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Healthy

  Cigarette Smoke Damage  
 
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Conditions that suggest it | Contributing risk factors | It can lead to... | Recommendations

 

Although most smokers are aware of the harmful effects of smoking, this may not be enough to overcome the reasons why they are smoking. A careful review of the reasons why people continue to smoke may help them come to the conclusion that it is time to quit. How many people look back at the end of their lives and think "I'm sure glad I was a smoker" or "I really regret giving up smoking"? Now is the time to begin taking action and getting the help necessary to break this habit. You'll be glad you did.

Tobacco smoke is a dangerous substance with more than 500 known poisons. Every time a smoker lights up he or she is being injured to some degree by inhaling these poisons. Lung cancer is the leading cause of cancer death in men; women who smoke have an overall increasing death rate and are dying at an earlier age than male smokers.

Some of the diseases related to smoking are bronchitis, emphysema, coronary heart disease, cirrhosis of the liver, smokerís face, decreased birth weight, peripheral vascular disease, lip and tongue cancer, gum cancer, larynx cancer, lung cancer, peptic ulcer, bladder cancer and Buerger's disease.

Coronary Heart Disease. According to the surgeon General's Advisory Committee on Smoking and Health, the death rate from coronary heart disease among regular users of cigarettes is 70% greater than the rate for nonsmokers.
Recent studies revealed the risk of premature death from coronary heart disease among middle-aged smokers to be over three times as great for men, and twice as great for women if they smoke 10 or more cigarettes per day.

Chronic Bronchitis and Emphysema. Chronic coughing and shortness of breath are symptoms of these diseases. Studies involving over one million men and women have shown that the death rate for chronic bronchitis and emphysema is six times as high for smokers as for non-smokers.

Respiratory Diseases. Among cigarette smokers, there is far more damage to cells and tissues in the throat and lungs. Evidently the loss of the protective cilia allows harmful smoke particles, dust and bacteria to invade the lungs... thus reducing resistance to lung diseases.

Wrinkles. As with skin that is overexposed to sunlight, smoking causes thickening and fragmentation of elastin, the elastic fibers that are long and smooth in healthy skin. Smoking also depletes the skin's oxygen supply by reducing circulation. It decreases the formation of collagen, the skin's main structural component, and may reduce the water content of the skin, all of which increase wrinkling.

Smokers who have children with asthma may have another compelling reason for kicking the habit. Unknowingly, they could be contaminating their children's bloodstream with a major nicotine metabolite called cotinine, while damaging their children's bronchial function in the process. Shockingly, cotinine levels were nearly 10 times higher in children of parents who smoked more than half a pack of cigarettes per day, with the mother's smoking habits having by far the greatest impact on the child's cotinine levels. The higher the level of cotinine in the child's urine, the worse the child's bronchial sensitivity.
 

 
 

Conditions that suggest Cigarette Smoke Damage:
 
 
Autoimmune  Hyperthyroidism
 A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders.

  Chronic Thyroiditis
 A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders.

Circulation

  Increased Risk of Stroke
  Atherosclerosis
 Tobacco smoke contains more than 4,000 chemicals, more than 50 of which have been identified as carcinogens. These chemicals are extremely damaging to the cardiovascular system. Specifically, these chemicals are carried in the bloodstream on LDL cholesterol, where they either damage the lining of the arteries directly or they damage the LDL molecule which then damages the arteries. High cholesterol levels compound the risks.

It's well known that smoking cigarettes increases risk for a host of serious health problems from cancer to heart disease. Now a new study from Weill Cornell Medical College in New York City looks (Sept 12, 2007) at how they do their dirty work by contributing to atherosclerosis, or hardening of the arteries. The evidence points to nicotine, the addictive chemical in cigarettes.

By comparing reduced-nicotine cigarettes like Quest 3 and Eclipse with regular cigarettes, researchers discovered that the extent of cigarette-smoke induced atherosclerosis in mice correlated with the levels of nicotine -- the higher the nicotine, the more disease.

