This is related to “heart” health and a vigorous laugh always ‘does a heart good’.

Here is one of my favorite Irish Blessings:

May those that love us, love us.
And those that don’t love us,
May God turn their hearts.
And if He doesn’t turn their hearts,
May He turn their ankles
So we will know them by their limping.
~Irish Blessing

Several commonly prescribed drugs, such as Nexium and Prilosec, have been identified by the FDA as decreasing the effectiveness of the blood thinning drug, Plavix. This drug is often given to heart patients or patients who have had heart catheterizations for cardiac disease. It is considered critical for the effectiveness of heart procedures and important for maintaining patency of cardiac vessels.

Other drugs considered to have the same problem are as follows:

Tagamet: cimetidine

Prozac, Serafem and Symbyax: fluoxetine

Luvox: fluvoxamine

Ticlid: ticlopidine

Diflucan: fluconazole

Intelence: etravirine

Nizoral: ketoconazole

voriconazole

Intelence: etravirine

Felbatol: felbamate

One of the concerning things about this warning is that approximately half of the patients who take Plavix also take these medications to protect their stomach.

Don’t stop any medications without talking with your doctor first.  Call, make an appointment and discuss any risk with your doctor as soon as possible.



Numerous studies have documented epidemic levels of vitamin D deficiency in the population at large and in particular, the elderly suffer excessive rates of deficiency due, in part, to lower levels of sun exposure.  Studies have documented increased rates of infections and pneumonia in elderly subjects with vitamin D deficiency.  Another recent study took a look at physical performance related to vitamin D deficiency.

A recent journal article in the Journals of Gerontology reported vitamin D plays a critical role in musculoskeletal function.  In this reported study, researchers found an association between vitamin D status and physical performance in a sample of almost a thousand persons over the age of 65. Initial blood tests revealed nearly 3/4 of women and over half of men had vitamin D levels that were considered insufficient.  Subjects were analyzed using handgrip strength and a physical performance battery, including measures of walking speed, ability to stand from seated position and maintenance of balance.  Among those subjects with low vitamin D levels, physical performance and grip strength were significantly lower than those without a deficiency.  Researchers included consideration of other variables and results maintained validity.

Physical performance and ability to conduct activities of daily living along with getting adequate exercise are related to numerous other disease states such as diabetes, heart and vasculature disease, impotence, obesity along with all complications of obesity.  These study results are stunning in their illustration of the apparent dependence on vitamin D for vitality.

Recommendations for daily supplemental vitamin D intake have increased in the last 2 years for elderly and our youngsters.  For elderly, intake of at least 600 IU of vitamin D is currently the governmental standard.  I personally recommend intakes of approximately 1200-2000 IU per day.  Since vitamin D is a fat soluble vitamin, it is possible to take too much.  Consult your physician for further information on supplemental intake of this critical nutrient.

*************

Any information, medical or otherwise, contained in this blog is purely for entertainment and is not intended as medical advice or medical treatment.  Please consult your own doctor for any medical advice or treatment.

If you or your loved ones take any of the following drugs: Zetia, Vytorin or Inegy, you may need to see your doctor as soon as possible to have your medications evaluated.

 

A new study, just published in the New England Journal of Medicine, evaluated the addition of either Extended-Release Niacin (also known as vitamin B3 or nicotinic acid) or Ezetimibe (found in the above named drugs) to statin therapy for reduction of cardiovascular risk factors.  The study found that despite the fact that Ezetimibe was designed to further lower bad cholesterol levels, the end result was thickening of the arteries (a bad thing!) and increased rates of cardiovascular events.

 

Authors of the study state: “Thus, we believe that prudent clinical practice currently favors the avoidance of ezetimibe, with consideration of further restriction on its use in lieu of clinically validated regimens, until its net effect on clinical outcomes can be fully ascertained.”

 

It is important that you not change your medication without seeing your doctor first.  It is also important to know that if you can tolerate Extended-Release Niacin, this may be a better choice for reduction of cardiovascular risk factors, as we have previously recommended.

 

 

www.symtrimics.com

http://twitter.com/mtnmd

NEJM, Nov 15, 2009, Extended-Release Niacin or Ezetimibe and Carotid Intima-Media Thickness, Taylor et al

Groups at Risk of Vitamin D Inadequacy:

This list, obtained from the NIH, [http://bit.ly/27f6Vn ], explains the various reasons why someone could be more prone to vitamin D deficiency.  It is worth a quick read to see if you fall into one of these categories.  If you do, supplementation with 2000 IU of D3 is becoming standard.  You may want to have your vitamin D and calcium levels checked by your physician first, and I will be sharing more exciting news on vitamin D in the coming months.  Stay tuned for one of the biggest stories in medicine in decades!!

