Tuesday, 25 July 2017

The circadian rhythm-night sweats link in primary Sjogren's patients

It's a bit redundant to say that I am positively inclined to firmly believe that the circadian rhythm has a lot to do with night sweats in Sjogren's syndrome. Redundant because it's common knowledge that melatonin, ACTH, cortisol and the circadian rhythm are intrinsically related to basically the fundamentals of our well-being from a number of perspectives. If anything consider that proper sleep, quality sleep, represents wellness in all its capacity, for anyone (be it a sick or healthy individual, young or elder, etc etc etc).

Late, disturbed and irregular sleep impacts tremendously on fatigue, on nausea states, and on incidence of dizziness, all so unfortunately typical of Sjogren's. But what I have observed as the most typical result of an externally disturbed sleep pattern are the night sweats. As stated in this incredible article by Papagerakis et al (2014) the circadian system is a complex network that communicates and determines the functioning of peripheral organs and tissues. Do not forget the relevant link between primary Sjogren's and the adrenal glands [1] and the cascading unwellness that can emerge from their disturbance.

An affected circadian rhythm will result in an affected genetic expression that controls and maintains different human homeostatic patterns. Most importantly, as the author so well describes, an affected circadian rhythm will negatively impact and condition the functioning of the salivary glands, teeth development and other oral processes/structures [2]. Don't forget there is an adrenal glands - night sweats link taking place in menopause, so there is probably an exertion to the adrenal glands that is responsible for the night sweats in primary Sjogren's syndrome. I am inclined to believe that the cortex part of the adrenal glands, the part that is in fact responsible for the secretion of corticosteroids involved in (among numerous other things) the immune system's functioning, is the agent that we all need to lay our eyes on.

I recently found a website that teaches how to determine whether one is going through adrenal exhaustion, however, I am not a doctor, so all I can do is state that if you want to be positive of the quality of such test you definitely should seek advice from a HCP. The test is fairly simple to perform as the picture below describes:


That's it for now, I'll most definitely be posting soon on yet another recent discovery I made whilst reading a few articles on incidence of candidiasis in Sjogren's patients. This is a terrible issue for most of the patients as roughly Sjogren's patient's are affected with this problem up to four-fold in comparison to the controls. The article is a great read and I will try and bring in a summary for the blog's audience. That and a temporary relieve-treatment based on onions that can alleviate athlete's foot. You must not miss it.

[1] Mavragani, C. P., Schini, M., Kaltsas, G., Moutsopoulos, H. M. (2012). "Brief report: adrenal autoimmunity in primary Sjogren's syndrome". Arthiritis and Rheumatism, 64(12), pp. 4066-4071.

[2] Papagerakis, S., Zheg, L., Schnell, S., Sartor, M. A., Somers, E., Marder, W., McAlpin, B., Kim, D., McHugh, J., Papagerakis, P. (2014). "The circadian clock and the oral health and diseases". Journal of Dental Research, 93(1), pp. 27-35.

[3] Adrenal exhaustion, Lorna Vanderhaeghe Health Solutions - Women helping women, [http://www.healthyimmunity.com/books/An-A-Z-Woman-s-Guide-to-Vibrant-Health/Adrenal-Exhaustion.asp], last visited on the 25-Jul-2017, last update unknown.

Image kindly taken from menopause and your disturbed sleep, MyMT, [https://www.mymenopausetransformation.com/mymt/why-your-bodys-natural-circadian-rhythm-is-so-important-during-menopause/].

Monday, 24 July 2017

Back from holidays with some active ageing tips and a bit more of Sjogren's

Hello everyone, I'm finally back from my short break in Portugal. The sun really improved my positiveness and loaded my batteries for a British Winter that never surprises me. It's always terribly cold!

During my absence I realised some people left a few comments and questions to previous posts. Mostly on the bay leaf one. I am really happy that my writing is getting to different parts of the globe and I promise I'll be responding to every single query. However, it might take some time 'til I get to everyone. My professional obligations, two children of very young age and some other personal projects represent a lot on my plate and I always want to deliver deluxe quality.

I will be posting more frequently, but shorter articles. How a big mouth like mine can do that? It's a personal challenge but I need to make it possible for the good of the blog and my own health!!!

