Get the Facts About Hyperlipidemia: 4 Crucial Questions, Answered

Hyperlipidemia (high cholesterol) can stem from genetic causes, but the majority of the time, it results from lifestyle choices and environmental factors. As it causes no symptoms itself, it’s vital that health care practitioners routinely screen for this silent condition. Lifestyle changes involving diet and physical activity form part of any successful hyperlipidemia treatment plan, and the use of proven supplements can be a highly effective complementary treatment.

More frequently referred to as high cholesterol, hyperlipidemia is the medical term used to describe unusually elevated blood levels of lipids (fat molecules). Though it’s possible to inherit hyperlipidemia, most cases can be traced back to lifestyle choices and environmental factors. Hyperlipidemia itself causes no symptoms, but it does adversely impact your health—most notably by increasing your risk of developing coronary artery disease.

Read on to learn how hyperlipidemia develops, 14 risk factors for hyperlipidemia, how doctors diagnose hyperlipidemia (as well as the different types), and natural treatments for hyperlipidemia.

1. How Does Hyperlipidemia Develop?

To understand how high cholesterol develops, you must first have a basic grasp of some essential facts about cholesterol itself. Cholesterol, a type of fat made in the liver, makes vital contributions to the functioning of the human brain, development of membranes surrounding cells, production of hormones, and storage of vitamins.

In order to travel through the bloodstream, cholesterol pairs with proteins to form lipoproteins. There are two forms of lipoproteins—high-density lipoproteins (HDL) and low-density lipoproteins (LDL)—each of which carry out different functions.

  • Low-density lipoproteins (LDL): Because LDL cholesterol has been linked to the development of cardiovascular disease, it’s known as “bad cholesterol.” LDL cholesterol moves cholesterol molecules through your arteries, and when levels get too high, fatty deposits begin to build up on the walls of your arteries. This leads to atherosclerosis, the hardening or narrowing of the arteries, which in turn raises your risk of heart disease.
  • High-density lipoproteins (HDL): HDL cholesterol, or “good cholesterol,” can actually counterbalance the negative effects of LDL cholesterol. That’s because HDL transports unused cholesterol molecules back to the liver, where they can be excreted. This prevents the development of high blood cholesterol levels and the associated adverse health outcomes, such as heart attack and coronary heart disease.

If your doctor elects to perform a lipid profile, they will likely measure your triglyceride levels too. Your body stores any calories not required for immediate energy needs in the form of triglycerides. Regularly consuming more calories than necessary to fuel your body, particularly if you consume a diet high in carbohydrates, is likely to result in high triglyceride levels (technically speaking, hypertriglyceridemia).

High cholesterol levels in the blood, as touched on in our discussion of LDL cholesterol, causes deposits of fat to accumulate in the blood vessels. As these deposits grow, they can restrict blood flow through the arteries. If a deposit spontaneously breaks loose, it can create a clot that triggers a heart attack or stroke.

This makes it important to monitor and manage your cholesterol levels. For HDL cholesterol, this means keeping your levels at or above a certain threshold while for LDL cholesterol, it means making sure they do not rise too high. Optimal levels for total, HDL, and LDL cholesterol as well as triglycerides are impacted by whether or not you have heart disease, diabetes, or other conditions that put you at higher risk of developing high cholesterol.

The guidelines for each category are as follows:

  • Overall cholesterol
    • Optimal: Under 200 milligrams per deciliter (mg/dL)
    • Concerning: 200-239 mg/dL
    • High: 240 mg/dL and higher
  • HDL cholesterol
    • Optimal: 60 mg/dL and higher
    • Adequate: 50-59 mg/dL for women and 40-59 mg/dL for men
    • Low: Under 50 mg/dL for women and 40 mg/dL for men
  • LDL cholesterol:
    • Optimal for those with heart disease or diabetes: Under 70 mg/dL
    • Optimal for those at risk of heart disease: Under 100 mg/dL
    • Adequate for those with no heart disease, concerning for those with heart disease: 100-129 mg/dL
    • Concerning for those with no heart disease, high for those with heart disease: 120-159 mg/dL
    • High for those with no heart disease, very high for those with heart disease: 160-189 mg/dL
    • Very high: 190 mg/dL and higher
  • Triglycerides:
    • Optimal: Under 150 mg/dL
    • Concerning: 150-199 mg/dL
    • High: 200-499 mg/dL
    • Very high: 500 mg/dL and higher

Making Sense of Your Cholesterol Levels

2. What Factors Raise Your Risk of Hyperlipidemia?

As we covered in the last section, hyperlipidemia results from an unbalanced ratio of LDL cholesterol to HDL cholesterol. While certain types of hyperlipidemia have a genetic component (meaning it’s important for you to know if you have a family history of hyperlipidemia), most result from lifestyle choices.

According to a study published in 2017, both age and sex influence a person’s likelihood of developing high levels of LDL cholesterol or triglycerides. The cross-sectional study, which enrolled 2,000 individuals, also found correlations between hyperlipidemia and lifestyle choices such as smoking, physical inactivity, and the consumption of fatty meats. Meanwhile, individuals who ate more fruits and vegetables were less likely to develop high cholesterol.

Research points to other risk factors as well, such as having a large waist circumference and consuming excessive quantities of alcohol. There are also links between elevated cholesterol levels and several health conditions, such as: kidney disease, polycystic ovary syndrome (PCOS), and decreased thyroid activity. Certain medications affect cholesterol levels too, like steroids, progestin, retinoids, diuretics, and in some cases, beta blockers.

Other factors shown to raise your risk of developing hyperlipidemia include:

  • Sedentary lifestyle: Failing to engage in physical activity on a routine basis can skew your cholesterol levels. It appears that exercise increases production of HDL cholesterol and increases the size of LDL cholesterol molecules, rendering them less harmful.
  • Use of tobacco products: Scientists have observed that smoking cigarettes injures blood vessel walls, which increases the odds that fat will build up on them. Smoking also appears to adversely impact HDL cholesterol levels.
  • Consumption of saturated and trans fats: Studies show that regularly eating foods that contain saturated fats (for instance, fatty meats) and trans fats (commonly included in processed foods like crackers, microwave popcorn, cookies, and more), leads to higher cholesterol levels.
  • Blood sugar levels: Analysis reveals a connection between high blood sugar and high levels of very-low-density lipoprotein (VLDL), a particularly unhealthy type of cholesterol, as well as lower levels of HDL cholesterol.
  • Body fat percentage: Researchers have also found a link between how much body fat a person has and their likelihood of having hyperlipidemia.
  • Overall physiology: As you age, your liver becomes less effective at removing LDL cholesterol, making you more likely to develop hyperlipidemia.

14 Hyperlipidemia Risk Factors

3. How Do Doctors Diagnose Hyperlipidemia?

Hyperlipidemia itself causes no noticeable symptoms, which is why it’s important for doctors to routinely check cholesterol levels, particularly for individuals who have a higher risk of developing the condition.

They do this, as touched on previously, with a test called a lipid panel. This simple blood test allows doctors to measure your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. In order to ensure accurate results, your physician may ask that you fast for between 8 and 12 hours leading up to the blood draw.

However, recent research trends toward a consensus that fasting may not be necessary. According to a study published in JAMA Internal Medicine in 2019, fasting prior to a lipid profile produced negligible differences to total, LDL, and HDL cholesterol levels. Triglyceride levels were consistently slightly higher for participants who did not fast.

The study enrolled close to 8,300 participants, all of whom had documented cardiovascular risk. Each participant had fasting and nonfasting lipid profiles done with a minimum of 1 month’s time in between the tests. The fasting protocol used required them to abstain from eating or drinking anything except water for 8 hours before the test. By following participants for a median of 3 years, the authors were able to determine that whether or not individuals fasted prior to the lipid profile did little to impact doctors’ ability to predict their risk of future health problems. This is exciting news not only because just about everyone dreads fasting, but more significantly, because fasting can cause issues for older individuals as well as those with diabetes.

5 Different Types of Hyperlipidemia

Experts have categorized the different types of hyperlipidemia that have a genetic component based on the different fats involved in each as well as how each affects the body.

  1. Type I, hyperlipidemia familial lipoprotein lipase deficiency: This inherited condition interferes with the mechanisms by which the body breaks down fats. It can cause abdominal pain, chronic pancreatic infections, and swelling of the liver and the spleen. It’s one of the more severe types of hyperlipidemia, and tends to develop during childhood.
  2. Type IIa, familial hypercholesterolemia, and type IIb, familial combined hyperlipidemia: Both type IIa and type IIb lead to elevated levels of LDL cholesterol. As the names of these types indicate, they do have a genetic component. They’re also one of the few types that can cause visible symptoms—specifically, deposits of fat under the skin and near the eyes. Both types put individuals at increased risk of heart problems.
  3. Type III, familial dysbetalipoproteinemia: This type involves increased total cholesterol and triglyceride levels in combination with decreased HDL levels. It, too, can cause visible symptoms—orange or yellow discoloration of the palms and the development of yellowish deposits of lipids in the skin over the elbows and knees. This type also raises your risk of cardiovascular disease.
  4. Type IV, familial hypertriglyceridemia: This type is differentiated from the others by the fact that it involves elevated levels of triglycerides, not cholesterol. It has been linked to obesity, high blood glucose, and high insulin levels. Typically, this condition remains unnoticed until early adulthood.
  5. Type V, mixed familial hyperlipoproteinemia: This type is quite similar to type I, but it also involves elevated levels of VLDL cholesterol. It’s quite common among patients diagnosed with metabolic syndrome.

Hyperlipidemia without a genetic component, also known as acquired hyperlipidemia, tends to mimic the forms described above.

4. Are There Natural Treatments for Hyperlipidemia?

There are a variety of prescription drugs on the market that can decrease cholesterol and triglyceride levels, such as:

  • Statins
  • Bile-acid-bindingresins
  • Cholesterol absorption inhibitors
  • Fibrates
  • Niacin

While these drugs do effectively treat hyperlipidemia, they can cause seriously unpleasant side effects. Statins, the first option most doctors will try, have been known to cause muscle aches, digestive upset and mental cloudiness. In rare cases, they can also cause liver damage and rhabdomyolysis, a serious condition that results in intense muscle pain, liver damage, and if left untreated, kidney failure and death.

Depending on which type of hyperlipidemia you have, as well as the results of your lipid profile, it’s possible that lifestyle changes and natural cholesterol treatments will allow you to avoid the use of potentially harmful prescription drugs. And even if a drug is necessary to manage your risk of more serious health problems like a heart attack or stroke, lifestyle shifts will still be an important part of your overall treatment plan.

Here are five lifestyle changes and natural treatments that can bring your cholesterol and triglyceride levels into the healthy range.

1. Develop a Healthy Diet

There’s no one right way to eat, but there are certain science-backed elements you can use to build a healthy diet that works for you.

When it comes to lowering bad cholesterol levels and raising good ones, the fats you eat make a big difference. Saturated fats found in red meat, bacon, and sausage and trans fats found in fried and processed foods are particularly problematic. Omega-3 fatty acids, on the other hand, have a wealth of heart-health benefits. Fatty cold-water fish like salmon and mackerel contain plenty of these good fats, as do walnuts and flaxseeds.

It’s also important to consume plenty of soluble fiber, which has been shown to lower LDL cholesterol levels. Load up on fiber-rich vegetables and fruits, legumes, and oats.

2. Engage in Physical Activity

Researchers have found that your physical activity levels have a pronounced impact on your HDL cholesterol levels. The more you exercise, the better those levels will be. And the less you exercise, the lower they’ll drop.

It appears that for cholesterol-management purposes, you should shoot for 40 minutes of moderate to vigorous exercise on 3 or 4 days of the week. Aim for a minimum of 150 minutes of exercise total per week.

If you have the time necessary to try swimming laps at the pool or joining a game of pick-up basketball, that’s wonderful. But finding ways to incorporate exercise into your daily routine, like biking to work or picking up the pace when you take your dog for a walk, can also help you hit that physical activity threshold.

3. Stop Smoking

As mentioned earlier, smoking causes HDL cholesterol levels to fall and triglyceride levels to rise. Furthermore, it independently increases your risk of developing heart disease. If you’re a current smoker, no matter which type of high cholesterol you have, quitting will be an important part of your treatment plan.

As you’re almost certainly aware, it can be quite a challenge to quit. It may be helpful to talk to your doctor about strategies for doing so, like using a nicotine patch, or to seek support from others who have successfully kicked the habit.

4. Evaluate Your Weight

There can be a connection between body weight (particularly fat mass) and cholesterol levels. Research has shown that by adopting dietary strategies designed to produce sustainable weight loss, individuals were able to raise their HDL cholesterol levels and lower their LDL cholesterol levels.

Learn more about strategies for pursuing healthy weight loss here.

5. Incorporate Proven Supplements

If you’re committed to pursuing natural methods of lowering your cholesterol, you can find more in-depth advice about proven methods for doing so, as well as the rationale behind choosing a natural approach, in this article.

For our purposes, it will suffice to say that supplements can play a very important role in naturally addressing hyperlipidemia.

For instance, compelling research has revealed that taking an essential amino acid supplement can produce highly desirable results on cholesterol levels.

Studies have shown that essential amino acids, which stimulate the synthesis of the proteins that transport lipids out of the liver as well as those that flush fatty acids into safe storage areas, can lower levels of total cholesterol, LDL cholesterol, VLDL cholesterol, and triglycerides in the liver as well as the bloodstream. These results have been seen with a dosage schedule of two 11-gram doses, twice a day.

These all-natural, completely safe compounds bring benefits for your overall health and—it’s important to note—they can be combined with statins without any ill effects. In fact, they actually make them more effective, per the findings of an Italian research team.

If you’re curious about amino acid supplementation, this primer is a great place to begin.

5 Natural Ways to Address Hyperlipidemia

Conclusion

Hyperlipidemia is the medical term for high blood levels of lipids. It can stem from genetic causes, but the majority of the time, it results from behavior choices and environmental factors such as an overly sedentary lifestyle, the use of tobacco products, or excessive alcohol consumption.

As it causes no symptoms itself, it’s vital that health care practitioners routinely screen for this silent condition, which has been linked to an increased risk of cardiovascular disease.

There are a variety of prescription medications available that can be used to get cholesterol levels under control, but they can cause unpleasant side effects. And even if the benefits of using one of those drugs outweighs the risks, it’s still important to make lifestyle changes such as developing a healthy diet that facilitates lower levels of LDL cholesterol and higher levels of HDL cholesterol as well increasing physical activity. It can also be quite valuable to incorporate supplements with proven benefits for bringing cholesterol levels into a healthy range, such as essential amino acids.

The Best Multivitamin for Over-50 Adults: Top 13 Multivitamins for Men and Women

What is the best multivitamin for over-50 adults? Here’s our recommendations on the top five brands for men and women, plus three unisex products with key features like affordability and minimal drug interactions.

As we age, our bodies naturally change and mature, and so do our nutrient needs. This article has the top 13 options for the best multivitamin for over-50 adults, those designed for men specifically, those attuned to women, and a few unisex dietary supplements with special features for the health requirements and concerns of mature adults.

