Treatments to Reduce Alzheimer’s Disease

Alzheimer’s disease is a degenerative brain disease and the most common type of dementia. It causes a slow decline in memory, thinking, and reasoning skills. Age is the biggest risk factor for the disease, followed by sex and family history.

There is currently no cure for Alzheimer’s disease. However, there is progress in Alzheimer’s and dementia research that is creating promising new treatments for those living with the disease.

The U.S. Food and Drug Administration (FDA) has approved medications for Alzheimer’s disease, which fall into two categories:

· Drugs that change disease progression in people living with early Alzheimer’s

· Drugs that temporarily ease some symptoms of Alzheimer’s

Drugs that change disease progression target the underlying biology of the disease process by aiming to slow the decline of memory and thinking, as well as function.

Anti-amyloid treatments work by removing a protein that accumulates into plaques in the brain, called beta-amyloid. Each treatment works differently and targets beta-amyloid at a different stage of plaque formation.

These treatments change the course of the disease significantly for those who are in the early stages by giving them more time to be able to participate in daily activities and live independently.

The two treatment therapies that change disease progression are Donanemab and Lecanemab.

Donanemab is an anti-amyloid antibody intravenous (IV) infusion therapy that is delivered every four weeks to treat early Alzheimer’s disease, which includes people who are living with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s who have been diagnosed with elevated beta-amyloid in the brain.

Donanemab was the third therapy that demonstrated that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

Lecanemab was the second therapy to demonstrate that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

It is important to note that anti-amyloid treatments do have side effects, such as allergic reactions, amyloid-related abnormalities (ARIA), infusion-related reactions, headaches, and falls.

As Alzheimer’s progresses, brain cells die, and the connections among those cells are lost. When this occurs, it causes cognitive and noncognitive symptoms to worsen.

Although these medications don’t stop the damage that Alzheimer’s disease causes to brain cells, they may lessen or stabilize symptoms for a limited time by affecting specific chemicals involved in delivering messages among and between the brain’s nerve cells.

The medications that are prescribed to treat symptoms related to memory and thinking include:

Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment, and other thought processes. These medications prevent the breakdown of a chemical messenger important for memory and learning, called acetylcholine. Cholinesterase inhibitors support communication between nerve cells. The most prescribed cholinesterase inhibitors include:

· Benzgalantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Donepezil treats mild-to-severe dementia due to Alzheimer’s disease

· Galantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Rivastigmine treats mild-to-moderate dementia due to Alzheimer’s disease as well as mild-to-moderate dementia due to Parkinson’s disease

Possible side effects for these medications include:

· Headache

· Dizziness

· Diarrhea

· Increased frequency of bowel movements

· Nausea

· Vomiting

· Loss of appetite

Glutamate regulators are medications prescribed to improve memory, attention, reasoning, language, and the ability to perform simple tasks. This medication regulates the activity of glutamate, a different chemical messenger that helps the brain process information.

Memantine is a glutamate regulator that treats moderate-to-severe Alzheimer’s disease. It can cause side effects that include headaches, constipation, confusion, and dizziness.

A cholinesterase inhibitor combined with a glutamate regulator, such as donepezil and memantine, treats moderate-to-severe Alzheimer’s disease. Possible side effects can include nausea, vomiting, loss of appetite, confusion, dizziness, increased frequency of bowel movements, and constipation.

Alzheimer’s disease doesn’t just impact memory and thinking. It also impacts a person’s quality of life by affecting a variety of behavioral and psychological symptoms that come with dementia, such as agitation, hallucinations and delusions, and sleep disturbances. Some medications focus on treating these non-cognitive symptoms for a time; however, it is important to try non-drug strategies to manage behaviors before adding medications.

The FDA has approved only one drug to manage symptoms of insomnia that has been tested in people who are living with dementia, and one that treats agitation.

Orexin receptor antagonists are prescribed to address symptoms of insomnia and inhibit the activity of a type of neurotransmitter involved in the sleep-wake cycle called orexin.

