Wednesday, October 31, 2018

Fish oils and Cardiovascular Disease.

Don't Give Up on Fish Oil for CVD Prevention Just Yet

Hello. I'm Dr Arefa Cassoobhoy, a primary care internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.
You'd be forgiven if you were skeptical that fish oil could have a practice-changing role in preventing major adverse cardiovascular events (MACE). The data have been, at best, conflicting.
But now, recent topline results from the REDUCE-IT trial (see attached below), suggest that high doses of at least one omega-3—EPA (eicosapentaenoic acid)—could resurrect faith in fish oil for cardiovascular health.
The global study involved more than 8000 patients whose LDL levels were controlled on a statin. They also had risk factors, including persistently high triglyceride levels, cardiovascular disease, or diabetes with another risk factor.
The patients received either 4 g of EPA daily or placebo. After about 5 years, the EPA group saw a 25% relative risk reduction in MACE. And the results were highly statistically significant. MACE included death, nonfatal myocardial infarction or stroke, coronary revascularization, or unstable angina requiring hospitalization.
It's thought that the higher dose of pure EPA used in this study is the reason that they saw a stronger effect from fish oil compared with previous studies. Look out for more information when the data are presented at the 2018 American Heart Association meeting.


REDUCE-IT: 25% Reduction in MACE With High-Dose EPA

High doses (4-g daily) of the omega-3 oil eicosapentaenoic acid (EPA) have shown a large benefit on cardiovascular events in the randomized, double-blind REDUCE-IT trial.
Top-line results of the trial were announced yesterday in a press release by the sponsor, Amarin, which manufactures the high-dose EPA product under the brand name Vascepa.
The study involved 8179 patients from 11 countries who were at elevated cardiovascular risk (had a previous cardiovascular event or diabetes with one additional risk factor) and had raised triglyceride levels. All participants, who were already taking a statin, were randomized to 4 g of the pure EPA product daily or placebo.
After a median follow-up of 4.9 years, there was an approximately 25% relative risk reduction in the primary endpoint of first occurrence of a major adverse cardiovascular event — any one of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina requiring hospitalization — in the EPA group, which was highly significant (P < .001), the company reported.
There were also "robust demonstrations of efficacy across multiple secondary endpoints," the company's statement said.
In terms of safety, the high-dose EPA was said to be "well tolerated," with similar proportions of patients experiencing adverse events and serious adverse events in the active and placebo treatment groups.
More details of REDUCE-IT will be presented by principal investigator Deepak L. Bhatt, MD, Brigham and Women's Hospital, Boston, Massachusetts, at the American Heart Association (AHA) Scientific Sessions 2018 on November 10, 2018 in Chicago, Illinois.
During a company conference call, John Thero, president and chief executive officer of Amarin, referred to the benefit of the high-dose EPA as "huge" and "exceeding all expectations."
"The 25% relative risk reduction in major cardiovascular events seen with Vascepa is comparable to that seen with atorvastatin, one of the most successful drugs of all time," he said, "and the benefit of Vascepa was seen on top of statin therapy therefore is addressing an unmet medical need."
"Clearly, lowering low-density lipoprotein cholesterol (LDL-C) alone is not enough," he said. "That can give a relative risk reduction of 25% to 35%, but this leaves a residual risk of 65% to 75%. The additional 25% relative risk reduction seen in this study is the single most impressive advance for preventative cardiovascular drug therapy since the advent of the statins."
The product is also easy to use, taken orally, safe, and inexpensive compared with other branded cardiovascular drugs, Thero added, "and it now has the potential to be used in millions of patients on top of statin therapy for additional cardiovascular risk reduction.”
500 mg/dL. The company plans to apply to the US Food and Drug Administration for this new indication based on results of REDUCE-IT in early 2019. 
In an interview with Medscape Medical News, REDUCE-IT investigator Christie Ballantyne, MD, Baylor College of Medicine, Houston, Texas, said it was very important to understand the patient population enrolled in the study.
He noted that "70% of patients were secondary prevention and 30% high-risk primary prevention (had diabetes and one additional risk factor). All patients had baseline triglycerides over 150 mg/dL on statin therapy. This is very different from other studies which did not include elevated triglycerides as an entry criterion.”
