medicina deportiva

#Estudo sugere que 4400 passos por dia bastam para reduzir risco cardiovascular

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exercicios

Estudo sugere que 4400 passos por dia bastam para reduzir risco cardiovascular

 

Quando se trata de viver mais tempo e melhor, alcançar a meta dos 10 mil passos por dia pode não ser mais necessário. Essa é uma informação gerada de um estudo observacional publicado recentemente no JAMA Internal Medicine.

Ainda de acordo com o novo estudo, as mulheres mais velhas que andaram mais do que os seus companheiros tiveram taxas de mortalidade menores. Elas deram apenas 4400 passos por dia para se exercitar.

Mas, de onde saiu esse número?

Curiosamente, o número tem como origem uma campanha de marketing do Japão dos anos 1960. Na preparação para a Olimpíada de 64, em Tóquio, uma empresa criou um dispositivo voltado aos consumidores preocupados com a saúde. Ele era chamado de Manpo-Kei, que significa “medidor de 10 mil passos”.

O aparelho foi um dos primeiros podômetros, baseado no trabalho do médico Yoshiro Hatano, do Departamento de Saúde e Bem-Estar da Universidade Kyushu.

Por que isso importa?

A maioria das pessoas, independentemente de sua idade ou nível de condicionamento físico, pode andar em seu próprio ritmo, tornando essa forma de atividade física amplamente acessível.  Mas para muitos idosos, a ideia de dar 10 mil passos todos os dias pode parecer assustadora, podendo desencorajá-los a caminhar mais.

Com tudo isso em mente, o Comitê Consultivo de 2018 sobre atividades físicas solicitou mais pesquisas sobre a relação dose-resposta entre passos diários e uma boa saúde.

Metodologia

Ao longo de uma semana, 16. 741 mulheres com idade média de 72 anos usaram acelerômetros durante suas horas de vigília. Os pesquisadores coletaram dados ao longo de quatro a sete dias. As mulheres foram divididas em quatro grupos, com base enquanto caminhavam. Os pesquisadores rastrearam quantas mulheres morreram em cada quartil durante uma média de 4,3 anos de acompanhamento.

Resultados

  • As mulheres tomaram uma média de 5499 passos por dia. Foi um pouco mais do que a média dos Estados Unidos, medida por smartphones, de 4800 passos. Durante o seguimento, 504 mulheres morreram;
  • Mulheres com média de, aproximadamente, 4400 passos diários tiveram taxas de mortalidade menores do que aquelas que tomaram cerca de 2700 passos por dia;
  • Houve uma resposta à dose, particularmente no extremo inferior ou inativo do espectro;
  • Houve declínios adicionais na mortalidade entre as mulheres que andaram mais. Mas apenas até cerca de 7.500 passos diários. Além desses, as taxas de mortalidade se estabilizaram;
  • Andar mais rápido ou mais devagar não pareceu afetar as taxas de mortalidade quando o número de passos foi calculado.

Uma advertência

Este tipo de estudo não pode provar definitivamente que andar mais ajuda as pessoas a viver mais. É possível que as mulheres que estavam doentes no estudo tenham reduzido os seus passos, por exemplo.

No entanto, os pesquisadores controlaram muitos fatores que poderiam ter influenciado os resultados. Incluindo o estado de saúde, a idade, a dieta e o estilo de vida.

Também foram analisados novamente os dados, com resultados semelhantes, após a exclusão de mulheres que podem não estar em boa saúde com base em fatores como diabetes, câncer ou baixo peso.

O que os pesquisadores dizem?

Os resultados provavelmente se aplicam a todos os indivíduos que não são muito ativos, incluindo homens e mulheres mais jovens. Essa informação veio do principal autor do estudo, I-Min Lee, MD, ScD, do Hospital Brigham and Women e Harvard Medical School, em Boston.

“Dê mais passos, até mesmo um número modesto de etapas está associado a uma mortalidade mais baixa. Todas as etapas contam, não apenas as tomadas durante o exercício”, disse I-Min Lee.

 

PebMed

Autora: 

Jornalista carioca. Diretora executiva do Digitais do Marketing, colunista de cultura e maternidade dos sites Cabine Cultural e Feminino e Além, respectivamente.

Referências:

#Deeper Dive Into CTE, #Dementia in Football Reveals New Players

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It turns out that white matter matters. Researchers have found greater white matter changes in association with more years of playing American football — a novel finding that paints a more complete picture of dementia risk beyond tau protein and other factors known to contribute to dementia.

A post mortem study of 180 former football players who donated their brains supports previous findings that a greater amount of phosphorylated tau protein in the brain is associated with dementia and duration of play.

The research advances the field with findings of a direct association between severity of white matter changes, number of years of playing football, and risk for dementia in these former athletes who had been diagnosed with chronic traumatic encephalopathy (CTE).

Another new finding emerged — that a factor not associated with repetitive head impacts (RHIs) contributed equally to dementia risk — atherosclerosis associated with aging and cardiovascular disease.

“The findings underscore that the etiology of dementia and other clinical signs and symptoms among older, former American football players is multifaceted and likely related to tau and non-tau pathologies,” lead author Michael L. Alosco, PhD, assistant professor of neurology and clinical care and co-director of the Boston University Alzheimer’s Disease Center and the Boston University CTE Center at Boston University School of Medicine, told Medscape Medical News.

“It is therefore critical that treating physicians consider these multifaceted etiologies of the clinical signs and symptoms when treating and coordinating care for symptomatic individuals who have been exposed to repetitive head impacts,” he said.

The study was published online August 5 in JAMA Neurology.

Arteriosclerosis an Equal Contributor

The association between phosphorylated tau and dementia “is consistent with what we see in other neurodegenerative disease fields, like Alzheimer’s disease,” Alosco added. “However, it was quite notable that white matter rarefaction and arteriosclerosis equally contributed to dementia in this sample.”

Previous research suggests that tau and non-tau pathways, including cerebrovascular disease, are related to the delayed effects of repetitive head injury with respect to dementia among individuals with CTE.

However, the contribution of phosphorylated tau pathologic changes, comorbid neurodegenerative disease, or other pathologic conditions to dementia in CTE remains unclear, the researchers note.

To learn more, the investigators studied 180 men who were aged 40 years or older at the time of death and who had played US football. Each person had been neuropathologically diagnosed with CTE.

Their brains were donated to the Veterans Affairs–Boston University–Concussion Legacy Foundation brain bank as part of the ongoing Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) study.