Suvorexant treats insomnia and has been shown in clinical trials to be effective for people who are living with mild to moderate Alzheimer’s disease. Possible side effects can include a risk of impaired alertness and motor function, worsening depression or suicidal thinking, complex sleep behaviors, sleep paralysis, and compromised respiratory function.

Atypical antipsychotics are a group of antipsychotic drugs that target the serotonin and dopamine chemical pathways in the brain. These drugs are mainly used to treat schizophrenia and bipolar disorder, as well as add-on therapies for major depressive disorder. The FDA requires that all atypical antipsychotics carry a safety warning that the medication has been associated with an increased risk of death in older patients who are experiencing dementia related psychosis.

Many atypical antipsychotic medications are used “off-label” to treat dementia-related behaviors, and there is only one FDA-approved atypical antipsychotic to treat agitation associated with dementia due to Alzheimer’s disease. It is important to try non-drug strategies to help manage non-cognitive symptoms such as agitation before adding any medications.

Brexpiprazole treats agitation associated with dementia due to Alzheimer’s disease. Possible side effects may include weight gain, sleepiness, common cold symptoms, dizziness, and restlessness.

If you or a loved one is experiencing any symptoms of Alzheimer’s disease or would like to learn more about treatment options, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Thyroid Awareness Month

January is Thyroid Awareness Month, a month that observes the importance of raising awareness of thyroid disorders and how they affect the lives of millions of people around the world.  

The thyroid is a gland located in front of the neck. It is a part of the body’s endocrine system and produces hormones that play an important role in many of the body’s systems, such as cells and tissues, the heart, brain, liver, and kidneys.  

The hormones the thyroid produces include: 

  • Thyroxine (T4)- the primary hormone made and released by the thyroid. It is the hormone that the thyroid makes the most of; however, it doesn’t have much of an effect on the metabolism 
  • Triiodothyronine (T3)- the thyroid makes lesser amounts of this hormone, but it has a much bigger impact on the metabolism than T4 
  • Reverse triiodothyronine- the thyroid makes very small amounts of RT3. This hormone reverses the effects of T3 
  • Calcitonin- this hormone helps regulate the amount of calcium in the blood 

These hormones also affect several bodily functions, including: 

  • Blood pressure 
  • Body temperature 
  • Heart rate 
  • Metabolism 
  • Breathing 
  • Digestion 
  • Brain development 
  • Mental activity 
  • Skin and bone maintenance 
  • Fertility 

Four main conditions affect the thyroid, including: 

  • Hypothyroidism, which is an underactive thyroid gland 
  • Hyperthyroidism, which is an overactive thyroid gland 
  • Goiter, which is an enlarged thyroid gland 
  • Thyroid cancer 

Different thyroid conditions have different symptoms. Symptoms depend on whether the thyroid is under- or over-producing hormones and can often be silent or present symptoms that are overlooked due to their subtlety.  

Symptoms that may signal a thyroid condition include: 

  • Slow or rapid heart rate 
  • Unexplained weight loss or weight gain 
  • Difficulty tolerating the cold or heat 
  • Depression (caused by hypothyroidism) or anxiety (caused by hyperthyroidism) 
  • Irregular menstrual periods 

When a healthcare provider wants to check the health of a person’s thyroid, they perform a blood test that measures the levels of thyroid-stimulating hormone (TSH). They will also check the levels of T4 and T3 in the blood. If the results of these tests come back and are abnormal, the healthcare provider may suggest an imaging test such as a thyroid scan or an ultrasound of the thyroid.  

There are several treatment options for thyroid conditions, depending on what they are and their severity. The three main treatment options for thyroid conditions include: 

  • Medication 
  • Surgery 
  • Radiation therapy and chemotherapy 

Thyroid conditions are common and can affect anyone at any age. However, some people face a higher risk if they: 

  • Have a family history of thyroid disease 
  • Have an autoimmune condition, such as type 1 diabetes, rheumatoid arthritis, or lupus 
  • Take a medication that’s high in iodine 
  • Are older than 60, especially if you’re female 

Fortunately, there is a way for a person to keep their thyroid healthy. This can be done by getting enough iodine in their diet with foods that are fortified with iodine, such as cheese, cow milk, eggs, yogurt, saltwater fish, shellfish, seaweed, soy milk, and soy sauce. 