"It's hard to believe that in this era of precision medicine there has never been a study before specifically addressing whether the lowering of triglycerides is beneficial in patients with elevated levels," Ballantyne commented. 
He also pointed out that the dose of EPA used was probably a key factor in the benefit seen. "We used a high dose (4-g daily) of EPA alone, whereas most previous studies of omega-3 oils (most recently in the ASCEND trial) have used much lower doses of mixed oils. The only prior study that used EPA alone at higher doses was the Japanese JELIS trial, which used 1.8-g daily and also showed benefit."
Ballantyne noted that the JELIS trial did not stipulate that patients had to have raised triglyceride levels but the most benefit was seen in those who did. "The REDUCE-IT trial confirms the results of the JELIS trial but REDUCE-IT has a more rigorous design and a different patient population."
Ballantyne was reluctant to speculate on the clinical implications of the results at the present time. "I will let the clinicians at the AHA meeting decide on the clinical relevance of the data when they see it for themselves in more detail."
But he did say that "the study was powered for a 15% relative risk reduction, and we achieved a 25% relative risk reduction. Whenever you exceed the benefit aimed for, you get excited by the results."
"I have been in this field for a long time and witnessed many failures of drugs aiming to reduce cardiovascular risk. It will be great to get these data out to the cardiology community at AHA."
Commenting for Medscape Medical News, Henry Ginsberg, MD, University of Columbia, New York City, who was not involved in the study, said the reported results are "fascinating and important."
"I really didn't think that fish oils would show such a strong effect. I was guessing they might achieve a 10% to 12% benefit at the most. So this is terrifically exciting," he said. "It will change practice."
He agreed that the dosage was probably a key issue. "Previous fish oil studies have mainly used doses of around 1 g daily of mixed omega-3 oils and have not shown benefits. This trial has used 4 g of pure EPA," he noted. "The JELIS trial used 1.8-g daily of EPA, which showed a 19% benefit and was significant for secondary prevention but not for primary prevention."
"The JELIS study did not stipulate raised triglycerides for entry and the drop in triglycerides was modest," he noted, "but a post-hoc analysis showed a greater benefit in those patients with raised triglycerides at baseline."
Although lowering triglycerides with high-dose EPA was the main focus of the REDUCE-IT trial, Ballantyne noted that high doses of EPA have been shown to have other beneficial effects.
"Previous studies have suggested that in addition to lowering triglycerides, EPA has a favorable effect on inflammation and several other markers of atherosclerosis," he said. "Basically we don't know the mechanism. It may be the reduction in triglycerides but it also appears to do lots of other good things."
Thero added, "We view the JELIS results as supportive for using EPA to benefit patients without raised triglycerides as well as those with raised triglycerides. It suggests that the benefits of EPA are not brought about by triglyceride reduction alone."
Ginsberg estimated that about 30% of the US population have triglyceride levels above 150 mg/dL. "This percentage would be higher in a secondary prevention population — possibly 40%," he said.   
Another trial of high-dose omega-3 oils for cardiovascular event reduction is underway. The STRENGTH trial is using a combination EPA/docosahexaenoic acid product with a total of 4-g omega-3 oils daily in patients with triglycerides over 200 mg/dL. Results are due out next year.
"The REDUCE-IT trial has shown a strong result," lead investigator of the STRENGTH trial, Steve Nissen, MD, Cleveland Clinic, Ohio, commented to Medscape Medical News.
"I am not surprised that it was successful," Nissen said. "Prior studies used small dosages of fish oil (1 g) and studied a broad group of patients. Both REDUCE-IT and STRENGTH treated patients with high triglycerides with full doses (4 g)."
The authors have reported no relevant financial relationships.
Reference: "A Study of AMR101 to Evaluate Its Ability to Reduce Cardiovascular Events in High Risk Patients With Hypertriglyceridemia and on Statin. The Primary Objective is to Evaluate the Effect of 4 g/Day AMR101 for Preventing the Occurrence of a First Major Cardiovascular Event. (REDUCE-IT)” - ClinicalTrials.gov Identifier: NCT01492361

Tuesday, October 30, 2018

Emotional Wellbeing...

