Vitamin B

Next in our quick series of Vitamin FAQ’s we look at vitamin B (if you missed Vitamin A – you can read it here).

There are actually lots of different types of vitamin B, but for our bodies the main ones are:

  • B1 – thiamin
  • B2 – riboflavin
  • B3 – niacin
  • B5 – pantothenic acid
  • B6 – pyridoxine
  • B7 – biotin
  • Folate (folic acid)
  • B12

 

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In general, they all aid the process of breaking down key aspects of our food, releasing much needed energy into our system, as well as helping keep our eyes, skin and nervous system healthy.

Vitamin B6 has a specific role in using and storing the protein and carbohydrates we take in as part of our diet and helping our body to produce haemoglobin. Haemoglobin is what makes our blood look red and critically carries oxygen around the body.

Folic acid – most well known as the supplement that is needed in pregnancy – is crucial for reducing the risk of developmental defects of the central neural tube of unborn babies. The neural tube is the early form of our central nervous system. Developmental problems at this crucial stage of a baby’s growth can lead to problems such as spina bifida. However it’s not just pregnant women – it also helps all of us to make healthy red blood cells.

Perhaps the most well known is vitamin B12. This actually helps us to use folic acid. It also is vital in keeping the nervous system healthy and plays a key role in making red blood cells.

With so many types of B vitamins, the ways we can get this into our diet are varied. Importantly, some of these vitamins cannot be stored in the body – so we need a daily supply in our diet. Thiamin cannot be stored – and it’s recommended that men need around 1mg/day and women around 0.8mg/day. Similarly we need daily riboflavin at around 1.3mg for men and 1.1mg for women. Niacin also cannot be stored and men should aim for around 16.5mg and women around 13mg.

A word of caution about niacin – too much for a long time can lead to liver problems and cause skin flushes. Similarly B6 in excessive amounts  (e.g. more than 200mg) can lead to a problem called peripheral neuropathy. This is a problem of the nervous system where we can develop loss of sensation in our limbs (peripheries). Men should aim for around 1.4mg/day of B6 and women around 1.2mg.

Many foods are rich in a number of B vitamins including: eggs, fresh/dried fruit,  leafy green vegetables, broccoli, wholegrain bread, fortified cereals, milk (cow’s), nuts,

Some specific diets e.g. vegetarians and vegans can sometimes struggle with B vitamins, and B12 in particular. B vitamins are in abundance in animal products – meats, fish, eggs, cows milk etc. However with careful planning, it is possible to get all the recommended amounts in your diet without additional supplementation. However, a multivitamin can be a helpful addition to more restrictive diets and might be worth discussing with your doctor.

Folic Acid

As we have already learned, folic acid (or folate) is pivotal in a baby’s development and throughout our life by helping us produce red blood cells. The average adult needs 200micrograms of folic acid/day and it cannot be stored meaning you need a daily amount. An additional supplement is provided to pregnant women – either 400mcg of 5mg depending on their medical history. Caution is required with additional supplementation – too much can possibly cover up an existing B12 deficiency.

This is found in vegetables such as asparagus, peas, sprouts and broccoli. It is also prevalent in liver but this should be avoided in pregnancy.

B12

The most well known of all B vitamins is B12. A deficiency of B12 is something that has been in the media more of late. This is the vitamin that those who avoid animal products in their most struggle with – as it is only found naturally in animal products – meats, milks, eggs.  It is some fortified cereals however.

We need around 1.5micrograms/day and this is something we can store in the body.

Deficiency in B12 causes wide ranging symptoms including low mood, changes in mental state, altered or abnormal sensation, fatigue, irritability, anaemia and reduced fertility. Whilst some changes can be reversed with treatment, if left unchecked and untreated, some of the damage can be permanent.

Vitamin A

In a series of short posts we will be looking at crucial vitamins for our body – today we’re looking at Vitamin A.

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Mango

You might know Vitamin A as retinol, and is helpful for your body’s natural defence against illness as well as keeping our skin healthy. It’s also important in aiding us see in low light.

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Eggs

 

Men need around 0.7mg a day and women around 0.6mg, mango and apricots as well as eggs and cheese are good sources for vitamin A to include in your diet.