The investigators performed semiquantitative assessment of white matter rarefaction and arteriolosclerosis. Rarefaction reflects overall white matter integrity, including degree of myelin loss, extent of tissue attenuation or vacuolization around small blood vessels, and the density of reactive astrocytes.

They also conducted telephone interviews with informants and recorded medical and clinical histories, including the presence, nature, and timeline of symptoms associated with cognition, behavior, or mood and daily functioning.

The number of years playing football was a proxy for experiencing RHIs.

Diverse Pathologies

Of the 180 donors with CTE, 120 had dementia prior to death.

The investigators linked increasing age with more severe white matter rarefaction (β, 0.37; 95% confidence interval [CI], 025 – 0.50), high CTE stage (β, 0.32; 95% CI, 0.19 – 0.45), and increased likelihood for dementia (β, 0.27; 95% CI, 0.13 – 0.42). All of these differences were statistically significant (P < .001).

Race did not significantly affect white matter rarefaction, CTE stage, dorsolateral frontal cortex neurofibrillary tangles burden, or dementia.

Adjusted analysis showed that compared to participants with a lower burden of dorsolateral frontal cortex neurofibrillary tangles, those with a high burden had a 2.65 greater increased risk for dementia (odds ratio [OR], 2.65; 95% CI, 1.24 – 5.70; P = .01).

Although arteriolosclerosis was not associated with number of years playing football, it was independently associated with dementia (β, 0.21; 95% CI, 0.07 – 0.35; P = .003).

Alosco and colleagues note that white matter rarefaction and arteriosclerosis “seemed to be a result of different causes, with white matter rarefaction related to repetitive head impact exposure…and arteriolosclerosis from cardiovascular disease.

“The findings speak to the diverse pathologies found in CTE and how they each uniquely contribute to clinical signs and symptoms, including dementia,” they add.

Future research is warranted, Alosco said. Longitudinal studies in living individuals exposed to repetitive head impacts that use various in vivo biomarkers to estimate white matter and cerebrovascular disease and other pathologies “are essential to determine how these pathologies might contribute to the clinical course and presentation of CTE or other neurological disorders associated with repetitive head impacts.

“Along these lines, we are continuing to investigate risk factors and biomarkers for CTE in order to facilitate the ability to diagnose this disease during life,” he added. “This is the critical next step.”

New Insights, Intriguing Data

“The authors uncovered several important and new insights into the pathologic pathways to dementia in deceased individuals who had played football and had had CTE,” Julie A. Schneider, MD, of the Rush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, notes in an accompanying editorial.

The researchers showed that the number of years of playing football was associated with severity of tau pathology independently of other neurodegenerative disorders, she noted.

“More intriguing was a second white matter pathway, which connected years of play with dementia via the severity of white matter rarefaction independent of the tau pathway,” Schnieder writes.

Therefore, “the authors provide intriguing data regarding the importance of both the white matter and tau pathways,” said Schneider, who is also affiliated with the Department of Pathology at Rush University Medical Center.

Furthermore, the study is noteworthy because the investigators also “found that small-vessel disease in the form of arteriolosclerosis provides a third and distinct pathway to dementia in football players with CTE,” she writes.

Comprehensive neuropathologic examinations, advanced statistical techniques, and multiple sensitivity analyses are strengths of the study, Schneider notes.

Selection bias is an “important limitation.” The researchers assessed a convenience sample of individuals who had played football, were deceased, had opted in or been opted in for brain donation, and were found to have CTE.

“Thus, the frequency of pathologic characteristics in this group should not be generalized to estimate the prevalence of neuropathologic conditions in living individuals who have played or are playing US football,” she writes. Recall bias is an additional potential limitation, she notes.

“In spite of these limitations, the authors should be applauded for elegant work and compelling support for multiple pathologic pathways to dementia in football players with CTE,” Schneider states.

The study was supported by grants from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, the Department of Veterans Affairs Merit Award, the Nick and Lynn Buoniconti Foundation, and the National Center for Advancing Translational Sciences. The study authors’ relevant financial relationships are listed in the original article. Schneider has been an expert consultant for the National Football League and the National Hockey League.

JAMA Neurol. Published online August 5, 2019. AbstractEditorial

 

 

 

#Excesso de exercícios físicos pode afetar o coração e o fígado

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exercícios

Excesso de exercícios físicos pode afetar coração e fígado

 

Já é fato que treinar demais e descansar pouco causa problemas como insônia, enfraquecimento da imunidade e dores musculares. Mas os malefícios podem ir além. Cientistas brasileiros estão em busca dos efeitos do exercício físico excessivo no coração e no fígado.

Pesquisadores da Universidade Estadual de São Paulo (USP) e da Universidade Estadual de Campinas (Unicamp) reuniram as suas principais descobertas sobre o tema em um artigo publicado recentemente no periódico Cytokine. As pesquisas receberam apoio da Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp).

Em testes realizados com camundongos, coração, fígado, músculos e sistema nervoso mostraram alterações (algumas prejudiciais) após treinos muito intensos. Os exames incluíram corridas no plano, na subida e na descida por oito semanas.

Nos músculos, as células demonstraram mais dificuldade em captar a glicose no sangue. Na descida, por exemplo, os animais apresentaram ainda sinais de atrofia e má formação de proteínas no interior das células.

Novos testes mostraram que, como as células musculares mostraram maior dificuldade de captar glicose, o fígado ajudou o organismo a aumentar o estoque.

Por outro lado, os cientistas constataram também maior acúmulo de gordura no fígado e sinais de inflamação (esteato-hepatite). Isto pode estar relacionado à atuação compensatória do fígado na administração do estoque de glicose, mas isso ainda não foi confirmado.

“O aumento da gordura no fígado é muito ruim, pois tem relação com uma série de doenças, como obesidade e diabetes. Mas é importante destacar que, nos experimentos, não constatamos essas doenças, apenas o acúmulo de gordura”, destaca Adelino Sanchez Ramos da Silva, coordenador da pesquisa e professor da USP.

Até mesmo o coração incrementou a sua participação na captação da glicose, com um maior acúmulo da substância em seus tecidos. Mas, como efeito negativo no coração, após as oito semanas de treino excessivo, foi observado também sinais de fibrose no ventrículo esquerdo.

Tanto neste órgão, quanto no fígado, sangue e músculos, foram detectados ainda marcadores inflamatórios.

Um período de descanso de duas semanas fez com que os camundongos recuperassem o seu peso e apetite, duas alterações clássicas no estudo dos exercícios de intensidade.

