Rheumatoid arthritis and heart disease

 Rheumatoid arthritis and heart disease

People with rheumatoid arthritis are at increased risk for developing heart disease. In particular, they have a greater likelihood of developing hardening of the arteries (atherosclerosis), which can lead to heart attacks. The connection between heart disease and rheumatoid arthritis is not well understood, but it may relate to inflammation. 

People with rheumatoid arthritis have inflammation in joints and elsewhere in the body. Inflammation is known to promote atherosclerosis.

Because of this connection, people with rheumatoid arthritis must be carefully evaluated to identify other risk factors for heart disease. These should be addressed to help lower the chances for developing heart disease. Risk factors for heart disease include:
• high blood pressure (more than 140/90 mm Hg)
• total cholesterol greater than 200 mg/dL
• low-density lipoprotein (LDL) cholesterol greater than 160 mg/dL
• high-density lipoprotein (HDL) cholesterol less than 40 mg/dL
• diabetes
• smoking
• family history of heart disease.

Exercise and a healthy diet can help to address these risk factors. If healthy lifestyle changes don’t do the trick, medications to lower blood pressure, cholesterol, and blood sugar should be considered. Some medications used to treat rheumatoid arthritis have been shown to actually lower the risk for dying from heart disease. These include methotrexate and anti-TNF agents. Others, such as NSAIDs, may increase risk. Water Cure: Drugs Kill. You might like to review the water cure protocol in this blog site.

Safe Sex / Intercourse

 The only sure way to prevent sexually transmitted diseases (STDs) is to not have sexual intercourse or other sexual contact. But the next best choice is to follow these safer sex guidelines:

• Engage in sexual intercourse only with one partner who has been tested and who is having sex only with you.
• Use a latex or polyurethane condom or a female condom every time you have sex.
• For oral sex, use a latex or polyurethane male condom or a female condom.
• For anal sex, use a latex or polyurethane male condom.

immune system? Myths vs facts and strategies for healthier living

 Your immune system is on the job around the clock to protect you from infectious bacteria, viruses, fungi, and parasites that cause disease, suffering, and death. The immune system is an extremely complex network of cells and molecules that researchers are still working to understand. Because there is so much about immune function that remains unknown, immune system myths abound and commercial enterprise have exploited them.

The following are three common immune system myths.

Immune system myth #1: The more active your immune system is, the healthier you will be.

Immune system fact #1: Where the immune system is concerned, there can be too much of a good thing. A hyperactive immune response is responsible for allergic reactions to ordinary nontoxic substances. It also underlies a number of major diseases, including diabetes, lupus, and rheumatoid arthritis. According to Dr. Robert Shmerling, medical editor of the Harvard Medical School Special Health Report Rheumatoid Arthritis, it is not known why the immune system malfunctions in people with rheumatoid arthritis. "Theories (and myths) abound," he said. "Infections, diet, and environmental toxins have all been blamed at one time or another–but there is no convincing evidence supporting any one of these as a specific cause of rheumatoid arthritis. In fact, there may be multiple reasons why the immune system malfunctions."

Immune system myth #2: Getting more than the recommended dietary allowance of a vitamin or mineral will improve your immune system.

Immune system fact #2: So far, there is no evidence that taking extra amounts of any vitamin will improve your immune system or protect you if you don't have micronutrient deficiencies. However, older people, who are more likely to have such deficiencies, should discuss this question with a physician who is well versed in geriatric nutrition.

Immune system myth #3: Many vaccines have health risks.

Immune system fact # 3: Nearly everything we do involves some level of risk. The risk of dying in a car accident is one in 6,700. The chance of drowning in the bathtub is one in 840,000. But the risk of a serious reaction from a vaccine is small by comparison: one in a million for the diphtheria, tetanus, and pertussis, or DTaP vaccine, for example. And yet most of us don't hesitate to take a bath or ride in the car.

