Amino Acids for Hearing Loss: Understanding the Vital Role Certain Amino Acids Play

Chances are, when you think about protecting your hearing health, nutrition isn’t the first thing that comes to mind. But maybe it should be. Here’s how nutrient intake, specifically of certain key amino acids, impacts hearing health.

Though nutrition may not be the first thing that comes to mind when you consider your hearing health, researchers working in the field of nutrient science have found that certain vitamins, minerals, and amino acids can be quite impactful. Before delving into what scientists have uncovered so far about amino acids for hearing loss, we’ll first review some fundamental facts about hearing loss.

Basic Facts About Hearing Loss

Hearing loss occurs when part of the ear or overall auditory system malfunctions. Possible sites where malfunctions might occur include:

  • Hair cells of the inner ear
  • Organ of corti
  • Spiral ganglion
  • Stria vascularis
  • Auditory brainstem

Hearing loss has degrees of severity ranging from mild, which limits a person’s ability to hear soft sounds, to profound, which prevents a person from hearing anything but very loud sounds.

Normal hearing is defined as hearing thresholds of 25 decibels (dB) or better in both ears. Any individual who does not meet that criteria technically has some degree of hearing loss. The colloquial phrase “hard of hearing” applies to individuals with mild, moderate, and severe hearing loss. Typically, those individuals can communicate through spoken language, though they may find hearing aids, cochlear implants, captioning, and other interventions useful.

Those who identify as deaf most likely have profound hearing loss. Because they can hear very few, or no, sounds, it’s common for deaf individuals to use sign language to communicate.

According to a fact sheet compiled by the National Institute on Deafness and Other Communication Disorders (NIDCD), more than 2 out of every 1,000 children born in the United States annually have detectable hearing loss in one or both ears. Hearing tests show that 13% of people over the age of 12 who live in the United States have hearing loss in both ears. Furthermore, 37.5 millions adults living in the United States experience some level of hearing loss.

As individuals grow older, their odds of experiencing hearing impairment increase. In fact, age is the single most significant predictor of hearing loss for adults between the ages of 20 and 69—the highest rates of hearing loss occur among those in the 60 to 69-year-old age bracket.

Sex affects your odds of experiencing hearing loss too. Men have nearly twice the risk women do of developing hearing loss. And race seems to play a role as well, with non-Hispanic white adults reporting higher rates of hearing loss than other racial and ethnic groups.

It’s common for age-related hearing loss to become increasingly severe. Approximately 2% of adults between the ages of 45 and 54 have hearing loss significant enough to be considered disabling, meaning “hearing loss of 35 decibels or more in the better ear, the level at which adults could generally benefit from hearing aids.” That rate rises to 8.5% for adults between the ages of 55 and 64. By age 65 nearly a quarter of adults could benefit from hearing aids, and by 75, more than half could.

Unfortunately, very few of the people for whom hearing aids could be helpful actually use them. Only one in three adults 70 and older with significant hearing loss have used hearing aids.

7 Quick Facts About Hearing Loss

Probing the Link Between Nutrition and Hearing Health

Though some studies on nutrition and hearing health were conducted as early as the 1930s and 40s, it took until the late 1980s for researchers to clearly state that diet plays a role in the development of certain hearing disorders. Now, scientists have conclusively determined that insufficient dietary intake of certain nutrients, including amino acids, can cause hearing loss.

These findings stem largely from population-based studies as well as trials done with animal subjects. A study done by Saudi Arabian researchers, for example, looked at whether dietary deficiencies of certain amino acids correlated to hearing impairment among 18 to 21 year olds.

The authors used a food questionnaire to determine the dietary habits of study participants—with a focus on amino acid intake—in combination with other survey questions. They also reviewed existing literature and findings on the beneficial impact amino acids can have on hearing health.

First, they looked at arginine, a conditionally essential amino acid known for its blood pressure and protein synthesis benefits. “Studies have indicated that arginine is protective against sensorineural hearing loss,” the authors note, as well as “cochlear damage caused by the toxins that are produced in Streptococcus pneumoniae infections.” Evidence supports the use of arginine as a preventative treatment in order to provide cochlea protection.

They also address the role played by methionine, an essential amino acid with powerful antioxidant properties. This amino acid has been shown to lower a person’s risk of ototoxic hearing loss, which occurs as a result of the ingestion of chemicals, including those found in some medications, that cause damage to the inner ear.

The authors mention, too, that deficiencies of methionine may produce hearing loss. They reference an epidemic of peripheral neuropathy in Cuba from 1992-1993 that affected over 50,000 people, some of whom developed high-frequency sensorineural deafness. “Obvious malnutrition was not present,” the authors wrote, “but a deficit in micronutrients including methionine appeared to be a primary determinant of the epidemic.”

They also reference the ability of glutathione, a free-radical scavenging antioxidant made up of three amino acids (L-cysteine, glycine, and L-glutamate), to reduce your risk of developing hearing loss caused by acoustic overstimulation, or noise exposure. “A depleted glutathione state increased noise-induced hearing loss, whereas replenishment of glutathione lessened the damage,” they explained. Furthermore, glutathione can protect against ototoxic hearing loss caused by gentamicin, particularly for individuals whose diets contain low levels of protein.

Last but certainly not least, they touch on the important role played by taurine, another conditionally essential amino acid. Taurine appears to make vital contributions to the development of human hearing capacities, both anatomically and functionally. “Infants with inadequate taurine in their diets had shorter auditory brain stem responses,” the authors stated. And animal studies have shown that supplementing with taurine encourages the brainstem auditory response to mature earlier.

Further Findings on Amino Acids for Hearing Loss

Taurine may hold particular promise as a means of treating tinnitus, a hearing malfunction that impacts approximately 10% of adults living in the United States. Neuroscientists at the University of California, Berkeley published findings in the journal Proceedings of the National Academy of Sciences indicating a correlation between tinnitus and decreased levels of GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter. The team concluded that finding ways to change GABA functions could help to treat tinnitus, and taurine could be one possible route for doing so.

A separate study published in Hearing Research examined how daily taurine supplementation impacted chronic tinnitus in rats. Rats given a high dose of taurine—294 mg/kg—showed significantly reduced symptoms of tinnitus. “These results are consistent with the hypothesis that taurine attenuates tinnitus and improves auditory discrimination by increasing inhibitory tone and decreasing noise in the auditory pathway,” the authors concluded.

The connection between amino acids and hearing health appears to be intimately intertwined with the way amino acids influence neurotransmitter levels. A review published in Neural Regeneration Research offers perspective on this issue as it applies to glutamate and glycine. “Glutamate is well established as an excitatory neurotransmitter of auditory nerve fibers,” the authors explained, and likely other ascending auditory pathways as well. Glycine, meanwhile, acts as an inhibitory neurotransmitter in the central auditory system.

How to Use Amino Acids to Maximize Hearing Health

Your particular hearing concerns will determine which amino acids you’ll want to seek out in order to maximize your hearing health. The following overview of the links between certain amino acids and auditory functions can help you build a personalized diet and supplement plan.

Arginine

Evidence shows that arginine, a conditionally essential amino acid, helps protect against sensorineural hearing loss,  which accounts for about 90% of all cases of hearing loss. Arginine can also prevent cochlear damage resulting from illnesses caused by Streptococcus pneumoniae bacteria such as pneumonia, meningitis, and sinus and ear infections.

Foods high in arginine include:

  • Chicken
  • Dairy products
  • Lentils
  • Turkey
  • Soybeans
  • Spirulina

Carnitine

Carnitine, an amino acid already quite popular for its anti-aging impact, appears to have a positive impact on hearing loss related to brain stem auditory deficits caused by diabetes. It may also increase hearing health for older individuals.

Experts advise supplementing with acetyl-L-carnitine because the body absorbs it more readily and it facilitates the transportation of fatty acids to the mitochondria of inner ear cells, a crucial step for energy production.

Cysteine

This nonessential, sulfur-containing amino acid plays a number of important roles related to your hearing. First, it safeguards the function of inner ear cells and second, it acts as a precursor for glutathione, another amino acid relevant to hearing health.

Evidence indicates that when individuals supplement with n-acetyl-cysteine, they’re unaffected by noise levels sufficient to cause permanent hearing damage in other individuals. Plus, it can counteract the negative effects certain medications and cancer treatments have on your hearing, including cisplatin.

Glutathione

Deficiencies of glutathione (an antioxidant composed of cysteine, glycine, and glutamate) make individuals more susceptible to hearing loss following noise exposure. Those already experiencing this type of hearing loss can mitigate the damage by supplementing with glutathione. Glutathione also prevents gentamicin from harming the cochlear.

As we age, our glutathione levels decrease sharply. This can be particularly dramatic in the auditory nerve, raising the question of whether age-related hearing loss might be caused in part by dropping glutathione levels.

Histidine

Our bodies need histidine, an essential amino acid, to maintain the protective myelin sheaths that surround our nerves. Histidine deficiencies can contribute to nerve deafness as well as other types of hearing loss.

Methionine

Methionine keeps auditory hair cells as well as auditory neurons safe from ototoxicity, particularly from aminoglycosides, ionic platinum compounds, and cisplatin. However, this amino acid plays somewhat of a dual role in hearing health as it’s a precursor to homocysteine. Excess levels of homocysteine may obstruct blood flow to the inner ear.

If you increase your methionine intake, be sure to maintain optimal levels of folic acid as well as vitamins B6 and B12 to keep your homocysteine levels in check.

Taurine

As addressed in some detail previously, humans need taurine to develop brainstem auditory responses. There’s also some indication that this amino acid could be used to treat tinnitus.

Dietary taurine comes primarily from red meat, poultry, and fish, so vegetarians and vegans may need to pay particular attention to sourcing this crucial nutrient.

Use These 7 Amino Acids to Prevent and Treat Hearing Loss

What Everyone Should Know About B-Type Natriuretic Peptide and Congestive Heart Failure

B-type natriuretic peptide is a hormone produced by the heart ventricles in response to pressure changes linked to heart failure. By testing BNP levels, doctors can screen for heart disease and assess the efficacy of heart disease treatments. Learn what to expect from a test and how to keep your BNP levels in the healthy range.

Brain natriuretic peptide, commonly called B-type natriuretic peptide or, even more succinctly, BNP, is a hormone produced by the heart ventricles (the pumping chambers of the heart) in response to pressure changes linked to heart failure. Since its discovery in the late 1980s, it has earned a place of prominence in the medical world, as it can be used as a biomarker to facilitate the diagnosis of congestive heart failure (CHF).

Researchers have found that B-type natriuretic peptide measurements can be used not only to help with the diagnosis of heart failure, but also to predict future cardiovascular events and the risk that such events will prove fatal. This is part of what’s known in clinical practice as risk stratification: the separation of patients into low risk, rising risk, and high risk in order to develop the most effective treatment plan possible.

According to an article published in Circulation, a journal published by the American Heart Association, BNP levels are “a powerful marker” for cardiovascular risk stratification. “In a recent study of 78 patients referred to a heart failure clinic, BNP showed a significant correlation to the heart failure survival score,” the authors wrote. “In addition, changes in plasma BNP levels were significantly related to changes in limitations of physical activities and were a powerful predictor of the functional status deterioration.” They mention, too, that measurements of BNP levels taken when patients came in through the emergency department could be used to predicate how patients would fare once they were discharged, with higher BNP levels strongly associated with worse prognoses.

