Anxiety

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Barbara Sternberg, Ph.D.

A basic human emotion, anxiety is the sensation of worry, fear, apprehension, panic, tension, or unease that occurs in response to situations that seem overwhelming, dangerous, threatening, or distressing.  Manifesting in such forms as worry prior to a major test, nervous anticipation of a social occasion or business event, or heightened alertness in the face of apparent peril, anxiety is an intuitive recognition that action of some kind should be taken.

Anxiety that prompts appropriate action is a normal, adaptive response to temporary stress or uncertainty.  Detrimental anxiety overwhelms the individual experiencing it, preventing appropriate action or producing counterproductive responses.  Prolonged, intense, or inappropriate worry that interferes with normal function or that is a source of significant emotional or physical distress may signal the presence of an anxiety disorder.  Free-floating anxiety that occurs in the absence of an external threat and is pronounced enough to impair daily function may also be symptomatic of an anxiety disorder.

An estimated 40 million Americans over 18 years of age — about 18 percent of the adult population of the United States — experience anxiety disorders.  In contrast to relatively mild transient anxiety induced by a stressful event like public speaking or a first date, anxiety disorders persist for six months or longer and can worsen without treatment (NIMH). According to the National Comorbidity Survey Replication, overall lifetime prevalence of anxiety disorders in the U.S. is 28.8 percent, meaning that more than one out of every four adults experiences at least one anxiety disorder during his or her lifetime. Anxiety disorders are approximately twice as common in women as in men. Most people who are affected by anxiety disorder have more than one, and nearly 75 percent of those who have an anxiety disorder experience their first episode by the time they reach 21.5 years of age.

Although anxiety disorders are highly treatable, only about one third of those with these disorders receive treatment.

Coping with Anxiety

Although evidence indicates that early treatment of anxiety disorders can prevent such complications as depression and severe phobic avoidance, only about one victim in four ever seeks medical help. Recommended self-help strategies for anxiety management include:

  • maintaining perspective.
  • being informed.
  • having a positive outlook.
  • building resilience.
  • creating a social network.
  • seeking help when necessary.

When personal anxiety management proves ineffective, a family physician can help determine if symptoms are caused by an anxiety disorder, another medical condition, or combined factors.  Coexisting medical conditions may have to be treated or brought under control before the anxiety disorder can be addressed, by a psychologist, psychiatrist, social worker, or counselor. Some people with anxiety disorders must try several treatments or combinations of treatments before finding one that relieves their distress.  Medications do not cure anxiety disorders, but antidepressants, anti-anxiety drugs, and beta-blockers may control some physical symptoms while the patient receives psychotherapy.

Obsessive-Compulsive Disorder

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Barbara Sternberg, Ph.D.

Occurring in men and women with comparable frequency, obsessive-compulsive disorder (OCD) affects about 2.2 million Americans 18 years or age and older — one percent of the adult population of the United States.  Initial symptoms usually manifest themselves in childhood, adolescence, or early adulthood, and median symptom onset is 19 years of age.  One third of adults with OCD experience their first symptoms as children.

 OCD is characterized by repetitive, intrusive, unwanted, and disturbing thoughts known as obsessions and by the performance of rituals known as compulsions — in an urgent attempt to control the anxiety that the obsessions generate.

Fear of social embarrassment, for example, could prompt someone with OCD to comb his or her hair so compulsively that the individual becomes unable to look away from the mirror.  Thoughts of engaging in violence, bringing harm to loved ones, and having a persistent preoccupation with performing distasteful sexual acts or violating one’s religious beliefs are common obsessions.  Common rituals include repeated hand-washing, counting, or touching objects (especially in a particular sequence).

People who have OCD may be preoccupied with order and symmetry, have trouble discarding things, and accumulate or hoard things they don’t need.  Healthy people perform such rituals as repeatedly making sure the stove is off before leaving the house.  People with OCD perform rituals that distress them, interfere with daily life, and provide no more than a temporary respite from their obsession-induced anxiety.  Most people who have OCD are eventually enslaved by their own compulsions. 