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Apricots

It may be possible to have too much vitamin A with studies suggesting that sustained high doses might lead to increase risk of osteoporosis – where bones break more easily.

 

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If you’re pregnant, larger amounts of vitamin A can also harm your unborn baby so it’s best to avoid foods that contain liver as these are particularly high in vitamin A.

Your sense of self: the magic five.

Self Confidence.

Self Esteem.

Self Worth.

Self Belief.

Self Respect.

All priceless. All fragile. All unique.

Our sense of self is intricately tied to our personalities, experiences, belief systems and the bubble we find ourselves in. It can take a life time to build and a second to shatter.

 

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On the face of it, the five S’s may all seem similar concepts but each one is a like a snowflake – outwardly uniform but subtly different to the next.

In today’s society when we are so often judged on how well we do our job, how many exams we passed, how productive we are, what material possessions we have or don’t have, it can be easy to conflate our self-confidence by listing our many achievements. However to face and accept our flaws and weaknesses takes real strength. It’s our self-esteem that allows us to look at these facets of our character and not be lessened by them. A robust sense of self esteem enables to us own our flaws, learn from them, use them, grow from them.
Alexander Pope wrote An Essay on Criticism in 1709 and told us “To err is human, to forgive is devine”. Whether you have faith in a higher power is immaterial, and whilst Pope may have been talking about literary critics, his words ring true when considering self-esteem.

Mistakes, flaws and errors are part of what makes us human. Being able to forgive ourselves is part of our ongoing development. We need to acknowledge and accept these to be able to move forwards.

Valuing what we can offer our friends, our family, our colleagues, the wider community or, more importantly, ourselves helps to re-affirm our sense of worth and place in the world. We all have a place.

What we do with that place, to a greater or lesser extent, has much to do with our self-belief. Einstein said that insanity is doing the same thing over and over and expecting different results. If we never change what we put in to something, how can we ever expect a different result?

At a couple of stages in my professional life I have had attacks of “Imposter Syndrome”, a pervasive feeling that at some point I would be uncovered as a fraud. I lacked the confidence and belief in myself and my abilities. The first was immediately after medical school. For years as I rotated through my house officer (residency) jobs, I kept all my old med school notes and textbooks – just in case the university called to tell me they had made a mistake and I hadn’t actually passed my finals!

The second time was shortly after I qualified as a GP. I worried all the time that I would be “found out” and that I wasn’t really “good enough” to do my job. Thankfully with time, supportive colleagues and a helpful husband, I learned to settle in my work. I still have moments when doubt starts to creep in, but using strategies I have developed over time to refocus my self-belief and confidence, I can pick myself back up.

Having a goal – whether it be in your work, your home life, weight loss or fitness goals – and the effort and drive it takes to reach it – all relies on your self-belief. That intense faith you place in yourself that you will reach your target. This one (as they all are) is tricky. It’s vulnerable to knocks along the way and this can lead you to deviate from your goals.

An analogy I often use with patients when we talk about goal setting is to imagine climbing a mountain. When you are in the foothills looking at the summit, it can seem an awful long way up. It’s easy to think of at least ten reasons not to start the journey – it’s a long way, it’ll be hard, I’m not prepared… But if you think of that same journey as a series of shorter journeys, perhaps from the foothills to base camp. From base camp to the next rest stop, and then to the next and so on until you reach the summit. Then at each rest stop allowing time to gather yourself and evaluate your progress. Whilst the journey might still seem a challenge, breaking it down to smaller chunks makes it more manageable.

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A buzz phrase in medicine, and education generally, is SMART. A tool for setting goals, it tells us that goals should be:

Specific (what are you going to achieve)

Measurable (how will you know when you achieve it)

Achievable (is it within your ability – if your idea of art is drawing is limited to stick people it might not be achievable to think you’ll open at the Tate Modern or MOMA in twelve months time)

Realistic (perhaps you are a great artist but accept it might take ten years for an opening in prestigious galleries) and

Time Specific (when are you going to achieve it by)

Either way to get to our goal takes self-confidence to learn our strengths, self-esteem to accept our weaknesses, self -worth to believe we have value and the right to dream and self-belief to push on and achieve it.

