What’s happening in our bodies as we age?

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What’s happening in our bodies as we age?

January 23, 2017 6.10am AEDT

As we reach adulthood, we notice changes in our bodies at every stage of ageing. We might find we need glasses when we hit our thirties, we can’t keep weight off as easily into our forties, we mightn’t feel as strong playing sport with the kids in our fifties, and we can’t hear a conversation across a crowded dinner table in our sixties.

All of these occur because the cells and processes in our bodies have existed for longer and longer periods of time. There are many theories as to why our body ages, but two main explanations are that the DNA within our genes determine how long we will live; the other is that over time, our body and DNA are damaged until they can no longer function as before, often referred to as “wear and tear”.

The ageing brain

As we age, the volume of the brain declines. There are many explanations for this, including cell death, in which the brain cells’ structure declines over time.

Although the precise reasons for the decline in brain volume remain unclear, some research indicates it may be due to hormone levels, and wear and tear.

Some also believe that the volume of blood reaching the brain decreases due to conditions within the blood vessels and associated systems. However, this doesn’t have a great impact on a person’s ability to remember, as the brain has the ability to compensate for these changes.

You may have heard of neuroplasticity. This is the term used to explain how the brain can rewire itself by creating new pathways within the nerve cells to compensate for damage to an area. These new pathways are created when new experiences occur. So doing crosswords all of your life won’t increase the number of pathways, but if you add a new activity that you need to learn and practise, then new pathways can form.

While the risk of dementia increases with age due to many of the hundreds of causes being more present as we age, it is not a normal part of the ageing process. It is a result of damage to the brain. The reason why it is more likely to occur as we age is simply because the longer we live, the longer we expose ourselves to possible damage to the body through disease or injury, which are the main causes of dementia.

Doing crosswords in old age will only improve brain function if it’s a new activity. from http://www.shutterstock.com

Alzheimer’s Disease, the most common cause of dementia in Australia, occurs when there is plaque build-up in the brain. This is as a result of protein build-up over time that inevitably causes tangles in the neurons (brain cells).

Changes in muscle strength

As we age, there’s a decrease in the amount and strength of muscle tissue, due mostly to the influence of decreasing hormones. To make up for the muscle mass lost during each day of strict bed rest, older people may need to exercise for up to two weeks.

However, additional decreases in muscle occur due to a decrease in activity, not just as part of the normal ageing process.

Decrease in bone density

As the body ages it absorbs less calcium from food, a vital mineral for bone strength. At the same time, changes in hormone levels affect the density of the bones.

Ageing people also often spend less time in the sun, thereby reducing their Vitamin D intake. This in turn reduces calcium absorption.

It is important people continue to exercise as they age. Exercise will not only help to maintain muscle strength, but also assist in combatting the decrease in bone density that occurs as the body ages, thereby reducing the risk of falls and hip fractures.

Exercise will help to combat common fractures in old age. from http://www.shutterstock.com

Changes to our senses

Changes that occur directly as a result of ageing include those to vision, hearing, taste and smell. Impacts of the changes in vision are usually the first things noticed, making a person feel that they are ageing.

Changes to the eye that occur as part of the ageing process include stiffening and colouring of the lens, a reduction in the number of nerve cells, and a decrease in fluid in the eye. These lead to difficulty in focusing on close objects, seeing in low light becomes more difficult, and the ability to adapt to changes in light decline.

Some people appear clumsy, as their ability to judge the distance between objects – a cup and table, for example, or the height of stairs – becomes a problem. Many people do not realise their spills and trips are occurring as a result of shifts in their vision, known as depth perception changes. Eyes can also become drier, making them feel irritated. This can be treated with lubricating drops.

Changes in hearing include changes in registering high-pitched sounds, and words may become difficult to understand. Speaking more loudly to someone in this circumstance does not help, as the pitch is the problem, not the volume. Instead speaking slightly slower and concentrating on complete words can be helpful.

