FLUIDS



Hydrate! Hydrate!! Hydrate!!! Today we look at why we need to take enough water every day. We’ve all heard that water is life. This is because while we can survive for weeks without food, we can stay only or survive about a week without water depending on the environmental temperatures. For this reason we need to replenish the water we lose from our body. 




How is water used in the body? Water is a medium for various biochemical reactions. It is part of some reactions especially those that produce energy. It lubricates cells, tissues and joints. It acts as a shock absorber for our brains and spinal cords. Water is necessary for temperature regulation through sweat and respiration. Water forms saliva needed for digestion. It forms tears that clean our eyes. Water also transports nutrients, waste products and hormones around the body.
In sickle cell anaemia, it is important to take enough water to prevent pain crises. The condition also affects the kidneys which are the organs that used to excrete waste products through urine. The kidneys purify our blood so that it is free from toxic compounds. There is slightly more urine production with the sickle cell condition so more water is needed to replace that lost in urine.
To ensure that we have enough water in the body, at least 8 glasses of water daily are recommended. This is about 2litres of water daily!!  It is important that the water we drink and use to cook and clean is safe to prevent water-borne infections. Tap water is treated by the public water systems to remove hazards. Disinfectants like chlorine are used to kill microorganisms. However, the water should be boiled or treated accordingly using chemicals to ensure safety. When buying bottled water, make sure that it is certified by authorities. The source is also important as sources near agricultural areas may be contaminated by chemicals. As taking plain water can get boring, you can add a thin slice of lemon, cucumber or apple to add some flavor.
The foods we eat also contribute to our daily water needs. Fresh fruit, raw vegetables and fresh fruit juices are encouraged while caffeinated drinks and sodas should be avoided. 




Caffeine makes you produce more urine. Losing water affects the blood and the cells will sickle more easily. Too much soda is not good for teeth and bone health. Finally, remember to drink a little more water when you participate in exercises due to loss through sweat.
Well just I pen off here are some fun facts about water!!!
·         The adult body is made up of about 60% water which is about 11% less than the water that covers the earth’s surface.
·         Babies and infants have more water than adults with around 75-78% at birth. This reduces to 65% by the time the babies turn one.
·         Women have less water than men.
·         People with more fatty tissue have less water than leaner people.
·         Different organs have various water percentages. Blood is 92% water, the brain and heart comprise of 75% water, the skin is 64% water, muscles and kidneys are 79% water and the bones are about 22% water.

      Adieu!! Love Life!!

Joyner

Sickle Cell Anaemia Symptom #3 - Leg Ulcers

I decided to speak about leg ulcers this week because of my very good friend Rachel. Rachel has had leg ulcers for a couple of year now and finally today, she got the opportunity to have a grafting procedure done on the leg ulcers.

What are Leg Ulcers?

Like many other Sickle Cell warriors, leg ulcers are a big pain, physically and visually. Leg ulcers are acute or chronic wounds that occur on the lower extremities around the ankle, in areas with less subcutaneous fat, thin skin, and with decreased blood flow. They are open sores marked by a complete loss of the top layer of the skin (epidermis); which does not tend to heal quickly. Leg ulcers are a chronic complication for people living with sickle cell disease. Ulcers tend to be difficult to treat successfully, healing slowly over months or years. They can severely disrupt quality of life, increase disability, require extended absence from the workplace, and place a high burden of care on healthcare systems.

They may be classified as acute or chronic according to their duration, however, there is no consensus as to a specific length of time to define chronicity. An acute ulcer usually should heal in less than a month. Among chronic ulcers, a duration of six months seems to define the most recalcitrant ulcers. It is not uncommon for ulcers to last many years, often closing and re-opening repeatedly. Leg ulcers are painful and often disabling complications of SCD. They tend to be indolent, intractable and heal slowly over months to years. The pain may be severe, excruciating, penetrating, sharp and stinging in nature. In most patients, opioid analgesics are needed to achieve some pain relief.

