WHEN YOU LOSE WEIGHT WHERE DOES THE FAT GO

Despite a worldwide obsession with diets and fitness regimes, many health professionals cannot correctly answer the question of where body fat goes when people lose weight, a UNSW Australia study shows.

The most common misconception among doctors, dieticians and personal trainers is that the missing mass has been converted into energy or heat.

"There is surprising ignorance and confusion about the metabolic process of weight loss," says Professor Andrew Brown, head of the UNSW School of Biotechnology and Biomolecular Sciences.

"The correct answer is that most of the mass is breathed out as carbon dioxide. It goes into thin air," says the study's lead author, Ruben Meerman, a physicist and Australian TV science presenter.

In their paper, published in the British Medical Journal today, the authors show that losing 10 kilograms of fat requires 29 kilograms of oxygen to be inhaled and that this metabolic process produces 28 kilograms of carbon dioxide and 11 kilograms of water.

Mr Meerman became interested in the biochemistry of weight loss through personal experience.

"I lost 15 kilograms in 2013 and simply wanted to know where those kilograms were going. After a self-directed, crash course in biochemistry, I stumbled onto this amazing result," he says.

"With a worldwide obesity crisis occurring, we should all know the answer to the simple question of where the fat goes. The fact that almost nobody could answer it took me by surprise, but it was only when I showed Andrew my calculations that we both realised how poorly this topic is being taught."

The authors met when Mr Meerman interviewed Professor Brown in a story about the science of weight loss for the Catalyst science program on ABC TV in March this year.

"Ruben's novel approach to the biochemistry of weight loss was to trace every atom in the fat being lost and, as far as I am aware, his results are completely new to the field," says Professor Brown.

"He has also exposed a completely unexpected black hole in the understanding of weight loss amongst the general public and health professionals alike."

If you follow the atoms in 10 kilograms of fat as they are 'lost', 8.4 of those kilograms are exhaled as carbon dioxide through the lungs. The remaining 1.6 kilograms becomes water, which may be excreted in urine, faeces, sweat, breath, tears and other bodily fluids, the authors report.

"None of this is obvious to people because the carbon dioxide gas we exhale is invisible," says Mr Meerman.

More than 50 per cent of the 150 doctors, dieticians and personal trainers who were surveyed thought the fat was converted to energy or heat.

"This violates the Law of Conservation of Mass. We suspect this misconception is caused by the energy in/energy out mantra surrounding weight loss," says Mr Meerman.

Some respondents thought the metabolites of fat were excreted in faeces or converted to muscle.

"The misconceptions we have encountered reveal surprising unfamiliarity about basic aspects of how the human body works," the authors say.

One of the most frequently asked questions the authors have encountered is whether simply breathing more can cause weight loss. The answer is no. Breathing more than required by a person's metabolic rate leads to hyperventilation, which can result in dizziness, palpitations and loss of consciousness.

The second most frequently asked question is whether weight loss can cause global warming.

"This reveals troubling misconceptions about global warming which is caused by unlocking the ancient carbon atoms trapped underground in fossilised organisms. The carbon atoms human beings exhale are returning to the atmosphere after just a few months or years trapped in food that was made by a plant," says Mr Meerman, who also presents the science of climate change in high schools around Australia.

Mr Meerman and Professor Brown recommend that these basic concepts be included in secondary school curricula and university biochemistry courses to correct widespread misconceptions about weight loss among lay people and health professionals.

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Why Does Neuropathy Make Us So Damned Tired

Today's post from neuropathyjournal.org (see link below) tries to explain why many people living with neuropathy (especially autonomic neuropathy) become progressively more tired as the years go on. There's no easy answer and there can also be many other reasons why fatigue and weakness start to affect our lives so strongly but for many people, along with degradation of nerve fibres, comes muscle and mental fatigue and it can be very difficult to live with. LtCol Richardson does a good job of explaining the process but also offers some helpful tips to help us cope with and improve our tiredness levels. Worth a read.

Fatigue in Peripheral Neuropathy 
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS9

Unfortunately fatigue is a central part of many neuropathies and especially the immune mediated neuropathies. It is central to many other chronic illnesses that affect the body’s immune system. The causes are often complex and many.

Dr. Scott Berman, in his book Coping with Chronic Neuropathy notes in chapter VIII “Dealing with Fatigue and Insomnia” that this symptom is one of the most difficult and challenging for the neuropathy patient. Dr. Berman is a Psychiatrist, a member of the Board of Directors of the NSN and a Medical Advisor. Scott lives with untreatable CIDP.