O importante papel das citocinas

Uma outra inovação proposta pelos pesquisadores diz respeito ao papel das citocinas. Uma explicação aceita na literatura científica até agora é a de que as citocinas seriam liberadas com o exercício excessivo, levando a várias mudanças no organismo e à queda na performance.

A hipótese da citocina considera que um desequilíbrio envolvendo exercício excessivo e recuperação inadequada induz trauma musculoesquelético, aumentando a produção e liberação de citocinas pró-inflamatórias, principalmente interleucina 6 (IL-6), fator de necrose tumoral alfa (TNF-alfa), e interleucina 1 beta (IL-1beta), que interagem com diferentes sistemas orgânicos, iniciando a maioria dos sinais e sintomas ligados ao decréscimo de performance.

Este estudo utilizou dados recentes para discutir as bases científicas da teoria das citocinas de Smith e destacou que os efeitos adversos do exercício excessivo vão além do declínio do desempenho, propondo uma abordagem de múltiplos órgãos para essa questão.

Essas descobertas recentes permitirão que treinadores e fisiologistas do exercício desenvolvam estratégias para evitar resultados adversos crônicos induzidos pelo exercício exagerado.

Entretanto, os estudos liderados pelo pesquisador Adelino Silva vem demonstrando que, mesmo quando as citocinas já estão em níveis normais após uma série de exercícios, a performance pode continuar prejudicada.

Assim, os cientistas brasileiros defendem que as citocinas não são a única explicação para a queda na performance. Portanto, a busca por outras justificativas continua.

 

PebMed

Autora: 

Jornalista carioca.

Referências:

#La grosse cote des #cétones sur le Tour de France

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Qu’est-ce qui fait le buzz (et peut-être les performances) sur le Tour de France ? Deux mots : low carb et cétones. Décryptage avec les commentaires du Dr Fabrice Kuhn.

Low carb, régimes céto et cétones

Le low carb, c’est le régime pauvre en glucides adopté par Chris Froome pendant l’entraînement, également suivi par les rugbymen All Blacks et un nombre croissant d’athlètes dans le monde.

Les cétones, ce sont ces composés issus des graisses, que le foie fabrique au cours d’un jeûne ou d’un régime cétogène (très pauvre en glucides), qui est la forme extrême du low carb.

Les cétones peuvent aussi être utilisées sous la forme de compléments alimentaires. Les suppléments de cétones, utilisés de pair avec un régime pauvre en glucides, sont considérés comme une source d’énergie supplémentaire qui aide à préserver le stockage du glycogène, à réduire l’acide lactique et à aider à la récupération. Il ne s’agit pas de produits dopants.

Jumbo-Visma en pointe

L’utilisation de suppléments de cétones dans le cyclisme professionnel remonte aux Jeux Olympiques de 2012 à Londres. Plusieurs équipes du Tour 2019 font appel à des suppléments de cétones, selon une enquête parue dans le journal néerlandais De Telegraaf. Les cétones seraient notamment employées par les coureurs d’Ineos (ex-Team Sky) et par ceux de QuickStep. Mais seule l’équipe Jumbo-Visma en parle ouvertement. Peut-on parler de lien de cause à effet avec le palmarès d’ores et déjà impressionnant de cette équipe ? Impossible à affirmer, mais il y a eu sur le Tour 2019 la victoire de Mike Teunissen, celle du contre-la-montre par équipe, celle du sprinter Dylan Groenewegen et celle du débutant Wout van Aert.

Une petite étude contrôlée, de l’Université de Louvain (Belgique), parue en avril 2019, a conclu que la prise de de cétones par des cyclistes lors des phases de récupération permet d’augmenter de 15% les performances. L’étude était conduite par l’équipe du Pr Peter Hespel, par ailleurs consultant de QuickStep. Dix-huit jeunes hommes en bonne forme physique ont participé à deux séances d’entraînement quotidiennes pendant 3 semaines, 6 jours par semaine tout en recevant soit un ester cétonique, soit une boisson témoin après chaque séance. La charge d’entraînement soutenable en 3e semaine ainsi que la puissance dans les 30 dernières minutes d’une séance d’endurance standardisée de 2 heures étaient 15 % plus élevées chez les volontaires ayant pris des cétone.

En pratique

Les corps cétoniques peuvent être pris sous forme de boisson, en général une petite bouteille de 25 grammes, mais, “à un prix déraisonnable”, dit le Dr Fabrice Kuhn, auteur du livre « Ultra-performance », qui décrit comment conduire des entraînements à glycogène bas. Cette bouteille augmente la concentration de corps cétoniques dans l’organisme comme le ferait un jeûne alimentaire ou un régime cétogène. La quantité maximale recommandée est de trois bouteilles de 25 grammes par jour. “Ces boissons serviraient de substrat de l’effort“, explique le Dr Kuhn. “Elles permettraient également d’économiser le glycogène musculaire; de plus, les cétones pourraient orienter le mélange des carburants de l’effort vers les lipides; enfin, les cétones pourraient faciliter la reconstruction des stocks glycogéniques musculaires après un effort. Mais les résultats sur la performance ne sont pas clairs, même si des gains de perfromance de ont té observés en aviron et lors d’un contre-la-montre de 50 minutes à vélo“.

Une alternative consiste, en période d’entraînement à suivre un programme à glycogène bas comme le détaille le Dr Fabrice Kuhn dans son livre.

#Cardiomiopatia Hipertrófica: uma das principais causas de morte súbita em atletas

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Cardiomiopatia Hipertrófica: uma das principais causas de morte súbita em atletas

 

No último dia 12 de julho, o jogador de futebol profissional Adilson Warken, 32 anos, volante do Atlético-MG, anunciou sua aposentadoria do futebol em razão de uma miocardiopatia hipertrófica (MCH). Assim, acendeu-se um alerta sobre a doença e o porquê ela teria sido tardiamente diagnosticada. Vamos a literatura para correlacionar essa doença ao esporte.

“A MCH é uma das principais causas de morte súbita em atletas relacionada com exercício e o esporte em indivíduos com menos de 35 anos”

Essa é a primeira frase do tópico da diretriz sobre MCH. Esta evidencia a importância dessa enfermidade no dia-a-dia de quem trabalho com atletas de alta performance. Algumas evidências são interessantes e mostram que 10,3% dos óbitos com atletas são causados por MCH. E, desses, 27,5% possuíam coração normal.