In the case of Rachel, her leg ulcers prevented her from doing a number of things including walking and/or standing for long hours. Aside from the fact that both of her legs were in bangages, the severe pain during the night was one of the many things she endured. The physiological manifestations of leg ulcers prevents many warriors from living normal pain free lives. I can only imagine what having a persistent wound does to someone's psyche.

Causes of Leg Ulcers

Most of the causes of leg ulcers in Sickle Cell Warriors especially is the lack of blood flow to the skin in the lower extremeties of the legs. Another huge fact is the problem of low immunity which prevents wounds to heal properly and timely. Other major causes are listed below.
  • Obstruction by dense sickled red cells
  • Venous incompetence (impaired blood flow)
  • Bacterial infections, trauma and inflammation
  • Abnormal autonomic control with excessive vasoconstriction when in the dependent position
  • Localized blood clots
  • Anemia with decrease in oxygen carrying capacity
  • Decreased nitric oxide bioavailability leading to impaired endothelial function
  • Arteriovenous shunting that deprives the skin of oxygen
  • Lower musculoskeletal exercise tolerance and oxygen consumption due to the lowered oxygen supply to the exercising muscles in SCD patients

#10003 Sickle Cell Symptom #3 - Leg Ulcers


Management of Leg Ulcers

Management can only be advised depending on how severe the leg ulcer is. This is usually determined by the size, depth and duration of the particular leg ulcer manifestation. The management of chronic leg ulcers in sickle cell patients can be difficult and protracted. It often results in significant pain, limits physical activity and potential employment, and reduces the quality of life for these patients.

Coming back to Rachel, her leg ulcer was chronic. It was deep, relatively large and had persisted for a couple of years. In her case, the option given by the doctors was to administer a skin graft on the wound to help in the healing process. This is because it is a much better option for her since the wound has not been able to heal on itself. However, with the help of a skin graft, healing and closing up of the wound is possible.

With regards to pharmaceutical intervention, studies show that arginine butyrate, RGD peptide, L-cartinine report change in ulcer size However, RGD peptide significantly reduces ulcer size and has reported incidences of complete wound closure. Local treatment with either surgical or sharp debridement, hydrogels, enzymatic digestion, or topical gm-CSF have been recommended but responses are slow and often incomplete. 

  1. Systemic therapies with zinc replacement that help with wound healing and use of antibiotics to prevent and control bacterial growth and infection of the ulcer.
  2. Regular cleaning and dressing of the wound is highly recommended. This helps greatly to improve circulation and treat any rising infections on the wound. Weekly cleaning to remove debris and dressing with clean bandages help to heal the wound quickly.
  3. Transfusion therapy has been used to improve oxygen carrying capacity as well as to decrease levels of hemoglobin S. It has also been used in preparation for surgery, and in the treatment of non-healing leg ulcers. However, it is associated with significant alloimmunization and iron overload which requires aggressive chelation therapy.
  4. Bed rest and elevation to reduce edema (accumulation of fluid) could be beneficial in the treatment of lower extremity wounds. This helps prevent collection of fluid and bring it back to the heart. Elevation also reduces pressure to the blood vessels on the extremities and reduces swelling of the leg around the affected area.
  5. The use of compression for sickle cell ulcers with reference to the use of either Unna's boot or elastic compression bandages and absorbent dressings. This helps keep the blood pressure regulated but not stopped.
  6. And then of course the use of skin grafts to influence wound healing and wound closure.


The use of aggressive medical, wound, and physical therapeutic management is recommended for the successful healing of a chronic wound and leg ulceration in patients with SCD.

Prevention of Leg Ulcer
Since it is clear that leg ulcers are majorly caused by poor circulation and immunity, we can easily be able o prevent their occurrence especially among Sickle Cell Warriors.