He notes:

…that in one study looking at fatigue in autoimmune neuropathy 80% of 113 patients had severe fatigue. The fatigue was independent of motor or sensory symptoms and was rated as one of the top three most disabling symptoms. (“Fatigue in Immune-Mediated Polyneuropathies,” Neurology 53: 8 November 1999, I.S.J. Merkies, et al).

For decades in living with untreated Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Autonomic Neuropathy (AN) and Progressive Polyneuropathy due to exposure to Agent Orange in Vietnam, I can attest to the facts noted above. While other major symptoms respond to treatment with Immune Globulin (IVIg), the symptom of severe fatigue continues as one of the symptoms that responds only temporarily to the infusions followed by several days of total fatigue following infusion and then with some lessening until the next infusion.

Dr. Norman Latov in his book “Coping with Peripheral Neuropathy”, states what I have heard other neurologists share, that the fatigue we feel, first appearing as weakness, increases as the weakness (or damage) of motor nerves expands. At this point with only a few muscles doing the whole job of lifting a leg or arm or carrying on autonomic functions, the body becomes weak and eventually extreme fatigue occurs. Think of a young child who tires easily because the muscles and nerves are not fully developed and only a few underdeveloped nerves or muscles are doing the job of moving!

On the other hand, to state the obvious, pain in some neuropathies does not help us sleep. Neuropathy patients must seek medical help in finding medications or other options which works for them. The medical practitioners have increased their knowledge in recognizing the reality of neuropathic pain. These strange symptoms from damaged peripheral nerves are present in sensory neuropathies. It is become less common for these patients to be told that it is all in their ‘head’ and are finally getting the help they need.

Impact on family and friends:

Families and friends, as we all have learned, may not understand this reality since we “look so good” and may even believe/suggest that you are just lazy or unmotivated or worse. The best thing you can do for them is to have them watch the DVD Coping with Chronic Neuropathy which will be an education about the impact of any neuropathy on our lives.

Educating yourself about neuropathy:

At any rate, fatigue is something we struggle with every day and often regulates/determines our daily activities.

While fatigue in neuropathy and other chronic illnesses is not fully understood by the experts, from a practical standpoint, here is what I have learned to do or not do in coping with fatigue. If you have found other things that help, send us a message and we will add it to the list.

1. DO NOT think negatively about fatigue, thus feeling guilty about your fatigue. Go take a nap! (See DVD “Coping with Chronic Neuropathy”).

2. Learn when your “fatigue” periods occur, as these often establish a pattern at certain times of the day. Then go lay down and stop moaning about it, as it is what it is until it isn’t.

3. I have learned that you do not even have to actually “sleep”, but just allowing your body to rest/stop for an hour takes care of the exhaustion as the body recovers. But whatever works for you, do it without guilt or apology.

4. For nighttime, have a standard bedtime routine in preparing for sleep that tells your body that it is time to sleep.

5. Do not eat a large meal just before bedtime or take a stimulant that keeps you awake or might interfere with sound sleep (i.e. caffeine, for some alcohol).

6. Do consider drinking a glass of milk as for many this encourages the body to sleep.

7. Do consider one of those special recordings of quiet music or rain falling or similar if it helps.

8. Do consider using a ticking clock if that helps. As a child in the 40s I got my best sleep on the floor in front of the big radio in the living room listening to Dragnet or was it the Lone Ranger, maybe the Big Story. Today most TV programs have the same effect, sleep! Pun intended.

9. Muscle spasms and/or restless leg can make sleeping difficult and rob you of needed sleep. Speak to your doctor and have tests done for calcium, salt, potassium levels and other deficiencies which can make it difficult for muscles to work properly. This is especially true if you are on a diuretic which can empty your body of needed minerals. Getting up and having a glass of orange juice worked for my mother and works for me. If the lack of something is not the problem, have the doctor find out what may be causing these muscle problems. There are also medications to help prevent these muscle spasms and cramps for they are very common in neuropathy.

10. I have found that if I wake up with my mind creating solutions to an issue or writing poetry (happens) and not able to sleep, I go to another room or go do some work on my computer (write out the solution or poetry) until I begin to feel sleepy again. It works for me.

11. For some insomnia is a real curse. There are medications that one can use as Dr. Scott Berman mentions in his book, so speak to your doctor. Frankly, I would work on natural solutions first and be creative to see what works for you. But if ALL else fails these medications may help and be a heaven sent blessing.

12. My Nurse told me that many patients with this effect of a chronic illness, take Folic Acid and it is known to help. So you many want to speak to your doctor in this regard.

13. Dr. Erika Schwartz, M.D. (national leading expert on wellness) suggests that patients with extreme fatigue have the physician check your basal metabolic rate and your thyroid function. Low thyroid is a common cause of fatigue. So speak to your doctor in this regard.

