11 Action Steps on How to Prevent a Stroke!

StrokeMany people look at a stroke as a brain problem.  In reality it’s a cardiovascular problem that can have deadly consequences.  For Americans, stroke is the number one cause of adult disability.  Thus, learning how to prevent a stroke will have a positive impact on decreasing its harmful effect on our community.

As pointed out in a previous article, it’s estimated that 750,000 Americans will experience a stroke this year.  Of this number, 160,000 will die.  The rest will forever have their lives changed in significant and profound ways.

For our African American friends, they are twice as likely to die from a stroke as Caucasians. The rate of having their first stroke is almost doubled.  One half of all African American women will die from either a stroke or heart disease.  For those with sickle cell anemia, 11% will have experienced a stroke by the age of 20.

All of this is pretty depressing until you understand that, according to the National Stroke Association,

“… 80% of strokes are preventable!”

Everyone is at risk for a stroke but everyone also has the power to reduce this risk.  This article will empower you with 11 action steps to help you learn how to prevent a stroke.  So, let’s get started.

Risk Factors For Stroke:  Uncontrollable vs. Controllable!

There are some uncontrollable risk factors for stroke like:  age, gender, race, family history and a previous stroke or TIA. Now, before we examine how to prevent a stroke, I would like to make some observations about two of these uncontrollable risk factors.

  • Age. Although you have no control over your chronological age, you do have the ability to reduce your biological age. One of my readers recently shared with me that he has been making some gradual changes in his eating and exercise habits.  These changes have resulted in him losing over 10 pounds.  He now has greater energy and stamina for his daily work activities as well as his recreational endeavors.  Even though his chronological age will keep moving forward, he has begun the process of improving his biological age.  Each person has the ability to make positive lifestyle changes that can significantly improve their overall health and wellness while reducing their risk for stroke and other cardiovascular diseases.  The key is to concentrate on improving the health of your endothelial cells and their ability to produce nitric oxide.
  • Family History. If someone in your family has had a stroke, then you are at a higher risk for a stroke.  Part of this could be genetics.  Part of your family history could be lifestyle.  You have no control over the genetics but you certainly have control over your lifestyle. You have the power to change the eating, drinking, smoking, and lifestyle choices that contributed to your family member’s stroke.  The 11 action steps in this article will help you break this cycle.

Even though there are 5 uncontrollable risk factors, the good news is that there are 8 controllable risk factors that give you a high degree of control; control that can help you learn how to prevent a stroke!  They are:

  • Control High Blood Pressure.
  • Control Heart Disease especially Artial Fibrillation.
  • Stop Smoking.
  • Control Alcohol Consumption.
  • Control Your Cholesterol.
  • Control Your Diabetes.
  • Control Your Weight Through Diet, Exercise, and Nutrition.
  • Check for Other Circulatory Problems.

I talk about these 8 controllable risk factors in the article “African Americans and Stroke!” We will also take them up in the following 11 steps.

11 Steps That May Reduce Your Stroke Risk!

These 11 steps will help you learn how to prevent a stroke. Some of these steps will be pretty clear and easy to implement.  Others will require you to make a lifestyle choice.  It’s our daily choices that end up determining our overall health.

Step 1 – Go See A Qualified Physician. If you do not know what your blood pressure reading is, what your cholesterol level is, or where your blood sugar level is at, then you must get these benchmarks measured as soon as possible.  These are the big three in learning how to prevent a stroke. Also, have your physician check your heart and circulatory system especially the carotid arteries.

Step 2 – Make Sure Your Blood Pressure is under 120/80. Anything over 120/80 is of concern and anything over 140/90 is a red flag to take action. It’s the #1 risk factor for a stroke because high blood pressure increases your stroke risk 4-6 times.  This makes learning how to control your blood pressure a critical factor in learning how to prevent a stroke.

Step 3 – Make Sure Your Cholesterol Level is under 200. Anything over 200 is of concern and anything over 240 is a red flag to take action.

Step 4 – Make Sure You Are Not A Diabetic. Diabetes is not something to play around with.  Not only does it increase your risk for stroke but it also affects so many other organs in your body.  Most of the damage is due to oxidative stress on the endothelial cells and the resulting poor blood flow to the organs.

Step 5 – Control Your Weight. If you’re overweight by 30 pounds or more, then you need to make some positive changes in your eating patterns.  I’m not talking about going on a diet.  Diets don’t work! Most people have dieted their way to their current overweight condition.  The article “The Secret to Weight Loss! can assist you in implementing some simple keys; keys that can make a major impact on your weight and overall health.  Additionally, by controlling your weight you can also help lower your blood pressure, lower your cholesterol level, and better control your blood sugar.

Step 6 – Increase Your Fiber Intake! At best the typical American is only getting 50% of the needed fiber in their diet.  Proper fiber intake may reduce 3 of the risks for stroke:  cholesterol, diabetes, and overweight/obesity. This step is so important that I have prepared a special article entitled, “Fiber and Cholesterol Reduction!” There is also a guide entitled, “Fiber, Cholesterol and Other Heath Benefits!” This guide identifies foods that will add more fiber to your diet.  This is an important step in learning how to prevent stroke.

Step 7 – Increase Your Water Intake. Proper water intake is fundamental to good health and proper weight management.  Use this simple rule of thumb.   You need 8 ounce of water for every 15 pounds of body weight. Coke, coffee, and other doctored beverages don’t count.  Only pure water!

Step 8 – Stop Smoking! You know this is a nasty habit.  Not only does smoking affect your lungs but it also affects your heart, pulmonary arteries, liver and several other systems.  Once you stop smoking, your risk from this activity will drop significantly within two years.

If you’re a woman over 30 who smokes and takes high-estrogen birth-control pills your risk for a stroke is 22 times more likely than the average non-smoker!

Step 9 – Learn STR. Smile, Talk, Raise could save your life and the life of a loved one!  I’ve designed a special “Stroke Warning Sign – The STR Poster!” that you can download and print off. Share it with family, friends, and neighbors.  Ask your barber, hair stylist, and local merchant to display it in a prominent place for as many as possible to see.  Please help educate our entire community. Together our quick response could be the difference between life or death, permanent disability or significant recovery.

