Small Health Clues: Constipation

While constipation isn’t exactly a dinner hour topic, as a dietitian, I hear about it so often that it doesn't phase me at all. My clients start talking about one thing and then, toward the end of our visit they shyly bring up their struggles with constipation. And, it isn’t a matter of just adding fiber and wa-la! no more worries. Constipation is more complicated then that because there could be several causes including:

- Inadequate fiber intake
- Inadequate water intake
- Stress
- Inactive lifestyle
- Change in diet or schedule due to travel
- Overuse of laxatives
- Medications
- Supplemental iron (especially if taken in large doses)
- Hypothyroidism
- Eating disorders
- Irritable bowel syndrome (IBS)
- Certain diseases
- Colon cancer

And, some people are just more prone to constipation. So, what can you do? Take a look at this list and start figuring how the potential contributing causes that may apply to you. Next, see what you can do about them. You may not be able to switch medicines but you can exercise more, drink more water and boost both your insoluble and soluble fiber intake. You can also treat IBS by finding out which foods bother you (LEAP tests are recommended by some) and taking a probiotic (Align is often recommended), switching to an iron supplement that doesn’t constipate (or at least decreases the likelihood of constipation) and be very cognizant of what you eat when traveling.

To see Dr. Oz’s depiction of constipation and his recommendations, click here.

Wounds that Don't Heal

If you have a wound that won't heal or bleeds what seems like a river for a small area, it's time to get it checked out. Wounds that won’t heal or random spots on your skin that bleed excessively, could mean a number of things from skin cancer or diabetes to poor nutrition.

Skin cancer isn't always very easy to spot. Patches of skin that look rough or like acne (pearly bumps) may actually be actinic keratoses (precursor to skin cancer), basal cell or squamous cell carcinoma. Check out the signs of skin cancer as well as a few pictures here.

Another contributing cause to wounds that are slow to heal is diabetes.

And finally, poor nutrition shows up in your skin and may delay wound healing, especially if you haven't been consuming good sources of zinc and vitamin C.

If there's something wrong with your body, oftentimes you get a warning sign or even a few warning signs. The problem is, many of us ignore those warnings until they start to interfere with our daily life. Start paying close attention to changes in your body and, when something doesn't seem right, talk to your doctor or nurse.

More than Just a Bad Hair Day: Thinning Hair

Volumizing sprays, thickening shampoos, oxygen delivery directly to the scalp - there are a number of products and services on the market that target people with hair loss. I equate this to the weight loss market. If you aren’t vein about your hair, holding on to every strand you’ve got, you might be after you drive down the highway and see a larger than life billboard with before and after pictures of a man with hair plugs. Do I look like the before picture? Wait, do I need this procedure?

While some men lose hair in patches and others have general thinning, women typically lose overall volume, which may make their hair loss very subtle and easy to overlook initially. Regardless of whether you are a man or woman, if you want to save your strands, it’s time to get to the root of the problem. And, the majority of hair loss is considered genetic and therefore medication (either topically, like Rogaine) or orally such as Merck’s Propecia (for men only) will decrease hair loss and possibly stimulate hair growth. But, you shouldn’t just assume that your hair loss is due to your genetic makeup. There are several causes of hair loss including:

- chemotherapy

- alopecia areata (an autoimmune disease)

- hypothyroidism

- androgenic alopecia (pattern baldness, this occurs in men and women)

- physical or emotional stress

- anorexia
For help with anorexia nervosa or other eating disorders, see EDIN or Something Fishy.

- poor nutrition – diets low in protein or iron (and possibly vitamin D), crash diets, gluten intolerance or celiac disease (possibly), fad diets and eating disorders can all lead to hair loss. If the other causes listed here do not apply to you, get a full iron panel done (not just hemoglobin and hematocrit) because iron deficiency without anemia can cause hair loss. And, get your vitamin D levels checked.