Conceitua-se a doença por ter base genética, autossômica dominante. E se caracteriza por um desarranjo miofibrilar dos miócitos, apresentando hipertrofia assimétrica com ou sem obstrução da via de saída.

Os portadores da MCH podem ser totalmente assintomáticos ou apresentar sintomas como: lipotimia, síncope, palpitações e angina. Isso se correlaciona ao esporte por aumento da demanda miocárdica ou obstrução da via de saída. Além disso, é possível diagnosticar por alguns testes e exames, como:

Teste Genético

Os testes genéticos vêm mudando o olhar sobre essa doença. Já estão mapeados mais de 1700 mutações genéticas. Os genes da cadeia pesada da betamiosina (MYH7) e da miosina carreadora da proteína C (MYBPC3) são os mais frequentes. Nesses casos, aconselhamento genético por equipe multidisciplinar se faz necessário.

ECG

Há alterações características no segmento ST e na onda T, inversão de onda T, sendo profundas nas derivações laterais. Além dessas alterações, é possível verificar o aumento atrial esquerdo, com prolongamento da onda p > 120 ms nas derivações I e II, com porção negativa da onda p >= 1 mm na derivação V1 e BRE, podendo sugerir MCH.

Ecocardiograma

Método fundamental na avaliação da MCH. Pois, além do grau da hipertrofia, pode determinar o gradiente entre VE e a aorta, alterações da valva mitral, como movimento anterior sistólico da mitral e padrões de alteração da função diastólica. É importante a integração de informações como distribuição da hipertrofia, espessamento parietal, tamanho das cavidades, função diastólica pelo doppler tissular e história familiar. Os atletas apresentam menor espessura de parede de VE, maior diâmetro diastólico final e maior fração de ejeção. Porém, há uma zona cinzenta (13 a 15 mm), como mostra a tabela abaixo, que sugere atenção a alguns pontos.

Ressonância Magnética Cardíaca

A RNM vem ganhando papel de destaque no diagnóstico por imagem na MCH. Isso acontece por esse exame ser considerado padrão ouro em casos de dúvida diagnóstica. No exame, é possível visualizar mudanças sutis na espessura e na contratilidade do VE ao longo do tempo. Além disso, é capaz de detectar áreas de fibrose, assim como auxilia no diagnóstico diferencial entre amiloidose e sarcoidose.

Teste Ergométrico e Teste Cardiopulmonar

O TE apresenta seu valor no prognóstico do paciente. Uma das alterações que é possível ver são alterações no segmento ST, que podem indicar isquemia sem ter alteração nas coronárias. Geralmente, utiliza-se o protocolo de rampa, individualizado, sendo feito para durar de 8 a 12 minutos.

O TECP pode estratificar os doentes com relação a morbimortalidade e auxiliar atletas que se encontram na zona cinzenta, entre a hipertrofia fisiológica do coração do atleta e a patológica da MCH. Isso é possível pois esse teste consegue mensurar o consumo de oxigênio e o pulso de oxigênio de pico. Atletas possuem consumo de pico de oxigênio mais elevado do que atletas com MCH.

Logo, é comum, e há relatos de atletas de descobriram a doença após a aposentadoria, indicando que a MCH não necessariamente irá causar morte súbita. Porém, é importante ressaltar que o exercício intenso pode ser um gatilho para arritmias graves, aumento da obstrução da via de saída do VE e/ou isquemia por compressão dos pequenos vasos e pode causar morte súbita.

Sendo assim, atletas com diagnóstico provável devem ser excluídos dos esportes competitivos. Exceto, os de baixo risco, que podem participar de esportes como golfe, bilhar, boliche e tiro.

 

PebMed

Autor: 

Cardiologista e médico do esporte.

Referências:

  • Ghorayeb N, Stein R, Daher DJ, et al. Atualização da Diretriz em Cardiologia do Esporte e do Exercício da Sociedade Brasileira de Cardiologia e da Sociedade Brasileira de Medicina do Exercício e Esporte. Arq Bras Cardiol. 2019; 112(3):326-368.

#20 Warning Signs of Poor Blood Circulation in Your System

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Good health depends on a lot of different factors, and a proper blood circulation is one of its main ones. The blood in our bodies is the responsible fluid to take nutrients and oxygen from one spot to another. Helping our body functioning correctly and being balanced. Whenever our blood circulation fails to deliver the proper nutrients to the specific parts of our body, that leads to a diverse range of health issues.

If these issues are left untreated, poor blood circulation can cause severe damage to our heart, brain, liver, limbs, and kidneys. There are many reasons why you may suffer from poor blood circulation. One of the most common ones if atheroscletosis. Which is also known as the hardening of the arteries. As well as peripheral artery disease (also known as PAD).

However, poor blood circulation can also be a result of a variety of health problems. Such as heart diseases, diabetes, blood clots or obesity. An excess of drinking, smoking, and also things like eating disorders or pregnancy can make you extremely vulnerable to this conditions.

If you are aware of the symptoms that show up when your blood circulation isn’t the appropriate, you will be able to control the reason behind it and find a timely treatment. Poor blood circulation can also lead to heart attacks, strokes, or even death. So make sure to check up with your doctor if you experience any of the symptoms listed below in this article. Keeping a healthy blood circulation is key to staying healthy and leading a good lifestyle!

Doctors can process a number of tests on you to find out what is causing your poor blood circulation, thus finding an appropriate solution in a timely manner. So read our article below to find out more about blood circulation.

1.Blood circulation: Swelling of lower extremities

A number of causes can produce swelling on your feet. For example, sitting or standing for a very long period of time in the same position. Or suffering from obesity, malnutrition or PMS (pre-menstrual syndrome). Among others such as high salt intake, ageing, leading a sedentary lifestyle or being pregnant. However, these listed types of swelling are only temporary and do get better within hours.

If the swelling or edema on your feet lasts for a long time, then the reason may relay on poor blood circulation. The explanation for this is that the lack of proper blood circulation make it so that the kidneys are unable to function as they should. By not being able to keep fluids in the blood vessels where they should be. The result of this is the leeching out of fluids which then settle in the surrounding tissues. This leads to swelling. In very severe cases, this poor blood circulation process can cause leg ulcers.

An easy trick to reduce swelling on your feet and legs is by laying down and raising your legs above heart level. Use some pillows or a higher chair to do so. Relax and apply cold if possible (never directly on the skin, always use towels or blankets to prevent skin burns from ice). If swelling does not reduce within a couple hours, please do consult your doctor. Blood circulation should improve once you’re laying down. But if it doesn’t, it could be a sign of poor blood circulation and needs to be diagnosed

If you also get swelling in other extremities or if your swelling includes discolouring or bruising under your skin make sure to inform your physician about that. Take pictures and write down when it happened and how it happened, if anything triggered it.

