Your thyroid medication…is it the dose for the season?

Some people's thyroid function could be affected by the seasons. So, if you are taking medication for hypothyroidism, your dose may need adjustment.

In winter, your body's requirement of thyroid hormone may increase. This may cause your Thyroid Stimulating Hormone (TSH) level to rise, your free T3 and free T4 to drop. 

This means that the dose you were taking during summer, may not be enough for you in winter. 

If you notice you "don't feel well" as the weather 

gets colder, it may be worth your while to get your 

thyroid function checked again by the doctor. 

Some physical symptoms and signs of hypothyroidism 

(this is not an exhausive list):

• Heart beats very slowly (bradycardia), slow pulse rate
• Dry skin especially on face, elbows and legs
• Problem regulating your body temperature
• Face is puffier than usual
• Hair loss
• Sluggish and slow to move
• Tired especially in the morning
• Slow to think and act
• Brittle and slow growing nails

Some conditions which may increase the demand of your thyroid medications like Thyroxine:

• Taking other medication, this includes Hormone Replacement Therapy (HRT), Oral Contraceptive Pill and Beta-blockers e.g. metoprolol, antenolol and propanolol
• Consuming a high protein diet
• Sudden increase in exercise or physical activity

Body Composition Assessment

Part of anthropometric assessment is the determination of body composition. The measurements provide information on muscle mass (lean weight) and fat reserves.

There are different methods of measuring body composition:

1) Calipers

2) DEXA

3) Hydrostatic weighing

4) Bioelectrical Impedance

Calipers

Pros: It is portable and most gyms offer for little or no cost. It is quick.

Cons: Some people may find it uncomfortable and invasive. The accuracy of the skinfold is dependant on the technician's skill as well as the calliper type and the skin fold prediction equation used. Results vary when done by different technician.

DEXA (Dual Energy X-ray Absorptiometry) 

Pros: This method is considered a gold standard because of its reliability, precision, and the fact that it is based on three body components (fat, muscle, bone) rather than two (fat and muscle) as in most other methods including hydrostatic weighing. It allows fat distribution throughout the entire body to be read in a single scan. 

Cons: Expensive and a person must lie perfectly still for 10-20 minutes while the scan is taken. You are exposed to radiation. DEXA is found mainly in research facilities and through some X-Ray services. 

Hydrostatic Weighing 

Pros: Done correctly, this method is also quite accurate and considered a gold standard. 

Cons: Hmm, uncomfortable to say the least! The test relies upon the person's ability to expel all oxygen from their lungs while submerged in a tank of water. Oxygen remaining in the lungs will skew the results. In clinical settings, this procedure is repeated a number of times, and an average is taken. The "tank" is expensive and the inconvenience to the user is considerable. Because of the cost, lengthy testing process, and physical burden to the subject, this method is more suitable for research studies. 

Bioelectrical Impedance

Bioelectrical impedance analysis uses a very small electrical signal to measure body impedance. The signal is conducted through the water contained in the body. Lean muscle has much more water than fat tissue and allows the signal to pass easily. It is measuring the resistance electricity varies between fat, muscular and skeletal tissue.Fat causes impedance or resistance to the signal. This is the method we use for body compostion assessment.

Pros: Affordable and relatively simple and quick assessment. The device we use produces very accurate results that are highly correlated with both DEXA and hydrostatic weighing. Measurements are very repeatable when tests are performed under consistent conditions. 

Cons: Some machine does not take into account of gender, therefore it is less accurate. The one we use does. This is important because men and women store fat differently around the abdomen and thigh region, the results can be less accurate as a measure of total body fat percentage.

Results are effected by hydration, such as alcohol or food consumption or alcohol, sleep, intense exercise, medication or pre-menstruation or simply having a very full bladder during the assessment.  

Test can be skewed if taken at different times of the day. For a more accurate result, test at the same time of day, preferably before meals, before training, and after hydrating.

