Secondary hyperparathyroidism and calciphylaxis symptoms; an update with lab values

Last month I described some health difficulties that I had been experiencing for quite awhile. Lab tests that had been drawn earlier in the summer suggested that the problem might be secondary hyperparathyroidism and I also had been having a number of odd symptoms including calciphylaxis that can be associated with secondary hyperparathyroidism but is a more common in end stage renal disease (ESRD) particularly for patients on dialysis who were also receiving calcium supplements (and calciphylaxis is associated with eight times increased morbidity in ESRD). In the second post I reported that I was already feeling much better on the treatment plan that I had developed for myself.

I started taking 300-500 mg calcium per day based on the theory that the symptoms were related to calcium deficiency secondary hyperparathyroidism. I also increased my protein intake except for eliminating egg white and tree nuts from my diet – as a precaution in case I had developed autoimmune sensitivity to those protein sources which I had been eating more regularly than other foods during a time when I wasn’t eating enough overall. A steroid skin cream containing Triamcinolon 0.5% applied twice a day helped the calciphylaxis like skin sores heal. And I started taking 40 mg Benicar/olmesartan per day in an attempt to modify the low vitamin 25 D and vitamin 1, 25 D > 42 pg/mL. Levels of vitamin 1, 25 D above 42 pg/mL signals the bones to release calcium and phosphorus and can increase risks of osteoporosis and soft tissue calcification. [1, 2: MPKB- Science behind olmesartan (Benicar).]

  1. Secondary hyperparathyroidism, calcium deficiency and irritability, 
  2. Elevated parathyroid hormone (PTH) and 1-25-D, calcium deficiency and calciphylaxis, 

The 6/15/15 lab values:

  • Parathyroid hormone level – PTH Intact – 154.1 pg/mL — normal range: [15.0-75.0]
  • Calcium – 8.8 mg/dL — normal range: [8.4-10.2]
  • Phosphorus was not ordered but would probably be good to check.
  • Vitamin D, 25 – 10.9 ng/mL — normal is considered: [30.0-100.0]
  • Vitamin D 1, 25 – 55 pg/mL — normal is considered: [18-72] (the active hormone D)

The 10/12/2015 lab values:

  • Parathyroid hormone level — PTH Intact — 66.1 pg/mL — normal range: [15.0-75.0]
  • Calcium — 9.3 mg/dL — normal range: [8.4-10.2]
  • Serum Phosporus — 3.6 mg/dL — normal range: [2.5-4.5]
  • Vitamin D, 25 — 18.4 ng/mL — normal range: [30.0-100.0]
  • Vitamin D 1, 25 — 36  pg/mL — normal range: [18-72] (the active hormone D)

So I started taking calcium supplements and 40 mg of Benicar on September 23 and on October 12 my parathyroid hormone level is back within the normal range. My active 1, 25 D is below the osteoporosis inducing level of 42 pg/mL and my inactive vitamin 25 D level increased from 10.9 to 18.4 ng/mL — even though I am not taking vitamin D supplements but I do get more than fifteen minutes of sunshine most days of the week. My calcium level is still within the normal range but it went up from near the low end of the range to closer to the middle, from 8.8 to 9.3 mg/dL.

During the last couple days the calcium supplements have been causing me to have increased muscle cramps and irritable mood and I found that soaking in Epsom salt tub or footbath helped reduce the muscle cramps and bad mood. So the balance between magnesium and calcium intake is important and intestinal malabsorption of magnesium may be part of the underlying problem.

Overall I’m feeling much better than I was in early September before I started taking the calcium supplements. I had been having a racing heartbeat on very little exertion (like tachycardia) and for a long time I had been having an internal jittery-ness that felt like a bottled up pressure that needed a release valve or pinprick to pop the overfull bubble. The painful skin sores had been a fairly new and very unpleasant development. So yippee I have skin again! And I can walk downstairs without having to pause to let my heart rate slowdown.