"Right now, the general consensus is that the problem with cigarettes is tar and that nicotine is safe. That's why you can buy nicotine gum or patches to help you stop smoking. Our study presents new evidence that nicotine may not be safe at all, especially for your heart," says Dr. Daniel F. Catanzaro, principal investigator of the study, recently published in the journal Cardiovascular Toxicology. Dr. Catanzaro is associate research professor of physiology and biophysics in the Departments of Medicine and Cardiothoracic Surgery at Weill Cornell Medical College.

  Intermittent Claudication
 Cigarette smoking is the most important risk factor for vascular disease bar none.

Environment / Toxicity

  Heavy Metal Toxicity
 Tobacco smoking is the most important single source of cadmium exposure in the general population. It has been estimated that about 10% of the cadmium content of a cigarette is inhaled through smoking. The absorption of cadmium from the lungs is much more effective than that from the gut, and as much as 50% of the cadmium inhaled via cigarette smoke may be absorbed.

On average, smokers have 4-5 times higher blood cadmium concentrations and 2-3 times higher kidney cadmium concentrations than non-smokers. Despite the high cadmium content in cigarette smoke, there seems to be little exposure to cadmium from passive smoking. No significant effect on blood cadmium concentrations could be detected in children exposed to environmental tobacco smoke.

Infections

  Periodontal Disease - Gingivitis
 Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. [Journal of Periodontology, May 2000]

Lab Values

  Elevated Triglycerides

Mental

  Panic Attacks
 Female patients with panic disorder had a significantly higher smoking prevalence at the onset of their illness than did control subjects 10 years previously (54% vs. 35%). Current smoking prevalence was also higher in those patients with panic attack versus controls (40% vs. 25%). Male smoking rates did not differ between the groups. [Psychiatric Research, 1992;43: pp.253-262]

Organ Health

  COPD (Chronic Obstructive Pulmonary Disease)
 People who smoke or have chronic bronchitis have an increased risk of emphysema.

  Liver Detoxification / Support Requirement
  Macular Degeneration
 Any type of smoking or exposure to tobacco smoke can accelerate the development of the "wet" type of macular degeneration. Smokers on average exhibit only half the density of yellow macular pigment (lutein and zeaxanthin) and develop macular degeneration 7 years sooner than non-smokers.

Risks

  Increased Risk of Mouth/Throat Cancer

Uro-Genital

  Cervical Dysplasia
 Women who smoke may be 50% more likely than nonsmokers to develop cervical cancer or precancerous lesions.

  Erectile Dysfunction (ED, Impotence)
 Men with high blood pressure who smoke are 26 times more likely to be impotent than non-smokers. Even former smokers with high blood pressure (hypertension) are 11 times more likely to be impotent than non smokers. [Study conducted by Dr. John Spangler, MD at Wake Forest University Baptist Medical Center]
 
 

Risk factors for Cigarette Smoke Damage:
 
 
Lifestyle  Recent/heavy smoking
  (Much) second-hand smoke exposure
  Smoking several cigars/smoking a cigar daily or smoking 2-4 cigars per week
 In terms of health risks, puffing on a stogie but not inhaling is roughly the equivalent of smoking two cigarettes. Inhaling boosts the exposure to the equivalent of as many as three cigarettes.


Counter-indicators:
  (Recently) quitting smoking or being a non smoker
  No recent history of tobacco use
 
 

Cigarette Smoke Damage can lead to:
 
 
Autoimmune  Chronic Thyroiditis
 A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders.

Circulation

  Atherosclerosis
 Tobacco smoke contains more than 4,000 chemicals, more than 50 of which have been identified as carcinogens. These chemicals are extremely damaging to the cardiovascular system. Specifically, these chemicals are carried in the bloodstream on LDL cholesterol, where they either damage the lining of the arteries directly or they damage the LDL molecule which then damages the arteries. High cholesterol levels compound the risks.