Regular light exercise that is comfortable for the warrior is recommended. This may include but not limited to, walking, yoga, swimming or anything that promotes movement and circulation of oxygenated blood within the body.

Increasing intake of nutritional foods especially those that promote body detox and promotes wound healing such as green vegetables and fruits. These foods help build one's immune system to keep off bacteria and infection, improve wound healing and increases overall body energy.

Vitamin C helps in the healing process and increase in blood circulation. Vitamins E, B complex, Zinc and amino acids also help in healing and circulation. For blood clotting, Vitamin K is a huge factor. Being vigilant in your diet will help quicken the healing process. Dark green vegetables and fruits have a dense wealth of nutrition that help oxygenate blood among other things. Do stay away from sweets, refined sugars/carbs and animal protein that reduce and even stop the healing process.



As far as Rachel is concerned, we wish her a full recovery post-surgery and healing that will give her back a full life that she deserves.
All the best Rachel.



Love Life!

Lea














Ref

Pathophysiology and Multidisciplinary Management of Leg Wounds in Sickle Cell Disease: A Case Discussion and Literature Review 

Leg Ulcers in Sickle Cell Disease 

Treatments for leg ulcers in people with sickle cell disease 






LET’S GET SOME ENERGY!!!!


‘You need to finish your food. You need the energy.’
Now am sure we've all heard this phrase more than a million times especially when eating was, well, the last thing on our minds. Like when you are in the middle of a game of snakes and ladders and you were well on your way to winning. So what was the fuss all about? I mean we can eat anything and at any time? I’ll still be ok? Right?



Sufficient energy is important for good health. Energy is needed by the body to carry out activities.
Muscle movement, breathing, healthy heartbeats and even thinking need energy. When these body
functions are doing well we are able to carry out chores, duties, daily activities and exercise well. This promotes proper growth and development.

The main source of energy for the body is carbohydrates. The body can also get energy from fats and
proteins. The Red blood cells utilize glucose only. The brain and nerve cells rely primarily on glucose. Fat is used when we are resting or doing low-intensity activities like sitting. The Red blood cells and brain cells will still use glucose when we are at rest. Proteins are used when carbohydrates and fats are not enough to give energy like during long periods of starvation. So where is the challenge when I have Sickle Cell Anemia?

In Sickle cell anaemia, there is insufficient energy for the body to work well. A lot more energy is used to carry out the same activities as everyone else. One of the major reasons is poor appetite. A poor appetite will make us not eat enough food to give us energy. The glucose we get is not used efficiently by the cells. The hemoglobin which is already too little will be bound to the free glucose in the blood. As a result of this, the hemoglobin will package and carry little oxygen for us to use. Low energy makes it difficult for the red blood cells to have healthy membranes. The membrane becomes rigid and breaks down fast. Finally, the body organs are overworked and organ-specific disease like kidney disease can develop. Is there a way to make sure I have enough energy?

Taking good care of ourselves involves making wise food choices. The one thing we need to maintain is steady supply energy for the body. This way we can fuel our daily activities efficiently and carry them out with ease. And how can I do this?

 Eat whole grain foods with a low glycemic load. Unlike refined white and overcooked foods, Wholegrain foods provide us with sufficient energy through the day. They do this by slowly releasing glucose into our body system.  This way, the blood glucose level rises steadily but slowly. The body can utilize the glucose efficiently as the system is not overloaded.

 Have a high calorie-nutrient dense diet. This can be achieved by eating carbohydrate foods with
low glycemic load with protein. For example, we can have chicken with brown basmati rice or
scrambled eggs and whole grain rye bread. High fibre meals like brown rice with beans also
lower the glycemic load. Use vegetable oils like olive oil and sesame oil that have beneficial fatty
acids that prevent heart disease.

 Vegetables. Dark green leafy and root vegetables should be part of our diet. They can be eaten
raw or cooked with five servings per day being good enough. Dark leafy vegetables provide
micronutrients that help us utilize glucose. Root vegetables like cassava and sweet potato provide us with glucose. Vegetables provide us with fibre that slows digestion of carbohydrates.



