Tag Archives: physiology

Mean Ole B

If for some reason you thought that the B complex referred to a psychological fear of Bee stings that make it impossible to cope, then you should probably read this article on vitamin B

the softer side of Vitamin B 

terrifying image of chihuahua moments before deadly fit of rage.
petsjubileebox.blogspot.org

I have to be honest with you. I’ve been avoiding the B vitamins like a rabid chihuahua (terrifying mental image). At first glance they are just a little intimidating, the nutritional deep end of the pool. However, I owe it to you, my fellow information seekers, to bring you the facts, raw and uncut. Today we are crashing this academic adult swim called the vitamin B complex. The shirts are coming off and we’re going full frontal in the name of science (metaphorically of course). Let’s get to it.

Let’s talk about absorption

Life is a day to day struggle. You can break your back just trying to fit in all the essential vitamins and nutrients your body needs in one day only to have to do it all over again the next and why is that? The answer is solubility my friends. Vitamins like C and the members of the B complex dissolve in water (water soluble) like so many spoonfuls of powdered, orange Tang. The advantage to this is that in small amounts they can be readily transported throughout the body. The downside is that like vitamin C, what we can’t use immediately will get excreted as waste rather than stored. So a fresh supply of B vitamins must be sought through our diets and via dietary supplements daily.

There are boat loads of chemically distinct B vitamins but we typically focus on eight. Hey, eight is plenty. Luckily, the B vitamins all play quite well together and are found, naturally in a lot of the same foods, which is why they were originally thought to be a single vitamin and have been grouped together in recent years.

and now a confession…

random assortment of grains and beans that capture the warrior spirit of the B complex

random assortment of grains and beans that capture the warrior spirit of the B complex

Ok here’s the thing, I’m really lazy. There is a small part of me that feels obligated to describe in great detail the amazing super powers of each B vitamin. The problem is that the B complex is all over the place. They maintain muscle control, nerve impulses, cellular metabolism, a healthy immune system, digestion, red and white blood cell production, hormone regulation, the construction of DNA molecules, and I wouldn’t be surprised if they somehow prevented dry, split ends. They have so many different applications that not only do I NOT care to memorize them all, but I doubt that you care to sift through a long, boring list of them. So this is me not listing them. My deepest apologies. Moving on…

All Star Players

vitamin B1 street name: Thiamine

vitamin B2 street name: Riboflavin

vitamin B3 street name: Niacin

vitamin B5 street name: Pantothenic acid

vitamin B6 street name: Pyridoxine

vitamin B7 street name: Biotin

vitamin B9 street name: Folic acid

vitamin B12 street name: Cobalamins

All roads lead to riboflavin

a small furry rodent...not to be confused with quinoa, the South American seed crop

a small furry rodent…not to be confused with quinoa, the South American seed crop

So where can you get your lipsmackin supply of B vitamins? I would be more than happy to break down each individual vitamin and tell you exactly which aile to steer your grocery cart down in the whole foods store, but you really don’t need to hunt down each one. Honestly, all you really need to do is EAT YOUR GRAINS. Yup, the bulk of these vital compounds can be acquired in robust amounts in foods that we love to avoid like oat bran, brown rice, BEANS (which house a ton of nutrients on their own), oatmeal, multigrain pastas, and quinoa, which always makes me think of a small furry rodent for some reason.

I will say that your B7 through B12s are a bit more abstract and not quite as abundant in plants. For these I might recommend looking either to the sea (fish, shellfish and the like) or let a little egg and dairy into your life.

When vitamins attack

6820213_f260Vitamins, not unlike teen celebrities, do not like to be ignored. Leaving out just one or two of your essential vitamins can lead to some pretty nasty consequences. In the case of pellagra, a serious vitamin B3 (niacin) deficiency, those consequences include skin lesions, madness, severe diarrhea, and death, neither of which can make for the best summer ever. Early Mesoamerican cultures like the Aztecs whose diets revolved mainly around corn, developed a method for processing their corn into ground meals with a mixture of wood ash and alkali that chemically unleashed the vital B vitamin. The Spanish conquistadors would later crash their tortilla party and swipe their corn but not their knowledge of processing it. This of course set up the conditions for a great deal of nutritional woe in the form of massive pellagra outbreaks in the years to come, not just for Spain, but all other cultures adopting the unprocessed corn as their staple food source. Hey don’t worry, they figured it out eventually and so did we. I just love happy endings 🙂

Vitamin D…raw and uncut!