What is emotional wellbeing and what does it look like for you? It is an interesting question to ponder and our health has become very dependent on emotional wellbeing.
More and more research is now linking our emotions to our overall health.

Emotional wellbeing is all about digesting our emotions and feelings in a healthy way. It is not about suppressing how we feel or avoiding our emotions. Our emotions are also linked to our thoughts and beliefs, and I say this because in many situations what we think and believe will trigger an emotional response. These emotional responses may not always be positive and when a belief system or though pattern in held for long enough it become imprinted in our cells.

We need to detoxify from our negative thoughts, feelings and beliefs just like we must detox from harmful chemicals, to obtain and maintain perfect health. Holding on to old grudges or emotions does extensive harm to your biology and physiology.

Many of our emotions and wounds and belief systems are formulated in childhood by our experiences and they tend to shape our lives. Some do so immediately, offering us challenges to overcome and builds character in the process,  and some take many years to surface. Usually in adulthood when our close relationships help to bring out the deepest aspects of ourselves. This is when deeply suppressed childhood wounds may make themselves known in a call for healing.

In adulthood issues of trust and abandonment and co-dependancy (to name a few) come up,  we may also find ourselves mirroring actions form our past instinctively.  It is then that we consider our emotional wellbeing and are in a position to nurture and heal our inner child. We have the power within us to be the loving parent or guardian we needed as a child. We are whole spiritual beings and we can nurture ourselves from that wholeness.

It is important to recognize the wounds and old emotions/patterns coming up and working toward healing/resolving them. We can visualize the situation and try on different outcomes. Using our wisdom born from age and experience we may be able to view them form a different perspective, bringing new understanding and being able to free ourselves from the hold they may have on us.

Life offers us many opportunity to clear the weeds in the garden of our soul (as Madisyn Taylor says)
Clearing these weeds are not always easy or comfortable and choosing to ignore them or find easier ways to move through life means these wounds continue to drain our energy and emotional wellbeing. They destroy the beauty and resilience of our garden. They corrupt the soil.

Sometimes we need to turn to a trainer professional to assist us in facing the events of the past, to weeding and clearing our souls garden. They can offer us tools and support through different healing modalities. Remember the child we were still lives on within us and we are always free to go and love and nurture that child and correct mistakes, perceptions, right old wrongs and forgive, thus beginning anew.

I highly recommend healing the wounds and recreating a life you desire with emotions, thoughts and feelings that support your dreams. You have the power within you to change your world and change your internal vibration to support overall health and wellbeing. Your thoughts and feelings become the things you manifest in your world. They attract the people and events in your life. Your life and it's creation is totally within your power and absolutely your responsibility.

There are a few books that I recommend that shed some light on how your emotions affect your cells and health...Molecules of Emotion by Candice Pert, Biology of belief by Bruce Lipton (to name just a few)

Good or bad cholesterol...

HDL-C: Is It Time to Stop Calling It the 'Good' Cholesterol?

Nearly every consumer story on high-density lipoprotein cholesterol (HDL-C) will include the phrase "good cholesterol." Yet HDL-C–raising drugs, including niacin[1] and cholesterylester transfer protein inhibitors,[2] failed to show a benefit in cardiovascular disease outcomes and multiple population studies show a U-shaped curve indicating a higher risk for all-cause mortality in people with very high levels.
Is it time to retire the phrase "good cholesterol"? "Absolutely," responded Robert Rosenson, MD, Mount Sinai Icahn School of Medicine, New York City, who has chaired four international working groups on the biology of the misunderstood particle. "HDL can be a good, bad, or neutral particle," he said, explaining by phone that it is the surface proteins that confer the cardioprotective effects. Loading up HDL particles with cholesterol in a bid to lower cardiovascular risk was a mistaken therapeutic strategy, he added.