How to get the greatest accuracy out of our monitor:

If your body is dehydrated, you will likely experience a higher than normal reading. If you are over-hydrated, you could experience a slightly lower reading. We suggest the following protocol:

• Take readings at least 3 hours after rising, eating a large meal, or exercising.
• Taking readings more than once per week is not beneficial since body fat does not change from day to day.)
• Average your readings for the month (if you're monitoring weekly)
• Compare average

Take readings once a week or month at the same time of day under the same conditions from month to month.By following this format, hydration fluctuations throughout the month will average out, and you will be able to better assess any real change in your body fat percentage over time.

FAQ

Is it safe to use the monitor if I'm pregnant? 

There is not enough research done on this population, so we do not recommend the use. Since there are dynamic physiological changes that occur during pregnancy, a pregnant woman cannot expect an accurate body fat reading.

I have a electronic medical device or implant, is it safe for me to use the monitor? 

You should not use the monitor if you have a pacemaker or other electronic medical implants . Non-electronic medical implants are fine and you may safely use the monitor. Any metallic implant in your body could affect the body fat reading, giving a slightly lower than normal reading. However, since the metal will continue to have the same affect on the reading each time you use the monitor; you can still use the monitor to successfully track the relative change in body fat over time.

Is this suitable for Body Builders or professional athletes? 

If you are an adult who has approximately 10 hours of intense physical activity per week and have a resting heart rate of approximately 60 beats per minute or less, you probably considered a professional athlete. 

You may obtain a higher than normal body fat reading. Despite this fact, you may still want to use our monitor to gauge their progress of losing body fat. The great repeatability of the product enables one to establish a baseline and use the product for "trending purposes" to assess loss or gain in body fat over time.

Protein pancakes (Shared by Alvina Foo)

Ingredients:
1 cup of steel cut oats
1 cup of almond milk
Extra almond milk
1/4 cup of tapioca flour or arrowroot flour 
15mL maple syrup
5 eggs
1 heaped tbsp spoon of plant based protein
1/2 tsp baking soda
a pinch of salt
Coconut oil

Toppings:
1 cup of dates soaked overnight in 100mL of filtered water
Bananas

About the oats...You can use rolled oats too. I prefer steel cut oats as it is nuttier and more flavoursome. 
Almond Milk substitute: In the past, I have used plain greek yoghurt, homemade yoghurt, coconut water and butter milk. They are all fine to use. You may even choose to use water with perhaps a squeeze of lemon juice. That's perfectly fine too.
Tapicoa flour…This is not the same as arrowroot flour. I remembered buying some from a local supermarket because it was labelled "Arrowroot flour", but I soon realise that in Australia, the term tapicoa and arrowroot flour are used interchangeably. Anyway, I managed to source some from one of our suppliers. (See below if you're interested in why I choose arrowroot flour.)
Maple syrup…this is after all a protein pancake recipe, so I tend to limit the amount of sugar I use. If you have a sweet tooth, you can always drown it with maple syrup when serving!
Coconut oil substitute: macademia oil, rice bran oil, butter or ghee. Do you know that butter contains minimal amount of lactose and casein? Of course, if you're extremely sensitive, don't use it. Ghee is clarified butter. This is the top layer of the melted butter, ghee does not contain the milk solids, so this is better tolerated by many. Ghee originated from India and has been used for thousands of years in cuisine.  

Method:

• Soak the oats in almond milk overnight or for at least 6 hours. It is fine leaving it on the kitchen bench top. 
• Next morning, add baking soda, salt, maple syrup and plant based protein powder into the oat mixture. 
• Add tapicoa or arrowroot flour to almond milk and make up 1/3 cup of mixture. Stir well and pour this into the oat mixture. 
• Pour the eggs into the BioChef blender (or high powered blender).
• Pour the oat mixture into the blender.
• Set blender on high and blend for about 1 minute or until you get a batter.
• Using medium heat on stove, lightly brush frying pan with oil or butter. I try not to use high heat in my cooking, as it reduces and destroys nutritients in our food. 
• Pour batter into the frying pan. I prefer my pancakes to be thin, so pour and swirl to cover base. 
• Cook for 1 minute or until light golden brown. 
• Flip the pancake and cook for another minute.
• Transfer to plate and repeat with more oil and remaining batter.