- illness

- hormonal changes (high testosterone levels in women)

- hair treatments – dye, bleach, straighten or perm your hair one too many times and it will become damaged and weak. Over-styling hair can also cause problems.

- scalp infection – ringworm or a fungal infection to your scalp can lead to hair loss. Most experts believe that dandruff is due to overgrowth of the fungi pityrosporum ovale or malassezia globosa. If you treat the dandruff, dandruff-related hair loss should subside. Anti-fungals such as zinc sulfate, salicylic acid and ketoconazole (found in Nizoral Shampoo and this ingredient supposedly kills the fungus) help. In addition, coal tar can reduce the appearance of flakes. And finally, you can try an age-old remedy for stopping the fungus – apple cider vinegar. And one more trick of the trade – never wrap wet hair in a towel or bunch it up on top of your head or put it in a ponytail. Yeast thrives in a damp environment!

Hair loss can impact how you feel about yourself, your morale and confidence. If you notice even the first sign of hair loss, instead of racing for the drug store for volumizing products, turn to the American Hair Loss Association for self-help and to find a dermatologist or endocrinologist. Starting early will lead to better results. And, finding the root of the cause will help you find an effective solution versus taking a shot in the dark.

Small Health Clues: Brittle Fingernails

Your nails keep breaking off or splintering and coming off in layers. So, what’s the obvious fix? Buy a nail strengthening polish and brush on a few coats prior to putting color on. But, doing this would be like continually slapping a Band-Aid on a wound that just won’t heal. There’s a reason for both and until you find the underlying problem, you’ll never actually “fix” anything. So, we are going to play a little game of sleuth and uncover some of the common issues that occur with your fingernails and what causes them:

Lines across your fingernails – these lines may pop up after an illness or if you are malnourished.

- Brittle or splitting nails – hyperthyroidism, hypothyroidsism or lack of adequate nutrition (most often iron deficiency or low biotin intake) can lead to brittle nails. If your toenails are strong and fingernails are not then an environmental cause may be to blame (winter heat, use of strong household cleaners or constantly washing and drying your hands).

If you have brittle nails, start wearing gloves when you wash dishes and clean your house, try non-acetone nail polish remover and apply lotion to your nails and cuticle areas often. Also, increase your intake of biotin-rich foods or can take this B vitamin as a supplement alone or in a B complex vitamin. Biotin rich foods include: tomatoes, romaine lettuce, carrots, oatmeal, onions, strawberries, Swiss chard, halibut, almonds and walnuts. Also, avoid raw egg whites or products that contain raw eggs since a protein in egg whites, avidin, can bind biotin preventing adequate absorption of this vitamin. When eggs are cooked, avidin no longer binds biotin.

- Abnormal shape (koilonychia) – if your fingernails have raised ridges are thin and curved inward, you probably have iron deficiency anemia.

- Pitting – depressions in your nail may be caused by psoriasis.

- General damage – disease, injury or illness can cause general damaged nails.

Here’s the bottom line – if you have issues with your fingernails that just won’t go away, even after your injury or illness has, it’s time to see a doctor. Sometimes seemingly little cues mean larger issues lie underneath.

Small Health Clues: Cracks at the Corner of Your Mouth

They say a dentist can tell a lot about your overall health by examining your mouth. Likewise, an optometrist or ophthalmologist can also tell you about various aspects of your health by examining your eyes. In the meantime though, there are little signs we should pick up on to make us realize there may be a bigger issue we need to address.

But, it’s the little telltale signs that we may dismiss as irrelevant. But, simple things like ridges in your fingernails and cracks at the corner of your mouth can sometimes be the first warning sign you notice. So what about those painful cracks at the corner of your mouth?

Technically, cracks at the corner of your mouth are called angular cheilitis and there are a few causes:

- Infection – you know how you close your mouth and a little saliva gets stuck at the corners? Yeast loves saliva and therefore
fungal infections are the most common infections at this site. Watch how much you lick your lips and ask your physician
for an anti-fungal medicine. They work like a charm.