Which leaves the toughest one of all, self-respect.

Underpinning all of these is the respect we have for ourselves. Our esteem, worth, belief and confidence are, in general, internal concepts. They are what we think. Our respect is generally what we do to ourselves in the physical sense. Self-respect doesn’t care what happened in the past, it’s about what you are doing right now.

If the other four S’s are talking the talk, your self-respect is walking the walk.

No one, in any shape or sphere can or should take your self-respect. The only person who has any right to your self-respect is you. If you have a bad day, or week, or even a bad month your esteem, confidence, worth or belief might take a beating, but it’s your self-respect that will build you back up.

Self-respect is lifetime work. There will always be critical voices and adverse life events ready to knock you. However if you can ensure you respect you for you, you’ll make it through. Imagine your self-respect as a small seed, planted in the ground. To grow, it needs to be nourished and fed to flourish, ignore it and it will risk withering and decaying.

Having respect for yourself means taking care of your body, your mind and your actions. Be proud of you. Don’t settle for something that is less than you deserve. Forgive yourself, we have all done things we are not proud of, but berating yourself for these for the rest of your life won’t get you anywhere. Surround yourself with positive people and influences. Take care of your body – you only get the one. Don’t compare yourselves to others. Theodore Roosevelt told us that “Comparison is the thief of joy”. Treat others with respect but do not allow others to disrespect you.

“Self-respect cannot be hunted. It cannot be purchased. It is never for sale. It cannot be fabricated out of public relations. It comes to us when we are alone, in quiet moments, in quiet places, when we suddenly realize that, knowing the good, we have done it; knowing the beautiful, we have served it; knowing the truth, we have spoken it” Alfred Whitney Grisworld

 

–Alex

 

 

Time to hydrate

All this week we’re focusing on Nutrition and Hydration Week, an awareness campaign that could be custom made for us. It’s aim is to spread the important message of maintaining health by considering our nutrition and hydration.

Today we’re looking at the most basic and yet the most vital aspect of nutrition and hydration: Water.

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Why not try infusing your water with fresh fruits or herbs for extra flavour?

Aqua. H2O. Whether you take it still, sparkling, tap or bottled, infused or iced there is no escaping the importance of water to our bodies.

Our bodies are roughly two thirds water and it role is crucial. It can be incredibly difficult to know how much to drink, especially once you start to consider the impact of the exercise, weather and general state of health.

Water is not just important for the normal functioning of our bodies. It can have a crucial role in weight loss. Drinking with your meal or between meals can help to increase your sense of fullness. Those hunger pangs might not be hunger, often it’s thirst.

The human body has evolved to be a highly sophisticated filtration system. A series of chemical reactions and responses triggering further reactions and responses to maintain as steady state as possible (homeostasis).

The amount we drink is triggered by our thirst response. We drink when we’re thirsty, our body utilises the fluid it needs and any excess is eliminated by the kidneys or bowels. To counteract this loss, the thirst cycle starts again.

 

The actual amounts we are recommended to drink can vary depending on what study you read. In general terms, the European Food Safety Authority suggest 2L for men and 1.6L for women. Within the UK, the average bottle of water is about 500ml – so a man would need around four of these and women just over three.

However, it starts to get more complicated when you factor in the level of activity that you engage in, your physical health, your size and weight and whether it’s a hot day or not.

I often find I am encouraging my patients to drink more, and there seems to be some confusion over what we should be drinking. Water is always going to be the best option. Alcohol may feel like it quenches your thirst but it’s a diuretic meaning you’ll pass urine more frequently which may actually dehydrate you. The hangover effect and the ubiquitous headache with alcohol, in part, is due to this dehydration mechanism. One option is to alternate your alcoholic drinks with a glass of water to help counteract the dehydration.

Fruit juices and soft drinks are also options, but these can contain high amounts of sugars so should be drunk in moderation.

The vast majority of tea and coffee, unless you choose a de-caffeinated option, contain some caffeine. Caffeine can also have a mild diuretic effect and can hinder your hydration.

Dehydration, a state whereby the body lacks fluid, may cause you to feel thirsty or pass urine which is darker in colour or stronger smelling. You might also feel sluggish, light headed and or have a dry mouth.