I still have autoimmune thyroid antibodies but my thyroid hormone and thyroid stimulating hormone levels are within normal range — 10/12/2015 lab values:

  • Serum Thyroglobulin AB — 41 IU/mL — normal range: [0-40]
  • Serum Thyroid Peroxidase AB — 301 IU/mL — normal range: [0-34]
  • T3 Free Serum — 4.09 pg/mL — normal range: [2.77-5.27]
  • T4 Free Serum — 1.14 ng/dL — normal range: [0.65-1.86]
  • Serum Thyroid Stimulating Hormone — 1.20 mIU/L — normal range: [0.46-4.68]

To prevent autoimmune hyperthyroid symptoms I have been avoiding foods containing gluten and iodine sources since receiving the diagnosis in 2013. The gluten protein molecule contains a section called gliadin that is chemically similar to the thyroid hormone. The chemical similarity between gliadin and the thyroid hormone may allow autoimmune thyroid antibodies to develop in susceptible individuals, so avoiding gluten in the diet may be helping reduce or prevent the production of the autoimmune thyroid antibodies.

–The bad news – my endocrinologist still wants me to take a vitamin D supplement for my low vitamin D. [previous post: Whether to be compliant or to be healthy seems like an easy question to answer

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

 

Neuraminic acid was known first as sialic acid

Neuraminic acid, or sialic acid as it was first called, is a monosaccharide with nine carbons. It has a negative electric charge which gives compounds containing it a negative charge. This is useful for keeping molecules like red blood cells from getting too near to each other. The negative charge on the surface glycoproteins repels the red blood cells from each other or from the walls of blood vessels which also have compounds containing sialic acid.

Mature red blood cells have an active life for about seven days.  White blood cells remove older red blood cells and de-sialylation of the surface proteins is one way the older cells are identified. Cancer cells with the ability to produce excess surface sialyation may have an increased chance to metastasize and turn up somewhere else in the body. [13]

Our bodies need to be healthy and well enough nourished overall to keep the whole system working. The neuraminic acid is produced within our cells from other chemicals in a series of membranous channels called the endoplasmic reticulum and the golgi apparatus. The channels have embedded enzymes along the way somewhat like an assembly line in a factory. We can not just eat more sialic acid in our diet and have it show up on our cell surfaces – we have to be healthy enough and well enough nourished over all in order to be able to manufacture our own supply of sialic acid. All of the different enzymes within the assembly line like system of the endoplasmic reticulum and Golgi apparatus would have to be present and working which would mean trace minerals such as zinc might be essential for producing neuraminic acid/sialic acid.

Therapeutic glycoproteins are being developed and the problem of just the right amount of sialylation is one of the hurdles being studied. [2] In addition to the negative charge sialic acid tends to stabilize and stiffen the protein portion of the glyco-compound.  The proteins that line vessels were described to be somewhat like bottle-brushes; the protein being somewhat like the sturdy wire handle of the brush and with the negatively charged sialic acid acting as bristles that electrically repel other molecules of sialic acid. [1]

/This article was originally posted on 8/21/2013./ /Disclaimer: Information presented on this site is not intended as a substitute for medical care and should not be considered as a substitute for medical advice, diagnosis or treatment by your physician./

More recent research from the scientists at the University of Zurich, regarding sialic acid, found an association between the presence of autoimmune disease and reduced levels of sialic acid on the individual’s antibodies, which are important for the body’s immune cells to be able to recognize and remove infected or foreign or decaying cells: “Specific Sugar in Antibodies Structure Determines the Risk of Autoimmune Diseases,” Oct. 7, 2015, [molecularbiologynews.org]

References:

  1. S.A. Brooks, M. V. Dwek, U. Schumacher, Functional and Molecular Glycobiology, (BIOS Scientific Publishers, Ltd., 2002), Amazon.
  2. Bork K, Horstkorte R, Weidemann W., “Increasing the sialylation of therapeutic glycoproteins: the potential of the sialic acid biosynthetic pathway.” J Pharm Sci. 2009 Oct;98(10):3499-508. doi: 10.1002/jps.21684.  [ncbi.nlm.nih.gov]
  3. R. T. Almaraz, et. al., “Metabolic Flux Increases Glycoprotein Sialylation: Implications for Cell Adhesion and Cancer Metastasis.” Mol Cell Proteomics. 2012 July; 11(7): M112.017558. Published online 2012 March 28. doi:  10.1074/mcp.M112.017558 [ncbi.nlm.nih.gov]

 

Elevated parathyroid hormone (PTH) and 1-25-D, calcium deficiency and calciphylaxis

I’m feeling so much better after only two days of calcium supplements that I feel like throwing a party. Fatigue is tiring. Replenishing supplies of a trace nutrient deficiency can help resolve symptoms so quickly that it feels like a miracle. I’ve experienced rapid resolution of symptoms in the past when I had a problem with low B1 intake [2] that was due to a low intake of everything – I had an anorexic appetite at the time which I later found may have been due to an underlying zinc deficiency.