About arrowroot flour

Arrowroot is a rhizome that originated from native tropical American.  The flour is made from drying and powdering the root. It is easily digestible and was once used in baby formula. The demulcent property made it favourable for bowel complaints. Apart from containing calcium ash, it also contains potassium, magnesium, phosphorus, sodium, iron and other trace minerals. 

Leave Certificates

Sometimes you are too sick to go to work (or shouldn’t go to avoid spreading your disease) but don’t actually need to go to the doctor.

Blooms pharmacists are able to issue leave certificates for the purposes of sick leave or carers leave in certain circumstances.

Essentially under the law ANY registered healthcare professional is able to issue a leave certificate for conditions that fit within their scope of expertise.  e.g. A dentist could give you a leave certificate for a dental problem.

An example of where this would be appropriate is someone who may be suffering from a bad cold.  Obviously they should stay home and recuperate and not spread the cold to their co-workers or contacts, but the only thing the doctor will usually do is issue the certificate and tell you to take symptomatic relief (as most common colds do not require antibiotics).

Another situation where you may need a certificate issued by a pharmacist may be where you have a health problem or sickness which prevents you from work but you can’t go to the doctor the same day or the issue may resolve in a day or two without the requirement for a Doctors treatment.

So what's involved:

1. You need to present in the pharmacy and have a consultation with the pharmacist.  If you require a Carers Leave certificate you obviously need to bring the person who requires care with you.
2. The pharmacist will assess if there is a need to provide a certificate.  A decision whether to issue a certificate will not be made lightly, we have a legal obligation to make an objective evaluation.
3. The pharmacist will also consider if your condition requires referral to the Doctor or some other health professional.  They may issue a certificate and a referral or just give you an urgent referral meaning you should follow that up straight away.
4. Where the pharmacist issues a leave certificate there is a $30 fee payable.

Frequently (& sometimes) asked questions.

1. Why would I pay $30 when I can go to the Doctor for free?  It’s certainly a choice you need to make for yourself.  Remember:  the  doctor is not “free” the government pays the Doctors fee, so in reality the pharmacist is charging LESS than the Doctor.  Reasons people may choose to get a medical certificate from the pharmacy include; convenience and no need for an appointment, their wish to get back home to bed as soon as possible or the desire to not sit in a waiting room full of sick people.
2. Does my boss have to accept a pharmacist's leave certificate?  The fair work act 2009 states that a leave certificate can be written by any registered healthcare professional.  So yes, employers are obliged to accept them.  Other bodies such as schools (where not an employer) or sports bodies who may require a Doctors certificate for different reasons will make their own rules on who can and who cannot issue the certificates.

Vitamin D

Do you know that Vitamin D is technically not really a vitamin?

Vitamin D is a hormone, which is produced by our body after absorbing the sunlight. You do get some from our food, but it is scarce. Once ingested from the diet or produced in the skin, the liver and kidneys then convert it to the active form. 

Is Vitamin D that important? It’s only needed for the bones, right?

Literally, vitamin D receptors are found in almost EVERY tissue type! Just to name a few, it is located in our bones, pancreas, kidneys, brain, intestines, spinal cord, thyroid glands, adrenal glands and reproductive organs. This means that they are very important and essential for the normal functioning of our body.

Studies have now shown that vitamin D deficiency is associated with many chronic conditions, such as, cardiovascular disease, type II diabetes, cancer and autoimmune diseases.

Since we are in the middle of winter, it is important to ensure that we have sufficient vitamin D in our bodies. The cells of our immune system have a substantial number of vitamin D receptors, so together with vitamin D, it helps maintain a strong, healthy and balanced immune system.

How much to take?

It depends on your vitamin D status. Vitamin D level is easily measured by a lab test ordered by the doctor. The most common daily dose is between 1000iu to 5000iu. Although, sometimes specialist like the endocrinologist may kick start their patient with a dose as high as 100,000iu for a short period of time! The best time to take vitamin D is with a main meal as it is a fat-soluble vitamin.