Taste and smell often decrease as part of the normal ageing process, as the cells responsible decrease in number and the ability to regenerate worn out cells decreases with age. The results make food less tasty and people less likely to eat. In addition, people’s taste can change altogether, so people who loved chocolate as a young person may prefer chilli as they age.

Overall there are many changes to the body as part of the normal ageing process as well as many that occur as a result of lifestyle factors. We are not all fated to age in a negative spiral. Many lifestyle choices made earlier in life can assist us in the future. With proactive decisions and community understanding, we can look forward to adapting to a positive ageing process

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HRT reduces risk of getting Diabetes

 Estrogen in women is a gift that just keeps giving. I do not need to tell you that diabetes is in epidemic proportion in Australia as well.
Endocr Rev. 2017 Jun 1;38(3):173-188. doi: 10.1210/er.2016-1146.

Menopausal Hormone Therapy and Type 2 Diabetes Prevention: Evidence, Mechanisms, and Clinical Implications.

Mauvais-Jarvis F1, Manson JE2,3, Stevenson JC4, Fonseca VA1.

Author information

1
Department of Medicine, Division of Endocrinology and Metabolism, School of Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana 70112.
2
Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115.
3
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115.
4
National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London SW3 6NP, United Kingdom.

Abstract

Type 2 diabetes has reached epidemic proportions in the United States. Large, randomized controlled trials suggest that menopausal hormone therapy (MHT) delays the onset of type 2 diabetes in women. However, the mechanisms and clinical implications of this association are still a matter of controversy. This review provides an up-to-date analysis and integration of epidemiological, clinical, and basic studies, and proposes a mechanistic explanation for the effect of menopause and MHT on type 2 diabetes development and prevention. We discuss the beneficial effects of endogenous estradiol with respect to insulin secretion, insulin sensitivity, and glucose effectiveness; we also discuss energy expenditure and adipose distribution, both of which are affected by menopause and improved by MHT, which thereby decreases the incidence of type 2 diabetes. We reconcile differences among studies that investigated the effect of menopause and MHT formulations on type 2 diabetes. We argue that discrepancies arise from physiological differences in methods used to assess glucose homeostasis, ranging from clinical indices of insulin sensitivity to steady-state methods to assess insulin action. We also discuss the influence of the route of estrogen administration and the addition of progestogens. We conclude that, although MHT is neither approved nor appropriate for the prevention of type 2 diabetes due to its complex balance of risks and benefits, it should not be withheld from women with increased risk of type 2 diabetes who seek treatment for menopausal symptoms.

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Postmenopausal hormone therapy and the risk of colorectal cancer: a review and meta-analysis.

One of the many benefits of estrogen to women is that it reduces the risk of getting bowel cancer by about 30%.
Am J Med. 1999 May;106(5):574-82.

Postmenopausal hormone therapy and the risk of colorectal cancer: a review and meta-analysis.

Grodstein F1, Newcomb PA, Stampfer MJ.

Author information

1
Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Abstract

PURPOSE:

Colorectal cancer is the fourth most common cancer and the second leading cause of cancer death in the United States. Accumulating evidence indicates that postmenopausal hormone therapy may reduce the risk of colorectal cancer in women.

METHODS:

Through MEDLINE computer searches (January 1966 to September 1998) and a review of references, we identified English-language articles with quantitative data on the relation of postmenopausal hormone therapy to colorectal cancer. We reviewed the studies and made summary estimates of relative risks (RR) by weighting the results of each study in proportion to its precision, using a general variance-based, fixed-effects model.

RESULTS:

In our meta-analysis of 18 epidemiologic studies of postmenopausal hormone therapy and colorectal cancer, we found a 20% reduction [RR = 0.80, 95% confidence interval (CI), 0.74 to 0.86] in risk of colon cancer and a 19% decrease (RR = 0.81, 95% CI, 0.72 to 0.92) in the risk of rectal cancer for postmenopausal women who had ever taken hormone therapy compared with women who never used hormones. Much of the apparent reduction in colorectal cancer was limited to current hormone users (RR = 0.66, 95% CI, 0.59 to 0.74).