If you would like to get your thyroid checked or to receive more information about Jamaica Hospital’s endocrinology service, you can make an appointment by calling 718-206-7001. 

                                                                                                                                                                                                                                                                                                             

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Symptoms of Autoimmune Disease

Autoimmune diseases are health conditions that happen when the immune system attacks the body instead of defending it. They are also called autoimmune disorders by healthcare providers. 

The immune system is the body’s built-in defense system. It automatically detects substances that shouldn’t be in the body, such as viruses, bacteria, or toxins. It sends out white blood cells to eliminate them before they can damage the body or make a person sick.  

If a person has an autoimmune disease, their immune system is overactive. When it doesn’t have anything to attack, the immune system turns on the body and damages healthy tissue.  

Autoimmune diseases are chronic conditions, which means a person will have to manage them and the symptoms they cause for the rest of their life.  

There are more than 100 different autoimmune diseases, and they can affect almost any tissue or organ in the body, depending on where the immune system malfunctions. These autoimmune diseases can include: 

  • Joints and muscles 
  • Rheumatoid arthritis (RA) 
  • Lupus 
  • Myositis 
  • Skin and blood vessels 
  • Sjögren’s syndrome 
  • Psoriasis 
  • Psoriatic arthritis 
  • Dermatomyositis 
  • Scleroderma 
  • Vasculitis 
  • Rheumatoid vasculitis 
  • Urticarial vasculitis 
  • Vitiligo 
  • Digestive system 
  • Crohn’s disease 
  • Celiac disease 
  • Ulcerative colitis 
  • Autoimmune gastritis 
  • Endocrine system 
  • Type 1 diabetes 
  • Addison’s disease 
  • Hashimoto’s thyroditis 
  • Graves’ disease 
  • Nervous system 
  • Multiple sclerosis (MS) 
  • Myasthenia gravis (MG) 
  • Guillain-Barré syndrome 
  • Chronic Inflammatory Demyelinating Polyneuropathy (CIPD) 

Autoimmune diseases are very common due to there being so many different types, with experts estimating that around 1 in 15 people in the U.S. has an autoimmune disease. 

Autoimmune diseases can cause a wide range of symptoms that can affect a person’s body from head to toe. Conditions that affect the muscles can cause muscle weakness, joint pain, swelling, or stiffness, indicating a condition such as rheumatoid arthritis. Type 1 diabetes causes high blood sugar. And some autoimmune diseases can affect a person’s vision. 

Many autoimmune diseases can cause inflammation, which causes a feeling of warmth, discoloration or redness of the skin, swelling, and pain.  

Additionally, a lot of autoimmune diseases can cause recurring symptoms. These episodes of more noticeable or more severe symptoms are called flares or attacks.  

Unfortunately, experts don’t know for certain what causes autoimmune diseases, and researchers are still studying what makes the immune system start attacking the body in the first place.  

However, some studies have found certain factors, or triggers, that might increase the risk of developing an autoimmune disease. They include: 

  • Viral infections such as COVID-19 and the Epstein-Barr virus 
  • A person’s sex, as women are more likely to have an autoimmune condition 
  • Having biological relatives with autoimmune diseases, as some are genetic and can be passed through generations of a biological family 
  • Having one autoimmune disease can increase a person’s odds of developing another one. This is called multiple autoimmune syndrome 
  • Exposure to chemicals or other environmental factors may trigger autoimmune diseases 
  • Smoking and other types of tobacco use can cause many health issues, including potentially triggering autoimmune diseases 

A healthcare provider diagnoses autoimmune diseases when they perform a physical exam and discuss a person’s health history with them. They will examine their body, specifically if they are experiencing symptoms in a specific area. They will ask about the person’s symptoms and when they first noticed them.  

A healthcare provider will perform tests for several different conditions that can cause the symptoms until they find a cause. This is called a differential diagnosis. They may order blood tests to look for specific markers, or clues the immune system leaves behind after it damages the body or causes specific issues, of autoimmune diseases.  