The anorexic appetite symptom resolved when I added zinc and B6 supplements after reading about pyroluria. Pyroluria is not yet treated or accepted by most main stream health practitioners but it is believed to be due to a genetic defect affecting an enzyme that helps break down old hemoglobin for reuse and recycling. Molecules of B6 and zinc are involved in the process and in normal health would be recycled but if the person has the genetic modification than the B6 and zinc is released in urine rather than being retained for reuse. [1]

Calciphylaxis is a symptom that is not well understood but is associated with severe hyperparathyroidism. It is a rare symptom in the general population but is seen more frequently in people with end stage renal disease. When the kidneys are no longer able to make normal amounts of 1, 25 dihydroxy D the plasma calcium levels can drop. And to try to maintain normal calcium levels the body responds by having the parathyroid glands increase production of parathyroid hormone which in normal health would tell the kidneys to activate more 1, 25 dihydroxy D which would then tell the intestines to absorb more calcium and would tell the bones to release more calcium from storage. [3] But in end stage renal disease there aren’t functional kidneys and the elevated levels of parathyroid hormone can cause other symptoms like irregular or rapid heart rate or in severe cases calciphylaxis may occur.

Calciphylaxis “is a poorly understood and highly morbid syndrome of vascular calcification and skin necrosis.” [4] The word calciphylaxis may refer to the syndrome or to the patches of necrotic (decaying) tissue which may occur internally on the surface of bones or externally in patches on the surface of the skin. The decaying areas occur more commonly on the lower legs. The areas can first appear as reddish or purplish bruised areas that may feel like they have small hardened nodules under the skin. The skin surface may be itchy and eventually may break down to be an open wound that doesn’t heal easily. There is a risk of skin infections developing in the open wound which can become severe enough to cause sepsis and death as the patches of decaying skin or bone areas do not heal well.

Calciphylaxis is more of a risk with end stage renal disease but it has also been found in people who had normal vitamin D levels and normal kidney health. And “high dose vitamin D administration is capable of inducing STC (soft tissue calcification) and calciphylaxis in murine models. [56, 57] In an attempt to reestablish normal calcium-phosphate homeostasis, ESRD patients receive vitamin D analogs that could theoretically increase their risk of calciphylaxis if hyperphosphatemia and hypercalcemia ensued. [58, 59]” [3]

“Experimental sensitizing events and agents included nephrectomy and exposure to parathyroid hormone (PTH) and vitamin D. Substances used as challengers included egg albumin and metallic salts. Calciphylaxis was the end result.4  – from a 1962 study, abstract is free. [4.5]

Eczema is something I’ve had to cope with since infancy along with severe congestion problems. The images of calciphylaxis do not look quite like the itchy patches that I’ve been dealing with for a few months but they resemble the images of calciphylaxis more than they look like the patches of eczema that I’ve had off and on since infancy.

The fun thing about autoimmune disease is all the nifty weird symptoms that you get to experience – and which are so rare that many physicians don’t want to see you or the symptoms in their office –  because those unusual symptoms must be covered by some other specialist’s field. This quote said it well:  Calciphylaxis “is a poorly understood and highly morbid syndrome”. [4]  Maybe I wouldn’t want that syndrome to be my professional responsibility either, and maybe it is just too bad for me that it might be my personal responsibility whether I like it or not. However maybe I’m lucky that my professional and personal experiences have left me more informed about odd symptoms than other health professionals, and therefore I may possibly be better equipped to cope with the odd symptoms.

Thankfully just two days of calcium supplements (while continuing to avoid excess vitamin D and sunshine) have left me feeling less itchy and my open wound areas are beginning to form scabs instead of remaining open wounds with seeping plasma.