 Fruits. Three or more servings of fruit daily will contribute to our energy needs. Fresh fruits and
fresh fruit juice are better sources than canned or dried fruits. They keep our tummies filled for longer. Diluted fruit juices and dried fruits should be eaten less frequently and in small
quantities.

 Healthy habits and Sugar alternatives. Foods with refined sugar like ice cream provide us with a
burst on energy and soon we are left with cravings for more sugar and bouts of hunger. Avoid caffeinated drinks like tea and energy drinks as they have a similar effect. We can have fruit
instead of desert and also add some to breakfast cereal to sweeten it. Fruits, nuts and seeds are
healthier snacks. You can have untreated honey instead of sugar. Heat treated sugar has a fast
releasing sugar like glucose that we want to avoid.



 Meal Portions. It is better to take little and often meals than ‘gorge’ on large and greatly spaced
meals. This caters for the needs of a poor appetite. It encourages us to eat just what we can at a
time but also get energy. The body also breaks down the carbohydrates little by little so it is not
over worked.

 Exercise. Sweat inducing exercise like biking are recommended. The sweat is the body’s way of
removing waste products from the activities it does. This will ensure that major body fluids have an alkaline pH conducive for energy extraction.


Well guys, I am sure we will be getting the most of our days with all the energy in the room!! Till
then Hydrate! Hydrate! Hydrate!! Water is Life!!

N.B: Kindly consult the Food Pyramid and Food Composition table for the food servings.


Love Life!

Joyner.

One Who Fears To Open Up To The Doctor Cannot Get Healed

In my language we have a proverb atya okubirira omusawo tawona loosely translated as the one who fears to open up to the doctor cannot get healed. This proverb means if you hide anything from the doctor, you will not get full treatment and probably your healing will be half baked.
It’s more common to get to the doctor’s room and refuse to tell him symptoms which you think are minor. At times the minor symptoms may be the cause of major problem.
The first step in securing the correct treatment plan for your pain and discomfort is to tell your doctor about all your symptoms and any changes in those symptoms as the treatment progresses. Even if you feel that they are not related to your condition, your doctor needs to know about them. You should also be completely honest about your lifestyle. For example if there is any other drugs you use apart from the one prescribed, tell your doctor.
This information will be held in the stricter confidence and will only guide your doctor towards the most appropriate plan of care.

Tell your doctor
  • When the symptoms started
  • What they feel like
  • How they are affecting your  life and
  • What makes the symptoms better or worse


The more specific your explanation, the more helpful it is.
 

Love Life!
Ssebandeke Ashiraf

FOLIC ACID AND SICKLE CELL ANAEMIA



Sickle Cell Anaemia as seen earlier adversely affects the production and the quality of red blood cells. The cells have a shorter lifespan. This leads to increased folic acid losses. Today we focus on this vitamin and its importance. Let’s begin, Shall we?
Folic acid, also called folate, is a B vitamin. It is referred to as Vitamin B9. The name is derived from the Latin name foliage meaning ‘leaf’. This is because folate is found in highest levels in green leafy vegetables. Folic acid can be artificially synthesized. It is used in food fortification and manufacture of supplements.
Folic acid plays a key role in certain body functions. Folic acid is critical for nucleotide synthesis. It is essential for protein utilization and red blood cell synthesis. Folic acid works well with other B vitamins especially vitamin B12. Now let us look into each of these roles and consequences of deficiency in more detail.

·         NUCLEOTIDE SYNTHESIS. Folic acid is required for the synthesis of purines and thymidine. These are important for DNA synthesis. DNA controls cell division in growth and development. Folic acid is crucial for pregnant women during the first four weeks. This ensures proper development of the brain and nerves from the neural tube that is formed by the 28th day of pregnancy. Folate is needed on in life to maintain the integrity of body tissues and repair. Folic acid deficiency in pregnancy leads to neural tubal defects like spina bifida in newborns. It is of great importance that all women of childbearing age take adequate folate (additional 400mcg aside dietary folate) regardless of whether or not they intend to get pregnant.