14. So what do you do or not do that helps? Send it to us and we will enter it here!

DISCLAIMER: The information in this article and on the website or the links or in the guidance provided is intended to be educational and informative and not medically prescriptive or diagnostic. All patients are encouraged to consult with their own medical doctor when considering any this information.

Copyright – 2014-2015 Network for Neuropathy Support, Inc., 501c3, dba as Neuropathy Support Network. This article or its contents may be reprinted or published for educational purposes as long as the printing or publishing is not for profit and acknowledgement is granted the author.

https://neuropathyjournal.org/fatigue-in-peripheral-neuropathy/

How Does Pernicious Anemia Relate To Neuropathy

The last 4 posts and this one, all relate to Vitamin B12 and neuropathy. If you weren't a hypochondriac before reading these, you may well be afterwards, so taking a sensible view of the many symptoms shown here is advisable. Strangely, most HIV and/or neuropathy patients aren't standard tested for B12 deficiency but it may well be worth asking your doctor to do exactly that - it may explain several things. All 5 posts come from the same site B12patch.com (see links below the articles), which is pretty much an 'all you would ever want to know' type of information site but the descriptions of what neuropathy is are accurate and honest and explained in language that we all can understand. Very interesting and worth discussing with your doctor if there's time, especially if you're considering taking B12 supplement pills (usually need Folic acid to help absorption) - injections may be better in your case.

Pernicious Anemia- Vitamin B12 Deficiency is Nerve Rattling- Peripheral Neuropathy

Saturday, March 3rd, 2012

Do your legs keep going numb? It could be vitamin B12 deficiency. Peripheral neuropathy -nerve damage from pernicious anemia-vitamin B12 deficiency- causes symptoms like pain, burning, and tingling sensations in your fingers and toes. Find out how vitamin B12 supplements can help…

They’re like Fed Ex for your nervous system

Your peripheral nerves operate outside your brain, shunting messages between your brain and your spinal cord. They communicate signals about taste, touch, hearing, smell, and sight.

The peripheral nerves also transmit messages influencing your motor skills, muscular coordination, and autonomic reflexes like breathing, heartbeat, bowel control, and blood pressure.

Damage to your peripheral nerves is called peripheral neuropathy. Depending on which nerves are impaired, symptoms of peripheral neuropathy may include disorientation, “brain fog,” loss of muscle control, “pins and needles” sensations, and digestive disorders.

Pernicious anemia-vitamin B12 deficiency is a common cause of peripheral neuropathy. (Read Do you have Franken-DNA from Pernicious Anemia?)

I think I’m having a nervous breakdown…

Symptoms of peripheral neuropathy vary from patient to patient. Nerve damage caused by pernicious anemia may differ from neuropathy resulting from alcoholism, for example.

• Burning and painful numbness in the toes, feet, legs, fingers, hands, and legs
• Decreased ability to differentiate between hot and cold
• Loss of muscular control
• Muscular feebleness
• Tripping
• Muscular twitching, including eyelids
• Indigestion, heartburn, and bloating even after small meals
• Vomiting
• Acid reflux
• Diarrhea
• Constipation
• Bladder problems
• Sexual dysfunctions
• Sensation of food getting stuck in your throat
• Dizziness
• Fatigue
• Excess sweating

What causes peripheral neuropathy?

At least 20 million US citizens suffer from one of many different types of peripheral neuropathy.
About 30% of the time, doctors are unable to find a cause or cure, and the diagnosis is “idiopathic peripheral neuropathy.” (Meaning, we don’t know why you’re having nerve pain.)
Another 30% of nerve pain is related to diabetes. Diabetic neuropathy is one of the leading known causes of painful tingling, numbness, and soreness in the feet.
The remaining 30% is caused by an assortment of conditions and ailments:

• Autoimmune disorders like pernicious anemia and rheumatoid arthritis
• Vitamin B12 deficiency
• Tumor
• Kidney disease
• Infection
• HIV
• Toxic reaction to alcohol, drugs, or chemotherapy
• Poor circulation
• Hypothyroidism
• Heredity

Treatments for peripheral neuropathy

Not all kinds of peripheral neuropathy can be cured. However, understanding the cause, be it vitamin B12 deficiency or Crohn’s disease, can help your doctor prescribe proper coping mechanisms and lifestyle habits to avoid complications.