There’s some evidence as well that B-type natriuretic peptide concentrations have predictive value for other cardiac conditions, such as acute coronary syndromes and pulmonary embolism.

It’s rare that a relatively new diagnostic measurement results in such rapid and widespread changes to clinical practice. Read on to learn exactly what B-type natriuretic peptide is and how measurements of BNP levels, which can be analyzed with a simple blood test, allow doctors to evaluate complicated elements of cardiovascular health.

What Is B-Type Natriuretic Peptide?

In scientific terms, B-type natriuretic peptide (BNP) is a polypeptide made of 32 different amino acids. When the muscles of the heart stretch excessively in response to changes in blood volume caused by heart failure, they release BNP along with its inactive, 76-amino acid synthetic byproduct, known as N-terminal prohormone BNP, or NT-proBNP.

BNP is one of four natriuretic peptides. All the members of this protein hormone family are secreted by components of the circulatory system. Atrial natriuretic peptide (ANP) is secreted by the atria of the heart (the upper pumping chambers), as its name indicates. BNP comes from the larger, stronger lower chambers, while C-type natriuretic peptide (CNP) is generated primarily in the blood vessels. The highest levels of dendroaspis natriuretic peptide, or D-type natriuretic peptide (DNP), the most recently discovered member of the family, have been found in blood plasma but are believed to be secreted by the heart.

All four natriuretic peptides appear to help regulate circulation. So far, experts have compiled the most data on the actions of ANP and BNP, which are jointly known as the cardiac natriuretic peptides. Both cause the blood vessels to dilate, allowing more blood to flow through them and lowering the risk of clot formation. They also help the kidneys flush out higher quantities of water as well as salt (a process called natriuresis).

Furthermore, researchers have found that ANP and BNP downshift the production of hormones like adrenaline, angiotensin, and aldosterone that narrow blood vessels, increase fluid retention, or elevate the heart rate.

The overall effect of the actions of ANP and BNP—namely, relaxing blood vessels, thereby lowering blood pressure, and improving renal function—ensures that the heart does not have to overtax itself. That’s why when the heart is under stress, the body increases levels of these protective peptides.

What is B-Type Natriuretic Peptide?

How B-Type Natriuretic Peptide Relates to Heart Disease

As touched on in preceding sections, pressure changes inside the heart stimulate release of both B-type natriuretic peptide (BNP) and N-terminal (NT)-pro hormone BNP (NT-proBNP). Because those pressure changes tend to be indicative of either heart failure or some other type of cardiac malfunction, experts have proposed that both BNP and NT-proBNP levels might have prognostic value as a simple, inexpensive method of screening for cardiovascular diseases, particularly chronic heart failure.

The Effects of Chronic Heart Failure on the Body

Chronic heart failure, also called congestive heart failure (CHF), occurs when the ventricles (the walls of the heart chambers) become either too weak or too tense to properly pump blood throughout the body. Two of the top underlying causes are coronary artery diseases and high blood pressure. Other causes include heart valve diseases and, less frequently, diseases of the heart muscle (cardiomyopathies).

The heart’s purpose is to draw in the blood that has been circulating through the veins and push it back out into the arteries. As the muscles weaken, the hearts of individuals with CHF cannot contract enough to fully pump blood back into the arteries. As a result, blood begins to collect in the lungs, then the veins, and the tissues of the body do not receive the supply of oxygenated blood they need.

Because of this lack of sufficient oxygen in their bodily tissues, individuals with CHF often feel fatigued and unable to exert themselves physically. Renal function becomes impaired—sometimes permanently—exacerbating the fatigue and making treatment more challenging. The brain suffers from this lack of oxygen-rich blood as well, causing confusion.

The blood collected in the lungs and veins produces its own set of symptoms, beginning with lung function. Shortness of breath is the definitive symptom of CHF. Initially, it only sets in during physical exertion, but as the disease progresses, it transpires while individuals are resting. Advanced CHF can make it impossible for individuals to sleep lying flat—when they do, their shortness of breath can intensify to the point where they are awakened by it. Other ways CHF shows up in the respiratory system include wheezing, coughing, and increased susceptibility to pneumonia. The most severe presentation is acute pulmonary edema, a buildup of fluid in the lungs that requires emergent medical attention.

Other symptoms of CHF include:

  • Weakness
  • Loss of appetite
  • Fluid retention in the feet and legs
  • Abdominal bloating
  • Swelling of the scrotum and penis
  • Frequent nighttime urination
  • Diminished urine output throughout the day and night
  • Weight loss (cardiac cachexia)

People of all ages can develop chronic, congestive heart failure—even children!  Statistics show close to 5 million Americans currently have CHF, and around 555,000 new diagnoses are made each year.

This serious condition can be fatal, and it’s common for death to occur suddenly. Individuals with CHF experience sudden death at a rate that’s between 9 and 10 times that of the population at large! This makes it vital for doctors to have the means to rapidly and accurately diagnosis CHF.

13 Symptoms That Can Indicate Chronic Heart Failure (CHF)

Using B-Type Natriuretic Peptide to Diagnose Chronic Heart Failure

When it comes to diagnosing CHF in the advanced stages, doctors have a plethora of screening tests at their disposal. By that point, the symptoms will be quite clear, and chest X-rays, electrocardiograms (EKGs), or certain blood tests can confirm a doctor’s suspicion.

Earlier presentations of CHF can be harder to catch, however, as symptoms overlap with those of a number of lung, liver, and kidney diseases. In order to determine the root cause of a patient’s symptoms, doctors historically used an ultrasound test called an echocardiogram, or an echo for short. This safe, typically painless test allows doctors to see the heart muscles at work and to determine its ejection fraction, a measurement of the quantity of blood pumped by the left ventricle with each contraction. The healthy range for ejection fractions is between 50% and 70%.

The downside to echocardiograms is that they can be expensive and may not be available under all circumstances. This is where the value of BNP tests becomes clear. These simple, low-cost blood tests can be carried out bedside in an emergency department if need be. According to experts in the field, about 98% of the times that a BNP test reveals normal levels, it’s accurate to rule out CHF as a diagnosis. This suggests to doctors that they should focus their attention on alternate explanations for shortness of breath or other symptoms that could indicate CHF.

At most facilities, a test revealing BNP levels below 100 picograms per milliliter (pg/ml) is grounds for eliminating CHF as a potential diagnosis. If patients are experiencing kidney failure, the threshold rises to 200 pg/ml.

When tests show high BNP levels, next steps become less certain. This alone does not fully support a CHF diagnosis, as there are other factors that can affect BNP levels, such as:

  • Age
  • Sex
  • Lung, kidney, and liver health
  • Blood pressure
  • Thyroid function
  • Cortisol levels
  • Some uncommon tumors
  • Brain hemorrhages
  • Body weight

Certain medications, including diuretics, beta blockers, ace inhibitors, and spironolactone also impact BNP levels.

That said, BNP levels of around 900 pg/ml in individuals between the ages of 50 to 75, or over 1,200 pg/ml for those older than 75 correlate to a diagnosis of CHF 90% of the time. In most cases, patients with high BNP levels who do not have CHF have either severe lung or kidney disease.

BNP levels can not only help doctors make a diagnosis of CHF but also evaluate how far the disease has advanced, develop treatment plans, and determine how patients respond to different interventions. Generally speaking, the higher BNP levels are, the more severe the situation. As treatments take effect, backed up blood begins circulating into the rest of the body once again, and heart muscle cells begin to recover and to secrete less BNP.

A systematic review of clinical trials published in The BMJ looked at how accurate BNP measurements—both initial levels and changes in response to treatments—are for predicting risk of death, myocardial infarction (heart attack), and other cardiovascular events in heart failure patients. The authors determined that BNP has strong prognostic value for heart failure patients at all stages of the disease as well as for asymptomatic patients.

They went as far as to state that their findings raise “important questions concerning the way that heart failure is defined and diagnosed.” The majority of the recent trials and studies they analyzed used ventricular systolic function, expressed in terms of ejection fraction measurements, as the reference standard for the diagnosis of heart failure. “This is despite the fact that it is recognized that 20-50% of patients with heart failure have preserved systolic function,” they wrote. Given those statistics, they propose that BNP may be a superior method for identifying patients who would benefit from treatment for heart disease.

What Factors Impact BNP Levels, Other Than Chronic Heart Failure?

Can B-Type Natriuretic Peptide Levels Be Used to Diagnose Coronary Artery Disease?

When patients have coronary artery disease (CAD) without CHF, the muscles of their heart do not stretch in the way that spurs the release of BNP. If they have extensive coronary artery blockages, however, or active vascular inflammation, this can cause heart muscle cells to become ischemic (oxygen-deprived). Ischemic heart muscles cells also release BNP, though in smaller quantities than when they’re attempting to counterbalance the effects of CHF.

Experts are quite excited about the possible use of BNP values to diagnose CAD, particularly for patients with asymptomatic CAD. As a review published in QJM: An International Journal of Medicine put it, “It would be of great benefit if a simple blood test could identify those most likely to have CAD.” As a follow-up to that screening measure, individuals whose test results indicate they’re likely to have CAD could undergo “more definitive but more invasive tests,” like angiography and stress tests. The authors believe BNP testing “has the potential to reduce cardiac deaths” because its widespread use will let doctors “better target cardioprotective strategies to those who most need them.”

What to Expect from a BNP Test

Now that you have a sense of why experts in the field of cardiovascular health find BNP tests almost endlessly exciting, you may be wondering, what exactly occurs during a BNP test?

As you know, the test measures BNP concentrations in the blood. In clinical practices, doctors are likely to recommend a BNP test when patients have symptoms of chronic heart failure like the classic shortness of breath. This simple, inexpensive test can catch CHF in the early stages before more serious complications develop. BNP tests can also be used to evaluate whether heart disease treatments are having the desired effects.

A BNP test does not require any special preparation, such as fasting. The test involves drawing blood from a vein using a hypodermic needle, so if you feel faint at the sight of blood, you may wish to ask a family member or friend to accompany you and drive you home.

The blood sample will then be sent to a laboratory where machines measure levels of BNP as well as NT-proBNP. This process typically takes between 15 and 20 minutes if the laboratory is located in the same facility where the test was performed. If the blood sample has to be sent to a separate laboratory, it make take up to a week for the results to be ready.

Once a doctor has reviewed the BNP test results, they will let you know whether your levels are high enough to indicate a diagnosis of heart failure. If you already have a confirmed diagnosis of CHF, your doctor will update you on whether your current treatment protocol is working effectively, as evidenced by lower BNP levels.

As touched on earlier, BNP levels under the threshold of 100 pg/ml usually exclude a diagnosis of heart disease. However, normal, healthy BNP levels fluctuate depending on your age and sex.

