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Ask the doctor.

Q Recently, my 62-year-old mother began showing signs of confusion and memory loss. I worried she might be suffering from early-stage Alzheimer's disease, but her doctor attributed her symptoms to electrolyte imbalance. What causes electrolyte imbalance and how does it lead to cognitive problems?

A Electrolytes are substances in the body that regulate the electric charge and flow of water molecules across cell membranes. Optimal electrolyte balance helps ensure proper functioning of the brain and other organs. Sodium, chloride, potassium, magnesium and calcium are examples of electrolytes, whose many functions include regulating oxygen delivery, maintaining fluid balance, and regulating the activity of the heart muscle. Electrolyte levels in the blood that are higher or lower than the normal range can cause a variety of adverse effects, and even lead to such severe symptoms as cardiac problems, organ failure, coma or death. An imbalance can cause mental symptoms that include confusion, problems with short-term memory and concentration, disorientation, and depression.

The most serious electrolyte imbalances involve abnormalities in the body's levels of sodium, calcium or potassium. These disturbances may be caused by disease, diet, medications or other factors. Loss of body fluids or dehydration is one common cause of electrolyte imbalance. Individuals who have suffered fluid loss from impaired kidney function, diarrhea, vomiting, fever, or chronic laxative abuse--or who have become dehydrated because of hot, dry weather, or inadequate water intake--are at greater risk for electrolyte imbalances. Common causes of abnormal calcium levels include parathyroid disorders and excessive use of over-the-counter medications such as antacids and calcium supplements.

Q I developed multiple sclerosis (MS) 12 years ago at age 49 and have generally avoided physical exercise out of fear it would cause overheating and exacerbate my condition. Lately I have heard that lifting weights can be good for people with MS. Can you tell me more?

A Research suggests that sensible exercise can be helpful in lessening fatigue, and improving muscle strength and quality of life for people with MS, without adversely affecting the course of their disease or its symptoms. A study conducted at the University of Florida looked into the impact on MS patients of resistance training using conventional gym equipment. Subjects worked out twice a week for no more than 30 minutes at a time, focusing on lower back, abdomen and legs and progressing to higher weight resistance once they could do 15 repetitions consistently.

After the 16-week study period, assessments indicated patients had developed stronger muscles, better walking ability, and less overall fatigue and disability. Without increasing body temperature--a potential problem that can exacerbate pain in MS patients--strength training effectively builds up muscles. If you plan to try resistance training, be sure to check with your doctor first. Be careful not to get too overheated, and start out slowly so that you minimize risk of injury.

Q Are panic attacks dangerous? I have them frequently and am always afraid. My doctor assures me I'm in good health, but I'm worried I may have a heart attack or stroke.

A Panic attacks may be very uncomfortable and frightening but they are not associated with heart attacks or strokes, and they are temporary and not harmful to your system. Symptoms are caused by adrenaline released as part of a normal process intended to prepare your body for an emergency. Panic attacks are periods of intense fear or anxiety that tend to come on quickly and usually end within five or 10 minutes. These attacks are accompanied by at least four of the following symptoms of arousal: palpitations (heart racing); sweating; trembling or shaking; shortness of breath or choking; chest pain; feeling dizzy, lightheaded or "woozy"; nausea or upset stomach; face or skin flushing or hot or cold flushes; tingling in hands, feet or other parts of the body; "spaciness" or feeing unreal or cut off from one's surroundings; or feeling as if one may be dying, going crazy or losing control.

If you have undergone a comprehensive medical evaluation and your doctor is satisfied with your cardiovascular health, you needn't worry about a heart attack or stroke. The fact that you have suffered many panic attacks before without serious harm should reassure you. Ask your doctor about getting treatment for your panic attacks--medications and/or therapy are available that may help you.
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Title Annotation:medical research
Author:Fava, Maurizio
Publication:Mind, Mood & Memory
Article Type:Column
Date:Mar 1, 2007
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