1Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114.
Several reports have suggested an increased prevalence of osteopenia and osteoporosis in HIV-infected individuals. Vitamin D can be ingested either through diet or supplements, or synthesized in the skin following exposure to ultraviolet radiation. Subclinical vitamin D deficiency is common in the general population and has been shown to correlate with osteoporosis.
Adult HIV-positive outpatients were recruited from the Infectious Disease Clinic at Massachusetts General Hospital (MGH) during the winter and spring.
Subjects were asked to verify their current medications and were asked about exercise, vitamin use, and lactose intolerance.
Patients were recruited during their regularly scheduled ambulatory care visits at the MGH HIV Clinic.
We found a high frequency of vitamin D deficiency in HIV-infected outpatients followed in the northeastern United States during and immediately after the winter months, when ambient sunlight is too weak for adequate vitamin D synthesis. Secondary hyperparathyroidism was uncommon in a study of hypocalcemic HIV-infected patients with more advanced disease in pre-HAART.45 The authors of that study proposed an inadequate response of parathyroid cells in the setting of hypocalcemia in AIDS as a mechanism to explain their findings. 3,15,30,32,33 We found a tendency for higher frequency of moderate 25-D deficiency in subjects receiving NNRTI. In conclusion, we found a high frequency of vitamin D deficiency in ambulatory HIV-infected patients seen in a Boston HIV clinic during mid-winter and spring months.
Ingested K+ is absorbed rapidly and enters the portal circulation, where it stimulates insulin secretion. An increase in extracellular potassium concentration also stimulates aldosterone secretion (via angiotensin II), and aldosterone increases K+ excretion. Potassium homeostasis is maintained by the balance of potassium excretion and potassium cellular shifts. This applies to certain high-risk patient populations with cardiac disease, such as ischemic or scarred myocardium, left ventricular hypertrophy, congestive heart failure, or myocardial infarction). Hypokalemia is found in about 20% of hospitalized patients, but it occurs in less than 1% of otherwise healthy adults. Hypokalemia can result from transcellular shifts (from extracellular into intracellular spaces), or when potassium losses are increased; these losses can be from renal or nonrenal causes (Box 1). When hypokalemia is reported, the initial step is to ascertain whether it is associated with clinical symptoms or arrhythmias that would require prompt intervention. In a person with normal renal function and average potassium intake, FEK is approximately 10%.
The usefulness of the FEK and TTKG is limited by their variability with diet and chronic kidney disease. Cause of hypokalemia should be addressed (remove drug, change diet, stop gastric drainage). All other situations except for renal tubular acidosis: replace with oral potassium bicarbonate, citrate, acetate, or gluconate. More than 80% of hyperkalemic episodes are caused by impaired potassium excretion from renal insufficiency.1 Usually, another event that prevents or overcomes the renal adaptation precipitates the hyperkalemia. Patients with hyperkalemia are usually asymptomatic, although some patients may present with generalized muscle weakness, and cardiac conduction may be impaired.
The initial step with reported hyperkalemia is to ascertain whether it is associated with clinical symptoms or arrhythmias that would require prompt intervention.
The urine potassium concentration, FEK, and TTKG can also be used to help distinguish between renal and nonrenal causes of hyperkalemia. Ascertain whether it is associated with clinical manifestations, such as arrythmias, which require immediate treatment. A careful history and a physical examination should be done, especially looking for evidence of catecholamine surge, hypertension, vomiting or diarrhea, and medication use. Ascertain whether it is associated with clinical symptoms, such as changes on the ECG, which require immediate attention. Careful history and physical examination should be done, looking specifically for chronic kidney disease, medications, dietary, or clinical situations associated with transcellular shifts, such as hyperglycemia. Batlle DC, Arruda JA, Kurtzman NA: Hyperkalemic distal renal tubular acidosis associated with obstructive uropathy. Elisaf M, Siamopoulos KC: Fractional excretion of potassium in normal subjects and in patients with hypokalaemia. Ethier JH, Kamel KS, Magner PO, et al: The transtubular potassium concentration in patients with hypokalemia and hyperkalemia.
