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Hair restoration

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Related terms
Background
Theory/evidence
Safety
Author information
Bibliography
Treatment

Related Terms
  • Adequate protein diet, Barry Sears, carbohydrate, diet, fat, low carbohydrate diet, protein.

Background
  • The Zone diet is an unproven dietary regime, which has been popularized by Dr. Barry Sears through sales of his 1995 book, The Zone. Despite claims made in the book, there is little available research to support its overall benefit.
  • The Zone diet is a calorie-restricted diet that provides adequate protein, moderate levels of carbohydrates, essential fats and micronutrients spread through three meals and two snacks that approximately maintain the protein-to-carbohydrate ratio throughout the day.
  • Proponents believe that the Zone diet promotes optimal metabolic efficiency in the body by balancing the hormones insulin and glucagon. Insulin is responsible for converting, in the blood, incoming nutrients into cells. Glucagon regulates glucose in the liver. Overall, the Zone's food plan consists of a dietary intake of 40% carbohydrates, 30% protein and 30% fat.
  • Under this diet, recommended foods include fruits and vegetables (fresh or frozen), oatmeal (whole grain), protein powder (e.g. soybean isolate), chicken, turkey, lean beef, fish, low-fat cottage cheese, soy food, nuts (e.g. almonds, cashews, macademia, pistachios), extra virgin olive oil, natural sweeteners, such as fructose or stevia.

Theory / Evidence
  • Recent research seems to indicate that a low total caloric intake is associated with longer life expectancy. Based on animal studies, animals eating calorie-restricted diets may live 1.5 to 2 times as long as animals eating high-calorie diets. Theoretically, similar effects may occur in humans. The caloric restriction recommended by the Zone diet is below that of the average American and may be of benefit in weight loss and if maintained over decades in increasing life expectancy. On the other hand, athletes in training will likely suffer from decreased performance if restricted to the low calorie diet recommended by the Zone.
  • Despite proposed benefits, currently there are no high quality clinical trials available about the Zone diet or similar diets consisting of the recommended 40% carbohydrates, 30% fat, and 30% protein. The Zone diet is quite complex in terms of caloric restriction, ratio of carbohydrates/protein//fat, spacing of meals, preferential intake of certain fats, and avoidance or inclusion of a few specific foods.

Safety




Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Cheuvront SN. The zone diet and athletic performance. Sports Med. 1999;27(4):213-228.
  2. Natural Standard: The Authority on Integrative Medicine.
  3. Sears B. The Zone Diet and athletic performance. Sports Med. 2000;29(4):289-294.

