Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease because are indicative of infectious disease.

OBJECTIVE: emerging evidence suggests that women with vasomotor menopausal symptoms (VMS): flushing, sweating, palpitations, may have increased risk of future cardiovascular disease. We investigated that VMS are related to an irritable bowel syndrome (abdominal discomfort and/or pain, bloating, gas, diarrhea, constipation); a functional bowel disorder caused by eating any sugar (gluten and grains) artificial sweeteners or processed and fermented foods in genetically predisposed individuals. Colitis is often considered as a state of intestinal swelling, appears in fact, among the complaint of women entering menopause.   States of chronic colitis can lead to metabolic and neuroendocrine  perturbances, can involving organs and apparatus in the inflammatory state, lack of assimilation of the necessary elements for their proper functioning, can weakening the immune system that predisposes the organism to recurrent bacterial and viral infections with severe damage to organs like the heart, kidneys, joints.  The typical symptoms of flushing, sweating, palpitations are indicative of flu symptoms. Since not all women have symptoms in menopause, this means that menopause is not a problem in healthy body, in this act eating habits and hereditary factors.

INTRODUCTION: The significance of the combination of "nutrition, prevention, valid at any age after menopause, should be a rule without exception.  The problem is to define what constitutes "proper nutrition" because even in this field there is much confusion. We have taken into account colitis due to an adverse reaction to foods (RAA) 1-2 and celiac disease or gluten sensitivity 3. Celiac disease is a specific digestive disease that results in damage to the small intestine. The disease is genetically inherited and chronic. When individuals with celiac disease consume gluten, their bodies have an immune response. As a result, the villi of the small intestine become damaged, which causes nutrients to pass through the digestive system without being absorbed. This leads to gastrointestinal distress and eventually, malnutrition. Malabsorption of nutrients has many serious side effects. There are several forms of celiac disease including classic (gastrointestinal), atypical (extra-intestinal), and silent or gluten sensitivity. Symptoms of celiac disease vary with individuals and may include diarrhea, gas, bloating, vomiting, constipation, constipation alternating with diarrhea, nausea, skin irritation, malabsorption, weight loss, anemia, chronic fatigue, weakness, muscle cramps, neurological complaints, and possibly migraine headaches, concentration and memory problems. Malabsorption caused by celiac disease can have serious effects on many other organs in the body.

The bowel function may be compromised and thus involve and affect the functionality of the liver, pancreas (latent or overt diabetes), ovary or uterus, urinary tract or vagina. If an intestinal inflammatory condition, often asymptomatic, endures over time, the processes of assimilation can be compromised. The intestinal bloating could be the cause of a deficient or altered absorption of calcium (osteoporosis) 4-5-6, iron (anemia), elastin (flebectasie, hernias, stretch marks, prolapse), iodine ( thyroid dysfunction) 7.  The thyroid has two functions:  a) regulates the metabolism of fats;  b) prevent infection of the upper airway.  For this reason a relative iodine deficiency due to malabsorption from chronic intestinal inflammation, may cause a slower metabolism of lipids and a tendency to more easily contract infections of the upper airway and systemic infections that do not always detect specific haematological indices. A slow metabolism of fat, the presence of abnormal inflammatory markers in the blood, including clotting factors, are risk factors for disease cardiovascolare8. In the Framingham study, hypertension, smoking, obesity, diabetes and physical inactivity are other risk factors 9. Among the risk factors in cardiovascular disease, age, sex and genetic predisposition can not be changed. Recent studies show that inflammation and bacterial and viral infections recurring since childhood, play a key role in the development of cardiovascular disease and can lead to heart attack, are implicated in various bacteria and viruses, including herpes simplex virus 1 and 2 , cytomegalovirus, Epstein-Barr virus, Haemophilus influenzae, Chlamydia pneumoniae, Mycoplasma pneumoniae and Helicobacter pylori 10-11. There are no published studies in the literature that assess the possible association "chronic colitis and the risk of cardiovascular disease, but there are studies that put the association in celiac disease (CD) with different diseases including tiroiditi12 and cardiomyopathy with important implications13-14. CD is often associated with other autoimmune diseases, some of which, such as autoimmune thyroiditis, connective tissue diseases, psoriasis, alopecia, arthritis, cerebellar ataxia and diabetes mellitus

Further studies to identify the pathogenic mechanisms underlying this association will be needed in the future, given the encouraging positive results demonstrated by the gluten-free diet on performance and quality of life.