Step 10 – Utilize Integrative L-arginine / L-citrulline Supplementation. Your endothelial cells line all of your cardiovascular system.  They have a total surface volume equal to approximately 4 tennis courts.  They also have a tremendous influence over the health of the cardiovascular system.  Unfortunately, your endothelial cells are damaged by oxidative stresses caused by high blood pressure, high cholesterol levels, and high blood sugar levels.  This damage reduces their ability to properly produce nitric oxide which is critical to cardiovascular health.

By using a proven L-arginine / L-citrulline supplement you can help prevent and reverse this oxidative stress to the endothelial cells.  You can also improve their ability to produce nitric oxide which is the master signaling molecule of the cardiovascular system.  This is extremely important for the African American community.

Genetic research has uncovered a significant genetic variance that directly increases the risk of cardiovascular disease in many people of African descent.  African Americans produce too much of an enzyme called arginase.  In the bloodstream, arginase destroys the amino acid L-Arginine so that it’s no longer available for the production of nitric oxide. This can lead to weakened or damaged blood vessels and significantly increase the risk for heart attack, high blood pressure, and stroke.

I recommend ProArgi-9 Plus since it has been clinical shown to improve the cardiovascular system and help to heal and reverse the damage to the endothelial cells allowing them to properly produce nitric oxide.

Step 11 – Control Your Alcohol Consumption. For most, moderate drinking doesn’t affect their risk for stroke.  “Moderate” drinking means limiting your alcohol intake to no more than one drink per day.  By definition, a “moderate” drink is 1.5 oz. of hard liquor, 4 oz. of wine, or 12 oz. of beer.  However, drinking more than 2 drinks per day may increase your stroke risk by 50%.

Conclusion

I hope these 11 Steps will be a direct benefit in helping you learn how to prevent a stroke. I’ve given you some very specific steps.  These steps can start you on the path towards reducing your risk for stroke while improving your overall health and wellness.  As you continue to read articles and gain information, you will be learning how to make other positive changes in your life.

Together we can work to save a million lives!

Dan Hammer

Dan Hammer has a background in biology, chemistry and exercise physiology.  He used to run one of the largest health club operations in the Chicagoland area and has been helping people with their wellness issues for more than 25 years.
The information contained in this article is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contained in this article about stroke has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.

Sickle Cell Disease – 14 Helpful Steps!

African American Doctor 2Sickle cell disease primarily affects people of African, African American, Mediterranean, Middle Eastern, and Asian Indian ancestry. There is also a growing segment in the Latino-American population particularly those of Caribbean, Central American, and South American ancestry that are affect by this disease.  In the United States one out of every 400 births has this disease.  The most common type of sickle cell disease is sickle cell anemia.  In my companion article “African Americans and Sickle Cell Anemia” I covered a lot of material about the cause and symptoms of this disease.  

This article will provide you with 14 helpful steps in managing this disease.  Plus, new research confirms the importance of proper nitric oxide production in helping to reduce the painful symptoms of sickle cell anemia. 

Brief Overview of Sickle Cell Disease! 

Sickle cell disease is caused by a genetic change in the hemoglobin portion of the red blood cell.  Hemoglobin is the oxygen-carrying protein inside the red blood cell.  Normal red blood cells are oval and flexible.  Red blood cells in sickle cell disease have a tendency to reshape themselves into rod-like structures that resemble the curved blade of a sickle; thus, the term sickle cell.  

Sickle cells have a much shorter life span than normal red blood cells.  This results in chronic anemia and reduced oxygen to the tissues of the body.  In addition, sickle cells are less flexible than normal red blood cells.  This presents a problem.  They become trapped in the small blood vessels preventing blood flow to the body’s tissues and organs.  This compromises the delivery of oxygen and usually results in pain and potential damage to the associated tissues and organs. 

Recent Research – The Importance of Nitric Oxide! 

Researchers at Duke University and Howard Hughes Medical Institute recently discovered one of the keys to the cause of pain in sickle cell disease.  Their findings were reported in the January 31, 2005 Proceedings of the National Academy of Sciences.  Their research showed that when normal red blood cells move through the arteries they release a signaling molecule that tells the arterial walls to expand.  The signaling molecule is nitric oxide.  Nitric oxide causes the smooth muscle in the wall of the blood vessel to relax.  This helps to open up the blood vessel allowing the red blood cells to pass through it.  

The researchers at Duke University discovered that when red blood cells distort to their sickle shape, the walls of the arteries don’t expand.  This distorted shape of the sickle cells, combined with the fact that they tend to clump together, ends up blocking blood flow through these small arteries and capillaries.  The Duke researchers also noted that as the blood pulses, the walls of the arteries didn’t expand like they do when normal red blood cells are present. 

Their research also noted that the degree of nitric oxide deficiency directly correlated with symptom severity for those with sickle cell disease.  This means that the less nitric oxide produced the greater the pain.  The Duke/HHMI study found that when nitric oxide was administered to people with sickle cell anemia their symptoms were relieved.  One of the conclusions from this study was that abnormal nitric oxide processing may be the real cause of sickle cell circulatory restrictions.  In addition to the Duke/HHMI study, several other studies have demonstrated that when nitric oxide is administrated to people with sickle cell anemia their symptoms are greatly reduced.         

1998 Nobel Prize in Medicine! 

In 1998 the Nobel Prize in Medicine was award to three American researchers.  Part of what came out of their research was that the primary pathway for creating nitric oxide in the body came from an essential amino acid called L-arginine.  L-arginine is called an essential amino acid because your body cannot produce it.  It must be brought into your body through your diet.  L-arginine is found in foods like milk, cheese, yogurt, meat, and other proteins.  In fact, L-arginine is considered one of the most important molecules ever discovered.  Columbia University refers to L-arginine as the “MAGIC BULLET” for the cardiovascular system.  

