Thursday, March 31, 2011
THOUGHT FOR THE DAY
The ultimate in being healthy is to operate at full throttle—physically, emotionally and spiritually.
No Energy? 8 Ways to Get from Slow to Go
It’s 4 p.m. and you’ve hit the wall. You can’t concentrate and your zip is zapped. But hold off on that Snickers fix. Find out what’s draining your energy and learn how to put more pep in your step…
You haven’t been getting enough sleep lately, but could that be all that’s zapping your energy?
Constant weariness may stem from more than a few late-night parties. Some culprits? Disease or heavy bleeding, for example. Or it could be your couch-potato habits and poor diet.
Whatever its cause, ongoing fatigue can leave you vulnerable to infections, according to a Carnegie Mellon University study published in 2009 in the Archives of Internal Medicine.
Of 153 healthy men and women aged 21-55, those who got less than seven hours of sleep were almost three times more likely to catch a cold than those who slept eight hours or more.
But fatigue isn’t just triggered by physical causes, says Lilian Cheung, R.D., a Harvard University lecturer and director of health promotion and communication at the Harvard School of Public Health’s Department of Nutrition. It’s mental too.
Being stressed out or working too hard – even thinking too much – saps energy levels, she says. “The mind needs to rest.”
Sometimes an underlying medical condition – diabetes, chronic fatigue syndrome, lupus, fibromyalgia – drains your get-up-and-go and you’ll need a doctor’s help to treat or manage symptoms.
But we can be our own energy-sapping enemies. Here are 8 ways you may be depleting your pep. Plus, learn new ways to get from slow to go:
Energy Zapper #1: A sugar- and fat-filled breakfast
Mom always told you to eat breakfast. But wolfing down a bagel or muffin as you sprint out the door isn't the nutrition she had in mind.
That carbohydrate-rich meal tastes great, but you’ll be crashing in a few hours.
Sugar-and-starch combos boost energy temporarily because of the way our bodies process glucose (sugar), says Stuart Fischer, M.D., founder of the Park Avenue Diet and author of Dr. Fischer’s Little Book of Big Medical Emergencies (Barricade Books).
Eating stimulates the pancreas to release the hormone insulin, which helps glucose enter your cells and gives you an energy burst.
A typical sugar-loaded breakfast puts too much glucose too quickly into the bloodstream. The cells can’t absorb it all, so excess glucose is converted to the molecule glycogen, which is stored in the liver and muscle tissue. That’s when blood sugar levels drop and you start to drag.
If glucose levels drop too much, “your brain can get a little fuzzy,” Cheung says. “Some people have trouble concentrating.”
Re-energize: Start the day with whole grains and/or lean protein, which take longer to convert into glucose and can sustain energy levels for longer periods.
Fisher’s breakfast Rx? A bowl of oatmeal or two boiled or poached eggs with tomato and lettuce.
Energy Zapper #2: Not exercising
Too tired to work out? Whatever you do, don’t skip it. Exercise will put spring back in your step.
People who regularly complained of fatigue increased energy levels by 20% with regular, low-intensity exercise, according to a 2008 University of Georgia study.
You don’t have to run marathons either. The study found that those who did low-intensity exercises, such as walking, cut fatigue levels more than those who ran or did high-impact aerobics.
Re-energize: Exercise every day, even for as little as 10 minutes.
If you’re in a time crunch, just “take a walk around the hallway,” Cheung says.
If possible, work out first thing in the morning, Fischer says. “It can be as stimulating as an espresso [for] waking you up.”
If you’re drooping after lunch, take a 10- to 20-minute walk. Even just standing up while working instead of sitting in front of a computer helps loosen the body.
“That’s why I love the speakerphone,” Cheung says. “I don’t have to hold it or bend my neck in a way that drains me.”
Energy Zapper #3: The bottomless coffee cup
Heading to the java joint around the corner for your fifth cup of the day? Not only will the caffeine keep you tossing all night, it also does a number on your hormones. Coffee stimulates production of adrenaline and cortisol, two hormones that increase alertness.
But that effect doesn’t last, so you pour another mugful. Trouble is, after the third cup, the caffeine stops working. “It’s like squeezing a sponge,” Fischer says. After a while, you only get a few drops.
