12 | Himalaya Livline | Vol 6 | No. 5 | Sep–Dec 2023 An InterviewWith Dr Sunil K Sharma Doctor, how is appetite regulated in the human body? Hunger, satiation, and satiety are the 3 components of appetite that are controlled by the brain, digestive system, endocrine system, and sensory nerves. These control systems can drive an individual’s appetite by regulating the response to the physical presence or absence of food and to different components of food. How does loss of appetite affect the body? Loss of appetite is known to affect various body systems. Loss of appetite often leads to nutritional insufficiency in infants, children, and the elderly. Hence, weight loss and undernutrition are considered as the direct results of loss of appetite. Starvation-induced protein and fat catabolism leads to loss of cellular volume and function, resulting in adverse effects on the heart, brain, liver, intestines, kidneys, and muscles. In the elderly, activation of proinflammatory cytokines due to acute and chronic diseases, sensory changes, and side effects of certain medications may also lead to loss of appetite. What are the clinical manifestations of poor appetite? Nutritional deprivation due to loss of appetite can lead to physiologic disturbances such as bradycardia, hypothermia, and hypotension. Further, dry skin, alopecia, constipation, bloating, delayed gastric emptying, osteoporosis, hypoglycemia, amenorrhea, and thyroid abnormalities also occur in individuals suffering from loss of appetite. How does loss of appetite trigger hypoglycemia? Loss of appetite accompanied by weight loss can lead to depletion of the hepatic glycogen reserve and disruption of hepatic gluconeogenesis, resulting in abnormalities of glucose metabolism and hypoglycemia. What alterations in the liver biochemistry are detected in those with a poor appetite? About 2 to 3 times elevations in aspartate transaminase and alanine transaminase are the most common laboratory abnormalities detected in individuals suffering from loss of appetite. Starvation and weight loss usually trigger elevation of transaminases. The increase in liver transaminase levels is usually due to cell death in events such as hepatocellular necrosis, hepatic inflammation, or the autophagy process. Doctor, how do you address poor appetite in all age groups? Loss of appetite can be managed using appetite stimulants, comprising vitamins B12, B3, and B6, lysine, and zinc, and by changing meal patterns and eating habits. Additionally, I prescribe Liv.52 (drops, syrup, and tablet forms), an Ayurvedic proprietary formulation from Himalaya Wellness Company, to patients complaining of loss of appetite. Liv.52 normalizes the basic appetite–satiety rhythm; improves appetite, digestion, and assimilation processes; and promotes weight gain. Dr Sunil K Sharma, MD General Physician 380-A, Gandhi Nagar Jammu 180004, Jammu and Kashmir India We thank our field correspondents for their input and support. Rajiv Koul, Regional Manager Rahul Chaman, Pharma Sales Officer HimalayaWellness Company —Editor expert comments
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