Inside the world of fibromyalgia, Personal Insights, Treatments and Advice

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Fibromyalgia is a long-term (chronic) condition that can cause widespread pain and tenderness over much of the body. It’s quite common – up to 1 person in every 25 may be affected, so that means everyone you talk to will have a friend or relative who has fibromyalgia !

1981 The first scientific study confirmed that symptoms and tender points could be found in the body.


1990 The American College of Rheumatology wrote the first set of guidelines to help diagnose fibromyalgia.


2005 The first guidelines for treating fibromyalgia pain were published by the American Pain Society.


2007 The first prescription medication was FDA-approved to manage fibromyalgia.

In 1880, American neurologist George William Beard coined the terms neurasthenia and myelasthenia to describe widespread pain along with fatigue and psychological disturbance. He believed the condition was caused by stress.

Fibrositis, coined in 1904 by British neurologist Sir William Gowers, is the one that stuck. The symptoms Gowers mentioned will look familiar to those with fibromyalgia:

  • spontaneous pain
  • sensitivity to pressure
  • fatigue
  • sleep disturbances
  • sensitivity to cold

Symptoms of fibromyalgia ( can range from mild to severe )

  • Inability to concentrate (called “fibro fog”)
  • Restless legs syndrome
  • feeling too hot or too cold – this is because you’re not able to regulate your body temperature properly.
  • Fibromyalgia can affect your sleep. You may often wake up tired, even when you’ve had plenty of sleep.
  • The pain could feel like:
    • an ache
    • a burning sensation
    • a sharp, stabbing pain

Depression

In some cases, having the condition can lead to depression. This is because fibromyalgia can be difficult to deal with, and low levels of certain hormones associated with the condition can make you prone to developing depression.

  • constantly feeling low
  • feeling hopeless and helpless
  • losing interest in the things you usually enjoy

Fibrositis continued to gain acceptance, even though doctors couldn’t agree on exactly what it was. In 1949, a chapter on the condition appeared in a well-regarded rheumatology text book called Arthritis and Allied Conditions. It read, “[T]here can no longer be any doubt concerning the existence of such a condition.” It mentioned several possible causes, including:

  • infection
  • traumatic or occupational
  • weather factors
  • psychological disturbance

Overlapping conditions include:

Overlapping conditions are different in each case of fibromyalgia but they are very important to keep a record of because they may give a clue as to the cause of the individuals condition, every cause is different for each individual and that’s why doctors approaches often fail because they aren’t looking at the individual as a unique person. They just treat illnesses with the same textbook drugs and therapies which can be very damaging to the individuals lack of vitamin B12 can wreak havoc in your body and make your FM symptoms worse. If you think you may have low vitamin B12 levels, be sure to ask your doctor to order a blood test to check your vitamin levels.

A lack of vitamin B12 can wreak havoc in your body and make your FM symptoms worse. If you think you may have low vitamin B12 levels, be sure to ask your doctor to order a blood test to check your vitamin levels.

In 1997, researchers at Sweden’s Goteborg University’s Institute of Clinical Neuroscience surveyed 12 women who suffered from fibromyalgia and chronic fatigue syndrome. All the women had higher than normal levels of a substance called homocysteine in their cerebrospinal fluid. They also suffered from low B12 levels. The Swedish researchers found a correlation between B12 deficiency and the high homocysteine levels.

Glitzwood interviewed Michelle Morales who blogs at http://livingextra-ordinary.com ( pictured below) We chatted about the true reality of living with fibromyalgia. Please visit Michelle’s blog and show support !

michelle

“I’m riding the waves of life as they come. Don’t fight against the current just ride through the current”

“My symptoms are morning stiffness, joint pain, muscle spasms, nerve pain (shocking, itchy, creepy crawlies, numbness in certain areas) insomnia, anxiety, depression, extreme fatigue, TMJ and sometimes when I’m in a flare I feel as if my entire body is vibrating. That’s the only way I can explain it. I feel the vibration in my eyes and I can even hear the humming in my ears. I have tired every medication there is for nerve pain and fibromyalgia. The only one that has helped my pain and symptom was, Lyrica. I know many people hate it and claim it’s poison. But, it has reduced my nerve pain dramatically. I take Tramadol for pain, muscle relaxers as needed to relax my muscles and turmeric daily to control my inflammation. I also do an infusion treatment called Meyers Cocktail in my Rheumatologist office every 4 weeks.  It’s a mixture of different vitamins, b12, magnesium, calcium, etc. This treatment has helped with my morning stiffness, fatigue, joint pain, swelling and overall pain. Along with fibromyalgia I have server back issues, Herniations, building disc and ruptured disc. So, I am in the process of treatments for that. My back issues tend to flare up my fibro a lot. I’m trying to find my balance between work, home, kids & social time with adults (which I don’t have often)” 