They may also perform imaging tests to look inside the body, including: 

  • X-rays 
  • MRI 
  • CT scan 
  • Ultrasound 

Autoimmune diseases may need a variety of treatments, since they cause a variety of symptoms. Which treatment is needed depends on which condition a person has. Everyone’s immune system, genetics, and environment are different, which means the treatments will be unique to each person. Some common treatments to manage autoimmune disease symptoms include: 

  • Pain relievers 
  • Anti-inflammatory medications such as NSAIDs or corticosteroids 
  • Immunosuppressants 
  • Physical therapy 
  • Occupational therapy 
  • IVIG infusions 

A person may need specific treatment based on what condition they have. People with Type 1 diabetes will need insulin therapy. People with celiac disease will need to eat a gluten-free diet. 

The Division of Rheumatology at Jamaica Hospital provides consultations for patients in Queens, NY, who develop rheumatological disorders. If you would like to make an appointment, please call 718-206-6742. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

ALS

Amyotrophic lateral sclerosis, commonly referred to as ALS, is a neurological disorder that affects nerve cells in the brain and spinal cord. ALS causes loss of muscle control.

ALS is often called Lou Gehrig’s disease after the baseball player who was diagnosed with it. There is no exact known cause of the disease. However, a small number of cases, about 10%, are inherited. For the other cases, there isn’t a known cause.

The symptoms of ALS can vary from person to person. Symptoms depend on which nerve cells are affected. ALS typically begins with muscle weakness that gradually worsens over time. Symptoms might include:

  • Trouble walking or doing usual daily activities
  • Tripping and falling
  • Weakness in the legs, feet, or ankles
  • Hand weakness or clumsiness
  • Weakness associated with muscle cramps and twitching in the arms, shoulders, and tongue
  • Untimely crying, laughing, or yawning
  • Thinking or behavioral changes

ALS often starts in the hands, feet, arms, or legs, with muscle twitching and weakness in an arm or leg. It then spreads to other parts of the body, causing muscles to get weaker as more nerve cells die. The disease eventually affects control of the muscles needed to move, speak, chew, eat, swallow, and breathe. Unfortunately, there is no cure for this fatal disease.

There is generally no pain in the early stages of ALS. Pain is also not common in the later stages. ALS usually doesn’t affect bladder control. And it also doesn’t affect the senses, including the ability to taste, smell, touch, and hear.

There are several risk factors for ALS, including:

  • Genetics
  • Age
  • Sex

Several environmental factors have been associated with an increased risk of ALS. They include:

  • Smoking
  • Environmental toxin exposure
  • Military service

ALS can cause several complications as the disease progresses, including:

  • Breathing problems
  • Speaking problems
  • Eating problems
  • Dementia

ALS can be hard to diagnose early because it can have similar symptoms to other diseases. Tests that can rule out other conditions or help diagnose the disease can include:

  • Electromyogram (EMG)
  • Nerve conduction study
  • MRI
  • Blood and urine tests
  • Spinal tap
  • Muscle biopsy
  • Nerve biopsy

Treatments for ALS can’t reverse the damage, but they can slow the progression of symptoms. They can also prevent complications and make you more comfortable and independent.

You may need a team of healthcare providers and doctors trained in many areas to provide your care. This team will work together to prolong your survival and improve your quality of life. They will work to select the right treatment options for you.

The Food and Drug Administration (FDA) has approved two medicines for treating ALS:

  • Riluzole
  • Edaravone

There are many forms of therapy and forms of support when ALS affects your ability to breathe, speak, and move. They include:

  • Breathing care
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Nutritional support
  • Psychological and social support

If you are experiencing any symptoms of ALS, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

World Vitiligo Day

June 25th is World Vitiligo Day. Vitiligo is a disease that causes skin to lose color or pigmentation. Smooth white or light areas called macules or patches appear on the skin. It generally starts on the hands, forearms, feet, and face.