OK, here’s the list from the NIH:

Obtaining sufficient vitamin D from natural food sources alone can be difficult. For many people, consuming vitamin D-fortified foods and being exposed to sunlight are essential for maintaining a healthy vitamin D status. In some groups, dietary supplements might be required to meet the daily need for vitamin D.

Breastfed infants
Vitamin D requirements cannot be met by human milk alone [4,48], which provides only about 25 IU/L [49]. A recent review of reports of nutritional rickets found that a majority of cases occurred among young, breastfed African Americans [50]. The sun is a potential source of vitamin D, but AAP advises keeping infants out of direct sunlight and having them wear protective clothing and sunscreen [51]. As noted earlier, AAP recommends that exclusively and partially breastfed infants be supplemented with 400 IU of vitamin D per day [20].

Older adults
Americans aged 50 and older are at increased risk of developing vitamin D insufficiency [33]. As people age, skin cannot synthesize vitamin D as efficiently, and the kidney is less able to convert vitamin D to its active hormone form [4,52]. As many as half of older adults in the United States with hip fractures could have serum 25(OH)D levels <12 ng/mL (<30 nmol/L) [5].

People with limited sun exposure
Homebound individuals, people living in northern latitudes (such as New England and Alaska), women who wear long robes and head coverings for religious reasons, and people with occupations that prevent sun exposure are unlikely to obtain adequate vitamin D from sunlight [53,54].

People with dark skin
Greater amounts of the pigment melanin result in darker skin and reduce the skin’s ability to produce vitamin D from exposure to sunlight. Some studies suggest that older adults, especially women, with darker skin are at high risk of developing vitamin D insufficiency [41,55]. However, one group with dark skin, African Americans, generally has lower levels of 25(OH)D yet develops fewer osteoporotic fractures than Caucasians (see section below on osteoporosis).

People with fat malabsorption
As a fat-soluble vitamin, vitamin D requires some dietary fat in the gut for absorption. Individuals who have a reduced ability to absorb dietary fat might require vitamin D supplements [56]. Fat malabsorption is associated with a variety of medical conditions including some forms of liver disease, cystic fibrosis, and Crohn’s disease [27].

People who are obese or who have undergone gastric bypass surgery
Individuals with a BMI ≥30 typically have a low plasma concentration of 25(OH)D [57]; this level decreases as obesity and body fat increase [58]. Obesity does not affect skin’s capacity to synthesize vitamin D, but greater amounts of subcutaneous fat sequester more of the vitamin and alter its release into the circulation. Even with orally administered vitamin D, BMI is inversely correlated with peak serum concentrations, probably because some vitamin D is sequestered in the larger pools of body fat [57]. Obese individuals who have undergone gastric bypass surgery may become vitamin D deficient without a sufficient intake of this nutrient from food or supplements, since part of the upper small intestine where vitamin D is absorbed is bypassed [59,60].

***************

Any information, medical or otherwise, contained in this blog is purely for entertainment and is not intended as medical advice or medical treatment. Please consult your own doctor for any medical advice or treatment.

Why are vampires like false teeth?  They all come out at night.

OK, groan.  But truly, your dental health is critical to not only your appearance and your comfort, but your cardiovascular health, infection prevention and longevity, itself.

That is why a study from the American Journal of Clinical Nutrition may be of interest to you.  This study demonstrates a link between the incidence of gum disease and vitamin D intake.  This study looked at over 11,000 adults.  80% of those studied had inadequate vitamin D levels (which should be shocking enough at face value) and found that the lower the level of vitamin D, the greater the risk of tooth loss.

When looking at those 50 and older, those with the lowest vitamin D levels had a more than 25% increase in tooth loss than those in the highest range.  We think that vitamin D acts as an anti-inflammatory to decrease periodontal disease, which cuts down on tooth loss.   Vitamin D levels are important for many body functions.  Now we know — a healthy smile is one of them!

 ***************

Any information, medical or otherwise, contained in this blog is purely for entertainment and is not intended as medical advice or medical treatment.  Please consult your own doctor for any medical advice or treatment.

The sweat pouring down her face expressed the incredible pain she was in. How could this be happening? She was only 45 years old and found herself in the emergency room with severe chest pain. She heard the physician explain that she is having a heart attack.  “I’m too young for this,” she thought to herself.  “My parents are alive and healthy. How can this be happening to me?” 

