De Quervain syndrome is mucoid degeneration of two tendons that control movement of the thumb and their tendon sheath. This results in pain and tenderness on the thumb side of the wrist. Radial abduction of the thumb is painful. On occasion, there is uneven movement or triggering the thumb with radial abduction. Symptoms can come on gradually or be noted suddenly.There is speculation that the problem is related to use of the hand, but this is not supported by experimental evidence. Humans tend to misinterpret painful activities as causing the problem to get worse and this misinterpretation is associated with greater pain intensity. For this reason, its better not to blame activity without strong scientific support. The diagnosis is generally based on symptoms and physical examination. Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist.There is some evidence that the natural history of de Quervain tendinopathy is resolution over a period of about 1 year. Symptomatic alleviation (palliative treatment) is provided mainly by splinting the thumb and wrist. Pain medications such as NSAIDs can also be considered. Steroid injections are commonly used, but are not proved to alter the natural history of the condition. Surgery to release the first dorsal component is an option. It may be most common in middle age.
The same can occur with elements in food, such as calcium, which impacts both heme and non-heme iron absorption. Absorption of iron is better at a low pH (i.e. an acidic environment), and absorption is decreased if there is a simultaneous intake of antacids. Many other substances decrease the rate of non-heme iron absorption. One example is tannins from foods such as tea and phytic acid. Because iron from plant sources is less easily absorbed than the heme-bound iron of animal sources, vegetarians and vegans should have a somewhat higher total daily iron intake than those who eat meat, fish or poultry.Taken after a meal, there are fewer side effects but there is also less absorption because of interaction and pH alteration. Generally, an interval of 2–3 hours between the iron intake and that of other drugs seems advisable, but is less convenient for patients and can impact on compliance. History
The first pills were commonly known as Blauds pills, which were named after P. Blaud of Beaucaire, the French physician who introduced and started the use of these medications as a treatment for patients with anemia. Administration
By mouth
Iron can be supplemented by mouth using various forms, such as iron(II) sulfate. This is the most common and well studied soluble iron salt sold under brand names such as Feratab, Fer-Iron, and Slow-FE. It is in complex with gluconate, dextran, carbonyl iron, and other salts. Ascorbic acid, vitamin C, increases the absorption of non-heme sources of iron.Heme iron polypeptide (HIP) (e.g.