In normal physiology the activated hormone form, 1, 25 dihydroxy D, is typically found in elevated amounts only in areas of rapid growth or membrane breakdown, such as in scab formation by white blood cells, [6], and within the placenta during pregnancy. [5] – Maybe elevated 1, 25 dihydroxy D can also be an underlying problem causing calciphylaxis rather than it being due only to deficiency of the inactive vitamin 25-D or the active hormone 1, 25-D.

Yes, my vitamin 25-D level was low at 10.9 ng/mL and anything below 20-30 is considered deficient and I was recommended by my endocrinologist to take vitamin D and calcium. However my hormone 1, 25-D level was 55 pg/mL which is considered within the normal range by mainstream medicine (range: 18-72 pg/mL). Specialists in vitamin D/hormone D metabolism would consider levels of 1, 25-D above 42 pg/mL to be elevated enough to be an osteoporosis risk because above that level the bone cells start releasing calcium, phosphorus, and magnesium into the blood supply instead of absorbing the minerals from circulating plasma and storing them for increased bone strength or for later use. [7]

Calcium and magnesium are so important as electrically active ions that the body has a variety of ways to maintain the blood levels of the two minerals within a narrow range. Blood tests for calcium and magnesium levels may be normal even though there is inadequate dietary intake because the bones can act like a savings account at the bank. In normal health if the blood plasma dips a little low for calcium or magnesium, more minerals are released from the bone, and if levels are getting too elevated than more would be excreted by the kidneys, less would be absorbed by the intestines, and more would be absorbed into the bones for long term storage.

However if 1, 25-D levels are elevated above 42 pg/mL than even if calcium levels were elevated in the blood the abnormally elevated 1, 25-D level would still be telling the bones to release more calcium and for the intestines to absorb more calcium which would lead to way too much calcium for the kidneys to be able to excrete during good health let alone during renal disease (elevated blood calcium would normally signal the body to make more of the enzyme that de-activates 1, 25-D but some microbial pathogens seem to bypass our immune system by disabling our body’s ability to make that enzyme). Adequate magnesium is necessary for the kidneys to be able to excrete calcium and elevated 1, 25-D causes the intestines to preferentially absorb calcium rather than magnesium.

And it turns out that eczema is an autoimmune disease so I may have been trying to figure out how to feel healthier since I was a baby. [8]

My mother gave up trying to spoon feed me. She said I would spit food into my hand, look at it, then put it back into my mouth before swallowing. She put cookie sheets around my highchair to block the mess (and possibly the view) and left me to feed myself from a fairly early age. I still don’t like to be fed by others, whether it’s just a taste of something on a spoon, or whether it is a dietary supplement that might cause my underlying autoimmune condition to worsen.

I’m feeling less itchy and the open wound areas are beginning to heal. The tachycardia problem is better, (having a rapid heart rate with little exercise), and an internal jittery feeling is less. The problem with trying to medicate a nutrient deficiency with psychiatric drugs is that the psychiatric drug can’t take the place of a nutrient in metabolic pathways. For years now physicians, family members and friends have been encouraging me to just take the psychiatric medication as prescribed and stop complaining about psychosomatic symptoms and imaginary problems. But the psychiatric medications that were offered all had bad side effects and while some helped slow down whirling thoughts they didn’t make the thoughts less sad or negative and they didn’t take away the internal feeling of tension.

I felt like a coiled spring internally, very jittery all the time and unable to concentrate as well as normal. I knew something was wrong and I knew feeling like a coiled spring all the time wasn’t an imaginary delusion and the feeling didn’t go away with the three different anti-psychotic medications that physicians or psychiatrists had me try.

We can’t afford ineffective health care as individuals or as a global community. Harsh medications that cause side effects in humans are probably also causing side effects in the health of the environment once the chemicals become waste products. Expensive pharmaceuticals that cause side effects in patients without addressing the person’s underlying condition are primarily helping the pharmaceutical company and may be causing the person’s condition to worsen over the long term.

