allergies (especially if genetic)
120
What are some potential causes for morning sickness?
- high HcG levels
- high oestrogen (oestradiol)
- poor nutritional status
- poor blood sugar regulation
- heightened sense of smell
121
List some risk factors for pre-eclampsia
- 40+
- first pregnancy
- twin pregnancy
- family history
- hypertension
-
122
list some pre-eclampsia symptoms
- water retention
- severe headaches
- vision problems
- pain below the ribs
123
If someone has pre-eclampsia, when is it recommended they give birth?
35-37 weeks