- Denture problems, missing teeth, ill-fitting braces – when your bite is thrown off, a number of other things are as well and
this can cause painful cracks.

- B vitamin deficiency –deficiency in one or more B vitamins can lead to issues in your mouth including a red tongue, a
swollen tongue, cracks at the corners of your mouth, and throat swelling.

- Iron deficiency – this is rarely the cause of cracks here but, iron deficiency is the most common nutrient deficiency
worldwide. If you’ve ruled out all other causes, get your iron levels checked.

Even if something on your body seems minor though a bit annoying, get it checked out. There are many small cues to bigger problems.

Why You Should Take Nutrition Information with a Grain of Salt

Today starring me in the face, I remembered why I often tell people to listen to the message but then take decide if it applies to you. If you don’t know, ask your dietitian or physician. But, always keep in mind that there isn’t a one-size-fits all approach to nutrition. What you hear in the media may have nothing to do with you. An above average BMI may mean little to nothing as long as you are otherwise healthy and active. And just because your co-worker thinks she needs to lose 5 lbs, that doesn’t mean you should jump on that bandwagon.

So my personal wake up call of the day was about sodium. I agree with CDC’s take that many people consume too much sodium and hypertension (high blood pressure) is prevalent. I discuss this message in the media, advocate that most sedentary people watch their sodium intake yet carefully monitor how much sodium my athletes get to ensure they don’t cramp or worse yet, end up with dangerously low blood sodium. However, somewhere in this mix of people to look after and messages to convey, I forgot the very thing that has helped me for years - regularly salting my food. You see, I’m on the opposite end of the spectrum compared to the majority of Americans. My blood pressure is very low. Normally my body warns me, I get dizzy or end up with postural hypotension (get dizzy and my vision blurry when standing up too quickly). But today an ordinary blood pressure cuff and a nurse with a puzzled look on her face made me realize I had slacked on the advice a doctor gave me years ago: “salt your food!” This just goes to show you how subconsciously, messages seep in and we think “yes, I need to take vitamin C daily” or “everyone else is taking fish oil, I’ll take some and see what it does.” And, that my friends, is like playing a game of Nutrition Scrabble. Taking a ton of advice, mixing it up and seeing if you can spell out a health prescription.

As your own health advocate, read, ask and listen but consider what is good for your own body, not your neighbors, the general public or your coworker’s body. There isn’t a one-size-fits-all approach to nutrition or health. And sometimes, you have to ignore what the people around you say and do what’s best for you. And, be diligent about it…..even if it goes against popular opinion.

And, here I go, back to the odd looks people give me and comments like “that stuff’s gonna kill ya, you should know better” when they see a dietitian salting her food.

Does Supplemental Iron Improve Athletic Performance?

Studies report a high prevalence of iron deficiency and iron deficiency anemia in female athletes and soliders. And, iron needs may be higher in athletes due to the demands of training and iron loss (for example, blood cells actually break down from running – something termed foot strike hemolysis). In addition, women lose iron through menstruation every month.

Iron deficiency occurs in 2 main stages:

1) Iron deficiency – too little iron in the body. This is the most common nutrient deficiency worldwide and, according to the NIH, as much as 80% of the world’s population may be iron deficient!

2) Iron deficiency anemia – by the time you reach anemia, you have advanced iron depletion. Your iron storage is deficient and your blood levels of iron cannot meet your daily needs. A general CBC (Complete Blood Count) includes a test for hemoglobin, which will show up below normal when you are anemic. According to the NIH, 33% of the world may have iron deficiency anemia.

While iron deficiency and iron deficiency anemia can slow you down, taking iron will improve performance and help you feel significantly better (though if you have normal iron levels, taking iron isn’t warranted and doing so will have no effect on performance).

Symptoms of iron deficiency and iron deficiency anemia include muscle weakness, fatigue, feeling cold often and impaired cognitive performance.