Yoga Combats Fibromyalgia
Posted by on November 1, 2010 - 2:22pm

According to new research conducted at Oregon Health & Science University, yoga exercises may have the power to combat fibromyalgia — a medical disorder characterized by chronic widespread pain. The research is being published in the November 10 edition of the journal Pain and will appear online Thursday, Oct. 14.

Fibromyalgia is a syndrome predominantly characterized by muscle pain and fatigue. It can cause sleep problems and psychological stress. Other symptoms often include morning stiffness, tingling or numbness in the extremities, headaches, memory problems, difficulty with swallowing, and bowel and bladder problems.  Fibromyalgia affects between 11 million and 15 million Americans with 85-90% of the cases in women.  The cause of fibromyalgia is currently unknown, but it is believed that genetics and physical/emotional stress may play a role.

“Previous research suggests that the most successful treatment for fibromyalgia involves a combination of medications, physical exercise and development of coping skills,” said James Carson, Ph.D., a clinical health psychologist and an assistant professor of anesthesiology and perioperative medicine in the OHSU School of Medicine. “Here, we specifically focused on yoga to determine whether it should be considered as a prescribed treatment and the extent to which it can be successful.”

In this study, researchers enrolled 53 female study subjects previously diagnosed with fibromyalgia. The women were randomly assigned to two research groups. The first group participated in an eight-week yoga program, which included gentle poses, meditation, breathing exercises and group discussions. The second group of women — the control group — received standard medication treatments for fibromyalgia.

Following completion of the yoga program, researchers assessed each study subject using questionnaires and physical tests. The results were then compared with testing results obtained prior to the yoga classes. The members of the control group underwent the same evaluations. In addition, each participant in the yoga group was urged to keep a daily diary to personally assess their condition throughout the entire program.

Comparison of the data for the two groups revealed that yoga appears to assist in combating a number of serious fibromyalgia symptoms, including pain, fatigue, stiffness, poor sleep, depression, poor memory, anxiety and poor balance. All of these improvements were shown to be not only statistically but also clinically significant, meaning the changes were large enough to have a practical impact on daily functioning. For example, pain was reduced in the yoga group by an average of 24 percent, fatigue by 30 percent and depression by 42 percent.

“One likely reason for the apparent success of this study therapy was the strong commitment shown by the study subjects. Attendance at the classes was good as was most participants’ willingness to practice yoga while at home,” added Carson. “Based on the results of this research, we strongly believe that further study of this potential therapy is warranted.”

New Report Evaluates Progress in Women's Health
Posted by on September 28, 2010 - 1:48pm

A new report by the Institute of Medicine issued on Sept. 23, concludes that there has been some progress in women's health over the past two decades especially in lessening the burden of disease and reduced deaths among women in the areas of cardiovascular disease, breast cancer and cervical cancer, specifically. The effort has yielded less but still significant progress in reducing the effects of depresssion, HIV/AIDS, and osteoporosis in women.   However, the report also identifies several areas that are important to women that have seen little progress, namely, unintended pregnancy, autoimmune disease, alcohol and drug addiction, lung cancer, and dementia.

Overall, few gains have been made on chronic and debilitating conditions that cause significant suffering but have lower death rates, pointing to the need for researchers to give quality of life similar consideration as mortality for research attention.  The report also points out that barriers such as socio-economic and cultural influences still limit the potential reach and impact of research developments, especially among disadvantaged women.

Several observations made by the experts who wrote the report are in areas the Institute for Women's Health Research at Northwestern has raised as ongoing problems.   One of those issues is the the fact that many research projects, even if they include both men and women, rarely report the results by sex.   Furthermore, as pointed out in a recent paper in Nature, written by IWHR director, Teresa Woodruff, PhD, and her graduate students, scientific journals should require authors to include sex data in their publications.

Another challenge discussed in the report is how best to communicate complex research findings to the public and the media.   The IWHR through it blog, website and monthly e-newsletters is striving to meet that challenge.

Over the next month or so, this blog will discuss issues in the IOM report in greater detail but in the meantime click HERE to read the press release,  the entire report on line or to order a copy.

Science Mini-Lesson: X chromosome inactivation
Posted by on October 21, 2009 - 10:00am
Image: Indigo Instruments

Image: Indigo Instruments

In a recent post called, "Autoimmunity and Gender", we mentioned that one reason women are more prone to autoimmune disorders, or those conditions where the body's immune system attacks its own cells, is because of chromosomal influence, but we didn't elaborate. If you're guessing that it has something to do with the sex chromosomes, the X and Y, you are totally correct...but it may not be for the reason you think. It is not merely the presence of the two X chromosomes in genetic females that leads to autoimmune disorders, but the way the body handles them.

