“Know Huntington’s disease is a rare, inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain. Huntington’s disease has a wide impact on a person’s functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders.  Huntington’s disease symptoms can develop at any time, but they often first appear when people are in their 30s or 40s. If the condition develops before age 20, it’s called juvenile Huntington’s disease. When Huntington’s develops early, symptoms are somewhat different and the disease may progress faster.  Medications are available to help manage the symptoms of Huntington’s disease. But treatments can’t prevent the physical, mental and behavioral decline associated with the condition.”

MAYO CLINIC

Causes:

Huntington’s disease is caused by an inherited defect in a single gene. Huntington’s disease is an autosomal dominant disorder, which means that a person needs only one copy of the defective gene to develop the disorder.

With the exception of genes on the sex chromosomes, a person inherits two copies of every gene — one copy from each parent. A parent with a defective gene could pass along the defective copy of the gene or the healthy copy. Each child in the family, therefore, has a 50 percent chance of inheriting the gene that causes the genetic disorder.

Complications:

After the start of Huntington’s disease, a person’s functional abilities gradually worsen over time. The rate of disease progression and duration varies. The time from disease emergence to death is often about 10 to 30 years. Juvenile Huntington’s disease usually results in death within 10 years after symptoms develop.

The clinical depression associated with Huntington’s disease may increase the risk of suicide. Some research suggests that the greater risk of suicide occurs before a diagnosis is made and in the middle stages of the disease when a person has begun to lose independence.

Eventually, a person with Huntington’s disease requires help with all activities of daily living and care. Late in the disease, he or she will likely be confined to a bed and unable to speak. However, he or she is generally able to understand language and has an awareness of family and friends.

Common causes of death include:

• Pneumonia or other infections
• Injuries related to falls
• Complications related to the inability to swallow

Prevention:

People with a known family history of Huntington’s disease are understandably concerned about whether they may pass the Huntington gene on to their children. These people may consider genetic testing and family planning options.

If an at-risk parent is considering genetic testing, it can be helpful to meet with a genetic counselor. A genetic counselor will discuss the potential risks of a positive test result, which would indicate the parent will develop the disease. Also, couples will need to make additional choices about whether to have children or to consider alternatives, such as prenatal testing for the gene or in vitro fertilization with donor sperm or eggs.

Another option for couples is in vitro fertilization and preimplantation genetic diagnosis. In this process, eggs are removed from the ovaries and fertilized with the father’s sperm in a laboratory. The embryos are tested for presence of the Huntington gene, and only those testing negative for the Huntington gene are implanted in the mother’s uterus.

“Huntington’s disease (HD) is a progressive brain disorder caused by a defective gene. This disease causes changes in the central area of the brain, which affect movement, mood and thinking skills. The cause of this disease is the defective gene identified in 1993 causes virtually all Huntington’s disease.

The Huntington gene defect involves extra repeats of one specific chemical code in one small section of chromosome 4. The normal Huntington gene includes 17 to 20 repetitions of this code among its total of more than 3,100 codes. The defect that causes Huntington’s disease includes 40 or more repeats. Genetic tests for Huntington’s disease measure the number of repeats present in an individual’s Huntington protein gene.”

Alzheimer’s Association (https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/huntington-s-disease)

Huntington’s disease is an inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain. Huntington’s disease has a broad impact on a person’s functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders.

Most people with Huntington’s disease develop signs and symptoms in their 30s or 40s. But the disease may emerge earlier or later in life.

When the disease develops before age 20, the condition is called juvenile Huntington’s disease. An earlier emergence of the disease often results in a somewhat different set of symptoms and faster disease progression.

Medications are available to help manage the symptoms of Huntington’s disease, but treatments can’t prevent the physical, mental and behavioral decline associated with the condition.

Symptoms

Huntington’s disease usually causes movement, cognitive and psychiatric disorders with a wide spectrum of signs and symptoms. Which symptoms appear first varies greatly among affected people. During the course of the disease, some disorders appear to be more dominant or have a greater effect on functional ability.

Movement disorders

The movement disorders associated with Huntington’s disease can include both involuntary movement problems and impairments in voluntary movements, such as:

• Involuntary jerking or writhing movements (chorea)
• Muscle problems, such as rigidity or muscle contracture (dystonia)
• Slow or abnormal eye movements
• Impaired gait, posture and balance
• Difficulty with the physical production of speech or swallowing

Impairments in voluntary movements — rather than the involuntary movements — may have a greater impact on a person’s ability to work, perform daily activities, communicate and remain independent.

Cognitive disorders

Cognitive impairments often associated with Huntington’s disease include:

• Difficulty organizing, prioritizing or focusing on tasks
• Lack of flexibility or the tendency to get stuck on a thought, behavior or action (perseveration)
• Lack of impulse control that can result in outbursts, acting without thinking and sexual promiscuity
• Lack of awareness of one’s own behaviors and abilities
• Slowness in processing thoughts or ”finding” words
• Difficulty in learning new information

Psychiatric disorders

The most common psychiatric disorder associated with Huntington’s disease is depression. This isn’t simply a reaction to receiving a diagnosis of Huntington’s disease. Instead, depression appears to occur because of injury to the brain and subsequent changes in brain function. Signs and symptoms may include:

• Feelings of irritability, sadness or apathy
• Social withdrawal
• Insomnia
• Fatigue and loss of energy
• Frequent thoughts of death, dying or suicide

Other common psychiatric disorders include:

• Obsessive-compulsive disorder — a condition marked by recurrent, intrusive thoughts and repetitive behaviors
• Mania, which can cause elevated mood, overactivity, impulsive behavior and inflated self-esteem
• Bipolar disorder — a condition with alternating episodes of depression and mania

In addition to the above symptoms, weight loss is common in people with Huntington’s disease, especially as the disease progresses.