West ML, Marsden PA, Richardson RM, Zettle RM, Halperin ML: New clinical approach to evaluate disorders of potassium excretion. West ML, Marsden PA, Richardson RM, et al: New clinical approach to evaluate disorders of potassium excretion. It is imperative to maintain an ideal Cholesterol level at all times and this chart will give you an insight of the recommended cholesterol levels with respect to your gender and age. After checking with this cholesterol chart if you find yourself lacking or in surplus, it’s time you review your diet and consult your physician. In our hospital, Shijiazhuang Kidney Disease Hospital, we treat kidney problems by combining western medicines and Traditional Chinese Medicine (TCM). Based on nearly 30 years of researches and clinic practices, we have gained much experience on treating kidney disease. This tells you how much sodium is lost in the urine – a healthy kidney can resorb at least 99% of sodium, so the F E NA % should be less than 1%.
Will Watson 2006,with help from Dr Elizabeth Sinclair, Dr Predrag Bjelogrlic, Dr Ruth Cruickshank and some books. Artificial food dyes are one of the most infuriating ingredients that I have become aware of since starting our healthy food journey. There are currently seven artificial food dyes approved for consumption in the United States. The prevalence of childhood ADHD raises the possibility of a widespread risk factor like artificial dyes. In the early 1970s, research conducted by Dr.
In one study (source 4) preschool-aged children were fed a diet with no artificial food dyes and benzoate preservatives (a common preservative in many processed foods) for 4 weeks.
The second study (source 5) expanded on the first study and also looked at older children. As in the previous study, children were placed on an elimination diet and then tested using double-blind techniques for their behavior to a drink containing artificial food colors and preservatives. The results of these two studies do suggest that synthetic food dyes can contribute to hyperactive behavior in some children.


Yes, schools and daycare make it very hard to completely eliminate processed foods and artificial food dyes. 20 In temperate latitudes near sea level, cutaneous production of vitamin D almost ceases in winter.
Daily intake of calcium and vitamin D was assessed using a previously validated questionnaire administered by a research assistant.21 Medications, medical problems, and most recent laboratory values were extracted from the medical records (CD4 cell count, viral load, and albumin).
Individuals deficient in 25-D commonly develop secondary hyperparathyroidism, increased bone turnover, and reduced bone mineralization.21 The effects of vitamin D extend beyond bone metabolism. Our patients had less advanced immunosuppression and the majority were taking HAART, so perhaps they were able to develop a state of normocalcemic secondary hyperparathyroidism from vitamin D deficiency that sicker patients with HIV infection could not develop. Interventional studies are warranted to define the effects of vitamin D and calcium supplements on serum PTH, bone health, and innate immune defenses in HIV-infected patients. About 90% of total body potassium is intracellular and 10% is in extracellular fluid, of which less than 1% is composed of plasma.
Insulin increases Na+,K+-ATPase activity and facilitates potassium entry into cells, thereby averting hyperkalemia.
In the steady state, K+ excretion matches intake, and approximately 90% is excreted by the kidneys and 10% in the stool. Transcellular shifts can occur in pathologic conditions associated with a catecholamine surge, such as chest pain syndromes, or mediated by acid-base disturbances. Manifestations of hypokalemia include generalized muscle weakness, ileus, and cardiac arrhythmias. In the absence of compelling indications for immediate therapy, a careful history and physical examination should be performed. Hypokalemic patients with a lower FEK would suggest extrarenal loss of K+, whereas hypokalemia from renal losses would be associated with an elevated FEK. The numerator is an estimate of the luminal potassium concentration, and the osmolality ratio is used to correct for the increase in UK caused by water extraction. Mortality data caused by hyperkalemia are unavailable for the general population but accounted for 1.9% of patients with end-stage renal disease in the United States in 1993. The earliest electrocardiographic changes are tenting of T waves, followed by widening of the QRS complex, atrioventricular conduction block, ventricular fibrillation, and then asystole. If no compelling indication for immediate therapy exists, a careful history and physical examination should be performed, with particular emphasis on medication, diet, and chronic kidney disease.
Intravenous calcium is required for rapid reversal of conduction abnormalities that are present. Maintaining an optimized Cholesterol level will encourage you to lead a life potentially free of heart disease balancing your body weight alongside. Our therapies are more natural and effective, since they can help protecting remaining kidney function by repairing damaged renal tissues. Free medical answers from Professionals!Please remember to leave your Full Name, Email ID, or Phone No. This is because they serve no purpose except to make food look appetizing. Artificial food dyes are derived from coal tar and petroleum which are not ingredients that I want to be eating.