The D stands for "Don't test me fool!"

The D stands for “Don’t test me fool!”

If you’ve ever succumbed to the late night temptation of a pint of cookies n cream and thought “well at least I got my calcium today” then you are not alone my friend. However, have you ever wondered where that calcium goes and what’s the deal with vitamin D? Stay tuned for these and other mysteries.

Sometimes I’ll walk past a neighbor’s lawn or a big leafy plant in the window and think “man, plants sure have it easy.” All they do is lay out in the sun all day, not working, sponging off our tax dollars, and more importantly not having to worry about food. Plants can convert atmospheric carbon dioxide and water into sugars in the presence of sunlight…lazy good for nothings. What if we had the ability to produce something our body’s need just by laying out in the sun? Well guess what you freak, you can! That’s right, good ole vitamin D is produced in our skin when exposed to UV radiation. [Sorry for calling you a freak. I get carried away sometimes. Let’s be friends]

The Nuts and Bolts…

Vitamin D acts as a hormone to regulate calcium levels in our bodies. It is what allows the calcium we effortlessly soak up from foods like milk and cheese to be absorbed. This process is of course tightly monitored and controlled by parathyroid hormone as well as the level of calcium and phosphate circulating in our bloodstream. Calcium and phosphorous build bone. Calcium in it’s ionized form is involved in all manner of enzymatic mayhem (but in that fun way). In fact, aside from buiding bone, ionized calcium (Ca2+) facilitates electrical conduction in the heart, allows for nerve impulses, and aids in muscle contractions (remember that the heart is also a muscle). If the level of calcium in the blood is high and inhibits the action of parathyroid hormone then the cool kids (scientists) refer to this kind of inhibition as negative feedback.

America, let’s talk about the facts

There’s a little confusion these days about what foods actually provide solid sources of vitamin D. There are fewer foods than you may think, and if you were about to say the M word then allow me to hit you with some knowledge. Milk, as in cow’s milk, is actually fortified with vitamin D. In the states we have fortified a lot of our dairy products like milk, cheese, and yogurt with vitamin D. This makes a lot of sense since these foods are naturally rich in calcium. It all started as a public health campaign back in the late 1920’s/early 1930’s to combat a nasty vitamin D deficiency linked bone deformity in children called Rickets, or osteomalcia in adults. Yes, “Rickets” is a real word. In fact I’ve always found the word nostrils to be pretty funny too, but let’s stay focused. NOSTRILS.
Adding the vitamin D allows us to absorb the calcium we are getting from that mouth watering hunk of aged white cheddar or that cold, frothy glass of chocolate 2 percent perfection that is chocolate milk (guilty pleasure I admit).
If you are looking for foods that are naturally rich in the “D” may I suggest you look to the sea. Oily fish like maceral, tuna, and salmon all contain healthy doses of vitamin D. If you combine that with the sunlight you should already be exposing yourself to during the day, then you’ll be all set. Just to be clear, I advise that you expose yourself to sunlight and not that you expose yourself…um..in the sunlight. I don’t want to get calls later. Ok bye!

Mean Green

What are free radicals and why shouldn’t they be free? Why have green tea extracts suddenly hit the big screen, playing supporting roles in everything like some new whole food’s MSG? Stay tuned…

Ah..nothing like green tea for that earthy, clean Saturday morning taste of wet grass clippings.

Ah..nothing like green tea for that earthy, clean Saturday morning taste of wet grass clippings.

Antioxidants get more media play than any summer blockbuster celeb fresh out of rehab could ever hope to aspire to. You say you don’t like tea..no problem. These days herbal extracts are trigger-happily infused into everything from chewing gum to butter biscuits, and why is that? Antioxidants my friends. These potent biochemicals boast less filling, long lasting protection from the aging damage of free floating electrons (free radicals) aimed at ripping your cells apart one at a time. We’ll get to that.

Free Radicals..why so serious?

Why don’t we like free radicals? Short answer: people are terrified of growing old. More specifically, free radicals are molecules with unpaired electrons that are highly reactive. Since this molecule is missing electrons it tends to pull what it needs from another molecule which in turn curses that molecule to become a free radical too. Now you have a molecular zombie apocalypse on your hands.