Genetic Polymorphism and the Importance of L-citrulline! 

Unfortunately, there is a genetic polymorphism common to the African-American community.  Many African-Americans produce too much of an enzyme called arginase.  In the bloodstream, arginase destroys L-arginine so that it is no longer available for the production of nitric oxide.  This compounds the problem of not have a sufficient supply of nitric oxide available to help relax the small arterial walls.  This is especially important when the red blood cells change into their sickle form. 

Fortunately, there is an amino acid that your body can convert to L-arginine to help bypass the arginase enzyme.  It is L-citrulline.  A recent paper (January 18, 2010) entitled Potential utility of full-spectrum antioxidant therapy, citrulline, and dietary nitrate in the management of sickle cell disease by MF McCarty discussed this very issue.  Here is a brief but important quote from this paper: 

“Suboptimal endothelial arginine levels, reflecting increased plasma arginase activity and elevated ADMA, contribute to the loss of NO bioactivity in sickle cell disease; supplementation with the arginine precursor citrulline may ameliorate this defect.” 

This means that proper dietary supplementation using the amino acid L-citrulline can help the body bypass the destructive effects of the enzyme arginase so that proper nitric oxide production can be restored.  Since nitric oxide regulates the muscle tone of blood vessels this becomes extremely important in preventing blockages.  Additionally, nitric oxide prevents blood platelet cells from grouping together in a clot which also helps to prevent blockages in the blood vessels. 

14 Steps to Help Those with Sickle Cell Disease!

Understanding the past and most current research will help to chart a plan of action to help those who suffer from sickle cell disease.  The following 14 steps will help in this process.  However, please remember that these steps are for informational purposes only and is not a substitute for professional medical advice, examination, diagnosis, or treatment.  Always seek the advice of a physician or other qualified healthcare provider with any questions you may have regarding this or any medical condition.  Never disregard professional medical advice or delay in seeking it because of something you have read in this article.  If you think you may have a medical emergency, always call your doctor or 911 immediately. 

Step 1 – Proper hydration.  It’s estimated that 75% of Americans have mild, chronic dehydration.  This will affect blood flow so getting the proper amount of water on a daily basis is critically important.  And, it must be pure water!  Pop, coffee, diet soda, alcohol, or other doctored beverages do not count.  Your body must replace 2-3 quarts of water everyday.  As a rule of thumb, for every 15 lbs of weight, you need 8 ounces (1 cup) of water.   

Step 2 – Stay warm.  Cold reduces blood flow because capillaries constrict.  If you live in a cold environment, then take extra precaution to keep your extremities, especially fingers and toes, properly protected.  

Step 3 – Avoid high altitudes.  Geographic locations with high elevations should be avoided due to the reduce level of oxygen in the atmosphere.

Step 4 – Exercise.  Intense exercise should be avoided but mild to moderate aerobic exercise can be a benefit.  Exercise improves blood flow.  Research has shown that blood flow across the endothelial cells will stimulate nitric oxide production.  Additionally, exercise will produce collateral capillary beds that can aid in providing alternative pathways for blood flow when an arterial pathway becomes blocked.  Collateral capillary beds are extremely important for those with sickle cell disease.  However, before starting an exercise program, you should always consult your physician.  

Step 5 – L-arginine supplementation.  The body utilizes L-arginine to create nitric oxide.  Nitric oxide is necessary for the proper function of the cardiovascular system especially in the control of the elasticity of the arterial walls.  

Now, before you go out and start buying L-arginine supplements you need to be aware of the dark side of this amino acid.  L-arginine ingested in its pure form tastes terrible.  By itself, L-arginine can have some serious side effects.  Because L-arginine can have negative side effects it must be properly formulated if it is to have a positive impact on helping the body create nitric oxide.  It is critical that the company and the person who formulates an L-arginine product have both experience and clinical documentation to its effectiveness.

From my experience, the best L-arginine supplement comes from Synergy WorldWide.  Their product, ProArgi-9 Plus, was developed by Dr. Joe Prendergast who is Board Certified in Internal Medicine as well as Endocrinology and Metabolism.  Dr. Prendergast is an expert in integrative L-arginine therapy and has been using it in his practice since 1991.  As a precaution, you should discuss this with both your physician and pharmacist especially if you are on any type of medication. 

Step 6 – L-citrulline supplementation.  This step is as important as step number 5 and maybe even more important.  Usually L-arginine provides a 30 minute to 2 hour window of improved nitric oxide production.  By supplementing with L-citrulline that window of improved nitric oxide production increases to 24 to 36 hours.  When properly combined with L-arginine and other important heart healthy ingredients, this dramatically improves the endothelial cells ability to properly produce nitric oxide, the master signaling molecule for the cardiovascular system.  This is an important component in ProArgi-9 Plus

Step 7 – Rest.  It’s important to get adequate rest since stress can have a negative effect on your overall health and wellness as well as lowering your immune system. 

Step 8 – Support your immune system.  There is so much that could be said in this area.  Increasing your consumption of antioxidant rich fruits and vegetables would be an important first step.  Daily consumption of at least 500 mg of vitamin C would help both the immune system and liver function.  

Step 9 – Support your liver.  Again, there is so much that could be said in this area.  Adequate amounts of green leafy vegetables with proper water intake are two good first steps to help the liver.  Taking 500 mg of vitamin C will help increase the rate of synthesis of glutathione which is a major component in liver detoxification. 

Step 10 – Avoid people with colds and flu.  Try not to place yourself in situations that allow for infections to occur.  This may require you to use a mask if your work or school environment is compromised with illness issues. 

Step 11 – Immunizations.  Stay up-to-date with the proper immunizations.  Work with your health care provider to set up a schedule so that all the proper steps are taken to stay on top of this area. 

Step 12 – Folic acid supplementation.  Folic acid is a necessary component for the production of red blood cells.  The recommended daily amount for adults is 400 micrograms and 600 micrograms in pregnancy.  If you are thinking about taking a larger amount, then you should discuss this with both your physician and pharmacist.  This is an important component in ProArgi-9 Plus.