Normal BNP levels by Age and Sex

5 Expert-Approved Methods for Lowering BNP Levels

If you improve your heart health, your BNP levels will drop. Certain risk factors for heart disease are out of your control, such as a family history of the disease and your underlying genetic makeup. However, there are a variety of steps you can take on your own to address lifestyle-related risk factors known to negatively impact heart health, including:

  1. Stop smoking cigarettes. As you almost certainly know, smoking cigarettes harms your health. Studies have shown it undermines heart health in multiple ways, including raising your blood pressure, decreasing good high-density lipoprotein (HDL) cholesterol levels, and elevating your heart rate. It can be quite challenging to stop, but the benefits are undeniably worth the effort. After just 1 year, your susceptibility to heart disease drops significantly, and 15 years after cessation, it’s equivalent to that of someone who has never smoked.
  2. Engage in regular physical activity. The Centers for Disease Control (CDC) recommend that adults get at least 2 hours and 3 minutes of moderate-intensity aerobic activity each week, along with at least two strength training sessions. If you find it difficult to fit exercise into your schedule, don’t despair: even three 10-minute sessions daily can add up to make a difference. Try taking a brisk walk or spending time outside gardening. You can also build healthy habits into your day by taking the stairs, parking in the spot furthest from the door, or commuting to work on your bike. Ideally, you should also be finding ways to enhance your fitness by increasing the intensity, frequency, and duration of your workouts.
  3. Prioritize stress management. Scientists have uncovered a clear link between uncontrolled stress and heart disease. The body responds to stress by releasing a hormone called cortisol, which can have a detrimental impact on your cardiovascular health. This is particularly true if stress becomes chronic. Be sure to find ways to manage the stress that inevitably arises as a part of life. Strong research supports the use of mediation and breathwork for this purpose.
  4. Get adequate sleep. Safeguarding your sleep is a vital part of stress management as well as the fortification of your overall health. Unfortunately, findings show that 30% of Americans experience intermittent insomnia, while many more struggle with milder forms of sleep deprivation on a regular basis. Building healthy sleep habits, such as refraining from working or eating in bed as well as using a computer or cell phone too close to your bedtime, can help you get the 7 to 8 hours experts advise for adults.
  5. Supplement with essential amino acids. As mentioned earlier, one of the physiological causes for chronic heart failure (CHF) is the weakening of the heart muscles. Researchers have found that amino acids can help counteract three of the ways that heart failure impairs muscle function: accelerated breakdown of muscle protein, poor regulation of muscle blood flow, and impaired production of cellular energy. Learn more about how to use essential amino acids to increase heart health here.

5 Ways to Lower Your BNP Levels and Enhance the Health of Your Heart

Understanding Autophagy: Loose Skin, Chronic Disease and Cancer—Some Scientists Say It Could Be the Key to Treating and Preventing All of These 

Maximize the ability of autophagy, a cellular cleansing process, to prevent loose skin after weight loss, chronic diseases, and even cancer. Read on to learn about the science behind autophagy as well as how it can help those on weight-loss journeys.

Autophagy (pronounced ah-TAH-fuh-gee), a medical term, describes a regenerative cellular process that decreases your risk of developing a multitude of serious diseases, extends your lifespan, and improves your overall health and well-being. In some circles, there’s particularly intense interest in the impact of autophagy on loose skin following weight loss, a frustrating side effect that can require surgery to address.

Read on to learn about the science behind autophagy as well as how it can help those on weight-loss journeys.

What Is Autophagy?

In simple terms, the concept of autophagy can be defined as follows: without external nutrients, the body begins to consume itself. The term comes from the Greek words “auto” meaning self and “phage” meaning to eat.

While this may sound like the premise for a horror movie, it can be incredibly beneficial. During the process of autophagy, specialized membranes seek out cells that are dead, damaged, or diseased and use their component parts for energy or to make new cells.

“Think of it as our body’s innate recycling program,” said Dr. Colin Champ, assistant professor at the University of Pittsburgh Medical Center, in an interview. Other experts have summed it up as “cellular housekeeping” or “cellular quality control.”

Though Belgian biochemist Christian de Duve originated the term “autophagy” in 1963, much of what we now know about this vital process was not discovered until well into the 2000s. In fact, pioneering Japanese biologist Yoshinori Ohsumi won a Nobel Prize for his investigations into the mechanisms of autophagy in 2016. Scientists working in the field, however, caution that what we currently don’t know about autophagy would fill far more books than what we do.

7 Proven Benefits of Autophagy

Autophagy plays a fundamental and essential role in overall cellular function by recycling disused or dysfunctional components that, if left in place, can become problematic. By doing so, autophagy can prevent the development of several types of diseases. Here are 7 proven ways autophagy benefits your health.

1. Decrease Systemic Inflammation

A 2017 review published in Clinical and Translational Medicine states that “increasing evidence” demonstrates autophagy can help to prevent the development of inflammatory diseases.

“Autophagy plays critical roles in inflammation through influencing the development, homeostasis and survival of inflammatory cells, including macrophages, neutrophils and lymphocytes; effecting the transcription, processing and secretion of a number of cytokines, as well as being regulated by cytokines,” the authors state. Essentially, this means that autophagy helps to ensure that all the cells regulating your body’s inflammatory processes are working properly.

The authors go on to say that studies suggest autophagy’s positive influence on inflammatory cells offers promise as a therapeutic intervention for diseases linked to inflammation, including:

  • Crohn’s disease
  • Cystic fibrosis
  • Pulmonary hypertension
  • Obstructive pulmonary disease

2. Treat Neurodegenerative Diseases

Findings published in Frontiers in Neuroscience, a leading journal in its field, point to autophagy as a way to slow the progression of neurodegenerative diseases.

As we’ve established, autophagy repurposes cellular components, including misfolded proteins. The accumulation of misfolded proteins is believed to cause symptoms of many neurodegenerative diseases to worsen. So, by preventing that, autophagy can mitigate the severity of those diseases.

3. Safeguard Mental Health

Some research has shown that when autophagy does not occur with sufficient frequency, your mental health can be negatively impacted.

A study published in Molecular Psychiatry, a peer-reviewed journal, looked at the connection between autophagy and mental health. When they analyzed the brains of schizophrenia patients, the authors found clear reductions in post-mortem levels of proteins that control autophagy. They determined that the direct association between autophagy and the progression of schizophrenia could offer a pathway to new methods of treatment.

4. Increase Longevity

A review published in the Journal of Clinical Investigation claims that inducing autophagy can counteract cellular aging processes and enhance the metabolic activity of your cells, resulting in increased longevity.

This claim stems from experimental findings, and it’s not yet clear exactly how autophagy increases anti-aging activity and extends life spans, though studies with mice have shown that to be the case.

5. Suppress Tumor Growth

It’s clear that the process of autophagy is intimately linked to the development of cancer, but exactly what effect it has on tumor initiation and development remains somewhat murky.

Per a review published in the International Journal of Molecular Sciences, “Many studies have found that autophagy plays dual roles in cell survival and cell death in the context of tumor initiation and development.” The authors elaborate that while autophagy has been shown to suppress tumor formation in certain instances, it also seems to contribute to cancer progression by supplying nutrients to cancer cells in others.

More research is needed to fully understand how to harness the power of autophagy to prevent cancer. In the future, however, the authors believe it could be “a potentially effective therapeutic strategy in anticancer therapy.”

6. Support Maintenance of a Healthy Weight

Some of what we know about autophagy comes from research in what happens in its absence. For instance, a study done with mice and published in Cell Metabolism found that deleting an essential autophagy gene led to higher body weights, increased fat mass, and higher rates of glucose intolerance.

According to the authors, these findings indicate that an autophagy deficiency may play a role in the development of obesity.

7. Prevent Sagging Skin Post-Weight Loss

Though this benefit does not have rigorous scientific support, solid anecdotal evidence indicates that autophagy can help those who have lost weight—particularly, individuals who have lost a lot of weight—from needing skin removal surgeries. Dr. Jason Fung, a nephrologist who specializes in research into fasting, has developed a program designed to help people successfully lose weight and reverse conditions linked to weight gain, such as type 2 diabetes, polycystic ovarian syndrome (PCOS), and fatty liver.

“We’ve never sent a single person for skin-removal surgery,” said Dr. Fung in an interview. “We have anecdotal cases where people have lost 120, 130 pounds, and they said their skin also shrank, too.”

Fung believes this happens because the body harvests the protein contained in excess skin. “Remember, during fasting, you’re activating a pathway within your body that says, ‘Okay, we need to buckle down because we’re in a time of famine, so to speak, and we don’t need all that extra skin, so let’s burn it. And if you need it, we’ll build it again.’”

How to Increase the Efficacy of Autophagy for Loose Skin

Is It Possible to Trigger Autophagy?

Though it has not yet been definitively proved that it’s possible to trigger autophagy in humans, studies done with animals indicate that fasting and calorie restriction may be means of inducing autophagy.

A literature review published in Ageing Research Reviews in 2018 found that “the evidence overwhelmingly suggests that autophagy is induced in a wide variety of tissues and organs in response to food deprivation.” In other words, there’s a very high likelihood that if you fast, autophagy will occur.

Studies done with mice have historically delineated 24 hours as the marker for when autophagy sets in, but it’s not clear whether the same would hold true for humans. Dr. Fung believes that autophagy most likely sets in during the later stages of an extended fast, “somewhere around 20 to 24 hours is my guess, and it probably maxes out somewhere around 32 hours, again, my best guess.”

While scientists have yet to agree upon a surefire way to trigger autophagy, this process does occur naturally, though it’s unclear how frequently or extensively it takes place without outside stimulus. Fasting, exercise, and other forms of physiological stress seems to cause the process to accelerate.

However, it’s quite challenging to measure autophagy (technically, what would be measured would be termed autophagic flux) in humans, as it requires tracking the levels of minuscule proteins, including protein 1A and LC3.

Does Autophagy Have Any Negative Effects?

While autophagy clearly has a host of remarkable benefits, it can cause problems too. An article published in PLOS Biology termed it a “double-edged sword.”

Author Andrew Thorburn of the Department of Pharmacology at the University of Colorado School of Medicine explained that “autophagy’s effects may work for both the good and the bad of an organism.” When it comes to conditions like treating bacterial infections, autophagy sometimes leads to improvement and sometimes causes conditions to worsen. According to Thorburn, using autophagy effectively will require a better understanding of which cells it degrades and under what circumstances.

It’s important to note as well that using fasting as a method for inducing autophagy comes with its own risks. There are no universal medical recommendations at this time, but most experts agree that extended fasts—going without food for 36-, 48-, or even a full 72 hour-fast—should only be undertaken by those in good health. Extended fasting should not be done too frequently either. As a general rule, it should only be undertaken 2 or 3 times annually. Confer with a trusted doctor before embarking on a fast to make sure it’s safe for you.

If you have previously engaged in unhealthy food restrictions behaviors or have been diagnosed with an eating disorder like anorexia, it’s likely best to avoid fasting.

Expert Advice on Triggering Autophagy

Because autophagy is a stress response, to intentionally trigger it, you will have to endure some discomfort. “It’s our ancestral and evolutionary response to dealing with feast and famine in times of stress,” said Dr. Champ.

If you’d like to try triggering autophagy, one of these three methods is a good place to start.

1. Enter a State of Ketosis

If the idea of fasting feels daunting or there are reasons you should avoid it, evidence shows you can also activate autophagy by entering ketosis. By restricting your carbohydrate intake and increasing your fat intake, you can shift your body into a state in which it uses fat rather than carbs as its primary source of fuel. This is the scientific basis for the immensely popular high-fat, low-carb ketogenic diet, commonly abbreviated as the keto diet.

In order to adhere to the keto diet, you’ll need to keep your carbohydrate intake at no more than 5% of your total calories, your protein intake between 20% and 30%, and your fat percentage at between 60% and 70%.