 

Michelle mentioned the mayers cocktail if you are interested in knowing more check out this website here : https://resquaredmedical.com/everything-you-want-to-know-about-myers-cocktail/

“My advise to a fellow suffer is don’t give up. Keep trying different treatments and find what works for your body. Everyone is different and respond differently to medication, herbs & infusions treatments. Keep searching for the right doctors who are willing to listen and help you. Find what makes you happy and really focus on that, keep strong and remember that you are loved. This is going to be a bumpy ride but in the end, you can say you lived through it all. I’ve seen some really dark times and found myself in a place that I never want to be at again. I’ve realized that I will always be in pain and it’s never going to completely go away. I’ve accepted my illness and limitations and learned to adjust my life and live with them. I like to say, “I’m riding the waves of life as they come. Don’t fight against the current just ride through the current”. Once you’ve reach this place of content, you will feel a little lighter and learn to ride through your flares. Everyday is a learning curve.”

fibromyalgia Action UK is a charity that offers information and support to people with fibromyalgia. If you have any questions about fibromyalgia, call the charity’s helpline on 0300 999 3333.

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xx

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Health benefits of adding strawberries to your diet

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One cup of sliced strawberries provides 163% of your daily dose of vitamin C (more than a whole orange) and 12% Daily Value (DV) of fiber, as well as 9% DV of the B vitamin folate. Its amazing what just one fruit can do for your life ! I hope this inspires you to eat more fruit in the future.

strawberry

Strawberries are considered one of the healthiest fruits. They are packed with antioxidants, lower blood pressure and protect your heart. Packed with essential vitamins and minerals.

The anthocyanins boost short term memory by 100 percent in eight weeks. (The Journal of Agricultural and Food Chemistry)

Flavonoids — which are responsible for the colour and flavour of strawberries — lower the risk for heart disease.

The compound nitrate found promotes blood flow and oxygen in our body, which is great for weight loss.

Strawberries contain anthrocyanin, which is a powerful antioxidant that protects us from the damaging effects of our environment, especially the sun. The antioxidant power of the anthrocyanins found in strawberries lasts up to 24 hours after consumption; this makes them a great defence against free radical damage.

Photo credit: Asif A. Ali*

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xx

 

 

Why am I depressed ?

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Feeling under the weather? 


Seasonal disorder or SAD is more than just wishing for warm weather during the gloomy winter months. We need sunshine to help keep our body’s internal clock functioning like it should. Daily exposure to just 15 to 20 minutes of sunshine can be enough to reap the benefits. Along with Vitamin D, the sun also supplies us with Nitric Oxide (NO). NO is imperative to the human body as a tool for regulating important physiological processes, including metabolism. Proper exposure to NO from the sun will help keep your metabolism running smoothly and discourage overeating. Vitamin D deficiencies can lead to the development of prostate and breast cancer, memory loss, and an increased risk for developing dementia and schizophrenia.

  • People who have depression go outdoors less, so they are less likely to have adequate vitamin D in their blood.

  • Research does seem to show a link between low levels of vitamin D in the blood and symptoms of depression

depressionOmega-3 deficiency


If you don’t eat enough omega-3 fatty acids, you can be at an increased risk for depression. To get your omegas, just eat fatty fish – like salmon, sardines and tuna.

Healthy fats, known as essential fatty acids (EFAs) come in several different forms including the omega-3 and omega-6 type. Our modern lifestyle intake of omega-3 fats tends to be low. A rich natural source of omega-3 fats is oily fish. These contain two main types of omega-3 fatty acid; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Within the body, EPA and DHA are found in very high concentration in brain tissue and are believed to play an important role in nerve function and mood regulation.