Antioxidants have the charismatic ability to donate electrons without becoming unstable themselves. They effectively neutralize these potentially harmful chain reactions before critical damage to cellular structures, or more importantly, before damage to intracellular DNA can occur (which can lead to mutation and the potential proliferation of cancerous cells).

So how do we stock up on these taster’s choice, biochemical riot police? This is where vitamins come in handy. I can think of two that are perfectly suited for the job. Vitamin E and C are both all natural and metabolically bad to the bone.

I'm more than just a cunning visual metaphor..I'm a weapon against free radicals. Go Joe!

I’m more than just a cunning visual metaphor..I’m a weapon against free radicals. Go Joe!

I like to call them the dynamic duo (I’m weird that way). What is particularly interesting about these vitamins is that their chemical properties (water vs. fat solubility) influences what borders they protect. Not unlike G.I. Joe special forces troops, they are both adapted to different environments. Vitamin E is fat soluble and is well adapted for combating nasty oxidizing substances that build up in the tissues (like peroxides) as a result of metabolic processes. Vitamin C is water soluble and is perfectly suited for cruising through the fluids of cells, neutralizing drama caused by harmful toxins from the environment that slip into the bloodstream. What kind of environmental toxins you ask? Well let’s just say it’s no coincidence that prolonged cigarette smoke mimics the wrinkling effects of aging.

mmm..green tea, good to the last phenol

The reason why green tea gets so much Cosmo cover girl hype is due largely to the potent, plentiful compounds locked inside the leaves (Camellia sinensis) called polyphenols. Polyphenols are a great source of antioxidants and since all you have to due to reap the benefits of this biochemically active compound is brew a cup and drink the stuff I think the street credit is well deserved.

Well, ok just one thing…there are different classes of polyphenols, some of which aren’t so warm and fuzzy when it comes to nutrient availability. Green tea has a sleek, sexy user friendly form called epigallocatechin gallate (EGCG) which has only been used in herbal medicine for a few thousand years or so (which is why I feel perfectly happy drinking the stuff). Red wine has resveratrol which is believed to help keep cholesterol levels in check (when consumed responsibly of course). It’s still a hotly debated topic in nutritional research. There are certainly benefits to imbibing beneficial “super fruit” juices and extracts but you may have to wait around for a while before a recommended dietary value is actually agreed upon. Sorry kids, but as soon as the scientific community figures it out I’ll be all over it like cheap wine on khaki slacks. In the meantime, stay classy and never stop learning.

True Blood

Blood, in our day and age, plays nothing more than a supporting role to teen vampires on the big screens with perfect bed hair. Well today the fake fangs are coming off, the microscopes are coming out, and we’re giving blood the red carpet treatment it deserves in this segment of Forgotten Physiology.

6952917_f260Alright, take a deep breath and let it out slowly. We’ll need to shake off all those icky vibes we get whenever we mention the word “blood.” It’s time to take a closer look at that crazy vampire juice, and by closer I mean at roughly 400x magnification. I’ll wait till you catch up. Just say when. Outstanding, let’s get to it!

Oh sure, I realize that anyone who’s learned to turn on a computer or operate a stove when their parents aren’t home has probably figured out by now that our blood is composed of red blood cells. There are a few white blood cells floating around in the mix as well, fighting off infections but that’s for another article. Today I want to focus on the true work horses of our circulatory system, the red blood cells.

What is blood exactly? No wait, that’s a boring, safe question. Perhaps a better question might be why do we have blood? I mean what’s the evolutionary advantage of having a bunch of flat, pink disks floating around in a murky straw colored, neutral pH solution at 37 degrees Celsius? It’s all about clever chemistry my friends, gas exchange to be more precise. Red blood cells, or erythrocytes, as the cool kids (scientists) call them are nothing more than transport vessels. They are not unlike tiny FedEx drivers transporting their oxygen payloads from the lungs to the cellular tissues of the body (I never liked the term tissue…just feels dirty) “How do they accomplish this?” you cunningly ask. Ha! Well played.