Low protein intake may be involved as hypoalbuminemia is a risk factor for calciphylaxis. [9 -includes images of calciphylaxis wounds.] I don’t know for sure that my weird skin patches are early stage calciphylaxis wounds but I hadn’t been eating much protein in the weeks before my bruise like symptoms became more like open painful sores and I have probably had a low calcium intake ever since I started limiting my use of dairy products. I did take calcium supplements in the past but my chronic muscle cramps became a problem and the calcium seemed to make it worse. More recently not eating much for a couple weeks would have further reduced my intake of calcium from the sources such as sesame seeds and tree nuts that I normally do eat. Just two days of calcium supplements have helped me feel calm internally instead of jittery (I’m using about 500 mg spread out through the day in low doses). I’m also eating a more adequate amount of protein and other foods and the odd skin patches have less of a burning itchy painful feeling and the areas are starting to heal rather than remain open seeping wounds.

Twenty three and a half to fifty million Americans may have one or more types of autoimmune diseases. [10] So I don’t think that I am the only one who has been regularly told that her symptoms must all be imaginary and to go see a talk therapist or to go get stronger and stronger psychiatric medications. We can’t afford ineffective health care because it doesn’t help the patient and the medications may be bad for the environment once they become waste products. Calcium is a natural mineral that is not harmful to the environment and it is inexpensive.

6/15/15 lab values:

  • Parathyroid hormone level – PTH Intact – 154.1 pg/mL — normal range: [15.0-75.0]
  • Calcium – 8.8 mg/dL — normal range: [8.4-10.2]
  • Phosphorus was not ordered but would probably be good to check.
  • Vitamin D, 25 – 10.9 ng/mL — normal is considered: [30.0-100.0]
  • Vitamin D 1, 25 – 55 pg/mL — normal is considered: [18-72]

I did schedule an appointment with a physician but it will be a few weeks and the tachycardia was not pleasant, the internal coiled spring feeling made it hard to concentrate and hard to not over react to outside events, and the open seeping sores were painful.

I don’t see why I should not try to take care of myself rather than having to follow the orders/recommendations of physicians or psychiatrists when they are working from the premise that “we don’t know what is causing your symptoms or how to cure them but we would really like you to take these harsh medications anyway because we guess that they might reduce some of your symptoms – and please just ignore the negative side effects that the medication is actually adding to your problems because we guess that the medication might help reduce some of the symptoms that you originally came to see us about.” That is an example of circular logic based on guesses and I’m not buying it anymore now than I did when I was sitting in a highchair covered with eczema, milk based formula, and baby food.

Medications can be life saving and certainly are a modern miracle but nutrients will always be our body’s building blocks. Providing medicines to reduce symptoms of nutrient deficiency will only prolong the time the body is left without adequate nutrients and some deficiencies can cause long term damage that is not reversible once the nutrient is added back to the diet. A long term deficiency of Vitamin B12 can cause irreversible nerve damage, [11], and it turns out that calcium or vitamin D deficiency can cause osteoporosis if the deficiency is chronic enough to lead to secondary hyperparathyroidism.

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Bibliography:

  1. Pyroluria: anxiety and deficiency of B6 and zinc
  2. Thiamin: people with anorexia or alcoholism are more at risk for vitamin B1 deficiency
  3. Julia R Nunley, MD, “Calciphylaxis,” Medscape, July 21, 2014, [4-Overview,  4.5-Pathophysiology]
  4. Liu NQ et al., “Vitamin D and the regulation of placental inflammation.” J Immunol. 2011 May 15;186(10):5968-74. doi: 10.4049/jimmunol.1003332. Epub 2011 Apr 11, [5]
  5. Eleftheriadis T., et al., “Vitamin D receptor activators and response to injury in kidney disease.” JNephrol 2010: 23(05): 514-524 [6]
  6. Meg Mangin, Rebecca Sinha, and Kelly Fincher, “Elevated 1,25(OH)2D appears to be evidence of a disabled immune system’s attempt to activate the VDR to combat infection.” Inflamm Res. 2014; 63(10): 803–819., 2014 Jul 22. [7]
  7. by Charlotte LoBuono, “For the First Time, Study Proves Eczema Is an Autoimmune Disease.” Jan. 5, 2015, [8]
  8. Dermnet NZ, “Calciphylaxis,” [9]
  9. AARDA, “Autoimmune Statistics,” [10]
  10. Vitamin B12 deficiency can cause long term nerve degeneration.” August 21, 2013, [11]

Additional references about risk factors for calciphylaxis in dialysis patients:                   These articles are not mentioned in the text above and the research studies are not about secondary hyperparathyroidism but they do suggest that adequate protein intake may help reduce risk for calciphylaxis and that having elevated phosphorus or alkaline phosphatase levels may increase the risk.