What you can do to improve your immune system

Following general good-health guidelines is the single best step you can take toward keeping your immune system strong and healthy. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

• Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.
• Stay up to date with recommended immunizations.
• Don't smoke.
• Eat a diet high in fruits, vegetables, and whole grains. Restrict saturated fats and sugars to 10% of total calories. Minimize consumption of red and processed meats.
• Exercise regularly. Try to get 150 minutes of moderate activity a week.
• Maintain a healthy weight.
• Control your blood pressure.
• If you drink alcohol, do so only in moderation.
• Get adequate sleep.
• Get regular medical screening tests for people in your age group and risk category.

Coronavirus Vaccines: Your Questions Answered

 Ernest Grant, the president of the American Nurses Association, is taking part in a Moderna coronavirus vaccine trial. He says he wants to increase trust in science.

GETTING THE VACCINE

I am a 68-year-old snowbird that lives in Florida from November to April. However I am a Pennsylvania resident. Will I be able to receive a vaccination in Florida when it is available for elderly people?

From William Schaffner MD, medical director of the National Foundation for Infectious Diseases:

The short answer is yes. You should be able to get the vaccine in Florida when it is available. But be mindful that you have to get 2 doses separated by 3 weeks and it has to be the same vaccine (i.e. Pfizer or Moderna). It would be most advisable for you to go back to the same provider because the records there will be the clearest and there will be no confusion. If you get the first vaccine in Florida, stay there for 3 weeks to get the second vaccine there as well.

I am 65 and live in a 55-plus community. When do you feel I can realistically expect to be able to get the vaccine?

From William Schaffner MD, medical director of the National Foundation for Infectious Diseases:

The determining factor will be your age, not your community. You’ll be in the second or third group to receive a vaccine, likely by sometime this spring. We know healthcare providers are first, and then residents of long-term care facilities. We are waiting on advice from the CDC Advisory committee on who should go next -- essential workers, or people who are 65 or older.

WHAT ARE THE SIDE EFFECTS AND EFFECTS ON SPREAD?

[What are the] side effects [from the vaccines] for people with underlying health issues. Do they even know?

From Dr. William Moss, executive director of the International Vaccine Access Center:

Both [Pfizer and Moderna vaccines] use messenger RNA technology, a really novel vaccine platform. ...There still remain many questions to be answered as we go forward. At this juncture, we're only going to know about short-term side effects, but we need to know whether there are any potential rare, long-term side effects. Short-term side effects that we know of now appear in about 5% to 15% of participants. They include inflammation, soreness at the injection site, a low-grade fever, headaches, muscle aches and fatigue. These can last from 12 to 36 hours after vaccination.

Can I get or spread COVID-19 from the vaccine?

From Side Effects Public Media:

No. The COVID-19 vaccine doses developed by Pfizer-BioNTech and Moderna ... has been in development for about three decades, but is only now being used for COVID-19. According to the CDC, mRNA vaccines teach your cells how to make a protein – or even just a piece of a protein – that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects you from getting infected if the real virus enters our bodies.

WHAT IF I’M IMMUNOCOMPROMISED OR HAVE OTHER PRE-EXISTING CONDITIONS?

Is it safe for patients with autoimmune disease who take immunosuppressive medications to be vaccinated against COVID? Is it effective?

From Dr. William Moss, executive director of the International Vaccine Access Center:

There's no doubt that we're going to have to look very carefully at data on both the safety and efficacy because that too can be impaired in immunocompromised individuals. The vaccines that are typically not recommended routinely for severely immunocompromised individuals are what we call attenuated viral vaccines, where we take the natural virus and make it weaker. And this is a very old way of making vaccines. But for example, our measles, mumps, and rubella vaccines are attenuated viral vaccines. None of the front runners for COVID-19 or SARS-CoV-2 are that type of vaccine. So I don't anticipate problems with safety ... but that will need to be studied going forward.

Should organ (liver) transplant recipients who are taking anti-rejection medications (Prograf/Tacrolimus) be vaccinated for COVID-19?

From William Schaffner MD, medical director of the National Foundation for Infectious Diseases:

The short answer is yes. Although this population hasn't been studied, we don’t think there is any chance of harm. It may be that the immune response is somewhat blunted, but it could do some good. The CDC advisory committee said it probably won’t hurt but it might help.

Do any of the manufacturers know if their vaccine is safe for people with HIV?