Here’s How

the steamy, Fe2O3 love connection that allows iron oxides to form can explain iron rich hemoglobin's affinity for O2

the steamy, Fe2O3 love connection that allows iron oxides to form can explain iron rich hemoglobin’s affinity for O2

Inside each red cell are specialized proteins called hemoglobin and inside these are tiny iron molecules. Like all proteins they are composed of certain amino acid chains that only fold a certain way, but what makes them unique and a hit at all the parties are their ability to cling on to that sweet, sweet iron. It’s not just any ole iron, but the ionic “taster’s choice” ferrous form of iron, Fe2+. These iron molecules have a real knack for accepting molecular oxygen, or O2. If you’ll recall, metallic iron tends to rust or “oxidize” when exposed to moisture and air. Once you’ve made that connection feel free to go “Ahhhh!”

There is however, another gas that our red cells love playing catch with and that’s carbon dioxide, CO2. You know that ole cellular metabolism that our cells go through to convert carbohydrates into energy is messy business. If it weren’t for our red cells that CO2 (the byproduct of respiration) would build up in our tissues slowly poisoning us, which is not ideal. The very same red cells transport that stuff from our tissues to the lungs for gas exchange, or as it’s known on the mean streets, “exhaling.” The other advantage red cells have for shipping gas to and fro is the fact that each mature red cell loses it’s nucleus. This makes room for gas exchange to take place, but it also limits the lifespan of the red cell. A mature (non-nucleated) red lives about 120 days. By that time it will have lost it’s ability to metabolize, let its facebook page expire, let himself go. Whatever, it’s just too old and worn down to be effective.

That is the basic mambo of our red cells. 24 hours a day, 365 days a year they carryoxygen to cells and carbon dioxide away from the cells. It’s pretty basic, reliable stuff. Blood is also quite honest. Those red cells travel through the vessels surrounded in fluid, which is mostly water and dissolved minerals, nutrients, proteins and gases. This funky fluid, or plasma interacts with everything, all the tissues of the body. So when you come down with an infection or any ailment for that matter, physicians, nurses, and lab specialists like myself rely on the blood to give us all the juicy gossip about what’s going down.

“psst…hey Dr. Oz, Mrs. Doe has high blood sugar today.” – Your BFF, the plasma

Now what is important to note about those red cells when it comes to testing the plasma is that they are alive. That’s right, they are still maintaining low levels of metabolism, a form of glycolysis the cool kids refer to as the Embden Meyerhof pathway (which sounds like a race track in Germany). Since these cells are alive and intact they are continually taking electrolytes in, but if those cells are ruptured they will release things like potassium and glucose back into the plasma. This can give the person examining your blood misleading and often alarming results. So if you’ve ever had your blood drawn one day and then got called back to the doctors office later to have the same tests redrawn due to “questionable results” there is a good chance that the blood was hemolyzed, i.e. those cells were ruptured in the process. Sorry about that, but it happens sometimes. Drawing blood is not an exact science and each individual’s vasculature is different. This can also happen when well meaning, handsome, young lab techs leave the tourniquet on for too long. Sorry Ms. Jackson [not her real name] I’ll lay off the cafe mochas next time.

in case you slept through the 90's, this was quality television

in case you slept through the 90’s, this was quality television

So the next time you’re enjoying Twilight recaps on Hulu, getting your finger pricked at the doctor’s office, or knocking back a cold one while watching your favorite scene from Buffy the Vampire slayer (no question, an American classic) take a moment to appreciate the rosy, red concoction that makes it all possible. Red Blood Cells, this bud’s for you.

Stay classy my friends and never stop learning 😉

Got Protein?

my oatmeal never makes me feel this centered :(

my oatmeal never makes me feel this centered 😦

Let’s say you cut back on red meat, pork, dairy, or whatever this month’s Vanity Fair, fad diet recommends you stay away from in order to slim down and center your chakras. You’ve decided to turn over a new leaf, literally. You become one with the salad greens, the baby spinach, the arugula and the dark green kale that melts in your mouth and not in your stock pot. Yet something is missing, “Well it can’t be protein.” You tell yourself. “I read the labels. The lentils had 6 grams. The almond butter had 8 grams and I just let all my facebook peeps know that it’s complicated with me and chickpeas.”

You’d be right to feel betrayed because while these nutritious foods bring plenty of protein to the table they do not provide, wait for it….a “complete” source of protein. Huh?!! What you talkin bout F.P.? (Forgotten Physiology)

7471098_f260Wait a minute, slow down…put down the Salisbury steak. I’m not saying that these incomplete sources of protein can’t be brought together in nutritional matrimony to compliment each other. We just need to be a bit more crafty about how we bring them together. It’s not the amount of protein in foods that I’m harping about. It’s a matter of how those proteins are constructed. That’s right, amino acids, those nifty chains of nucleic acids constructed by the ribosomes from mRNA instructions stored in our DNA. Oh yes my friends, high school biology just got practical.