It's well known that smoking cigarettes increases risk for a host of serious health problems from cancer to heart disease. Now a new study from Weill Cornell Medical College in New York City looks (Sept 12, 2007) at how they do their dirty work by contributing to atherosclerosis, or hardening of the arteries. The evidence points to nicotine, the addictive chemical in cigarettes.

By comparing reduced-nicotine cigarettes like Quest 3 and Eclipse with regular cigarettes, researchers discovered that the extent of cigarette-smoke induced atherosclerosis in mice correlated with the levels of nicotine -- the higher the nicotine, the more disease.

"Right now, the general consensus is that the problem with cigarettes is tar and that nicotine is safe. That's why you can buy nicotine gum or patches to help you stop smoking. Our study presents new evidence that nicotine may not be safe at all, especially for your heart," says Dr. Daniel F. Catanzaro, principal investigator of the study, recently published in the journal Cardiovascular Toxicology. Dr. Catanzaro is associate research professor of physiology and biophysics in the Departments of Medicine and Cardiothoracic Surgery at Weill Cornell Medical College.

  Increased Risk of Stroke
  Intermittent Claudication
 Cigarette smoking is the most important risk factor for vascular disease bar none.

  Aneurysm / Weakened Arteries
 278 consecutive patients with aneurysmal subarachnoid hemorrhage were compared with 314 hospitalized control patients. Regression analysis showed that recent alcohol intake and smoking were significant independent risk factors for hemorrhage. [Stroke 24: pp.639-46, 1993]

Studies have consistently found a 50% decrease in mortality from abdominal aortic aneurysms among former smokers compared with current smokers. [ Medical Clinics of North America, March 1992;76(2): pp.333-353]

  Cardiomyopathy
 The risk of being diagnosed with cardiomyopathy goes up with the number of cigarettes smoked per day. Although there is room for controversy, all doctors recommend that smokers with DCM quit smoking.

  Phlebitis / Thrombophlebitis
 Smoking increases the risk of phlebitis.

  Buerger's Disease
 Smoking is the cause of Buerger's disease.

Infections

  Periodontal Disease - Gingivitis
 Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. [Journal of Periodontology, May 2000]

Musculo-Skeletal

  Dupuytren's Contracture
 See the link between Diabetes II and Dupuytren's Contracture.

Organ Health

  Macular Degeneration
 Any type of smoking or exposure to tobacco smoke can accelerate the development of the "wet" type of macular degeneration. Smokers on average exhibit only half the density of yellow macular pigment (lutein and zeaxanthin) and develop macular degeneration 7 years sooner than non-smokers.

  Liver Detoxification / Support Requirement
  Pancreatitis
 Smoking appears to be associated with an increased risk of acute and chronic pancreatitis, according to a report in the March 23, 2009 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, the risk of developing the disease may be higher in those who smoke more.

Risks

  Increased Risk of Lung Cancer
 In addition to heart disease, cigarette smoking, with an increased consumption of polyunsaturated fatty acids, is the single major cause of cancer death in the United States. Cigarette smokers have total, overall cancer death rates twice that of nonsmokers. The greater the number of cigarettes smoked, the greater the risk. Smoking alone increases lung cancer risk by as much as 40 times.

  Increased Risk of Kidney Cancer
 Smokers develop renal cell carcinoma about twice as often as nonsmokers and develop cancer of the renal pelvis about 4 times as often.

  Increased Risk of Alzheimer's / Dementia
 When antioxidant intake of cigarette smokers was evaluated, Alzheimerís risk was reduced by 35% with vitamin C, 42% with vitamin E, 46% with flavonoids and 51% with beta-carotene. [ JAMA June 26, 2002]

  Increased Risk of Pancreatic Cancer
 Cigarette smoke contains a large number of carcinogens and therefore it should come as no surprise that cigarette smoking is one of the biggest risk factors for developing pancreatic cancer. For example, smoking during college has been associated with a 2 to 3-fold increased risk of pancreatic cancer.

  Increased Risk of Cancer Of The Larynx
 People who stop smoking can greatly reduce their risk of developing cancer of the larynx, as well as cancer of the lung, mouth, pancreas, bladder, and esophagus.