CONCLUSION:

Observational studies suggest a reduced risk of colorectal cancer among women taking postmenopausal hormones. There is biologic evidence to support this association

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Verbal memory and menopause

 

  • Menopausal hormone therapy should not be prescribed for the sole purpose of improving cognition.
  • Midlife women should be advised that memory complaints are common during the menopausal transition and memory problems appear to return to baseline during the postmenopausal period.
  • Midlife women should be advised that dementia is rare at this age and referral to a neurologist should only be recommended if memory problems significantly disrupt daily function.
  • Women should be advised to practice healthy sleep habits and engage in cardiovascular exercise to improve memory.

Abstract

Midlife women frequently report memory problems during the menopausal transition. Recent studies validate those complaints by showing significant correlations between memory complaints and performance on validated memory tasks. Longitudinal studies demonstrate modest declines in verbal memory during the menopausal transition and a likely rebound during the postmenopausal stage. Clinical studies that examine changes in memory following hormonal withdrawal and add-back hormone therapy (HT) demonstrate that estradiol plays a critical role in memory. Although memory changes are frequently attributed to menopausal symptoms, studies show that the memory problems occur during the transition even after controlling for menopausal symptoms. It is well established that self-reported vasomotor symptoms (VMS) are unrelated to objective memory performance. However, emerging evidence suggests that objectively measured VMS significantly correlate with memory performance, brain activity during rest, and white matter hyperintensities. This evidence raises important questions about whether VMS and VMS treatments might affect memory during the menopausal transition. Unfortunately, there are no clinical trials to inform our understanding of how HT affects both memory and objectively measured VMS in women in whom HT is indicated for treatment of moderate to severe VMS. In clinical practice, it is helpful to normalize memory complaints, to note that evidence suggests that memory problems are temporary, and to counsel women with significant VMS that memory might improve with treatment.

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What’s actually in our blood?

Caboolture has a lovely library and Art Gallery, at the Hub, which is in the centre of town, one block away from where i work at the medical centre. At present the Brett Whitely exhibition is on (free) and i can recommend it to all those interested in art. I suggest that you pop in after your visit to me and spend some time there. Well worth it. Details below.

https://www.moretonbay.qld.gov.au/subsite.aspx?id=162784

Explainer: what’s actually in our blood?

July 25, 2017 6.12am AEST

Our blood has more functions than we probably realise – all vital for life. from http://www.shutterstock.com.au

This week we’re running a series in collaboration with the Australian Red Cross Blood Service looking at blood: what it actually does, why we need it, and what happens when something goes wrong with the fluid that gives us life. Read other articles in the series here.


Blood is vitally important for our body. As it’s pumped around our body through veins and arteries, it transports oxygen from our lungs to all of the other organs, tissues and cells that need it. Blood also removes waste products from our organs and tissues, taking them to the liver and kidneys, where they’re removed from the body.

About 45% of our blood consists of different types of cells and the other 55% is plasma, a pale yellow fluid. Blood transports nutrients, hormones, proteins, vitamins and minerals around our body, suspended in the plasma. They provide energy to our cells and also signal for growth and tissue repair. The average adult has about five litres of blood.

The different types of blood cells include red blood cells, platelets, and white blood cells, and these are produced in the bone marrow, in the centre of our bones.

The Conversation, CC BY-ND

Red blood cells

Red blood cells are essential for transporting oxygen around the body. Red cells are very small, donut-shaped cells with an average lifespan of 120 days within the body. They contain a protein called haemoglobin, which contains iron and binds very strongly to oxygen, giving blood its red colour.

Red cells are flexible and able to squeeze through even the tiniest of our blood vessels, called capillaries, to deliver oxygen to all of the cells in our body. When the red cells reach our organs and tissues, haemoglobin releases the oxygen.