MATERIAL AND METHODS:  we have seen 500 women (Group 1) who attended our specialist study from 1994 to November 2010 showed the typical symptoms of flushing, sweating, palpitations. The criteria for inclusion in the study Group 1 included: age between 45 and 65 years, presence of almost one of the three symptoms, the symptom can be recurrent or persistent.

We considered 500 control patients (Group 2), without typical menopausal symptoms. The two groups did not differ in age; all patients were in menopause for at least one year, without hormone replacement therapy. Were also taken into account family history of hypertension, diabetes, lipid disorders, heart attack. For each patient a medical record has been established: personal and family medical history, dietary habits, routine blood tests, and was performed ultrasound of the pelvic and abdominal organs, thyroid and breast, every six months for control Group 2, every three months for Group 1.

The data reveal that the pelvic and abdominal ultrasound scans of the patients in group 1 were more difficult than those of Group 2, because the presence of intense intestinal bloating. A careful anamnestic investigation revealed that patients Group 1 had suffered from gastroenteritis since childhood, had colitis, gastritis, dyspepsia 15 or "irritable bowel" 16, the intestinal inflammatory state, represented by intense ultrasound bloating was chronic, not occasional, it was clear to every ultrasound examination. Patients in Group 1 had more frequent problems related to their state of colitis (tavola1). 

 

Table 1. Clinical features and symptoms in the two study groups

CLINICAL FEATURES

Group 1

Group 2

Celiac disease

 

 

 

 

 

 

 

 

 

 

 

 

 

19%

2%

U.S. show gastrointestinale bloating

     100%

occasional

Gluten sensitivity

89%

2%

Rheumatic disease

44%

3%

Arthralgia

79%

12%

Irritable bowel

77%

23%

Depression

38%

1%

Anxiety

       40%

2%

Headache

22%

3%

Imnsonia

       38%

4%

Decreased memory

       67%

3%

H. pylori gastritis

17%

1%

Osteoporosis

48%

3%

Malignant disease associated

17%

0%

Urinary tract disorders or infections

20%

2%

Appendectomy

40%

1%

Tonsillectomy

69%

2%

Kidney stones

3%

1%

Gallstones

9%

2%

Gastritis, esophageal reflux

44%

3%

Thyroid disfunction

36%

1%

Upper respiratory tract infections

51%

2%

Allergies, autoimmune diseases

38%

3%

Irregularities of the hive

88%

11%

Abdominal pain

24%

2%

Fatty liver

45%

1%

Varicose veins phlebitis haemorrhoids

43%

2%

Gynecological diseases

34%

3%

Change in inflammatory markers

 

78%

2%

Alteration of coagulation factors

 

66%

3%

Ca 125, Ca 19-9, Ca 15-3 alteration

5%

0%



 

 

Compared with the control group, patients in Group 1, showing more frequent signs of celiac disease or gluten sensibility and consequently onset of autoimmune disease, diabete, thyroid disfunction. With hypothyroidism and thyroid subclinical or clinical disfunction, individuals routinely become more susceptible to impairement of  lipid metabolism and susceptible to viral and bacterial infections with alteration of inflammatory marchers in blood. This are risk factor for cardiovascular disease 17.

 

 

Table 2. Clinical features related to risk of cardiovascular disease. 

CLINICAL FEATURES

Group 1

Group 2

Blood glucose> 100

 

 

 

 

 

 

 

 

 

 

 

 

59%

2%

Obesity  

78%

13%

Insulin  resistance

44%

1%

Glycated hemoglobin

78%

11%

Peptide C (nmol/L) >1.3

36%

0%

Hyperhomocysteinemia

51%

2%

Dysfibrinogenaemia

38%

1%

Blood Pressure (mmHg)>135/85 Hg)135/85hypertensive 17 - Borderline 38 0 
Triglycerides>

88%

11%

Triglycerides>150

24%

1%

HDL cholesterol (mg/dL)>45
HDL cholesterol (mg / dL) <45
HDL cholesterol (mg / dL) <45

19%

45%

Total cholesterol>200

43%

2%

LDL cholesterol>130

34%

3%

Microalbuminuria (mg/L)>30-200

73%

3%

Uric acid (mg/dL)>7

 

78%

2%

Precordialgie arithmia

66%

3%

antithrombin III deficiency

34%

2%

C-reactive proteine CRP>  10 mg/L

       48%

7%

Protein C and protein S deficiency

39%

9%

Leukocytosis neutrophilia mmmmocymonocytosis

       69%

        5%

Plateled alteration

       39%

       10%

Echocardiography abnormal

       49%

         8%

VES alteration

       45%

         4%

 

 

Researchers found that people who consume higher amounts of added sugar 18, such as in processed foods and beverages, are  to have higher heart disease risk factors Gluten, grain, milk and dairy products, refined sugar and sugary products certain fruits and vegetables were the foods responsible for the chronic colitis in patients Group 1.  For this patients we proposed a protein-based diet to satiety, meat, once a week pasta or bread gluten free, fish, egg, some cheese, raw vegetables, roots, some fruit tolerated, dried fruit. One of the signs and benefits of this diet is that the hunger pains will rapidly resolve.