Vitiligo occurs when the cells that produce melanin, melanocytes, stop making it or die. It is unclear what exactly causes vitiligo; however, it may be related to the following:

  • An autoimmune condition
  • Family history
  • A trigger event, such as stress, severe sunburn, or skin trauma, such as a chemical burn

About 1% of the global population has vitiligo. It affects all races and sexes equally. Vitiligo is more visible in people with darker skin tones. Although the disease can develop at any age, macules or patches usually become apparent before the age of 30.

A person may be at a higher risk of developing vitiligo if they have certain autoimmune conditions, such as:

  • Addison’s disease
  • Anemia
  • Type 1 diabetes
  • Lupus
  • Psoriasis
  • Rheumatoid arthritis
  • Thyroid disease

There are several types of vitiligo, including:

  • Generalized- the most common type of vitiligo that causes macules to appear in various places on the body
  • Segmental- this type only affects one side of the body or one area, such as the hands or face
  • Mucosal- this type affects the mucous membranes of the mouth and/or genitals
  • Focal- this rare type is where the macules develop in a small area and don’t spread in a certain pattern within one to two years
  • Trichome- this type causes a bullseye with a white or colorless center, then an area of lighter pigmentation, and an area of the person’s natural skin tone
  • Universal- this rare type causes more than 80% of the skin to lose pigment

The signs and symptoms of vitiligo include:

  • Patches of skin or mucous membranes that lose color and appear white or lighter than your natural skin tone
  • Patches of hair on the body turn silver, gray, or white

Symptoms can be mild and only affect a small area of the body or severe, affecting a large area of the skin. Some people with vitiligo experience itchy skin before depigmentation starts.

To diagnose vitiligo, a healthcare provider will ask about your medical history and examine your skin, possibly with a special lamp. This evaluation may also include a skin biopsy and blood tests.

The choice of treatment for vitiligo depends on your age, how much skin is involved and where, how quickly the disease is progressing, and how it’s affecting your life.

Medications and light-based therapies are available to help restore skin color or even skin tone, though results may vary and are unpredictable. Some treatments have serious side effects, so a healthcare provider may suggest that you try changing the appearance of your skin by applying a self-tanning product or makeup first.

If you and a healthcare provider decide to treat your condition with a drug, surgery, or therapy, it may take several months to judge its effectiveness. You may also have to try a combination of approaches before finding what works best.

If you have vitiligo, certain self-care tactics may help you care for your skin and improve its appearance, including:

  • Protecting your skin from the sun and artificial sources of UV light
  • Concealing affected skin
  • Not getting a tattoo

To schedule an appointment with a dermatologist at Jamaica Hospital Medical Center, please call (718) 206-7001.

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Sickle Cell Disease

Sickle cell disease is a group of inherited blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body. A genetic mutation in the HBB gene causes sickle cell disease. The HBB gene is responsible for making a part of hemoglobin. The disease gets its name from the abnormal crescent or “sickle” shape that some red blood cells develop, causing those red blood cells to block the blood flow through the body, creating recurring episodes of pain.

Sickle cell disease is a lifelong disease affecting more than 100,000 people in the United States and 20 million worldwide. It is the most common inherited blood disorder in the United States. In the U.S., most people who have sickle cell disease are of African ancestry or identify themselves as black. About one in 13 Black or African American babies is born with the sickle cell trait. About one in every 365 Black or African American babies is born with sickle cell disease. Many people who come from Hispanic, Southern European, Middle Eastern, or Asian Indian backgrounds also have sickle cell disease.

There are many symptoms of sickle cell disease. Early symptoms can include:

  • Jaundice- a condition that causes the color of the skin or whites of the eyes to turn yellow
  • Extreme tiredness
  • Painful swelling of the hands and feet

Many serious symptoms and complications of sickle cell disease include:

  • Episodes of severe pain
  • Anemia symptoms- fatigue, shortness of breath, dizziness, and an irregular heartbeat
  • Fever
  • Acute chest syndrome
  • Stroke
  • Priapism
  • Avascular necrosis
  • Pulmonary hypertension
  • Organ damage
  • Leg ulcers
  • Gallstones
  • Deep vein thrombosis
  • Pregnancy complications
  • Vision problems
  • Frequent infections

Sickle cell disease is diagnosed using a blood test that can check for the form of hemoglobin that underlies sickle cell anemia. In the United States, this test is part of routine newborn screening, but older children and adults can also get it.