  • Zacharias JM, Calcium use increases risk of calciphylaxis: a case-control study. Perit Dial Int. 1999 May-Jun;19(3):248-52.  [link] *This small research study is about calciphylaxis occurring in patients on kidney dialysis – calcium supplements were found to increase risk of calciphylaxis, while iron intake may have been protective, vitamin D intake made no difference between groups, (n=8 women). The study group’s parathyroid hormone and albumin levels were not found to be significantly different then the lab values of the control group of dialysis patients who did not have calciphylaxis. The conclusion includes the suggestion that “use of calcium salts as a phosphate binder” during dialysis might have something to do with the increased rate of calciphylaxis that was being seen at dialysis centers at the time.
  • A Rauf Mazhar, et. al., Risk factors and mortality associated with calciphylaxis in end-stage renal disease.  Kidney International (2001) 60, 324–332; doi:10.1046/j.1523-1755.2001.00803.x [link] *This study (n=19) found an increased risk for calciphylaxis in dialysis patients who were female, and when the patient had elevated phosphorus and/or alkaline phosphatase levels and/or low serum albumin levels. “Calciphylaxis independently increased the risk of death by eightfold.”
  • Doweiko JP, Nompleggi DJ. The role of albumin in human physiology and pathophysiology, Part III: Albumin and disease states. JPEN J Parenter Enteral Nutr. 1991 Jul-Aug;15(4):476-83. [link] *Albumin is the main protein found in blood plasma and having low albumin levels is also associated with poor wound healing and an increased risk of death.
  • Albumin levels can be low even when there is adequate protein intake in the presence of edema. Fluid imbalance can make the albumin values seem lower due to the change in concentration of the blood serum rather than due to changes in diet. However edema and low protein intake may both be problems. A low protein intake can increase the risk for edema.
  • Pickwell K, Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer. Diabetes Care. 2015 May;38(5):852-7. doi: 10.2337/dc14-1598. Epub 2015 Feb 9. [link] *Severe edema is also a sign of ill health. the presence of edema increased the risk of poor wound healing and the need for amputation for patients with a diabetic foot ulcer.

 

Glycocalyx – What’s Mucous All About?

*This post was written in 2010 as the second chapter of a book that I had started writing about nutrition and my own struggles with health. I’ve shared other sections from the book but I had never shared the following chapter because of the taboo nature of nasal mucous — common sense suggested that it is just too controversial a topic to write about nasal congestion — but snot’s all right, we need it to help stabilize the thin layers of membranous cell walls that surround all of our cells and organs.

A more recent article from Harvard.edu: All About That Mucus: How it keeps us healthy.

Good behavior is attained at a young age.”                            – Burkino Faso proverb

[1, African wisdom desk calendars, Annetta Miller]

To sniff or blow? When is nasal discharge too much of a good thing? When allergies cause thin watery discharge that continually drips or causes congestion and difficulty breathing. Nasal discharge does typically drain to the back of the throat where it may be swallowed naturally. Childhood is too often filled with shaming about runny noises and dirty faces or sleeves or fingers. Is picking it and eating it a disgusting and filthy habit or an oral vaccination boost to the immune system? Traditional Eskimo cultures conserved fluid and heat by picking and eating it. [3] My mother tried to teach me good manners, as mothers do in Africa and all around the world, but I had allergies and wasn’t good at always having a fresh tissue with me.

Just what is snot, or more politely – mucus/mucous? It may be described as a freeform gelatinous matrix of glycolipids and glycoproteins that covers our internal surfaces and is known as the glycocalyx.