Research indicates that OCD may be a familial disorder.  Many adults who have OCD recognize the futility of their actions, but children and some adults who have OCD are unaware that their behavior is unusual.  The course of OCD can vary.  Symptoms may emerge and disappear, ease or intensify, or prevent the individual from carrying out his or her responsibilities.  Many people with OCD try to control their disorder by avoiding circumstances that trigger their obsessions or by self-medicating with alcohol or drugs.

 

History of Meditation

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

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By Barbara Sternberg, Ph.D.

The earliest roots of meditation go back too far to trace with full confidence. We do know, however, that the practice of meditation was refined in the temples, caves, and monasteries of the East and Near East.  Meditation has found its way to the West in the past century. In slightly different form, meditation also appears in the Judeo-Christian tradition.

Meditation dates back to our earliest ancestors, who stared in wonder at the sky as they waited for hours to hunt for prey.  Perhaps these ancestors waited while communal fires burned. Our ancestors had plenty of time on their hands.  Because meditation entails a shift from thinking and doing to just “being,” these ancestors were probably able to meditate during the course of many of their days.

Long before the arrival of Buddha in the East, or the great Indian yogis, shamans — people with alleged access to what is good and evil — living in hunter-gatherer cultures all over the world used meditative techniques to enter altered states of consciousness known as trances. Focusing their minds using simple rhythms and chants, and sometimes employing hallucinogenic substances, these shamans traveled to the “spirit world” and returned with wisdom, healing abilities, magic abilities, and spirit blessings to bestow on their people.

Cave paintings dating back at least 15,000 years show figures lying on the ground in poses of meditative absorption. Scholars have determined that these were shamans in a trance state asking the spirits for a successful hunt. Other cave pictures showed shamans transformed into animals and taking on the animals’ magical powers.

Although shamanism has declined considerably, there are still world cultures that utilize shamans as healers, guides for the dead, and intermediaries between humans and spirits. Recent years have shown an upsurge of interest in shamanism, due in some part to the writings of Carlos Castaneda, Michael Harner, and Joseph Campbell.

But perhaps meditation’s deepest roots can be traced to India, where sadhus (traveling holy men and women) and yogis have practiced meditation in one form or another for more than 5,000 years. It was in India that meditation first flourished, and it is from India that meditation later traveled and spread to distant parts of the globe.

The earliest Indian scriptures, the Vedas, don’t have a word for meditation but described what are now known to be meditative rituals requiring great concentration. Over time, these practices evolved into a type of prayerful meditation that entailed the use of breath control with devotional focus on the Divine. From these earliest roots, three of India’s best-known meditative traditions blossomed:  yoga; Buddhism; and tantra (a range of religious traditions).

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Treating Drug Overdose

Posted on Posted in Brain Science, Continuing Education, Homestudy, Seminars, Webinars

52118By Barbara Sternberg, Ph.D.

Overdose (OD) occurs when a toxic amount of a drug or combination of drugs overwhelms the body. Many substances can be involved in overdosing, including alcohol, opioids, and a combination of drugs. Mixing heroin, prescription opioids (such as morphine, Vicodin®, Percoset®, etc.) and other downers such as alcohol and benzodiazepines (e.g. Xanax®, Klonopin®, Valium®, Ativan®, etc.) is particularly dangerous because they all affect the body’s central nervous system.  The nervous system slows breathing, affects blood pressure, and slows heart rate — in turn, reducing body temperature. Stimulant drugs like speed, cocaine, and ecstasy raise heart rate, blood pressure, and body temperature and speed up breathing. The result can be seizure, stroke, overheating, or heart attack. “Overamping” is the term that is now being used to describe an overdose of speed.

Opioid overdose occurs when the level of opioids, or combination of opioids and other drugs in the body cause a person to become unresponsive to stimulation  or cause his or her breathing to become inadequate. This happens because opioids fit into the same brain receptors that signal the body to breathe. In that case, oxygen levels in the blood decrease, and the lips and fingers turn blue (cyanosis). Oxygen starvation will eventually stop vital organs like the heart and then the brain and can lead to unconsciousness, coma, and possibly death.