·         PROTEIN UTILIZATION. Proteins are made of many smaller units called amino acids. Folic acid is needed for the metabolism of various amino acids including glycine, serine and methionine. Folic acid, together with Vitamins B6 and B12 are important in methionine metabolism. Folate and B12 convert homocysteine to methionine while B6 converts homocysteine to cysteine. High levels of homocysteine are associated with vascular disease. The role of folic acid is cemented in the regulation of these diseases through homocysteine regulation.

·         RED BLOOD SYNTHESIS. As we saw earlier, folic acid is important for DNA synthesis. DNA controls the production of red blood cells. In sickle cell anaemia because the red blood cells are short-lived, the levels of folate in the body are often low. As a result, DNA synthesis is impaired and the red blood cells fail to divide well. They remain as large immature precursors of the red blood cells. This condition is referred to as megaloblastic anaemia. These cells have little haemoglobin. They cannot package and transport oxygen sufficiently. Because of the anaemia, one may be anxious, lack energy, have a poor appetite, stomach pains, and cracked lips. You may also suffer from depression. This deficiency severs the sickle cell condition because the red blood cell levels are already too low and crescent shaped cells are predominant.

We need to have a daily balanced diet to be provided with adequate folic acid. This is to prevent folate deficiency. Green leafy vegetables are highly recommended. Some good sources are spinach, cauliflower and sprouts. Whole grains, lentils and pinto beans can be included in the diet. Red meats like beef liver are rich in folic acid but should be eaten in minimal amounts. The red meats are rich in saturated fats hat are bad for our health. This is because they contribute to development of vascular disease. Folic acid is heat sensitive therefore we are advised to eat fresh, uncooked vegetables and fruits. Avocado, beets, sesame nuts (simsim) and cashew nuts are good sources of such. Enriched cereals are also encouraged.
While a balanced diet provides enough folic acid, your doctor or nutritionist may recommend that you take daily folic acid supplements.




This is to cover the losses due to red blood cell death as well as slow metabolism by the body. The supplement tablets should provide between 400-1000 micrograms of folic acid daily. Majority of  patients have a high-dose folic acid  prescription of 1000mcg(1mg) daily. In some cases a B-complex supplement may be given. This particularly true when one has vitamin B12 deficiency, pernicious anaemia.*Folic acid can clear the blood signs of B12 deficiency and hide the neurological signs masking the deficiency. Vitamin B12 is needed for growth and maintenance of the insulating myelin sheath around nerve fibres. Only a skilled professional can diagnose the nutrient deficiency. Self-diagnosis and advice from unskilled self-proclaimed experts are not advised. Well, that’s folic acid for you. Remember to take you greens, drink your water and exercise to stay in tip-top shape.


*The exact doses of folic acid taken by patients that hide B12 deficiency are still subject to research.

Love Life!!
Joyner

Sickle Cell Symptom #2 - Infections : Effects and Prevention

Continuing our discussion on infection, last week we found out why Sickle Cell Warriors are highly predisposed to infections.If you missed it, you can read it HERE.

Speaking from personal experience, infections are no fun. The body becomes very sluggish and crisis ensues. Afterwhich many Sickle Cell Warriors fall ill admitted in hospital, pumped full of antibiotics. When an infection enters the body, the sickle cell warrior is compromised. What I mean to say is, the body directs all its defenses and energies towards destroying the foreign pathogen making it vulnerable and weak.

Borrowing from Catherine Booth, Baba Inusa and Stephen K. Obaro who wrote an article about infection and Sickle Cell on the International Journal of Infectious Diseases, they tell us what an infection does to the body of a Sickle Cell Warrior.