2.Blood circulation: Numbness of hands and feet

Numbness of hands and feet can be a consequence of numerous factors. But it can also be a sign of poor blood circulation. Numbness is usually felt in two different ways. The first one being a slight tingling on your extremities. This is reported to feel like little insects or ants walking over your skin. Just like when your hands or feet fall asleep and start waking up again.

The second symptom being what is usually called numbness. A feeling of numbness is when you stop feeling your extremities the way you usually do. When poor blood circulation comes into play, you will have this feeling that your hands and feet are swollen and cannot really feel what you touch. Like if your extremities had fallen asleep and couldn’t really wake up.

In this case, you need to be careful not to hurt yourself when doing normal activities as you won’t have full sensitivity in your hands and feet. Whenever your blood circulation is not at its best, there are several things you can do to help your extremities.

First of all, keep your hands and feet warm. Move them around, clap your hands, walk often. Don’t let your blood circulation get the best of you! If you have to sit or stand in the same position for long at work, make sure to take small breaks. Move around and stretch to help your blood circulation get back to normal. This will also help you get a little extra fitness!

If you do feel like your hands or feet are often feeling numb or tingling, you may want to check with your doctor. Blood circulation issues can be solved easily if treated on time. Just give a quick call to your local doctor if you have any of these symptoms.

3.Blood circulation: Cold hands and feet

Similarly to the above, having cold hands and feet is a symptom of bad blood circulation. It usually goes hand in hand with numbness and tingling, but not always. You may experience them together or separately.

Our blood is what maintains our body temperature. Thus, when having poor blood circulation, your extremities may suffer from a loss of temperature. Your hands and feet are the furthest parts of your body, so it’s normal that they suffer first. Including your fingers and toes. Additionally, blood circulation is what takes the oxygen to the cells around the body. When oxygen levels drop in your cells, this can lower the body’s temperature.

If you feel like your hands and feet are getting too cold, make sure to rub them. Try clapping your hands, jumping, massaging your hands and feet. Moving around will help getting your blood circulation going. However, poor blood circulation is not the only thing that could cause this symptom. A peripheral neuropathy, Raynaud’s syndrome, or even an underactive thyroid are common causes. Make sure to cover your extremities if it is cold outside and to use loosen clothes. This will help with your blood circulation. Additionally, make sure to use the correct size of shoes to tackle the problem on the feet. High heels or open shoes may cause blood circulation issues if used with the wrong size or temperature.

Whatever the cause, it is very important to tackle the problem correctly. Your doctor will be able to diagnose what causes your cold hands and feet. If related to blood circulation, you will get proper treatment. Make sure to bring all your current medications with you and to list any other symptoms that you may feel. Same applies to any other causes whenever needed.

4.Blood circulation: Persistent tiredness and fatigue

Tiredness is a typical symptom of physical effort and can also be linked to numerous drugs. Nonetheless, when consistently feeling weakness and fatigue, the reason may lay on poor blood circulation to various body parts.

Struggling organs will fight to make sure they continue functioning correctly. It even influences the way muscles work. As they are not getting enough nutrients and oxygen.

Alongside weariness and tiredness, a few people may significantly experience the ill effects of shortness of breath, absence of stamina and sore muscles. These are few of the associated symptoms of poor blood circulation related to your system. More reasons for tiredness include excessive drinking (alcohol abuse), uncontrolled intake of caffeine, lack of quality sleep, inactivity, bad dietary patterns, anxiety, grief, depression and stress.

All in all, having proper blood circulation means having good health. As soon as blood circulation is affected, our body will show symptoms to alert us. If you feel like you have any of the ones listed in this article, you really want to contact your doctor. Blood carries the oxygen around our body, and a lack of oxygen in our cells and brain can cause critical issues in the long-term. When caught early enough, it can be cured and controlled without further issues.

However, tiredness and fatigue may also be the symptoms of a list of other diseases. This is also why it is important to always keep your doctor in the loop of what happens within your body. Either by poor blood circulation or any other reason, it is important that you feel energetic and ready to conquer the day at any given time! If that is not how you feel, you definitely need to visit your doctor of choice to check your blood circulation.

5.Blood circulation: Slow healing and weak immune system

A slow blood circulation (also called circulatory system) will directly affect your immune system and general health. Because of poor blood circulation, your body is not receiving the vitamins and minerals that it needs to fight off diseases and infections. As these are not distributed in a timely manner or even in proper amounts. This directly affects the capacity of your body to recognise, diagnose, and fight off pathogens.

Whenever your immune system is weak, you will notice that your body suffers more often from common diseases or takes you longer to heal. You may also notice that you get bruised easily, this is due to blood thinning. Or even that small wounds hurt more and take very long to heal or scar. Your gums may bleed as well as your nose.

To enhance your blood circulation and get your immune system back to work, make sure to incorporate exercise in your every day schedule. Even just 20 minutes of walking, five to seven times a week can make a real difference to your blood circulation and immune system. Additionally, keep a balanced diet so that your body gets all the right nutrients. Make sure that your dishes are colourful and incorporate plenty of leafy greens, veggies, fruits, and proteins. Avoid sugars and processed foods, as well as carbonated sodas.

If after doing all these things you still feel weak and not healing properly, it is necessary that your refer your problems to your doctor. The physician will be able to diagnose whether your issues are related to poor blood circulation or to any other cause. Whatever the reason, make sure to follow the steps your doctor lays down for you and keep a balanced lifestyle with exercise and proper nutrition.

6.Blood circulation: Varicose veins

Varicose veins developing in the legs can be a side effect and also a reason for poor blood circulation. Because of an incorrect blood circulation system, there is a pressure buildup in your legs. This leads to varicose veins just under the first layer of the skin. Veins then become extremely visible, twisted, and swollen.

Varicose veins have a tendency to show up on the lower part of the legs and cause itchiness, irritation, pain, restlessness, heaviness and burning sensations. The presence of protruding veins is obviously a beauty concern for those suffering it and having to show off their legs at work or social events. However, varicose veins are not only caused by poor blood circulation. They are also common symptoms of hereditary diseases, obesity, hormonal changes, jobs that require standing still, the use of birth control pills, and even constipation.