In medicine we call this a teachable moment. Unfortunately, many people do not survive their teachable moment. The truth of the matter is we are all creatures of delusion. We delude ourselves into thinking the French fries we eat for lunch each day are not affecting us. We delude ourselves into thinking we look better than we do by pulling in our gut while looking in the mirror. We write internet profiles utilizing a photograph from 10 years prior. We make excuses when we can’t keep up with the group. As time goes on, these excuses become so prolific we just don’t even think about it. That is the only way over 60% of us have become overweight or obese. There is no other explanation. You are not alone in this habit.

The great news about this is we can utilize these same powerful mental tactics to create a vital, healthful life. We can actually create healthy delusions that support us in our lifestyle. In fact, this is truly the only way to permanently adopt a healthful lifestyle.

Here are three healthy delusions you can develop which will propel you forward in your health goals.

Delusion number 1: I can do anything with and for my family and loved ones:  Having a loving partner can be a significant motivating factor. If you really care about the person you’re with you must know that they want you to be healthy. But more importantly, if you love them you would not want to burden them with a partner who is in ill health. One of my favorite concepts is “love is a verb.”  If you want to put your love in action, keep yourself healthy and vital for your partner. 

Additionally, one of the biggest health motivators I have found is your children and your grandchildren. Many of the things in life we would never do for ourselves, we will do for our children. We will get up earlier, we will go farther, we will do more to make the lives of our children and our grandchildren better. If you want to spend great quality time with your children and your grandchildren, then being healthy is one of the best steps to make that happen. If you want to climb mountains, play on the floor, spend a long day or be alert and present for those in your family, being healthy is one of the best ways you can make that happen.

Delusion number 2: I live a happy and passionate life. Working in medicine for decades, I’ve noticed that happiness is not necessarily connected to health. I have seen people that were very challenged with their physical bodies who maintained a very happy attitude. I’ve seen people who were essentially very healthy but not very happy. However, it is true that living a life free of pain and suffering makes it much easier to achieve a happy existence. If you are creating a happy life, becoming healthy is a great start. In addition, thousands of studies document the connection between healthful eating, normal weight and good muscle tone with the lack of depression. In fact, a recent study demonstrated that an exercise program of 30 minutes of vigorous movement per day was as effective as taking antidepressants — without all the side effects! If you want to be happy, start moving today.

Delusion number 3:  I live a life free of pain. If you have anyone in your family with advanced diabetes, ask them what neuropathy feels like. This is a sharp, stinging, needle-like pain occurring in the feet of those with long-lasting diabetes. If you have anyone in your family who has osteoarthritis, ask them what it feels like in the morning when they wake up. If you have anyone in your family with advanced cancer, ask them what it feels like. Being unhealthy is associated with a variety of pains. These symptoms may seem like a vague occurrence that happens to other people but not to you. I will assure you that all of the people with these problems felt the same way. If you want to live a long life free of pain and suffering, establishment of a healthy eating pattern, increased movement and psychological peace is the best way to accomplish this.  No time like the present to begin!

So the next time someone jokingly refers to you as being delusional, just smile and agree.  The quizzical look on their face will just be a bonus!

*******************

Any information, medical or otherwise, contained in this blog is purely for entertainment and is not intended as medical advice or medical treatment.  Please consult your own doctor for any medical advice or treatment.

Passing on some interesting information:

 

 

The Amazing Cucumber

This information was in The New York Times several weeks ago as part of their “Spotlight on the Home” series that highlighted creative and fanciful ways to solve common problems.

1. Cucumbers contain most of the vitamins you need every day, just one cucumber contains Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5, Vitamin B6, Folic Acid, Vitamin C, Calcium, Iron, Magnesium, Phosphorus, Potassium and Zinc.

2. Feeling tired in the afternoon, put down the caffeinated soda and pick up a cucumber. Cucumbers are a good source of B Vitamins and Carbohydrates that can provide that quick pick-me-up that can last for hours.

3. Tired of your bathroom mirror fogging up after a shower? Try rubbing a cucumber slice along the mirror, it will eliminate the fog and provide a soothing, spa-like fragrance..

4. Are grubs and slugs ruining your planting beds? Place a few slices in a small pie tin and your garden will be free of pests all season long. The chemicals in the cucumber react with the aluminum to give off a scent undetectable to humans but drive garden pests crazy and make them flee the area.

5. Looking for a fast and easy way to remove cellulite before going out or to the pool? Try rubbing a slice or two of cucumbers along your problem area for a few minutes, the phytochemicals in the cucumber cause the collagen in your skin to tighten, firming up the outer layer and reducing
the visibility of cellulite. Works great on wrinkles too!!!

6. Want to avoid a hangover or terrible headache? Eat a few cucumber slices before going to bed and wake up refreshed and headache free. Cucumbers contain enough sugar, B vitamins and electrolytes to replenish essential nutrients the body lost, keeping everything in equilibrium, avoiding both a hangover and headache!!