They say that, during infection with any pathogen, changes occur at a cellular level, which predispose to crises. Levels of circulating leukocytes and inflammatory cytokines increase, with elevated expression of adhesion molecules on both the blood vessels and leukocytes themselves. This occurs locally in infected tissues and systemically. Local acidosis and hypercapnia (increased CO2) in areas of inflammation increases the Hb oxygen, promoting unloading of oxygen from Hb and thus increasing sickling.

The sickling process is initially reversible when HbS is reoxygenated, but dehydration of RBCs increases HbS concentration, promoting extensive polymerization (cell adherence) and causing irreversible membrane damage. These poorly deformable dense cells contribute particularly to vaso-occlusion (vessel obstruction), adhering readily to leukocytes (white blood cells) and endothelium, and also undergo hemolysis (Red blood cell destruction).

In addition, infections can have more non-specific effects on the host physiological milieu, which increase the risk of sickling. Fever with water loss due to sweating, anorexia, and nausea with reduced oral fluid intake, diarrhea, and vomiting all contribute to dehydration. Renal impairment in SCD causes poor urinary concentrating ability, so plasma osmolarity (osmotic concentration) can rise, promoting RBC dehydration. The stress and emotional response, accompanied by neural and hormonal changes, may also play a role.

Sickle Cell Anaemia Infection Prevention #10003


Common pathogens associated with infection in sickle cell anemia with underlying mechanisms for predisposition

Pathogen and Predisposing factors


Encapsulated bacteria (e.g., Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Salmonella spp) - Impaired splenic function & Impaired opsonization (bacteria destruction)
·         Salmonellae               - Recurrent vaso-occlusion with intestinal infarct, necrosis and increased gut                                           permeability & Decreased neutrophil (white blood cell) killing
·         Malaria                - Decreased deoxyhemoglobin solubility
·         Parvovirus           - Increased red cell turnover
·         Hepatitis B, C      - Multiple blood transfusion
·         Chlamydophila    - Unknown
·         Yersinia enterocolitica - Iron overload
·         Mycoplasma        - Unknown
Edwardsiella tarda - Increased intestinal permeability and biliary sludging

Prevention
Simple general measures are important in reducing the risk of infection, though the aim is to ensure as normal a lifestyle as possible. Meticulous attention to hygiene, particularly hand-washing, is vital, and to protect against Salmonella, patients are advised to cook food thoroughly, particularly chicken and eggs, keep items refrigerated, and avoid contamination. Nutritional supplementation with zinc has been reported to reduce infection risk, improve growth rates in SCD children, and possibly improve skeletal and sexual maturation as well as having psychological benefits. Early identification of infections is another key area, enabling prompt initiation of treatment to reduce complications. Parents are encouraged to monitor their children closely at home and seek advice if they have a fever or respiratory symptoms, while maintaining good hydration. There should be a low threshold for the use of antibiotics in ill children with SCD, particularly in the presence of chest signs or symptoms, which may herald ACS(Acute Chest Syndrome).


I hope behind the biological jargon, you all learned something. I promise to make it easier to digest next time. If there is any question or comment with regards to infection and sickle cell, post it below on the comment section.

Otherwise, until next time. Stay healthy and,


Love Life!
Lea


·        

Top Nutrients That Boost Your Immune System




Top nutrients that boost your immune system

So you learned how a strong immune system is important in the management of sickle cell disease. Well when it comes to diet & nutrition,it takes much more than an apple a day to keep the doctor away. It turns out that eating some pretty surprising nutrients will help keep your immune system on guard.
Hold on; let’s go back to the beginning for a minute. On the whole, your immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it fails very easily, especially when you have a condition such as sickle cell disease: A germ invades successfully and makes you sick. The idea of boosting your immunity is enticing, but the ability to do so has proved elusive for several reasons. The immune system is precisely that — a system, not a single entity. To function well, it requires balance and harmony. So is it possible to intervene in this process and make your immune system stronger? What if you improve your diet? Take certain vitamins or herbal preparations? Make other lifestyle changes in the hope of producing a near-perfect immune response?
Your first line of defense is to choose a healthy lifestyle. Following general good-health guidelines is the single best step you can take toward keeping your immune system strong and healthy. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

