Pinch of salt!

The importance of common salt, essential not just for life but for good health especially in hot times is unfortunately often overlooked. The balance and concentration of sodium in our body, is one of the most delicately monitored and finely tuned body functions and is kept constant concentration of 0.9%.

Salt, also known as table salt, or rock salt is a crystalline mineral that is composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of ionic salts. It is essential for animal life in small quantities, but is harmful to animals and plants in excess. Salt is one of the oldest, most ubiquitous food seasonings and salting is an important method of food preservation. The taste of salt (saltiness) is one of the basic human tastes.

Most people expect a straight flat answer to the question “ How much salt should we consume each day?”. The National Academy of Sciences, USA, recommends that Americans consume a minimum of 500 mg/day of sodium to maintain good health. Individual needs, however, vary enormously based a person's genetic make-up, lifestyle, place of residence, climate and presence of other diseases.

As salt or sodium tends to retain water, people working outdoors on hot summer days for instance need a generous intake of salt to keep their blood pressures and from getting dehydated. A manual labourer working under the hot sun may require as much as 15 g of salt for day. It is this craving for salt that makes us relish the well salted cucumbers and kakris in railway stations or on the road side.

Our body’s hunger for salt is also reflected in our seasonal food preferences. A well salted “nimbu paani” or “mango pana” is often our preferred drink in the daytime, pickles and papads, rich in salt, tend to go down well with “daal chawal” and drinks such as Bloody Mary that are served with “salt bridge” are welcomed before meals at this time of the year.

Low salt levels in the body, or hyponatremia, often manifests as undue fatigue, lethargy, muscle pain and muscle cramps. The blood pressure may fall and the pulse may be feeble. In severe cases it may even cause drowsiness and death.

Our kidneys play a crucial role in regulating the body’s salt balance, conserving it if our blood pressure dips or exceting it through urine if there is excess. Restricting salt intake is usually beneficial for people with high blood pressure and in edematous conditions such as heart, kidney or liver failure when the body tends to retain salt and water. Checking the serum sodium level (normal range 135-145 meq/L) periodically can help ensure that one is in the safe zone.

If you have to go oudoors often and are feeling listless and tired these days, an extra pinch of salt could revive the zest to life. Try and feel the difference. 

As published in HT City ( Hindustan Times) dated 17 June, 2012.

Beware of Unnecessary Medications!

An elderly lady who had tolerated her mild symptoms of abdominal gas for decades, was suddenly metamorphosed to a vegetative state thanks to an unusual side effect of a newly launched drug for gaseousness!. The disturbing video of this lady, with shaking of hands and twitching of face, shown to a gathering of doctors in a meeting in Lucknow recently evoked a uniform surprise “Gosh, I did not know this could also happen!”. Dr Debnandan further shared information gathered from the net that several such instances of an ailment resembling Parkinson ’s disease have been reported with this agent, the disorder becoming permanent in many.

Adverse reactions to medicines do occur in a minority and every doctor faces them from time to time. What constitutes a tragedy is when the reaction is grave or life threatening while the indication for prescribing the medicine was mild.

Take for instance the side-effect of constipation that comes with many draugs such as pain-killers, anti-spasmodics or anti-depressants. It does not pose a danger to life, and if anticipated, can be prevented by co-prescribing a fibre laxative like Isabgol.

Liver damage can however be a fatal complication of some drugs, especially ones used for treating tuberculosis. I recall looking after an eminent scientist who developed jaundice due to anti-tubercular medicines for a mild chest infection. By the time he was brought to us he was deeply jaundiced, developed liver failure, went into liver coma and passed away despite all efforts. Very careful serial monitoring of liver functions is therefore mandated when drugs with potential to harm the liver are prescribed.

Another side-effect we dread is suppression of the bone marrow, a condition in which the white blood cells, platelets and red blood cell counts fall precipitously predisposing the patient to fulminant infections or bleeding. An antibiotic chloromycetin often prescribedfor typhoid fever, used to be the commonest culprit, It occurs nowadays with anti-cancer drugs, but may also occur with certain medications like azathioprine used for treating ulceartive colitis and auto-immune hepatitis.

In this case atleast, help has come from the laboratory. A blood test now helps recognize individuals prone to developing this complication, either based on their genetic make-up (genetic polymorphism in our jargon) or the level of enzymes that inactivate the drug (TPMT enzyme assay). Although somewhat expensive (around Rs 3000/-) getting it done before starting the azathioprine adds a dash of safety and is now internationally recommended.

Unfortunately such tests are very few while the list and inventory of drugs and the catalogue of their serious adverse reactions is sky-rocketing! What means do we then have to make our lives safer?

A useful dictum is to give home remedies a try first and resist the tempation of popping a pill for every minor discomfort. Doctors need to avoid prescribing more drugs than absolutely necessay and remember that old trusted medicines are often safer than the new ones touted as magic cures.

As published in HT City( Hindustan Times) dated 10 June, 2012

Deodorants and Sweat Connection!

The deodorant spray, the next gen’s all too familiar “deo”, may be the cause of our excessive fatigue and exhaustion during hot summer days.

Deodorants, meant to tackle the bad body odour especially from the underarms, do so by two methods. One is by killing the germs that colonize in these warm moist sites and break down secretions into smelly substances. Almost all deos are therefore antiseptic agents of a sort, containing some form or other of spirit, natural oils and perfumes. They work to keep us feeling clean and fresh.

Many deos however are anti-perspirants as well, and work by blocking the secretion of sweat from the sweat- glands. This variety of sprays has become trendy as they make the skin look cool and dry even on sweaty days. They prevent the embarassing wet dark maps from appearing on the shirts, and make us stink less as there is less soaking of clothes with skin secretions.

While many use the terms deodorants and anti-perspirants interchangably, they are not the same. Anti-perspirants work to stop perspiration from occuring. Deodorants allow perspiration, and work to kill the bacteria that causes odor when we perspire.

While anti-perspirants keep the skin and armpits dry and clean, they block the body’s vital cooling mechanism, allowing it to get heated up. Heat stroke and heat exhaustion occur when the body’s temperature rises well above its normal of 37⁰C and it finds itself unable to dissipate heat into the atmosphere.

 From a purely natural standpoint, it makes more sense for us to use deodorants as it allows the natural process of sweating to continue, a mechanism by which the body keeps itself cool when the outside temperature rises.

If you feel unusually exhausted and tired by noon or evening, check your body spray and ensure that you are using the right one. Anti-perspirants could be bottling up your body heat and causing your symptoms.

Further, anti-perspirants contain aluminium, a chemical that has come under scrutiny for a variety of health problems. High aluminium levels have been linked to seizures, breast cancer, kidney disorders and Alzheimer’s disease. Although very small quantities of aluminium contained in anti-perspirant-sprays cross the skin and reach the inner tissues, there is speculation whether even these small amounts could accumulate and cause disease when used for several years.

Most human achievements have come with toil and the proverbial sweat. The deleterious effects of blocking this symbol of hard work can extend well beyound our bodies to our social perception of human effort too. 

As published in HT City( Hindustan Times) dated 3 June, 2012.