If you or your child has sickle cell disease, your healthcare provider may suggest other tests to check for possible complications. If you or your child carries the sickle cell gene, you will likely be referred to a genetic counselor.

If you have sickle cell disease, there are many ways to manage and treat it, including:

  • Medicines
  • Blood transfusions
  • Blood and bone marrow transplant
  • Gene therapies
  • Complementary and alternative medicine (CAM)

Your healthcare team will probably include a doctor specializing in blood diseases called a hematologist.

If you need help managing symptoms of sickle cell disease or sickle cell trait, schedule an appointment with a hematologist at Jamaica Hospital Medical Center’s Department of Internal Medicine at (718) 206-7001.

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Lupus Awareness Month

May is observed as Lupus Awareness Month, a month used to educate, advocate, and support those affected by lupus.

Lupus is an autoimmune disease that occurs when the body’s immune system attacks its tissues and organs. Inflammation caused by lupus can affect many different body systems, such as the joints, skin, kidneys, blood cells, brain, heart, and lungs.

Healthcare providers sometimes call lupus systemic lupus erythematosus (SLE). It is the most common type of lupus, which means you have lupus throughout your body. Other types of lupus include:

  • Cutaneous lupus erythematosus is lupus that only affects your skin
  • Drug-induced lupus occurs when some medications trigger lupus symptoms as a side effect. It is usually temporary and might go away after you stop taking the medication that caused it
  • Neonatal lupus occurs when babies are sometimes born with lupus. Babies born to biological parents with lupus aren’t certain to have lupus, but they might have an increased risk

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have a mild form of the disease characterized by flare-ups, when signs and symptoms may get worse for a while, and then improve or disappear completely for a time.

The signs and symptoms of lupus you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include:

  • Fatigue
  • Fever
  • Joint pain, stiffness, and swelling
  • A butterfly-shaped rash on the face that covers the cheeks and bridge of the nose, or rashes elsewhere on the body
  • Skin lesions that appear or worsen with sun exposure
  • Fingers and toes that turn white or blue when exposed to cold or during stressful periods
  • Shortness of breath
  • Chest pain
  • Dry eyes
  • Headaches, confusion, and memory loss

Lupus likely results from a combination of genetics and environment.

People with an inherited predisposition for lupus may develop the disease when they come into contact with an environmental trigger of the disease. Some potential triggers of lupus include:

  • Sunlight
  • Infections

Diagnosing lupus is difficult because signs and symptoms can vary from person to person and may change over time, overlapping with those of many other disorders.

No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and results of a physical examination can lead to a diagnosis. Blood and urine tests may include:

  • A complete blood count
  • Erythrocyte sedimentation rate
  • Kidney and liver assessment
  • Urinalysis
  • Antinuclear antibody (ANA) test

If your healthcare provider suspects that lupus is affecting your lungs or heart, they may suggest imaging tests that can include:

  • A chest X-ray
  • An echocardiogram

Lupus can harm the kidneys in many ways, and treatments can vary depending on the type of damage it causes. Sometimes, a kidney biopsy is needed to determine the best treatment. A skin biopsy can be performed to confirm a diagnosis of lupus affecting the skin.

A healthcare provider will suggest treatments for lupus that manage your symptoms. The goal is to minimize damage to the organs and how much lupus affects your day-to-day life. Most people with lupus need a combination of medications to help them prevent flare-ups and lessen the severity of symptoms during one. Medications you might need include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids
  • Antimalarial drugs
  • Immunosuppressants
  • Biologics

Simple measures can help prevent lupus flare-ups if they occur, and help you to better cope with the signs and symptoms you experience, including:

  • Seeing your doctor regularly
  • Being sun smart
  • Getting regular exercise
  • Quitting smoking
  • Eating a healthy diet
  • Asking your healthcare provider if you need vitamin D and calcium supplements

For more information about the Lupus Center at the campus of Jamaica Hospital Medical Center or to make an appointment with a lupus doctor, call (718) 206-9888 or the Lupus Hotline at 1-877-33-LUPUS.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

The Difference between Type 1 and Type 2 Diabetes

Diabetes is a chronic disease that occurs when the body doesn’t produce enough insulin or can’t use the insulin it produces effectively.