This is the situation…

There are 20 amino acids necessary to sustain human life. Our bodies make 11 of those which leave 9 crafty “essential” amino acids that we have to seek out in our diets. It can be a real nutritional scavenger hunt if you don’t know what you’re looking for. Sure there are a handful of oats, grains, and beans…”oh my” that come close. The reason meat contains all of your essential AA’s is because when that poor critter was alive it was stocking up on protein for itself. Dairy comes fully equipped because mammals like cows are delivering all the nutrients from their foraging to their offspring through the milk they produce. Most plants (soybeans are an exception) only contain a portion of those because that was their particular growth requirement…a little isoleucine here…a little phenylalanine there.

It said "bean bag chair" on the front of the box.

It said “bean bag chair” on the front of the box.

When you chomp down on a cheese steak it doesn’t get separated into perfect microscopic IKEA parts labeled “for the kidneys” or “for the triceps.” Those proteins are digested and the amino acids recycled in order to supply our body’s amino acid pool, that hard working transfer RNAs pull from when it comes time to make our own proteins (remember that’s called RNA translation). That kind of thing is going on right now inside our cells. What proteins we are able to make is dependent on what amino acids we have available. It’s the kind of “little thing” that only matters when you start to feel rundown because there’s not enough tryptophan around to make the proteins that keep your thyroid happy.

"We just love it when he talks whole grain"

“We just love it when he talks whole grain”

Now right about now you’re probably thinking. “I don’t have time to look up the amino acid content of everything I eat.” To that I say tough tabouli brah! That’s the cost of eating healthier. Don’t worry, I won’t leave you hanging, but ask anyone who has made a successful transition to vegetarianism and they will probably give you an earful about the websites and books they checked out. Besides, it’s fascinating stuff and chicks dig guys who know their quinoa 🙂

Here are just a few ideas to get you started and I’m leaving you some nutrition links at the end. I hope they’re helpful.

Non-meat protein sources aren’t nearly as dispersed as jigsaw puzzles. I think of them in terms of what they did for the plant they came from. Roots like carrots and parsnips stored energy for that plant. So it would make sense that these would be sweet, starchy, fibrous, and packed with minerals and carbohydrates, but relatively low on the protein scale. Now tubers like potatoes or yams, and legumes like lima beans or lentils are packed with carbohydrates and protein because their respective plants sprouted from them. They provided the fuel and the molecular raw materials for the growth of those plants. It is the same story for seeds. So for the times when I would go vegetarian (mainly to lose weight) it always made sense to me to essentially rebuild those plants in my diet…seeds and beans, roots, stems, and leaves. Now that’s not including dairy which I’ll get to…I NEEDS MY DAIRY!

What’s with this soy business?

Oh yeah, this bean get’s its own section. It truly is a wonder food, containing all of the essential amino acids. What’s really nice about the versatility of soy is that it can take many product forms (tofu, soy milk, soluble protein powder) which allow you to reasonably incorporate the stuff into even your most hectic daily routine. It is important to remember that while soy has all of the AA’s it is lower in some than others like methionine for example.

Dairy is your friend…

If you’re cutting out dairy for certain principles or to trim the fat I totally respect that. Just don’t be surprised if you find it harder to smile…that’s a Ben & Jerry’s deficiency.

In the course of your interweb browsing and research it will inevitably become apparent to you just how many of the AA’s are covered by dairy products. Low fat sources like yogurt, feta, cottage cheeses are CRAZY loaded with good stuff. Remember, cheeses were an ancient energy food. I will say that for my lactose intolerant friends out there (which make up a large percentage of the population) you probably want to stick to traditionally made yogurts and harder cheeses which have had most of their lactose sugars converted by active lactose fermenting bacterial cultures or separated out from the milk solids. Hey, don’t feel bad that stuff is good too and usually of higher quality. It’s going to have a little more fat but give yourself a break…you’re living off tree bark and rabbit food for crying out loud (that was mean..didn’t mean that)

Stay curious. Stay classy and never stop learning 🙂

Secret Life of Vitamins

Why can't I get my tap water to do this?

Why can’t I get my tap water to do this?