People who keep chugging cups throughout the day may over-stimulate adrenaline production. That stresses and slows the adrenaline gland, causing hormone depletion, Fischer says.
Re-energize: Cut back – but don’t necessarily give up – coffee. One to three cups a day may make you sharper, Cheung says, noting studies have shown that java improves cognitive function in the elderly.
Researchers found that midlife coffee drinkers had a lower risk for dementia and Alzheimer’s as they age compared to those drinking little or no coffee, according to a long-term Finnish study published in 2009 in the Journal of Alzheimer's Disease.
Check out 9 Caffeine Myths Explained.
Energy Zapper #4: Carb-loaded snacks
It’s 4 p.m. and you need a wake-up call. A trip to the snack-room vending machine might perk you up, right? Wrong – that’s where you get burned.
“A candy bar actually depletes [energy] in the long term,” Fischer says.
Remember what happened with your sugar-coated breakfast? Candy, too, provides the boost but it’s quickly followed by a slump. So goes for high-energy drinks, such as Red Bull.
Energy drinks are particularly bad for overweight people – “like poison,” Fischer says.
Obese people are already overproducing insulin from the excess sugars they consume. A candy bar sends another huge jolt of sugar into their systems, he says.
Eventually it leads to insulin resistance, a condition in which the body produces but does not process insulin correctly, and type 2 diabetes.
Watch out for “healthy” juices too, because they’re often loaded with sugar, Cheung says. About 12 ounces of orange juice has 10 spoonfuls of sugar – the same as in 12 ounces of cola.
Re-energize: Choose high-fiber or protein snacks, like a slice of turkey wrapped around a carrot stick or celery stalk, Fischer says.
For a refreshing low-sugar sip, drink seltzer water with a splash of juice, Cheung advises.
Edamame (green soy beans) are an excellent source of soy and protein – and healthy for women because they contain phyto-estrogen, a plant-based form of the hormone, Fischer says. Microwave them for a quick snack.
Nuts, such as pistachios, raw almonds and walnuts, are another energy-booster.
“I love nuts,” says Keri Glassman, R.D., author of The O2 Diet (Rodale Books). “They’re filled with antioxidants and have fiber, healthy fat and protein.”
An added bonus: They keep your ticker healthy. People who ate nuts several times a week reduced their risk of heart attack, sudden cardiac death or cardiovascular disease by 30%-50%, according to three recent studies.
Just don’t mindlessly munch handfuls all day because nuts are high in calories. If you’re on a diet, practice portion control – an ounce or so a day, Cheung says.
Energy Zapper #5: You’re not getting enough magnesium
Nodding off at your desk? Sleepiness and muscle weakness are symptoms of magnesium deficiency.
Many Americans consume less magnesium than the recommended amounts. "The good news is that it's widely available” in a lot of foods, says Jill Weisenberger, R.D., C.D.E, Lifescript’s Nutritionist.
The mineral is crucial to keep your body functioning – it plays a role in more than 300 of its biochemical reactions, according to the National Institutes of Health. It maintains muscle and nerve functions, keeps the heart ticking steadily and your immune system strong and promotes bone strength.
Plus, “blood pressure creeps up as we age and diets rich in magnesium help keep it in check,” Weisenberger says.
Certain drugs, such as some diuretics (Lasix, Bumex and hydrochlorothiazide) and antibiotics (Gentamicin, tetracycline and Amphotericin), can cause a magnesium deficiency. So can some disorders, such as Crohn’s disease, a serious chronic inflammation of the intestines, and poorly controlled diabetes.
Re-energize: Head for the salad bar: Dark-green leafy vegetables, such as spinach, are the best source of magnesium. Same goes for certain fish, like halibut, which has 90 milligrams (mg) in a 3-ounce serving.
“Eat a variety of whole grains, nuts, beans like pintos and kidney beans and dark-green vegetables,” Weisenberger says.
Women need 310-320 mg of magnesium a day – more if you’re pregnant (350-400 mg) or breastfeeding (310-360 mg). You can take supplements, but first get your doctor's OK.
Energy Zapper #6: Heavy periods
Do you drag during heavy menstrual periods? You could have iron-deficiency anemia, a condition where you don’t have enough iron in your blood. The mineral is crucial to making hemoglobin, the protein in red blood cells which carries oxygen throughout the body.