There are two main types of diabetes: type 1 and type 2.

Type 1 and type 2 diabetes have similar names, however, they are different diseases with distinctive causes.

A key difference between type 1 and type 2 diabetes is type 1 is caused by an autoimmune reaction and develops early in life. Type 2 diabetes develops over several years and is related to lifestyle factors such as being inactive and carrying excess weight, and is usually diagnosed in adults.

Type 1 diabetes is believed to be caused by an autoimmune reaction where the immune system attacks and destroys the insulin-producing beta cells in the pancreas, mistaking them for foreign invaders. After the beta cells are destroyed, the body can no longer produce insulin.

Researchers are unsure why the immune system attacks the body’s cells. They believe it may be due to genetic and environmental factors, such as being exposed to viruses.

People who have type 2 diabetes have an insulin resistance. The body can still produce insulin but is unable to use it effectively.

Researchers aren’t sure why some people become insulin-resistant and others don’t, but several lifestyle factors may contribute to it, such as being inactive and carrying excess weight.

Other genetic and environmental factors may also play a role. When a person develops type 2 diabetes, the pancreas will overcompensate by producing more insulin. Because the body can’t effectively use the insulin, glucose accumulates in the bloodstream.

Risk factors for type 1 diabetes are less clear than risk factors for type 2 diabetes.

The known risk factors for type 1 diabetes include:

  • Family history
  • Age

Risk factors for type 2 diabetes include:

  • Having prediabetes or slightly elevated blood sugar levels
  • Carrying excess weight or having obesity
  • Having a lot of belly fat
  • Being physically active less than three times a week
  • Being over the age of 45
  • Having had gestational diabetes
  • Giving birth to a baby weighing more than nine pounds
  • Being Black, Hispanic or Latino, American Indian, or Alaska Native due to structural inequities contributing to health disparities
  • Having an immediate family member with type 2 diabetes
  • Having polycystic ovary syndrome (PCOS)

If not managed properly, type 1 and type 2 diabetes can lead to symptoms that can include:

  • Urinating frequently
  • Feeling very thirsty and drinking a lot of fluids
  • Feeling very hungry
  • Feeling very fatigued
  • Having blurry vision
  • Having cuts or sores that don’t heal properly
  • Having very dry skin
  • Having more infections than usual

People with type 1 and type 2 diabetes can also experience irritability, mood changes, and unintentional weight loss.

Unfortunately, type 1 diabetes can’t be prevented. However, it is possible to lower the risk of developing type 2 diabetes through lifestyle changes that include:

  • Maintaining a moderate weight
  • Working with a healthcare provider to develop a healthy weight-loss plan, if you are overweight
  • Increasing activity levels
  • Eating a balanced diet and reducing the intake of sugary foods and overly processed foods

If you are experiencing diabetes symptoms, you can call to schedule an appointment with an endocrinologist at Jamaica Hospital Medical Center’s Ambulatory Care Center at (718) 206-7001.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

National Afib Awareness Month

September is National Afib Awareness Month. Afib stands for atrial fibrillation, a type of arrhythmia or abnormal heartbeat. During Afib, the heart’s upper chambers, or the atria, beat chaotically and irregularly. They beat out of sync with the lower heart chambers, the ventricles.

Afib can lead to blood clots in the heart. It also increases the risk of stroke, heart failure, and other heart-related complications.

It usually isn’t life-threatening, but it is a serious medical condition that needs proper treatment to prevent serious health issues.