In the case of opioid overdose, survival or death depends completely on maintaining the ability to breathe and on sustaining oxygen levels. Fortunately, the overdose process takes place over time, with most people stopping their breathing gradually — minutes to hours after the drug or drugs were ingested. In most situations, there is time to intervene between the beginning of an overdose and before a victim dies. Even if an overdose takes place immediately after drug ingestion, proper response can reverse the overdose and keep the person breathing and alive.


Naloxone

Also known by the brand name Narcan®, naloxone is an opioid antagonist used to counter the effects of opioid overdose, specifically, to counteract the life-threatening depression of the central nervous system and respiratory system, making it possible for an overdose victim to breathe normally. Naloxone is not a controlled substance, and it is only effective as an antidote to opioid overdose. Naloxone has a stronger affinity for the opioid receptors than many opioids, so it is capable of knocking the opioids off the receptors for a short time, allowing the person to breathe again and reverse the overdose. Traditionally administered by emergency response personnel, naloxone can be administered by minimally trained laypeople. Naloxone is administered via injection  or nasal spray.

Many people who have died from opioid overdose have failed to receive proper medical attention because a person who was with them delayed or did not call 911 for fear of police involvement. While not all opioid overdoses are fatal, the administration of naloxone by laypeople to an overdosing person saves hundreds of lives each year. Timely provision of naloxone may also help reduce some of the morbidities associated with non-fatal overdose, such as brain damage and other dangers.

In most jurisdictions, naloxone is only used in hospital settings or by emergency medical personnel.  Naloxone can be made available to people experiencing an overdose if and when emergency medical services are accessed. Recently, take-home naloxone programs are being established in communities throughout the United States. These programs expand naloxone access to drug users and their loved ones by providing training on overdose prevention, recognition, and response.

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Horses as Therapeutic Animals

Posted on Posted in Continuing Education, Elder Care, Homestudy, Psychology, Webinars

horse-1330690_640By Barbara Sternberg, Ph.D.

Hippotherapy is the technical term for therapy with horses. While it has been around for more than a century, hippotherapy came to the fore when a woman named Liz Harwell, whose legs were essentially paralyzed by polio, won the Silver Medal in dressage at the 1952 Helsinki Olympic Games. Today, half a century later, hippotherapy programs are ongoing in multiple countries, and therapeutic riding programs have been developed for people with physical, psychological, cognitive, social, and behavioral problems including cerebral palsy, spina bifida, mental retardation, and depression. The North American Riding for the Handicapped Association makes a distinction between hippotherapy, or horse-based physical therapy under the direction of a licensed therapist, and therapeutic riding, which utilizes different methods to improve strength, muscle control, eye-hand coordination, and social skills.

Riding a horse involves what physical therapists refer to as three-dimensional movement. With each step, the person’s pelvis tilts up, sideways and forward, and back. The horse repeats the sequence and the sensation of these bodily motions for people with physical or neurological handicaps, reacquainting their muscles with how they are supposed to move. The pressure of the horse’s hooves hitting the ground is also three-dimensional, and stimulates the rider’s knees, hips, and spine. It is believed that this movement stimulates the brain, directly affecting the nervous system.

Even speech and language therapy can be enhanced by therapeutic riding programs. Ruth Dismuke-Blakely, a speech therapist from New Mexico, has been working with patients on horseback since 1981. She believes that most speech therapy addresses only the mouth and the brain, disconnected from the rest of the body, but that in fact, the rest of the body is very important for speech. Horses, with their well organized neurological systems, “lend their ordered system to a disordered one.”

Other speech therapists also find horseback riding a therapeutic venue in which to conduct treatment because patients learn more quickly when engaged in real-life settings than when in an office. Hippotherapy is actually approved by the American Speech and Hearing Association as a therapeutic modality.

Psychotherapy takes place in the realm of horses, too, specifically in the stall, along with the horse, the patient, and the therapist. According to psychotherapist Marilyn Sokoloff, PhD the additional aspect of having a horse to touch and interact with speeds up the pace of psychotherapy. The human-horse interaction gives the therapy a here-and-now component to analyze that can cut through resistances that have hindered progress for years. Sokoloff has used horses in group therapy sessions with women, convening the sessions in a horse barn with the women seated in chairs in a circle and the horses in their stalls all around them. Physical contact with the horses is encouraged as a mode of putting the women in touch with their feelings. These women suffer from depression, anxiety, eating disorders, and physical and sexual abuse and are challenged by the horses to find new ways of control. Getting a horse to do what you want raises issues of power and control which are confronted by the women in the group, often to powerful effect.