From William Schaffner MD, medical director of the National Foundation for Infectious Diseases:

It probably won't hurt, but it could help. The second vaccine in line -- the Moderna vaccine -- included a small study of people with HIV infection and we expect to see that data shortly. But in the meantime, if people with HIV are offered the Pfizer vaccine they should take it.

I am a health care worker. I will be 62 years old next month. I have intrinsic asthma maybe twice a year. Can I/should I prep for the vaccine with just Benadryl? I have taken the influenza vaccine for the last 2 years without issue or prep.

From William Schaffner MD, medical director of the National Foundation for Infectious Diseases:

No preparation is necessary for someone with asthma. That person should have the same sort of response of any 62-year-old without asthma.

WILL I HAVE TO PAY FOR THE VACCINE?

From Side Effects Public Media:

No. Vaccine providers will be able to bill insurance for a fee to administer the vaccine, but will not be able to charge you. They can seek reimbursement for uninsured patients from the Health Resources and Services Administration’s Provider Relief Fund.

EMPLOYER’S RESPONSIBILITY

What responsibility does an employer have to all its employees when an employee tests COVID positive? Aren’t they obligated to inform everyone? No employer can possibly know all the employees the infected employee came in contact with!

From Zack Flood, an associate attorney specializing in labor and employment law, and Bob Simandl, chair of the Labor and Employment Group, both at the Milwaukee-based law firm von Briesen & Roper:

Zack Flood: There is a patchwork of state and local guidance across the country with regards to employer responsibilities. The most important thing is the general duty under federal Occupational Health and Safety Administration laws to create and maintain a safe workplace. The employer's responsibility to other employees when they find out that they have a positive test is first to make sure that person is not coming into work, because that is going to create a threat. But also communicating to the rest of the workforce that there has been a positive test, but not disclosing the identity of that employee. The identity of the individual must be kept confidential.

Bob Simandl: The employer should already have a policy that addresses what its role will be as it relates to an employee testing positive and in communicating with fellow employees about the risk and ways to remain safe. The overarching responsibility for the employer is to provide a safe workplace and to keep employees informed about those policies. The employer needs to communicate with employees where the exposure took place and how they are working with authorities to safeguard employees and families. Ultimately there has to be a post-mortem done on how the policy worked.

What It's Like To Get Russia's Sputnik V COVID-19 Vaccine

 MARY LOUISE KELLY, HOST:

To Russia now, where President Vladimir Putin is singing the praises of his country's homegrown COVID-19 vaccine. It is called Sputnik V, and Putin's been encouraging Russians to get it. The Kremlin is using the vaccine to project some Russian soft power with other countries that are struggling to get or to afford Western-made vaccines. The backdrop here is Sputnik V was unveiled last year before all the usual tests were completed. Many Russians have been wary, have been reluctant to take it, as was our Moscow correspondent, Lucian Kim, until today. Lucian's on the line from Moscow now.

Hey, there.

LUCIAN KIM, BYLINE: Hey, Mary Louise.

KELLY: So I hear you are fresh out of a city hospital where you got the Sputnik V. How are you feeling?

KIM: I'm feeling fine, thanks. My left arm is just a little sore...

KELLY: (Laughter) Yeah.

KIM: ...But I've been getting vaccines since I was a baby, so (laughter) I know that's pretty normal.

KELLY: And is the Sputnik V, is it a two-dose vaccine or are you done now?

KIM: No, it's a two-dose vaccine. I have to go back in three weeks.

KELLY: In three weeks. OK. Well, tell us about today at the hospital. How did - how does it work there? Was there a big line? Did you have to wait?

KIM: Well, it was a really easy process. I could sign up at a nearby public hospital. I qualify for the vaccine as a journalist. Then I got a confirmation by text message and then just went there this morning. There was no line at all. It was very organized. You know, it was just your standard vaccination as you can hear on this recording I tried to (laughter) make while getting my shot.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED NURSE: (Speaking Russian).

KIM: So the nurse is telling me to relax my arm. And then it was all over before I knew it.

(SOUNDBITE OF ARCHIVED RECORDING)

KIM: (Speaking Russian).

