Rightways: Think Global, Act Local; Change & Grow Rich; Sow as You Reap & Soar High!
Follow along using the transcript.
Go ahead, get the giggles out of the way; we’re about to take a close look at urine, and in such conversations, bathroom humour is often the number one byproduct.
But once you’re through, perhaps you can also relieve yourself of the notion that urine is simply material for third-grade (primary school) punchlines – or even simple at all.
Urine is the result of a fascinating and complex system – of which the kidneys are the star – that evolved to keep our internal systems in balance, said University of Alabama at Birmingham cardio-renal physiology and medicine co-director and professor of medicine Dr David Pollock.
“It’s basically what keeps your cells alive,” he said.
“It maintains the internal environment of your entire body.”
Which makes understanding what’s in your pee important.
And that begins with understanding how it’s made.
Kidney control
Urine is created in the kidneys, whose job is usually described as filtering blood.
But the kidneys do much more than that, Prof Pollock said.
“There’s a very close relationship between the heart and the kidneys,” he said.
The kidneys control how much sodium and water your body retains.
That water equates to the volume of blood you carry, and the greater the volume, the higher the pressure will be.
And that makes the kidneys the primary organ in charge of blood pressure.
“And basically, the kidney is responsible for making sure that it doesn’t get too high,” said Prof Pollack.
The kidneys control that volume by regulating sodium.
When sodium is retained, blood volume goes up.
The kidneys also regulate potassium, which helps limit the effects of sodium.
Both are electrolytes, and the kidneys maintain electrolytes at “very, very precise concentrations,” said George Washington University School of Medicine and Health Sciences professor of medicine Dr Janani Rangaswami.
Those concentrations can significantly affect health, said the chief of nephrology at the Washington VA Medical Center.
Electrolyte imbalances such as low sodium levels, can lead to seizures.
High or very low potassium could lead to heart rhythm problems.
The kidneys also balance the blood’s acidity and filter out waste products, as well as some drugs, from the bloodstream.
The result of all this balancing and filtering is urine.
It flows from the kidneys through the ureters to the bladder, where it’s stored until the next commercial break, rest area or whenever it’s your turn in the bathroom.
Depending on a person’s size, the kidneys might filter around 48 gallons (181.7l) of blood each day, Prof Rangaswami said.
That might yield up to a couple of quarts (1.9l) of urine, although it’s important to not fixate on how much urine you produce, she said.
Patients sometimes get the mistaken notion that “if they don’t have a certain urine output, that’s a bad thing, which is not true,” she said.
In reality, the amount can be “all over the place”, varying because of how much fluid you’re drinking, the health of your kidneys and the medications you may be taking.
Urine composition
The exact composition of urine can vary day to day as well, she said.
But most of it – from 91% to 96% – is water.
Thousands of additional components have been identified in urine.
Prof Pollock and Prof Rangaswami say these are the most prominent ones:
“Your body takes the protein that you eat, it breaks it down and takes energy from it, and then you have urea left over,” Prof Pollock said.
Urea is mostly nitrogen.
It makes a good fertiliser, and bacteria break it down into ammonia.
This made urine valuable in pre-industrial times for everything from tanning leather to cleaning laundry.
In ancient Rome, urine was collected from public toilets, and it was taxed.
Ammonia is what makes urine smell the way it does, Prof Pollock said.
In addition to sodium and potassium, electrolytes include chloride, magnesium and calcium.
Phosphorus, another electrolyte, is what causes urine to glow under ultraviolet light.
This nitrogen-based compound is created when the body breaks down food and drinks that contain chemicals called purines.
Meats, seafood, beer, beans and some vegetables are high in purines.
Too much uric acid can lead to kidney stones or gout.
This waste product is created as muscles work and as protein is digested.
A test called UACR, which stands for urine albumin-creatinine ratio, looks for albumin, a protein that can be a warning sign of kidney disease, Prof Rangaswami said.
That, along with blood tests that look at creatinine or urea nitrogen levels, can give doctors a good idea of current kidney function and future risk for worsening kidney function.
That’s important, she said, because “kidney disease is a powerful risk enhancer for cardiovascular disease”.