Before I start jumping into researching for my answers for the different articles I have planned, let me propose you all two videos. The first one is an overview of the Sjogren's Syndrome Foundation to celebrate yet another World Sjogren's Day (23rd of July 2017). Please watch the video to get to know the work of the incredible Sjogren's Syndrome Foundation Inc that have been helping raise awareness and the levels of quality of life of many patients and relatives of patients world wide. If you feel enticed and value their mission, please use this link to donate to this important cause. I have already done it to the extent of my current financial possibilities; humbly every pound, penny, buck counts.

Finally, it is my pleasure to introduce you to a real educational conversation on active ageing. The human kind is living longer, we are ageing differently in comparison to our ancestors, mostly due to our very sedentary lives and stressful rhythms. If you want to learn more about a fresh approach to become a healthier elder by ageing actively and proactively, please watch this video where my aunt (damn I'm sooooo proud!!!) takes you through the understanding of your options, and through conceptions that we very often neglect. The only minus is that the video is only available in Portuguese. WATCH IT HERE.

Wednesday, 28 June 2017

Did you know that...

It's time for a break. It has been a loooong time since I had a break. The body and mind demand a pause/still so I can reset the whole factory of thoughts. It's just like Lil Dicky puts it on that amazing music video "Pillow Talking feat. Brain" (in my opinion the most creative and intelligent music video for the last decade):

Who gettin money?
That's brain
Who make decisions?
That's brain
Who make the hits?
That's been brain
Who run the whole operation?
That be brain

My brain has been running the whole operation for quite some time and needs a break now. Some sun. Some laughter. By the end of July I'll bring you some juicy new posts and we'll take it from there. For now just please revisit some of the old posts, there's loads of nice stuff covered in the blog. In the meanwhile, let me also propose you some of the best reading I've been doing on some other clever blogs. Did you know that...

The World Health Organisation released a database on the progress made by the different countries in tackling antimicrobial resistance? Access this LINK and you will be mesmerised by what the most developed countries have NOT been doing!

Are you crazy about bacteria, their past, present, future and colour??? Then this BOOK is for you. If you have $319 to invest in knowledge!!!

Now, time for some holidays!

Sunday, 18 June 2017


My heart with the families of the more than 100 victims of one of the most horrifying tragedies in Portugal. This is unacceptable and must urge our politicians towards a solution; the same that has been postponed for years in a row, so to feed the corrupted leech that this 'business' has become for all of them over time. 

Friday, 16 June 2017


When it comes to the root of events that triggered the emergence of pharmacovigilance, regulatory affairs, adverse event recognition and keeping records of bad medical experiences by 'good' patients, everyone considers thalidomide [1] as the starting point. I guess I wrote very briefly about it here. But in fact thalidomide and its nasty teratogenic effects recognised in the 1960s cannot be considered the sole potentiator of utter vigilance and attentive pharmacological screening. There was yet another product that also contributed to this wind of change, but because of a lesser visual impact turned out to be the poor relative of a family of historical drugs that would change our relationship with medicines forever.


[1] Grootheest, K. (2003). "The Dawn of Pharmacovigilance". International journal of Pharmaceutical Medicine, 17(5), pp. 195-200.

Thursday, 15 June 2017

What Portugal needs is a € Vision not the EuroVision

For such a small country like Portugal is, winning the European Champions football title and right after the Eurovision Song Contest is proof that we know how to do things, we mean business. When given the adequate tools, we deliver. However, this is a tale to be told to the outsiders who visit our country, be it as tourists or mere web-surfers wanting to know more about the rectangular piece of terrain in the Iberian Peninsula some imbeciles still believe belongs to Spain. Portugal - A country so famous for the cheap sense of happiness, peacefulness, freedom, sun, beaches, and Summer festivals.

It's good to see the country recognised for its merits, it's even better to see big rich countries astonished by the incredible potential the Portuguese are showing on the different areas of our modern society. We are resourceful, very capable, flexible, versatile, intelligent and adaptable people. 

And even though I consider that we played terrible bad football when we won the recent European title, or that winning the EuroVision Song Contest should be a matter of shame for any participating country, rather than this poetic flood of star-status travesty nothingness intensely breathed by all involved... Being a pain in the ass of other bigger nations (embedded with an egocentric self-awareness) in a very positive and peaceful manner, is a victory on its own. 

Winning such 'tough' battles when the country is going through levels of austerity since even before austerity was a fancy proposal as response to the world economic crisis... it's a statement of quality, a statement of intention, an incredible stamp of warranty that with the Portuguese employee and implemented humane employment warranties, all is going to be OK.