Children and the elderly, are more at risk of becoming dehydrated. Signs that might give your doctor cause for concern is if children are becoming drowsy, having fewer wet nappies or if they are breathing more quickly. Older people often may not realise that they are dehydrated and confusion is a common presentation of dehydration in the elderly.

Patients experiencing vomiting, diarrhoea or sweats as a result of a fever can become dehydrated quickly unless they are able to replace the extra water lost from the body.

*Originally written for The Independent July 2015, rewritten for blog post March 2017.

World Kidney Day 2017 : Kidney Disease and Obesity

Annually, a global event is held to help drive awareness of kidney problems and how we can all help to protect these vital organs. This year the theme is ‘Kidney disease and obesity’.

Our kidneys are organs like no other in the body, acting as a filtration system for our blood helping us to eliminate toxins as well as playing a crucial role in other functions such as controlling blood pressure.

It’s a myth that kidney disease only effects elderly people, and whilst it is true that some forms of kidney problems are more common as we age, kidney disease can strike at any age.

 

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So how does obesity link to kidney disease?

It is a sad fact that obesity levels are on the rise across the world, in all age ranges. Carrying extra weight places increased pressure on so many different bodily systems – including our kidneys. Patients who are obese are at an increased risk of diabetes and high blood pressure – both of which can, in turn, increase the risk of developing kidney troubles. It is estimated that by 2025, 18% of all men and 21% of all women worldwide will be obese.

What is more worrying to us as doctors is the rate of childhood obesity and the alarming frequency we see it in our clinics. Children are developing problems, normally associated with adults, at a younger and younger age. Radical action is needed to ensure that we are setting up our future generations for the healthiest possible lives.

One of our main passions in our work is promoting the preventability of disease. We know that there are many things in life, and in health, that we have no control over, but if we can help to reduce the factors that increase our risk of illness we have at least taken a step in the right direction.
Obesity is largely preventable. It isn’t easy, but it is preventable. 

 

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One of the key themes of this World Kidney Day is to promote the achievability and affordability of healthy choices in helping us to tackle the global obesity epidemic. As practicing GP’s we often hear from patients that it costs more to eat healthily, and there is some truth in that. When you can get a burger in minutes for less than a couple of pounds it is too easy to see why we as a global community battle our weight.

However being informed about healthy choices, and armed with a little forward planning, it is possible to eat well without breaking the bank. Celebrity chefs including the likes of Jamie Oliver often provide the breakdown of a cost per head per meal – and these fall well below the cost of a take away.

Quick Kidney Facts (www.worldkidneyday.co.uk)

  • Our kidneys will filter around 180 litres of blood every day. That’s the same amount as just under 55 cans of an average sized canned drink.
  • Kidney failure can be fatal without dialysis or transplant
  • 64,000 people in the UK are currently being treated for kidney failure
  • 3,300 kidney transplants take place in the UK each year but over 5,200 are still waiting
  • Every year in the UK there are an estimated 40,000 premature deaths related to chronic kidney disease

 

Why not take a few moments to read more about world kidney day on their website?

 

–Alex

 

 

 

Welcome

We’re all on a journey.

Welcome to our very first blog post.

The Soul Medics are a husband and wife team of General Practitioners in the UK who passionately believe in promoting health and wellness. We have over twenty years of medical experience between us, in both the NHS and in private health services.
Prevention is often better than the cure, and we want to help empower others to make choices that improve not only their physical health but their emotional wellbeing. Being well is not just about being on the right medications, although we know all too well that sometimes it is needed.

Tackling problems like inactivity, obesity and stress can seem daunting, especially on your own. We’re here to share our tips, thoughts and ideas on how we can all make those positive choices.

This is a journey we are on as well, so when we are talking about being more active, choosing healthier food options or trying to improve our general wellbeing – we’re living it too.

We woke up midway through 2016 and realised we had gained several stone of weight, our fitness levels were non-existent, we were working long hours and spending little time taking care of ourselves and each other.

So we decided to make a change.

We decided to really practice all those things we had spent years telling patients about. Our journey isn’t over and we would love for you to join us on it.