Observing your pee
Although urinalysis is as old as medicine itself – Sumerian and Babylonian physicians recorded their findings on clay tablets 6,000 years ago, and Sanskrit texts from 100 BC noted 20 types of urine – your urine can tell you several things even without a test.
Urine gets its yellow colour from a chemical called urobilin, or urochrome.
But the intensity of that colour can vary depending on how much water you’ve been drinking.
“A lot of patients wrongly infer that if their urine looks concentrated, or if it’s dark yellow, that something is wrong,” Prof Rangaswami said.
“That’s just a reflection of the urine being more concentrated.
“And usually, drinking more fluids will make it clear.
“So there is no reason to get concerned every time you notice a slight change in the colour.”
Certain foods, such as beets and asparagus, and some medications can also cause exotic, but harmless, changes in the colour or smell of urine, she said.
But “any blood that is visible in the urine should always prompt a medical evaluation,” Prof Rangaswami said.
And persistent foamy urine could be a sign of too much protein in the urine.
This would be a symptom to discuss with a doctor, she said, particularly for someone who is at risk for kidney disease.
That would include people with diabetes, obesity or high blood pressure.
Prof Rangaswami encourages people to make sure their healthcare team is performing routine UACR tests to monitor kidney health, and to follow a doctor’s advice if they have specific conditions such as kidney stones.
But for the most part, healthy urine flows naturally from healthy kidneys, and kidneys are kept healthy by the same habits that help the rest of the body.
“In terms of diet, what would generally be considered a heart-healthy diet is also a kidney-healthy diet,” she said.
That would include eating less sodium and more fresh fruits, vegetables and whole grains, while backing off on heavily-processed foods.
Overall, Prof Rangaswami said, a conversation about urine is a good way to put the importance of kidney health in focus.
And “anything we can do to protect and keep the kidneys healthy is going to be good for their heart as well”. – By Michael Merschel/American Heart Association News/Tribune
MAGNESIUM is an essential mineral that plays a critical role in more than 300 bodily functions, including muscle and nerve function, energy metabolism, and maintaining bone integrity.
Unfortunately, a significant number of individuals experience magnesium deficiency, often stemming from inadequate dietary intake, increased stress levels or underlying health conditions.
Aside from traditional oral supplements, transdermal magnesium sprays offer a practical alternative to ensure sufficient intake.
These sprays utilise magnesium chloride, allowing for direct absorption through the skin.
This method avoids the digestive system altogether, which can often lead to discomfort when using oral supplements.
The magnesium chloride flakes in the spray are mixed with water to create a solution with a slightly oily texture.
This formulation is favoured for its high bioavailability, making it an effective option for delivery through the skin.
The concentration of magnesium chloride in various products varies, but most aim to provide an adequate therapeutic dosage per application.
The skin’s semi-permeable nature facilitates the passage of magnesium ions into the bloodstream.
However, several factors can influence how effectively the magnesium is absorbed:
> Skin condition
Hydrated or damaged skin tends to absorb magnesium more efficiently than healthy, unbroken skin.
Applying the spray after a warm shower can maximise absorption.
> Application duration
Leaving the spray on the skin for at least 20 minutes allows for greater penetration of magnesium ions.
> Concentration levels
Higher concentrations may enhance absorption, but could cause irritation for those with sensitive skin.
> Targeted application areas
Regions such as the feet, calves and abdomen are preferable due to their larger surface areas and thinner skin.
The skin’s lipid barrier may impede absorption, but formulations that include penetration enhancers could improve delivery, albeit with the risk of skin irritation in sensitive individuals.
health The following benefits of are magnesium: some of the > Enhancing and performance muscle recovery
Magnesium is particularly recognised for its role in supporting muscle recovery and performance.
It aids in muscle contraction and relaxation, while also reducing post-exercise inflammation.
Athletes and those experiencing muscle soreness can benefit significantly from topical application, which offers a swift alternative to oral supplementation by circumventing digestive absorption challenges.
> Improving sleep and promoting relaxation
Often referred to as “nature’s relaxant”, magnesium plays a key role in regulating melatonin and calming the nervous system.
The spray has gained popularity as a method for improving sleep quality, particularly for individuals struggling with insomnia.
A study indicated that topical application could enhance overall well-being and sleep, making it a practical alternative to pharmaceutical sleep aids.