On the off chance that you have varicose veins, it is extremely important to wear pressure stockings to allow for appropriate blood circulation to occur. Additionally, counsel your specialist to decide the correct reason and treatment for your varicose veins. Varicose veins can be treated with non-invasive procedures such as massages, use of compression stockings, and laser. But can also be reduced with injections and surgery.

Additional Information:

Making a few changes in your lifestyle and nutrition will help control, reduce, and prevent the appearance of varicose veins. If the reason behind them is indeed poor blood circulation, your doctor will be able to prescribe proper medication. As well as providing important advises to get your circulatory system in motion again! Always make sure to bring a list of your medications when visiting the doctor and listing any other symptoms you may be suffering from. This will help with the diagnose and get you back on your feet in a timely manner!

7.Blood circulation: Hair loss

Balding with no apparent reason is an unmistakable sign that blood isn’t getting pumped appropriately around your system. The moment your scalp is not receiving the appropriate amount of essential nutrients, you will feel your hair becoming thin and dry. Thus falling out at a higher rate than usual.

When the hair loss issue is related to poor blood circulation, the use of specific shampoos is unnecessary. Instead, it is very important to activate the follicles in your scalp. In order to do so, make sure to wash your hair with your head downwards and massage throughout. This will activate the cells of your scalp and bring more blood circulation to it. Another way to diagnose blood circulation issues is to check your skin and nails. If you get brittle and weak nails, as well as dry skin and hair loss, you are not getting the proper nutrients. Which is usually related to poor blood circulation.

Even though hair loss is usually encountered in men, women can also suffer from it when it comes from poor blood circulation. Other factors causing baldness are stress, excessive smoking, aging, hormonal imbalance, nutritional deficiencies, thyroids, anemia, chronic illnesses, and genetic factors among many.

If you notice that your hair is falling off faster than usual, it is getting thinner and the ends are split, check your skin and nails. If they’re dry and brittle, then get an appointment with your doctor. After running a few tests you will be able to have a proper diagnose of the causes for your hair loss and start treatment straight away. Make sure to tell your doctor if you noticed any other symptoms and bring with you your most recent blood tests and list of current medication as to avoid any interactions.

8.Blood circulation: Erectile dysfunction

Blood is the reason why most of our organs work the way they do. When there is poor blood circulation, many things will stop working or will work from time to time. This includes the reproductive organs. A poor blood circulation can cause erectile dysfunction in men. This issue is represented by consistent problems in sustaining and even achieving an erection even though the subject feels aroused.

Erectile dysfunction (also known as ED) is also frequently associated with atherosclerosis. This is another very important reason to leave any embarrassment behind and to contact your doctor as soon as this becomes a recurrent problem. Due to erectile dysfunction being caused by physical and not emotional issues, it can be treated if diagnosed correctly.

Whenever visiting your doctor, make sure to take with you not only a list of your current medications and illnesses. But also a detailed list of the dates and times erectile dysfunction has happened to you. This will help the doctor diagnose the reasons behind erectile dysfunction and help you correct it as soon as possible. Once the issue is solved, either blood circulation or atherosclerosis, you will be able to achieve and sustain proper erections, thus returning to a satisfactory sexual life with your partner.

Do not feel ashamed or afraid to talk about this. Many men suffer from erectile dysfunction and the only way to solve the issue is talking to a physician. Keeping it a secret will only add to your stress and anxiety and make the problem not only physical but also psychological. Leading to a more complicated treatment. Make sure to talk about it with your physician and also with your partner as to get the proper support and treatment, you will soon be happy again!

9.Blood circulation: Cyanosis or skin discolouring

On the off chance that your skin or lips turn blue, it unmistakably shows low blood oxygen levels due to poor blood circulation. This issue is otherwise called cyanosis or skin discolouring.

When your blood circulation is normal, your skin will look its natural shade and organs will look either pink or red. However, whenever your blood circulation levels drop, your skin and organs will turn of a greyish color. Some part of your body will turn blue instead, similar to a bruising color. These parts are: fingers, toes, nails, eyes, gums, and lips.

Blue skin is also an early sign of heart disease in babies. It is very important that if you ever get or see someone getting blue or extremely discoloured skin, that you call a doctor or emergency services. Cyanosis can be the indication of something going extremely wrong with your heart and blood circulation so it needs to be treated as soon as possible.

Family history, current medications, and a list of all the symptoms that you have felt is what the doctor needs to diagnose you and treat you correctly. Make sure to take them with you when you attend your next appointment or the emergency room at your nearest hospital. Congenital heart diseases are a major factor for skin discolouring so it is very important to have the above with you when seeing a doctor. Take a friend or relative with you in case you need to be administered medication that may make you dizzy or hospitalised for the time being. Don’t worry, this can be treated, but it is important to catch it on time. Do not wait for the next time it happens, go as soon as occurs the first time. Better safe than sorry, even more when talking blood circulation!

10.Blood circulation: Heaviness in the chest

Our heart is the main and most important organ in your body. Its function is to pump blood around, thus being the manager of blood circulation as we know it.But in order to pump blood correctly, it also needs to receive blood correctly. If your arteries are not bringing enough blood back to your heart, it will cause heaviness and tightness.

The pain will not be constant, it will come and go. This pain is usually known as andina pectoris or angina. However, pain and heaviness in your chest can also be a symptom of atherosclerosis in your arteries. In addition, this same pain can also represent heartburn, muscle spasms, acidity, stomach ulcers, indigestion, or upper respiratory infections.

Because of its nature, it is important that chest pain is treated as soon as possible. Either one of the reasons above can lead to serious heart damage as well as many other organs. Please make sure to check with your physician as soon as possible.

11. Reduced cognitive function

When you think of blood, you do not always think of the brain. The first thing that generally comes to mind is the heart along with its accompanying veins and arteries. This is correct, and technically blood does not go into the brain. There is even something called the Blood-Brain Barrier which is specifically designed to keep blood out of the brain.

While blood does not enter the brain, the brain does need the things that get carried by the blood. This includes oxygen and nutrients to name but a few. Therefore, the brain, like every other part of the body, requires sufficient blood flow if it is to operate correctly. When this blood flow has been decreased, then there will certainly be problems.

Many symptoms of poor circulation are a lot more intuitive than reduced cognitive function. But, if a person has problems remembering things, or possibly they feel a bit mentally foggy, then they could be suffering from reduced or poor circulation. A diagnosis of this kind can only be made if the person displays other symptoms, but it is completely advisable to take it very seriously if the cognitive function is impaired.