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Music As Medicine

Posted on Posted in Brain Science, Continuing Education, Elder Care, Psychology, Seminars, Webinars

By Barbara Sternberg, Ph.D.

Music has long been recognized as an effective therapy for emotional disorders. But the idea of using music to treat physical ailments is relatively new. The past several years have seen an explosion of research on the uses and benefits of music for both mental and physical health. In a meta-analysis of 400 studies, it was found that music improves the body’s immune-system function and reduces stress. In reducing anxiety prior to surgery, listening to music was also found to be more effective than prescription drugs. In addition, listening to and playing music increased the body’s production of the antibody immunoglobulin-A and natural killer cells. Music also reduced levels of the stress hormone cortisol.

ukulele-516503_640A recent study on the link between music and stress found that music can help calm pediatric emergency-room patients. In a trial with children ages three to 11, University of Alberta researchers found that young patients who listened to relaxing music while having an IV inserted reported significantly less pain, and some showed less distress compared to patients who did not listen to music. Also, for the music-listening group, more than two-thirds of the healthcare providers reported that the IVs were very easy to administer.

Music is also helpful in reducing pain among adult patients as well. In one study, patients in palliative care who participated in live-music therapy sessions reported relief from persistent pain. Music therapists worked closely with the patients to tailor the intervention. Patients sang, played instruments, discussed lyrics, and wrote songs.
Another study evaluated the analgesic effects of music in patients with fibromyalgia pain. Fibromyalgia patients were exposed either to relaxing, pleasant music which they had chosen, or to a control auditory condition (white noise). They rated their pain level, and their functional mobility was evaluated using a standardized measure.
Functional mobility was found to be superior in the patients exposed to music compared to the controls.

In addition, music has been shown to enhance certain quality of life aspects among older adults. A study evaluated the impact of piano training on cognitive function, mood, and quality of life in older adults. Thirteen participants received piano lessons and practiced daily for four months and were compared to an age-matched control group of 16 who participated in other forms of leisure activities such as physical exercise, computer lessons, or painting lessons. In terms of executive function, inhibitory control, and divided attention, significant differences were found for the group that received piano-training. Piano lessons also decreased depression, induced positive mood states, and improved the psychological and physical quality of life of the elderly participants. The researchers concluded that playing piano and learning to read music can be a useful intervention in older adults to promote cognitive reserve and improve subjective well-being.

There is growing evidence that music may be useful in medicine – in areas including reducing stress and pain and improving mood and cognitive function. On word fluency, working memory, and recognition memory, other studies have examined the effects of listening to music. These studies also showed enhanced performance in these cognitive abilities in older adults.

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Learning to Meditate

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

buddha-918068_640By Barbara Sternberg, Ph.D.

Meditation is a practice that is nearly as old as our oldest ancestors. It has been practiced in cultures around the world and is as popular today as it has ever been. Practiced by holy men and women and by individuals seeking the health benefits meditation can provide, it is a state of relaxed concentration and enhanced awareness. Also, it gives an inward focus that allows you to see and better understand the workings of your own mind.

Simple to learn, meditation is in fact a skill that can take a lifetime to perfect. If you are curious about meditation and would like to sample its benefits, start with one of the meditations outlined here. Remember to give yourself time–the benefits of meditation come with practice and patience. The more you can adopt an openly receptive state of mind, the more successful your meditating experience will be.

Focusing Inward

One of the most popular forms of meditation in the world’s many spiritual traditions involves meditating on one’s breath. Although it may seem mundane, and it certainly is repetitive, the process of focusing on one’s breathing can, over time, lead to all of the physical and mental health benefits meditation promises to provide, including reduced stress, improved mood and improved pain control. It can also provide a deeper pleasure in life and a sense of connection with one’s essential inner core of being.