They had two groups of rats: one that ate a high dose of food dye and one that ate a low dose of food dye.
Benjamin Feingold found that when hyperactive children were given a diet free of artificial food additives and dyes, symptoms of hyperactivity were reduced.
The ingestion of synthetic food colors caused an increase in a measure of global hyperactivity. It is important to note that while intake of synthetic dyes and preservatives statistically increased hyperactivity, the investigators also reported substantial variability in the responses of children to artificial dye drink. The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. I figure that if I can do my best to make sure my kids only eat real food at home, then I just have to let go of some of the control about what they eat away from the house.
We aimed to determine the prevalence of vitamin D insufficiency in an outpatient HIV clinic in Boston. Some of the circulating 25-D is further 1a-hydroxylized in the kidneys and other tissues to 1,25-OH vitamin D (calcitriol, 1,25-hydroxyvitamin D, 1,25-D), which is the active form of vitamin D. Serum 25-D and 1,25-D levels were measured by Immunoassay IRA (DiaSorin, Stillwater, MN) at the MGH clinical laboratory or at Quest Laboratory. We also found a high frequency of secondary hyperparathyroidism, possibly from vitamin D deficiency.
Renal K+ excretion is mediated by aldosterone and sodium (Na+) delivery (glomerular filtration rate [GFR]) in principal cells of the collecting ducts.3 K+ is freely filtered by the glomerulus, and almost all the filtered K+ is reabsorbed in the proximal tubule and loop of Henle (Fig.
In patients with ischemic or scarred myocardium, left ventricular hypertrophy, congestive heart failure, or myocardial infarction, hypokalemia is associated with an increased incidence of ventricular ectopy, ventricular tachycardia, and ventricular fibrillation.
Important clinical clues such as medication, vomiting, and hypertension should be specifically sought.
Moreover, in patients with chronic kidney disease (lower GFR), adaptive responses increase K+ excretion, with resultant increases in FEK and TTKG.
Pseudohyperkalemia can occur with thrombocytosis, hemolysis, and extremely high white cell counts.
Impaired K+ excretion or impaired potassium entry into cells accounts for all other causes of hyperkalemia.
The serum potassium concentrations are poorly correlated to the electrocardiographic and conduction abnormalities. An exception to this is hyperkalemia caused by digoxin toxicity because acute hypercalcemia can potentiate the toxic effects of digoxin. However, when the kidneys are damage, it can leak out since the glomeruli have become thicken and scarred.
More over, our characteristic treatments aim at expanding blood vessels, anti-inflammation, and degrading extracellular matrixes. They can also be found in some surprising places like yogurt, vitamins, medicine, cereal, and most packaged foods. They found that the rats in the high dose food dye group showed significant increases in serum creatinine and albumin compared to control group. Some clinical studies confirmed these findings, but over the past couple of decades the results have been mixed and inconclusive  As a result, research on the role of food dye and its effects on ADHD slowed. The amount of food dyes and preservatives in the drink was not excessive in any way and would be comparable to what a child would normally consume in a day. The intake of food dyes had negative effects in some children,and in others they found no effects.


There are a lot of natural dyes out there that can be used to brighten food if you are cooking. We collected serum levels of 25-OH vitamin D and evaluated calcium and vitamin D intake in adult HIV-positive outpatients during the winter and spring of 2005. Vitamin D is deposited in adipose tissue, but the depot is not large enough to prevent seasonal variations in plasma concentrations. One unexpected finding was a possible association between concurrent antiretroviral use and elevated PTH levels.
Factitious or spurious hypokalemia, which can occur in patients with leukemia or elevated white cell counts because K+ is taken up by these metabolically active cells in the test tube, should be ruled out. Therefore, the normal values will vary, making the interpretation of significance difficult.
In these cases, lysis of the cells in the test tube releases potassium into the serum and increases potassium concentrations. Acute therapy is also directed at rapidly moving potassium into cells with intravenous dextrose and insulin. Even though there are natural alternatives, companies like to save money by using these artificial dyes.