Studies have shown that entering ketosis can bring about significant fat loss while maintaining muscle mass. Other proven medical uses for the keto diet include improving the treatment of epilepsy and other brain conditions (in fact, it was developed to treat epilepsy in children), lowering your risk of diabetes, and assisting your body in defeating cancerous tumors.

According to Champ, “Ketosis is like an autophagy hack. You get a lot of the same metabolic changes and benefits of fasting without actually fasting.”

2. Experiment with Intermittent Fasting

Extended fasts can be grueling, but that may not be necessary in order to spur autophagy.

A Brazilian research team published a research review indicating that intermittent fasting can help increase autophagy, which makes cancer treatments more effective and reduces side effects. They note, however: “Additional studies are required to better understand the molecular mechanisms evoked by fasting, aiming to identify the context in which fasting may be beneficial as an adjunct to cancer treatment.”

In the meantime, it certainly seems worthwhile to give intermittent fasting a try, if for no other reason than the wealth of benefits they mention that have been associated with intermittent fasting, such as an extended lifespan and a lower risk of diseases including:

  • Diabetes
  • Heart disease
  • Neurodegenerative conditions

As with extended fasting, there are limitations on who should try intermittent fasting. It’s typically not advisable for children, pregnant women, or individuals with diabetes or other blood sugar issues to follow this fasting protocol.

3. Engage in Regular Exercise

As you may know, exercising creates microscopic tears in your muscles. When your body repairs those tears, that process leads to bigger, stronger muscles. It appears that exercise also increases the rate at which your body carries out autophagy.

A study published in Nature, an international journal of science, found: “Acute exercise induces autophagy in skeletal and cardiac muscle of fed mice.” The authors discovered that after 30 minutes of running on a treadmill, the rate at which mice recycled their own cells via autophagy increased significantly and continued to do so until the 80-minute marker at which point rates leveled out.

Scientists have not yet pinpointed the threshold require for humans to kickstart autophagy. Dr. Daniel Kilonsky, a cellular biologist specializing in autophagy, says that at the moment, it’s proving quite difficult to answer that question.  However, he reminds us that exercise, like intermittent fasting, has many other benefits.

3 Possible Methods for Triggering Autophagy

Additional Advice on Naturally Addressing Loose Skin

If your primary interest in autophagy has to do with its potential role in addressing loose skin following weight loss, you may want to incorporate these other natural methods for resolving loose skin without plastic surgery.

A key aspect of doing so is improving skin elasticity. Without proper elasticity, your skin cannot adapt to physical changes such as weight loss. To maintain or enhance skin elasticity, you’ll need to sustain an adequate supply of collagen.

All the collagen in your body begins as procollagen. To make procollagen, your body uses two amino acids: glycine and proline. Certain nutrients have been shown to increase the rate at which your body produces those amino acids, such as vitamin C, copper, selenium, and zinc.

Citrus fruits, strawberries, bell peppers, and raw liver all contain high concentrations of vitamin C. Organ meats are generally high in copper, as are cashews, sesame seeds, lentils, and cocoa powder. You can get plenty of selenium from seafood (salmon in particular) and Brazil nuts, while oysters and red meat are rich in zinc.

Consuming foods high in glycine and proline themselves also boosts procollagen production. Good sources of glycine include gelatin as well as pork and chicken skin, while egg whites, dairy products, wheat germ, mushrooms, asparagus, and cabbage provide lots of proline.

Because your body needs a balanced supply of all the amino acids in order to effectively utilize them, you’ll also want to eat foods with overall high levels of amino acids, like:

  • Red meat
  • Poultry
  • Seafood
  • Legumes
  • Tofu

Interestingly, eating foods high in collagen, such as bone broth, is not necessarily the best way to raise levels in the body. That’s because when you consume protein, your body breaks it down into its component amino acids.

3 Possible Methods for Triggering Autophagy

How to Avoid Loose Skin After Weight Loss

Significant weight loss can result in loose, sagging skin. Studies show these 6 methods can help you avoid loose skin or minimize its appearance.

We tend to treat weight loss, particularly major weight loss, as the triumphant endpoint of a difficult journey. We divide weight-loss journeys into “Before” and “After,” often with a single photo representing the start and finish of that journey. However, this story only captures one aspect of what it’s like to lose weight. What often gets left out of weight-loss stories is that when you move from a higher body weight to a significantly lower one, you may experience other unwanted physical changes, such as loose skin. There is absolutely nothing wrong with embracing loose skin—as individuals like Kenzie Brenna, an actress, writer, and body-positivity activist, have publicly done—in fact, it’s an admirable goal and an indication of deep self-acceptance. That said, there’s also nothing wrong with wanting to learn how to avoid loose skin after weight loss.

For some people, loose skin can be damaging to their mental health and self-esteem. It can also be physically uncomfortable, particularly during physical exercise. Once you develop loose skin, it can be quite challenging to reverse without plastic surgery.

Less invasive options do exist, however, many of which are most effective when put in place preemptively. Before sharing eight ways you can avoid loose skin after weight loss, we’ll first cover some basic facts about the skin as well as risk factors that impact how likely you are to develop loose skin.

How Does Skin Function?

One of the pitfalls of the rapid loss of a lot of weight is the development of excess skin. A New York Times article covering a pioneering study that followed contestants from season eight of the popular TV show “The Biggest Loser” for 6 years after the series finale addressed this issue. Per the article, prior to the finale weigh-in during the show’s finale to determine the winner, contestants “dressed carefully to hide the rolls of loose skin that remained, to their surprise and horror, after they had lost weight. They wore compression undergarments to hold it in.”

In order to understand why rapid, significant weight loss so often results in loose skin, you must have a basic grasp of how skin functions.

The skin—which is the largest human organ—acts as a barrier to keep your body safe from viruses, fungi, bacteria, and other potentially harmful contaminants. Collagen and elastin, two proteins found in the second layer of the skin, (the dermis), allow it to stretch and contract as we move and grow.

As an individual gains weight, those proteins must continually stretch to allow the skin to adapt to that change. This can cause the fibers of those proteins to become weak and damaged. Thus, when significant weight-loss occurs, the elastin and collagen in the skin may not be readily able to contract.

“Skin stretches to form the shape of your body since it’s an ‘elastic’ organ,” Certified Exercise Physiologist Lizbeth Simancas summarized. “Your skin may not contract back to its smaller shape if weight is lost too quickly.” This can be seen most clearly for individuals who undergo bariatric surgery, but those who quickly lose a lot of weight through intense diet and exercise practices, like competitors on “Biggest Loser,” can experience this too.

The more weight is lost, the greater the demand on the skin’s previously overtaxed capacity for elasticity. And, therefore, the greater the likelihood of saggy skin post-weight loss.

What Factors Contribute to the Development of Loose Skin After Weight Loss?

Dr. Christine Choi Kim, medical and cosmetic dermatologist, underlines that fact that the skin is a living organ, and while it responds to weight gain by stretching and expanding, its ability to contract in response to weight loss is inherently more limited. Dr. Kim notes, too, that this ability to tighten depends on a number of factors, such as:

  • Age: The aging process often causes the skin to become less elastic, impairing its ability to tighten after weight loss.
  • Genetics: Some individuals are more prone to sagging skin as they grow older, regardless of weight loss.
  • Baseline strength of elastin and collagen proteins: As is the case when it comes to your genes and your age, you can’t control the impact your baseline skin elasticity will have on its ability to bounce back after you lose weight.
  • Degree of weight gain and loss: As touched on previously, the more weight you lose, and the shorter the period of time in which you lose it, the harder it will be for your skin to adapt.
  • Nutrient intake: To keep your skin healthy, you’ll need to provide it with a balanced intake of nutrients, particularly vitamins C and E and the substances that act as precursors for the development of collagen and elastin.
  • Sun exposure: While some degree of sun exposure is a healthy way to meet your body’s vitamin D needs, excess exposure can lead to skin damage.
  • Smoking history: Yet another reason to kick the habit, or avoid  cigarettes in the first place. A plethora of studies show that smoking speeds the normal aging process of your skin.

Understanding the factors that influence skin elasticity can help you avoid loose skin after weight loss. If possible, it’s best to address this issue preventatively as it’s far more difficult to tighten skin that has already begun to sag than it is to forestall the sagging.

According to Kim, “Excess skin can lead to embarrassment and a lack of satisfaction with your body image—even after significant weight loss.” Equip yourself with the knowledge you need to keep the triumph of achieving a major weight-loss goal from being marred by unexpected changes to your skin.

7 Factors That Contribute to the Development of Loose Skin

How to Avoid Loose Skin After Weight Loss

First, it’s important to be clear that there is no guaranteed way to avoid loose skin after weight loss. Depending on the amount of weight you lose, when you gained the weight and how long you carried it, as well as your skin’s baseline elasticity, some extra skin may be unavoidable. However, the experts say that the following 6 practices can help you avoid loose skin after weight loss, or minimize the appearance of existing excess skin.

1. Lose Weight Gradually

Perhaps the single most effective way to avoid loose skin after weight loss is to progress gradually toward your weight-loss goal. Slower weight loss makes it less arduous for skin to snap back into place.

The Centers for Disease Control and Prevention (CDC) recommends aiming to lose between 1 and 2 pounds per week. Not only will this make it easier for your skin to keep pace, but it also makes it less likely that you’ll regain the weight.

Furthermore, a study published in the International Journal of Endocrinology and Metabolism found that losing weight slowly results in more favorable changes to body composition. Study participants were randomly divided into two groups—a rapid weight-loss group that followed a diet plan designed to produce a daily 1,000- to 1,500-calorie deficit and a slow weight-loss group whose diet produced an energy deficit of 500 to 750 calories daily.

While both protocols led to reductions in waist circumference, hip circumference, body fat mass, and more, individuals in the slow weight-loss group experienced more significant reductions to waist circumference, hip circumference, fat mass, and percentage of body fat, all of which are linked to improved health.

2. Engage in Regular Cardio and Strength Training Exercise

Adding exercise to your gradual weight-loss plan also increases the odds that your skin will be able to tighten up as your weight decreases.

Both strength training and cardio make important contributions. Cardio, or aerobic exercise, can be a highly effective way to burn calories, which will help you move toward your weight-loss goal. However, if you exclusively engage in cardio training, you may lose lean muscle mass also with fat, which can increase the appearance of saggy skin as well as adversely impact your metabolism.

Strength training, however, can help you build muscle, which in turn raises your metabolic rate. One of the factors that determines your basal metabolic rate (BMR), which accounts for the vast majority of the calories you burn each day, is the amount of lean muscle you have. Muscle tissue has higher energy (calorie) demands than fat while at rest, meaning that even when you’re not working out, having more muscles translates to a greater caloric expenditure. No matter what you weigh, the more muscle and the less fat you have, the higher your BMR.

“If you have more muscle, it burns fuel more rapidly,” stated Columbia University professor Michael Rosenbaum, who specializes in weight loss and metabolism. Rosenbaum cautions, though, that if you do succeed in speeding up your metabolism, “you have to fight the natural tendency to [want to] eat more as a result of your higher metabolism.”

Still, when taking the long view of your overall health, there are clearly more benefits to physical activity than drawbacks, including the fact that weight lifting and resistance training can minimize the appearance of existing loose skin by building muscles that will fill it out. If your goal is to look lean and toned rather than built and bulky, don’t worry, you won’t accidentally develop the physique of a bodybuilder—that requires a high level of intention and commitment.