> Managing stress and anxiety
Transdermal magnesium sprays are frequently marketed as a topical solution for alleviating stress and anxiety.
Some studies suggest that adequate magnesium levels can contribute to a balanced mood by influencing neurotransmitter regulation.
While magnesium may offer some relief from anxiety symptoms, it should not be considered a substitute for professional mental health treatment.
> Supporting bone health
Magnesium’s role in maintaining bone health is undeniable, as it helps regulate calcium levels and supports bone structure.
For individuals who cannot tolerate oral supplements, topical magnesium presents a convenient option that may help improve bone density, especially in those with conditions like osteoporosis.
> Enhancing hair and scalp health
A transdermal magnesium spray may also benefit scalp health by regulating oil production and alleviating inflammation, which can combat issues like dandruff and psoriasis.
Direct application can soothe irritation and promote hair growth through improved blood flow to hair follicles.
There is also anecdotal evidence suggesting benefits for conditions such as restless legs syndrome and sleep disturbances, but further scientific validation is needed.
Using a transdermal spray comes with notable benefits, compared to oral supplements, including:
> Avoiding digestive issues
Bypassing the gastrointestinal system helps prevent side effects, such as diarrhoea, making it a suitable option for individuals with sensitive stomachs or absorption difficulties.
> Localised pain relief
The spray provides targeted relief from pain and inflammation when applied to sore muscles or stiff joints, making it particularly beneficial for athletes or those suffering from muscle cramps and spasms, and muscle soreness after exercise.
Magnesium sprays may be useful for people with fibromyalgia too.
> Convenience
The ease of application allows users to incorporate it into their daily routine effortlessly.
When utilised correctly, magnesium sprays are generally safe.
However, users should be aware of potential mild side effects, which may include:
> Skin irritation: Some individuals may experience tingling or a burning sensation, especially on sensitive or compromised skin.
> Allergic reactions: Although rare, allergic responses to the ingredients can occur, making a patch test advisable.
It’s important to note that magnesium sprays are for external use only; ingestion can lead to elevated magnesium levels, although this risk is lower, compared to oral supplements.
While transdermal magnesium sprays show promise, their efficacy remain a subject of debate due to limited research, often involving only small participant groups.
A pilot study in 2017 suggested that topical magnesium can increase cellular magnesium levels, but the small sample size limits the reliability of these findings.
Moreover, the methods used to measure magnesium levels, such as hair mineral analysis, lack consistency.
Ongoing studies are focusing on several areas related to transdermal magnesium, including: > Standardised measurement techniques: Developing reliable methods for assessing skin absorption.
> Long-term safety and efficacy: Investigating the sustained effects of transdermal magnesium across various populations.
> Comparative analyses: Evaluating the effectiveness of transdermal versus oral magnesium supplementation. Future findings could elucidate the role of transdermal magnesium in clinical applications.
Before using a transdermal magnesium spray, consider the following recommendations: > Patch-testing: Conduct a patch test to check for skin sensitivity, especially for individuals with conditions like eczema. > Dilution for sensitivity :For those with sensitive skin, consider diluting the spray (e.g. a 10:1 ratio with water) to reduce discomfort.
When using the spray, apply it to clean, dry skin on wellperfused areas (e.g. arms, legs or abdomen).
Avoid application on broken or irritated skin.
For improved absorption, apply after a warm bath and massage gently without rinsing for at least 20 minutes.
Begin with five to 10 sprays per day and adjust based on individual tolerance.
First-time users should start with a lower dosage.
Use before bedtime or postactivity for targeted benefits while adhering to manufacturer guidelines.
Consult a healthcare provider if you have any medical conditions, such as kidney disease or heart issues, or if you’re on medications that affect magnesium levels.
Pregnant or breastfeeding women should also seek medical advice.
While mild side effects like tingling may subside over time, users should dilute the spray or apply it to less sensitive areas to minimise discomfort.
If irritation persists, discontinue use and consult a healthcare provider.
Ensure that you store the spray in a cool, dry environment, away from sunlight.
Opt for high-quality magnesium chloride products that avoid additives or fragrances to reduce the risk of irritation.
Individuals are encouraged to consult healthcare professionals before integrating transdermal magnesium into their wellness routines.
- Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@ thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