• If vitamin B12 deficiency is the cause, then you will need to take vitamin B12 supplements, possibly for life.
• If pernicious anemia or digestive disorder is the cause of vitamin B12 deficiency, then you will have to use delivery methods that dispense vitamin B12 directly into your bloodstream, bypassing the digestive system.
• With diabetic peripheral neuropathy, you must check your feet often for blisters and cuts, in order to prevent infections.
• Daily exercise helps to improve circulation and relieve nerve pain.
• Get regular foot and hand massages to improve circulation.
• Don’t sit in the same position for a long time, and don’t put pressure on your arms and legs.
• If you suffer from Crohn’s disease or other GI disorders, then eat light meals that are low in fat, and avoid processed foods.
• Alternative treatments that are beneficial include herbal supplements, antioxidants, acupuncture, and biofeedback.

http://www.b12patch.com/blog/tag/peripheral-neuropathy/

Curcumin Curcuma Turmeric Does It Help With Neuropathy Pain

Today's post from informahealthcare.com (see link below) takes another look at the potential for curcuma, (Turmeric) to help reduce the discomfort of neuropathy. In this case, the study was done on mice and achieved significant success but what this does is really back-up the mass of evidence produced by ordinary people who have tried curcuma and also found it to be beneficial. It's one of those alternative treatments that have a place in folklore but are rarely tested scientifically but because of all the apocryphal evidence, this and other tests are justified. The problem is that like all potential treatments for neuropathic pain, it works for some and not for others and furthermore, it's not just a question of taking supplements for a month and seeing if they make a difference; in reality curcuma has to form part of a long-term plan, even if it is just as a supplement. The evidence certainly seems to bear out what many people claim but you will need to discover for yourself if you can benefit personally. One big plus is the price - as a pill or capsule supplement, it's not expensive and is widely available.

Effect of curcumin in mice model of vincristine-induced neuropathy Anand Babu, K. G. Prasanth, and Bhaskar Balaji June 2015, Vol. 53, No. 6 , Pages 838-848 (doi:10.3109/13880209.2014.943247)

Department of Pharmacology, PSG College of Pharmacy,
Coimbatore, Tamil Nadu , India

Abstract

Context: Curcumin exhibits a wide spectrum of biological activities which include neuroprotective, antinociceptive, anti-inflammatory, and antioxidant activity.

Objective: The present study evaluates the effect of curcumin in vincristine-induced neuropathy in a mice model.

Materials and methods: Vincristine sulfate (0.1 mg/kg, i.p. for 10 consecutive days) was administered to mice to induce neuropathy. Pain behavior was assessed at different days, i.e., 0, 7, 10, and 14 d. Sciatic nerve total calcium, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), nitric oxide (NO), and lipid peroxidation (LPO) were also estimated after the 14th day of study. Pregabalin (10 mg/kg, p.o.) and curcumin (15, 30, and 60 mg/kg, p.o.) were administered for 14 consecutive days.

Results: Curcumin at 60 mg/kg significantly attenuated the vincristine-induced neuropathic pain manifestations in terms of thermal hyperalgesia (p < 0.001) and allodynia (p < 0.001); mechanical hyperalgesia (p < 0.001); functional loss (p < 0.001); and in the delayed phase of formalin test (p < 0.001). Curcumin at 30 and 60 mg/kg exhibited significant changes (p < 0.001) in antioxidant levels and in total calcium levels in vincristine-injected mice.

Conclusion: Curcumin at 30 and 60 mg/kg dose levels significantly attenuated vincristine-induced neuropathy which may be due to its multiple actions including antinociceptive, calcium inhibitory, and antioxidant effect.

http://informahealthcare.com/doi/abs/10.3109/13880209.2014.943247

Does Pregabalin Lyrica Really Help with Neuropathic Pain

Pregabalin or Lyrica, is one of the most frequently prescribed drugs to help with neuropathic pain. It's an epilepsy/seizure drug that has found a new lease of life in the treatment of neuropathic disorders but there are strong arguments both for and against its usefulness. Many people can't live with the side effects and many people find that it just doesn't work for them. That, set against the people for whom there is a marked improvement, makes it a difficult medication to evaluate. The fact that they're still studying it and that the first American Academy of Neurology guidelines will not emerge until April, 2012, makes you wonder why it is so widely issued by doctors and neurologists. It forms part of what is now accepted as a standard pathway through the possible options for neuropathy patients: somewhere between anti-depressants and morphine! Pregabalin/Lyrica definitely remains a viable option but it's advisable to ask every question that worries you and research as much as you can because at best, you will be suppressing symptoms and not curing them, by using a drug with known side effects. However, for many people if that takes away the pain, then it's worth it. The article comes from emaxhealth.com (see link below).