There is a lot of evidence linking depression to omega-3 fat deficiency. One study published in 1996 found that depression was associated with a relative deficiency of EPA.

The chemistry of the brain is finely tuned, and can be upset by certain foodstuffs.

Perhaps two of the most disruptive dietary elements are sugar and caffeine

Medications
Depression is a side effect of many medications. Be sure to check the side effects of any new medications you take.

Poor relationships
You may have friends or co-workers who are a negative influence on you. Over time, the negative attitudes of others can wear off on you. Watch out for jealousy at home or in the work place people are sneaky and use subtle comments to bring you down.

Dismissive remarks about their partner’s appearance and attempts at conversation become the norm. With verbal attacks, they try to manipulate partners into believing they’re the ones in need of help and cause them to question their own judgment. At social gatherings, the depressed partners can make cutting remarks and ignore their partners while engaging happily with everyone else. At the worst, verbal abuse can even escalate to physical attacks.

One of the hallmarks of depression is the overpowering sense of worthlessness. Self-esteem is replaced with self-contempt. An inner voice persuades the partner to think this way: I can’t do anything right, and I’ve never been able to. I’m just too stupid. Everyone else may think I’m fine but they just don’t know what really goes on inside me.

If you are experiencing abuse from a partner, at work or at home. This person may be a narcissist look at this article here. I have directly experienced this myself and at first you don`t even know that they are like this. As soon as you understand whats going on things get much better. they person that`s annoying you may not be a narcissist here are some other articles to help you. Jealousy in relationships, Harassment at work & Growing up with a narcissistic mother.

Under active thyroid

The link between an under active thyroid and depression has been documented. Up to 50% of people with hypothyroidism will have some depression-like symptoms. It’s worth having your thyroid hormone levels checked if you are feeling depressed, along with other symptoms such as fatigue, dry skin, cold sensitivity or hair loss.

The psychiatric disturbances which accompany hyperthyroidism and hypothyroidism, the two commonest thyroid disorders, mimic mental illness. People with an overactive thyroid may exhibit marked anxiety and tension, emotional lability, impatience and irritability, distractible overactivity, exaggerated sensitivity to noise, and fluctuating depression with sadness and problems with sleep and the appetite. In extreme cases, they may appear schizophrenic, losing touch with reality and becoming delirious or hallucinating. An underactive thyroid can lead to progressive loss of interest and initiative, slowing of mental processes, poor memory for recent events, fading of the personality’s colour and vivacity, general intellectual deterioration, depression with a paranoid flavour, and eventually, if not checked, to dementia and permanent harmful effects on the brain. In instances of each condition, some persons have been wrongly diagnosed, hospitalized for months, and treated unsuccessfully for psychosis.

Toxic household mold

The mold found in many homes across the country is microscopic fungi that grow on any host surface. Although mold prefers to grow and even thrives on certain surfaces like paper, cloth, wood, etc, it can grow just about anywhere if the conditions are right. This means mold could even grow on concrete or glass. They are survivors and very adaptable, easily able to not just survive but thrive in many home environments.

Most often molds found in the home are caused by some type of water damage or brought in from the outside to grow and flourish. Indoor flooding, leaking pipes or windows, and leaking roofs all are common causes of indoor mold.

The dangerous or toxic molds are those molds that produce mycotoxins. Mycotoxins are known to cause allergic and other adverse health reactions in animal species.

In small amounts molds are generally not harmful. When the levels grow unchecked the spores become airborne. This is where the potential health problems arise, especially in susceptible individuals.

 

Photo credit : https://www.flickr.com/photos/45635774@N00/2687450903

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RAPESEED oil – The silent epidemic that sweeping Britain and making millions ill

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This is a very important blog post ! So it will be very long and informative. People who are reading this now may have a family member or baby that`s suffering due to a rapeseed oil allergy or even just suffering due to the effects of this silent profit making oil. They have even went as far now as changing on walkers crisps it to sunseed oil. Which is a mix of sunflower oil and rapeseed oil. Which is completely misleading to the consumer.

A variety of rapeseed developed in 1998 is considered to be the most disease- and drought-resistant canola. This and other recent varieties have been produced using genetic engineering. In 2009, 90% of the rapeseed crops planted in Canada were genetically modified, herbicide-tolerant canola varieties.

