Integrative medicine最新文献

While Cushing syndrome is rare, but well-recognized, subclinical hypercortisolism (defined as excessive cortisol secretion without the classic manifestations of Cushing syndrome) is significantly more common. Subclinical hypercortisolism contributes to several chronic diseases, such as diabetes, osteoporosis, sarcopenia and hypertension. The incidence increases with age and correlates with body load of environmental toxins such as bisphenol A (BPA). This editorial discusses prevalence, contribution to disease, causes, diagnosis, and intervention.

As the COVID-19 pandemic has raged on, considerable research has been performed around the world evaluating the environmental, genetic, lifestyle, and nutritional factors that significantly impact the COVID-19 pandemic. Many studies have now shown that key risk factors for SARS-CoV-2 infection, severity, and even death are modifiable. Patients, whether partially vaccinated, fully vaccinated, or not vaccinated, are expecting their clinicians to provide them with evidence-based guidance and to help them prioritize the factors most important for them. In this editorial we review the current state of the research on modifiable risk factors for SARS-CoV-2 infection, disease severity, and death.

Background: Coenzyme Q10 is one of the most widely sold nutritional supplements in the United States. Coenzyme Q10 is available in both its oxidized form (ubiquinone) and its reduced form (ubiquinol). The predominant marketing of Coenzyme Q10 to physicians and patients asserts that the ubiquinol form of Coenzyme Q10 has superior absorption to the ubiquinone form. This study has been designed to compare and contrast the stability and absorption of ubiquinol supplements, as well as the claims made for ubiquinol compared with ubiquinone.Ubiquinol, the reduced state of Coenzyme Q10, is commercially available as a nutritional supplement; however, ubiquinol, by its nature as an electron donor, is much less stable than ubiquinone, the oxidized state of Coenzyme Q10. The absorption, bioavailability and efficacy of ubiquinol products has been much less often tested in clinical trials. Consequently, insufficiently documented marketing claims are being made for ubiquinol supplements.

Methods: In Part 1 of this report on the instability of the lipid-soluble antioxidant ubiquinol, SIBR Research presented data from lab studies showing that oral ubiquinol is likely to be oxidized to ubiquinone and absorbed as ubiquinone. In this Part 2, SIBR Research conducted a study of the transfer and absorption of orally ingested ubiquinol in large dogs.

Results: In the dog studies, the percentage of ubiquinol converted to ubiquinone increased as the capsule contents passed through the stomach and small intestines and into the lymph system.

Conclusions: The dog studies demonstrate that oral ubiquinol in commercial nutritional supplements is not stable in the gastrointestinal tract of large dogs. Based on these results, it seems likely that in humans also, most of the ubiquinol from capsules will be oxidized to ubiquinone in the acid profile between the stomach and the small intestines, where there is a wide range of acidity. The ubiquinol from the supplement will be absorbed in the ubiquinone state and will pass into the lymph system as ubiquinone, where it will be reduced back to ubiquinol. It will pass from the lymph system into the blood circulation as ubiquinol.

Functional dyspepsia is a common presenting concern that includes symptoms such as gastrointestinal reflux, postprandial bloating, and abdominal pain. Aside from mainstay conventional therapies such as proton pump inhibitors and antacid tablets that seek to manage symptoms, naturopathic therapies can similarly offer symptom relief and simultaneously address factors underlying functional digestive disturbances. In this case, a 25-year-old female and first year graduate student presented with abdominal bloating, epigastric pain, flatulence, eructations, reflux, and straining with stool. Onset of symptoms occurred after her transition to graduate school, which resulted in a more stressful and rigorous workload, time-pressured eating habits, and a dearth of whole food consumption. Physical exam findings were unremarkable except for moderate epigastric pain, hyperactive bowel sounds, and a geographic tongue. While she met all the Rome IV criteria for functional dyspepsia, clinical findings did not warrant referral for endoscopy to rule out structural/organic causes of disease. As a result, therapeutic interventions consisted of an elimination diet and the use of apple cider vinegar and L-glutamine powder, in addition to a compounded homeopathic formula containing UNDA #4 and Nux vomica. Within 1 week, the patient reported significant improvement in presenting concerns, and within 1 month had denied the presence of every presenting symptom except for straining with stool. This case demonstrates that a naturopathic approach to functional dyspepsia can offer significant symptom relief as soon as 1 week after treatment, and that an effective treatment plan can be offered to patients in 1 visit lasting no longer than 60 minutes. Furthermore, compliant patients can experience a significant improvement in overall gastrointestinal function as early as 1 month after treatment initiation.

A 26-year-old Caucasian woman presented with a two-year history of depression concomitant with irritable bowel syndrome (IBS-C; constipation subtype, gas/bloating). Past evaluation resulted in a clinical diagnosis of IBS-C in August of 2015. Between August and November of 2015, the patient developed worsening bowel irregularities and persistent depression. The patient opted out of conventional treatment and was referred for nutritional care in November of 2017. Throughout one year of treatment with dietary interventions, Chinese herbal medicine, and targeted nutritional supplementation, the patient gradually reached full remission of all complaints.