Step 13 – Support groups.  Because of the emotional challenges that come with sickle cell disease it always helps to find a support group to share frustrations, challenges, hopes, and successes. 

Step 14 – Family planning.  Due to the genetic nature of sickle cell disease, it’s always helpful to discuss options with a family practitioner who has experience in genetic counseling.  

Because of the genetic nature of sickle cell disease there is no pill to cure it.  This can leave individuals and family members feeling helpless in their battle against the symptoms of this disease.  That’s why it’s important to discuss these 14 steps with a qualified physician.  Together you can develop a plan of action; one that will empower you to have better control over the symptoms of sickle cell disease. 

Together we can work to save a million lives! 

Dan Hammer 

Dan Hammer has a background in biology, chemistry and exercise physiology.  He used to run one of the largest health club operations in the Chicagoland area and has been helping people with their wellness issues for more than 25 years. 
The information contained in this article is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this article has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.

African Americans and Sickle Cell Anemia!

Concerned Woman.Recent research on sickle cell anemia has shown how improving nitric oxide production can make a significant difference in symptom severity.  I’ve written about this in my article “Nitric Oxide and Sickle Cell Anemia!”  The purpose of this article is to provide a basic understanding of this genetic disease. 

Although African Americans are affected the most by sickle cell disease, it can affect Mediterranean, Middle Eastern, and Asian Indian ancestry.  There is a growing segment in the Latino-American population particularly those of Caribbean, Central American, and South American ancestry who are also affected by this disease. 

In the United States one out of every 400 births has this disease.  The most common type of sickle cell disease is sickle cell anemia. 

Definition and Description of Sickle Cell Disease 

Sickle cell disease is a group of inherited blood disorders that center on red blood cells.  These red blood cells can function abnormally resulting in small blood clots, chronic anemia, painful events, and potential complications associated with tissue and organ damage.  These blood disorders include sickle cell anemia, Mediterranean blood disease, and the sickle beta thalassemia syndromes. 

All types of sickle cell disease are caused by a genetic change in the hemoglobin portion of the red blood cell.  Hemoglobin is the oxygen-carrying protein inside the red blood cell.  Normal red blood cells are oval and flexible.  Red blood cells in sickle cell disease have a tendency to reshape themselves into rod-like structures that resemble the curved blade of a sickle; thus, the term sickle cell.  

Sickle cells have a shorter life span than normal red blood cells.  This results in chronic anemia and reduced oxygen to the tissues of the body.  Sickle cells are sticky and less flexible than normal red blood cells.  This presents a problem since they can be trapped in the small blood vessels preventing proper blood flow to the tissues.  This compromises the delivery of oxygen and results in tissue pain.  It also has the potential to damage the associated tissues and organs. 

Carriers of the sickle cell gene are referred to as having sickle cell trait.  Most of the time sickle cell trait does not cause health problems.  In fact, sickle cell trait can be beneficial because it provides protection against malaria, a disease caused by blood-borne parasites transmitted through mosquito bites.  It is estimated that one in 12 African-Americans has sickle cell trait. 

The Cause of Sickle Cell Disease! 

The hemoglobin molecule of a red blood cell is made up of three components:  

  • Heme
  • Alpha or alpha-like globin
  • Beta or beta-like globin.   

Sickle cells contain a genetic change in the beta globin component of the hemoglobin molecule.  This is caused by a change in the genetic coding on chromosome 11.  One small change in a single DNA nucleotide results in a different amino acid being inserted into the beta globin protein of the hemoglobin molecule.  This results in the unique properties of sickle cells.  For simplicity we will call this altered gene the “sickle cell gene” and the regular gene the “normal red blood cell gene.” 

For most individuals, they have two copies of the “normal red blood cell gene” to produce normal beta globin resulting in typical red blood cells.  Individuals with sickle cell trait have one “normal red blood cell gene” and one “sickle cell gene” so they produce both normal red blood cells and sickle cells in roughly equal proportions.  Because of this they do not usually experience significant health problems as a result of having sickle cell trait.  Those with sickle cell anemia have two “sickle cell genes.” 

Genetics play a significant role in both the disease, symptoms, and in family planning.  If both members of a couple have sickle cell trait, then there is a 25% chance in each pregnancy for the baby to inherit two sickle cell genes.  The resulting child will have sickle cell anemia.  Correspondingly, there is a 50% chance the baby will have sickle cell trait and a 25% chance that the baby will have the “normal red blood cell genes”.  

If both members of a couple have sickle cell anemia, then the baby will have sickle cell anemia 100% of the time.  If one member of the couple has sickle cell anemia and the other has both “normal red blood cell genes”, then the resulting child will have sickle cell trait 100% of the time.  Finally, if one member of the couple has sickle cell trait and the other has both “normal red blood cell genes”, then the resulting child has a 50% chance of having normal red blood cell hemoglobin or a 50% chance of having sickle cell trait. 

The Need for Oxygen! 

Oxygen is necessary for life and the optimal function of all cells.  Red blood cells transport the oxygen from your lungs to the tissues of your body.  It’s the hemoglobin molecule that binds oxygen to itself in the lungs.  It then releases oxygen to the tissues for proper cell respiration.  However, once the oxygen is released by the sickle cell hemoglobin it can cause the red blood cell to alter its normal oval shape into the rigid, sickle shape characteristic of sickle cells.  Low oxygen can be a trigger for this change.  Studies also seem to indicate that cold temperatures and dehydration can be additional factors in triggering this change. 

Normal red blood cells can survive for approximately 120 days where as sickle cells typically last 10-12 days.  This is an important factor because it leaves the bloodstream chronically short of red blood cells and hemoglobin which leads to anemia.  This creates its own shortage of oxygen which could trigger a shape change in the oval red blood cell to the sickle shape.  This rigid, sickle shape causes circulation problems especially in small blood vessels.  