Now think about this:

ONE in each FOUR Portuguese citizens survives with an average of €322 a month [1] - a fourth of the country's population. And for those preparing the guns of supposed common sense that shoot bullets of "yeah but it's a cheap country", I defy any of said claimers to go and live in Portugal for the same money. Pay rent, pay health bills, pay scholar bills, eat, drink and invest in your kids' education and safety. If you do it you are definitely a resilient son-of-a-gun.

If you think that the rest of the crew has got some good money and this 'paraphrased' fraction of our society are the unprivileged ones, here's another amazing piece of stats: the average money a Portuguese citizen manages monthly is €731!!!

Add to that a real unemployment rate of 15.8% in 2013 [2] (twice as much as in the UK for the same time period) and you have a nice picture that no one really debates publicly outside of Portugal these days. Why should they, though?

So when my friends complain that I do not celebrate our victories, that does not correspond to the truth. I celebrate every single one of these as if they were mine, personally. But I am positive that what Portugal needs is a €Vision and not so much the EuroVision.

[1] Survey on Living Conditions and Income, Instituto Nacional de Estatistica, 2016,  [https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=281091354&DESTAQUESmodo=2], last visited on the 15th of June 2017, last updated on the 16th of May 2017.

[2] Eurostat: Real unemployment double than the official rate, The European Sting, [https://europeansting.com/2014/01/21/eurostat-real-unemployment-double-than-the-official-rate/], last visited on the 15th of June 2017, last updated on the 21st of January 2014.

1st Post image from Global News.

2nd Post image from D+C Development and Cooperation.

Sunday, 11 June 2017

Best weaponry for fighting Sjogren's Syndrome - Division Human Shield - Part 3 of 3

Times have been so incredibly busy for me that I looked on the computer clock and said to myself "How on Earth will I find energy to post anything this month"? But I had to find that energy somewhere because the blog must go on, the information is important, the need for information must be satiated and it's all for a greater good. So what do you do on those times when all your energy phased away but you love something so much you need to find the diesel to get yourself going? Having a blog you love is almost like having a child, with the respective emotional integrity but the honesty in the feeling behind loving your blog is vital to maintain it afloat. 

So I just 'scrubbed' my eyes, not rubbed... and decided to play some motivational music that would give the energy but not in a rage type modus operandi. I didn't go for the typical fury-driven songs, I played Jack Johnson and John Legend, dreamt of sharks playing guitars, sea starts dancing on the background and sexy velvety R&B dancers. Crazy stuff? Definitely, but at least I managed to start typing some initial paragraphs towards what is really important, i.e., sharing with you my experiences, my acquired information.

This is the final chapter to the Best Weaponry for Fighting Sjogren's Syndrome - Division Human Shield. The other two parts can be found here and also here. With this third and final part to my personal advice towards a better management of your problem, there is no disregarding of a visit to a specialist. I do it every year by visiting my rheumatologist. And we actually have great conversations. She appreciates my efforts in getting to know this problem better and looking for solutions to remedy it. And I don't say this of medical doctors very often, mostly because some, if not the biggest part of them, are actually arrogant presumptuous people who can't see past their incredibly tough to gain titles. The fact that their jobs exist on the grounds of people being sick and needing treatment says very little to a lot of them. However, I can see a wind of change and some are starting to understand that the very privileged professional group they compose, orbits around the horizon threshold of the black hole that sickness is, especially for something so 'unknown' as Sjogren's Syndrome. Some are starting to understand that humility is the first step towards knowledge, and for one to improve knowledge one needs to admit that there is so much more to learn and a lifetime is not at all enough to know it all.

And because there is no such thing as knowing it all, I decided to share MY learned information, so we can exchange ideas and get much better some day. The recipe is simple, read with interest, judge with impartiality, share with love:

Coconut oil and olive oil instead of hydrogenated fats

(image from bbcgoodfood.com)

Hydrogenated fats/Trans-fats are triggers to inflammation. As simple as it gets. The highest our intake on these type of fats the worse it gets in terms of inflammatory proneness and endothelial function. In addition, a more vegetarian diet, say a much more reduced in saturated and trans-fats and low in protein, is known to result in a profile of higher antioxidant levels, reduced levels of C-reactive protein (an inflammation marker) and lower risk of coronary heart disease [1, 2]. And in all honesty our body does not know very well how to use these hydrogenated/trans-fats anyways, so why poison it any further? If you don't believe me read Kinsella et al (1981) [3]. The good alternative I've been using is coconut oil, the virgin version whenever possible. The anti-inflammatory potential of this natural oil, alongside its anti-pyretic properties has been vastly confirmed with acute inflammatory models [4].