Good snot, bad snot, it’s not all the same. Healthy mucous layers are two millimeters thick — about the same width as a piece of thread or single strand of hair. Obviously we can produce a lot more than that in response to sickness or allergies. Over the course of my life I have had a lot of experience with nasal mucous and congestion. Most of my childhood was spent breathing through my mouth because I was so congested, so often. On a good day I would be able to breath through one or the other nostril but usually both were congested – and messy. Eventually I learned how to tell whether I needed antibiotics or more antihistamine based on the color, texture, and smell of my nasal mucous.

Gross yellowish-green mucous that had a rotten smell and a stringy, sticky texture meant go to the doctor and get antibiotics because the congestion has become a lung infection.

Thin, watery, clear or whitish mucous is produced in large amounts during allergy attacks. Mucous produced due to allergies didn’t have smell associated with it in my experience. The thin fluid mucous produced in such large amounts during allergies may be helping the body carry the allergen debris up and out of the lungs. Constantly suppressing this response with medications may produce short term symptom relief, however in the long run using medications that dry up mucous may be allowing the allergens full access to deeper lung tissue made accessible through the artificially opened airways. The mucous is part of our body’s defense system.

Coughing and sneezing and moving the mucous out may be better for your health than regularly using an over the counter medication. Cleaning up the environment and removing dust and allergens would also probably be better for your health, when possible, ie: you can stop smoking but you have little control over smog alert days beyond wearing a face mask and voting for environmental protection; or you can vacuum and wash your bedding weekly but you may not be able to give away the family pet as easily.

I tried a nasal steroid spray for the first time recently and discovered myself producing a brand new type of mucous. My airways felt more open than usual but I also developed a new cough that felt like I had something stuck in my throat that I was choking on, like a cat with a hairball. When I successfully cleared the mucous, it appeared a typical whitish color but the texture was much stickier and slimier — more like my childhood toy can of Slime. I stopped using the steroid nasal spray fairly quickly; free flowing snot’s all right — sticky, slimy snot is not — it isn’t able to be expelled as easily. Free flowing mucous allows the body to carry allergens and pathogens up and out of the lungs when the mucous is thin enough to allow productive coughing.

Occasionally I would blow my nose and find little round globule of clear semi-solid mucous — fascinating for an easily amused and not easily disgusted child — they looked just like a gelatin dessert without the bright food coloring. The chemical structure of mucous is similar to a gelatin dessert or fruit jams and jelly. Fruit jams and jelly thickens when the pectin fiber is cooked. Heating the pectin fibers cause them to change shape and form the semi-solid structure of the jam or jelly. Gelatinous mixtures are all fairly chemically unstable and minor changes in acidity or hydration may cause changes in the structure or cause the gelatinous mixture to dissolve back into a fluid.

Chemical mixtures are made when we cook food. Tiny chemical changes can produce big changes in a “free-form gelatinous matrix.” You could experiment by adding a little lemon juice or carbonated beverage to a bowl of a gelatinous dessert or scoop of jam. The acidity should cause the gelatinous structure to break apart and get watery looking again.

The glycocalyx may act a little like glue between cells or like a sealant coating pipes in a plumbing repair. The jelly-like glycocalyx helps protect our inner surfaces around cells and in the lining of blood vessels and throughout the intestinal tract. A healthy glycocalyx layer may help prevent allergens from leaking through the intestinal lining into the bloodstream. Pectin is important for making jam or jelly and eating fiber rich foods everyday is probably just as important for maintaining a healthy glycocalyx. Good sources of fiber include any whole plant foods such as: vegetables, fruits, mushrooms, whole grains, beans, nuts and seeds, and herbs and spices. There is also a healthy type of fiber in edible insects called chitin.

Happy dining!

— on fiber rich foods of course.     ;-)

Read more about which types of fiber are beneficial within the GI tract and which types of foods and fiber might help with nasal congestion:  Nasal congestion and fiber; a glycocalyx clarification

A gelatin dessert.

*Having enough water every day is also important for healthy mucous. And the electrically active minerals sodium, potassium, calcium, and magnesium are also important in fluid balance and healthy mucous .

Read more: Electrolytes are essential, magnesium helps protect brain cells 

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Bioslime is another word that is used specifically to describe the gelatinous glycocalyx layer produced by pathogens on the surfaces of transplant devices and tubing used in patient’s wounds for drainage or tube feedings.