In addition, there are altered chemical properties that develop which increases the cells’ “stickiness”.  This is why sickle cells tend to adhere to the inside surfaces of small blood vessels, as well as other blood cells, resulting in blockages.  These blockages prevent oxygenated blood from reaching the tissues resulting in pain.  If kept without oxygen long enough possible organ and tissue damage can occur. 

Symptoms of Sickle Cell Anemia! 

Common symptoms for those with sickle cell anemia include the following: 

  • Bloody urine
  • Bone and/or abdominal pain
  • Chest pain
  • Delayed growth and delayed puberty
  • Excessive thirst
  • Fatigue, breathlessness, rapid heart rate
  • Frequent urination
  • Increased susceptibility to infections, fever
  • Pain which can vary from moderate to intense
  • Paleness, yellow eyes and/or skin, jaundice
  • Poor eyesight or blindness
  • Ulcers on the lower legs usually in adolescents and adults 

For those with sickle cell anemia, the severity of symptoms varies widely and cannot be predicted solely on genetic inheritance.  Some with sickle cell anemia develop health and life threatening problems in infancy while others only have mild symptoms throughout their lives.  Others experience various degrees of health issues as they age.  Certain variations of sickle cell disease tend to have less severe symptoms than other types of sickle cell disease. 

Organs Affected by Sickle Cell Anemia 

Various organs and body systems can be effect by sickle cell disease.  As you will see from this list, sickle cell anemia has a wide range of effects on the body.  The bottom line is that any tissue that needs oxygen and adequate blood flow can be at risk. 

  • Acute Chest Syndrome – Acute chest syndrome or ACS is a leading cause of death for those with sickle cell disease.  It takes place in the lungs.  Rapid diagnosis and treatment is very important.  ACS can occur at any age.  It is similar to pneumonia in symptoms but distinct in its damage. 
  • Anemia – As we learned early, sickle cells have a life span of 10-12 days resulting in a deficiency of red blood cells in the bloodstream.  It is the hemoglobin of red blood cells that carry oxygen, so with this deficiency there is a reduction in oxygen to the tissues.  Common symptoms of anemia include fatigue, paleness, and a shortness of breath.  The heart rate will increase.  This circulates more blood helping to make up for the lack of oxygen to the tissues. 
  • Delayed Growth – Because of the short life span of sickle cells, the demands on the bone marrow to produce more red blood cells compete with the demands of a growing body.  Children with sickle cell anemia may experience delayed growth and reach puberty at a later age.  However, by early adulthood, they catch up on growth and height but may still remain below average in weight. 
  • Infections and the Spleen – Children under the age of three with sickle cell anemia are particularly susceptible to life-threatening bacterial infections especially from Streptococcus pneumoniaeUnfortunately, 15% of these types of cases result in death.  Since your spleen helps to fight bacterial infections, it is particularly vulnerable.  For those with sickle cell anemia, it is not uncommon to see the loss of spleen function by late childhood. 
  • Jaundice and Gallstones – Jaundice is indicated by a yellow tone in the skin and eyes due to increased levels of bilirubin.  Bilirubin is the final product of hemoglobin degradation when red blood cells are destroyed.  Bilirubin is  removed from the bloodstream by the liver.  Elevated levels can increase the chance for gallstones.   
  • Joint Problems – The blood supply to the connective tissues, especially in the hip and shoulder joints, can be blocked by the sickle cells resulting in bone damage and poor healing.  This complication can affect an individual’s physical abilities and result in substantial and chronic pain. 
  • Kidney Disease – Kidneys are particularly prone to damage from sickle cells.  Adults with sickle cell disease often experience reduce kidney function which can progress to kidney failure. 
  • Painful EventsThis is the hallmark symptom of sickle cell disease.  The frequency and duration varies tremendously from individual to individual and over an individual’s lifetime.  These painful events are also the most common cause for hospitalization.  This hallmark symptom results when the small blood vessels become blocked by the sickle cells preventing oxygen from reaching the tissues.  Although pain can affect any area of the body, the most frequent sites are the extremities, chest, abdomen, and bones. 
  • Priapism – Only males have to deal with this since it is a condition characterized by a persistent and painful erection.  Blood vessels become blocked by sickle cells so that blood is trapped in the tissue of the male’s organ.  It’s extremely painful and can result in damage to this tissue causing impotence.   
  • Retinopathy – The blood vessels that support the tissue at the back of the eye may be blocked by sickle cells resulting in this condition.  Regular ophthalmology evaluations and effective treatment can help a person avoid permanent damage to their vision. 
  • Stroke – This is the most concerning complication of sickle cell disease.  Approximately 11% of individuals with sickle cell anemia will have a recognizable stroke by the age of 20.  A stroke in a person with sickle cell disease is usually caused by a blockage of a blood vessel in the brain by the sickle cells.  This results in lack of oxygen to the affected area of the brain.  The consequences are far ranging from undetectable effects, to apparent or subtle learning disabilities, to severe physical or cognitive impairment, to life-threatening situations. 

Diagnosis and Treatment of Sickle Cell Anemia 

The inheritance of sickle cell disease or sickle cell trait cannot be prevented but it can be predicted so screening is recommended.  If you exhibit symptoms, then contact your physician so that accurate tests can be done.  These tests can determine if you carry the “sickle cell gene” and what level of risk you are at.  For newborns, more than 40 states include sickle cell screening as part of the battery of blood tests.  However, don’t just assume the test is done.  You must always be proactive. 

Hemoglobin trait screening is always a good choice for any person of a high-risk ethnic background especially if you are planning on having children.  If you and your partner are found to have sickle cell or any other hemoglobin traits, then you might want to receive genetic counseling to better understand the risk of sickle cell disease for your offspring.  There are various testing options available to you to help you in your planning. 

There are various treatment options to help prevent some of the symptoms and complications of sickle cell disease.  These treatment options can include: 

  • Access to comprehensive health care
  • Adequate nutrition
  • Avoiding stresses and infection
  • Blood transfusions
  • Bone marrow transplantation
  • Getting proper rest
  • Good hydration
  • Hydroxyurea
  • Pain management
  • Proper immunizations
  • Supplementation with folic acid
  • Support groups
  • Surgery
  • Use of preventative antibiotics

As with any disease condition, you want to always work with a qualified health professional to develop a course of action that best fits your individual situation. 