Most people are caught up in the everyday details of life–our families and jobs, what we need to get done, checking our email and texting our friends, reading the news of the day, and watching our favorite television show. Most of us get so caught up in these details that we fail to pay attention to what is going on inside us–in our own hearts, minds, and bodies. In truth, popular culture is designed to get us to believe that happiness and satisfaction come from outside, in the world of popular culture and advertising messages. Focusing our attention inward can seem like a huge step in a different direction.

Relaxing Your Body

As you gain experience practicing meditation, you will find that the process naturally relaxes your body while at the same time it focuses your mind. As a beginner, however, it may be difficult to experience bodily relaxation in the early days or weeks of meditating. It may be helpful for you to practice a relaxation technique before you meditate, especially if you are aware of feeling tense or stressed.

Meditating on Your Breath

Paying attention to the inhalations and exhalations of our breath certainly isn’t exciting, but it does slow our minds to match the speed and rhythms of our bodies; we breathe an average of 12 to 16 times per minute. There are several different ways to do this, but one to try — in the early stages of meditating — is counting the number of breaths needed to build concentration. The structure of counting provides a structure so that we can quickly notice when our minds are wandering off the task.

Learn more about meditation in our homestudy course, Meditation.

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The Basics of Addiction

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

alcohol-428392_640By Barbara Sternberg, Ph.D.

Alcohol and drug use are as old as civilization. Equally ancient is the mystery of why one person can use a substance moderately while another becomes addicted. New research is now shedding light on this complex genetic, and biological, psychological, and sociological phenomenon. Many people and clinicians today have strong opinions on the best way to treat addiction. Indeed, the question of whether “harm-reduction” approaches can be successful is highly controversial.

One of the major risks of alcohol and drug use is the potential for overdose. Overdose happens when a toxic amount of a drug or combination of drugs overwhelms the body. Alcohol and drug overdoses have the potential to cause serious health consequences or death. Various factors influence the degree of risk experienced by any particular alcohol or drug user.

An over-the-counter medication called Naloxone (Narcan®) can be used to counter the effects of overdose from opioids such as morphine or heroin and can save lives. It is only effective for treatment of opioid overdose. However, it has no effect if a person does not have opioids in his or her system.

Addiction is defined as the compulsive need to use a habit-forming substance, or an “irresistible urge” to engage in a potentially harmful behavior. Two defining characteristics of addiction are tolerance and withdrawal. Tolerance is the ever increasing need for more of the substance to obtain the same effect. Withdrawal refers to the uncomfortable physical and psychological symptoms that occur when substance use is stopped suddenly or withheld.

The term addiction has come to refer to a wide range of behaviors. While most commonly used to refer to ingestion of alcohol, drugs, cigarettes, and food, it is sometimes used to mean excessive indulgence in activities including work, exercise, shopping, sex, and video-game playing although there is insufficient research evidence to warrant including these activities as diagnosable psychiatric disorders. In DSM-5, pathological gambling is classified as a behavioral addiction.

Addictive behaviors have been characterized as patterns, habits, compulsions, impulse control disorders, and physical addictions. Many psychologists believe that they can be best understood as learned habits or behavior patterns. According to this view, addictive behaviors are maladaptive habits and behavior patterns which are subject to the same principles of learning that govern all behaviors. Old or maladaptive habits can be broken and replaced with alternative and less harmful behaviors. In this way, addictive behaviors can be unlearned and new, healthier behaviors learned in their place.

Learn more about addiction in our homestudy course, Addictions: Alternatives to Abstinence.

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Chocolate: Junk, Nutrition or Medicine?

Posted on Posted in Continuing Education, Homestudy, Nutrition, Psychology

By Barbara Sternberg, Ph.D.

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Christopher Columbus and his crew were the first Europeans to “discover” chocolate. In 1502, during Columbus’ fourth voyage to the New World, he and his crew found what they called “almonds” in a canoe they had captured. Taken back to Europe, the cacao beans were initially overlooked by the Spanish royalty, who were more interested in gold and other valuable treasures.