Women are particularly susceptible to iron-deficiency anemia because of heavy bleeding, long periods and uterine fibroids. Tiredness is one hallmark; other symptoms include shortness of breath, dizziness and weakness.
“Anemia from a heavy period produces fatigue that can’t be helped by exercise, coffee or anything else,” Fischer says. “It’s as if the person isn’t breathing as much.”
Re-energize: Women need 18 mg of iron a day; less (8 mg) if you’re 51 and older.
See a doctor for a blood test to diagnose anemia. Don’t take iron supplements on your own, Fischer warns, because the supplements can cause upset stomach, constipation and other digestive problems.
Plus, it’s best to get the mineral from iron-rich foods, including clams, organ meats, eggs, green leafy vegetables, dried beans and legumes.
Energy Zapper #7: Not enough zzz’s
It almost goes without saying: If you don’t get enough sleep, you’ll be tired – and gain weight. Too many late nights spark cravings for sweets and high-carb treats, Fischer says.
Re-energize: Women need at least 7-9 hours of sleep a night. If you’re not getting that, take short “power naps” of 10-20 minutes if you can, Glassman says.
Or meditate for 10-15 minutes to clear your mind and refresh your body.
It’s like rebooting your brain, just like you do with your computer, says Hawaii-based psychologist Matthew B. James, Ph.D. The goal is to ease your brain temporarily from an active beta wave state to an alpha wave state, the state that precedes sleep.
His suggested meditation:
Step 1: Stare out the window or at a pleasant picture and slow down your thoughts.
Step 2: Take long breaths through your nose and out your mouth with a “ha” sound.
It doesn’t have to take much time. You can meditate anywhere and almost any time, says Cheung, author of Savor – Mindful Eating, Mindful Life (HarperOne) with Buddhist master Thich Nhat Hahn.
“People think you meditate only on a cushion,” she says. “You can be standing in an airport security line.”
Energy Zapper #8: Stress
The brain doesn’t distinguish between the anxiety of being late for work or being chased by a saber-tooth tiger. Either way, our “fight-or-flight” system releases hormones, including adrenaline, to give us a burst of speed or action.
But unless you’re actually running from a huge hungry cat, the hormones build up in your body and eventually wear you out. It may be in your head, but psychological stress can cause physical problems such as lower energy levels, chronic pain, digestive problems and illnesses like heart disease and diabetes.
Re-energize: There’s one stress management tool that women carry with them everywhere, Cheung says: Their breath.
“All they need to do is focus on the breath, following their ‘in breath’ and their ‘out breath,’ ” Cheung says.
Even simpler? Just smile, she says. This relaxes facial muscles and releases tension.
You haven’t been getting enough sleep lately, but could that be all that’s zapping your energy?
Constant weariness may stem from more than a few late-night parties. Some culprits? Disease or heavy bleeding, for example. Or it could be your couch-potato habits and poor diet.
Whatever its cause, ongoing fatigue can leave you vulnerable to infections, according to a Carnegie Mellon University study published in 2009 in the Archives of Internal Medicine.
Of 153 healthy men and women aged 21-55, those who got less than seven hours of sleep were almost three times more likely to catch a cold than those who slept eight hours or more.
But fatigue isn’t just triggered by physical causes, says Lilian Cheung, R.D., a Harvard University lecturer and director of health promotion and communication at the Harvard School of Public Health’s Department of Nutrition. It’s mental too.
Being stressed out or working too hard – even thinking too much – saps energy levels, she says. “The mind needs to rest.”
Sometimes an underlying medical condition – diabetes, chronic fatigue syndrome, lupus, fibromyalgia – drains your get-up-and-go and you’ll need a doctor’s help to treat or manage symptoms.
But we can be our own energy-sapping enemies. Here are 8 ways you may be depleting your pep. Plus, learn new ways to get from slow to go:
Energy Zapper #1: A sugar- and fat-filled breakfast
Mom always told you to eat breakfast. But wolfing down a bagel or muffin as you sprint out the door isn't the nutrition she had in mind.
That carbohydrate-rich meal tastes great, but you’ll be crashing in a few hours.
Sugar-and-starch combos boost energy temporarily because of the way our bodies process glucose (sugar), says Stuart Fischer, M.D., founder of the Park Avenue Diet and author of Dr. Fischer’s Little Book of Big Medical Emergencies (Barricade Books).