A person cannot survive without their brain and if poor circulation is left untreated, the brain will not only suffer in the short-term. If the brain is left without proper blood flow for too long, then the cells will start to die. Unlike other cells in your body, brain cells don’t regenerate properly. Once they have been damaged, the chances of them recovering are incredibly slim. Your mother may have told you that you only get one set of eyes, but you also get one brain.

12. Digestive irregularities

This is another system that one doesn’t usually associate with blood flow. When you think of your digestive system as a whole, you think of food and the waste matter that is created once this food has been broken down. But, consider for a second how this system works. It is a very active system that requires a reliable source of blood, and it needs this blood constantly. No part of the digestive system can be left without blood for any period.

If there is a case where circulation is reduced, then there will be disruptions to digestion. These disruptions can be of many different kinds as the digestive system is quite complex and is made up of many different parts. The noticeable digestive problem that could result from poor circulation is a pain in the abdomen. The abdomen houses the digestive system, so clearly this is the area that would hurt if something goes amiss. This pain may be localized, or it could be a pain that spreads through the general area.

The other problem which could arise is related to the stool. You can tell a lot about the health of a person by looking at their stool. In the case of poor circulation, there is a multitude of things that could go wrong with one’s stool. A person could experience very uncomfortable bouts of diarrhea, or they could even be very constipated.

The type of issue that one is having with their stool is almost irrelevant. The point is, if there has been a drastic change in a person’s bowel movements, then they could very well be suffering from poor circulation.

13. Systemic cramping and pain

There is not a single person on this planet who has not experienced muscle pain at some point or other. There is muscle pain that results from exercise. Then there is the pain that accompanies an injury. Most people also know what it is like to have stiff joints. Granted, this is generally more felt by the elderly, but on the whole, people are quite aware of the concept. The same can be said for cramping. People sleep in awkward positions and pull their backs out all the time. The one thing that all these types of aches and pains have in common is that the people suffering from them can generally pinpoint the root of the problem.

They know that they may have pushed their workout too far, or possibly the sat in an awkward position for too long. If, however, a person has muscle pain or joint cramping and they have no clue why they are feeling that way, then the problem could be poor circulation.

The concept is quite simple, and muscles need blood to function. They need oxygen, and they need nutrients. If they do not get these things, then they will stop working properly. If this wasn’t bad enough, not only will the muscles stop working, they will also start to hurt. This pain will generally result from the stiffness and cramping that will arise when the muscles do not get enough blood.

There will also be pain that will be associated with the reheating of the hands and feet which have become cold due to inadequate blood flow. This pain will be more throbbing than stabbing, but it will be pain none the less.

14. Ulcers on the legs

This condition is not one that is very well known. People may know about ulcers when they think of their mouths as mouth ulcers are relatively common. But, it is possible to get ulcers elsewhere on one’s body. In particular, these ulcers can appear on one’s legs. First, let us have a look at what would happen to the blood in the legs if circulation was decreased.

When blood circulation has been impaired or reduced, what happens is that the blood starts pooling in the veins. This does not necessarily occur in the arteries as the blood here is pumping out the heart and isn’t as affected by gravity. But, the blood in the veins has to try and work against gravity to make its way back up to the heart.

When the circulatory system has been impaired then this blood pool, especially in the legs, which then creates a hospitable environment for ulcers. It is more likely for these to develop on one’s legs, but it is possible for them to appear in other parts of the body. Another reason why a person with bad circulation is prone to ulcers is that of how bad circulation affects a person immune system.

If blood is not flowing correctly, then a person’s immune system is compromised. When this happens, then it will take longer for them to heal which is another thing that will contribute to the development of ulcers. This symptom of poor circulation is one of the more visible ones as an ulcer on the legs or feet of a person is incredibly hard to miss. There are also not many other conditions which will result in this kind of skin condition.

15. Inability to perform strenuous tasks

The secret to living a healthy and happy life is no real secret. There is no mystery here, and there is no real debate. There may be people out there who would want to argue the finer points, points like whether it is healthier to be vegetarian or whether humans need meat to survive. These points will be discussed until the end of the earth. But at the core of each argument is that to be healthy a person needs to do a few simple things.

They need to eat healthy food that is not overly processed, and that is not loaded with chemicals. Added to this diet is exercise. A person who is not exercising is a person who is certainly not healthy. Now, this is all well and good, but what about the people who physically cannot exercise.

Put aside fitness levels for a moment and think about what it must be like to not even be able to walk up a flight of stairs without getting severely out of breath. Or trying to lift something heavy and not be able to move it an inch. This is a very real reality for people with poor circulation. They may not even know that this is why they are unable to perform specific physical tasks. They might think that they are unfit and that they need to try harder.

The reason why people with bad circulation are less physically capable is that their muscles are not getting enough blood and not at the correct speed. Their heart is also taking the strain as it is forced to pump harder to try to get the blood to where it needs to go.

 

16. Unexplained weight loss

These days everyone is obsessed with their weight. People go to the gyms on mass. They spend thousands on diet products and are always on the lookout for the next best thing that will make them thin without having to put in too much effort. This is the society we live in. The thinner, the better. It is for this reason, that if a person suddenly loses weight, they would not blink an eye.

They would more likely be thanking their lucky stars rather than sitting back and trying to figure out what is happening. But, and there is no argument here if a person loses weight and they can find no explanation for it they should not just brush it under the rug. This person needs to take a moment to try and figure out what has changed in their lifestyle. Are they more stressed than usual or possibly they have changed their diet? Maybe they have started a new medication?

If they can find absolutely no reason for this weight loss and they have a few of the other symptoms on this list, then the culprit could be poor blood circulation. Poor circulation does not necessarily affect one’s weight directly, and it is more of a secondary consequence. When a person’s blood is not getting appropriately circulated, they are more inclined to have a decreased appetite, after an extended enough period, this will lead to weight loss. There is also the case of malabsorption. If the digestive system is not getting the correct blood flow, then it does not operate properly. Food is not broken down and absorbed correctly, also leading to weight loss over time.

17. High blood pressure

Blood pressure is a bit of an odd physiological value. It is not one that is widely understood by those who do not work in the medical field. People know about their heart. They know that it beats and on the whole, they can find their pulse if they need to. Barring this, they can feel their heartbeat if they are paying enough attention. But heart rate is only one part of the equation. There is the speed at which the heart pumps blood around the body, and then there is the actual pressure that is created when the heart pumps this blood.