New Research on Nitric Oxide! 

There is new research that shows a direct correlation between nitric oxide deficiency and symptom severity for those with sickle cell anemia.  I will discuss this in my companion article “Sickle Cell Disease – 14 Helpful Steps!”  This article discusses the latest research.  It also provides 14 suggestions you can use to help those with sickle cell disease. 

I hope this article has given you a better understanding of sickle cell anemia.  I encourage you to take the steps to educate yourself and any loved ones who may have this health issue.  We can help empower them to take the necessary steps to improve their overall health and wellness. 

Together we can work to save a million lives! 

Dan Hammer 

Dan Hammer has a background in biology, chemistry and exercise physiology.  He used to run one of the largest health club operations in the Chicagoland area and has been helping people with their wellness issues for more than 25 years.   
The information contained in this article is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this article has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor. 

African Americans and Cardiovascular Disease!

African American DoctorCardiovascular disease is the number one killer of people worldwide.  Unfortunately, it’s even worse for the African American community.  There are several reasons for this and hopefully this article will help begin the process of changing this sad reality.   To address these reasons I’ve broken this article into three parts:  The Bad News, Several Underlining Causes, and Steps to Decrease Your Risk! 

The Bad News! 

It’s important for you to understand the depth of cardiovascular disease confronting the African American community.  Below is a brief summary of the ailments that directly affect African Americans:  

  • Diabetes.  Type 2 diabetes has grown to epidemic proportions in the United States.  People with diabetes have a greater risk for stroke, heart disease and circulatory issues.  Most diabetes-related deaths are due to cardiovascular disease.  Twice as many African Americans will develop diabetes when compared to the Caucasian community. 
  • Erectile Dysfunction.  Erectile dysfunction affects 50% of the male population over the age 40 and is even greater in the African American community. 
  • Heart Disease.  African American women in the age range of 25-44 have a 2.5 times greater risk of coronary heart disease and African American men have a 1.5 times greater risk than the Caucasian community. 
  • High Blood Pressure.  The number one risk factor for stroke is high blood pressure, and 1 out of every 3 African Americans suffers from this ailment.  The American Heart Association estimates that 28% of African American adults and more than 66% of African Americans over the age of 60 have high blood pressure.  
  • High Cholesterol Levels.  High blood cholesterol is a significant risk factor for heart disease.  Unfortunately 50% of African American men and 54% of women have too much cholesterol circulating in their blood stream. 
  • Sickle Cell Anemia.  It’s estimated that one in 12 African Americans has sickle cell trait and one out of every 400 births have sickle cell anemia. 
  • Stroke.  African Americans are twice as likely to die from a stroke as Caucasians.  The rate of having their first stroke is almost doubled that of Caucasians.  One half of all African American women will die from either a stroke or heart disease.  For those with sickle cell anemia, 11% will have experienced a stroke by the age of 20.  

That’s quite a list of ailments affecting African Americans.  If you look closely at all seven health issues you will see that the common denominator is your cardiovascular system.     

The key for reducing your health risk for these cardiovascular diseases is to make sure your cardiovascular system is as healthy as possible.  This article will provide several steps to address this but before we do you need to understand some of the underlining causes of why cardiovascular disease is so prevalent in the African American community. 

Several Underlining Causes! 

Within your cardiovascular system there is one particular essential amino acid, one critical signaling molecule, one critical cellular structure and one detrimental enzyme that directly impact its overall health.  They are: 

  • L-arginine – Key Essential Amino Acid
  • Nitric Oxide – Key Signaling Molecule
  • Endothelial Cells – Key Cellular Structure
  • Arginase – Key Detrimental Enzyme 

The first three keys of L-arginine, nitric oxide and endothelial cells are interrelated so we will examine them as a whole.  The endothelial cells form the interior lining of all your blood vessels.  These cells ultimately determine your cardiovascular health.  One function of these endothelial cells is to take the essential amino acid L-arginine and convert it into the signaling molecule nitric oxide.  Very simply, you couldn’t live without nitric oxide! 

Nitric oxide is the master signaling molecule of the cardiovascular system.  It regulates blood vessel tone and flexibility.  Its production is completely dependent upon the health of your endothelial cells and an adequate supply of the essential amino acid L-arginine.  Here are some of the benefits of nitric oxide: 

  • Nitric oxide regulates the muscle tone of blood vessels to have a major impact on controlling blood pressure.  This directly relates to high blood pressure.
  • Nitric oxide causes penile erections by dilating blood vessels.  This directly relates to erectile dysfunction.
  • Nitric oxide prevents blood platelet cells from grouping together in a clot.  This minimizes blockages in the blood vessels to reduce the risk for heart attacks, strokes and complications from sickle cell anemia.
  • Nitric oxide promotes vascular reparative mechanisms and is one of the keys to reversing atherosclerosis.  This helps to reduce the damage caused by high cholesterol levels and assists in preventing the vascular complications of diabetes. 

Nitric oxide is literally involved in all cells to help keep you fit and healthy.  It’s important to understand that this interrelationship between the endothelial cells, L-arginine and nitric oxide production is common for all races.  

What is not common is a genetic polymorphism inherent to the African American population.  This genetic polymorphism causes African Americans to have higher levels of an enzyme called arginase in their blood stream.  Arginase destroys L-arginine which is the main ingredient for creating nitric oxide in the body. 

For the African American community, nitric oxide production is compromised on both sides of the equation!

On the front end, the enzyme arginase destroys L-arginine which interferes with the production of nitric oxide.  On the back end, the health of your endothelial cells determines how much of the remaining L-arginine can be converted to nitric oxide.  Unfortunately, your endothelial cells are damaged by high blood pressure, high sugar levels, high cholesterol, smoking, and oxidative stress.  This damage reduces the production of nitric oxide which compounds the problem and increases the risk for cardiovascular disease. 