UNIDENTIFIED NURSE: (Speaking Russian).

KIM: And the examining doctor gave me some recommendations I should follow.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED DOCTOR: (Speaking Russian).

KIM: So she's saying I'm not allowed to swim, go to the gym or a sauna or drink any alcohol for the next three days.

KELLY: Ah. OK. I'm curious just what you were weighing when you decided whether to do this or not, Lucian. Because as we mentioned, a lot of Russians have been wary of the vaccine, but the latest reports have been that it is actually quite effective.

KIM: Right. Well, this vaccine is very political. As you mentioned, President Putin unveiled it before it had been fully tested and has since promoted it around the world. But I've spoken to experts, and nobody I talked to said there were really any issues about the science behind this vaccine. There were results published in the British medical journal The Lancet last week that showed that Sputnik V is very effective, almost 92%.

So my concerns with the vaccine were more about the way it might be stored or transported. But it only needs to be kept at cold and not super cold temperatures like some other vaccines. I've also wondered about how long the vaccine will be effective. The doctor today could not tell me that. But at the end of the day, I just decided that Sputnik V is better than no protection at all.

KELLY: And give us a sense of what the national conversation is in Russia when it comes to the COVID vaccine. Do most Russians still have reservations about this or are they lining up now?

KIM: No, there's real resistance to getting vaccinated. I was really surprised that the nurse who gave me my shot still hasn't been vaccinated herself.

KELLY: Huh.

KIM: Polls have shown about half of the Russian population doesn't want to get vaccinated. And, you know, the explanation is the same as in many other countries. There's a lot of skepticism about what the government says people should do.

Sort of a mystery to me is that Vladimir Putin still has not announced that he received the Sputnik V vaccination. He's been the biggest promoter of the vaccine. He said he'd get it when his age category was approved. And now that he can, we still haven't heard that he's done it.

You know, COVID-19 has hit Russia really hard. If you believe the official statistics, there have been almost 80,000 deaths. But according to Russia's own statistics agency, last year there were 358,000 deaths more than normal - what's called excess mortality. Even the government says most of those deaths are linked to COVID-19, which suggests that Russia's real number of COVID-19 deaths last year may have been many times higher than the official figure.

KELLY: That is NPR's Lucian Kim talking about getting the Russian vaccine in Moscow today.

Lucian, stay well and good luck with that sore left arm.

KIM: Thanks, Mary Louise.

How to boost your immune system

1. Helpful ways to strengthen your immune system and fight off disease

Stay Informed

How can you improve your immune system? On the whole, your immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it fails: A germ invades successfully and makes you sick. Is it possible to intervene in this process and boost your immune system? What if you improve your diet? Take certain vitamins or herbal preparations? Make other lifestyle changes in the hope of producing a near-perfect immune response?

What can you do to boost your immune system?

The idea of boosting your immunity is enticing, but the ability to do so has proved elusive for several reasons. The immune system is precisely that — a system, not a single entity. To function well, it requires balance and harmony. There is still much that researchers don't know about the intricacies and interconnectedness of the immune response. For now, there are no scientifically proven direct links between lifestyle and enhanced immune function.

But that doesn't mean the effects of lifestyle on the immune system aren't intriguing and shouldn't be studied. Researchers are exploring the effects of diet, exercise, age, psychological stress, and other factors on the immune response, both in animals and in humans. In the meantime, general healthy-living strategies are a good way to start giving your immune system the upper hand.

Immunity in action. A healthy immune system can defeat invading pathogens as shown above, where two bacteria that cause gonorrhea are no match for the large phagocyte, called a neutrophil, that engulfs and kills them (see arrows). Photos courtesy of Michael N. Starnbach, Ph.D., Harvard Medical School

Healthy ways to strengthen your immune system

Your first line of defense is to choose a healthy lifestyle. Following general good-health guidelines is the single best step you can take toward naturally keeping your immune system strong and healthy. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

• Don't smoke.
• Eat a diet high in fruits and vegetables.
• Exercise regularly.
• Maintain a healthy weight.
• If you drink alcohol, drink only in moderation.
• Get adequate sleep.
• Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.
• Try to minimize stress.