Platelets

Platelets are even smaller than red blood cells. In fact, they are tiny fragments of another much larger type of cell, called a megakaryocyte, which is located in the bone marrow. Platelets are formed by budding off from the megakaryocyte. Platelets have an average lifespan of eight to 10 days within the body, so they are constantly being produced. When body tissue is damaged, chemicals are released that attract platelets.

Platelets clump together and stick to the damaged tissue, which starts to form a clot to stop bleeding. Many of the proteins that help the clot to form are contained in plasma. Platelets also release growth factors that help with tissue healing.


Infographic – From animal experiments to saving lives: a history of blood transfusions


White blood cells

Blood also carries white blood cells, which are an essential part of our immune system. Some white cells are able to kill micro-organisms by engulfing and ingesting them. Other types of white cells, called lymphocytes, release antibodies that help to fight infection.

Blood cells don’t act alone; they work together for normal body function. For example, when we cut our skin, platelets help plug the cut to stop it bleeding, plasma delivers nutrients and clotting proteins, white cells help to prevent the cut from becoming infected, and red cells deliver oxygen to help keep the skin tissue healthy.

Blood transfusions

Sometimes patients who are having surgery, cancer treatment or when they are seriously injured need a blood transfusion. This is usually because they have lost a lot of platelets, red cells or plasma, or because their cancer treatment has killed many of their blood cells.

The journey of blood.

In Australia, blood is donated by voluntary blood donors at the Australian Red Cross Blood Service. A typical whole blood donation is just over 450 mL, and it takes around ten minutes to collect. Every time a donation is made, the donor is screened for infectious diseases such as hepatitis and HIV, so these aren’t transferred to the patient receiving the blood.

After donation, the blood is separated into its different parts: platelets, red cells and plasma, which are known as blood components. White cells are removed because they can cause problems in patients who receive them. Once the blood has been separated, it’s stored until it’s needed by hospitals. The red blood cells are stored in a refrigerator and the plasma is frozen. The red cells can be stored for six weeks, and the plasma can be stored for up to a year. Platelets can only be stored for five days. When a hospital needs blood it’s packed into special blood shippers, and transported to the hospital blood bank to be transfused

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Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women

I am much better today and hope to return to work tomorrow.

Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: A randomized, double-blinded, placebo-controlled trial

Menopause, 11/17/2016

For this study, researchers assess the adequacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women and assess its impact on the serum levels of testosterone. Tribulus terrestris might be a safe alternative for the treatment of hypoactive sexual desire disorder in postmenopausal women since it was viable in diminishing symptoms with few side effects. It is a likely mechanism of action involves an increase in the serum levels of free and bioavailable testosterone.

Methods

  • In this study researchers played out a prospective randomized, double–blinded, placebo–controlled study, amid year and a half.
  • An aggregate of 45 healthy sexually active postmenopausal women reporting decreased libido were chosen to participate in the study and were haphazardly appointed to get 750 mg/d of T terrestris or placebo for 120 days.
  • Randomization was performed utilizing sealed envelopes.
  • All participants answered the Female Sexual Function Index and the Sexual Quotient–female version questionnaires and had their serum levels of prolactin, thyroid–stimulating hormone, total testosterone, and sex hormone–binding globulin measured.

Results

  • A sum of 36 participants finished the study because 3 from each group were excluded because of side effects and 3 dropped out because of personal reasons.
  • FSFI questionnaire results showed an improvement in all domains in both groups (P < 0.05) except for lubrication which was enhanced only in the study group. QS–F results demonstrated a significant improvement in the domains of desire (P < 0.01), arousal/lubrication (P = 0.02), pain (P = 0.02), and anorgasmia (P < 0.01) in women who utilized T terrestris, whereas no improvement was seen in the placebo group (P > 0.05).
  • Moreover, free and bioavailable testosterone levels demonstrated a significant increase in the T terrestris group (P < 0.05).

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