Genetic females have two X chromosomes while genetic males have one X and one Y, so females have twice as many X genes as males, right? Wrong! The X chromosome is incredibly rich in genes that are then made into proteins, while the Y has significantly fewer important genes. Fortunately, the body recognizes this potentially harmful difference in gene number and corrects the problem by a process called X-chromosome inactivation. In this process, every cell in the body chooses one X chromosome, either the one inherited from the mother or the one from the father, to make inactive. That DNA in that chosen chromosome is then wound up very very tightly to form what is called a barr body. Because it is wound up so very tightly (a formation called heterochromatin), the genes from the barr body can not be made into proteins, so it is considered inactive.

If genetic females have one active X chromosome, and so do males, how does this influence the risk of autoimmune disorders? Well, remember that every cell chooses which X chromosome to inactivate and that they do this independently of each other. One heart cell may inactive the X chromosome from the mother, while another right beside it inactivates the X chromosome inherited from the father. This makes all genetic females a type of genetic mosaic: our cells can express two different sets of chromosomes depending on which X chromosome is inactivated.

Image: Haane-Mugaas.com

Image: Haane-Mugaas.com

Getting to the point, think about immune cells: they're these destroyer cells whose sole mission is to hunt down and kill any cells that don't match their DNA code. Usually, this is a good way to target the bacteria and viruses that don't belong, but the immune cells can also get a little too good at their job. If an immune cell that has inactivated the maternal X chromosome meets a nerve cell that has inactivated the paternal X chromosome, that immune cell could be triggerred to destroy the "invader." That, in the end, is how having two X chromosomes can lead to increased risk of autoimmune disorders in genetic females.

PS- Why the picture of the calico cat? Besides the fact that cats rule, fur color is also X linked and depends on X chromosome inactivation. One fur cell decides to inactivate the maternal X carrying orange color, so that cell (and all the cells that come from it) are black or white. Nearby, the opposite happens and you get a patch of orange fur from Mom's X chromosome staying active. It's science in action!

For more information:

Overlooked or misdiagnosed conditions in women
Posted by on October 19, 2009 - 9:18am
Image: WOLDCnews.com

Image: WOLDCnews.com

CNN Health has just published a nice article outlining many conditions that can be overlooked in women, including polycystic ovary syndrome (PCOS), fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome (IBS), and several autoimmune disorders such as lupus, rheumatoid arthritis, and multiple sclerosis. Included in the article is a quote from Virginia Ladd, founder and executive director of the American Autoimmune Related Diseases Association:

"More than 40 percent of women eventually diagnosed with a serious autoimmune disease have basically been told by a doctor that they're just too concerned with their health or they're a hypochondriac."

The resounding message of the article is to trust your (possibly irritable) gut; if you feel off somehow, keep pursuing the topic with your doctor or get a second opinion.

PS- Look for our blog entry on Wednesday about autoimmune disorders and X chromosome inactivation. It will be a more in-depth entry about the genetic reasons women are more at risk for these conditions.

Autoimmunity Disorders and Gender
Posted by on September 22, 2009 - 12:48pm

The NIH has a pretty cool monthly podcast called “Pinn Point on Women’s Health,” which is hosted by Dr. Vivian Pinn, director of the NIH’s Office of Research on Women’s Health. For September, the topic was Autoimmune Disease in women (NIH summary and directions for downloading the podcast can be found here.)

The topic is fascinating! Autoimmune diseases are those where the body , for whatever reason, starts fighting its own cells with an immune response in the same way it would if the cells were a foreign invader (bacteria, virus etc). Women are more likely to get a whole host of autoimmune diseases than men are, including multiple sclerosis, rheumatoid arthritis, and lupus. Apparently, out of all the people suffering from auto-immune diseases in the US, 80% are female. That’s a phenomenal bias for a condition that, on the surface at least, has no clear tie to gender. According to the research (great review here), our increased risk of getting these diseases is simply our great immune systems working against us. Apparently, our immune systems are so great that we’re less prone to infection and have a much greater antibody response to those little invaders that do get in. Unfortunately, our systems are so strong that they also tend to go into overdrive, leading to this attack of our own bodies. The culprits (or overachieving heroes, depending on how you look at it), are likely exactly what you’d expect: hormones or chromosomal influences. The hormone research actually shows that during pregnancy, women's immune systems switch to a far less aggressive regimen, likely to avoid attacking the fetus as an invader. This decreased immunity is the reason for the increased risk of pregnant women getting the flu that Alison mentioned, but it’s also the reason that many pregnant women notice a decrease in their symptoms of autoimmune disorders. I actually have/had a condition called tranverse myelitis, which is thought to be an autoimmune disorder; I also very rarely catch the normal seasonal bugs that float around the office, and I don’t think I’ve ever had the flu (knock on wood!). It’s kind of amazing to think that both the bad and the good stem from the same source: an incredibly strong immune system! Anyone else notice that same thing in his/her self, or anyone they know with autoimmune disorders?