·         Don’t smoke.
·         Eat a diet high in fruits, vegetables, and whole grains, and low in saturated fat.
·         Exercise regularly.
·         Maintain a healthy weight.
·         Control your blood pressure.
·         Avoid alcohol.
·         Get adequate sleep.
·         Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.
·         Get regular medical screening tests for people in your age group and risk category.
Like any fighting force, the immune system army marches on its stomach. Immune system warriors need good, regular nourishment –yeah, here’s where the diet part comes in. You can ensure that your body and immunity run smoothly by rounding out your plate with plenty of colorful servings of fruits and veggies, plus 8 to 10 glasses of water a day, at the very least.There is some evidence that various micronutrient deficiencies — for example, deficiencies of zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, and E — alter immune responses in animals.

So what can you do? If you suspect your diet is not providing you with all your micronutrient needs — maybe you don’t like vegetables or you choose white bread over whole grains — taking a daily multivitamin and mineral supplement brings health benefits of many types, beyond any possibly beneficial effects on the immune system. Taking mega-doses of a single vitamin does not. More is not necessarily better. Researchers are investigating the immune boosting potential of a number of different nutrients, such as:


    a)     Vitamin A
For vitamin A, go colorful. Foods that are high in colorful compounds called carotenoids — carrots, sweet potatoes, pumpkin, cantaloupe and squash — are all great options. The body turns these carotenoids into vitamin A, and they have an antioxidant effect to help strengthen the immune system against infection.Experts have long known that vitamin A plays a role in infection and maintaining mucosal surfaces. Vitamin A deficiency is associated with impaired immunity and increased risk of infectious disease.

    b)     Vitamin B2
There is some evidence that vitamin B2 enhances resistance to bacterial infections in mice, I wonder what that can do for us!

    c)      Vitamin B6
This important vitamin — part of nearly 200 biochemical reactions in your body — is critical in how your immune system functions. Foods high in vitamin B6 include bananas, lean chicken breast, cold-water fish such as tuna, baked potatoes and chickpeas. Several studies have suggested that a vitamin B6 deficiency can depress aspects of the immune response, such as lymphocytes’ ability to mature and spin off into various types of T and B cells.

    d)     Vitamin C
You probably know about vitamin C’s connection to the immune system, but did you know you can get it from much more than just citrus fruits? Leafy green vegetables such as spinach and kale (sukuma wiki), bell peppers (hoho), Brussel sprouts, strawberries and pawpaw are also excellent sources. In fact, vitamin C is in so many foods that most people may not need to take supplements unless a doctor advises it.As much as itdoes this, it normally works with other micronutrients in boosting immunity rather than providing benefits alone.
    e)     Vitamin D
It’s best to get most of your vitamins from food, but vitamin D may be the exception to that rule. For many years doctors have known that people afflicted with tuberculosis responded well to sunlight. An explanation may now be at hand. Researchers have found that vitamin D, which is produced by the skin when exposed to sunlight, signals an antimicrobial response to the bacterium responsible for tuberculosis, Mycobacterium tuberculosis. So there’s another disease crossed off the list!You can increase your intake through foods such as fatty fish (salmon, mackerel, tuna and sardines) and fortified foods such as milk, orange juice and cereals. Many people have a hard time absorbing vitamin D from food, so if you have a vitamin D deficiency, talk to your doctor about supplements.

    f)      Vitamin E
Like vitamin C, vitamin E can be a powerful antioxidant that helps your body fight off infection. Almonds, peanuts, hazelnuts and sunflower seeds are all high in vitamin E. So are spinach and broccoli if you prefer to increase your intake through meals rather than snacks.