A person’s kidneys filter creatinine from the blood and remove it from the body during urination. There has been a renewed effort to study the connection between ADHD and artificial food dyes due to many anecdotal findings.
The results of the psychologists’ ratings did not differ based on the dietary conditions. I figure that as long as they get healthy breakfast and dinner at home that I will not worry too much about it.
Vitamin D stores can be estimated by measuring serum 25-D concentrations due to its half-life of approximately 2 weeks.
One regulates K+ excretion, or external balance through the kidneys and intestines, and the second regulates K+ shifts, or internal balance between intracellular and extracellular fluid compartments.
This absorption in the proximal part of the nephron passively follows that of Na+ and water, whereas reabsorption in the thick ascending limb of the loop of Henle is mediated by the Na+,K+,2Cl- carrier (NKCC2) in the luminal membrane.
If true hypokalemia is present, then determine whether it was caused by a transcellular shift or a decrease in total body potassium. Repeated fist clenching with a tourniquet can also release K+ from muscle cells and increase potassium concentrations factitiously. A plasma K+ determination, instead of serum determination, is sometimes necessary in addition, spurious hyperkalemia will not be associated with abnormalities on the electrocardiogram (ECG). The problem is that artificial food coloring has been linked to many health problems, including cancer and ADHD. People with poorly functioning kidneys generally develop increased creatinine levels in the blood.
However, the parents reported significant reductions in hyperactive behavior when children were placed on the elimination diet, and significantly greater increases in hyperactive behavior when children consumed the drink with dyes and preservatives than with the children who received the placebo drink. Blueberry juice, carrot juice, paprika, grape skin extract, beet juice, purple sweet potato, and strawberries are some good alternatives. Hypokalemia from transcellular shift is managed by treating the underlying condition or removing the offending agent. In hyperkalemic patients, a value greater than 10 suggests normal aldosterone action and an extrarenal cause of hyperkalemia. If hyperkalemia is indeed present, then determine whether it occurred with a transcellular shift or reduction in potassium excretion, or in the setting of preserved renal function. Longer term therapy for hyperkalemia without conduction abnormalities should be directed toward minimizing intake and increasing excretion of potassium. Over the past 50 years, daily per capita intake of these dyes has increased fivefold (sources 1 and 2). Eating these fake substances are all risk, no benefit. There are still many studies that have not been done to determine the safety of these compounds in our bodies. Pretty much any produce that you can juice, could be used in recipes to tint the food a certain color. 1) in the cortical and outer medullary collecting tubule, and the papillary (or inner medullary) collecting duct via luminal potassium channels (ROMK). Magnesium depletion reduces the intracellular potassium concentration and causes renal potassium wasting; it appears to be caused by an impairment of cell membrane Na+, K+-ATPase (Box 2). As far as processed foods, the ingredients listed in the above infographic are natural dyes.
Secretion in these segments varies according to physiologic requirements, and is responsible for most of the urinary potassium excretion.
Urine potassium, chloride, creatinine, and serum aldosterone levels are determined to distinguish the causes of extrarenal and renal losses of K+ so that the primary condition can be treated, in addition to replacement therapy (see Fig. By avoiding processed foods, you will be avoiding the vast majority of these artificial food dyes which have no purpose except to please your eyes. Secretion in the distal segments is also balanced by K+ reabsorption through the intercalated cells (see Fig. This process is mediated by an active H+,K+-ATPase pump in the luminal membrane and results in both proton secretion and K+ reabsorption.
There were several more that have been approved but are currently delisted and banned due to adverse effects. Betanin is extracted from beets and Pandan is made from Pandanus amaryllifolius which is a tropical plant and butterfly pea is from Clitoria ternatea, a flowering plant. Only time will tell which of these currently used dyes will be next to be banned based on adverse effects.
The risks of artificial dyes are too numerous just for the benefit that our food looks pretty. Natural colorings can make food looks just as appetizing, it is just more expensive for the food companies. These big industrial food companies will not voluntarily stop using artificial dyes until they are banned in the United States (They are actually not used in many other countries). For now, check all ingredient labels and avoid synthetic food dyes for the health of yourself and your kids.



High blood sugar in morning gestational diabetes
Blurred vision due to high blood sugar
Glucose meter free


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