  Increased Risk of Stomach Cancer
  Increased Risk of Cervical Cancer
 A 9 year prospective study of over 6,000 women found a dose-response relationship between smoking cigarettes and the risk of cervical cancer. Those who smoked 15 or more cigarettes per day were 80% more likely to develop cancer or precancerous lesions than nonsmokers. Those who smoked for 10 or more years were 80% more likely to develop cancer. Starting smoking younger than age 16 produced twice the risk of nonsmokers for developing cervical pathology. Smoking is one co-factor that makes HPV-infected cells more likely to turn cancerous.

  Increased Risk of Bladder Cancer

Skin-Hair-Nails

  Psoriasis
 Another disease can be added to the list of smoking-related disorders - psoriasis. Researchers have found that smoking increases the risk of developing psoriasis, heavier smoking increases the risk further, and the risk decreases only slowly after quitting. Investigators from the Massachusetts General Hospital, Brigham and Women's Hospital, the Harvard School of Public Health, all in Boston, USA, and Vancouver General Hospital, Vancouver, BC, Canada, have published the results in the November 2007 issue of The American Journal of Medicine.

Tumors, Malignant

  Non-Hodgkin's Lymphoma
 One study has found that, compared to men who had never smoked, men who had smoked had an elevated mortality rate for non-Hodgkin's, with a risk almost four-fold greater among the heaviest smokers.

Uro-Genital

  Cervical Dysplasia
 Women who smoke may be 50% more likely than nonsmokers to develop cervical cancer or precancerous lesions.

  Erectile Dysfunction (ED, Impotence)
 Men with high blood pressure who smoke are 26 times more likely to be impotent than non-smokers. Even former smokers with high blood pressure (hypertension) are 11 times more likely to be impotent than non smokers. [Study conducted by Dr. John Spangler, MD at Wake Forest University Baptist Medical Center]
 
 

Recommendations for Cigarette Smoke Damage:
 
 
Mineral  Selenium
 An Italian study of men who smoked found that heavy smokers had lower levels of selenium than lighter smokers and non-smokers. [Atherosclerosis, 1991;87: pp.129-134]

Nutrient

  Alpha Lipoic Acid
  TMG (Tri-methyl-glycine) / SAMe

Not recommended:
  Beta-Carotene
 High daily doses of beta-carotene, 30,000 to 50,000 IU (20 - 32mg), have been shown to raise the risk of cancer in heavy smokers.

Vitamins

  Vitamin E
 Smokers have been found to have a lower alpha tocopherol level than non-smokers. Furthermore, persons with low physical activity levels were found to have a lower level than those with high activity. [Journal of Internal Medicine, 1993;234: pp.53-60]

  Vitamin C (Ascorbic Acid)
 Second-hand smoke study - 22 subjects exposed to environmental tobacco smoke received 515mg/day of vitamin C. 21subjects received the same amount of vitamin C plus 794mg of vitamin E as mixed tocopherols and 95mg of alpha-lipoic acid. 22 subjects received placebo. A very similar significant reduction was shown in FZ isoprostane levels in both those who took vitamin C alone and in those who took the antioxidant mixture. [Nutr Cancer. 2003;45(2). pp.176-184]

  Vitamin Folic Acid
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Very strongly or absolutely counter-indicative
May do some good
Likely to help
May have adverse consequences







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Antioxidant:  A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.

Asthma:  A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.

Atherosclerosis:  Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.

Autoimmune Disease:  One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Beta-Carotene:  The most abundant of the carotenoids, beta-carotene has strong provitamin A activity and is a stronger antioxidant than vitamin A. It is widely accepted today as a cancer preventative. It is found in leafy green and yellow vegetables, often missing in children's diets. Beta-Carotene is believed to be a superior source of Vitamin A because it is readily converted into a more active form of the substance: your body converts it to Vitamin A as needed.