3. Optimize Your Diet

In order to lose weight and ensure you don’t subsequently gain weight, it’s important to build a diet based on whole, minimally processed foods.

A 2017 clinical trial called the DIETFITS study (the acronym stands for “Diet intervention examining the factors interacting with treatment success) set out to identify factors that predispose individuals to experience greater success when following certain weight-loss diets so that experts can more effectively match patients with dietary interventions.

Interestingly, participants in both the low-fat and low-carbohydrate groups lost comparable amounts of weight. This drew attention among health practitioners reviewing the results to the elements that remained consistent between the two diets.

Both groups were encouraged to:

  • Focus on unprocessed, high-quality foods
  • Eat as many vegetables as possible
  • Prepare meals at home
  • Restrict or eliminate trans fats, added sugars, and refined carbohydrates, including flour

Participants also had regular sessions with dietitians and access to counseling to help them break emotional eating patterns.

The findings are quite encouraging. You don’t need to follow a complicated or overly restrictive diet in order to lose weight. Instead, you can use the principles described above, which leave plenty of room for shaping a diet that accounts for your personal preferences and lifestyle.

4. Stop Smoking

Research unequivocally shows that skin damage is among the many adverse effects of cigarette smoking. In fact, even secondhand smoke exposure has been shown to decrease collagen levels, increase inflammation, and fuel oxidative damage.

A study published in Biochemical and Biophysical Research Communications found that when rats were exposed to cigarette smoke, collagen levels in their skin decreased significantly compared to control rats. The authors concluded that long-term secondhand smoke exposure would likely “affect the appearance of the skin [and] accelerate the skin aging process.”

If you’re serious about maximizing the elasticity of your skin, which you will need to do in order to prevent it from becoming loose or saggy, the decision is clear: stop smoking.

5. Try Firming Creams

If you have room in your budget and are looking for a way to immediately tighten loose skin, you may want to try firming creams.

The results of these products tend to be rather subtle, and most impactful when skin is also in need of hydration. These products often use retinoids or collagen as their active ingredient.

One of the ways retinoids work is by preventing free radical damage that negatively impacts skin tone. They can also speed up collagen production, which can boost the elasticity of the skin.

As you know, collagen is one of the key proteins that keeps your skin tight and firm. There’s some evidence that the topical application of collagen can temporarily improve the appearance of the skin, but collagen molecules are too large to be absorbed through the skin so the results will not be lasting.

A popular natural treatment, grapeseed oil, does have some scientific backing. A study published in Pharmacognosy Magazine looked at a number of herbal ingredients touted for their ability to increase skin’s elasticity and found that grapeseed did produce measurable changes to moisture levels, softness, and tightness.

6. Supplement Strategically

As wonderful as it would be if scientists could formulate a magic pill, or combination of supplements, that completely prevents or treats loose skin, that’s yet to be announced. In the meantime, an optimal supply of the following nutrients will ensure your skin has all the raw materials it needs to be maximally healthy.

While you might assume that collagen supplements would be on this list, it tends to be more effective to consume supplements that increase collagen production, such as vitamin C and certain amino acids.

Vitamin C

Scientists have confirmed that vitamin C has impressive abilities when it comes to stimulating collagen production.

A 2018 systematic review examined the efficacy of vitamin C supplementation as a means of promoting collagen synthesis, and found that not only did vitamin C increase collagen synthesis, but it also reduced oxidative stress. The authors also found no evidence of adverse side effects.

Furthermore, an article published in Nutrients in 2017 specifically touched on the impact of dietary vitamin C intake on skin sagging related to weight loss. According to the article, a higher intake of vitamin C can be linked to improved skin tightness.

Glycine

Collagen, one of the most abundant proteins not only in the skin, but also throughout the entire human body, contains between 2 and 10 amino acids. Glycine might be the most impactful of those. This simple, naturally occurring amino acid elevates collagen production, facilitates skin regeneration, and increases moisture retention.

Though your body produces its own glycine from other amino acids, it can be beneficial to increase your glycine intake, either by eating glycine-rich foods like red meat, poultry, fish, dairy products, and legumes or by taking a high-quality amino acid supplement.

Lysine

This essential amino acid plays a vital role in the function of your skin, ensuring that its supportive structures remain strong and intact. Our bodies also need lysine for collagen development, tissue repair, and other important physiological processes.

Good food sources of lysine include:

  • Meat
  • Poultry
  • Fish (especially cod and sardines)
  • Cheese (especially Parmesan)
  • Soy products
  • Spirulina
  • Fenugreek
  • Legumes
  • Nuts

6 Science-Backed Methods for Avoiding Loose Skin After Weight Loss

Losing a significant amount of weight, particularly if you do so after weight-loss surgery, or using another method to lose a lot of weight in a short period of time often causes loose skin to develop. Embracing this physical change is a viable and commendable option, but it’s equally valid to seek out ways to avoid loose skin after weight loss or to encourage skin to tighten.

There’s no one single skin tightening technique that can fully restore skin elasticity for each and every person; however, scientific findings indicate that using one or more of the methods described above will likely prevent or reduce the appearance of loose skin.

Trigger Point Injections: What They Are, When They’re Needed and How They’re Performed

Find out how trigger point injections work, what the procedure entails, and what the post-procedural care requires. This treatment option for myofascial pain syndrome could help restore your quality of life.

Trigger point injections are designed as pain management for myofascial pain syndrome.  We’re helping you decide if trigger point injections are right for you by providing an in-depth definition of the procedure, when it’s medically justified, how it’s done, and what the potential side effects may be.

What Is a Trigger Point Injection?

Trigger point injections are intended to provide pain relief by inactivating (basically stunning or inhibiting) certain trigger points involved in the symptoms of myofascial pain syndrome. To do this, a health care professional inserts a small needle containing a local anesthetic or saline, and possibly a corticosteroid, into the trigger point causing the muscle pain in order to subdue it.

What Is Myofascial Pain Syndrome?

Myofascial pain syndrome is a muscle disorder that causes pain around what’s known as myofascial trigger points. It’s a distinct syndrome from fibromyalgia, which also causes tender points throughout the body, though both of these conditions could occur in the same patient at the same time, making each of them more difficult to diagnose and treat.

Myofascial trigger points are hyperirritable spots that create musculoskeletal pain. They may have palpable nodules that exist in taut bands of muscular fibers, and they are still not widely understood even in the medical community. Treatment of these trigger points can involve ultrasound therapy, manipulative therapy, spray and stretch therapy using a topical anesthetic, or trigger point injections.

Trigger point injections are not required for every case or even every trigger point, especially if noninvasive physical therapy is effective. However, if a trigger point experiences chronic pain in certain areas like the lower back, a small needle injection may be the most effective treatment. The injection may be a corticosteroid, an anesthetic like lidocaine or bupivacaine, or a mixture of both.

Indications for Trigger Point Injections

Trigger point injections are indicated for those patients who have health care findings consistent with active trigger points (distinct from latent trigger points that don’t need treatment as they are asymptomatic). Other widespread pain disorders such as endocrine disorder or fibromyalgia are not eligible for trigger point injections unless they have myofascial pain trigger points also.

Seek medical advice to decide if injecting these points of muscle spasm is the safest way to treat painful areas, including the trapezius muscle (upper back and neck pain), the erector spinae muscles (along the spinal cord), the iliocostalis muscle (low back pain), and other areas of muscle which, if afflicted, can cause referred pain (pain felt in other areas that are not the origin spot), tension headaches, and a decline in quality of life.

Your doctor will examine your skeletal muscles for a local twitch response (a contraction or dimpling of the skin as muscle fibers tense), take into account your pain level and “jump response” to the exam, and discuss your various treatment options.

Contraindications for Trigger Point Injections

Trigger point injections have contraindications for:

  • Those with bleeding disorders or those on anticoagulants
  • Pregnant patients
  • Patients who are ill or who have conflicting medical conditions
  • Those with a higher risk of infection (such as those with diabetes mellitus or who are debilitated)
  • Patients on steroids

While a steroid injection can act as a nerve block, there have nevertheless been studies that show dry needling (needling without injection, akin to acupuncture for musculoskeletal disorders) may provide some relief, though a scientific consensus has not yet been reached. Researchers also warn against “sham needling” practices that are not done by properly trained medical personnel.

Trigger Point Injection Procedures: What to Expect

Here’s what you can expect at a trigger point injection procedure.

  • The needles involved will be long enough to reach the deepest muscles requiring treatment.
  • The area will be sterilized before injection.
  • Your health care provider will prepare the injection with local anesthetics and/or steroids.
  • The doctor will position you for best access to the affected muscle groups, and may also use ultrasound guidance to precisely pinpoint the injection.
  • Your clinician will isolate the trigger point area by pinching the skin between their fingers to keep it in place during the injections (the needling and injecting will be repeatedly redirected without removing the needle from the subcutaneous level of the skin).
  • This treatment of trigger points will include post-procedural care on your part: resting for 1-2 days and avoiding strenuous activity and pain-provoking activities that could overstress the muscles.

Your doctor will make sure you’re aware of potential complications resulting from trigger point injections, which could include vasovagal syncope (sudden fainting), hematoma formation, skin infection, pneumothorax (a collapsed lung), or needle breakage.

Trigger point injections: how they work.

Post-procedural Care

To ensure the best success with trigger point injections, post-procedural care may include the following.

Proper Stretching

While it’s important not to overstress the muscle, it is still recommended that you use your muscles to their full range of motion to help relieve stiffness and reclaim normal muscle functioning. To help your muscles relax and optimize the effects of the injections, stretching after your trigger point injections is an integral post-procedure component.  Your doctor will most likely stretch you as soon as the procedure is complete, and then send you home with instructions to continue proper stretching on your own.

Active Exercise

The whole purpose of undergoing trigger point injections is to restore full use of your muscles, and active exercise will help determine whether or not the treatment was effective. These exercises will target muscle stretching, muscle strengthening, and muscle conditioning to help relieve myofascial pain. Staying active with exercise will also help reduce the chances of developing more trigger points in your muscle fibers as you increase your muscle endurance.

Once you’ve built up enough strength via training, conditioning exercises like jogging, jumping rope, tennis, swimming, and/or bicycling are encouraged at least twice a week going forward.

Don’t Be Triggered

Alleviating neck, back, and shoulder pain are major aspects of physical medicine, and getting expert help with treating myofascial pain syndrome can help improve your quality of life while living with this musculoskeletal disorder. Trigger point injections are the last hope for pain relief for many, and they may finally bring you the treatment you need.

Pain Behind Knee When Walking: Top 10 Possible Underlying Causes

Pain behind your knee could be due to an injury or to dangerous medical conditions that need immediate attention. Find out what the symptoms you’re experiencing could mean.

Pain is how your body communicates with you. A pain in your head might mean you’re dehydrated, pain when touching a hot stove lets you know that’s a bad idea, and pain in your joints could be an indication of injury or arthritis. But what does pain behind your knee when walking mean? This article details potential conditions that could be causing this leg pain so you can address the issue before it becomes chronic and debilitating.

Understanding the Knee

Severe pain behind your knee when walking is not uncommon. Known as posterior knee pain, aches around the knee are a common complaint fielded by doctors.