It is almost counter intuitive, but when the body is experiencing poor circulation, a person will have increased blood pressure. This is because the heart has to work harder to pump blood throughout the body. If blood is pooling in one’s limbs and muscles then when the heart tries to beat as normal, it is trying to fit more blood into a space that already has blood.

On the surface, a slight increase in blood pressure may not seem that dangerous. This is only somewhat true. The body is designed to handle periods of high blood pressure. The heart and blood vessels will not be immediately affected if blood pressure increases. There are times when it is normal to have elevated blood pressure. The problem here would involve the timeframe.

High blood pressure in the short-term will not necessarily cause long-term damage. But, if this high blood pressure persists for too long, then the body will start taking the strain. This damage will not only be limited to the heart and blood vessels, but even organs like the kidneys will begin to falter if blood pressure remains high for too long.

18. A decrease in libido

Sex is very much a part of life. It is arguably one of the most critical aspects of the human experience. There are some who may even argue that it controls the world. If this is, in fact, the case, then it would be because sex is a huge motivator for many people. This number is not one that can be tested, but it is safe to say that a lot of us, maybe even all of us, make a lot of our decisions with sex in mind. Considering how important sex is in our lives, it is odd that we are so reluctant to talk about it.

While we may have made quite a bit of progress in this arena over the last couple of years, we are not almost nearly where we need to be. We need to be able to talk about sex not only for our mental health but our physical health as well. The reason for this is because sex is important as it is quite a reliable indicator of one’s overall health.

When using this as a health indicator, doctors will look at not only the reproductive organs themselves but also at a person libido. Libido is made up of a couple of components. There are quite a few hormones involved which are made in the brain and the organs themselves, and then there are the organs which contribute in their way to one’s libido. When it comes to poor circulation, if these organs do not get the correct supply of blood then they will not work in the way that they should.

This applies to both men and women and will manifest itself in a decreased libido. There will also be other dysfunctions in this area including irregular menstrual cycles for women and decreased fertility and functionality in men.

19. Dark rings underneath your eyes

Sleep is incredibly important. A person can go longer without food then they can without sleep. When a person sleeps, their body recharges, and it heals. If a person does not get enough sleep, the effects are incredibly visible. Symptoms of sleep deprivation range from mood disturbances to a decreased immune system. There is also the appearance of little bags and dark rings underneath the eyes.

While these bags and rings may not be attractive, they are temporary. But, if you have dark rings underneath your eyes that won’t go away even though you are getting the correct amount of sleep. Then there may be other factors that should be considered. One of these being bad circulation. There are certain items on this list which are more secondary consequences of poor circulation as opposed to a direct result.

When it comes to dark rings underneath the eyes, these appear because blood is not moving the way it should. Instead, it is pooling in that area and not being circulated by the natural mechanisms in place. As mentioned, there are other causes for these dark rings other than poor circulation. But, there is a very easy way to check whether circulation is the culprit.

The way to do this is to press down on the rings while looking in the mirror. If the rings subtly clear up for a few seconds and then darken up again, then the problem is poor circulation. This little at home test should tell you whether you are having circulation issues, but it will not tell you the extent of the problem. A doctor can only do this after further testing.

20. Brittle nails

When one thinks of their health, they do not generally look to their nails as indicators. Many people do not even look after their nails, so they wouldn’t even actually know if something is wrong with them. Sure, smokers may look at the discoloration and think that maybe their health is taking a beating, but this isn’t even an internal consequence and is only due to the nicotine in cigarettes.

While nails may not be the gold standard when it comes to testing one’s health, they can be good indicators if you know what to look for. The first thing that needs to be considered is the quality of the nail. Are the strong or are they brittle? Do they chip and break very easily or are they thick and hard to cut? If the nails are brittle, then there could be a circulation problem that exists. The reason for this is that nails, like every other part of the body, needs nutrients to grow.

If circulation is weak, then these areas will not be getting enough nutrients and they will, therefore, be weak and will not grow properly. Another way that nails can indicate the quality of circulation is by looking at the nail beds themselves. If you press down on them until they turn white and then release, look at how long it takes for them to go pink again. If this seems like it is taking too long, then there could be a prevailing circulatory problem.

When it comes too poor circulation, there are many symptoms which can be sought out simply because bad circulation will affect the entire body. By looking at one’s nails, you will not be able to make a full diagnosis, but it will give you a pretty good idea on the state of one’s blood circulation.

How to Improve Blood Circulation

• Add physical exercise to your daily routine.

• Stress can be one of the affecting causes of poor blood circulation. Practice meditation, mindfulness, and yoga to control your stress levels.

• Massage your body using warm olive oil and some drops of rosemary essential oil. Use it on your extremities such as hands, fingers, feet, and toes. As well as legs and arms.

• Try contrast hydrotherapy (jumping from hot to icy water and viceversa) to improve your blood circulation.

• Posture is a leading factor to blood circulation, either good or bad. Talk to a professional to make sure that you sit, walk, and stand properly.

• Caffeine is also not good for blood circulation as it causes anxiety. Change it for green tea or herbal teas in general.

• Alcohol intake must be reduced to a minimum.

• Smoking is bad either actively or passively, so we advise to quit smoking and to stay away from secondhand smoke.

• Add nuts, black pepper, cayenne pepper, seeds, onion, garlic, and ginger to your diet to boost your metabolism and blood circulation.

• Proper shoes are key to keep your legs and feet healthy and to help with blood circulation.

#Mixed exercise for #fibromyalgia: Cochrane review

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  •  Univadis Medical News

A new Cochrane Review which evaluated the benefits and harms of mixed exercise training for fibromyalgia has found that it probably improves health-related quality of life (HRQoL), physical function and fatigue in adults.

Researchers examined data on 2,088 people (98% female) from 29 randomised controlled trials and compared the effects of mixed exercise training protocols that include two or more types of exercises such as aerobic, resistance and flexibility for adults with fibromyalgia with other or no exercise interventions. Major outcomes were HRQoL, pain, stiffness, fatigue, physical functioning, withdrawals and adverse events.

There were 21 studies comparing mixed exercise versus a control programme. The authors found mixed exercise probably improves HRQoL, physical function and fatigue, compared to controls but said this improvement may be small and clinically unimportant for some participants. Low‐quality evidence suggested that mixed exercise may slightly improve stiffness.

While mixed exercise was well tolerated, the authors noted evidence on harms was scarce and said they were uncertain about its safety.

Overall, the reviewers said they considered the quality of evidence to be low to moderate because of small numbers of people in the studies, some issues involving study design and the low quality of results.