Rice milk instead of cow's milk

(image from superhumancoach.com)

I could come again with coconut milk or some vanilla-flavoured version of soy milk, but let's be creative, original, different. Rice milk tastes awesome, in opposition to almond milk that often makes me wanna puke! Rice milk works in a neutral way on my taste buds and helps me avoid as much as possible dairy. Actually, dairy products are a big NO NO for inflammatory diseases... and also for those who want to have ripe cut bodies for the Summer! The fact that the allergenic/immunogenic potential of dairy can trigger/increase immune/allergic responses is enough information for me. And I tell you of milk as I tell you of honey and peanuts that I also very much reduced to extremely limited consumption. Only when I have stupid cravings I resort to these, but even then I try to have the bare minimum. In addition, I also replaced the typical butter and yogurts for soy butter/yogurts, and/or olive oil butter (it's only 15% olive oil fat in a plant fat emulsion though - but with a really nice taste). 

And this is my final list of tips in regards to dieting. Believe me, after three years these guidelines made a whole lot of difference in my life. Just give it a try yourselves after consulting with a doctor and you might as well enjoy the same benefits I am enjoying these days. Now, in terms of products that help with my eye and mouth dryness, and those that just caused me loads of secondary effects, I have to tell you of the following. I AM NO FAN OF HYDROXYCHLOROQUINE and I definitely do not understand this new wave of applause that looks into this product as if it were the panacea for the immunologic imbalance. Pure stupidity in my humble opinion. A product that takes around 6-month to start producing proper results [5] and in the meanwhile can cause irreparable retinal toxicity with likelihood for irreparable damage [6], can only be a joke. I don't care if they say that the incidence of retinopathy (damage to the retina of the eyes) in users of hydroxychloroquine is low to very low. Vision, and the loss of it, is no joke for one to roulette it.  

Two comfort shields I have been using on a daily basis whenever I am dealing with terrible discomfort caused by Sjogren's on my eyes and mouth are: Hycosan Extra and Boots Expert Dental dry mouth spray. I should be charging these companies for publicity, but believe me these have helped me tremendously along the way. When things get more serious in terms of dry eyes and Hycosan is not enough anymore (which is rare though) I have to resort to a less fluidly and more oily option. This is typical of when I am stuck in closed environments with very active air-conditioning pumps working all day!

     (image from butterflies-eyecare.co.uk)                                                             (image from Amazon UK)

Finally, Naproxen helps when I can't control the inflammation by the rules of diet, but to be fair that happens once every year... which proves my point that this metabolic response can be optimised to reduce our afflictions. 

Remember, no artificial sugars, no 'artificial' fats, no immunogenic foods, no carbonated drinks that will pore your teeth even further. 

Be safe, be well.

[1] Szeto, Y. T., Kwok, T. C., Benxie, I. F. (2004). "Effects of long-term vegetarian dieton biomarkers of antioxidant status and cardiovascular disease risk". Nutrition, 20, pp. 836-866.

[2] Ridker, P. M., Rifai, N. R., Stamper, M. J., Hennekens, C. H. (2000). "Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men". Circulation, 101, pp. 1767-1772. 

[3] Kinsell, J. E., Bruckner, G., Mai, J., Shimp, J. (1981). "Metabolism of trans fatty acids with emphasis on the effects of trans, trans-octadecadienoate on lipid composition, essential fatty acid, and prostaglandins: an overview". American Journal of Clinical Nutrition, 34(10), pp. 2307-2318.

[4] Intahphuak, S., Khonsung, P., Panthong, A. (2010). "Anti-inflammatory , analgesic, and antipyretic activities of virgin coconut oil". Pharmaceutical Biology, 48(2), pp. 151-157.

[5] Hydroxychloroquine, RheumatoidArthritis.net, [https://rheumatoidarthritis.net/treatment/hydroxychloroquine/], last visited on the 11th of June 2017, last update unknown.

[6] Hydroxychloroquin and  Ocular Toxicity - Recommendations on Screening, The Royal Collge of Ophtalmologists - The British Society for Rheumatology, [http://www.bad.org.uk/shared/get-file.ashx?id=774&itemtype=document], last visited on the 11th of June 2017, last updated on October 2009.