Eating stimulates the pancreas to release the hormone insulin, which helps glucose enter your cells and gives you an energy burst.
A typical sugar-loaded breakfast puts too much glucose too quickly into the bloodstream. The cells can’t absorb it all, so excess glucose is converted to the molecule glycogen, which is stored in the liver and muscle tissue. That’s when blood sugar levels drop and you start to drag.
If glucose levels drop too much, “your brain can get a little fuzzy,” Cheung says. “Some people have trouble concentrating.”
Re-energize: Start the day with whole grains and/or lean protein, which take longer to convert into glucose and can sustain energy levels for longer periods.
Fisher’s breakfast Rx? A bowl of oatmeal or two boiled or poached eggs with tomato and lettuce.
Energy Zapper #2: Not exercising
Too tired to work out? Whatever you do, don’t skip it. Exercise will put spring back in your step.
People who regularly complained of fatigue increased energy levels by 20% with regular, low-intensity exercise, according to a 2008 University of Georgia study.
You don’t have to run marathons either. The study found that those who did low-intensity exercises, such as walking, cut fatigue levels more than those who ran or did high-impact aerobics.
Re-energize: Exercise every day, even for as little as 10 minutes.
If you’re in a time crunch, just “take a walk around the hallway,” Cheung says.
If possible, work out first thing in the morning, Fischer says. “It can be as stimulating as an espresso [for] waking you up.”
If you’re drooping after lunch, take a 10- to 20-minute walk. Even just standing up while working instead of sitting in front of a computer helps loosen the body.
“That’s why I love the speakerphone,” Cheung says. “I don’t have to hold it or bend my neck in a way that drains me.”
Energy Zapper #3: The bottomless coffee cup
Heading to the java joint around the corner for your fifth cup of the day? Not only will the caffeine keep you tossing all night, it also does a number on your hormones. Coffee stimulates production of adrenaline and cortisol, two hormones that increase alertness.
But that effect doesn’t last, so you pour another mugful. Trouble is, after the third cup, the caffeine stops working. “It’s like squeezing a sponge,” Fischer says. After a while, you only get a few drops.
People who keep chugging cups throughout the day may over-stimulate adrenaline production. That stresses and slows the adrenaline gland, causing hormone depletion, Fischer says.
Re-energize: Cut back – but don’t necessarily give up – coffee. One to three cups a day may make you sharper, Cheung says, noting studies have shown that java improves cognitive function in the elderly.
Researchers found that midlife coffee drinkers had a lower risk for dementia and Alzheimer’s as they age compared to those drinking little or no coffee, according to a long-term Finnish study published in 2009 in the Journal of Alzheimer's Disease.
Check out 9 Caffeine Myths Explained.
Energy Zapper #4: Carb-loaded snacks
It’s 4 p.m. and you need a wake-up call. A trip to the snack-room vending machine might perk you up, right? Wrong – that’s where you get burned.
“A candy bar actually depletes [energy] in the long term,” Fischer says.
Remember what happened with your sugar-coated breakfast? Candy, too, provides the boost but it’s quickly followed by a slump. So goes for high-energy drinks, such as Red Bull.
Energy drinks are particularly bad for overweight people – “like poison,” Fischer says.
Obese people are already overproducing insulin from the excess sugars they consume. A candy bar sends another huge jolt of sugar into their systems, he says.
Eventually it leads to insulin resistance, a condition in which the body produces but does not process insulin correctly, and type 2 diabetes.
Watch out for “healthy” juices too, because they’re often loaded with sugar, Cheung says. About 12 ounces of orange juice has 10 spoonfuls of sugar – the same as in 12 ounces of cola.
Re-energize: Choose high-fiber or protein snacks, like a slice of turkey wrapped around a carrot stick or celery stalk, Fischer says.
For a refreshing low-sugar sip, drink seltzer water with a splash of juice, Cheung advises.
Edamame (green soy beans) are an excellent source of soy and protein – and healthy for women because they contain phyto-estrogen, a plant-based form of the hormone, Fischer says. Microwave them for a quick snack.
Nuts, such as pistachios, raw almonds and walnuts, are another energy-booster.