Early Clues

Ironically, one of the early trials of a HDL-C–raising drug suggested as much. The Veterans Affairs High-Density Lipoprotein Intervention Trial showed a reduction in coronary artery disease events when gemfibrozil was given to men with low baseline HDL-C levels.[3] Back in 2006, a case-control substudy using nuclear magnetic resonance (NMR) spectroscopy revealed that the modest increase in HDL-C masked a higher increase in total HDL particles, particularly the small HDL particles that are relatively cholesterol-poor.[4] The authors speculated that "higher numbers of HDL particles might promote greater cholesterol efflux and protection of LDL [low-density lipoprotein] from oxidative changes." This theory was met with doubt by editorialists.[5]
Recent data from two population-based cohorts in Copenhagen of over 100,000 people showed that all-cause mortality rates increased significantly for men with HDL-C levels above 97 mg/dL and for women above 135 mg/dL.[6]This mirrored findings from a Canadian big data cohort of more than 630,000 individuals that saw higher risk for noncardiovascular death at fasting levels above 70 mg/dL for men and 90 mg/dL for women.[7] The researchers hypothesized that extremely high levels may reflect dysfunctional HDL-C.
Rosenson cautions against focusing on HDL-C levels at all. "It is the number of HDL particles and not the cholesterol content that is important," he said. By phone, Matthew Budoff, MD, Los Angeles Biomedical Research Institute, agreed that total HDL particles are a better measure of the antiatherogenic features. He doesn't believe that very high HDL-C levels are necessarily bad, using the analogy of a barrel that is filled with ping-pong balls or basketballs to represent volume of HDL-C. "Some people will have very high levels of HDL-C and a lot of particles, so they're protected, but others will have high HDL-C and very few particles." Dysfunction appears to be independent of the HDL-C level.[8]
Budoff isn't ready to give up on the terms "good cholesterol" and "bad cholesterol"; he finds that they help patients realize that total cholesterol alone is not a good metric. "For 95% of people, it [HDL-C] is good," he said.

The "Good"

The inverse association of HDL-C with coronary artery disease[9] sparked research on agents to boost low levels, typically defined as < 40 mg/dL in men or < 50 mg/dL in women. However, Rosenson sees HDL-C as little more than a marker of lifestyle: Levels tend to be higher in people who exercise more, weigh less, and don't smoke.
HDL got its good name primarily because of its role in reverse cholesterol transport as the body's Roomba®, vacuuming up cholesterol from macrophages. In addition, HDL has anti-inflammatory[10] and antithrombotic[11]properties, and may ameliorate endothelial dysfunction.[12]
This has led to calls to focus on measuring HDL function, not HDL-C.[13] Assays that measure HDL efflux capacity have been shown to better predict cardiovascular events than HDL-C level.[14] However, such tests are not clinically available, and there are no international standards for them or others that aim to measure various aspects of HDL function.
What triggers dysfunctional HDL? It has long been known that such conditions as acute coronary syndrome,[15] diabetes, or systemic inflammation can alter HDL from a cardioprotective particle to one that promotes inflammation and LDL oxidation.[16] Budoff and fellow investigators for the MESA study suggest that the transition to menopause should be added to that list. In the main MESA cohort, HDL-C was inversely associated with CAD and carotid intima-media thickness (cIMT).[17] In contrast, in almost 1500 postmenopausal women, HDL-C was positively associated with increased cIMT.[18] NMR analysis suggested that small HDL particles are less susceptible to adverse modification at menopause than larger particles. HDL particles were inversely associated with cIMT for men and women—a relationship that held even after adjustment for atherogenic particles.

What to Measure?