    g)     Zinc
Zinc is a trace element essential for cells of the immune system, and zinc deficiency affects the ability of T cells and other immune cells to function as they should. You can find zinc in oysters, crab, lean meats and poultry, baked beans (skip the kind with added sugar), yogurt and chickpeas. Zinc appears to help slow down the immune response and control inflammation in your body; this is why it’s probably the most talked about nutrient in the management of sickle cell disease.Caution: While it’s important to have sufficient zinc in your diet (15–25 mg per day), too much zinc can inhibit the function of the immune system.

     h)     Folate/folic acid
Folate is the natural form, and folic acid is the synthetic form, often added to foods because of its health benefits. To get more folate, add more beans and peas to your plate on a regular basis, as well as leafy green vegetables. You can also get folic acid in fortified foods (check the labels) such as enriched breads, pastas, rice and other 100 percent whole-grain products.

     i)       Iron
Iron, which helps your body carry oxygen to cells, comes in different forms. Your body can more easily absorb “heme iron,” which is abundant in lean poultry such as chicken and turkey, plus seafood; and “non-heme iron” in plant sources such as beans, broccoli and kale.

     j)  Selenium
Selenium seems to have a powerful effect on the immune system, including the potential to slow the body’s over-active responses to certain aggressive forms of cancer. You can find it in garlic, broccoli, sardines, tuna, brazil nuts and barley, among other foods.

    k) Herbs and other supplements:
Walk into a store, and you will find bottles of pills and herbal preparations that claim to “support immunity” or otherwise boost the health of your immune system. Although some preparations have been found to alter some components of immune function, thus far there is no evidence that they actually bolster immunity to the point where you are better protected against infection and disease. Demonstrating whether an herb — or any substance, for that matter — can enhance immunity is, as yet, a highly complicated matter. Scientists don’t know, for example, whether an herb that seems to raise the levels of antibodies in the blood is actually doing anything beneficial for overall immunity. 
But that doesn’t mean we should discount the benefits of all herbal preparations. Everyone’s immune system is unique. Each person’s physiology responds to active substances differently. So if your grandma says she’s been using an herbal preparation for years that protects her from illness, who’s to say that it doesn’t? The problem arises when scientists try to study such a preparation among large numbers of people. The fact that it works for one person won’t show up in the research data if it’s not doing the same for a larger group. Some of the supplements that have drawn attention from researchers are these:
·          
     Garlic contains the active ingredient allicin, which fights infection and bacteria. British researchers gave 146 people either a placebo or a garlic extract for 12 weeks; the garlic takers were two-thirds less likely to catch a cold. Other studies suggest that garlic lovers who chow more than six cloves a week have a 30 percent lower rate of colorectal cancer and a 50 percent lower rate of stomach cancer. So eating two raw cloves a day (or night, to avoid giving others a sniff of your garlic breath) and adding crushed garlic to your cooking several times a week is a brilliant idea.
·        Probiotics (good bacteria), or the "live active cultures" found in yogurt, are healthy bacteria that keep the gut and intestinal tract free of disease-causing germs. So as you shop for your yogurt, make sure you pick a brand with a ‘Live and Active Cultures’ label because it contains some beneficial “bugs”… I know it’s not as gross as it sounds.
·         Ginseng.
·         Aloe vera.
·         Astragalus membranes from the astragalus plant.
·         Echinacea.
·         Glycyrrhiza glabra (licorice root).

And that my friends, brings me to a conclusion in today’s article. I know, I know, you’re probably wondering how and where to get these nutrients and herbs from, how can they possibly improve my health and most importantly, how can they manage sickle cell disease. No worries, let’s hold onto this piece of info and take it all in. We will begin a series of articles focusing on each nutrient and supplement in the weeks to come. Until then, eat healthy and stay active!
Love life!
Sharlene