“I love nuts,” says Keri Glassman, R.D., author of The O2 Diet (Rodale Books). “They’re filled with antioxidants and have fiber, healthy fat and protein.”
An added bonus: They keep your ticker healthy. People who ate nuts several times a week reduced their risk of heart attack, sudden cardiac death or cardiovascular disease by 30%-50%, according to three recent studies.
Just don’t mindlessly munch handfuls all day because nuts are high in calories. If you’re on a diet, practice portion control – an ounce or so a day, Cheung says.
Energy Zapper #5: You’re not getting enough magnesium
Nodding off at your desk? Sleepiness and muscle weakness are symptoms of magnesium deficiency.
Many Americans consume less magnesium than the recommended amounts. "The good news is that it's widely available” in a lot of foods, says Jill Weisenberger, R.D., C.D.E, Lifescript’s Nutritionist.
The mineral is crucial to keep your body functioning – it plays a role in more than 300 of its biochemical reactions, according to the National Institutes of Health. It maintains muscle and nerve functions, keeps the heart ticking steadily and your immune system strong and promotes bone strength.
Plus, “blood pressure creeps up as we age and diets rich in magnesium help keep it in check,” Weisenberger says.
Certain drugs, such as some diuretics (Lasix, Bumex and hydrochlorothiazide) and antibiotics (Gentamicin, tetracycline and Amphotericin), can cause a magnesium deficiency. So can some disorders, such as Crohn’s disease, a serious chronic inflammation of the intestines, and poorly controlled diabetes.
Re-energize: Head for the salad bar: Dark-green leafy vegetables, such as spinach, are the best source of magnesium. Same goes for certain fish, like halibut, which has 90 milligrams (mg) in a 3-ounce serving.
“Eat a variety of whole grains, nuts, beans like pintos and kidney beans and dark-green vegetables,” Weisenberger says.
Women need 310-320 mg of magnesium a day – more if you’re pregnant (350-400 mg) or breastfeeding (310-360 mg). You can take supplements, but first get your doctor's OK.
Energy Zapper #6: Heavy periods
Do you drag during heavy menstrual periods? You could have iron-deficiency anemia, a condition where you don’t have enough iron in your blood. The mineral is crucial to making hemoglobin, the protein in red blood cells which carries oxygen throughout the body.
Women are particularly susceptible to iron-deficiency anemia because of heavy bleeding, long periods and uterine fibroids. Tiredness is one hallmark; other symptoms include shortness of breath, dizziness and weakness.
“Anemia from a heavy period produces fatigue that can’t be helped by exercise, coffee or anything else,” Fischer says. “It’s as if the person isn’t breathing as much.”
Re-energize: Women need 18 mg of iron a day; less (8 mg) if you’re 51 and older.
See a doctor for a blood test to diagnose anemia. Don’t take iron supplements on your own, Fischer warns, because the supplements can cause upset stomach, constipation and other digestive problems.
Plus, it’s best to get the mineral from iron-rich foods, including clams, organ meats, eggs, green leafy vegetables, dried beans and legumes.
Energy Zapper #7: Not enough zzz’s
It almost goes without saying: If you don’t get enough sleep, you’ll be tired – and gain weight. Too many late nights spark cravings for sweets and high-carb treats, Fischer says.
Re-energize: Women need at least 7-9 hours of sleep a night. If you’re not getting that, take short “power naps” of 10-20 minutes if you can, Glassman says.
Or meditate for 10-15 minutes to clear your mind and refresh your body.
It’s like rebooting your brain, just like you do with your computer, says Hawaii-based psychologist Matthew B. James, Ph.D. The goal is to ease your brain temporarily from an active beta wave state to an alpha wave state, the state that precedes sleep.
His suggested meditation:
Step 1: Stare out the window or at a pleasant picture and slow down your thoughts.
Step 2: Take long breaths through your nose and out your mouth with a “ha” sound.
It doesn’t have to take much time. You can meditate anywhere and almost any time, says Cheung, author of Savor – Mindful Eating, Mindful Life (HarperOne) with Buddhist master Thich Nhat Hahn.
“People think you meditate only on a cushion,” she says. “You can be standing in an airport security line.”
Energy Zapper #8: Stress
The brain doesn’t distinguish between the anxiety of being late for work or being chased by a saber-tooth tiger. Either way, our “fight-or-flight” system releases hormones, including adrenaline, to give us a burst of speed or action.