If tests for HDL function are not ready for prime time, could measuring the size of the subfractions be the way to go, because very small cholesterol-depleted HDL particles are the main players in cholesterol efflux?[19] This, too, is overly simplistic for Rosenson, who cautioned that there are many subclasses of HDL and they're not just differentiated by density. There are more than 60 different proteins associated with HDL, but most particles will only carry a few. Which proteins confer which properties is not fully understood either. The flaw with HDL-C–raising therapies, he noted, is that loading up the particle with cholesterol led to the loss of some surface proteins important in cardioprotection.
Both Budoff and Rosenson like non–HDL-C because it captures all atherogenic particles. But what about patients with very high levels of potentially dysfunctional HDL-C? Budoff explained that when he has a patient of uncertain risk with high LDL-C and very high HDL-C, he will get the HDL particle number; such tests are commercially available. He might also suggest she (he can't remember seeing a man with HDL-C > 100 mg/dL) get a calcium score. "If the coronaries are clean, the HDL is working," he said.
The HDL hypothesis, on the other hand, is not. As a recent editorial put it: "There remains a high degree of ignorance regarding the role of HDLs as either protectors or causes of disease."[13] Rosenson for one would like to hit the reset button and begin anew by focusing on the particle rather than the so-called "good" cholesterol.
References:
  1. HPS2-THRIVE Collaborative Group, Landray MJ, Haynes R et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. 2014;371:203-212.
  2. Barter PJ, Caulfield M, Eriksson M, et al; ILLUMINATE Investigators. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med2007;357:2109-2122.
  3. Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med. 1999;341:410-418.
  4. Otvos JD, Collins D, Freedman DS, et al. Low-density lipoprotein and high-density lipoprotein particle subclasses predict coronary events and are favorably changed by gemfibrozil therapy in the Veterans Affairs High-Density Lipoprotein Intervention Trial. Circulation. 2006;113:1556-1563.
  5. Barter PJ, Rye KA. Cardioprotective properties of fibrates: which fibrate, which patients, what mechanism? Circulation. 2006;113:1553-1555.
  6. Madsen CM, Varbo A, Nordestgaard BG. Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies. Eur Heart J. 2017;38:2478-2486.
  7. Ko DT, Alter DA, Guo H, et al. High-density lipoprotein cholesterol and cause-specific mortality in individuals without previous cardiovascular conditions: the CANHEART Study. J Am Coll Cardiol. 2016;68:2073-2083.
  8. Rosenson RS, Brewer HB Jr, Ansell BJ, et al. Dysfunctional HDL and atherosclerotic cardiovascular disease. Nat Rev Cardiol. 2015;13:48.
  9. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med. 1977;62:707-714.
  10. Barter PJ, Nicholls S, Rye KA, Anantharamaiah GM, Navab M, Fogelman AM. Antiinflammatory properties of HDL. Circ Res. 2004;95:764-772.
  11. Mineo C, Deguchi H, Griffin JH, Shaul PW. Endothelial and antithrombotic actions of HDL. Circ Res. 2006;98:1352-1364.
  12. Bisoendial RJ, Hovingh GK, Levels JH, et al. Restoration of endothelial function by increasing high-density lipoprotein in subjects with isolated low high-density lipoprotein. Circulation. 2003;107:2944-2948.
  13. Barter PJ, Rye KA. HDL cholesterol concentration or HDL function: which matters? Eur Heart J. 2017;38:2487-2489.
  14. Rohatgi A, Khera A, Berry JD, et al. HDL cholesterol efflux capacity and incident cardiovascular events. N Engl J Med. 2014;371:2383-2393.
  15. Besler C, Heinrich K, Rohrer L, et al. Mechanisms underlying adverse effects of HDL on eNOS-activating pathways in patients with coronary artery disease. J Clin Invest. 2011;121:2693-2708.
  16. Ansell BJ, Fonarow GC, Navab M, Fogelman AM. Modifying the anti-inflammatory effects of high-density lipoprotein. Curr Atheroscler Rep. 2007;9:57-63.
  17. Mackey RH, Greenland P, Goff DC, Jr, Lloyd-Jones D, Sibley CT, Mora S. High-density lipoprotein cholesterol and particle concentrations, carotid atherosclerosis, and coronary events: MESA (multi-ethnic study of atherosclerosis). J Am Coll Cardiol. 2012;60:508-516.
  18. El Khoudary SR, Ceponiene I, Smmargandy S, et al. HDL (high density lipoprotein) metrics and atherosclerotic risk in women: do menopause characteristics matter? MESA. Arterioscler Thromb Vasc Biol. 2018 Jul 19. [Epub ahead of print]
  19. Rosenson RS, Brewer HB Jr, Davidson WS, et al. Cholesterol efflux and atheroprotection: advancing the concept of reverse cholesterol transport. Circulation. 2012;125:1905-1919.