Nutrients and Food Over 50

Our bodies change with every year, and certainly every decade. Children can eat anything and seemingly never run out of youthful energy, but after the age of 25 absorption rates start to change, cell creation begins to slow, metabolisms wind down (including those lesser-known silent metabolic processes like autophagy), and suddenly our essential nutrient needs have shifted.

Most people don’t notice this shift in their 20s, but as we move into our 30s and 40s, we begin to notice that some injuries just don’t heal as quickly as they used to, and little aches and pains start to become chronic and long-lasting.

As we grow older, conditions related to unhealthy diet and lifestyle choices start to manifest, and by 50 it’s more important than ever to take control of diet and fitness when conditions like heart attack, stroke, diabetes, and obesity can still be reversed or avoided and there’s still plenty of time to go from sedentary to stacked with the right motivation and nutritional support.

Doctors and experts are always trying to dispel myths about aging, especially to patients who think that getting older means it’s too late to make changes, that the damage has already been done. That’s just not true: we’re never too old to improve, to feel better, move better, and eat better.

There’s also so much misinformation out there, it’s easy to go down the wrong diet path. For instance, some people think that once their metabolism has slowed they should eat less. But men and women over 50 often need more nutrition coming in to make up for lower rates of absorption than they had in their youths.

As we age, our bodies have a harder time absorbing zinc, iron, vitamin B12, and calcium, which is part of the reason why older people experience higher rates of bone loss and muscle weakness. As we age, we also don’t spend as much time outside in the sun, moving, playing, or walking. The sunshine vitamin, vitamin D, is needed for calcium absorption. But vitamin D deficiency is one of the most common nutrient deficiencies in the United States according to the National Institutes of Health, affecting up to an estimated 42% of adults.

Your doctor can tell you if you’re missing key nutrients in your bloodwork, and may recommend taking fish oil for omega-3 fatty acids or vitamin D3 and calcium supplements to make up for some of these deficiencies. Instead of getting these essential vitamins piecemeal however, many find it more convenient to take a once-daily multivitamin, which is why we’ve compiled the best vitamins available to promote strong bones and healthy longevity.

Best multivitamin for 50+ men and women.

Best Multivitamin for Men over 50: Top 5 Picks

Here are formulas developed for men’s prostate health, blood pressure support, and body vitality.

1. Rainbow Light Men’s One

This comprehensive men’s multivitamin has strong mineral content with zinc and selenium, along with an extensive vitamin profile (vitamins A, B, C, D3, and E), all derived from real food and plant extracts like beets, kale, dandelion, and spinach. With no artificial ingredients and developed to support sexual and cardiovascular health, this multi’s high price point may be worth it to those in search of a much-needed energy boost. The price is especially worth it if it helps you avoid heart disease, the leading cause of death for men and women worldwide.

2. One A Day Men’s 50+ Health Advantage

If cost is a real concern, this One A Day option may be preferred. With a formulation designed for men, this supplement has the recommended daily value of vitamin D for healthy bone support and vitamin B6 for heart health. With just one tablet per day (as the name suggests), men can cover a wide swath of their nutritional needs with a simple, affordable multivitamin.

3. Garden of Life’s Vitamin Code 50 & Wiser Men

For vegetarian men, Garden of Life has designed a multivitamin with nutrients derived from whole foods that has been third-party tested to guarantee its effectiveness. With gummy vitamin options and formulas for men aged 40 and 55+ in years, here’s a non-GMO raw foods option for all men, including those in need of a dairy- and gluten-free multivitamin, or those interested in adding probiotics to their daily multivitamin along with the standard vitamin E, zinc, and selenium included for prostate support.

4. Centrum Silver Men Multivitamin

Gluten-free and non-GMO, this multivitamin is designed with mature men in mind. With folic acid, vitamin B12, and vitamin D, it supports brain function and eye health along with heart and blood cell strength. Some consumers have found the pills too large to swallow and notice stomach upset when taken on an empty stomach. (Skip to the end section on unisex multivitamins for a powdered vitamin option if swallowing pills or capsules of any kind is an issue.)

5. Vimerson Health’s Men’s Daily Multivitamin Supplement

Another affordable option, Vimerson’s daily multivitamin has vitamin A and lutein to help combat age-related eyesight decline and night blindness, plus B vitamins and spirulina for benefits that include healthy weight management and cholesterol and blood sugar control. And it’s made without sugar, dairy, or soy. The recommended dose of this supplement is two capsules with breakfast each morning.

Best Multivitamin for Women over 50: Top 5 Picks

Here are the top selections for women’s multivitamins, designed for bone strength and hormonal support for menopause on top of the usual dietary needs common among all older adults.

1. One A Day Women’s 50+ Healthy Advantage

As popular among women as men, the One A Day formula includes vitamin B6 for increased energy and an extra boost of calcium for women’s bone health. Women suffer from osteoporosis at higher rates than men, especially those women who’ve been pregnant. One A Day also offers a specific formula for menopause for those whose symptoms are lengthy through the perimenopause stage and the full transition to post-menopausal health.

2. Nature’s Way Alive! Women’s 50+ Premium Gummy Multivitamin

This gummy multivitamin option is great for those who can’t (or just plain don’t want to) swallow large capsules or pills. With whole food-derived nutrients, these gummies amazingly contain no gelatin, artificial preservatives or flavors, but they do have sweeteners from tapioca syrup and cane sugar to make them better-tasting than the average vitamin. Plus, they’re full of vitamin D, lutein, high-potency vitamin B12, and more.

3. New Chapter’s Every Woman’s One Daily 55+

While some women find swallowing large pills difficult or uncomfortable, others find dropping all their vitamins onto a sensitive stomach at once to be untenable. That is where New Chapter’s gentle formula shines. It’s a multivitamin easy enough to take on an empty stomach and ideal for those with gastrointestinal issues or inflammatory conditions of the digestive tract. With plenty of vitamin C for immune system strength and B vitamins for energy, this organic formula will ease you comfortably to better health.

4. Garden of Life’s Vitamin Code 50 & Wiser Women

Focused on breast health and free of fillers and binders, this Garden of Life formula is gluten free, dairy free, soy free, and vegan, and comes in capsules that can be opened and mixed with other substances if swallowing capsules is undesirable. Intended to be taken twice a day (two capsules at a time for a total of four doses), the live enzymes and probiotics in this formula may be the exact right daily multivitamin for you.

5. Centrum Silver Women

Affordable and comprehensive, this gluten-free, non-GMO multivitamin has a smooth coating for better ease in swallowing, and contains B vitamins for heart and brain health, vitamin D for bone health, and lutein and vitamins A and E for eye health.

Best Unisex Multivitamins for Healthy Aging

Here are multivitamin products designed more generally for mature adults, but with special features that may sell either men or women on their formulas.

1. Rainbow Light 50+ Mini-Tablet

One of the best features of this small, easy-to-swallow multivitamin designed for men and women is that it doesn’t contain vitamin K, which causes issues with many blood-thinning medications. There’s also no iodine, which can cause problems for those with thyroid conditions, and no PABA (para-aminobenzoic acid), which can interfere with antibiotics. When it comes to avoiding harmful side effects, it’s the nutrients which aren’t in your multivitamin that matter.

2. Seeking Health’s Optimal Multivitamin Powder

Troubles with swallowing disappear with a multivitamin designed and delivered in powdered form. With the same vitamin C, E, and D that’s found in all the others on our list, this mix also comes with choline and boron, but without copper for those who may have elevated copper levels.

3. Kirkland Signature’s Adult 50+ Mature Multi

Designed to support healthy aging and with good amounts of vitamin D and vitamin B12, this incredibly affordable and popular option, with calcium for bone and teeth strength, can be found at Costco and Amazon online.

A+ Aging for 50+ Adults

Your body changes as you age, as do your essential nutrition requirements. Choose your multivitamin depending on your personal health concerns and nutrient needs. We hope you find the one that suits you and your lifestyle perfectly on this list!

Recognizing Cachexia: Unintended Weight Loss, Falling Energy Levels, Temporal Wasting and Other Signs to Look For

Treating cachexia, a frequently irreversible side effect of many major illnesses, requires a separate, multilevel approach. This is, in part, because diagnosing it can be quite tricky, as symptoms such as temporal wasting overlap with those of the underlying conditions. In addition to lifestyle-related shifts such as eating small, frequent meals, supplementing with amino acids has been shown to slow the rate of muscle mass loss as well as the fatigue caused by cachexia.

One way to think about cachexia is as the last illness. This metabolic disorder causes muscle wasting and involuntary, extreme weight loss, as well as temporal wasting. Cachexia occurs in the final states of almost every serious disease, including cancer, heart disease, HIV, and multiple sclerosis.

According to experts, approximately 9 million people around the world have cachexia. A 2016 estimate placed the number of cachexia diagnoses among individuals admitted to hospitals in the United States at 160,000 per year. Despite the staggering number of individuals affected by cachexia, doctors have historically focused on treating the underlying disease, rather than cachexia itself.

However, as we entered the twenty-tens, scientists began to examine cachexia as not just a symptom, but a condition that could itself be treated. Early studies showed that inflammation and metabolic imbalances drive cachexia, pointing the way to potential treatment approaches.

One of the challenges in treating cachexia is that it can be challenging to diagnose, particularly in the early stages when interventions are most likely to result in increased quality of life.

In this article, we’ll cover what causes cachexia, how to recognize temporal wasting and other symptoms of cachexia, and available treatments for cachexia such as targeted amino acid supplementation.

What Causes Cachexia?

Cachexia is a complex condition with no single cause. The term comes from the Greek words “kakos,” meaning bad, and “hexis,” meaning condition—and indeed, those with cachexia are in overall bad condition. This makes it challenging not only to tease out the factors that cause cachexia, but also to define the condition clinically. Though Hippocrates is widely acknowledged as the first to describe cachexia, a formal medical definition—which includes the loss of 5% or more of a person’s bodyweight over the course of a year as well as declining muscle strength—was not developed until 2006.

Scientists do know that in addition to altered levels of key bioactive substances, a primary force behind the development of cachexia is increased muscle protein breakdown which, in conjunction with decreased muscle protein synthesis, results in muscle atrophy, or muscle loss.

Other processes known to contribute to cachexia include systemic inflammation and elevated energy expenditure.

A number of factors contribute to cachexia, including the levels of these substances, the conditions that cause them, and the reaction they provoke from the body.

Who’s at Risk of Developing Cachexia?

As touched on in the introduction, cachexia commonly develops during the last stages of serious diseases. That means individuals with the following conditions are all at risk of developing cachexia as their diseases progress:

If you or a loved one has one of the conditions listed above, consider having a conversation with your doctor about preventative steps you can take to avoid cachexia and safeguard your quality of life.

9 Conditions That Put You at Risk of Developing Cachexia

Recognizing Temporal Wasting, Unintended Weight Loss, and Other Symptoms of Cachexia

Many of the symptoms of cachexia overlap with the symptoms of other conditions, including the very conditions that cause cachexia to develop. This can make it difficult to differentiate between true cachexia and other issues.

Some telltale indicators of cachexia include:

  • Muscle wasting: The core symptom of cachexia is muscle wasting. It’s important to note, however, that particularly in the early stages, individuals may be experiencing ongoing muscle loss without visibly appearing malnourished. In individuals who are overweight, this can make it even more unlikely that doctors will spot cachexia.
  • Unintentional weight loss: This refers to weight loss without conscious intent, and with the consumption of an adequate number of calories to maintain body weight or even a high enough caloric intake to result in weight gain under normal circumstances.
  • Loss of appetite: Known clinically as anorexia (and not to be confused with anorexia as an eating disorder), the loss of appetite experienced by those with cachexia is pronounced and consistent. They cease to find food appealing and lose the desire to eat it.
  • Decreased functional ability: Cachexia often results in fatigue, low energy levels, and malaise, which can make it difficult for a person to carry out daily activities. They may find even simple tasks such as brushing their teeth to be exhausting.
  • Edema: Cachexia causes protein levels in the blood to decrease, which in turn causes excess fluid to accumulate in the tissues of the body. As it builds up, it causes swelling.
  • Temporal wasting: The wasting of the temporal muscles and subcutaneous fat in the temporal region occurs with serious nutritional deficiencies and severe catabolism (meaning when muscle protein breakdown massively outpaces muscle protein synthesis).

6 Symptoms of Cachexia

Why Is It Challenging to Diagnose Cachexia?

Many of the symptoms of cachexia overlap with the symptoms of other conditions, including the very conditions that cause cachexia to develop. This can make it difficult to differentiate between true cachexia and other issues.

To further complicate matters, doctors don’t agree on the threshold at which muscle wasting becomes extensive enough to be considered cachexia. The definition of cachexia settled upon in 2008—”a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass”—largely hinges on presence of muscle loss either in the absence of, or that outpaces, fat loss.

Even mild muscle loss, which commonly accompanies the aging process, produces some feelings of increased weakness and fatigue. It can also make it more difficult for individuals to carry out the activities of daily life.

Most experts concur that the best approach for determining when muscle wasting has become significant enough to constitute cachexia involves quantifying:

  • Loss of muscle mass
  • Change to muscle strength
  • Degree of decrease to muscle tone

In the early 2010s, some researchers proposed that imaging techniques like MRI (magnetic resonance imaging) could be valuable tools for diagnosing cachexia.

At this time, doctors continue to use a variety of criteria for diagnosing cachexia. The most common lists the following diagnostic points:

  • Inadvertent loss of over 5% of overall body weight in a span of 6 to 12 months
  • Body mass index (BMI) of under 20 for individuals younger than 65 and under 22 for individuals age 65 and older
  • Less than 10% of body mass accounted for by body fat

The Importance of Early Recognition

Because loss of muscle strength and muscle mass often occur slowly and in tandem with chronic diseases and/or the aging process, cachexia diagnoses tend to happen once widespread muscle wasting has transpired. This eliminates the best window of opportunity for halting the progression of cachexia and securing an improved long-term quality of life.

Unfortunately, the patients under the closest medical observation often fare the worst, as hospitalization can instigate or exacerbate malnourishment, which in turn furthers the progression of cachexia. When a patient’s nutrient intake declines, longer hospital stays and worse outcomes tend to follow.

Conventional medical treatment plans are not designed to encourage the recognition of early signs of muscle wasting. The more pronounced the wasting becomes, the lower the efficacy rate for interventions.

In an effort to combat this, researchers developed guidelines for a condition termed “pre-cachexia,” which are as follows:

  • Presence of an underlying chronic disease
  • Unintentional weight loss less than or equal to 5% of typical body weight during the last 6 months
  • Systemic inflammation
  • Loss of appetite and related symptoms

Hopefully, the establishment of these guidelines will lead to greater recognition of early signs of muscle wasting. Even minor changes to body mass or appetite among those with chronic diseases can be indicators that something has gone awry, and should, therefore, be taken seriously. The sooner these symptoms are noted and addressed, the better the treatment results will be.

Diagnostic Criteria for Pre-Cachexia and Cachexia

Complications Associated with Cachexia

As cachexia progresses, it can seriously impact a person’s overall health. Muscle wasting, in particular, can significantly decrease longevity. According to a 2017 study, cachexia correlates strongly with survival and has been found to contribute to 20% of cancer fatalities.