That’s right, vitamins are more than just a passing fad like skinny jeans or ten minute workout DVD’s. Let’s strip away the pop star facade and go behind the music with these unsung heroes in this segment of “Forgotten Physiology”

Oh come on, you know you’re just a little curious about this topic. I’m willing to bet that you can’t go a day without hearing mention of vitamin C, vitamin D or both of these front page, poster child nutrients. Catchy, sexy phrases like fortified, enriched, and essential, tantalize us into reaching for 4 dollar cereal or that sleek, flashy carton of fresh squeezed, ruby red, cranberry, pomegranate plus tax super juice that moments after consumption leaves you just a little curious to know if “it’s” working. What does getting 120% of your total daily vitamin C at one time feel like Mr. Acai berry, however the hell you pronounce your fancy name? What’s the deal with vitamin D? How do our bodies manufacture it and does America’s mild addiction to Ben & Jerry’s help fill that insatiable calcium void? Let’s probe these and other vitamin mysteries shall we.

That’s C for can’t stop the groove…

Vitamin C is water soluble which basically means that the compound dissolves in water. This is also the reason why we have to replenish Vitamin C so often with our diet since whatever doesn’t get used by our bodys right then and there simply gets passed out through the urine. No, sadly it does not turn our pee the many colors of the rainbow like mystery flavor Koolaid (previously investigated in the name of science). The small amount of vitamin C that is utilized by our bodies certainly makes it count. Vitamin C is just another one of those fun essential components our bodies need that we don’t quite understand until we don’t have enough of it. Through various mystical biochemical pathways our body (as in our cells) utilize vitamin C, A.K.A ascorbic acid to synthesize a protein called collagen, a building block of connective tissue that basically holds us together…no literally. Collagen is in our skin, tendons, and even blood vessels – kind of a big deal

because when you say scurvy I think Johnny Depp

because when you say scurvy I think Johnny Depp

What happens if we don’t get enough vitamin C? The answer is Scurvy, my friends. That’s right, it’s more than just a fun word to say in a pirate’s voice. Scurvy, a severe form of vitamin C deficiency can lead to pale, spotty skin, fatigue, depression, and bleeding gums. It is essentially the breakdown of your connective tissue. Another common feature (as if that wasn’t sexy enough) are the presentation of wounds that are slow to heal. This could be largely connected with vitamin C’s role in immunity and as an antioxidant which protects the membranes of cells from oxidative stress. Oxidative stress occurs naturally in our bodies from the accumulation of free radicals, another name for stray electrons with no molecules to call home. It’s kind of the price we pay for having to breath oxygen. Eventually electrons from oxygen molecules stray from the herd and raise a little hell binding to molecules on the surfaces of our cell membranes and stripping them away. No worries though, the cool kids (scientists) just refer to this as “aging.” Yes, even you will age someday no matter how youthful and upbeat your facebook profile makes you look (making fun of myself there).

Vitamin C is also an important component of the immune system and is intimately tied to normal white cell function and proliferation…uh…somehow. It’s still a topic of current research so “da facts” are a little vague, sorry guys. Studies have shown that beefing up on vitamin C can promote a speedy recovery from colds.

Now a lot of animals can produce their own vitamin C. Sadly, we are not one of those animals, but hey, we are also the only mammals with grocery stores so….take that Mother Nature!

Oh yeah…and stay tuned for the follow up article about vitamin D..should be a good time.

stay classy my friends and never stop learning 🙂

Strep Poker

Don't you hate it when you have a sore throat and half of your face falls off? That's the worst.source:http://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate=11535.html

Don’t you hate it when you have a sore throat and half of your face falls off? That’s the worst!
source:http://www.aurorahealthcare.org

Not unlike blizzards or public radio telethon week, sore throats happen. Sure, you can eat all the right things, get plenty of exercise, wear a hat when it’s cold, and dry your hair when it is wet, but the honest truth is that sore throats will still happen. Whether it was the 5 yr old at the bank who never covered his mouth when he coughed or the fact that you never washed your hands before leaving the birthday party at Chuck E. Cheese, as far as your immune system is concerned, it is only a matter of time before an infection sets in. Thankfully, a number of safe, easy, and reliable testing methods have been developed in recent years to aid clinicians in identifying these elusive, agents of infection and help patients arrive at a speedy recovery.