There are many symptoms of Afib, they can include:

  • Feelings of a fast, fluttering, or pounding heartbeat
  • Chest pain
  • Dizziness
  • Fatigue
  • Lightheadedness
  • Reduced ability to exercise
  • Shortness of breath
  • Weakness

People can experience three types of Afib, including:

  • Paroxysmal Afib
  • Persistent Afib
  • Long-standing persistent Afib

The most common cause of Afib is problems with the heart’s structure. Other health problems and heart diseases that can cause Afib include:

  • A congenital heart defect
  • Sick sinus syndrome
  • Obstructive sleep apnea
  • Heart attack
  • High blood pressure
  • Lung diseases, including pneumonia
  • Coronary artery disease
  • Thyroid diseases
  • Infections from viruses

Many factors can increase your risk of Afib, including:

  • Age
  • Caffeine, nicotine, or illegal drug use
  • Drinking too much alcohol
  • Changes in the level of body minerals
  • Family history
  • Long-term health conditions
  • Obesity
  • Some medicines and supplements

Healthy lifestyle choices can reduce the risk of heart disease and prevent Afib. Some basic heart-healthy tips include:

  • Controlling high blood pressure, high cholesterol, and diabetes
  • Not smoking or using tobacco
  • Eating a diet that is low in salt and saturated fat
  • Exercising at least 30 minutes a day at least five days a week
  • Getting at least seven to nine hours of sleep a day
  • Maintaining a healthy weight
  • Reducing and managing stress

Afib is diagnosed when a healthcare provider examines you and asks questions about your medical history and symptoms. Tests may be done to look for conditions causing irregular heartbeats such as heart disease or thyroid disease, including:

  • Blood tests
  • ECG or EKG
  • Holter monitor
  • Event recorder
  • Implantable loop recorder
  • Exercise stress tests
  • Chest X-ray

The goals of Afib treatment are to reset and control the heartbeat and prevent blood clots. Treatment for Afib depends on how long you’ve had it, your symptoms, and the cause of the irregular heartbeat. Afib treatment can include:

  • Medications
  • Cardioversion therapy
  • Surgery or catheter procedures

If you are experiencing any symptoms of Afib, you can schedule an appointment at Jamaica Hospital Medical Center’s Cardiology Department by calling (718) 206-7100. If you are experiencing an emergency, please dial 911 right away.

 

 

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Sickle Cell Awareness Month

September is sickle cell awareness month. Sickle cell disease is a group of inherited red blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body. It is the most common inherited blood disorder in the United States. The disease gets its name from the abnormal crescent or “sickle” shape that some red blood cells develop, causing those red blood cells to block the blood flow through the body creating recurring episodes of pain.

Sickle cell disease is a lifelong disease affecting more than 100,000 people in the United States and 20 million worldwide. In the U.S., most people who have sickle cell disease are of African ancestry or identify themselves as black. About one in 13 Black or African American babies are born with the sickle cell trait and about one in every 365 Black or African American babies are born with sickle cell disease. Many people who come from Hispanic, Southern European, Middle Eastern, or Asian Indian backgrounds also have sickle cell disease.

There are many symptoms of sickle cell disease. Early symptoms can include:

  • Jaundice- a condition that causes the color of the skin or whites of the eyes to turn yellow
  • Extreme tiredness
  • Painful swelling of the hands and feet

Many serious symptoms and complications of sickle disease can include:

  • Episodes of severe pain
  • Anemia symptoms- fatigue, shortness of breath, dizziness, and an irregular heartbeat
  • Fever
  • Acute chest syndrome
  • Stroke
  • Priapism
  • Avascular necrosis
  • Pulmonary hypertension
  • Organ damage
  • Leg ulcers
  • Gallstones
  • Deep vein thrombosis
  • Pregnancy complications
  • Vision problems
  • Frequent infections

There are many ways to manage and treat sickle cell disease including:

  • Medicines
  • Blood transfusions
  • Blood and bone marrow transplant
  • Gene therapies
  • Complementary and alternative medicine (CAM)

Your healthcare team will probably include a doctor specializing in blood diseases called a hematologist.

If you need help managing symptoms of sickle cell disease or sickle cell trait, schedule an appointment with a hematologist at Jamaica Hospital Medical Center’s Department of Internal Medicine at (718) 206-7001.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.