In general, complications associated with cachexia include:

  • Impaired quality of life
  • Inability to live independently
  • Compromised immunity
  • Exacerbated symptoms of underlying disease
  • Shortened lifespan

How to Treat Cachexia

Because so many separate factors coalesce to cause cachexia, treatment typically involves multiple types of therapy. While it can be tempting to believe that simply encouraging a person to eat more, or to change the foods they eat, will halt the loss of body mass caused by cachexia, that will not produce the desired results.

According to doctors, dietitians, and other experts, the following steps can be valuable parts of a cachexia treatment plan.

  • Adopt an eating approach centered on small, frequent meals. While an increased caloric intake alone will not cure cachexia, it’s vital that individuals with cachexia consume as many nutrient-dense calories as they can tolerate. Most find it preferable to eat small portions of high-calorie meals throughout the day rather than three larger meals. It can also be helpful to add nutritional supplement drinks as between-meal snacks.
  • Emphasize the social elements of eating. Even if eating itself holds little attraction, individuals with cachexia can still draw enjoyment from gathering together to eat a meal. Encouraging a person with cachexia to focus on mealtime socialization can help recalibrate the relationship to food.
  • Educate the emotional support system. As cachexia and the underlying diseases associated with it progress, patients may entirely lose the desire to eat. This can be upsetting for family and friends, who may feel strong urges to compel them to eat. It’s important to understand that eating will not halt muscle wasting and weight loss. When patients reach this stage, prioritize their overall quality of life rather than caloric intake.
  • Try appetite stimulant medications. Certain drugs—for example, dronabinol, megestrol, and glucocorticoids—can stimulate the appetite. Again, keep in mind that eating more will not change the progression of the disease. However, it can be beneficial in that patients feel more integrated into familial and social interactions, which in turn improves mental health.
  • Engage in light exercise. If a person has the energy to do so, some believe that light exercise can help build muscle mass. That said, this hypothesis has yet to be fully substantiated.

Incorporating Amino Acids into a Cachexia Treatment Plan

Researchers have found that certain nutritional interventions can help to both treat and prevent muscle wasting. Given the paramount importance of amino acids for muscle growth, it should come as no surprise that strong evidence indicates that whey protein, as well as glutamine, arginine, and leucine, can help individuals with cachexia maintain and even increase their muscle mass.

Studies support the use of whey protein to build muscle. Whey, considered to have one of the best amino acid profiles of any natural protein, provides a wealth of amino acids that play active roles in muscle synthesis, including all three branched-chain amino acids (BCAAs): leucine, isoleucine, and valine. Multiple studies have shown that supplementing with whey protein can result in increased protein synthesis. Furthermore, the increases associated with the use of whey protein are greater than those linked to the use of casein or soy. That said, it’s not uncommon for these studies to have participants enroll in an exercise program, making it somewhat unclear whether the muscle mass increases stem from the whey protein, the exercise program, or the combination of the two.

Interestingly, carnitine, an amino acid derivative, can not only stimulate muscle protein synthesis but also increase energy production, thereby alleviating the ill effects of cachexia on two levels. Several studies have found that cancer patients with cachexia tend to have low levels of carnitine, and that supplementing with 2 to 6 grams of carnitine can help reduce fatigue and increase lean body mass.

A 2006 study conducted by an Italian research team found that taking 2 grams of L-carnitine 3 times each day for a month led to an average muscle mass gain of 4.4 pounds, significantly decreased fatigue, and markedly improved quality of life. Other studies done with cancer patients also found that supplementing with carnitine led to increased muscle mass and decreased fatigue.

As you may be aware, amino acids work in concert to orchestrate myriad essential physiological functions, including protein synthesis. Thus, while certain amino acids have been shown to be uniquely beneficial for the treatment of cachexia, it appears that supplementing with well-balanced blends of multiple amino acids produces better results than supplementing with a single amino acid.

For instance, the use of leucine in combination with glutamine and arginine can bring about lean muscle mass gains in individuals with muscle wasting. A study published in The Journal of Parenteral and Enteral Nutrition showed that a mixture of leucine, glutamine, and arginine given in two divided doses each day led to an average weight gain of 5.6 pounds of lean muscle mass compared to an average weight loss of 1.5 pounds of lean mass for those taking the placebo. Study participants, all of whom had HIV and documented weight loss of at least 5% of body mass over the previous 3 months, were randomly assigned to receive the amino acid mixture or the placebo. The study authors tracked their body weights, lean body mass, and fat mass using air displacement plethysmography and computerized tomography (CT). After 8 weeks, the researchers found that supplementing with the amino acid blend could “markedly alter the course of lean tissue loss” as well as improve immune status.

Studies done with cancer patients and other populations found similar results in terms of muscle mass gains.

How to Treat Cachexia

Research supports the idea that the use of amino acids to treat cachexia should include a well-formulated blend of essential amino acids. This ensures the body has all the raw materials necessary to carry out muscle protein synthesis at the highest rate possible. Only a small amount of amino acids—say, a 3-gram dose—is needed to bring about this effect.

Conclusion

Cachexia, a frequently irreversible side effect of many major illnesses, causes severe muscle wasting. The accompanying rapid loss of muscle mass can undermine a person’s overall health and even shorten their lifespan. Diagnosing cachexia is quite tricky, as symptoms such as temporal wasting overlap with those of the underlying conditions associated with it. Furthermore, it often accompanies the end stage of those diseases.

Cachexia is complex condition, and though it is intimately intertwined with the progression of the underlying disease, treating it requires a separate, multilevel approach. In addition to lifestyle-related shifts such as eating small, frequent meals, supplementing with amino acids has been shown to slow the rate of muscle mass loss as well as the fatigue caused by cachexia.

How to Lengthen Telomeres—and Why You Should

Shortening of telomeres plays a vital role in cellular division and the aging process, which has led to intense interest in how to lengthen telomeres. Research indicates that both telomerase therapy and RNA treatments could possibly be effective interventions, however, it will likely be some time before those treatments become available to the public. In the meantime, a new study points to amino acids as a possible method for enhancing the health of your telomeres. 

“Telomeres”—have you encountered that term yet? It seems that interest in telomere length and how to lengthen telomeres is reaching somewhat of a fever pitch.

Researchers describe telomeres as the cellular equivalent of the plastic tips placed on the ends of shoelaces to prevent fraying. The material telomeres keep intact, however, is your DNA.

When a cell divides and replicates, the replication does not include the full length of the DNA strand—a small section from the ends does not get copied. Telomeres cap the ends, ensuring nothing vital gets left out of the replicated cell. Each time a cell divides, a little bit of the telomeres at its ends gets left behind. So, over time, telomeres become shorter and shorter. When they get too short, the cell they’re attached to stops replication and enters senescence. The accumulation of senescent cells in the body is thought to contribute to the development of many age-related health conditions, such as:

A wealth of research indicates linkages between length of telomeres and overall health. While some have interpolated that to mean that short telomeres indicate a short lifespan, others feel it’s more complex than that.

Here’s what you should know about telomeres, the vital role of an enzyme called telomerase, and how to lengthen telomeres (including a very accessible option).

10 Quick Facts About Telomeres

What Are Telomeres?

The word telomere is derived from Greek (as many medical terms are)—specifically, the word “telos,” which means end, and the word “meros,” which means part. Scientists suspect that short telomeres may be a contributing factor to the development of many chronic diseases, while geroscientists think it’s possible that the shortening of telomeres may drive the entire aging process.

Telomere shortening can be thought of as the lighting of a fuse attached to a cell. With each cell division, telomeres grow shorter until (to continue the metaphor) the flame gets too close to valuable genetic information, triggering cellular senescence or apoptosis (cell death).

Technically speaking, telomeres are repeated sequences of DNA that keep our chromosomes stable during cellular division and protect our genetic information. Thus, shorter telomeres correlate with an increased risk of cancer and other diseases linked to genetic malfunctions. Telomeres also regulate the cellular aging process, dictating how many times a cell can safely divide. Scientists used to believe that cells could replicate indefinitely, and research into telomeres has been a vital component of efforts to better understand cellular replication and its effect on human health.

The Science of Telomeres

Pioneering scientists Hermann Muller (who gave telomeres their name) and Barbara McClintock were the first to recognize that telomeres appeared to have a protective function. After their groundbreaking work in the 1930s, however, it would take several more decades for researchers to comprehend how telomeres functioned in relation to cellular aging.

One reason for that was the persistent assumption that cells could divide endlessly, an incorrect belief that was shattered at last in 1961 when two scientists from the Wistar Institute of Anatomy and Biology in Philadelphia, Pennsylvania discovered that cells can only divide a limited number of times. For the lung cell cultures they observed that limit appeared to be set around 40 or 50 divisions.

The next decade ushered in the work of Elizabeth Blackburn, an icon in the field of human telomere research. At Yale University in the 1970s, she became the first to identify a telomere sequence.

Another major breakthrough took place in 1998 when a research team based in Menlo Park, California found that artificially extending the length of the telomeres attached to cells could allow them to continue dividing indefinitely, thereby officially “establishing a causal relationship between telomere shortening and in vitro cellular senescence.”

Then, in 2009, Elizabeth Blackburn, Carol Greider, and Jack Szostak won a Nobel Prize for their discovery of telomerase, an enzyme that lengthens telomeres and which remains shut off in most cells after the early phases of growth.

Since then, telomeres have become a hot topic among those interested in healthy aging. “Once telomeres became popular knowledge, all sorts of people came out of the woodworks selling nutraceuticals, natural products, claiming that it was the fountain of youth,” explained Jerry Shay, a biologist at the University of Texas Southwestern Medical Center who specializes in telomeres, in an interview.

Understanding the Role of Telomerase

As touched on briefly in the preceding section, the enzyme telomerase is responsible for telomere lengthening. When it restores length to telomeres, it bestows the cells those protective caps that are correlated with a longer lifespan. Because of this, some experts in the field of geroscience believe that increasing the body’s supply of telomeres can safeguard—and even restore—the length of our telomeres. This, in turn, will help to prevent the development of age-related diseases.

While a number of different proteins contribute to telomere upkeep, telomerase carries out the most important role—it rebuilds the ends that get shortened during cellular division.

As established earlier, the cells of the body can’t replicate indefinitely. To be more precise, however, somatic cells can’t replicate like that. Stem cells, however, are immortal. To continue dividing without compromising genetic code, stem cells use telomerase to rebuild the ends of their telomeres. With perpetually long telomeres in place, they can carry on dividing, and dividing, and dividing. Telomerase keeps their telomeres at a consistent length regardless of how many times they divide, allowing them to continue with their vital work, which includes tissue growth and regeneration.

It is because ordinary, somatic cells do not use telomerase that they can only divide a limited number of times.

So, you might be thinking that supplementing with telomerase would have to be the most effective anti-aging treatment ever. And in a sense, you’d be right. But scientists worry this approach could come with serious adverse side effects. You see, there’s another type of cell that uses telomerase—cancer cells. That’s why they’re able to replicate so ruthlessly. Experts worry that if telomerase levels rise too high, that could fuel the growth of cancer.

How to Lengthen Telomeres

Because of the potential risks associated with telomerase therapy, research so far has been conducted with rodents. That said, the results have been highly encouraging.

A 2012 study published in EMBO Molecular Medicine found that the use of telomerase gene therapy in adult mice successfully extended lifespans without increasing cancer risk. They found that higher levels of telomerase translated to “remarkable beneficial effects on health and fitness, including insulin sensitivity, osteoporosis, neuromuscular coordination and several molecular biomarkers of aging.” Even more impressive, however, were the increases to lifespan—an increase of 13% for 2-year-old mice and 24% for 1-year-old mice.

While this seems to indicate telomerase therapy could be an effective anti-aging tool, allowing us to live longer, healthier lives, it’s important to remember more research is needed to corroborate those findings. There are (obviously) many differences between humans and mice, including that mice have longer telomeres than humans at baseline.

That said, the results of in-vitro, test-tube studies have also shown that adding telomerase makes it possible for cells to continue to replicate long past the point at which they would typically undergo senescence or apoptosis.

Another interesting approach to lengthening telomeres is the use of RNA therapy. Dr. John Cooke, department chair of cardiovascular sciences at Houston Methodist Research Institute, led a team in analyzing whether RNA therapy could lengthen the telomeres of human cells, albeit in test tubes.

To do so, Cook and his team harvested cells from children living with progeria, a condition that causes such rapid aging, most who have it die in their teens. Earlier studies had already established that children with progeria have markedly short telomeres.

Before the RNA treatment, the harvested cells multiplied poorly and died quickly. Once the RNA was inserted, “cells proliferated normally,” stated Cooke. “It was a dramatic improvement.“ He noted, too, that the RNA treatment rolled back other indicators of aging, like the presence of inflammatory proteins.

A More Accessible Option

While findings on the use of telomerase and RNA are certainly exciting, it’s unlikely that most people will have access to these treatments in the near future. Luckily, there’s a more accessible way you can directly impact the health of your telomeres.

Vicki Lundblad, a professor in the Molecular and Cell Biology Laboratory at the Salk Institute for Biological Sciences, led a team who identified a key protein group that helps lengthen telomere ends. Through analysis of the structure of human telomerase, Lundblad uncovered three EST proteins—known as Est1, Est2, and Est3—that make major contributions to telomerase activity. Est2, along with RNA, does the cellular heavy lifting necessary for reconstructing telomeres, while Est1 and Est3 ensure that process progresses smoothly. Both Est1 and Est3 make unique contributions. Est 1 transports telomerase to the telomeres. “Without Est1, telomerase cannot get to the ends of chromosomes, and thus telomeres shorten,” Lundblad stated.

Ongoing analysis is centered on clarifying the role of Est3. What the team knows so far is that it uses specific amino acids to interact with telomerase. When the team inactivated those amino, shorter telomeres were produced, indication that telomerase activity had been measurably impaired.

In other words, without amino acids, the body cannot utilize telomerase. Yet another reason to ensure your body always has a ready, more-than-adequate supply of essential amino acids.

Conclusion

Telomeres ensure that the cellular division process does not result in the loss of genetic material. Instead, each time your cells divide, a section of your telomeres gets left behind. When telomeres become too short, cells stop dividing and become inactive.

This has led to intense interest in how to preserve and lengthen telomeres. Research indicates that both telomerase therapy and RNA treatments could possibly be effective interventions. However, it will likely be some time before those treatments become available to the public.

In the meantime, a new study points to amino acids as a possible method for enhancing the health of your telomeres. Given the many benefits associated with amino acids, this seems like a telomere-lengthening strategy worth trying.

The Reverse-Aging Diet: Is Autophagy the Key to Staying Young?

By using autophagy fasting techniques and nutritionally superior foods, you can reverse certain aspects of aging and recover your rightful vitality. Here’s what you need to know about the reverse-aging diet.

The reverse-aging diet is also known as “eating for autophagy,” but what does that mean for you? Autophagy is a biological process that allows the body to recycle aging or dying cells to synthesize new and better ones. It’s not exactly like a keto or paleo diet where you can just know what not to eat and carry on—there’s a timing aspect to autophagic eating, as well as specific foods that have their own anti-aging strengths. We’ll cover both aspects of the reverse-aging diet here.