Increase immunity the healthy way

Many products on store shelves claim to boost or support immunity. But the concept of boosting immunity actually makes little sense scientifically. In fact, boosting the number of cells in your body — immune cells or others — is not necessarily a good thing. For example, athletes who engage in "blood doping" — pumping blood into their systems to boost their number of blood cells and enhance their performance — run the risk of strokes.

Attempting to boost the cells of your immune system is especially complicated because there are so many different kinds of cells in the immune system that respond to so many different microbes in so many ways. Which cells should you boost, and to what number? So far, scientists do not know the answer. What is known is that the body is continually generating immune cells. Certainly, it produces many more lymphocytes than it can possibly use. The extra cells remove themselves through a natural process of cell death called apoptosis — some before they see any action, some after the battle is won. No one knows how many cells or what the best mix of cells the immune system needs to function at its optimum level.

Immune system and age

As we age, our immune response capability becomes reduced, which in turn contributes to more infections and more cancer. As life expectancy in developed countries has increased, so too has the incidence of age-related conditions.

While some people age healthily, the conclusion of many studies is that, compared with younger people, the elderly are more likely to contract infectious diseases and, even more importantly, more likely to die from them. Respiratory infections, influenza, the COVID-19 virus and particularly pneumonia are a leading cause of death in people over 65 worldwide. No one knows for sure why this happens, but some scientists observe that this increased risk correlates with a decrease in T cells, possibly from the thymus atrophying with age and producing fewer T cells to fight off infection. Whether this decrease in thymus function explains the drop in T cells or whether other changes play a role is not fully understood. Others are interested in whether the bone marrow becomes less efficient at producing the stem cells that give rise to the cells of the immune system.

A reduction in immune response to infections has been demonstrated by older people's response to vaccines. For example, studies of influenza vaccines have shown that for people over age 65, the vaccine is less effective compared to healthy children (over age 2). But despite the reduction in efficacy, vaccinations for influenza and S. pneumoniae have significantly lowered the rates of sickness and death in older people when compared with no vaccination.

There appears to be a connection between nutrition and immunity in the elderly. A form of malnutrition that is surprisingly common even in affluent countries is known as "micronutrient malnutrition." Micronutrient malnutrition, in which a person is deficient in some essential vitamins and trace minerals that are obtained from or supplemented by diet, can happen in the elderly. Older people tend to eat less and often have less variety in their diets. One important question is whether dietary supplements may help older people maintain a healthier immune system. Older people should discuss this question with their doctor.

Diet and your immune system

Like any fighting force, the immune system army marches on its stomach. Healthy immune system warriors need good, regular nourishment. Scientists have long recognized that people who live in poverty and are malnourished are more vulnerable to infectious diseases. Whether the increased rate of disease is caused by malnutrition's effect on the immune system, however, is not certain. There are still relatively few studies of the effects of nutrition on the immune system of humans.

There is some evidence that various micronutrient deficiencies — for example, deficiencies of zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, and E — alter immune responses in animals, as measured in the test tube. However, the impact of these immune system changes on the health of animals is less clear, and the effect of similar deficiencies on the human immune response has yet to be assessed.

So, what can you do? If you suspect your diet is not providing you with all your micronutrient needs — maybe, for instance, you don't like vegetables — taking a daily multivitamin and mineral supplement may bring other health benefits, beyond any possibly beneficial effects on the immune system. Taking megadoses of a single vitamin does not. More is not necessarily better.

Improve immunity with herbs and supplements?

Walk into a store, and you will find bottles of pills and herbal preparations that claim to "support immunity" or otherwise boost the health of your immune system. Although some preparations have been found to alter some components of immune function, thus far there is no evidence that they actually bolster immunity to the point where you are better protected against infection and disease. Demonstrating whether an herb — or any substance, for that matter — can enhance immunity is, as yet, a highly complicated matter. Scientists don't know, for example, whether an herb that seems to raise the levels of antibodies in the blood is actually doing anything beneficial for overall immunity.

