Friday, June 23, 2023


WHAT IS FOOD INTOLERANCE?

Food intolerance is a broad term that is used to describe a wide range of adverse reactions to foods, that cause symptoms after eating some foods. These include stomach pain, bloating, gas/flatulence, diarrhoea, irritable bowel syndrome (IBS), rashes, hives (urticaria), recurrent mouth ulcers or headaches. If food intolerances are not properly managed, these symptoms can adversely affect general health and wellbeing.

Food intolerances are sometimes confused with, or mislabelled as food allergies. Food intolerances involve the digestive system, whilst food allergies involve the immune system. Unlike Immunoglobulin E (IgE) antibody mediated food allergy, food intolerances (except for sulphite and benzoate reactions) do not cause anaphylaxis (severe allergic reactions), that can be life threatening.

What are the symptoms of a food intolerance?

Symptoms of a food intolerance include:

  • Abdominal (belly) pain.
  • Diarrhoea.
  • Gas and bloating.
  • Headaches or migraines.
  • Heartburn.
  • Nausea.
  • Upset stomach.

Natural substances in foods can cause food intolerances

Foods are composed of proteins, carbohydrates, fats, nutrients and several natural chemicals. The following naturally occurring substances often add flavour and smell to food, but they can trigger symptoms in some people:

• Lactose intolerance is an example of an enzyme deficiency, which occurs when people are born with, or develop, insufficient lactase enzymes to digest lactose in cow’s milk and other dairy products. This can result in bloating, gas/flatulence, stomach upset and diarrhoea after having dairy products. This condition is uncomfortable but not dangerous and does not cause rashes or anaphylaxis. Diagnosis is by temporary elimination of lactose and reintroduction.

• Monosodium glutamate -Glutamates also occur naturally in foods such as camembert cheese, Parmesan cheese, tomatoes, soy sauce, and mushrooms. MSG stimulates nerve endings, which may be why it is used as a flavour enhancer when it is added to food.

Vasoactive amines such as tyramine, serotonin and histamine are well known triggers of migraines in some people. They are naturally present in pineapples, bananas, baked meat, vegetables, red wine, wood-matured white wine, avocados, chocolate, citrus fruits, and mature cheese. Amines can act directly on small blood vessels to expand their capacity. This may be why they can trigger flushing, migraines, and nasal congestion in some people.

Salicylates are natural aspirin like compounds that are present in a wide variety of herbs, spices, fruit and vegetables. Reactions to salicylates may be even more common than reactions to artificial colours and preservatives. Aspirin can trigger hives, by acting directly on skin mast cells, and therefore salicylates can also worsen hives in some people.

Toxins can cause severe symptoms. Contamination of food with micro-organisms (such as bacteria) or their products (due to spoilage) can cause food poisoning due to toxins. For example, if some types of fish are stored poorly, their gut bacteria can convert histidine to histamine, resulting in allergy like symptoms.

Irritants such as caffeine and curry are gut irritants that can trigger indigestion in some people. It is important to realise that reactions to these substances are not due to allergy.

How is a food intolerance managed or treated?

You may need to change your diet to limit or eliminate problem foods. Many people with food intolerances find that consuming small amounts of food causes few symptoms if any. When symptoms occur, over-the-counter medicines like antacids or antidiarrheal can help.

People who are lactose intolerant can consume lactose-free milk and dairy products. You can also buy lactase enzymes at drugstores. You can take lactase pills before consuming dairy products or add lactase drops directly to milk to break down the lactose.

Tuesday, June 13, 2023

 

THYROID FUNCTION TEST

What is the thyroid gland?

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

How does the thyroid gland function?

The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms. To exert its effects, T4 is converted to triiodothyronine (T3) by the removal of an iodine atom. This occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. The amount of T4 produced by the thyroid gland is controlled by another hormone, which is made in the pituitary gland located at the base of the brain, called thyroid stimulating hormone (abbreviated TSH). The amount of TSH that the pituitary sends into the bloodstream depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4. Once the T4 in the bloodstream goes above a certain level, the pituitary’s production of TSH is shut off. In fact, the thyroid and pituitary act in many ways like a heater and a thermostat. When the heater is off and it becomes cold, the thermostat reads the temperature and turns on the heater. When the heat rises to an appropriate level, the thermostat senses this and turns off the heater.

What is thyroid function test (TFT)

Thyroid function tests are usually done to find out whether the thyroid gland is working properly. This is mainly to diagnose underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism).

TSH (Thyroid stimulating hormone) Test: The TSH test is often done first. If the thyroid hormone levels in blood are too low, pituitary gland makes larger amounts of TSH to stimulate production of thyroid hormone and vice versa.

T4 (Thyroxine) Test: A high level of T4 indicates hyperthyroidism. Most of the T4 in body is found to protein and a small percentage is free, together called Total T4. Need to monitor T4 levels if taking thyroid replacement therapy (medication), to check underactive thyroid in new-borns, evaluate conditions like goitre, thyroid nodules and issues with pituitary gland or hypothalamus.

Free T4 Test: A small portion of T4 is not bound to proteins and are called free T4, which are readily available for our body to use. High free T4 above normal range could mean you have an overactive thyroid also seen in Grave’s disease, an autoimmune disorder. Abnormally low free T4 levels may signal hypothyroidism.

T3 (Triiodothyronine)Test: T3 mostly exists as a bound form with proteins. Total T3 refers to the collection of both bound and unbound forms of T3 circulating in the blood. T3 test is most often used to diagnose hyperthyroidism.

Free T3 test: Free T3 are unbound T3 that enters one’s body tissues where its needed. Free T3 is in a small percentage compared to Total T3. However, measuring free T3 is more accurate than measuring Total T3 as it represents the immediately available thyroid hormone which can be used.

 

Thyroid function test Interpretation

TSH

Free T4

Free T3

Condition

Normal

Normal

Normal

None

Low

High

High

Hyperthyroidism

Low

Normal

Normal

Subclinical hyperthyroidism

Low

Normal

High

T3 toxicosis

Low

High

Normal

Thyroiditis

T4 ingestion

Hyperthyroidism in the elderly or with comorbid illness

Low

Low

Low

Euthyroid sick syndrome

Central hypothyroidism

High

Normal

Normal

Subclinical hypothyroidism

Recover from euthyroid sick syndrome

High

Low

Low

Primary hypothyroidism

High

High

High

TSH producing pituitary adenoma

 

 

 

MONOCLONAL ANTIBODIES

Antigens, by their nature as macromolecules having primary, secondary, tertiary, and quaternary structures, constitute a “mosaic” of antigen...