What Is Autophagy and How Does It Reverse Aging?

The body’s autophagy process was discovered in the 1950s and ’60s accidentally by Christian de Duve, a Belgian scientist who was studying insulin at the time. He named the process after the Greek words for “self” (auto) and “eating” (phagy), because in a sense that is what it entails: the body sends cells around to cannibalize the useful parts of dying cells, or to eat up the garbage byproduct of normal cell functioning, and uses those pieces to repair or replace dying cells with stronger cells. It’s like a molecular version of recycling and up-cycling material that would otherwise be clogging up the streets.

Scientific understanding of autophagy didn’t advance again until the 1970s and ’80s, when another Nobel prize-winning scientist, Yoshinori Ohsumi, discovered the genes that regulate the autophagic response. It was ultimately determined that, just as with all the other processes in the body, autophagy starts to decline with age. Autophagy on decline is sort of like having a broken garbage disposal and leaving leftover food bits in your sink: eventually this will gum up the works.

And yet, just as it’s possible to get your garbage and recycling habits back in working order, it’s also possible to trigger autophagy even as you age and the process naturally slows. By using diet to manipulate a “stress response” in the body, you can essentially assign cleaning days to your cells, the same way you might when creating a chore chart for a busy family: some days are for cleaning and some days are for more thoroughly enjoying life in a clean house.

Long story short, by using intermittent fasting practices and eating key nutritional foods, you can regularly bring autophagy out of a sluggish maintenance mode and make sure the cellular garbage in your body doesn’t overwhelm healthy functioning and lead to symptoms of aging.

Autophagy Fasting: How Does It Work?

Autophagy is actually part of some diets like keto and Atkins, diets that carefully put the body into a small nutritional crisis to manipulate healthy results. By inhibiting carbohydrate intake for example, the body becomes alarmed enough to start burning fat stores for energy. Usually the body guards these fat stores like piles of emergency gold in case of famine, but in a modern, First World context, famine is way less of a threat, while obesity contributes to more and more preventable deaths each year.

If you want to fast in a way that triggers autophagic metabolism and slows down the aging process, follow these basic steps:

  • Eat all of your meals within an 8-hour window. You still need your essential nutrients, but you want your body to spend some energy cleaning up rather than digesting and functioning all the time. For the best foods to eat for autophagy, read on to the next section.
  • Fast between 16 and 28 hours intermittently. Periods of nutrient deprivation trigger autophagy. The reason intermittent fasting works is that it triggers the sort of secondary metabolisms we evolved to survive in harsh climates, but it does so in small windows of time without actually starving us.
  • Sustain yourself and your energy with exogenous ketones. While fasting, water, tea, and black coffee are acceptable to consume. If you choose to add MCT oil (medium-chain triglycerides from coconut oil) to your drink, your body will have just enough energy to function and feel satiated without interrupting your fasting goals for weight loss or cellular clean-up.

Autophagy is also triggered by vigorous exercise routines, like HIIT workouts (high-intensity interval training), which, much like intermittent fasting, utilize small windows of high stress to elicit the biological responses we need to stay young and healthy. Modern life is often too safe and sedentary, and our survival mechanisms get weak from lack of use. Autophagy reminds our bodies that each day is still a matter of life and death.

What Is Autophagy and How Does It Reverse Aging

The Reverse-Aging Diet: Which Foods Keep the Body Young?

You’ll want to start by reducing (not eliminating) carbs. Eating more low carb starts inching your body towards ketosis, with the beneficial side effect of losing body fat and weight. In addition to lowering carb intake, you’ll want to consume nutrient-dense foods with compounds that contribute directly to the body’s anti-aging efforts.

Green Tea and Matcha Powder

Green tea has become nearly synonymous with longevity, so much so that statistically the more green tea you consume regularly, the longer you live. This is why it’s a staple in almost every anti-aging diet. Green tea and matcha powder (ground green tea leaves) contain polyphenols that help reduce the inflammation caused by free radical toxins. And catechins in green tea can help prevent the effects on sun damage and the appearance of fine lines when used topically in skincare products.

Kale and Leafy Greens

Cruciferous vegetables and leafy greens are rightly considered superfoods. Kale, broccoli and broccoli greens, spinach, Brussels sprouts—all of these lean greens contain hefty amounts of vitamin K, lutein, fiber, and phytochemicals that help reduce the risk of cancer and guard against the oxidative damage of free radicals. Their vitamin A content contributes to healthy, youthful skin and wound repair, while their vitamin C content serves as a precursor to collagen and new skin cell production. Plus, vitamin C acts as an antioxidant so powerful it helps prevent cold and flu infections. The vitamins and minerals in leafy greens are some of the best anti-aging nutrients to be found.

Walnuts and Almonds

Most nuts contain valuable amounts of omega-3 fatty acids and plant-based protein, but that isn’t the end of their value as anti-aging food. Walnuts in particular may extend life for up to 3 years, possibly by reducing the risk factors for cancer and heart disease. And almonds are full of vitamins A, B, and E, healthy fats, and antioxidants that belong in every healthy diet to help reduce inflammation from the skin to within.

Seeds

Just about any seed that isn’t poisonous is good for you, from chia to sunflower to flaxseeds. Ask any dietitian or nutritionist if you’re eating enough seeds, and the answer will likely be a resounding “no!” Most of us in the modern world don’t consume seeds nearly as much as we’re evolved to. In fact, we have intentionally engineered seedless foods like watermelon and bananas just to avoid what we should be consuming regularly.

Chia seeds are sources of water-soluble fiber that swells with liquid and helps slow down digestion and keep blood sugar levels from spiking. They are anti-inflammatory, full of omega-3s, and contain all nine essential amino acids necessary for new muscle growth at all stages of life.

These features can be found in flaxseeds as well, which have anti-aging nutrients for your skin and flavonoids known to help lower LDL (“bad”) cholesterol levels, improving the ratio between “good” HDL levels and lowering the risk of cardiovascular disease. If you enjoy a good trail mix with sunflower seeds, you’re also fortifying your body with vitamin E, an antioxidant that can help protect against the sun’s UV rays.

Oily, Fatty Fish

Eating the proper ratio of omega-3 to omega-6 fatty acids is necessary for optimal health. While both fatty acids are essential, the standard Western diet overemphasizes omega-6 fatty foods (they’re in vegetable oils, which infiltrate our foods as additives), and downplays omega-3s, which are found in abundance in oily fish like salmon, sardines, and mackerel.

Omega-3 fatty acids help lower inflammation, and subsequently rates of dementia, heart disease, and arthritis. Salmon is abundant in astaxanthin, a powerful antioxidant that defends against aging. And heart-healthy sardines can help reduce the risk of developing diabetes. Sardines have the added advantage of being on the bottom of the food chain, meaning they are less likely to contain toxins they themselves have consumed (as may be the case with larger fish, which have higher mercury levels).

Access to fresh fish is not always easy to come by or affordable for those who live far inland. Luckily a fish oil supplement is easy to find and can help improve your joint health as well.

Fermented Foods

Fermented veggies like kimchi and sauerkraut along with fermented dairy products like kefir and Greek yogurt carry healthy probiotic bacteria. While prebiotic foods contain fiber for your existing good gut bacteria to digest, probiotic foods introduce new live cultures of beneficial gut bacteria to support healthy digestion, detox efforts, and immune system functioning.

Sweet Potatoes

Don’t just pull out sweet potatoes for your fall menu. These spuds are some of the healthiest carbs around. As we pointed out at the top of this list, while it’s good to lower your intake of carbs (and the fast sugars that come with them), it’s not recommended to eliminate carbs entirely. Carbohydrates in fruits, starchy veggies, and foods like sweet potatoes can provide many beneficial nutrients. Particularly the skin of sweet potatoes contains concentrations of the anti-cancer compound anthocyanin, another valuable asset to staying young and healthy.

Red Wine and Dark Chocolate

Treats like red wine and dark chocolate contain useful nutrients too, specifically resveratrol, an anti-aging antioxidant. Consumed in moderation, the nutrients in the grapes that make red wine and the cacao nibs that make up the majority of dark chocolate provide protection against the age-accelerating damage of free radicals.

Mushrooms

It’s strange but true: while mushrooms are grown in dampness and dark, if you place them in sunlight after harvesting, they soak up vitamin D from the sun just like human skin does. In fact, they soak up so much that 3.5 ounces of mushrooms can provide you 130-450 IUs of vitamin D you need, so you don’t have to spend so much time in the sun or suffer the signs of aging that can come from sun damage.

Dark Berries and Fruits

Raspberries, blueberries, and pomegranates have deep coloring in common, as well as certain antioxidant concentrations that can greatly benefit your health. Pomegranates have enjoyed a recent hey-day as a superfood, but dark berries like blue and blackberries bring the same level of nutrition to every smoothie, yogurt, or dessert that includes them. These fruits’ concentrations of vitamin A, vitamin C, and the antioxidant anthocyanin all work to help prevent chronic conditions from gaining a foothold. They also help increase collagen production for more supple, youthful skin.

Avocados

Avocados are one of the most well-known and versatile healthy fats in a low-carb dieter’s kitchen. Delicious and creamy, they can be eaten as a veggie dip, utilized as a healthy spread, and turned into smoothies and dairy-free ice creams, all while providing you with vitamin A that protects your skin cells and omega-3 fatty acids that help your heart.

Carrots

Famous for improving eye health thanks to their beta-carotene content, carrots do even more to help preserve your youth and vitality. One study found a correlation between carotenoid consumption and romantic appeal and attraction. And if it’s health effects you’re after, the vitamin A in carrots protects your skin from viruses, bacteria, and the potential ravages of aging.

Turmeric

Speaking of brilliantly orange foods, turmeric and its active compound curcumin are famous natural remedies for inflammation, helping to ameliorate significant inflammatory conditions such as rheumatoid arthritis. Time and time again, in study after study, turmeric exhibits proven pain-relieving attributes and anti-inflammatory capabilities. So if you’re looking to reverse aging with diet, you definitely want to pepper turmeric into your food routine. Add a dash of black pepper to increase bioavailability!

Tomatoes

The tomato is a fruit used in culinary capacities as a vegetable, but no matter how you slice it, the lycopene content inside tomatoes provides valuable disease resistance, specifically against osteoporosis, which affects 1 in 3 women and 1 in 5 men over the age of 50. Along with the health benefits of lycopene, tomatoes provide B vitamins like niacin and folate, vitamin C, and vitamin K. Here’s a pro-tip for eating: add a little olive oil to help increase the nutrient absorption in your body.

Beets

Last but not least, maybe it’s appropriate that beets have the approximate shape of a heart, because the nitrates they contain help improve arterial health and blood pressure, as well as help reduce inflammation like so many other anti-aging foods on this list. The nitric oxide content also helps protect your kidneys, and the rich color of beets makes for a beautiful presentation whether in a smoothie or on your plate.

Aging Can Be Reversed

While you can’t turn back time, you can reverse the symptoms of aging that come from the slow-down of processes like autophagy. With the right supplies in your diet and an active lifestyle, you can easily be in better shape at 60 than you were at 30, when, in the brazenness of youth, many people don’t take proper care of themselves. Damage done by poor diets or unhealthy lifestyles can be reversed, and the more you know about how to best strengthen your body, the better prepared you are to improve with age.

The Truth Behind the Apple Cider Vinegar Fatty Liver Detox, Plus Science-Based Advice on Improving Liver Health

Advocates claim that conducting a cleanse with apple cider vinegar helps to flush toxins from the body, regulate blood sugar levels, and encourage healthy weight loss, all of which can improve liver health. However, there’s little scientific support for these claims. Read on for clear, evidence-based information about fatty liver disease, why some people believe apple cider vinegar can effectively treat this condition, and what steps to take to protect and improve your liver health.

Given that pharmaceutical companies have yet to devise a drug to treat fatty liver disease, it’s hardly surprising how much interest there is in natural remedies for this condition. One popular example of this type of home remedy is the apple cider vinegar fatty liver detox. Advocates claim that conducting a cleanse with apple cider vinegar helps to flush toxins from the body, regulate blood sugar levels, and encourage healthy weight loss, all of which can improve liver health. However, there’s little scientific support for these claims.

Read on for clear, evidence-based information about fatty liver disease, why some people believe apple cider vinegar can effectively treat this condition, and what steps to take to protect and improve your liver health.

What Is Fatty Liver Disease?

Before describing fatty liver disease, let’s establish what normal, healthy liver function looks like. The liver, the largest of the internal organs, carries out a host of absolutely vital functions, such as:

  • Cleansing toxins from the bloodstream
  • Metabolizing nutrients
  • Processing lipids and amino acids

When you consume foods that contain protein, your liver uses enzymes (specifically, deaminases and transaminases) to convert the amino acids your body absorbs from the protein into the most bioavailable, utilizable forms. The liver also converts excess carbohydrates into fatty acids and other substances that the body can use as energy sources or store as fat to be used at a later date. A small percentage of those fat molecules get stored in the liver itself.

Factors such as chronic alcohol abuse, long-term drug use, nutritional deficiencies, and metabolic disorders can all interfere with your liver’s ability to fulfill its many essential functions. One of the ways this manifests is that the liver begins to increase the amount of fat stored in its cells. At the moment the amount of fat stored in the liver reaches the threshold of 5% to 10% of total liver volume, an official diagnosis of fatty liver disease (or hepatic steatosis) can be made.

The Two Main Types of Fatty Liver Disease

Though the physical effects of fatty liver disease remain consistent across types, it’s valuable to have an understanding of the different pathophysiologies, as that influences how the body responds to treatment.

There are two primary types of fatty liver disease: alcoholic fatty liver disease and nonalcoholic fatty liver disease.

Alcoholic Fatty Liver Disease

As the name indicates, alcoholic fatty liver disease arises due to long-term alcohol abuse. Scientists have known for centuries that over-consumption of alcohol leads to liver disease. The majority of the metabolization of alcohol transpires in the liver, making it quite susceptible to alcohol-related injury.

In the first stage of alcoholic liver disease (also called alcoholic steatohepatitis), the liver begins to struggle to break down fatty acids. This can result in high serum triglyceride levels, inflammation of the liver (alcoholic hepatitis), and the development of scars in the liver tissue (cirrhosis).

Early intervention can, in some cases, allow the liver to cleanse itself, thereby naturally reversing the buildup of fat. Subsequently, it can function normally once more. Refraining from the consumption of all types of alcohol for a 2-week period can be sufficient, if this step is taken shortly after liver dysfunction sets in.

The longer the accumulation of fat in the liver goes on, the more extensive the related damage, and the greater the likelihood of long-term impairment of liver function, permanent scarring, and liver failure.