RESULTS 
All 500 patients in Group 1 have agreed and tried to follow the diet. After three months of strict diet, 145 patients had complete remission of
hot flashes, sweats palpitations and were able to correlate the return of symptoms at the time of eating disorders. The 355 remaining  patients had a significant improvement and reduction of them, not the complete remission. 
The  patients on a diet the ultrasound  examination showed reduction in abdominal bloating. Initially, the patients found it difficult to maintain the diet. After initial difficulties, the patients themselves extolling this type of diet for the well-being and better physical fitness found. After a strict diet, when the patients were introducing a food not tolerated, felt immediate complications, reappeared symptoms of swelling and difficulty to swallow, regurgitation or heartburn, weakness and reduced physical and visual performance, decreased ability to concentration, worse depression, anxiety, joint pain. More the intestine is  swollen and more  typical menopausal symptoms reappeared. Patients have learned to recognize themselves foods  not tolerated. The diet  has proved effective in reducing serum cholesterol. glucose,  correction of the colitis was achieved in time for some patients has led also to the normalization or reduction of clinical signs of cardiovascular disease risk.  Patients with presence of autoantibodies after three months of strict diet have obtained the reduction or total disappearance of autoantibodies, supporting the theory that gluten is the source of autoimmune diseases, the index of glycate hemoglobin wos back to normal.  The 355 patients who did not obtain complete remission of symptoms while on a diet or less constant in the following, with alteration of inflammatory haematological indices we proposed a support of antibiotic therapy. Under antibiotic therapy the VMS symptoms disappeared. Hot flashes,  sweats and palpitations are therefore an expression of the presence of infection in the body, and thus the risk of expression of bacterial infections and cardiovascular risk 19.

Each patient was tested separately, in different periods, for four kinds of antibiotics to see how to get the best benefits:

1) Erythromycin 600 mg every twelve hours

2) Amoxicillin 500 mg twice daily

3) Azithromycin 500 mg once daily 

4) Benzylpenicillin intramuscularly 1200000 IU

 

The therapy was prolonged to remission of symptoms and repeated every time they recur. 
 The antibiotic erythromycin was found to be most effective for symptom palpitations. 
The limitation of this therapy is that once applied, does not solve the problem forever, like all forms of rheumatism and influenza, diseases from infectious agents to recur periodically, linked to climate change or pandemics. The patients most at risk were those who had undergone tonsillectomy or who had suffered more frequently tonsillitis.

It could be argued that the prolonged use of antibiotics could lead to bacterial resistance. The positive factor is the fact that taking the antibiotic as needed, over time you get a reduction in the frequency and duration of employment. Other positive factors are that the symptoms completely disappear under antibiotic therapy, and not only that disappears depression, improve the state of anxiety, fatigue, sleep disorders, mood swings, arthralgias.

The follow-up to a year later showed a reduction / disappearance of inflammatory markers in the blood and indices of risk of cardiovascular disease for 70% of patient Group 1.

 

CONCLUSIONS 
Hot flashes, night sweats, palpitations indicate an inflammatory bowel that can lead to a variety of metabolic and neuroendocrine and expose the body to various infectious agents with risk of cardiovascular disease. Our study shows that patients with symptoms of menopause can have significant benefits in a diet that excludes foods that are not tolerated. For some patients who for genetic reasons or irreversible damage, there's more compromised in menopausal period, you need to diet-related antibiotics. It 'best to use an antibiotic to destroy infectious agents rather than wait for them destroy a vital part of our body. It should be remembered that our immune defense system depends on what we eat as well as the quality of life, to get old but intact. The presence of variables that are not well defined quantitatively and qualitatively, such as the degree of colitis, and response to intolerance, the degree of diligence and reliability of patients to follow the diet, genetic predisposition individual, hindering the processing of statistical data obtained in this study.
Further research is needed to confirm these initial observations and clarify whether the changes observed will contribute directly or indirectly to cardiovascular benefits beyond those expected from reductions previously seen in serum lipids and blood pressure.

 

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