Some of the chemicals used in the growing of rapeseed oil also cause concern. Nick Mole, UK and Europe coordinator for the Pesticides Action Network, points to the herbicide glufosinate ammonium and vinclozolin, “a fungicide that is also suspected to be an endocrine [hormone] disrupter”.

Rape seed oil is toxic because it contains significant amounts of a poisonous substance called erucic acid.

Canola oil is “widely recognized as the healthiest salad and cooking oil available to consumers.” It was developed through hybridization of rape seed.

Canola oil contains only trace amounts of erucic acid and its unique fatty acid profile, rich in oleic acid and low in saturated fats, makes it particularly beneficial for the prevention of heart disease. It also contains significant amounts of omega-3 fatty acids, also shown to have health benefits. This is what the food industry says about canola oil.

Canola oil is a poisonous substance, an industrial oil that does not belong in the body. It contains “the infamous chemical warfare agent mustard gas,” hemagglutinins and toxic cyanide-containing glycocides; it causes mad cow disease, blindness, nervous disorders, clumping of blood cells and depression of the immune system. This is what detractors say about canola oil.

We have had reports of allergies to canola, and internet articles describe a variety of symptoms — tremors, shaking, palsy, lack of coordination, slurred speech, memory problems, blurred vision, problems with urination, numbness and tingling in the extremities, and heart arrhythmias.

Wikipedia states

While studies done on laboratory animals in the early 1970s show that erucic acid appears to have toxic effects on the heart at high enough doses, an association between the consumption of rapeseed oil and increased myocardial lipidosis, or heart disease, has not been established for humans.( why not ? ) While there are reports of toxicity from long-term use of Lorenzo’s oil (which contains erucic acid and other ingredients), there are no reports of harm to people from dietary consumption of erucic acid.

Publication of animal studies with erucic acid through the 1970s led to governments worldwide moving away from oils with high levels of erucic acid, and tolerance levels for human exposure to erucic acid have been established based on the animal studies.

In 2003, Food Standards Australia set a provisional tolerable daily intake (PTDI) for an average adult of about 500 mg/day of erucic acid, extrapolated based on “the level that is associated with increased myocardial lipidosis in nursing pigs.”

“There is a 120-fold safety margin between this level and the level that is associated with increased myocardial lipidosis in nursing pigs. The dietary exposure assessment has concluded that the majority of exposure to erucic acid by the general population would come from the consumption of canola oil. The dietary intake of erucic acid by an individual consuming at the average level is well below the PTDI, therefore, there is no cause for concern in terms of public health and safety. However, the individual consuming at a high level has the potential to approach the PTDI. This would be particularly so if the level of erucic acid in canola oil was to exceed 2% of the total fatty acids.”

So there we go, we have a provisional tolerable daily intake law for poison that we must follow. So that basically proves that canola, lear, rapeseed, oil seed rape or whatever other false term they use to describe it is bad for peoples health.

Lately there have been finding of growers having a finished rapeseed product with a percentage much higher than our PTDI. this is making its way into millions of products, especially because companies are switching to using rapeseed because its cheaper and makes them more profit. I`m going to outline the symptoms of rapeseed poisoning below.

Digestive symptoms are stomach pain, diarrhea, gas, nausea and vomiting. They may develop in a light form or may be severe and exhausting. Sneezing, nasal congestion and watery eyes are among the most widespread symptoms of respiratory reactions to canola oil. It can also cause asthma attacks and difficulty breathing.

With the rising use of rapeseed oil in Britains products especially Iceland foods ( food store) A lot of people are getting unwell and putting it down to other causes. A woman thought her son had a virus when he kept getting ill and the doctor tested him for nearly everything. She scrutinized his diet and noticed every time he consumed rapeseed oil his symptoms would arise. The GP wouldn’t listen and said it was all in their minds, now they control the allergy at home.

Found this on a forum

It has taken me 6 years to work out that it is rapeseed oil that is instrumental in my migraine attacks, within 12 hours of having anything with this oil in I will have a migraine. There are many foods on the supermarket shelves that have this oil in their ingredients ,I have found, biscuits, breads, ready meals, frozen meals, and then of course eating out!
This oil is called ‘Canola oil’ in the states and Canada (wherer it got it’s name change), and there is a wealth of information about it on a fantasticlly informative and scientifically based website in the states called Weston price
http://www.westonaprice.org/know-your-fats/

I have also heard many stories about people having headaches after 20 minutes of consuming canola/rapeseed oils and feeling of sickness. Some range to severe migraines. So this woman’s post is of no surprise to me.