One of the biggest joints in your body, the knee joint is also one of the most complex and load-bearing joints, tasked with keeping the body upright as you stand and walk.

Your knee is vulnerable to many types of abuse, from arthritis to injury in any one of its many moving parts—the kneecap (patella), the thigh bone (femur), the shin bone (tibia), and the various muscles, tendons, cartilage, and ligaments that come together at the knee joint. Damage anywhere could spread or worsen, which is why knee pain needs to be identified and addressed as soon as possible to avoid any interruption to your mobility.

Let’s first explore what the pain behind your knee could mean, and then figure out how to remedy it.

Pain behind the knee when walking: possible causes.

Top 10 Possible Causes of Pain Behind the Knee When Walking

Pain behind your knee could be accompanied by swelling, visible lumpiness, or a locking sensation. Any accompanying symptom could help you determine the cause of this pain, so investigate your knee thoroughly, or better yet seek an examination from a medical professional, because some of the issues that may be causing your knee pain are quite serious. Let’s take a look at the most common causes of posterior knee pain.

1. Leg Cramp

You may well know the pain caused by a charley horse in your calf, but your other leg muscles can also experience cramps, including those on the back of the thigh. Cramps occur when your muscles tighten independently of your control, and can be caused by nutrient deficiency, dehydration, nerve problems, toxicity, or liver disease. Many women experience leg cramps during pregnancy, and even more people cramp up during exercise.

Muscle spasms usually don’t last very long, but the pain they cause can linger for hours or sometimes days. If you suspect a cramp is behind your leg pain, warm or massage the area to help it heal, but be sure to monitor it: if the pain doesn’t lessen and ultimately subside soon, consult a trusted health care professional.

2. Baker’s Cyst

A baker’s cyst, otherwise known as a popliteal cyst, is a fluid-filled pocket under the skin behind the knee. The fluid in this cyst is synovial fluid, which exists to help lubricate your joints and keep them working smoothly. However, too much synovial fluid in the area could build up into a cyst.

Symptoms of a baker’s cyst (along with pain) are palpable swelling, stiffness, or trouble flexing the joint. If the cyst bursts you’ll notice a very sharp pain in the area, which is why it’s recommended you seek professional assistance in identifying and draining the cyst before that occurs.

3. Jumper’s Knee

Jumper’s knee is the common name for patellar tendonitis, aka tendonitis of the knee. The tendon that connects your kneecap to your shin bone is susceptible to knee injuries from jumping, and is often treated in sports medicine, as it’s very likely to occur in those who play basketball, volleyball, and other sports that involve jumping.

Other symptoms of jumper’s knee besides pain below your kneecap could be stiffness, weakness in the joint, or difficulty straightening or bending the knee. Proper rest may be all that is required to heal this injury, but if it persists, you may want to consult a doctor to rule out other contributing factors.

4. Calf Strain

Calf strain, or gastrocnemius tendonitis, is tendonitis that affects the gastrocnemius (calf) muscle, which is, obviously, located at the back of the lower leg. Sports like squash or tennis that involve quickly switching from standing to running can cause calf strain, and the pain of this injury may be accompanied by visible calf bruising, swelling, or trouble standing up on your tiptoes depending on the severity. Use the RICE technique (rest, ice, compress, elevate) to help this injury heal as quickly as possible.

5. Arthritis

Arthritis is a degenerative joint disease that involves a gradual wearing away of the cartilage that cushions the bones of your leg. Without cartilage, the bones start to grind against each other, causing long-lasting damage and pain. Cartilage cannot regenerate, so medical assistance is required to prevent a worsening of the condition.

Different types of arthritis that could afflict the knee joint include autoimmune diseases such as rheumatoid arthritis, lupus, psoriatic arthritis (which also comes with scaly skin patches), and osteoarthritis. Treatment options include steroid injections, specific exercises, drugs targeting the immune system, or surgery. Seek medical advice to learn which is most appropriate for your circumstances.

6. Runner’s Knee

Runner’s knee, also called chondromalacia, is another joint pain issue involving cartilage breakdown, and can come about as a result of injury, overuse, arthritis, or aging. Pain behind the knee when walking occurs when your leg bones rub together without the protective divide of cartilage between them. The pain may manifest as a dull ache, and it may also worsen when climbing stairs. You may notice a grinding sensation when you walk as well.

7. Meniscus Tear

A meniscus tear is an injury to one of the two menisci that each knee has. A meniscus tear can happen suddenly, or gradually develop as the meniscus starts to wear down. Athletes often injure their menisci, and you may notice a popping sound or sensation at the moment of injury, followed by pain, swelling, weakness, stiffness, or a giving or locking feeling in the joint.

8. Deep Vein Thrombosis 

Deep vein thrombosis (DVT) is a blood clot in the leg that causes pain, particularly when you stand up. DVT is incredibly dangerous, as a “thrown” clot that breaks off and travels through the body could result in a pulmonary embolism and possible death.

Other symptoms of a blood clot include leg swelling, a warming sensation in the area, and reddened skin. Seek medical advice as soon as possible if you suspect deep vein thrombosis.

9. Hamstring Injuries

Hamstring tendonitis and hamstring sprain are two injuries that could affect one of the three hamstring muscles located at the back of your thigh (the biceps femoris muscle, semitendinosus muscle, and semimembranosus muscle). These muscles allow your knees to bend, and an injury there could manifest as pain at the back of the knee. It may also involve swelling, bruising, or noticeable weakness at the back of the leg. Hamstring injuries are common among athletes who compete in fast sports like track, tennis, basketball, and soccer.

10. Ligament Injury

The knee ligaments that attach your thigh bone to your shin bone include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL). PCL injuries are most often caused by car accidents, and ACL injuries are the most common overall as it is the ligament that crosses diagonally through the knees and keeps your shin bones from sliding up in front of your thigh bones. A ligament tear could cause knee-area pain when walking and may require surgery to repair.

Knee Pain Diagnosis

It is important to seek medical attention for many of these conditions. A doctor may utilize X-rays or an MRI to assess whether your pain is due to bone or soft tissue injury, and may also recommend treatment options spanning from over-the-counter nonsteroidal anti-inflammatory drugs (like ibuprofen) to surgery and physical therapy. Take care of your joints with natural joint health supplements, and be sure to help them heal when they’re injured, because an untreated joint injury could permanently limit your range of motion and disrupt the enjoyment of your life.

Thumb Knuckle Pain: The Top 6 Possible Causes

Thumb knuckle pain: what does it mean when you have unexplained pain in your thumb pad, lower joint, or knuckle? Find out what could be the underlying cause and how to get relief. 

If you have persistent pain at the base of the thumb, right at the knuckle joint, or in your thumb pad, you might be worried about what it could mean. Did you sprain your thumb, somehow sleep on it wrong, or could it be a sign of rheumatoid arthritis? This article reviews a few thumb knuckle pain culprits, and what you can do to help treat the cause of this discomfort.

Joint Pain Overview

If you’re young and experiencing joint pain, you may not immediately jump to the conclusion that it could be arthritis or some other serious joint-affecting condition like degenerative joint disease or gout. However, data shows that these conditions, though statistically more likely to develop with age, can afflict people as young as 40 (arthritis) or 30 (gout). In all honesty, our bodies start declining in little ways after the age of 25, and after that it’s just the luck of the draw on the genetic lottery sometimes, especially with autoimmune conditions like rheumatoid arthritis.

If you’re experiencing unexplained tenderness anywhere from the base of the thumb to thumb middle joint pain, discomfort so palpable that it’s interfering with your thumb’s range of motion, then it could be the sign of a serious condition, regardless of your age.

Thumb knuckle pain: top 6 possible causes.

Thumb Knuckle Pain: The Top 6 Possible Causes

Our thumb joints are one of the evolutionary wonders that differentiate us from our ape ancestors, and thumb knuckle pain can throttle your fine motor skills.

If you can’t think of any reason why your thumb knuckle is in pain—something as innocent as maybe you spent some time cracking walnuts or you’ve gotten a new keyboard and it could be a mild case of wrist tendinitis—then you could be worrying about one of the following underlying conditions.

1. Basal Joint Arthritis or Osteoarthritis

Basal joint arthritis could be causing your joint pain. The basal joint lies at the base of your thumb, just above the wrist. A wearing away of the cartilage in this joint is commonly called “thumb arthritis,” and comes not only with pain but also the loss of thumb mobility and the possible loss of thumb grip strength.

Our joint cartilage provides a cushion at the spot where two bones would otherwise meet and grind together. Cartilage cannot heal on its own, because, unlike other forms of tissue in the body, it has no blood supply to provide a healing pathway. Becoming aware of cartilage damage as soon as possible is important so you can ask your doctor how to prevent further breakdown.

Cartilage breakdown in the joints is also known as osteoarthritis, and it’s the most common form of arthritis worldwide.

2. Rheumatoid Arthritis

Thumb arthritis could also be caused by rheumatoid arthritis in the thumb. Rheumatoid arthritis is a chronic inflammatory autoimmune disorder that can affect many of your joints. Rheumatoid pain in your thumb joint might be experienced as a stabbing, burning, or milder creaking pain.

3. Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by a pinched or compressed median nerve in the “tunnel” it travels through your wrist. This could cause tingling, burning, numbness, or weakness in your finger joints, thumb joints, or wrists. A common condition in the United States, carpal tunnel affects up to 6% of adults, though it’s more likely to occur in women rather than men.

Long-term repetitive movements of the hand are risk factors for developing carpal tunnel. Imagine the repetitive work of jobs like stenographer, cashier, assembly line worker, musician, or hair stylist.

4. Sprain, Injury, or Break

A sprained, jammed, or even broken thumb could cause pain in the area. Jammed thumbs are commonly referred to as “skier’s thumb.” If you suspect an injury as serious as a thumb break, you should seek medical advice immediately to have it evaluated and properly set for healing.

5. De Quervain’s Tenosynovitis and Trigger Finger/Thumb

De Quervain’s tenosynovitis is a tendinitis condition that involves inflammation on the thumb side of your wrist. It’s often called “gamer’s thumb” in the modern world, as it can develop due to repetitive video game playing and the grip held on the controller.

Likewise trigger finger is the lay term for stenosing tenosynovitis, which is typified by a locking or catching sensation when you bend or straighten one of the digits on your hand. It most commonly affects the ring finger and the thumb, but it can impact any of the other fingers as well.

6. Gout

Though most people think of gout affecting the big toe joint, it can cause pain in any joint, including the knees, elbow, ankles, wrists, and fingers. Gout causes a buildup of uric acid crystals in these joints, which then leads to pain, swelling, and inflammation not unlike a feeling that the joint is on fire.

Thumb Knuckle Pain Treatment

Depending on the cause of your pain, treatment may involve little more than RICE (rest, ice, compression, elevation) if it’s due to an injury, or it may involve long-term care if it’s due to a chronic condition. A doctor may order X-rays or MRIs to assess the cause of this pain, and present you with treatment options, which may include:

  • Home remediesOver-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) like Tylenol or Advil, natural supplements and vitamins for joint pain, and devices like splints or ACE wrap bandages.
  • Medical treatments: Steroid injections, prescriptions for pain relief, physical therapy, or possible surgery may be appropriate for your situation. Your physician will review the pros and cons of each.

Thumb knuckle pain: top 6 possible causes.