7. Looking to fight off that afternoon or evening snacking binge? Cucumbers have been used for centuries and often used by European trappers, traders and explores for quick meals to thwart off starvation.

8. Have an important meeting or job interview and you realize that you don’t have enough time to polish your shoes? Rub a freshly cut cucumber over the shoe, its chemicals will provide a quick and durable shine that not only looks great but also repels water.

9. Out of WD 40 and need to fix a squeaky hinge? Take a cucumber slice and rub it along the problematic hinge, and voila, the squeak is gone!

10. Stressed out and don’t have time for massage, facial or visit to the spa? Cut up an entire cucumber and place it in a boiling pot of water, the chemicals and nutrients from the cucumber with react with the boiling water and be released in the steam, creating a soothing, relaxing aroma that has been shown the reduce stress in new mothers and college students during
final exams.

11. Just finish a business lunch and realize you don’t have gum or mints?  Take a slice of cucumber and press it to the roof of your mouth with your tongue for 30 seconds to eliminate bad breath, the phytochemcials will kill the bacteria in your mouth responsible for causing bad breath.

12. Looking for a ‘green’ way to clean your faucets, sinks or stainless steel? Take a slice of cucumber and rub it on the surface you want to clean, not only will it remove years of tarnish and bring back the shine, but is won’t leave streaks and won’t harm you fingers or fingernails while
you clean.

13. Using a pen and made a mistake? Take the outside of the cucumber and slowly use it to erase the pen writing, also works great on crayons and markers that the kids have used to decorate the walls!!

 

Historically, the medical knowledge regarding vitamin D was limited to its role in the deposition of bone.  Over the past 2 decades, an immense amount of research (over 3500 medical journal articles and counting) have allowed us a more comprehensive view of what this vitamin/hormone does.  It is becoming clear that vitamin D has a role in the function of every body system we have.  It is linked to diseases such as heart disease, osteoporosis, cancer, Alzheimer’s, bowel disease, brain development, etc., etc., etc. 

Some of these new studies are finding vitamin D deficiency to be an epidemic in developing countries.  So not only are we discovering the importance of this nutrient, but we are finding that most people are either mildly or severely deficient.  It is no wonder scientists are excited.

  

Why are people so concerned about the dose of vitamin D we take?

Unlike the water soluble vitamins which are excreted if taken in high doses, vitamin D is a fat soluble vitamin.  This means you can actually overdose on it.  Luckily for us, the safe levels of intake appear to be much higher than previously estimated.  In addition, there are medical conditions which would cause a hypercalcemia (or high blood calcium) if external vitamin D is taken.  For these, and other reasons, it is wise to get medical counsel regarding vitamin D intake.

 

What exactly does vitamin D do for my body?

Firstly, vitamin D does assist with the process that allows bone to be deposited in your body.  It is important for bone health.  Especially for children, whose bone structure is being developed, it is critical for these kids to get adequate D, calcium and other important nutrients to prevent fractures down the road.  In addition, vitamin D acts as a hormone, mediating untold functions in our cells including boosting a healthy immune system and supporting apoptosis, which is normal healthy cell death.  If your cells don’t die normally, this is cancer.  As many studies are revealing pronounced declines in cancer rates with high levels of vitamin D supplementation, I will assume we will continue hearing more about this nutrient in the future.

 

Who can I consult regarding vitamin D levels and intake?

 As mentioned above, it is important to have medical direction on your intake of this vital nutrient to make sure you don’t have any medical conditions which would contraindicate oral supplementation.

 www.symtrimics.com

One of the largest concerns regarding childhood obesity is the amount of screen time children spend each and every day. There is a tremendous amount of peer pressure along with marketing prowess at work to keep your child in front of that screen. There is one and only one thing that can keep your child from those screens. That is you. As a parent you must understand the importance of unfettered exploration and physical movement to your child’s brain and body.

When your child was a baby and you gazed into those beautiful big eyes, your heart swelled with the responsibility of caring for this human being. Now is the time for you to put those feelings into action. Identify activities your child can participate in that involve movement such as bicycling, walking, playing and exploring. How many of you remember finding a stick and making it into something magical? Now your children are sitting in front of the screen with a stick that is tied to someone else’s brain in someone else’s idea of what they should be thinking. Take the time and energy necessary to disconnect your child from that joystick.

If you truly want to have an influence on your child to allow this beautiful human being to become everything that is possible you must take the time and the energy to disconnect from peer pressure, marketing and the beseeching of your child. You are, after all, the parent.