Nowadays, people generally consider chocolate to be a tasty treat, a fattening indulgence, an irresistible hedonistic pleasure, and even a mood-altering substance. In one survey of college students’ attitudes toward chocolate, 81% perceived chocolate as fattening and 54% perceived it to be unhealthy. Few seriously consider chocolate in terms of its nutritional value. However, for most of chocolate’s history in human culture, long before humans were equipped to decipher the chemical make-up of the beans from Theobroma cacao, chocolate was considered not only a nutritional powerhouse but also a medicinal food.

Research shows positive claims for the medicinal uses of cacao over the centuries. These include uses of:

  • Chocolate eaten as an antidote to everything from anemia, angina, poor appetite, asthma and poor breast milk production, to constipation, fever, hangovers, hemorrhoids, pain, syphilis, low virility, vomiting, and worms.
  •  Preparations of cacao bark eaten to reduce abdominal pain and bloody diarrhea.
  • Cacao butter/fat/oil, used as a food or applied externally, for bronchitis, respiratory distress, and wound healing, among other ailments.
  • Cacao flower, used in baths, infusions, or applied directly to the skin, to soothe toothache pain, reduce fatigue, and treat burns.
  • Cacao fruit pulp, eaten, to facilitate childbirth.
  • Cacao leaf, applied externally to stop excessive bleeding and disinfect wounds.

Chocolate has the unique ability to induce pleasure and satisfaction in many people in a way that few other foods can. And based on current knowledge, it is safe to say that, for most people, this favorite snack or dessert food will not adversely affect health or add to risk for any major health problems. On the contrary, chocolate may actually have health benefits.

Learn More about chocolate and the benefits from indulging with our homestudy course.

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Probiotics: The Good Bacteria

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

girl-791563_640By Barbara Sternberg, Ph.D. and Clare Fleishman, M.S., R.D.

Probiotics are live, nonpathogenic microorganisms that are typically bacteria or yeasts. The term “probiotics,” also called “good bacteria,” has its root in the Greek pro, meaning “promoting” and biotic, meaning “life.” The term includes some types of beneficial microbes that can be found in probiotic supplements as well as certain microbes added to food. The term also refers to the trillions of friendly microbes that typically live in our digestive tracts and other organs.  Probiotics are naturally found in fermented foods such as yogurt, aged cheese, and kimchi. Thus far, the FDA (Food and Drug Administration) has not approved any health claims for probiotics.

People usually associate bacteria with infection and illness. However, most bacteria are not pathogenic for humans, and many play a very important role in supporting good health. Trillions of bacteria live on or in the human body, collectively known as microbiota, microbiome, or microflora.

Probiotics are found on the skin, in the respiratory system, and in the urinary tract, but most of them are in the gastrointestinal tract—some 100 trillion of them. These so-called gut bacteria greatly outnumber our body cells. Gut microflora get their nutrients from our bodies and create a healthy environment that protects us from illness and helps in disease control and the digestion of food.  Probiotics and humans have a symbiotic relationship.

Considerable research has been done and continues to be done on the relationship between these bacteria and various aspects of overall human physical and mental health, including obesity, celiac disease, inflammatory bowel disease, fatty liver disease, atherosclerosis, autoimmune disorders, and depression.

The gastrointestinal tract is an amazing metabolic machine. The surface area of the human gut is huge—about the size of a tennis court. Along this surface are nearly 1,000 different species of bacteria doing their important work — work that supports normal digestion. The numbers and balance of these bacteria vary. The numbers and balance are affected by diet, aging, geographical location, and environmental factors such as infections and the use of antibiotics.

How do gut bacteria facilitate health? They produce several B vitamins, vitamin K, and certain key fatty acids. The byproducts of bacterial interactions supply up to 10 percent of the body’s daily energy needs. In addition, gut bacteria play an important role in normal immune-system development. Their efficacy generally depends on a balance between the numbers and species of bacteria present. Disruptions of this balance can lead to significant problems with illness and disease.

Probiotics are vital for the immune system. They send signals to the immune system that reduce destructive overreactions, including inflammation. Insufficiency of probiotics affects immune responses and, hence, affect every aspect of our health.

Probiotics is a continuing education course available from the INR bookstore.  Check it out… and more.

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