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Ask Dr. Mike: How Can I Speed Up Wound Healing?

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

I have a wound that won't heal, and I don't have diabetes. What should I be taking (or not taking) to speed up healing?

A non-healing wound is a wound that does not heal, even though it's been given proper time and care to do so. People who are immunosuppressed (e.g., diabetics or other chronic disease sufferers) are more likely to have a non-healing wound.

In this case, this person doesn't have diabetes and wants to know what he/she can take. Dr. Mike first wants to read off the most important things to help wound healing. First is calories, carbohydrates, fats, vitamin A, vitamin C, proteins, zinc, and water.

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RadioMD Presents:Healthy Talk | Original Air Date: May 26, 2015

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DR MIKE: So, my first question is about a non-healing wound. It most commonly occurs in people who are immunosuppressed, diabetics--really anybody with a chronic disease often has issues with healing. And when I mean wound, this could -- you know, I have this question here from a listener. I don't know he or she.

I don't have a name. Doesn't even tell me what caused the wound. But when we say "wound", it could be a surgical wound -- you know, on purpose. Somebody went in and cut you open to, I don't know pull, out a tumor or infection, whatever. Or, it could be from an accident or trauma.

So, I'm using wound very generally here. But it doesn't, at the end of the day, there's a break in the skin and the body is supposed to be able to heal that, repair that and regenerate healthy tissue.

And for whatever reason -- again in those people with chronic diseases, immunosuppression, they often have a hard time in that healing process and it just doesn't work right. Sometimes it even overdoes it. You ever heard of a keloid? That's one of the scars that really kind of builds up and it's very visible. That's called a keloid. It happens in African-Americans more than anybody else for some reason. We still don't understand. So, sometimes you can get the reverse. You get this hyper healing. Let me just get to the question here.

"I have a wound that won't heal. I don't have diabetes. I write that because that's the first thing people ask. What should I be taking or not taking, to speed up healing?"
Now I'm going to keep to the question here. So, this person is asking taking something, right? So, either medicine, supplements – again, it's not about applying anything but about taking. I'm assuming something like a pill and that's what they are looking for.

And I'm going to stay away from the pharmaceutical stuff and I'm going to focus more on what we can do over the counter. Some basic things that maybe this person or, if you're somebody who has a wound that's not healing properly, it's taking a long time. Diabetic or not, immunosuppressed or not, these are some things that definitely can help with wound healing.

And the first thing -- you know there's a lot here -- let me do this, let me just read off probably the most important things and then I'll get into the specifics as much as I can. So, let me just read off the most important things to wound healing. Number one: calories. I'll get to what that means but you got to eat. Calories are important. Carbohydrates are important.

Protein, fats, vitamin A, vitamin C, zinc, and water. So, let's talk about each one of those individually. Calories: it takes a lot of energy to heal a wound. The larger the wound the more calories you need, right? You have to maintain sufficient energy supplies to have a robust immune response that can bring in the reparative cells. You have to have an energy supply that can produce the reparative hormones, like growth hormones in the insulin, like growth factors that are involved in wound healing.

Often what you see, especially if the wound is large and the person maybe even has an infection from it, obviously that infection has to be treated.

But the larger the wound the less active the person is, the less they feel like eating, especially if they are older. That can be bad and detrimental but we need to make sure that we're getting enough calories to supply this reparative process. There was a study published by a doctor named Leininger in 2002.

I don't have the journal here but Dr. Leininger is really one of the world's leaders in chronic wound healing and he has estimated that especially in older people you might need an increase of up to 25 to 30 calories per kilogram of weight. That's a lot! That's a lot of calories. So, yes, we have to make sure that we're eating enough to supply that reparative process. Carbohydrates are important to wound healing.

Carbohydrates have been shown to help meet the body's heightened energy requirements. That's number one. Number two, they aid in fibroblast movement which is vital in wound healing. A fibroblast is a type of cell that can come in there and eat up some of that necrotic decaying material, help to lay down some new connective tissue for the reparative process, and carbohydrates are important to enhanced white blood cell activity to strengthen your immune system. So, make sure you're getting a nice rich source of complex carbohydrates. Protein--very important and necessary for collagen synthesis. You know, collagen is the main connective tissue.

I mean, there's other connective tissue proteins but collagen is the key one and we have to make sure that we are taking in enough protein to do the normal things protein does. But at the same time increase collagen synthesis for the wound healing process. Along with collagen there would be one of the vitamins that I mentioned here and that is vitamin C.

So, you want to increase your protein intake for collagen. but then you also want to make sure you're getting vitamin C, maybe a 1000 to 2000 milligrams a day.

That's far above the recommended daily intake by the way, which is only about, I don't know, 50 to 100 milligrams. Vitamin C plays an important role in helping the body generate collagen, so as you're taking in more protein you need the vitamin C to activate an enzyme called procollagen hydroxylase.

Procollagen hydroxylase is the enzyme that helps to bring these parts of collagen together to actually make it strong. So, we want to increase calories; we want to make sure we're getting our carbs. We've got to bring in our proteins for collagen synthesis and then we got to make sure that we have enough vitamin C on board to activate that enzyme that makes the collagen as well. Fats play an important role, too.

The essential fats, phospholipid based fats, phosphoryl choline based fats are very important because those aid in the cell membrane and cell structure of the new cells that are being laid down in the wound. So, fats are very important. Zinc. You know, some research looking at zinc in wound healing has been very positive. Zinc plays an important role and I might go ahead and add to this B vitamins as well. So, zinc and B vitamins, they play important roles in cell proliferation and cell regeneration.

So, zinc and B vitamins: if you're eating enough calories, you're bringing your carbs, your fats, your proteins, you got enough vitamin C on board. So, you're producing more collagen and all that kind of stuff. But if you're not aiding in the regeneration of healthy cells which make healthy tissues, the whole process could break down and that wound can take a long time to close up. So, zinc and B vitamins play an important role in cell division and cell proliferation in the closing up of that wound.

And then don't forget about water. You know, when you're trying to repair a wound the larger -- this is even more true -- you're almost in a hyper metabolic state and that can leave your body what we call volume depleted. I don't like to use the word "dehydrated" because if you're dehydrated, you'd be dead. Dehydrated is without water. You'd be like a prune. So, I call it "volume depleted". But when you're hyper metabolic, you're activating all of these cell proliferation pathways, collagen production pathways, immune pathways, you're using a lot of water up, so make sure to remain hydrated.

So, calories, carbs--complex carbs--protein for collagen synthesis, fats for cell membrane structure and function, vitamin C for the collagen production along with the protein, zinc and B vitamins for cell proliferation and closing up that wound, and water for the hyper metabolic state. All of those might be helpful in wound healing.

This is Healthy Talk on Radio MD. I'm Dr. Mike. Stay well.