A Storm on The Horizon 

Morning is a cruel mistress

Morning is a cruel mistress

We can always feel it coming can’t we…that scratchy feeling in our throat, the dull twinge in our ears when we try to swallow. Oh yes, it’s sore throat time. Stayed out a little too late last night didn’t you? DIDN’T YOU?! Now just look what you did. That’s ok. Surprisingly, it is our body’s own immune response that produces the bulk of the drama when it comes to the really nasty cases of strep throat, especially in cases of neglected or under treated infections. Once the bacteria is recognized by our macrophages (the border patrol of our innate immunity) a cascade effect of cytokines, or cellular signals are released that bring about a variety of changes. Not only are white cells called to the site of the infection for a phagocytic schmackdown (when bacteria are either engulfed by macrophages or tagged by protective proteins for certain death by osmotic implosion), but inflammation is also induced by those white cells that are called to serve.

Blame those naughty antigens

The distinct molecular attributes of the streptococcus bacteria, or antigens, are largely to blame. The antigens (in this case, membrane bound proteins and carbohydrates that elicit an immune response) on the surface of the bacteria kick the immune system into overdrive, producing chemical cytokines or cellular signals that induce white blood cell action and inflammation (Phew…that’s technical!).This is what produces the characteristic soreness, swelling, and redness at the site of the infection. This not only makes swallowing difficult and painful but, lymph node glands can also begin to swell resulting in muscle ache in the neck. Fever and chills may also accompany the infection, as well as nausea and vomiting often in response to the persistent pain and discomfort. In the trade we like to refer to these as flu-like symptoms.

Sources of Infection

The bacteria can be spread from person to person by droplets from the cough or sneeze of an infected person. That’s right people, cover your pie holes! It is also possible to pick up the infection after touching contaminated surfaces like door handles or keyboards and then touching your eyes, nose, or mouth whereby the bacteria can easily gain access to the upper respiratory tract. Strep throat caused by S. pyogenes typically effects children or anyone with a weakened immune system. The infection can clear up on its own, however in some cases, S. pyogenes infections can lead to further complications, such as scarlet fever, toxic shock syndrome, and glomerular nephritis.

Behind the scenes

Typically when clinicians test for strep throat they are looking for the bacterium Streptococcus pyogenes. That is not to say that other bacteria as well as viruses are not just as capable of causing upper respiratory infections, but when it comes to the characteristically red, inflamed sore throats, in this region of the world anyway, it is S. pyogenes that usually gets called in for questioning. It is a handsome, frisky Group A, Beta-hemolytic strain of bead like bacteria that can produce mild to aggressive infections. “Beta hemolytic” refers to the ability of the bacteria to completely rupture (lyse) red cells on a culture plate, demonstrating a distinct, clear zone of red cell destruction. If you were to hold up an agar plate to the light it looks like someone took their thumb and rubbed the gel away where the Strep had been growing. Just think about the kind of damage something like that can do in your throat…ewww. That zone of hemolysis is a diagnostically reliable behavior that lab folks use to pick our star bad boy out of the line up.

Blinded by Science – Testing Principle

I hear lipstick models have really bad eyesight

I hear lipstick models have really bad eyesight

There is a bargain bin of strep testing kits out there in the biotechnology market. They all tend to work off the same testing principle of immunofixation whereby a sought after antigen (in this case the S. pyogenes membrane bound carbohydrate) is bound to specific antibodies within the testing media. There is also a color indicator in the mix that forms a unique complex which displays the presence of that antigen. The color change is then interpreted as a positive result. It is way less dramatic and not nearly as fun as mystery flavor koolaide. These tests are limited by sensitivity, meaning that an individual can in fact have a Strep infection that is below the detectable limits of the test. This is why it is a good practice for the physician to order a follow up culture for negative rapid strep screens.

Penicillin to the rescue!

As mean as sore throat infections can be they are often easily treatable. If they do not clear up quickly enough on their own we can typically zap them with antibiotics in the form of our favorite cell wall attacking antibiotics like penicillin, amoxicillin, or any taster’s choice cephalosporin on the market. Just be sure to take your full prescribed dose. Those microbes are sneaky and like to play dead. Under treating an infection is the perfect real world example of “what does not kill us, makes us stronger” except in this case it’s the Strep that can come back stronger. Of course, antibiotic resistance will have to wait for another article.

Stay classy my friends and never stop learning.