Stress and immune function

Modern medicine has come to appreciate the closely linked relationship of mind and body. A wide variety of maladies, including stomach upset, hives, and even heart disease, are linked to the effects of emotional stress. Despite the challenges, scientists are actively studying the relationship between stress and immune function.

For one thing, stress is difficult to define. What may appear to be a stressful situation for one person is not for another. When people are exposed to situations they regard as stressful, it is difficult for them to measure how much stress they feel, and difficult for the scientist to know if a person's subjective impression of the amount of stress is accurate. The scientist can only measure things that may reflect stress, such as the number of times the heart beats each minute, but such measures also may reflect other factors.

Most scientists studying the relationship of stress and immune function, however, do not study a sudden, short-lived stressor; rather, they try to study more constant and frequent stressors known as chronic stress, such as that caused by relationships with family, friends, and co-workers, or sustained challenges to perform well at one's work. Some scientists are investigating whether ongoing stress takes a toll on the immune system.

But it is hard to perform what scientists call "controlled experiments" in human beings. In a controlled experiment, the scientist can change one and only one factor, such as the amount of a particular chemical, and then measure the effect of that change on some other measurable phenomenon, such as the amount of antibodies produced by a particular type of immune system cell when it is exposed to the chemical. In a living animal, and especially in a human being, that kind of control is just not possible, since there are so many other things happening to the animal or person at the time that measurements are being taken.

Despite these inevitable difficulties in measuring the relationship of stress to immunity, scientists are making progress.

Does being cold give you a weak immune system?

Almost every mother has said it: "Wear a jacket or you'll catch a cold!" Is she right? Probably not, exposure to moderate cold temperatures doesn't increase your susceptibility to infection. There are two reasons why winter is "cold and flu season." In the winter, people spend more time indoors, in closer contact with other people who can pass on their germs. Also the influenza virus stays airborne longer when air is cold and less humid.

But researchers remain interested in this question in different populations. Some experiments with mice suggest that cold exposure might reduce the ability to cope with infection. But what about humans? Scientists have dunked people in cold water and made others sit nude in subfreezing temperatures. They've studied people who lived in Antarctica and those on expeditions in the Canadian Rockies. The results have been mixed. For example, researchers documented an increase in upper respiratory infections in competitive cross-country skiers who exercise vigorously in the cold, but whether these infections are due to the cold or other factors — such as the intense exercise or the dryness of the air — is not known.

A group of Canadian researchers that has reviewed hundreds of medical studies on the subject and conducted some of its own research concludes that there's no need to worry about moderate cold exposure — it has no detrimental effect on the human immune system. Should you bundle up when it's cold outside? The answer is "yes" if you're uncomfortable, or if you're going to be outdoors for an extended period where such problems as frostbite and hypothermia are a risk. But don't worry about immunity.

Exercise: Good or bad for immunity?

Regular exercise is one of the pillars of healthy living. It improves cardiovascular health, lowers blood pressure, helps control body weight, and protects against a variety of diseases. But does it help to boost your immune system naturally and keep it healthy? Just like a healthy diet, exercise can contribute to general good health and therefore to a healthy immune system. It may contribute even more directly by promoting good circulation, which allows the cells and substances of the immune system to move through the body freely and do their job efficiently.

Pesticides Exploded in France Farming

  Dr. Rath Health Foundation at  February 12, 2021

Use Of Pesticides Has ‘Exploded’ In France In Past Decade

French farmers have increased pesticide use by 25 percent in the past decade, an inquiry led by environmental organization La Fondation Nicolas Hulot has found. The increase has occurred despite the country’s goal to reduce pesticide usage by 50 percent by 2025.

The growing use of pesticides in France is having catastrophic environmental effects. Research published in 2018 found that dozens of species of birds have seen their numbers decline in the country, in some cases by two-thirds, because insects they feed on have disappeared.

Scientists have uncovered similar trends across the European continent, estimating that flying insects have declined by 80 percent and bird populations by more than 400 million. Significantly, therefore, pesticide residues have been found in 83 percent of soils in Europe, and in 166 different pesticide combinations. Pesticide pollution of streams is also now widespread in Europe.

To read how scientific research is increasingly confirming the health benefits of pesticide-free organic food, see this article on our website.