Another person wrote on a forum

have been trying to cope with rapeseed oil intolerance ffor over two years now and it is sorry to say getting worse, started out with IBS symptoms, now I get severe muscle pain and can be ill for upto three days.
On a positive, I have become a smarter shopper and found out things like ASDA’s own baked on site bread (white only) does not contain rapeseed (freezer always stocked) look at the cheapest brand crisps, nearly always made with sunflower oil. Uncle Ben’s sauces also free of th horrid stuff.
I keep asking everywhere I eat what oil they use and fly the flag for those of us with this intolerance by telling people about what the oil can do. I have been surprised by how many people come back with ‘I get that after eating’ . It is good to know I am not alone or going bonkers as I thought in the begning. ;)

If you think you have this allergy then keep a food diary and check your symptoms against what you have consume that day and you can narrow it down. A lot of migraine sufferers will find its rapeseed or gluten that`s done it.

Its amazing whats in our food nowadays, stay educated and informed and always read your labels.

 

Low iron ? Improve your diet and check your symptoms

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You can be low in iron due to menstrual bleeding and pregnancy and also other intestinal disruptions such as cealiacs, gluten allergy, barley allergy or crohns disease. Some people can be mildly anaemic and can improve absorption of iron through their diets. A fantastic tip is to take a lot of vitamin c rich foods as that aids iron absorption. If you have a severe low iron level get to your doctor and have an investigation. Low iron can mimic other illnesses and give you a lot of weird symptoms. low iron can also come hand in hand with low b12 vitamin levels and folate. Some iron supplements can make you feel ill and have side effects, always watch the mg amount a doctor gives you because you can overdose on iron very easily. It is best to build your iron up in small amounts.

The symptoms of moderate to severe iron deficiency anaemia include:
  • general fatigue
  • weakness
  • pale skin
  • shortness of breath
  • dizziness
  • strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  • a tingling or crawling feeling in the legs
  • tongue swelling or soreness
  • cold hands and feet
  • fast or irregular heartbeat
  • brittle nails
  • headaches

When caused by inadequate iron intake, iron deficiency anaemia can be prevented by eating a diet high in iron-rich foods and vitamin C. Mothers should make sure to feed their babies breast milk or iron-fortified infant formula.

Foods high in iron include:

  • meat, such as lamb, pork, chicken, and beef
  • beans
  • pumpkin and squash seeds
  • leafy greens, such as spinach
  • raisins and other dried fruit
  • eggs
  • seafood, such as clams, sardines, shrimp, and oysters
  • iron-fortified dry and instant cereals
Foods high in vitamin C include:
  • citrus fruits, such as oranges, grapefruits, strawberries, kiwis, guavas, papayas, pineapples, melons, and mangoes
  • broccoli
  • red and green bell peppers
  • Brussels sprouts
  • cauliflower
  • tomatoes
  • leafy greens

As your iron levels rise your symptoms should go away very fast !

Are you deficient in vitamin d? – Signs and symptoms of a vitamin D deficiency

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Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is also occurs naturally in a few foods — including some fish, fish liver oils, and egg yolks — and in fortified dairy and grain products.

Vitamin D deficiency is no laughing matter, it can cause a lot of horrible things such as depression, aching bones, gastrointestinal condition,  and Autoimmune diseases. Vitamin D is a potent immune modulator, making it very important for the prevention of autoimmune diseases, like multiple sclerosis and inflammatory bowel disease.
Infections, including influenza. It also helps you fight infections of all kinds. A study done in Japan, for example, showed that schoolchildren taking 1,200 units of vitamin D per day during winter reduced their risk of getting influenza A infection by about 40 percent. I believe it’s far more prudent, safer, less expensive, and most importantly, far more effective to optimize your vitamin D levels than to get vaccinated against the flu.
DNA repair and metabolic processes. One of Dr. Holick’s studies showed that healthy volunteers taking 2,000 IUs of vitamin D per day for a few months up-regulated 291 different genes that control up to 80 different metabolic processes, from improving DNA repair to having effect on autoxidation (oxidation that occurs in the presence of oxygen and/or UV radiation, which has implications for aging and cancer, for example), boosting your immune system and many other biological processes.
There are very few foods that actually have therapeutic levels of vitamin D naturally and even fortified foods do not contain enough vitamin D to support your health needs.
Despite its name, vitamin D is not a regular vitamin. It’s actually a steroid hormone that you are designed to obtain primarily through sun exposure, not via your diet.
Optimizing your vitamin D levels may help you prevent cancer, heart disease, autoimmune diseases, infections, mental health conditions, and more.

