Jenny 64 y.o

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Stress

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SPS 290 CHAPTER 6 :

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Digestion

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STRESS

luonut Marisol Gonzalez Villaamil

Jenny 64 y.o

Integumentary Sytem

Tongue scalloped shows hyperactivation of SNS

Nails

White spots indicating likely zinc or calcium deficiency

Hepatobilary System

Cephalexin 500mg and Capoten together needing to be eliminated daily causing liver burden and reduced synthesis of bile required for nutrient absorption

GIT

Microbiome diversity decreased

PREDISPOSING FACTOR: IBS from 25y.o

Low pancreatic enzyme production resulting in impeded nutrient absorption for 40 years!

Diarrhoeah every morning

Ageing parietal cells resulting in less HCL being produced impeding absorption of all nutrients and less intrinsic factor resulting in insufficient transport of nutrients intracellularly

Insufficient B12, calcium, magnesium and iron intracellularly and not enough activation of the antioxidant properies of ascorbic acid

Stools likely to be loose due to urgency every am

Indicates inflammation

Fast gastric motility- See Link to SNS

Differential Diagnosis

SIBO due to high carbohydrate content in food and bowel dysbiosis after antibiotics

Atherosclerosis

History

HELP syndrome when pregnant including elevated liver enzymes

Immune

Three upper respiratory infections in <12 weeks

Family History

Sister high cholesterol

Mother died of Stoke 74 years

father possible oesteoperosis

Respiratory System

Hay Fever Every Spring. Uses Telfast

Low Vitality

Cardio V. S

Tryglycerides 2.0

Risk of CVD or atherosclerosis due to high blood pressure, family history, downregulated superoxide dismutase increasing oxidative stress, low Vitamin A and high dietary salt (predisposes to arterial stiffening and higher blood pressure)

PREDISPOSING FACTOR: History of high Systolic Blood pressure for 30 years. Now 155/90 when usualy is 130/80

Cholesterol 4.4mol/L

Low plasma levels of both tryglycerides and cholesterol could mean chylomicrons could be collecting the cholesterol and transporting it to the liver

Nervous System

Widow for eight years and son separated from his wife causing stress affecting her sleep onset problems (see serotonin production decreased due to microbiome diversity which is precursor to melatonin)

Eye Twiches (Chvostek Sign)show Magnesium deficiency

Intractellular magnesium deficiency correlates positively with those who have hypertension because it causes greater intracellular calcium concentration resulting in calcium nail spots, vasoconstriction, vascular stiffness and endothelial dysfunction

Has a physical reaction to stress (urgent bowel motion in am)

SNS dominance heightened by Caffeine and imbalance of Potassium: Sodium Ratio both independently linked to SNS dominance

Lifestyle

Bold

Primary school teacher so indoors most of her life

Low Vitamin D

Difficult sleep onset due to stress

Diet

Lack of vegetables in diet resulting in lack of zinc and reduced fuel for healthy microbiome

Zinc levels insufficient

Difficulty absorbing B12, calcium, magnesium and iron due Zinc not present sufficiently as cofactor to synthesise transporter protein intrinsic factor req. for absorption of above minerals and also activation of Vitamin C

Lack of Zinc required to make HCL

Lack of zinc for mucosal healing

Zinc is required for Superoxide dismutase so this is downregulated resulting in higher levels of free radicals and oxidative stress

High dietary salt at 368% of RDI

Regular consumption of Red Meat

Low in Vitamin C and E- antioxidants

Low Dietary Calcium

Medication

Antibiotic Cephalexin

EXCITORY FACTOR: Cephalexin has been found to be increased AUC on intestinal level due to competitive methods of absorption with ACE inhibitors

EXCITORY FACTOR:Ace Inhibitor Capoten

Retain Potassium resulting in imbalanced Potassium: Sodium ratio which increases SNS dominance and results in kidney burden due to difficult renal vasodilation

Calcium supplement isn't a well absorbed form of calcium

SUSTAINING FACTOR: Diuretics 30 years excrete the following minterals resulting in

Insufficient Magnesium

Magnesium deficiency results in sufficient activation of NA-K ATPase pump which bontrols and trasnports homeostatis of electroyltes and metabolses Vitamin D

Insufficient B vitamins

Required for resoration of all cells due to cofactor in Creb cycle. Niacin is protective against CVD events

Insufficient Zinc

Dietary Fluid

Caffeine

Water intake 4 cups

Lymphatic system

Congested- likely congestion due to lack of hydration

Renal System

ACE Inhibitor Capoten and Thiazide Diuretic (which decreases blood volume) when taken together puts pressure on Renal System AND hyperactivation of Renin-Adosterone system which independently drives blood pressure up