Symptoms of juvenile Huntington’s disease

The start and progression of Huntington’s disease in younger people may be slightly different from that in adults. Problems that often present themselves early in the course of the disease include:

Behavioral changes

• Loss of previously learned academic or physical skills
• Rapid, significant drop in overall school performance
• Behavioral problems

Physical changes

• Contracted and rigid muscles that affect gait (especially in young children)
• Changes in fine motor skills that might be noticeable in skills such as handwriting
• Tremors or slight involuntary movements
• Seizures

“Hepatitis D virus and hepatitis E virus. Hepatitis D virus infection always occurs with hepatitis B infection, either with a chronic hepatitis B infection (superinfection) or as two simultaneous new infections (coinfection).Reports are rare. Cases of hepatitis D are typically associated with injection drug use. Cases of hepatitis E are typically travel associated.  Humans are the reservoir for hepatitis D, which is usually transmitted by contact with blood or body fluids, particularly sharing drug paraphernalia. Humans and animals (swine) are the reservoir for hepatitis E which is transmitted most commonly through fecal contaminated food, water, and environment.”

Washington State Dept of Health (https://doh.wa.gov/public-health-healthcare-providers/notifiable-conditions/hepatitis-d-and-e)

“Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is spread through contact with blood from an infected person. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment used to prepare and inject drugs. For some people, hepatitis C is a short-term illness, but for more than half of people who become infected with the hepatitis C virus, it becomes a long-term, chronic infection. Chronic hepatitis C can result in serious, even life-threatening health problems like cirrhosis and liver cancer. People with chronic hepatitis C can often have no symptoms and don’t feel sick. When symptoms appear, they often are a sign of advanced liver disease. There is no vaccine for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs.”

CDC Centers for Disease Control and Prevention (https://www.cdc.gov/hepatitis/hcv/index.htm)

“Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV). The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the feces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation, poor personal hygiene and oral-anal sex.Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. The virus can also be transmitted through close physical contact (such as oral-anal sex) with an infectious person, although casual contact among people does not spread the virus.  Now,Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.  Hepatitis B is transmitted through blood and sex including spread from mother to child at birth (perinatal transmission) or through horizontal transmission (exposure to infected blood), especially from an infected child to an uninfected child during the first 5 years of life. The development of chronic infection is common in infants infected from their mothers or before the age of 5 years.  A safe and effective vaccine that offers 98% to 100% protection against hepatitis B is available. Preventing hepatitis B infection averts the development of complications including chronic disease and liver cancer.”

WHO World Health Organization (https://www.who.int/news-room/fact-sheets/detail/hepatitis-a)

“In today’s fast-paced world filled with increasing demands, stress management is a life skill and a lifesaver. It’s also important to note that while the link between stress and high blood pressure (HBP or hypertension) is still being studied, stress is known to contribute to risk factors like a poor diet and excessive alcohol consumption.

In addition to the emotional discomfort we feel when faced with a stressful situation, our bodies react by releasing stress hormones (adrenaline and cortisol) into the blood. These hormones prepare the body for the “fight or flight” response by making the heart beat faster and constricting blood vessels to get more blood to the core of the body instead of the extremities.

Constriction of blood vessels and increase in heart rate does raise blood pressure, but only temporarily — when the stress reaction goes away, blood pressure returns to its pre-stress level. This is called situational stress, and its effects are generally short-lived and disappear when the stressful event is over.

Stress is a lifestyle factor and, to a certain extent, a fact of life. Each of us also has a certain level of anxiety. On the other hand, chronic anxiety and anxiety disorders are medically diagnosed conditions (like hypertension=High B/P), which can be impacted by stress.”

AHA American Heart Association (https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-stress-to-control-high-blood-pressure)

“The body needs a small amount of sodium to function, but most Americans consume too much sodium. High sodium consumption can raise blood pressure, and high blood pressure is a major risk factor for heart disease and stroke. While sodium has many forms, most sodium we consume is from salt.”

CDC Centers for Disease Control and Prevention (https://www.cdc.gov/salt/index.htm)

“High blood pressure—or hypertension—is a major risk factor for heart disease. Half of Americans have high blood pressure, and many don’t know they have it. Have yours checked and talk to a healthcare provider about what your numbers mean for you.  Before age 60, more men than women have high blood pressure.  After age 60, more women than men have high blood pressure.  While anyone can have high b/p, African Americans tend to get it at a younger age.  Young Hispanic adults, people of Cuba, Puerto Rico, and Dominican backgrounds are at higher risk.  Also know, life style habits play a part which includes: Eating too much salt, drinking too much alcohol, and not getting enough exercise can raise our blood pressure.”

NIH – National Heart Lung and Blood Institute (https://www.nhlbi.nih.gov/education/high-blood-pressure/high-blood-pressure-education-month)