Nonalcoholic Fatty Liver Disease 

Alcohol consumption is not the only risk factor for the development of liver disease. Other health considerations can also cause fat to build up in the liver, such as:

  • Family history of type 2 diabetes
  • Aging
  • Increased body weight, particularly the development of deposits of belly fat

These can also interfere with the body’s insulin sensitivity, and when the body does not properly register the presence of insulin, it responds to the perceived deficit by accelerating its innate insulin production process. This results in elevated insulin levels, which can set off a cascade of ill-effects, including high blood pressure, elevated serum triglyceride levels, and—you guessed it—the accumulation of fat in the liver.

Nonalcholic fatty liver disease (NAFLD) can be limited to the presence of excess fat in the liver, with very little inflammation and liver damage apart from that, or it can progress to non-alcoholic steatohepatitis (NASH), which involves both liver inflammation and damage. As is the case for liver disease stemming from alcohol abuse, NAFLD and NASH can progress to cirrhosis and liver failure. Experts estimate that between 80 and 100 million Americans have NAFLD, though many of them are not aware of that due to the fact that it’s largely asymptomatic.

14 Symptoms of Fatty Liver Disease

Diagnosing Fatty Liver Disease

Because the early stages of fatty liver disease are often unaccompanied by clear physical indicators, many people do not realize they have the condition until it’s progressed to a more advanced stage or until unrelated medical tests reveal liver dysfunction.

The challenge of detecting fatty liver disease is increased by the fact that blood tests, one of the most common methods of screening for chronic diseases, do not always accurately reflect the health of the liver. Fatty liver disease can cause liver enzyme levels to become elevated, but it’s also entirely possible for individuals with liver disease to have entirely normal enzyme levels, even when the disease progresses to the point of cirrhosis.

Ultrasound may be a more reliable way to diagnose fatty liver, according to a 2018 hospital-based, cross-sectional study published in the Journal of International Medical Research. The authors state that ultrasound’s “sensitivity and specificity in detecting moderate to severe fatty liver are comparable to those of histology [liver biopsy],” a far more invasive procedure. Ultrasound offers doctors a non-invasive way to screen for liver disease in individuals who do not show signs of the disease but may nevertheless be at risk, thereby ensuring they get earlier access to treatment.

Signs and Symptoms of Fatty Liver Disease

As fatty liver disease advances and liver function becomes increasingly poor, signs and symptoms do begin to appear. One clear indication of liver disease is altered amino acid metabolism—because of this, supplementing with amino acids (particularly, branched-chain amino acids) can significantly enhance liver health. We’ll share more on that later in the section on proven treatments for fatty liver disease, but first, let’s go over other indicators of liver disease.

Clinical evidence indicates that the following symptoms may point to the presence of liver disease.

  • Pain and tenderness in the upper-right abdomen, due to liver enlargement
  • Loss of appetite
  • Weight loss
  • Weakness
  • Fatigue
  • Jaundice (yellowing of the skin and eyes)
  • Weakness
  • Itchiness
  • Nosebleeds
  • Spider veins (clusters of blood vessels that resemble spider webs)
  • Confusion and difficulty focusing
  • Ascites (abdominal pain and swelling)
  • Edema (swelling of the legs)
  • Gynecomastia

What Is the Apple Cider Vinegar Fatty Liver Detox?

If you’re serious about improving the health of your liver, you have likely looked into various liver cleanses. There’s little data to support the supposed beneficial effects associated with several players in this realm, including lemon juice, green tea, olive oil, and apple cider vinegar (ACV).

Made from apples that have been mashed, distilled, and fermented, apple cider vinegar has been rumored to have detoxifying properties for centuries. As scientists have analyzed apple cider vinegar’s efficacy as a treatment for a wide range of conditions, they’ve concluded that the high levels of acetic acid and other compounds it contains may indeed influence human health, though exactly how they do so remains somewhat obscure.

Advocates of the detoxifying properties of apple cider vinegar claim that it can:

  • Flush toxins from the body
  • Facilitate weight loss
  • Bring the body’s pH into balance
  • Even out blood sugar levels
  • Drop high cholesterol into the healthy range

Given that, it’s understandable why those same advocates would believe you can use apple cider vinegar to treat fatty liver disease.

4 Safety Tips for Those Interested in Trying the Apple Cider Vinegar Fatty Liver Detox

Scientific Studies on Apple Cider Vinegar and Liver Health

Researchers have confirmed that the substances we eat and drink can both improve and undermine the body’s natural detoxification processes. What’s less clear, however, is whether apple cider vinegar specifically has a beneficial impact on liver health.

Some research has been conducted on proposed ACV benefits relevant to liver health, but the results are far from conclusive.

Weight Loss

This is perhaps the most hyped benefit of apple cider vinegar. Much of the excitement surrounding ACV’s weight-loss benefits can be traced back to a 2009 study done by a Japanese research team. The researchers found that daily consumption of vinegar resulted in modest reductions to:

  • Body weight
  • Visceral and subcutaneous fat mass
  • Serum triglyceride levels

However, the study did not look at the use of ACV in particular (though the researchers did cite ascetic acid and previous animal studies on its benefits).

A very small study from 2007 looked at the effect of apple cider vinegar on gastric emptying rate (GER) for 10 individuals with type 1 diabetes. They found that participants who paired a cup of water with 2 tablespoons of ACV mixed in with their serving of pudding had slower rates of gastric emptying than those who simply drank a cup of water. Slower gastric empyting can correlate with increased fullness, which can in turn led to weight loss. However, as the study authors themselves noted in their conclusion: “Clearly, a larger, randomized trial involving a greater number of patients would be needed to validate the findings of this pilot study.”

All in all, the enthusiasm about apple cider vinegar’s ability to encourage weight loss has yet to be corroborated by hard facts.

Cholesterol Levels

As we touched on in the previous section, the 2009 study did find some improvements to cholesterol levels, specifically, to serum triglyceride levels. However, that was not the primary focus of the study.

A small Iranian study that enrolled 19 participants with hyperlipidemia (high cholesterol levels) found that 8 weeks of apple cider vinegar consumption “significantly reduced harmful lipids, i.e., total cholesterol, LDL, and triglyceride, in blood samples of hyperlipidemic individuals who had never used any lipid-lowering drugs.”

While those are certainly promising results, further studies with larger and more diverse enrollment need to be conducted before arriving at firm conclusions about ACV’s impact on cholesterol levels.

Blood Sugar Regulation

There’s some evidence to suggest that drinking apple cider vinegar can prevent blood sugar spikes associated with carbohydrate consumption. Controlling blood sugar levels is of paramount importance for individuals with diabetes, who also face a higher risk of developing nonalcoholic fatty liver disease.

A small study that enrolled four men and seven women with type 2 diabetes (all of whom were not taking insulin to control their condition) found that ingesting apple cider vinegar before bedtime had a favorable effect on waking glucose levels. However, as is true of the studies on the benefits of ACV cited in the earlier sections, the findings are limited by the study’s small sample size.

Negative Side Effects Associated with the Apple Cider Vinegar Fatty Liver Detox

Given that there’s no conclusive evidence to support the use of apple cider vinegar to treat fatty liver, those interested in trying this treatment should carefully weigh the potential negative side effects against the benefits they hope to achieve.

One of the most common issues associated with apple cider vinegar consumption is the erosion of tooth enamel. A 2014 study designed to evaluate the effects of different types of vinegar on tooth enamel found between 1% and 20% mineral loss (depending on the pH of the vinegar) after 4 hours of exposure. However, this study was done in a laboratory, so it’s not entirely clear how those results would translate into real-life scenarios.

To be safe, those interested in adding ACV to their wellness routines should put one or more of following precautions in place:

  • Carefully monitor the amounts consumed
  • Mix with a glass of water
  • Rinse mouth after drinking
  • Use a straw

Because of its acidic nature, ACV has also been known to upset stomachs, yet another reason to dilute it in water. If you have a sensitive stomach, be sure to pair your doses of ACV with food.

It’s also important to note that apple cider vinegar can interact with certain medications, such as insulin, digoxin, and diuretics. If you currently take prescription drugs, it’s best to consult a doctor before taking ACV.

4 Proven Ways to Treat Fatty Liver Disease

While the evidence backing the use of the apple cider vinegar fatty liver detox can be characterized overall as weak, there are other natural methods for supporting and restoring liver health with much more robust scientific backing.

The best method for you will depend on the factors that have compromised your liver health, but it’s likely to involve shifts to your diet, increased physical activity and, potentially, weight loss. There are also some supplements that have been shown to produce measurable improvements to liver health.

1. Diet

Research has shown that diet has a strong impact on your risk of developing many health conditions, including fatty liver disease. Certain foods can hinder liver health, such as:

  • Trans fats
  • Simple sugars
  • Red meat
  • Salt
  • Fried foods
  • Processed foods

Eating other foods, though, can bring about significant health benefits. In general, a good fatty liver diet will include plenty of high-fiber plant foods and very minimal amounts of sugar, salt, and both trans and saturated fats. Even if alcohol is not the root cause of your liver problems, it’s essential to cut it out of your diet once your liver function has been harmed.

Those already dealing with liver problems, or interested in avoiding liver problems altogether, should be sure to include the following foods in their diets.

  • Green vegetables, such as spinach, kale, and broccoli, which studies found prevented fat from accumulating in the liver
  • Tofu, because soy protein has been shown to decrease fat buildup in the liver
  • Omega-3 rich fish, like salmon, trout, and tuna, since scientists have discovered polyunsaturated fatty acids substantially improve liver health on multiple levels
  • Nuts and seeds, especially sunflower seeds, which contain high levels of vitamin E, a powerful antioxidant proven to combat oxidative stress and halt the progression of liver disease

2. Physical Activity

To date, studies have shown that physical activity plays an overwhelmingly positive role in treating fatty liver disease. Per a 2018 review of 30 randomized controlled trials, “Physical inactivity is related to the severity of fatty liver disease irrespective of body weight.” After reviewing the 30 trials, the authors concluded that data supports the common-sense conclusion that increasing physical activity improves liver health. It appears that exercise affects the development of fatty liver disease across multiple pathways.

Exercise has been shown to:

  • Decrease insulin resistance
  • Reduce excessive transport of fatty acids and glucose to the liver
  • Increase fatty acid oxidation
  • Decrease fatty acid synthesis
  • Stymie the release of molecules that cause mitochondrial and hepatocellular damage

Both aerobic exercise and resistance exercise produce these positive effects.

3. Weight Loss

Carrying around excess body fat does elevate your risk of developing fatty liver disease. And conversely, losing even a small amount of weight can translate to major liver health improvements. According to a 2016 study, weight loss as achievable as 3% to 6% can decrease liver fat by between 35% and 40%.

4. Supplements

While lifestyle changes involving diet and physical activity produce the most profound effects on liver health, certain supplements do have scientifically validated liver health benefits. Three options we consider to be worthwhile are: milk thistle, turmeric, and amino acids.

Milk Thistle

This herbal remedy for fatty liver disease has potent anti-inflammatory, antioxidant, and antifibrotic (meaning, it reduces the formation of scar tissue) properties.

According to a study done by an Italian research team, silybin, the primary active compound found in milk thistle extract, has “a remarkable biological effect.” It can reduce liver damage associated with chronic liver disease, cirrhosis, and hepatocellular carcinoma. It has also been shown to increase cellular vitality and decrease the accumulation of liver fat, oxidative stress, insulin resistance, and mitochondrial dysfunction.

Turmeric

According to a systematic review published in 2019, turmeric and its active compound curcumin may decrease the severity of nonalcoholic fatty liver disease. However, the authors note that all the trials they analyzed had small sample sizes, leading them to deem turmeric a “promising, but not proven” treatment for NAFLD.

A study published in Integrative Medicine Research in that same year looked specifically at the findings of randomized controlled trials on the use of turmeric and curcumin supplementation on NAFLD in adult patients. The primary outcomes analyzed were levels of two specific liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The meta-analysis, which included results from a combined total of 228 subjects, found a significant reduction of ALT concentrations among participants who took at least 1,000 milligrams of curcumin daily. This lead the researchers to conclude that high doses of curcumin appear to have a favorable effect on NAFLD, though further large-scale, high-quality studies should be done to confirm that effect.

Amino Acids

A wealth of research supports the benefits of regular amino acid supplementation for individuals who have fatty liver, or who are at risk of developing the condition.

According to a 2018 study, taurine (a sulfur-containing amino acid) can prevent the accumulation of fatty acids in the livers of mice fed high-fat diets. Taurine also prevented oxidative damage and negative changes to liver enzyme levels. These effects led the study’s authors to conclude that taurine could have “therapeutic value” for the treatment of nonalcoholic fatty liver disease.

A 2012 study, also done with mice, looked at the use of the three branched-chain amino acids (BCAAs) leucine, isoleucine, and valine. The researchers found that supplementing with BCAAs in the early stages of fatty liver disease can slow the progression of the disease—specifically, by decreasing liver fibrosis as well as liver cell death.

Another sulfur-containing amino acid, cysteine—available in supplement form as N-acetylcysteine (NAC)—has antioxidant properties to rival those of taurine. Per a 2010 clinical trial, participants who received NAC had significantly improved results in terms of levels of alanine aminotransfrase, aspartate aminotransfrase, and alkaline phosphatase as well as fat buildup and other measurements of liver function. Based on the results achieved at the 3-month mark, the researchers concluded that NAC can improve liver function in patients with non-alcoholic fatty liver disease, and that better results may be achievable with longer use.

Given what scientists have uncovered about the synergistic effects of amino acids, it’s likely that the positive results achieved via supplementation with single amino acids could be amplified when taken in concert with an amino acid supplement that contains all nine essential amino acids. The essential amino acids work together to facilitate the body’s biological processes, and providing a properly balanced supply of all the necessary building blocks not only safeguards and enhances the health of the liver, but also of the entire body.

Proven Methods for Treating Fatty Liver Disease

Conclusion

Unsurprisingly, the high level of interest in natural remedies for fatty liver disease has led to the proliferation of some less than verifiable claims about certain treatment approaches.

While there’s limited evidence to support the use of the apple cider vinegar fatty liver detox, the evidence that exists comes largely from studies done with animal subjects or with very limited enrollment. Plus, none of the studies focused specifically on the impact of ACV on liver health, but rather on effects related to linked health conditions such as excess body fat, high cholesterol levels, and poor blood sugar regulation.

It’s also important to note that the apple cider vinegar fatty liver detox can have adverse side effects, such as the erosion of tooth enamel, stomach upset, and dangerous interactions with prescription drugs.

Given all that, the wisest choice is likely to try a natural treatment for fatty liver that has more substantial scientific backing. Effectively addressing fatty liver disease will likely require adopting a fatty liver diet and increasing your physical activity level, and may necessitate losing weight too. Incorporating supplements proven to improve liver health, like milk thistle, turmeric, and amino acids, can also be a valuable part of a fatty liver treatment plan.

The Top Vital Supplements and Vitamins for Liver Health

The liver is our largest organ, and it’s appropriately named because we cannot live without it. We have the information on the most vital supplements and vitamins for liver health here.

The liver is our largest organ, and it’s appropriately named because we cannot live without it. The liver’s role in human health is to metabolize what comes into our bodies, turning food into energy and filtering out toxins from the blood. Maintaining a healthy liver involves first avoiding intoxicants and poisons as much as possible, and second providing your liver with the essential nutrients it needs to function. On top of that, there are some natural ingredients that help the liver better perform its important duties. We have the information on the most vital supplements and vitamins for liver health here.