Vitamin D deficiency is prevalent in adults of all ages who always wear sun protection (which blocks vitamin D production) or limit their outdoor activities

FOODS THAT CONTAIN VITAMIN D

Mackerel
A small, 3½ ounce portion of these high omega-3 containing fish will give you 90% of your recommended daily amount. Currently, the FDA recommends that people eat more of these oily fishes to infuse their bodies with the vitamins and omega-3 essential fatty acids (EFA’s) that the human body cannot produce on its own.

Sardines
Sardines are one of the best foods sources of vitamin D. One small tin can of sardines will provide you with approximately 70% of your daily needs. These tiny canned fish are also a great source for vitamin B12, omega-3 fatty acids, protein, and selenium.

Tuna

Eat 3 ounces of tuna daily for 50% of your vitamin D needs. Fresh, wild-caught tuna is the most nutritious. Remember, eating oily fish can also lubricate the body with “good fats” that provide health benefits like better memory and brain function.
Eggs
Eggs are another food that contains vitamin D in small amounts. Eating one egg daily will provide you with approximately 10% of your daily needs. I personally recommend eating free-range eggs from a local farm.

The magical uses of Honey

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The vitamins present in honey are B6, thiamin, niacin, riboflavin, pantothenic acid and certain amino acids. The minerals found in honey include calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium and zinc. I learnt that “conductivity” is an indirect way of measuring the mineral content of a honey. Manuka honey has a higher than normal conductivity — about 4 times that of normal flower honeys. The higher the conductivity, the better the value of the honey.

Boosts Memory
The sweet nectar is loaded in antioxidants that may help prevent cellular damage and loss within the brain. A 2011 study published in Menopause found a daily spoonful of Malaysian honey may boost postmenopausal women’s memory, which can provide an alternative therapy for the hormone-related intellectual decline. After four months of taking 20 grams of honey a day, the women were more likely to have better short-term memory than their counterparts who took hormone pills.
Honey’s ability to help the body absorb calcium, helps aid brain health. The brain needs calcium in order to process thought and make decisions. As our populations continue to get older and older, the likelihood of dementia setting in because of poor intake of vitamins and minerals continues to get higher and higher.

Sleep Aid
Honey can be a health aid for sleepless nights. Similar to sugar, honey can cause a rise in insulin and release serotonin — a neurotransmitter that improves mood and happiness. “The body converts serotonin into melatonin, a chemical compound that regulates the length and the quality of sleep,” Rene Ficek, registered dietician and lead dietician nutritionist at Seattle Sutton’s Healthy Eating in Chicago, Ill., told Medical Daily in an email.

Hangover
When you get a hangover from drinking too much alcohol, combat its effects by applying honey remedy. Honey is gentle on the stomach and contains a mix of natural sugars such fructose which is known to speed up the oxidation of alcohol by the liver, acting as a ‘sobering’ agent.

Improves scalp and hair
Honey diluted with a bit of warm water was shown to significantly improve seborrheic dermatitis, which is a scalp condition that causes dandruff and itching. After applying the solution every other day for four weeks, “all of the patients responded markedly.” According to the researchers:

Itching was relieved and scaling was disappeared within one week. Skin lesions were healed and disappeared completely within 2 weeks. In addition, patients showed subjective improvement in hair loss “

Treatment with honey is called apitherapy, which includes replenishing energy, enhancing physical stamina and improving immune systems. Honey also is considered to have a calming effect on the mind and promotes sleep. Honey also helps indigestion and has sometimes been used to treat cardiovascular disease and respiratory complaints. A thin coat of honey can be applied on the skin to disinfect and heal minor skin wounds and chapped lips.