Bronchitis:  Inflammation of the mucous membrane of the bronchial tubes, frequently accompanied by cough, hypersecretion of mucus, and expectoration of sputum. Acute bronchitis is usually caused by an infectious agent and of short duration. Chronic bronchitis, generally the result of smoking, may also be known as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Carcinoma:  Malignant growth of epithelial cells tending to infiltrate the surrounding tissue and giving rise to metastasis.

Cardiovascular:  Pertaining to the heart and blood vessels.

Cholesterol:  A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Cirrhosis:  A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.

Collagen:  The primary protein within white fibers of connective tissue and the organic substance found in tendons, ligaments, cartilage, skin, teeth and bone.

Contracture:  An abnormal, often permanent shortening, as of muscle or scar tissue, that results in distortion or deformity, especially of a joint of the body.

Cotinine:  A chemical from cigarette smoke found in the urine of those exposed to smoke. Levels reliably reflect the degree of second hand smoke exposure also.

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Elastin:  A protein that is similar to collagen and is the chief constituent of elastic fibers.

Esophagus:  Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.

Fatty Acids:  Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.

Hemorrhage:  Profuse blood flow.

Hypertension:  High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.

Low-Density Lipoprotein:  (LDL): Also known as "bad" cholesterol, LDLs are large, dense, protein-fat particles composed of a moderate proportion of protein and a high proportion of cholesterol. Higher levels of LDLs are associated with a greater risk of cardiovascular disease.

Macular Degeneration:  Increasingly poor eyesight often accompanied by light sensitivity, distorted vision and a blank or dark patch in the center of vision.

Metabolite:  Any product (foodstuff, intermediate, waste product) of metabolism.

Pancreatitis:  Inflammation of the pancreas. Symptoms begin as those of acute pancreatitis: a gradual or sudden severe pain in the center part of the upper abdomen goes through to the back, perhaps becoming worse when eating and building to a persistent pain; nausea and vomiting; fever; jaundice (yellowing of the skin); shock; weight loss; symptoms of diabetes mellitus. Chronic pancreatitis occurs when the symptoms of acute pancreatitis continue to recur.

Panic Attack:  A brief, irrational episode of fear that is perceived as so real that an individual may be driven to escape from the place or situation where it occurs. The attack is sudden and increases in severity until it leaves, usually within ten minutes. Panic attack symptoms are numerous and involve both mental and physical signs and symptoms. A panic attack can occur in other anxiety states such as agoraphobia and with certain activities and places. It may occur spontaneously without an apparent cause.

Panic Disorder:  A condition whereby an affected individual has recurrent and unexpected panic attacks and worries a great deal of the time about having another. The individual may also have persistent concern or fear that a panic attack might cause unrelated health problems or a demonstrable change in usual behavior. The symptoms of panic disorder must be present for at least one month to confirm the diagnosis.

Peptic Ulcer:  A general term for gastric ulcers (stomach) and duodenal ulcers (duodenum), open sores in the stomach or duodenum caused by digestive juices and stomach acid. Most ulcers are no larger than a pencil eraser, but they can cause tremendous discomfort and pain. They occur most frequently in the 60 to 70 age group, and slightly more often in men than in women. Doctors now know that there are two major causes of ulcers: most often patients are infected with the bacteria Helicobacter pylori (H. pylori); others are regular users of non-steroidal anti-inflammatory drugs (NSAIDS), which include common products like aspirin and ibuprofen.

Phlebitis:  Inflammation of a vein. Symptoms of superficial phlebitis include pain, swelling, redness, and warmth around the affected vein. The vein feels hard to the touch because of the clotted blood.

Polyunsaturated:  Polyunsaturated fats or oils. Originate from vegetables and are liquid at room temperature. These oils are a good source of the unsaturated fatty acids. They include flaxseed with added vitamin B6 (pyridoxine), sunflower oil, safflower oil, and primrose oil.

Precancerous Lesion:  Abnormal tissue that is not yet malignant.

Psoriasis:  An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.

Stroke:  A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.

Thyroid:  Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.

Vitamin C:  Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Vitamin E:  An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.