How to Support Liver Function

Diseases like alcoholic fatty liver disease, non-alcoholic fatty liver disease (NAFLD), and viral hepatitis damage the liver and sometimes cause life-threatening health problems. Even without a medical condition impacting your liver, certain dietary choices and deficiencies can interrupt the liver’s detoxification processes and have a dampening effect on your overall health.

Luckily the liver is a resilient organ, able to heal and revive the way that other organs (like the heart and the kidneys) cannot. If you’re worried that something is seriously wrong with your liver, it’s important to consult a health care professional for medical advice, but if you’re just looking to support your liver with the proper vitamins and dietary supplements, we have a list of the ones you may need.

How to support liver function

The Best Supplements and Vitamins for Liver Health

Working in conjunction with your other digestive and detox organs, the liver is a real powerhouse, not least because it has the ability to store certain vitamins and nutrients for emergency use (iron, copper, and vitamins A, B12, D, E, and K). Eating a liver flush diet is one way to help the liver function, providing it with the antioxidants needed to fight off damaging free radicals. Another way to aid liver detox is to know which vitamins are most important for inclusion in a multivitamin and which natural ingredients can help the liver work to its best abilities.

Vitamin A and Iron

Deficiencies in vitamin A and iron are some of the most common dietary deficiencies worldwide. Together they help guard against iron deficiency anemia, as vitamin A is involved in regulating the release of iron from the liver. Supplementing with either one without the other could exacerbate your issues. Iron deficiency anemia can be especially dangerous to those with chronic liver disease or cirrhosis, making it all the more important for both nutrients to be in balance and agreement.

B Vitamins

The full array of B complex vitamins is important for liver health. Vitamin B12 is especially important. It can be stored for years in the liver, whereas other water-soluble vitamins generally cannot be stored (they get washed out daily and must be replenished).

Vitamin B12 is found in animal meats (beef and poultry) as well as fish, shellfish, eggs, and dairy products. Fortified cereals contain vitamin B12 as well.

Vitamin B12 is useful in the treatment of liver disease because it acts as a precursor of the amino acid methionine, which then converts to S-adenosylmethionine (SAMe) for possible liver disease prevention.

Amino Acids

There are other amino acids that play a vital role in liver health and help to reduce the risk factors for liver disease and liver cancer.

  • Branched-chain amino acids (BCAAs): The BCAAs are valine, leucine, and isoleucine. Not only have BCAA-rich medicines demonstrated positive results in cirrhosis patients, but they have also delayed the progression of chronic liver disease. Popularly known for their inclusion in pre-workout supplements, BCAAs contribute significantly to muscle building.
  • Cysteine (aka NAC): This sulfur-containing amino acid is available as a supplement in the form of N-acetylcysteine (NAC). NAC helps the body detox and prevents the side effects of environmental or drug toxins, so much so that intravenous NAC is given to patients experiencing acetaminophen overdose to help reduce or possibly prevent kidney and liver damage. NAC even acts as an antioxidant to reduce liver inflammation.
  • Methionine: The methionine provided by vitamin B12 converts into SAMe and into cysteine when needed, but beyond those two significant liver advantages, methionine also helps prevent excessive fatty buildup in the liver and beyond by acting as a lipotropic agent and breaking down fat during metabolism.
  • Threonine: A threonine deficiency has been shown to cause mitochondrial uncoupling in the liver and restrict the growth of the organ. Threonine is also used to treat nervous system disorders like familial spastic paraparesis, spinal spasticity, and multiple sclerosis.
  • Histidine: This amino works as an anti-lipogenic agent, able to reduce the fatty liver caused by high-fat diets. It also has anti-inflammatory properties that help reduce joint pain and an ability to prevent certain fungal infections that would otherwise burden our immune systems.

Other amino acids like lysine are needed to help the body absorb zinc, calcium, and iron, while the amino acid carnitine helps the mitochondria in our muscles burn fat, an ancillary benefit when trying to prevent fatty liver disease.

Our essential amino acids work in concert, many of them acting as precursors for others or in support of the overall efforts for protein synthesis and nutrient utilization in the body. A comprehensive amino acid supplement containing all nine essential aminos is therefore the most robust “vitamin” on this list, containing necessary compounds for repair and recovery, for muscle strength, for lipid level control, and for liver fat reduction.

Vitamin C

It’s old news that vitamin C provides powerful antioxidants that may help prevent colds and flu, but this 2014 review points out that vitamin C deficiency may play a role in the prevention of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis.

Preventing the damage caused by oxidation from free radicals helps reduce inflammation throughout the body, but the correlation between a deficiency of vitamin C in NAFLD patients is all the more reason to trust its health benefits in regards to your liver.

Vitamin D

Vitamin D deficiency is also linked to chronic liver disease patients, up to 90% of them. While a lack of vitamin D may not lead to liver disease, vitamin D is necessary to help liver disease patients prevent bone loss and muscle aches due to interferon therapy side effects, and to increase their chance of survival (especially if these patients also have hepatitis C).

If your liver is healthy today, vitamin D also helps support your immune system, bone and tooth health, nervous system, and cardiovascular health, and can help aid in diabetes management by regulating insulin levels. It is also found (like vitamin B12) in animal products such as eggs, dairy, and fish.

Vitamin E and Selenium

Vitamin E and the trace mineral selenium are two more providers of antioxidant liver support. Both contain protective compounds that guard your liver cells, and selenium in particular may help boost the effect of the antioxidant alpha-lipoic acid (next on the list).

Alpha-Lipoic Acid

Found in foods like animal products and green, leafy vegetables, the antioxidant alpha-lipoic acid is both water- and fat-soluble. Alpha-lipoic acid has been medicinally applied to conditions as far-ranging as diabetes nerve-related issues and weight-loss management. It also plays a huge role in removing the byproducts of fat breakdown and the toxic effects of substances like alcohol from the liver. Alpha-lipoic acid also boosts other antioxidants like CoQ10 and glutathione, and may in turn be boosted by taking in combination with selenium (above) and milk thistle (below).

Milk Thistle

When it comes to dietary supplements aimed at liver health and detoxification, milk thistle is the one used most often in the United States. It’s celebrated for its active ingredient, silymarin.

Clinical studies show that silymarin may help liver tissue regenerate, particularly in those with hepatitis B, hepatitis C, and cirrhosis of the liver. By working as an antioxidant, silymarin also helps reduce inflammation.

Silymarin has been shown to improve liver damage suffered by children being treated with chemotherapy for leukemia (a cancer of the bone marrow and/or the lymphatic system). After a 28-day period the children receiving milk thistle showed fewer signs of liver damage.

Silymarin has also been found to reduce specific liver enzymes that are markers of liver damage, specifically in patients with liver disease.

Though milk thistle has several promising indications, there has yet to be a scientific consensus, and additional information is still needed before declaring milk thistle a liver cure. Either way, there is currently no regulation from the U.S. Food and Drug Administration on the use of medicinal herbal products like milk thistle, as it is not considered a drug.

Dandelion Root

Speaking of natural herbal remedies, dandelion root has promising influence on liver health. This natural diuretic can help detox efforts in the liver and kidneys by flushing toxins from the body. Dandelion root can increase the liver’s bile flow, and at least one study has found that the polysaccharides in dandelion root may aid in liver health and function.

Again, when it comes to natural remedies, the science is slow to accumulate, but you can evaluate the information that currently stands to help decide which liver supplements may be right for you.

Turmeric

Turmeric, alongside its active ingredient curcumin, though a natural remedy like some of the others on this list, has much more scientific data backing up its anti-inflammatory abilities. Curcumin has been found to help stimulate bile production by the gallbladder. Bile is then used to escort toxins from the body and remove the buildup of harmful substances from the liver. Long used in Ayurvedic and Chinese traditional medicine, turmeric and its health benefits are consistently backed by modern science.

Artichoke

Artichokes contain cynarin, a liver-boosting compound that can speed along the liver’s breakdown and detox processes. Studies show that artichoke leaf may help encourage new liver tissue growth and protect your liver cells from damage.

Cynarin also increases bile production. A study published in Pharmaceutical Biology showed that liver damage caused by drug overdose in rats was lessened significantly by artichoke extract.

Human trials show similar results. People with non-alcoholic fatty liver disease who consumed 600 milligrams of artichoke extract for 2 months exhibited improved liver function, and in obese non-alcoholic fatty liver disease patients artichoke extract reduced inflammation and lessened fat deposition when compared to a control group.

Artichoke also contains silymarin, the same active component in milk thistle, and it and cynarin may be more powerful together.

The Top Vital Supplements and Vitamins for Liver Health

Vegetables and Vitamins for Liver Health

Other herbs show potential for liver health, including cilantro, oregano, and parsley. And a good balance of our essential vitamins in a daily multivitamin is always of benefit, along with an amino acid supplement to make sure your protein needs are met. If you want to help your liver, start with these vitamins and nutrients either in their natural food sources or in supplemental products, and ask your doctor for any further medical advice on preventing or possibly reversing liver damage.

When It Comes to Early Treatment of Fatty Liver, Ultrasound Detection Could Be Key

Fatty liver disease poses a serious public health challenge, in part due to the fact that it remains largely asymptomatic until the later stages. This makes identifying a noninvasive method for early detection of fatty liver disease a top clinical priority. Read on to learn why experts agree ultrasound has many advantages as a method for screening the general population for fatty liver disease.

Experts estimate that approximately 100 million individuals in the United States meet the criteria for non-alcoholic fatty liver disease, though most of them don’t know it. That’s because the early stages of fatty liver are often asymptomatic, meaning that a person has no indication they do not have a healthy, normal liver until the disease has progressed into more advanced stages. A key element of reversing this trend is finding ways to incorporate screening for fatty liver into routine clinical practice. Of the methods currently available for detecting fatty liver, ultrasound stands out as a noninvasive assessment option that efficiently and reliably detects the disease.

What Is Fatty Liver?

The liver, the largest internal organ, metabolizes nutrients and filters toxins from the bloodstream. It plays an especially active role not only in how your body digests fat, but also in how it produces and utilizes it. When the balance between those activities becomes skewed, fat builds up in the liver. As fat accumulates in the liver, it creates inflammation in the liver cells, which can lead to impaired liver function and scarring of liver tissue. If the disease is allowed to progress unchecked, it can ultimately progress to liver failure.

There are two primary types of fatty liver: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). The former refers to the development of fatty liver in individuals with high levels of alcohol use, and the latter refers to the disease when it develops without heavy alcohol consumption.

In the absence of excessive alcohol intake, the most common underlying cause of fatty liver is insulin resistance. A number of factors can impair the body’s sensitivity to insulin, such as:

  • Increased body weight
  • Aging
  • Family history of type 2 diabetes
  • Large fat deposits in the abdominal area

If the body cannot appropriately detect the presence of insulin, then it increases its own insulin production. Rising levels of insulin can cause other issues such as:

  • Increased blood pressure
  • High triglyceride levels
  • Accumulation of fat in the liver

Typically, individuals in the early stages of fatty liver disease have no perceptible symptoms. If the liver becomes sufficiently enlarged, they may begin to sense a mild ache or tenderness where it’s located in the upper-right abdomen.

The Link Between Insulin Resistance and Fatty Liver Disease

If individuals are able to address the insulin resistance that causes fat to build up in the liver, then it’s typically possible to restore full liver health without any lasting serious consequences. However, if the condition is not detected, then it can progress to a more serious form of fatty liver—non-alcoholic steatohepatitis (NASH). This is the stage at which inflammation of the liver as well as liver fibrosis (scarring) occur. This form of fatty liver can then cause cirrhosis and even liver failure.

What Happens When Fatty Liver Progresses to Cirrhosis?

As touched on above, fatty liver usually causes no noticeable symptoms. However, once it progresses from NAFLD to NASH to cirrhosis, symptoms begin to appear. Cirrhosis demarcates the point at which liver scarring becomes quite severe. Hallmark symptoms of cirrhosis include:

  • Weakness and fatigue
  • Decreased appetite
  • Weight loss
  • Jaundice (yellowing of the eyes and skin)
  • Itchiness
  • Nosebleeds
  • Spider veins (clusters of blood vessels that resemble spider webs)
  • Confusion and difficulty focusing
  • Ascites (abdominal pain and swelling)
  • Edema (swelling of the legs)
  • Gynecomastia

In most  cases, cirrhosis develops because of a long-term viral hepatitis C infection or ongoing alcohol abuse. However, untreated NAFLD can also progress to cirrhosis.

If cirrhosis is not effectively treated, it progresses to end-stage liver disease, which will prove fatal if a liver transplant does not occur in time. While it’s not possible to reverse the scarring that occurs, you can minimize its impact and prevent future scarring from taking place. The key to doing so is taking every possible opportunity to cleanse your liver and support its health and functioning. To learn more about managing a cirrhosis diagnosis, read this article.

11 Symptoms of Cirrhosis

For Early Detection of Fatty Liver, Ultrasound Could Be Key

Studies show that ultrasound images offer a reliable, efficient method for diagnosing fatty liver. According to a 2018 hospital-based, cross-sectional study published in the Journal of International Medical Research, ultrasound’s “sensitivity and specificity in detecting moderate to severe fatty liver are comparable to those of histology [liver biopsy],” a far more invasive procedure.

Preventing NAFLD from progressing to cirrhosis and even liver failure requires effective risk stratification and the development of strategic treatment plans. In order to do that, doctors need to evaluate:

  • How much fat has accumulated in the liver
  • Whether the liver is inflamed, and if so, to what degree
  • Whether scarring is present, and if it is, how severe

Liver biopsy has historically been the preferred method for confirming a diagnosis of fatty liver and developing a treatment plan. However, non-invasive imaging methods like ultrasound allow doctors to screen individuals who do not yet show signs of liver disease, allowing those in the early stages of NAFLD to access treatment faster.

Both B-mode ultrasonography (US) as well as ultrasound elastography (USE) can be used for this purpose. Ultrasound elastography even allows doctors to evaluate degrees of inflammation and scarring, vital pieces of information relevant to disease progression and treatment selection.

Medical professionals have determined that imaging tests like liver ultrasound have multiple advantages over both liver biopsy and blood tests to measure serum biomarkers, such as:

  • Non-invasiveness
  • Evaluation of a greater volume of fat accumulation in the liver
  • Less variability
  • More quantitive data

Ultrasonography

Conventional ultrasonography (US) is widely available, affordable, and noninvasive. Because of this, it’s common for US to be the first method used to clinically evaluate fatty liver, particularly when doctors want to screen for suspected NAFLD.

Key features found on ultrasound images that indicate fatty liver disease include:

  • Hepatomegaly, meaning the liver is visibly enlarged
  • Increased echogenicity, indicating the surface bouncing the echo can reflect increased sound waves
  • Intrahepatic vascular blurring, referring to blurred images of blood vessels in the liver

Ultrasound Elastography

Ultrasound elastography (USE), like conventional ultrasound, is widely available and relatively inexpensive. It’s attracted a high level of interest due to utility as a noninvasive method of assessing liver stiffness.