Pregabalin May Benefit Diabetic Nerve Pain
By Denise Reynolds RD on April 14, 2011

The American Academy of Neurology has issued new guidelines on the most effective treatments for diabetic nerve pain and has found that a seizure drug can treat the neuropathy and improve quality of life for patients with diabetes. The guideline was presented at the American Academy of Neurology’s Annual Meeting in Honolulu.

Diabetic Neuropathy Is Undertreated in the United States
Pregabalin, brand name Lyrica, is an oral medication used for treating pain caused by neurologic diseases as well as seizures. It is also used for treating fibromyalgia. It is believed to work by binding to calcium channels on nerves and possibly modifying the release of neurotransmitters. The US Food and Drug Administration approved pregabalin in December 2004.

Diabetic nerve pain, tingling or burning pain in the hands and feet caused by nerve damage from hyperglycemia, is estimated to affect 16% of the more than 25 million people in the United States living with diabetes. It is believed that about two out of five cases go unreported and untreated.

The recommended initial dose of pregabalin for neuropathic pain is 50 milligrams, three times a day. The dose may be increased to a maximum of 100 mg three times daily after one week. The most common side effects are dizziness, drowsiness, dry mouth, edema, blurred vision, weight gain and difficulty concentrating.

While the evidence is strong that pregabalin is effective in treating diabetic neuropathy, doctors should determine if it is appropriate for their patients on a case-by-case basis. Certain medications can interact with Lyrica, requiring careful monitoring by a physician

The American Academy of Neurology guidelines note that other seizure treatments such as gabapentin and valproate, antidepressants such as venlafaxine or duloxetine, and painkillers are probably also effective. Transcutaneous electric nerve stimulation (TENS) should also be considered as an option for treating diabetic nerve pain.

“We were pleased to see that so many of these pain treatments had high-quality studies that support their use,” said lead guideline author Vera Bril MD FRCP of the University of Toronto. “Still, it is important that more research be done to show how well these treatments can be tolerated over time since diabetic nerve pain is a chronic condition that affects a person’s quality of life and ability to function.”

The AAN guidelines will be released in 2012 and will appear in the April issue of the journal Muscle and Nerve from the American Association of Neuromuscular and Electrodiagnostic Medicine as well as the April issue of PM&R, the journal of the American Academy of Physical Medicine and Rehabilitation.

http://www.emaxhealth.com/1506/pregabalin-may-benefit-diabetic-nerve-pain

Cannabis And HIV What Does The Research Say

 Today's post  from  gaynz.com (see link below) is a short article adding to the information we already have about the various medical uses for cannabis, especially for people living with HIV. Of course this blog is most interested in any concrete information relating to HIV and neuropathic pain. The article takes a dispassionate look at the proven pro's and cons' of the issue.

 

Cannabis and HIV/AIDS: What the Research Says

October 15, 2012


In 2010, there was a useful summary of the role of cannabinoids in HIV/AIDS treatment, mostly in North America. In 2004, the Canadian AIDS Society became the first such NGO to back wider access to cannabinoids for People Living With HIV/AIDS, given their benefits in combatting problems like pain, nausea and appetite loss. According to North American studies, between a quarter to one third of all PLWHAs have used cannabis or cannabinoids for these purposes (c23-37 percent). In Canada, ninety percent of those sampled used it as an appetite stimulant, while seventy percent used it as a painkiller and to combat nausea or vomiting.

Pain is probably the best -researched area of medicinal cannabis derivatives useful effects for PLWHAs. It may originate from headache, both forms of herpes, back pain, throat pain, athralagia, lymphoma, anorectal carcinomas or ancillary side-effects of other preventative techniques like chemotherapy or radiation therapy. Its use against peripheral neuropathy ranges from thirty to fifty-five percent. Used for this purpose, cannabis/cannabinoids have no adverse effects on metabolism of antiretroviral medication such as indinavir and ritonovir. In the case of nausea, cannabinoids may be useful if patients do not respond to antiemetics in other contexts. However, there is little specific research data available on these particular effects other than anecdotal references to their benefits. When it comes to weight gain and appetite stimulation, the research indicates that administration of cannabinoids improves appetite and can reverse weight loss, assist food intake and assist sleep. Moreover, it also seems to assist antiretroviral drug compliance.

However, the study’s author cautions that there is lack of standardised measurement of delivery methods within amenable research, whether through cannabis cigarettes, pipes, tobacco/cannabis admixtures, or standardised levels of THC content. There are also difficulties with the small scale of such research samples. However, the research consensus also indicates no negative effects on viral load, CD4/CD8 T-cell levels, or ARV blood plasma levels.

http://www.gaynz.com/blogs/redqueen/?p=1924