Steps to Decrease Your Risk! 

Given the above information there are several important steps to decreasing your risk for cardiovascular disease.      

Step 1 – Monitor your blood pressure.  High blood pressure damages your endothelial cells.  If you do not know what your blood pressure is then you need to go to your doctor’s office, local pharmacy or health clinic and get your blood pressure taken.  If you have high blood pressure, then you need to take steps to bring it back into a normal range.  This is your first and most important step.  It’s so important that the Black Barbershop Health Outreach Program was established to exclusively address the issue of high blood pressure on a national level.  For more information on participating barbershops, go to http://www.blackbarbershop.org/ .

Step 2 – Monitor your blood sugar and cholesterol levels.  High sugar and cholesterol levels damage your endothelial cells.  Diet is extremely important for both of these areas.  One simple but highly effective step to stabilize your blood sugar levels and help your body naturally reduce its cholesterol levels is to increase your fiber intake.  Including dry beans or legumes into your diet is a quick and delicious way to increase your fiber intake. In fact studies have shown that consuming dry beans four times or more per week, compared with less than once a week, lowered the risk of cardiovascular disease by 22 percent. 

Step 3 – Stop smoking!  Smoking damages your endothelial cells.  This is a nasty habit that is extremely hard to break.  Part of the process is having a motivation greater than the habit.  

If your very life isn’t motivation enough, then maybe for the men your sex life is! 

Your endothelial cells control your nitric oxide production.  Your nitric oxide levels control an erection.  No nitric oxide no sex!  Every puff on your cigarette is destroying your endothelial cells which lowers your nitric oxide level and reduces your chances of having good sex.  

Step 4 – Increase L-arginine intake!  In addition to protecting your endothelial cells, you need to get an adequate intake of the essential amino acid L-arginine which is found in foods like milk, cheese, yogurt, meat, and other protein sources.  Most people take in enough L-arginine to meet basic bodily needs.  However, when your diet is poor and/or your stress level is high, then this essential amino acid will be lacking.  Couple this with the enzyme arginase that destroys L-arginine and the potential risk for cardiovascular disease is increased. 

Step 5 – Use L-citrulline to bypass Arginase!  Your body will convert the amino acid L-citrulline into L-arginine to help maintain its production of nitric oxide.  This process also helps to bypass the arginase enzyme since it has no effect on L-citrulline.  Having a good supply of L-citrulline provides the body with a 24 to 36 hour window in the production of nitric oxide.  This is important for all population groups but it’s critically important for African Americans especially those with sickle cell anemia.  Unfortunately, L-citrulline is not prevalent in most foods we eat.  Thus, supplementation is usually required. 

Step 6 – Consider ProArgi-9 Plus!  There is a clinically proven nutritional supplement called ProArgi-9 Plus which has the ability to bring in the proper balance of L-arginine and L-citrulline.  This product also combines other heart healthy ingredients to significantly improve the health of the endothelial cells and their ability to properly produce nitric oxide.  The most recent validation for this product is the remarkable results obtain for 33 congestive heart failure patients in the High Desert Heart Institute study.  

Conclusion

You have the power to directly improve the health of your endothelial cells to significantly reduce your risk for cardiovascular disease.  And, for those with sickle cell anemia, you can help to reduce your symptoms.  It all centers on helping your endothelial cells function optimally, with an above average supply of L-arginine, and a way to bypass the arginase enzyme so that nitric oxide is properly produced.  Improved production of nitric oxide is critical to helping African Americans decrease their risk for cardiovascular disease!

Together we can work to save a million lives! 

Dan Hammer 

Dan Hammer has a background in biology, chemistry and exercise physiology.  He used to run one of the largest health club operations in the Chicagoland area and has been helping people with their wellness issues for more than 25 years.   
The information contained in this article is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this article has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.

Nitric Oxide and Sickle Cell Anemia!

Red Blood CellsOutside our body Nitric Oxide is considered to be an environmental pollutant.  Inside our body it is one of the most important, if not THE most important signaling molecule for the cardiovascular system.  It even plays a role in helping to reduce the symptoms of sickle cell anemia.

Sickle cell anemia primarily affects people of African, Mediterranean, Middle Eastern, and Asian Indian ancestry.  Additionally, there is a growing segment of the Latino-American population particularly those of Caribbean, Central American and South American ancestry that are becoming susceptible to this hereditary disease.  It is estimated that one out of every 400 births has this disease.  (Please see my article “African Americans and Sickle Cell Anemia!” for a basic understanding of this disease.)

Recent Research – The Important of Nitric Oxide!

Researchers at Duke University and Howard Hughes Medical Institute recently discovered one of the keys to the cause of pain in sickle cell disease.  Their findings were reported in the January 31, 2005 Proceedings of the National Academy of Sciences.  Their research showed that when normal red blood cells move through the arteries they release a signaling molecule that tells the arterial walls to expand.  The signaling molecule is nitric oxide.  Nitric oxide causes the smooth muscle in the wall of the blood vessel to relax.  This helps to open up the blood vessel allowing the red blood cells to pass through it. 

The researchers at Duke University discovered that when red blood cells distort to their sickle shape, the walls of the arteries don’t expand.  This distorted shape of the sickle cells, combined with the fact that they tend to clump together, ends up blocking blood flow through these small arteries and capillaries.  This reduces or restricts blood flow resulting in lack of oxygen to the tissues causing pain and damage.  The Duke researchers also noted that as the blood pulses, the walls of the arteries didn’t expand like they do when normal red blood cells are present.

Their research confirmed that the degree of nitric oxide deficiency directly correlated with symptom severity for those with sickle cell disease.  This means that the less nitric oxide produced the greater the pain.  The Duke/HHMI study found that when nitric oxide was administered to people with sickle cell anemia their symptoms were relieved.  One of the conclusions from this study was that abnormal nitric oxide processing may be the real cause of sickle cell circulatory restrictions.  In addition to the Duke/HHMI study, several other studies have demonstrated that when nitric oxide is administrated to people with sickle cell anemia their symptoms are greatly reduced.