The theory supporting its use is that tissue stiffness can be used as a measure of the presence and degree of liver fibrosis, which in turn indicates how far the disease has progressed.

Currently available USE methods can be divided into two general groups: first, transient elastography, an ultrasound-based technique that does not rely on images and second, and elastography techniques that do use images.

Diagnosing Fatty Liver Disease with Ultrasonography and Ultrasound Elastography

Conventional liver ultrasound and ultrasound elastography can be seen as complementary screening measures as they provide different data points, all of which can be combined to form a diagnosis and treatment plan.

Research on the Use of Ultrasound to Detect Fatty Liver

The Journal of International Medical Research study cited earlier drew its findings from the analysis of 390 health histories, 226 from patients who were diagnosed with fatty liver after master health checkups and 164 who were not. The goal was to determine whether the diagnoses of fatty liver made using ultrasound findings correlated to laboratory blood test parameters for the disease. This, then, would show whether it’s valuable to include ultrasound screening for fatty liver in routine health checkups.

Patients whose ultrasound examinations showed fatty liver were classified as cases and those whose ultrasounds did not were classified as controls. Diagnostic findings from blood tests—lipid profiles [total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL)], serum GOT [aspartate transaminase (AST)], serum GPT [alanine transaminase (ALT)], and HbA1c levels—were obtained for both cases and controls when available. HbA1c levels were available for 311 patients, serum GPT levels for 266, and serum GOT for 261.

The authors found that lipid, liver enzyme, and HbA1c levels were all substantially elevated for cases compared to controls. Overall, the findings were consistent with previous studies in that they showed NAFLD to be the most common cause of high blood levels of GPT and GOT. The authors note, too, that NAFLD should not be viewed as “an isolated or random event in metabolic syndrome,” but instead treated as a component of the condition. Furthermore, they state that NAFLD should be regarded as a risk factor for the development of:

They note, too, that ultrasound can help to diagnose fatty liver in patients where it could otherwise be easily overlooked due to an absence of clinical markers that would raise suspicion. For instance, individuals from South Asian countries who develop fatty liver disease often maintain lower body mass indexes than those in European and American countries with the disease. This can cause the results of blood pressure tests to be misleading, as they may show normal levels despite the presence of increased liver fat. Ultrasound screening can be used for mass screening that will identify patients who might otherwise slip through the diagnostic cracks.

Because fatty liver disease tends to be asymptomatic, developing reliable screening methods to identify high-risk NAFLD patients is of paramount importance to managing the disease. Liver biopsy is reliable for diagnostic purposes, but impractical as a screening tool. Ultrasound, however, appears to be near-equal in terms of reliability and it’s far better suited for screening purposes.

How to Prevent, or Treat, Fatty Liver Disease

At this time, no medications exist for the treatment of fatty liver disease. However, it can be both prevented and treated with lifestyle changes. Depending on the underlying cause of the disease as well as a person’s overall health, doctors may recommend adjustments such as:

  • Limiting alcohol consumption
  • Eating more nutrient-rich foods and avoiding highly processed ones
  • Increasing physical activity

For individuals at risk of developing NAFLD, as well as those with NAFLD, adopting a fatty liver diet will be a crucial part of an effective treatment plan. Unsurprisingly, a central tenet of this diet is limiting consumption of both saturated and trans fats. It also involves completely cutting out alcohol, limiting salt and sugar, eating plenty of high-fiber plant foods, like whole grains and legumes, and upping your intake of fruits and vegetables.

Experts recommend the following foods as ideal components of a fatty liver diet:

  • Green vegetables: Broccoli, spinach, kale, and other green vegetables can help prevent liver fat buildup while supporting weight loss and enhancing your overall health.
  • Fish: Salmon, trout, tuna, and sardines contain omega-3 fatty acids that can actually lower liver fat levels and decrease liver inflammation.
  • Walnuts: Like fish, walnuts contain concentrated amounts of omega-3 fatty acids, which can improve your liver disease prognosis, liver function, and health.
  • Dairy: Studies show that whey protein can protect liver cells from damage linked to NAFLD.
  • Olive oil: This staple of the Mediterranean diet can lower liver enzyme levels and bodyweight, perhaps due to the omega-3 fatty acids it contains.
  • Green tea: Research indicates green tea can enhance liver function and decrease liver fat storage.
  • Coffee: This popular beverage can prevent liver damage associated with fatty liver disease as well as lower levels of liver enzymes.
  • Tofu: Soy proteins found in tofu can reduce the accumulation of fat in the liver.

There’s also some evidence to support the use of certain supplements, including vitamin E, to prevent or treat fatty liver disease. Studies indicate that milk thistle, which has anti-inflammatory and antioxidant properties, can have a positive effect on liver health. And turmeric, a potent antioxidant, can quell inflammation throughout the body, which can help to reduce your risk of liver disease as well as manage liver disease. To learn more about natural methods for detoxifying the liver, read this article.

Perhaps the most consequential choice you can make to protect or improve your liver health is to supplement with amino acids. According to the work of a team of scientists based in Kyoto, Japan, taking branched-chain amino acids (BCAAs) can slow, and potentially halt, the progression of chronic liver disease. After 11 weeks, blood samples showed that rats given BCAAs had liver enzyme levels that were 22% lower than the control group. The researchers also found that levels of the CTGF protein, which correlates to liver fibrosis, were an average of 75% higher in the control group. Even more significantly, markers that indicate rates of cell death, an enzyme called caspase 3 and a protein called albumin, were 100% and 80% higher in the control group.

Studies done with human subjects support the conclusion that amino acid supplements are an effective natural method for treating liver disease.

How to Treat and Prevent Fatty Liver Disease

Key Takeaways About Fatty Liver Disease and Ultrasound

Non-alcoholic fatty liver disease (NAFLD) is becoming an ever more pressing public health challenge, in part due to the fact that it remains largely asymptomatic until the later stages of the disease, and the determinants of the disease have yet to be fully understood. Once the disease reaches the later stages, in which liver fibrosis progresses toward cirrhosis, severe complications can ensue. This makes identifying a noninvasive method for detecting fatty liver disease a top clinical priority. Ultrasound has many advantages as a method for screening the general population for fatty liver disease. It’s efficient, widely available, and has been shown to be as accurate as biopsies, the gold standard for diagnosing liver disease.

What Is Hydrocephalus? Plus Causes, Symptoms and Prognosis

The causes of hydrocephalus, the accumulation of excess fluid around the brain, remain somewhat mysterious and the symptoms vary significantly from person to person. While it can be challenging to identify, it is treatable, though doing so requires surgery. Read on to learn more about this complex neurological condition.

Hydrocephalus, the accumulation of excess fluid around the brain, can affect infants, children, and adults. In infants and young children, the most obvious symptom tends to be a rapid increase in head circumference, or, if hydrocephalus is present from birth, an atypically large head. Older children and adults present with different symptoms, as their skulls cannot expand to make room for the buildup of fluid. While hydrocephalus causes remain somewhat mysterious, the condition can be treated, though doing so requires surgery. While prognosis after treatment varies, it’s entirely possible for individuals to recover and go on to experience a good quality of life.

What Is Hydrocephalus?

The medical term hydrocephalus, derived from Greek, is somewhat misleading. The word hydro means water in Greek while the word cephalus means head. Despite the fact that hydrocephalus was historically referred to as “water on the brain,” the accumulated liquid that’s characteristic of this condition is not water at all. It’s cerebrospinal fluid. The purpose of cerebrospinal fluid (CSF) is to surround and protect the brain as well as the spinal cord, however, a delicate balance of this fluid must be maintained.

CSF has three absolutely vital functions:

  1. Act as a cushion for brain tissue, protecting it from jostling and blows
  2. Transport nutrients and waste
  3. Offset changes to intracranial blood volume by moving between the cranium and the spine

When all is working as it should, CSF flows through the ventricular system (four spaces in the brain linked by narrow passages), spills into the cisterns located below the brainstem (which essentially act as reservoirs), travels across the exterior of the brain and spinal cord, and then enters the bloodstream where its reabsorbed.

The body continuously produces CSF, so if any element of the system malfunctions, causing the flow of CSF to be disrupted, it will begin to accumulate in the ventricles. As the ventricles widen to accommodate the buildup of fluid, excessive pressure is placed on the tissues of the brain. That pressure on the brain, in turn, causes hydrocephalus.

The Three Vital Functions of Cerebrospinal Fluid

Differentiating Between Types of Hydrocephalus

Per a fact sheet prepared by the National Institute of Neurological Disorders and Stroke (NINDS), a division of the National Institutes of Health, diagnoses of hydrocephalus fall into one or more of the following categories.

1. Congenital Hydrocephalus

When hydrocephalus is diagnosed at birth, it’s called congenital hydrocephalus. This type of hydrocephalus develops due to either genetic abnormalities or to events or environmental factors present during gestation.

2. Acquired Hydrocephalus

Any type of hydrocephalus that is not present at birth is deemed acquired hydrocephalus. This type of hydrocephalus can develop during infancy, childhood, or adulthood. It occurs as a result of diseases or injuries that affect the brain.

3. Communicating Hydrocephalus

This type of hydrocephalus describes presentations of the condition in which the normal flow of CSF stops after it leaves the ventricles. This means CSF can still move through and between the ventricles themselves.

4. Non-Communicating Hydrocephalus

Non-communicating, or obstructive, hydrocephalus (as you might be able to intuit) refers to conditions in which CSF cannot pass through one (or more than one) of the passages linking the ventricles. For example, in one type of non-communicating hydrocephalus, called aqueductal stenosis, the accumulation of CSF results from constriction of the aqueduct of Sylvius, which links the third and fourth ventricles at the center of the brain.

5. Hydrocephalus Ex-Vacuo

This form of hydrocephalus, which primarily occurs in adults, results from brain damage caused by strokes or traumatic injuries. This presentation differs somewhat from those described so far and is characterized primarily by the shrinking of brain tissue.

6. Normal Pressure Hydrocephalus

Known causes of normal pressure hydrocephalus (NPH) include head trauma, subarachnoid hemorrhages, tumors, infections, or surgical complications. However, it’s also possible for this type of hydrocephalus to transpire without the presence of a single one of the factors listed above. The highest rates of NPH are found among older adults. According to the NIH, approximately 375,000 older Americans develop NPH. The Hydrocephalus Association puts that number even higher, stating that a recent study found up to 700,000 older Americans may have NPH, with 80% of those cases going undiagnosed and untreated.

The 6 Types of Hydrocephalus

What Causes Hydrocephalus and Who Is at Risk?

In the simplest terms, hydrocephalus happens because a blockage interrupts the normal flow of CSF, the ability of your blood vessels to absorb CSF becomes compromised, or the brain begins to produce more CSF than it needs. Some common causes of hydrocephalus have already been described in the preceding section. Yet all in all, the instigating factors that result in hydrocephalus remain somewhat obscure. So far, researchers have identified the following potential triggers:

  • Genetic abnormalities
  • Developmental disorders
  • Infections during pregnancy, like rubella
  • Premature birth complications, including intraventricular hemorrhage
  • Meningitis and other central nervous system infections
  • Tumors
  • Traumatic head injuries
  • Subarachnoid hemorrhage
  • Bleeding from blood vessels within the brain
  • Complications following brain surgery

It can be challenging to determine how many people develop hydrocephalus annually or currently have this condition, especially given the potential for NPH to go undiagnosed. According to the Hydrocephalus Association, around 1 million Americans have hydrocephalus.

This condition affects people of all ethnicities, income levels, and stages of life. That said, it’s most common in infants and in adults age 60 and above. Statistics indicate that between 1 and 2 out of every 1,000 babies born have congenital hydrocephalus, making it just as prevalent as Down’s syndrome and more prevalent than both spina bifida and brain tumors. The NIH fact sheet mentions a review published in the Journal of Neurosurgery: Pediatrics in 2008 which found that hydrocephalus accounted for 1.8% of all pediatric hospital days and 3.1% of all pediatric hospital charges in the United States. It’s also the single most common reason children have to undergo brain surgery.

10 Possible Causes of Hydrocephalus

Recognizing Common Symptoms of Hydrocephalus

Because hydrocephalus can cause permanent brain damage, it’s extremely important to seek medical attention promptly. In order for that to happen, you must be able to recognize the symptoms of hydrocephalus. This can be a bit tricky, as symptoms shift depending on a person’s age at onset, how far the disease has progressed, and individual variations that impact response to fluid buildup. As an example of this, when hydrocephalus develops in an infant, their skull can adjust in response to increased CSF pressure and widening of the ventricles by expanding since the sutures (fibrous joints connecting the bones of the skull) remain open.

Here are symptoms of hydrocephalus to look for, categorized by age at onset.

Infancy

  • Protruding fontanel (the soft spot on the surface of the skull)
  • Swift increase in head circumference
  • Excessive fussiness
  • Sunsetting (tendency of eyes to deviate downward)
  • Poor feeding
  • Limited muscle tone and strength
  • Seizures
  • Vomiting

Childhood

  • Crossed eyes, double vision, or blurred vision
  • Uncontrolled eye movements
  • Sun setting
  • Craniofacial disproportion (changes to facial appearance and eye spacing)
  • Increased head size
  • Headaches
  • Difficulty concentrating
  • Balance problems
  • Muscle spasms
  • Impaired coordination
  • Delayed growth
  • Difficulty eating
  • Abnormal sleepiness
  • Low frustration tolerance
  • Decreased reasoning ability
  • Personality changes
  • Loss of bladder control
  • Nausea and vomiting
  • Seizures
  • Memory loss

Adulthood

  • Recurrent headaches
  • Difficulty walking and generalized loss of coordination
  • Bladder issues
  • Vision changes
  • Poor memory and concentration capacity
  • Slowing of movements

It’s important to note that the symptoms of normal pressure hydrocephalus, which frequently occurs in older adults, overlap with those of other disorders like Alzheimer’s disease. When a patient presents with symptoms such as urinary incontinence, difficulty walking, and increasingly worse memory, doctors are far more likely to suspect dementia than hydrocephalus. This leads to high rates of improperly diagnosed as well as undiagnosed cases of normal pressure hydrocephalus.

It should also be said that while the symptoms listed above cover the most common presentations of hydrocephalus, this condition presents differently each time it occurs.

Be Aware of These Common Symptoms of Hydrocephalus

Diagnosing Hydrocephalus

To evaluate a patient who may have hydrocephalus, a doctor will first conduct a thorough physical exam. Pediatricians in particular use this to check for a larger-than-normal head circumference, bulging fontanel, and slowed reflexes.

When evaluating an infant whose fontanel has not yet closed, a pediatrician may use ultrasound to examine the brain by bouncing high-frequency sound waves off of it to create images.

Other tests used to diagnose hydrocephalus include:

  • Neurological examination
  • Computed tomography scan (CT scan)
  • Magnetic resonance imaging (MRI)
  • Lumbar puncture, also known as a spinal tap
  • Lumbar catheter
  • Monitoring of intracranial pressure

Clinicians select the most appropriate test or tests based on a patient’s age, symptoms, and the known presence or indication of irregularities of the brain or spinal cord.