Cold season and wet cough

Natural Expectorants / Mucolytics... Wet Cough / Phlegm (Mucus)

If you have a congested cough, also known as a wet cough, phlegm (mucus), consider relief in natural expectorants. These substances thin out and break up the mucus stuck in your lungs, making it easier to breathe and your cough more productive. Remember to spit out any mucus that's dislodged, rather than swallowing it. 

Also, using natural expectorants can provide symptomatic relief, but be sure to address the underlying cause of your cough. In the meantime, drink lots of fluids--staying hydrated helps thin the mucus in your lungs.

What Is Phlegm?
Phlegm is a thick and sticky fluid that is secreted in your chest. Although this secretion is the result of a natural process, in some cases, it may be the result of an underlying disease. When you are running a cold or flu and cough phlegm up, it is termed as sputum. Your body doesn’t usually produce too much phlegm unless you are sick. The best way to find whether your phlegm is an indication of any disease is to look for its color. 

Given below is a phlegm color guide that can help you:

Green Or Yellow Phlegm
Green or yellow phlegm is usually an indication that your body is fighting a disease. Medical conditions like bronchitis, pneumonia, sinusitis, and cystic fibrosis may result in green or yellow phlegm. But you must also look for other symptoms to identify which one of these you are actually suffering from.
White Phlegm
The most common conditions that lead to the formation of white phlegm include viral bronchitis, gastroesophageal reflux disease, and congestive heart failure.

Brown Phlegm
Brown phlegm is usually rusty and most often hints at old blood. It is usually caused by bacterial pneumonia and bacterial bronchitis.
Red Or Pink Phlegm
The main cause of pink or red phlegm is blood. Infections like pneumonia, tuberculosis, congestive heart failure, pulmonary embolism, and even lung cancer may be the underlying cause of pink or red sputum.
Black Phlegm
Melanoptysis is another term used for black sputum. Black sputum is usually a sign that you have inhaled high amounts of something black, say coal dust or kohl. It is commonly caused by smoking, pneumoconiosis or a fungal infection caused by a black yeast called Exophiala dermatitidis.

Excessive phlegm is usually the result of an allergy or infection. It can also be caused by certain foods like milk and other dairy products, chemotherapy, pregnancy, or even candida infections.

The symptoms that surface with the build-up of phlegm usually vary depending on its cause. However, some common signs and symptoms of phlegm associated with excessive fluid build-up are mentioned below.

Signs And Symptoms Of Phlegm
The most common signs and symptoms of an excessive phlegm build-up include the following:
  • Coughing up mucus and phlegm
  • A runny nose
  • Nasal congestion
  • A sinus headache
  • A sore and congested throat
  • Shortness of breath

Most cases of phlegm build-up are a result of infections like a cold or flu and can be cured easily. 



Natural Expectorants / Mucolytics… 

N-acetylcysteine (NAC)

NAC is a supplement that can be used to thin the mucus in the airways and reduce the frequency and severity of a cough.

After analyzing 13 studies, researchers found that people with chronic bronchitis can benefit from taking 600 milligrams (mg) of NAC daily if no airway obstruction is present. Those with an airway obstruction may need to take up to 1,200 mg daily.