Treatment
  • General: Ringworm may be treated with medications applied to the skin (such as creams, ointments, or shampoos) or with medications taken by mouth. The type of treatment usually depends on the cat's age, other health conditions, fur length, and how serious the ringworm infection is. Sometimes it is necessary to use a combination of treatments applied to the skin and those taken by mouth to cure ringworm. Some treatments may be performed at home, while others treatments require visits to a veterinarian. All treatments should be continued until the cat tests negative for ringworm (usually 1-2 months), even if symptoms have disappeared.
  • For treatments applied to the skin, veterinarians may remove the cat's hair by clipping or shaving to help the treatment reach the infection. Hair removal may be useful for long-haired cats or for treatments that may disrupt the cat's fur (such as lime-sulfur treatments). However, some veterinarians discourage shaving, as it may spread isolated ringworm infections to other parts of a cat's body. If hair removal is performed, it should be done carefully to avoid spreading ringworm (especially to other animals or people), and the veterinarian should thoroughly clean any instruments (such as clippers) with an antifungal disinfectant.
  • Veterinarians often use a pathogen score, or p-score, based on the number of fungal colonies growing on the contact plate to determine the severity of the infection and to guide treatment. P-scores are assigned as follows: 1 (<4 colonies), 2 (5-9 colonies), and 3 (the plate is completely covered with fungal growth). If there is a p-score of 1 or 2 with no skin lesions, the cat will be treated with a lime-sulfur dip and retested. If there are skin lesions present (regardless of p-score), or if there is a p-score of 3, veterinarians may recommend treating the cat both with medications applied to the skin and systemically with oral medications.
  • Lime-sulfur dips: Veterinarians consider topical lime-sulfur treatments (or lime-sulfur dips) to be relatively safe and recommend this treatment for kittens over three weeks old and cats that are nursing or pregnant. In this treatment, a warm-water solution containing 8% lime-sulfur is sprayed on the cat or applied with a sponge. The solution should not be rinsed or shampooed off, but the cat should be dried with a towel. It is usually recommended that this treatment be repeated 1-2 times weekly until the cat tests negative for ringworm with fungal culture.
  • When the lime-sulfur solution is applied, care should be taken to avoid getting the solution in the cat's eyes. If the solution gets into the cat's eyes, saline solution should be used to flush the lime-sulfur out of the cat's eyes. After each treatment is applied, the cat should be prevented from grooming by a protective cone worn around the neck.
  • This treatment may be performed at home using commercially available lime-sulfur concentrated solutions and following the manufacturer's instructions closely. Alternatively, most veterinarians can also perform this treatment. Lime-sulfur treatments are relatively inexpensive, generally safe, and usually effective. However, they can leave an unpleasant odor and yellow or green stains on clothing, furniture, or the cat's fur.
  • Antifungals applied to the skin: In short-haired cats and kittens that are otherwise healthy, ringworm infections that are localized (not widespread) may usually be treated with an antifungal cream, lotion, ointment, or solution. Common antifungal medications used to treat ringworm in cats include clotrimazole, miconazole (MicaVed®, Miconosol®, or Conofite®), or thiabendazole (Tresaderm®). Clotrimazole cream (1%) is available over the counter (OTC) in most pharmacies without a prescription and is commonly used to treat athlete's foot (a fungal infection of the foot, or tinea pedis) in humans. However, miconazole (usually a solution containing 1.15% miconazole nitrate) and thiabendazole (usually a solution containing 40 milligrams of thiabendazole per milliliter) are available by prescription only. The medication is applied to the affected area as directed by the veterinarian (usually once or twice daily for 2-4 weeks). If the infection does not clear up by the end of the treatment, or if side effects occur, the veterinarian should be contacted immediately.
  • Antifungals taken by mouth: Oral treatment (or combined treatments taken by mouth and those applied to the skin) with an antifungal medication is usually recommended for cats with lesions or widespread ringworm infections. Veterinarians may also recommend oral antifungal medications if a cat with ringworm does not response to treatment to the skin.
  • Itraconazole (Sporonox®) and griseofulvin (Fulvicin®) are approved by the U.S. Food and Drug Administration (FDA) for treating ringworm in animals. Itraconazole is usually the preferred treatment. Other antifungals that are intended for human use, such as terbinafine (Lamisil®), may also be prescribed by veterinarians to treat ringworm. However, use is considered "off-label" because they are not FDA-approved for treating ringworm in animals.
  • Griseofulvin (Fulvicin®): Griseofulvin is a prescription-only antifungal medication that prevents fungal cells from dividing and multiplying. Once the fungus stops growing, the cat's own immune system can clear the infection. Griseofulvin is given at a dose of 25 milligrams per pound of body weight (about 50 milligrams per kilogram). It must be given with a fatty meal (such as tuna packed in oil) for the medication to be effective.
  • Griseofulvin was the standard treatment for ringworm for decades and is somewhat less expensive than itraconazole (Sporonix®). However, its use is becoming less common, due to its known side effects, which may be fatal. Gastrointestinal side effects, such as nausea, diarrhea, and vomiting are very common, especially in kittens. Griseofulvin should not be given with phenobarbital, a seizure medication, which makes griseofulvin harder to absorb and less effective.
  • Griseofulvin is known to cause birth defects, so it should not be given to female cats that are pregnant or lactating, that is, producing milk to feed their young. It should also not be used in male cats that are used for breeding purposes. Griseofulvin may cause serious liver damage, so it should not be given to cats that have liver problems. Griseofulvin is also dangerous to use in ill cats, especially those with feline immunodeficiency virus (FIV, or feline AIDS), because it can further weaken a cat's immune system.
  • Itraconazole (Sporonox®): Itraconazole is a prescription-only antifungal medication that weakens fungal cell walls, causing the fungus to die. It is usually given at a dose of 5-10milligrams per kilogram by mouth once daily (about 25 milligrams daily for an adult cat). Itraconazole can be expensive, but it has fewer known adverse effects than ketoconazole or letoconazole. Thus, it is the preferred oral antifungal medication for treating ringworm in cats.
  • Although oral itraconazole is generally safer than the alternative (griseofulvin), it still carries a risk of adverse effects. Like griseofulvin, itraconazole should be given with food and should not be used in female cats that are pregnant or lactating. It should also not be used in male cats that are used for breeding purposes. Itraconazole may cause serious liver damage, so it should be used cautiously in pets with liver problems. Itraconazole can interact with many drugs, including antacids and anticoagulants, so the veterinarian should be informed of all of the other medications (if any) the cat is taking.
  • Fluconazole (Diflucan®) or ketoconazole (Nizoral®, Ketosidin®, Panfungol®): Fluconazole and ketoconazole are related prescription-only antifungal medications that stop fungal growth by preventing the outer layer (wall) of fungal cells from forming. These drugs are not approved by the FDA for use in animals, but they are often prescribed by veterinarians to treat ringworm and other fungal infections. They are generally prescribed at a dose of 2.2-13 milligrams per pound of body weight and given once or twice daily for up to several months.
  • Fluconazole and ketoconazole can interact with many drugs, including antacids and anticoagulants, so the veterinarian should be informed of all the other medications (if any) the cat is taking. Fluconazole and ketoconazole should not be given to pregnant or nursing cats. Ketoconazole does not seem to be very effective against Microsporum canis, the most common cause of ringworm in cats. It may also harm the cat's liver. Therefore, many veterinarians discourage the use of ketoconazole in cats despite its widespread use. Fluconazole appears to be more effective than ketoconazole for some forms of ringworm, but this is not entirely clear.
  • Lufenuron (Program®): Program® is a medication that is given once monthly to control fleas, and some veterinarians have used higher doses to treat ringworm. However, most veterinarians now believe that the drug is not effective for treating ringworm. Thus, Program® is generally not recommended as a treatment for ringworm.
  • Surgery: Complicated cases of ringworm, such as deep (subcutaneous) infections, may develop into a condition known as dermatophytic pseudomycetoma. The lesions may become large ulcers or open sores with thick discharge. Severe lesions may need to be removed with surgery.
  • Vaccination: A vaccine, FeloVax MC-K, has been introduced for the treatment or prevention of ringworm in cats. However, the effectiveness of this vaccine is not certain. Veterinary experts believe that the vaccine only prevents symptoms from worsening and does not prevent the infection itself. Therefore, vaccinated cats may still be carriers of ringworm and transmit the disease to humans or other animals. Use of this vaccine by itself is generally discouraged.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.