Knuckle Down

There are many different causes that may be behind your thumb knuckle pain, anything from arthritis of the thumb to an injury that just needs time to heal.

If you’re experiencing persistent pain in your thumb pad, thumb joint, or thumb knuckle, don’t simply rely on anti-inflammatory medications to wait it out—chronic pain means there’s an underlying cause, and getting professional medical treatment sooner rather than later could make a massive difference when it comes to treatment, thumb mobility, and getting back to your daily activities.

Tendonitis Foot Pain: Causes, Symptoms and Solutions

Pain in your foot could be due to any number of tendonitis issues: find out the locations of the main tendons in your foot, the common causes of tendon inflammation, and how best to treat these injuries.

Tendonitis, or tendinitis, of the foot can occur in several areas of your foot, heel, and ankle. Tendonitis foot pain can severely hamper your daily activities, starting first thing in the morning (when it’s at its most painful), and then clear into the evening. Not only does tendonitis foot pain turn every step you make into a chore, it can also lead to decreased physical activity, and even back and neck problems if you develop a limp to ease the pain. This article has information on the causes, symptoms, and treatment options for different types of foot tendonitis so you can hopefully address the condition before it becomes chronic.

What Is Tendonitis?

The “-itis” in tendonitis refers to inflammation, and it can afflict just about any tendon in your body, from those in your shoulders, your elbows (familiar with tennis elbow?), your wrists, your knees (how about jumper’s knee?), and, of course, your feet. Tendonitis of the foot can be tricky to deal with because many of us need to be on our feet for hours each day. Plus, our feet are as complex as our hands are when it comes to the vast number of small bones and moving parts.

Each of our feet have 33 joints, 26 different bones, and over 100 tendons, ligaments, and muscles. Just one connector out of sync and it’s like a rope has snapped in the rigging of a massive sailing ship: it could be an easy fix or it could be the first domino to fall in a series of ever-greater catastrophes. Tendons are the cords that attach muscle to bone, and while they are encased in lubricating sheaths to help protect them from friction and injury, one misstep or ankle injury could cause compounding pain and inflammation unless it’s treated quickly and correctly.

Read on to discover the common causes and symptoms of tendon injury to help identify the problem as soon as possible.

Tendonitis foot pain: causes, symptoms, and solutions.

What’s Causing Tendonitis Foot Pain?

Our tendons are built tough, especially the ones in our feet. While the tendons in our wrists and hands can be injured easily due to the delicate fine motor skills they’re meant to conduct, our feet bear the full weight of our bodies every day: walking, running, extending, climbing, and jumping when needed. However, even these strong bands have limits as to how far they can stretch.

When a tendon is repeatedly stressed or injured, small tears develop along its length, causing the body to respond at first with healthy inflammation, which may then lead to painful, chronic inflammation. Common causes of tendonitis of the foot include overuse, having high arches or flat feet, and sports-related or accidental injuries, but determining which tendon has been afflicted is the first step in discovering the cause and the solution.

Let’s highlight the main tendons in the foot, so you can better determine the location of your tendonitis foot pain as well as the causes, symptoms, and suggested treatments.

Ankle and Achilles Pain

The Achilles tendon is the thick band that attaches the back of the heels to the calf muscles.

Causes

Achilles tendonitis is often due to an injury from sports like soccer, but can also be caused by:

  • Tight calf muscles
  • Heel spurs or plantar fasciitis (a condition affecting the ligament in the foot’s arch)
  • Sporting or accidental injury
  • Overuse without enough recovery time

Symptoms

Symptoms of Achilles tendonitis may include:

  • Achilles pain
  • Stiffness of motion
  • Swelling at the heel bone or ankle
  • Difficulty walking in the morning or after long periods of rest

Treatment for a one-time injury may require no more than rest, ice, and over-the-counter anti-inflammatory drugs like acetaminophen (Tylenol) or ibuprofen (Advil). However, for athletes or those suffering serious injuries, it’s recommended that you consult a health care professional to determine whether physical therapy or orthotic shoe support is appropriate. For those with an underlying anatomy problem like flat feet (overpronation), orthotic support will help remove strain from the area and may help drastically prevent future injury.

Inner Ankle Pain

Your posterior tibial tendon is on the inside of your leg near your inner ankle bone, and it attaches your calf muscle to the inside of your foot, holding up the arch as you walk.

Causes

Causes of injury to this tendon often come from:

  • High-impact sports movements (jumping and landing in basketball, soccer, tennis, etc.)
  • Obesity or being overweight
  • Wear and tear due to aging
  • Overpronated or flat feet

Symptoms

Pain in this tendon will have symptoms like:

  • Swelling of the inner side of the foot
  • Pain on the inner side of the foot
  • Radiating pain throughout the foot if the foot collapses

Once more, the standard treatment is rest, ice, and possibly anti-inflammatory medications, but if this is a chronic problem due to the shape of your foot, your gait, or a sporting activity you regularly take part in, consult a doctor or physical therapist for advice on orthotic support or perhaps cortisone steroid injections to the area.

Outer Foot and Ankle Pain

There are two peroneal tendons in each foot. One runs from the lower leg bone (the fibula, next to the shin bone) and wraps around the outer ankle bone to where it attaches to the little toe. The other runs underneath the foot, attaching to the inside arch. They help stabilize our ankles and our arches while walking.

Causes

Peroneal tendonitis could be caused by:

  • Repeated ankle sprains
  • Unsupportive footwear
  • Overuse or overtraining injury
  • Having high arches
  • Having muscle imbalances

Symptoms

Common symptoms of injury include:

  • Pain when pushing off the foot
  • Pain when turning the foot in and/or out
  • Pain and/or swelling at the back of the ankle
  • Ankle instability
  • The area feels warm to the touch

Treatment is the same: rest, ice, elevation, anti-inflammatory drugs or natural supplements, orthotics, and certain stretches meant to help loosen and strengthen the calf muscles and ankle stability. Seek medical advice from a physical therapist or health professional to learn proper stretching techniques for your specific tendonitis foot pain.

Top of the Foot Pain

Extensor tendons are in both our hands and our feet. In our hands they’re the ones on top that help to move our fingers, wrists, and thumbs, and in our feet they connect between the muscles at the front of our legs to our toes. They’re very close to the surface of the skin (you can feel them shift if you wiggle your toes), and thus are all the more vulnerable to injury.

Causes

Extensor tendonitis can be caused by:

  • Too-tight footwear
  • Being on your feet for extended periods of time (fast food workers, nurses, warehouse workers, etc.)
  • Walking or running on uneven surfaces
  • Tight calf muscles

Symptoms

Symptoms of extensor tendonitis may include:

  • Pain on the top of the foot
  • Swelling, bruising, tenderness on the top of the foot
  • Pain that worsens with activity and feels better when at rest

Treatment can involve rest, ice, and pain meds, but it also could be as simple a solution as changing the way you lace your shoes: if too much compression on these tendons is causing your foot pain, lacing shoes loosely, knotting the laces to the side instead of on top, or choosing a new style of footwear could alleviate the pain.

Big Toe Foot Pain

The flexor tendon runs from the lower leg, travels along the inside of the ankle, and attaches to the big toe.

Causes

The causes of flexor tendonitis may be:

  • Overuse of the big toe
  • Injury of the big toe
  • Improper footwear
  • Proper ballet dancing or other flawed forms of dance or sport

Symptoms

Symptoms of this tendonitis may include:

  • Pain deep within the inside back of the ankle
  • Pain in the foot’s arch (distinct from plantar fasciitis)
  • Pain when bending the big toe or on the outer side of the big toe
  • Tenderness anywhere along the course of the tendon

Treatment includes rest, ice, possible pain medications, stretching or massage, physical therapy, and (for dancers especially) taping up the foot to help protect the form and stability of the arch.

Don’t Foot the Bill for Tendonitis

Tendonitis foot pain is well known in sports medicine due to the extra strain put on feet during rapid or prolonged physical activity, but it can affect anyone. Tendonitis symptoms should be well-heeded, as taking care of these twinges and inflammatory reactions early can mean saving yourself from months or years of chronic pain.

Long-term foot pain can derail your exercise regimen and limit your range of motion, so it’s important to seek medical advice or to get a physical exam as soon as possible to rule out underlying medical conditions. The sooner you get the support you need, the more likely you’ll be able to relieve your pain through simple, nonsurgical treatment.

Building Muscle After 50: Top 7 Tips to Go from Sedentary to Stacked

Discover how to build muscle and maintain strength after turning 50: types of workouts, frequency of workouts, and how to supplement effectively now that you’re half a century strong.

One of the biggest concerns that face us as we age is muscle loss. Age-related muscle loss begins in our 30s and ramps up after 50. In advanced years that muscle loss can ultimately contribute to frailty if it’s not combated with proactive muscle building along the way. While those who have kept up with physical activity throughout their 20s and 30s have a much better foundation to build on, it’s never too late to begin weight training or resistance training, gaining muscles that get stronger the more they’re used. Because of these reasons, building muscle after 50 is necessary to keep you healthy and active for the rest of your life.

Sarcopenia: The Silent Breakdown

Age-related muscle loss is known as sarcopenia, and it’s one of the reasons that some of our grandparents lose their independence. The muscle loss that begins in our 30s and doubles down in our 50s gets even more aggressive after 70, but it’s not necessarily a downward slope. Studies show that we can gain muscle clear into our 90s, so not only is building muscle after 50 in the cards, but building muscle after retirement is a go as well. So what’s the holdup?

The issue is aging, and the fact that while we’re young we often don’t have to work as hard to stay fit and recover quickly. Side effects of aging come on gradually, and muscle-building efforts need to increase along with it. Maintenance just won’t cut it: to build muscle we have to challenge ourselves to workouts that are hard to perform at first, and when that level is mastered, we have to go harder.

Octogenarian bodybuilder Ernestine Shepherd was interviewed by The Independent, and revealed that she didn’t start her targeted muscle-building efforts until she was 56 years old, and this was after a lifetime of no exercise and even being exempt from phys. ed. in school because of car accident injury she’d had as a child. Nevertheless Ernestine says that she went from being a receptionist (a sedentary job) to a professional bodybuilder, in better shape and with more energy in every new year. In 2010 she was declared the oldest competitive female bodybuilder by the Guinness Book of World Records.

If, like Ernestine you’re starting from scratch after 50, how do you begin? Read on for some starter tips.

Top tips for building muscle after 50.

The Top 7 Tips to Begin Building Muscle After 50

When a young man or woman decides to build muscle, it often takes no more effort than just trying. Some weight lifting, some cardio, and before these youngsters know it they’ve got muscle groups popping up in places they didn’t even know they had. But for older adults, building muscles is not just about losing weight and looking good, muscle gain starts to become vitally important to staying healthy and independent as we approach our 60s, 70s, 80s, and 90s.

As you age, not only do your joints creak and your hairs turn gray, but your muscle cells start to get eaten up and then not replaced. The younger we are, the more quickly the metabolic process revolves between catabolism (metabolism involving molecular breakdown to access energy) and anabolism (the metabolism of building new complex molecules like muscle proteins with that energy). When we get older, that process—along with so many others—slows down.

Reaching 50 is ideally the halfway point of a long and healthy life, and maintaining muscle strength is important if we want another strong 50 years on this earth. So without further ado, here are seven ways you can optimize your protein intake and start building muscle after 50.