Bromelain

Bromelain is an enzyme that comes from pineapples. It is most plentiful in the core of the fruit. Bromelain has anti-inflammatory properties and may also have mucolytic properties, which means that it can break down mucus and remove it from the body.

Probiotics

Probiotics do not directly relieve a cough, but they may boost the immune system by balancing the bacteria in the gut. A superior immune system can help to fight off infections or allergens that may be causing the cough.

Licorice

Licorice is not only a natural expectorant, it soothes irritated throats and inflamed lungs and it acts as a cough suppressant as well. Drink a tea made with 1/2 tsp. licorice root three times a day, or use purchased lozenges as directed. Do not take licorice if you have high blood pressure.

Sage Tea

Sage is another natural herbal expectorant and is easy to take in the form of sage tea. Use 2 tsp. of fresh leaves or 1 tsp. of dried sage per cup of hot water. Drink two to three times daily; sweeten with honey if desired. The book Smart Medicine For Healthier Living suggests combining sage with thyme as a tea; thyme is another excellent expectorant. Pregnant and nursing women should avoid large medicinal doses of sage. Culinary use is permitted.

Horehound

Many herbalists recommend horehound as an effective natural expectorant. It also acts as a relaxant and cough suppressant, soothing irritated lungs. It is believed that marrubin, one of the compounds found in horehound, helps stimulate bronchial secretions. Horehound is very bitter, so sweetened lozenges are the usual remedy recommended; tablets are also available.

Eucalyptus

Eucaplytus acts as both a decongestant and an expectorant. Most people are familiar with it in lozenge form, but in the case of a persistent cough, it is perhaps more effective as a steam or chest rub. Health 911 suggests using 10 to 15 drops of eucalyptus oil plus three drops of hyssop oil, another strong expectorant, in a pot of boiling water; inhale the steam that results.

Cayenne

Cayenne thins and loosens mucus, making it easier to expel from the lungs. It also stimulates the body, including the chest. Home remedies include eating hot peppers and adding a dash of red pepper to medicinal teas. You can also take it in capsule form.

Garlic

Garlic has earned its reputation as an herbal cure-all. As an expectorant, it can be used as a steam inhalant, a chest rub or taken internally. Eat a raw garlic clove one to three times daily. Alternatively, you can prepare a garlic-based cough syrup. The easiest method is simply to grate a clove of garlic into a teaspoon of honey and eat.

Friday, October 5, 2018

Why Grounding is so important.

Have you heard the phrase, "are you grounded"
It may be a strange phrase to some and to others it is a daily practice and awareness. I am here to share why grounding is important and how simple it is to do.

When we feel tired, stressed and out of sorts or even feel lost, it is important to ground ourselves.
What does this mean? Grounding is really just being present in your body and on earth. I just read an interesting and simple explanation but Madison Taylor and it reminded me that even I tend to make it a bit more complicated than it needs to be. 

Start by taking a few deep breaths in and out, being aware of your breath, your lungs expanding and your exhalation. When you take a few deep breaths, you immediately relax and slow your heart rate. It creates a deeper awareness of you in your body, of your own energy. Once you have become aware of your breath and slowed down enough to pay attention to it, increase your focus on your body. Now scan your body with your awareness, meaning let your attention move from the top of your head all the way down to your toes, lingering on all the organs and muscles and limbs. Notice if there is any pain or sensations and send your breath there. (do this with your intent to breathe into that part of you)

You have now anchored your energy in your body and you are present with yourself. Now, extend that focus to your feet and how they are planted on the ground, the earth. Imagine that there is an energy or power extending out through your feet deep into the earth, like roots of a tree. These roots grow deeper and deeper into the earth.  Feel the connection and the peace of that.

Congratulations, you are now grounded.

From this space you can feel the earth energy and your physicality. You tend to make better decisions when you are present in the moment and not too in your head or out there in the present, or back in the past.

Grounding yourself is and can be as simple as deep breathing and your awareness of that, followed by flowing your energy through your body and deep into the earth. Try it, you will love feeling more connected to your present moment.