One such study was performed in 1997.  Researchers at the Massachusetts General Hospital released a study suggesting that inhaled Nitric Oxide might successfully treat sickle cell crisis.  This is the term used to describe the characteristic episodes of debilitating pain often associated with sickle cell anemia. 

As a genetic disorder, sickle cell anemia affects the structure of the hemoglobin portion of the red blood cell.  Hemoglobin carries oxygen from the lungs to the organs and tissues throughout your body.  When the abnormal hemoglobin releases its bound oxygen, it changes from the normal flexible disc of the red blood cell into a rigid, elongated sickle shape.  These sickle cells become sticky and adhere to each other as well as the walls of the tiny blood vessels.  This blocks blood flow to the tissue or organ resulting in excruciating pain and potential tissue damage from the lack of oxygen. 

The Massachusetts General Hospital researchers noted that Nitric Oxide would bind to the sickle cell hemoglobin allowing it to hold on to oxygen more avidly than it usually would.  This would help the red blood cell to hold its normal shape for a longer period of time thus reducing the risk of changing into an abnormal sickle shape.  According to Dr. Carlo Brugnara, director of the hematology lab in the Department of Laboratory Medicine at Children’s Hospital:

 “the novel idea of applying this interesting molecule to sickle cell disease may turn into one of the most significant treatment developments of this decade.”

An Additional Genetic Polymorphism!

Unfortunately, there is an additional genetic polymorphism common to the African-American community.  Many African-Americans produce too much of an enzyme called arginase.  In the bloodstream, arginase destroys L-arginine so that it’s no longer available for the production of nitric oxide.  This compounds the problem of not have a sufficient supply of nitric oxide available to help relax the small arterial walls.  This is especially important when the red blood cells change into their sickle form.

One of the ways around this is to use a nutritional supplement that combines the essential amino acid L-arginine with L-citrulline.  Your body will metabolize the amino acid L-citrulline to yield more L-arginine.  This helps to augment your body’s ability to produce Nitric Oxide and effectively bypasses the arginase enzyme.  Additionally, L-citrulline helps to optimize blood flow throughout the body and promote healthy energy levels.

It’s also important to protect and nourish your endothelial cells.  High blood pressure and diabetes will damage the endothelial cells reducing your body’s ability to produce Nitric Oxide.  This can compound the normal problems associated with sickle cell anemia.  For additional ways to help yourself or someone you know with sickle cell anemia please read my article “Sickle Cell Disease – 14 Helpful Steps!”

Together we can work to save a million lives!

Dan Hammer

The information contained in this blog is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this blogging website has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.

Aspirin or Nitric Oxide

Which is Better for Reducing the Risk of Blood Clots?

AspirinOn Monday, August 31, 2009 Yahoo Health had an article entitled “Daily aspirin may do more harm than good: study” in which researchers found that:

“. . . the risks of bleeding from taking aspirin were such that its routine use in healthy people ‘cannot be supported’ – although they did not dispute its use in patients with a history of vascular problems.”

The title of the study was Aspirin for Asymptomatic Atherosclerosis and was funded, in part, by the British Heart Foundation.  The lead researcher was Professor Gerry Fowkes from the Wolfson Unit for Prevention of Peripheral Vascular Disease in Edinburgh, Scotland.  It involved 3,350 men and women aged 50 to 75 years old who had low ankle brachial indexes but no symptoms of heart disease or history of heart attack.  Study subjects were given either a daily 100 mg dose of aspirin or a placebo and evaluated over an eight year period.  The results were that there was no significant difference between the two groups in the number of heart attacks, strokes and other cardiovascular events suffered.  However, major bleeding that required hospitalization occurred in 2.0% of the aspirin group but only 1.2% in the placebo group.

This study was presented at the European Society of Cardiology Congress in Barcelona.  According to Professor Peter Weissberg, medical director of the British Heart Foundation:

“We know that patients with symptoms of artery disease, such as angina, heart attack or stroke, can reduce their risk of further problems by taking a small dose of aspirin each day.  The findings of this study agree with our current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin, because the risks of bleeding may outweigh the benefits.”

Part of the rational for this study was the conflicting data regarding the use of aspirin for the primary prevention of cardiovascular events.  For example, in the Physician’s Health Study low-dose aspirin reduced the risk of a first myocardial infarction by 44% when compared with a placebo.  But, in the Women’s Health Study there was no significant difference in major cardiovascular events other than strokes.

What Does Nitric Oxide Have to Do Blood Clots?

The endothelial cells line all of your cardiovascular system.  One of their functions is to produce a molecule called Nitric Oxide (NO) which is critical in the proper control of blood pressure.  NO also inhibits platelet adhesion, activation, secretion and aggregation, as well as promoting platelet disaggregation.  This is extremely important in preventing blood clots in the vascular system that can lead to heart attacks and strokes.  It is also a critical factor in sickle cell anemia to help prevent red blood cells from changing, adhering to each other and clinging to the vascular walls.  This helps to prevent blockages which cause most of the pain and tissue damage associated with sickle cell anemia.

Even though your body uses NO to prevent blood clotting, it’s interesting to note that the endothelial cells are also necessary for blood to clot.  They synthesize the vitally important molecule called Factor VIII or von Willibrand’s Factor which is essential for blood clotting.  Without this molecule a person could bleed to death from a simple scratch.

A Final Consideration!

Aspirin is a drug and it has the potential for other side effects besides the risk of bleeding.  Some of the most common side effects are stomach pain, heart burn, nausea and vomiting.  Aspirin is one of the leading causes of gastrointestinal tract complications which include micro-bleeding and ulcers. 

If a person wants to reduce their risk for blood clotting then the proper repair of and support for the endothelial cells is vitally important.  Clinical studies have shown that a well designed L-arginine/Nitric Oxide protocol can repair the endothelial cells.  This allows them the perform one of their primary functions which is to keep the blood flowing without the danger of blot clotting.   

Together we can work to save a million lives!

Dan Hammer

The information contained in this blog is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this blogging website has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.