Treating Hydrocephalus

Without proper treatment, hydrocephalus can be fatal. While treatment may not allow for the reversal of brain damage that has already ensued, it can ensure that no more occurs by reestablishing a normal flow of CSF.

At this time, no medical therapy exists for the treatment of hydrocephalus—the only available options are surgical. In most cases, treatment of hydrocephalus involves conducting a surgery to insert a shunt system that allows CSF to travel out of the central nervous system and into another part of the body where reabsorbtion can occur during the normal process of circulation.

A shunt system is relatively simple in design and concept. It involves just three components: a strong, flexible tube called a shunt, a thin tube called a catheter, and a valve. During surgery, a neurosurgeon situates one end of the catheter either inside the brain itself or in the areas around the spinal cord where CSF circulates. The surgeon then places the other end of the catheter in a location where the CSF can drain and be absorbed. Typically, this is in the abdominal cavity, though the areas surrounding the lungs or heart chamber can also be viable options. The valve, located along the catheter, controls the direction and rate of CSF flow. A shunt system will typically need to remain in place throughout a person’s life and will require close monitoring.

A far less common treatment option is what’s called an endoscopic third ventriculostomy. During this surgical procedure, the surgeon uses a device called a neuroendoscope (a tiny camera) to view the surface of the ventricles. Once they have guided the scope into position, allowing them to examine this small, difficult-to-access surgical area, they use an instrument to create a very small opening in the bottom of the third ventricle. In cases where this would be a good treatment option, the hole then allows CSF to flow unobstructed into the area of reabsorption surrounding the brain’s surface.

Comparing Hydrocephalus Treatment Options

Life After Hydrocephalus

Given the number of variables involved in the development, progression, and treatment of hydrocephalus, it’s difficult to generalize about outcomes. Factors that impact a person’s prognosis include:

  • Underlying cause
  • Rapidity of diagnosis
  • Presence of related disorders
  • Degree of relief of CSF pressure

The success of shunt surgery and ventriculostomy vary quite a bit from person to person. In general, the earlier hydrocephalus is diagnosed and treated, the more complete a person’s recovery will be.

It’s important for those affected by hydrocephalus as well as their families to understand that this condition can affect cognitive as well as physical development. After surgery has been performed, treatment and management should be guided by an interdisciplinary team that includes rehabilitation specialists. When connected with the right rehabilitation therapies, individuals diagnosed with this condition can lead independent lives with few restrictions.

Unfortunately, fewer than 10 medical centers in the United States currently specialize in the treatment of this condition, according to the Hydrocephalus Association. Because it involves so many variables and unknowns, doctors who do not specialize in the condition can be reluctant to take on complicated hydrocephalus cases. This means that not everyone with hydrocephalus will be able to access appropriate care.

There has also been limited progress over the last half-century in terms of identifying more effective treatments for hydrocephalus or methods of prevention. “Research is essential,” states the Hydrocephalus Association. “At the very least, we need better treatments, with more positive long-term outcomes, and diagnostic tests that are accurate, cost-effective, and noninvasive.”

At this time, the bulk of the research that’s done is in the pediatric space. The Hydrocephalus Clinical Research Network (HCRN) is made up of seven pediatric medical centers that analyze data from all their hydrocephalus patients with the aim of more rapidly identifying treatment improvements. This collaborative research effort not only carries out concurrent studies at all seven centers, but also oversees an extensive database of patient histories and procedures.

The work of the HCRN, as well as other research efforts focused on hydrocephalus, are supported by the NINDS, along with other institutes of the NIH. While the primary goal of these endeavors is to uncover ways to treat, prevent, and cure hydrocephalus, researchers also investigate the immensely complicated mechanisms underpinning brain development with the hope of understanding more about the origins of neurological conditions.

Protein Replacement Therapy: A Promising Medical Treatment Approach

Protein replacement therapy is a method for treating diseases and disorders by replacing missing proteins in diseased cells. Clinical trials show it can help to treat rare diseases, like recessive dystrophic epidermolysis bullosa, as well as common conditions such as heart disease. Here’s what you should know about the science behind protein replacement therapy as well as its potential applications.

Most laypeople haven’t heard of protein replacement therapy, but the world of molecular medicine is abuzz with interest in this promising medical treatment. A chief aim for those working in the field of molecular medicine is to develop an efficient way to reliably replace missing proteins in diseased cells. Gene therapy is one possible method for achieving that, but according to the U.S. National Library of Medicine, a database overseen by the National Institutes of Health (NIH), this experimental approach comes with considerable risks and significant advances will need to be made before it becomes safe. Other methods of protein replacement therapy, however, do not require the transfer of genetic material into cells, which eliminates some of the most significant issues that arise with gene therapy while still allowing for the delivery of missing or deficient proteins.

Read on to learn more about protein therapy and its potential treatment applications.

The Science of Protein Replacement Therapy

So far, most of the research into protein replacement therapy has been focused on its use for the treatment of rare monogenic diseases. These conditions occur because of a single defect in a single gene found in human DNA. Though these diseases are considered rare, experts estimate there are over 10,000 of them and that they affect millions of individuals around the globe.

Supporting Research Into Treatments for Rare Diseases

Developing treatments for rare diseases can be quite challenging, in part because companies are less likely to make a profit off such treatments, and therefore less likely to fund research into potential treatments and cures. In an effort to address this, several countries have passed legislation to encourage companies to develop drugs to treat “orphan diseases,” a classification applied to “diseases with a prevalence of less than 200,000 affected individuals in the United States and less than approximately 250,000 affected individuals in the European Union (EU),” per an article titled “Protein Replacement Therapies for Rare Diseases: A Breeze for Regulatory Approval?” that was published in Science Translational Medicine in 2013.

The U.S. Orphan Drug Act, passed in 1983, extends regulatory, commercial, and tax incentives to companies investigating drugs designed to treat orphan diseases. In 2000, the EU passed a similar piece of legislation and multiple other countries have since followed suit. Currently, genetic diseases (along with rare types of cancer and drugs with pediatric indications) rank among the top three in terms of approved orphan drug treatments. And protein replacement therapies for monogenic diseases is a popular subcategory within that realm.

Justifying the Use of Monogenic Protein Replacement Therapies

Blood factors and enzyme replacement therapies for lysosomal storage disorders were two of the first monogenic protein replacement therapies (MPRTs) to receive regulatory approval with orphan drug classification in the United States and EU. When these drugs went to market, manufacturers introduced what’s known as “orphan pricing,” a system in which high premiums are charged to compensate for limited demand. According to the Science Translational Medicine article, the cost of MPRTs, a category that includes drugs like Fabrazyme, Elaprase, and Naglazyme, tops $200,000 annually while sales come in at over $100 million.

Given those numbers, it’s hardly surprising how much attention has been paid to the prices charged for orphan drugs, and, subsequently, the difficulties faced by health care systems when it comes to reimbursement. Determining which patients should be approved for these costly treatments requires complicated calculations, and not everyone agrees on which criteria should be used.

The paradigm so far has been that the use of MPRTs can be reimbursed in the United States, most member countries of the EU, and Japan. It’s also common practice for these drugs to be provided at no cost in countries with low average household income levels and underdeveloped health care systems.

The authors of the Science Translational Medicine article argue that in order to justify the high prices charged for orphan drugs and the rates at which health care systems reimburse for their use, manufacturers must demonstrate that they are, in the long-term, cost-effective treatments. While clinical trials have shown that long-term use of MPRTs can be safe, clinically effective, and lead to health-related improvements in terms of quality of life, more research is needed to conclusively prove that their use leads to net reductions in health care costs.

13 Vital Facts About Protein Replacement Therapy

Potential Applications for Protein Replacement Therapy

Clinical trials have investigated the use of protein replacement therapy for a variety of conditions, including:

Two of the most promising applications to date are for the treatment of recessive dystrophic epidermolysis bullosa and heart failure.

Protein Replacement Therapy for Recessive Dystrophic Epidermolysis Bullosa

Studies conducted on the use of protein replacement therapy to treat recessive dystrophic epidermolysis bullosa have yielded highly promising results.

This disease belongs to the epidermolysis bullosa family, a collection of genetic disorders related to structural proteins in the skin. Individuals with these disorders have atypically fragile skin and mucous membranes that are prone to splitting and blistering. To compound matters, the underlying gene defect compromises wound healing. If wounds do manage to heal, extensive scarring is typical.

Recessive dystrophic epidermolysis bullosa (RDEB), one of the most severe iterations, happens when the gene coding for type VII collagen protein either does not function properly or is absent. This protein helps the two primary layers of the skin—the epidermis and the dermis—adhere to each other. Without it, the skin often separates, leading to blisters and a higher risk of infection.

The NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases highlighted research done with mice that indicated protein replacement therapy could be the key to treating this debilitating genetic condition.

The research, published in Molecular Therapy and the Journal of Investigative Dermatology, examined two techniques for replacing absent or defective type VII collagen with the goal of improving wound healing and reversing both structural and molecular defects in the skin of individuals with RDEB.

The first technique involved topically applying human recombinant type VII collagen (rC7) to the backs of mice with normal collagen genes. After 2 weeks, the team of researchers led by David T. Woodley, M.D., and Mei Chen, Ph.D., of the University of Southern California discovered that the rC7 had been stably incorporated and sped up the skin’s healing process. It also decreased scarring compared to untreated mice. The beneficial effects lasted for 2 months.

Next, the researchers tried topical applications of rC7 on RDEB skin grafts attached to the backs of mice. When rC7 was applied to broken skin, it was successfully incorporated and improved wound healing. However, when it was applied to intact skin, it was not incorporated. The researchers concluded that this limits the use of topical rC7 as it can only help to increase the rate of healing for existing wounds and cannot prevent the formation of wounds or blisters.

The second technique was intravenous administration of rC7. The research team began by wounding the skin on the backs of mice with normal collagen genes and injecting rC7 into their tail veins. They discovered that the rC7 traveled to the wounds where it was successfully incorporated. Again, it appeared to accelerate healing. They found no evidence of rC7 in healthy, wound-free skin or internal organs.

Subsequently, the team examined the effects of administering rC7 intravenously to mice with RDEB skin grafts. The injected rC7 traveled to the skin grafts where it “created new anchoring fibril structures, which hold the epidermis together.”

According to study authors Drs. Woodley and Chen, “Intravenous delivery of rC7 opens up new prospects for more systemic treatment of the disease. Our data suggest that intravenous rC7 not only improves the healing of multiple RDEB-related wounds simultaneously, but it can also prevent new blisters from developing in RDEB skin.”

Protein Replacement Therapy for Heart Failure

While much of the excitement about protein replacement therapy has to do with its use for the treatment of rare genetic disorders, it shows promise as a treatment for more common health conditions too.

Myocardial infarction (heart attack) and heart failure are among the top causes of death in the United States and other countries. A myocardial infarction occurs when blood flow to a segment of heart muscle drops below adequate levels. The greater the length of time before treatment to restore blood flow takes effect, the greater the loss of cardiac muscle cells, or cardiomyocytes. Because the adult heart has little capacity for regeneration, the cardiomyocytes lost in the aftermath of a myocardial infarction get replaced by different types of cells, resulting in scarring and, frequently, heart failure.

To develop an efficacious means of promoting heart regeneration, researchers must find solutions to a multitude of quandaries. It appears that protein replacement therapy utilizing modified mRNA (modRNA) may avoid many common pitfalls. “Modified mRNA (modRNA) is a safe, non-immunogenic, efficient, transient, local, and controlled nucleic acid delivery system,” noted the authors of a 2019 article published in Molecular Therapy.

Increased understanding of the molecular pathways and genes involved in heart disease has led scientists to believe protein replacement therapy could be used to target signaling pathways involved in heart disease progression. Per the Molecular Therapy article cited above, delivering replacement proteins to the myocardium (the muscle tissue of the heart) can encourage the regeneration of cardiomyocytes.

Gene Therapy

Some approaches have fallen into the subcategory of gene therapy, which involves placing a defined gene into a cell to either replace a defective gene or to increase the amount of a certain gene in a specific cell or tissue in order to increase production of a needed protein. Some examples of work in that vein included using viral vectors like adeno-associated virus (AAV) to mediate the delivery of either FGF1 and p38 MAP kinase proteins or periostin.

However, the use of viral vectors comes with the risk of viral genome insertions. While preclinical studies have returned encouraging results, namely, “robust and consistent gene expression,” there has also been evidence of adverse effects, including immune responses to the viral vectors.

Direct Delivery of Proteins

As experts continue probing how best to use gene therapy to treat cardiac disease, a consensus is growing that the most practical way to change the expression of a protein of interest is to deliver the corresponding protein directly to the myocardium. This circumvents problems associated with other delivery methods, such as the potential immune responses triggered by viral vectors. It’s also been linked to benefits such as:

  • Higher levels of protein expression
  • Improved dose regulation
  • Enhanced control

Direct protein comes with some issues of its own, however, including the short half-life and overall instability of injected proteins.

Modified mRNA Therapy

Unlike gene therapy and the direct delivery of proteins, mRNA-based therapies have proven to be highly promising methods of treating heart disease as well as other disorders. One reason for that is its overall safeness, because mRNA does not integrate into the genetic code.

The first successful use of direct mRNA transfer occurred in the late 1980s in mouse models. Then, in 2008, a team of researchers from the Department of Neurosurgery and Department of Medicine at the University of Pennsylvania in Philadelphia, the Laboratory of RNA Molecular Biology at The Rockefeller University in New York, and the Department of Host Defense at the Research Institute for Microbial Diseases in Osaka discovered how mRNA therapy could be used in genetic and regenerative medicine. Essentially, by modifying mRNA with a naturally occurring modified nucleoside pseudouridine to produce modified mRNA (modRNA), researchers changed its structure so that the body was better able to utilize it to address issues related to protein defects or deficits.

According to the authors of the Molecular Therapy article, modRNA “allows rapid, transient, and efficient gene expression to a specific time window after cardiac injury.” They further state that modRNA protein replacement therapy could be “an excellent therapeutic agent to address experimental and clinical needs to induce cardiac regeneration and promote cardiac function in ischemic heart disease.”

Key Takeaways About Protein Replacement Therapy

Protein replacement therapy offers a way to treat diseases by transporting missing or deficient proteins to cells, thereby correcting the dysfunction that results in disease. Other techniques for doing this involve transferring genetic material into cells, which comes with a higher level of risk.

At this time, one of the most pertinent applications for protein replacement therapy is as a treatment for rare monogenic diseases, which fall into a category called “orphan diseases” because manufacturers are less likely to develop drugs to treat them due to the limited financial incentive for doing so. While some experts view protein replacement therapy as a much-needed option in a realm with a dearth of viable potential treatments, others feel manufacturers still need to do more work to show that using these treatments ends up being a cost-effective decision for health care systems.

It’s important to note, too, that the promise of protein replacement therapy is not limited to rare diseases. Clinical trials have shown it can also be used to overcome one of the central challenges of treating myocardial infarction and preventing heart failure.

As researchers continue to explore applications for protein replacement therapy, it seems likely that they’ll uncover an even broader swathe of diseases and conditions it can be used to treat.