1. Come to the Light

If you want to safely begin to build muscle after years of a largely sedentary lifestyle, you don’t want to head straight to the bench press. It’s not fun but it’s true: a twinge or a tweak to any one of your joints in these early days could snowball into a very severe injury if you’re not careful, derailing your efforts before you even really get going. You’ll get to the deadlifts and barbells soon enough after you’ve built up sufficient strength, but when starting out, start light.

Embracing lighter free weights can spur muscle growth without putting your wrist, elbow, and shoulder joints in any risk whatsoever. Studies show that more reps with lighter weights can stimulate protein synthesis just as well as lower amounts of reps with heavier weights. Lighter-weight training not only helps prevent initial injuries, but it also serves as a useful tool for repairing injuries. Similarly, higher reps with lighter weights leads to real muscle gain in older adults, so the only thing you’re losing out on is risk, not reward.

Once you build up a foundation of muscle, you and your joints will be strong enough to load up a barbell with ever-increasing weights, but as you begin, light is alright. Play to your strengths when it comes to strength training, and you’ll invariably improve as you age.

2. Stay on the Move

A sedentary lifestyle is dangerous to people at any age, but the damage done by inactivity compounds as we get older. To gain muscle, you have to not only incorporate a strength training program but also keep up with cardiovascular health. If your blood isn’t pumping well, you’re not getting the steady supply of oxygen and nutrients needed to build new protein for your muscles.

The cardio impact of walking and running changes in older adults, as seen in this 2010 study comparing younger (24 +/- 3 years) and older (64 +/- 6 years) participant groups. If you’re starting from scratch, begin with walking, increase to jogging and then treat yourself to new pair of running shoes, and know that you’re contributing to your muscle-building efforts with every new mile you cover.

3. HIIT Back

High-intensity interval training (HIIT) is a great way to burn calories and build muscle quickly for all ages and fitness levels. HIIT is characterized by alternating short bursts of intense physical activity with periods of rest, and according to the Mayo Clinic, it can particularly benefit seniors down to the cellular level, and even reverse certain symptoms of aging.

While experts don’t recommend that every workout be a HIIT workout, cycling it into your workout regimen can help push your abilities to higher heights. And if you’re in a HIIT class full of athletes, just remember that your high intensity is different from their high intensity, and that’s a-okay!

4. Rest to Recover and Rebuild

Regular exercise doesn’t mean constant exercise, and in fact research shows that rest days are just as valuable for muscle building as workout days are. Recovery time means rebuilding time for your muscles, while overtraining syndrome occurs when excessive exercise is paired with an inadequate amount of resting time. The results of overtraining come with side effects that disturb the body’s neurologic, endocrinologic, and immunologic processes, along with the unwelcome symptom of mood changes.

Your recovery times over 50 may be longer than they would be if you started working out in your 20s or 30s, but you’ll know your body best: rest as long as you need, and then get back at it with the gains you’ve made.

5. Stretch It Out

If your muscles are tight, it’s imperative that you stretch them. Stretching before (particularly dynamic stretches) and after your workout helps to limber up the muscle fibers and reduce the risk of muscle strains and sprains, whether you’re working out on your own or under the guidance of a personal trainer.

A full-body workout is not complete without stretching, so be sure to pencil it in, as increased flexibility can help you avoid injury and perform better in your workouts.

6. Good Things Come in Threes

Have you heard of the rule of thirds? It’s a photography guideline for visually pleasing picture compositions. Do you know what “omne trium perfectum” means? It’s Latin for “everything that comes in threes is perfect.” Those rules apply to your strength-training workout frequency too: 3 days a week is a perfect minimum.

While the more’s the better, especially if you’re diversifying your workouts (lift weights on one day, go for a run on the next, etc.), it’s nevertheless true that strength training at least 3 days a week can lead to good progression in muscle building and is a great place to start.

7. Feed Your Need

You cannot make muscles without protein. More specifically, you cannot synthesize new muscle protein without a proper amount of all nine essential amino acids. Most people looking to build muscle know that a high-protein diet and possibly consuming whey protein supplements will help them in gaining muscle, but just because you’re getting enough protein doesn’t necessarily mean you’re getting all the amino acids required to build lean muscle without your body cannibalizing the other muscle cells you have to supply the demand.

Research shows that consuming protein regularly throughout the day and especially after a workout helps stimulate muscle protein synthesis to its optimal degree in elderly people who are well advanced beyond age 50. To gain muscle while maintaining what you already have built, we recommend choosing a muscle-building protein supplement that has a full host of balanced amino acid content so you have all the ingredients you need to create new muscle.

You’ll Muscle Through

Building muscle mass is far from being a young person’s game: it’s everyone’s game to play and to win. While it’s important to start cautiously if you’ve never worked out before, it’s never too late to start building muscle, and the more you gain, the younger you’ll feel, as it’s been scientifically proven that proper fitness can reverse certain aspects of the aging process.

The health benefits of building muscle after 50 go far beyond improving your body weight and maintaining a trim physique. The strength-training efforts you start today can help you lose weight and, according to the American Bone Health organization, also help improve your bone density, which will matter more and more in the coming decades. Lifting weights or engaging in HIIT exercises 3 times a week could mean staying strong for the rest of your life.

The Balance Between Muscle Anabolism and Muscle Catabolism

Your muscle mass is dependent on the balance between anabolic and catabolic processes. Find out how they work together, and what nutrients will set you up for success.

The life cycle of a forest involves both creation and destruction. From the ashes of a forest fire come new blooms, just as decaying fallen trees enrich the soil for future growth. Your body operates the same way on a molecular level: your muscles break down and rebuild all the time. Both of these processes are forms of metabolism, genesis, and digestion. To find out the difference between muscle anabolism and muscle catabolism, read on for definitive answers and an explanation of how they work together to keep you strong.

Muscle anabolism vs. muscle catabolism in bodybuilding.

Metabolism Defined

Metabolism in the simplest terms is defined as the chemical processes that take place inside living organisms in order to maintain life. Included under this umbrella are the processes of anabolism and catabolism, one that builds up and one that breaks down. These chemical changes are happening in your body simultaneously all the time.

  • Anabolism: This form of metabolism involves the organization, building, and synthesizing of new complex molecules. During anabolism, smaller molecular compounds are linked together to form greater ones, as in the process of gluconeogenesis, which is the production of glucose derived from a non-carbohydrate source.
  • Catabolism: This is also known as “destructive metabolism,” the process by which molecules are broken down for use as energy, often leaving cell debris in its wake. An example of catabolism is glycolysis, the breakdown of glucose molecules in order to release their energy, a process that’s almost the direct inverse of gluconeogenesis.

Between these two undertakings is the process by which we burn fat (adipose tissue) for fuel, and then build muscle with that energy. Understanding this balance will help you better utilize muscle protein anabolism during exercise and throughout the day and night, because your metabolism doesn’t stop, even when you go to sleep.

The Balance Between Muscle Anabolism and Muscle Catabolism

Muscle catabolism is one of the dreaded concerns plaguing bodybuilders as they seek to bulk up their skeletal muscles (the muscles attached directly to our bones, as opposed to the muscles that pump our hearts and squeeze along our digestion). The goal in muscle building is to promote muscle protein synthesis and keep catabolism busy breaking down any other energy source that is not muscle: break down sugar for glucose energy, fat for ketone bodies, but please don’t run out and come for the muscles.

What follows are explanations of the key players in muscle anabolism and how best to keep your catabolic processes from cannibalizing the muscles you seek to build.

Hormones

Both anabolism and catabolism trade in hormones, though they each require different ones.

  • Anabolic hormones: The hormones estrogen, testosterone, insulin, and certain growth factors all play a role in building new molecular structures, including muscle proteins.
  • Catabolic hormones: In order to break down fuel sources, catabolism needs cortisol (the stress hormone), adrenaline, glucagon, and cytokines.

A disruption of your hormones could affect your muscle protein metabolism, particularly issues with the thyroid gland, as that is where our hormones are produced, stored, and dispatched to where they’re needed in the body.

Nutrition

Muscle anabolism and muscle catabolism cannot be reasoned with: one knows its job is to build, the other knows its job is to supply. If you’re hitting the gym hoping to build muscle, you need to be cognizant of your energy supplies to avoid a “one step forward, two steps back” conundrum between these two forms of metabolism.

For example, in 2010 researchers examined the anabolic-catabolic balance of male bodybuilders during competition training and found that the group who restricted their energy intake in an effort to burn body fat had a significant decrease in both their body fat and their muscle mass compared to the control group. The men exhibited decreases in their insulin levels, their growth hormone levels, and their testosterone levels too, leading researchers to conclude that their anabolic response pathways were compromised due to the lack of sufficient energy sources. They suggested other nutritional substances were needed beyond just high protein ingestion.

While catabolism is always at work somewhere, from a workout standpoint if you’re in an anabolic state you’re both building and (just as importantly) maintaining your muscle mass, whereas if you’re in a catabolic state, you’re losing muscle mass along with fat. How to balance the two? Nutrition.

The foods you eat pre- and post-exercise are the fuel sources that can keep catabolic processes working for you and not against you. Just as certain athletes will carbo-load before a big game or race to ensure they have complex molecules to supply longer durations of energy, the proper amount of muscle-building nutrients at the right times and concentrations helps optimize your resistance-training workout and the synthesis of new skeletal muscle protein.

Balance

You may have heard the phrase “you can’t make an omelet without breaking some eggs,” and that idea applies to the muscle protein turnover involved in bodybuilding. While you are creating new body mass, older muscle proteins that are no longer working at optimum levels will be recycled and replaced in a catabolic-anabolic cycle.

It’s the balance between protein synthesis and breakdown that dictates whether you’ve got muscle growth or muscle wasting (an especial danger for older adults). Muscle protein breakdown needs to be met with the right kind of energy and protein intake to replace it, and that’s where amino acid ingestion comes in.

Amino Acids for Muscle Anabolism

Under the expert guidance of amino-acid researcher Dr. Robert Wolfe, the Amino Co. has developed an amino acid supplementation formula to help build skeletal muscle mass with the correct balance of essential amino acids needed to synthesize new muscle growth in the first place.

As was seen in the above-linked study on bodybuilders, protein intake alone is not enough to prevent human muscle mass from being catabolized for energy, disrupting the body composition of even trained competitors.

While many bodybuilders supplement with whey protein, casein, or branched-chain amino acids (BCAAs), The Amino Co.’s formula has clinically informed levels of amino acid concentration to ensure not only muscle protein balance but also the energy needs required for a whole-body protein revolution.

The performance-focused formula includes:

The effects of leucine supplementation are particularly powerful when it comes to muscle anabolism, as free leucine is absorbed immediately after ingestion (postprandial). In a post-workout recovery drink it’s been shown to increase skeletal muscle hypertrophy and strength and may be useful in promoting human skeletal muscle growth safely in elderly individuals who are at risk of sarcopenia, the degenerative loss of skeletal muscle mass.

Break Down and Build Up

The response of muscle protein to the proper amount of amino acid nutrition and fitness is to grow and strengthen. Muscle mass maintenance is dictated by the give-and-take between anabolic and catabolic processes: the anabolic building that requires energy, and the catabolic breakdown that supplies it. Together they work to prune, repair, and replace spent cells with newer, stronger ones, and move your body’s composition to its optimal spot on the body mass index.