But unless you’re actually running from a huge hungry cat, the hormones build up in your body and eventually wear you out. It may be in your head, but psychological stress can cause physical problems such as lower energy levels, chronic pain, digestive problems and illnesses like heart disease and diabetes.
Re-energize: There’s one stress management tool that women carry with them everywhere, Cheung says: Their breath.
“All they need to do is focus on the breath, following their ‘in breath’ and their ‘out breath,’ ” Cheung says.
Even simpler? Just smile, she says. This relaxes facial muscles and releases tension.
How Do I Treat Interstitial Cystitis?
Question: My wife of 42 years was diagnosed with interstitial cystitis. The doctors she consulted did not share with us their suspicions, but rather subjected her to months of tests and x-rays while leaving her in pain. I am angry because I feel there was a lot of neglect and that the local medical system was milking all the insurance they could. That being said, she was told that her condition was not curable, and that the most that could be done would be to manage it. Would you please share with us the facts on interstitial cystitis? Is there hope for her to have a normal life?
Dr. Hibberd's Answer:
Interstitial cystitis is a non-infectious inflammatory condition of the bladder. 90% of cases occur in women. It is initially asymptomatic, but symptoms appear as damage to the bladder wall proceeds unchecked. Diagnosis is difficult without excluding other underlying curable conditions first; hence your slew of studies. It does indeed have no cure. With treatment, 90% of patients improve. Its causes are unknown, but appear to involve the loss of the protective layer of mucin from the bladder wall that is exposed to urine.
Our bladder is the collecting bag in the front of our upper pelvic area that serves as a reservoir for urine excretion from both of our kidneys. When the bladder loses its protective lining, the next cell layer becomes exposed and inflamed. Symptoms of bladder wall irritability are frequency and urgency with spasms, and are seen in the absence of any definable infectious process. Pelvic pain may be present. When persistent, bladder scarring occurs along with a loss of bladder elasticity and capacity. Incontinence of urine is often seen in progressive cases.
Treatment is difficult and involves dietary as well as topical bladder treatments. Surgery is not uniformly successful, but cystoscopic bladder ulcer resection may help some. Sacral nerve root stimulation has been used with some degree of success. Bladder removal and urinary diversion is provided as a last resort for those with unrelenting pain. No non-prescription supplements have been shown to reliably prevent or improve this condition.
Lifestyle changes may be very helpful. Avoid tobacco products, spicy foods, alcohol, and foods high in potassium, which include fruits, tomatoes, bananas, chocolate, and caffeinated drinks.
Oral treatments are useful and include pentosan (a heparin-like product that helps restore the bladders protective lining), and antihistamines.
A number of topical bladder lining treatments are provided by installation of various solutions into the bladder (i.e. BCG, DMSO, pentosan solution, etc), usually after a cystoscopy are used with varying degrees of success, so allow your urologist to offer these early.
Bladder pain is managed by low doses of anti-depressants (often tricyclic agents such as imipramine) and NSAID medications.
Interstitial cystitis is associated with an increase risk of bladder malignancy (remember that chronic inflammatory states often precede malignant cell transformation). Regular cystoscopic surveillance and biopsy for malignant change is advised.
Dr. Hibberd's Answer:
Interstitial cystitis is a non-infectious inflammatory condition of the bladder. 90% of cases occur in women. It is initially asymptomatic, but symptoms appear as damage to the bladder wall proceeds unchecked. Diagnosis is difficult without excluding other underlying curable conditions first; hence your slew of studies. It does indeed have no cure. With treatment, 90% of patients improve. Its causes are unknown, but appear to involve the loss of the protective layer of mucin from the bladder wall that is exposed to urine.
Our bladder is the collecting bag in the front of our upper pelvic area that serves as a reservoir for urine excretion from both of our kidneys. When the bladder loses its protective lining, the next cell layer becomes exposed and inflamed. Symptoms of bladder wall irritability are frequency and urgency with spasms, and are seen in the absence of any definable infectious process. Pelvic pain may be present. When persistent, bladder scarring occurs along with a loss of bladder elasticity and capacity. Incontinence of urine is often seen in progressive cases.
Treatment is difficult and involves dietary as well as topical bladder treatments. Surgery is not uniformly successful, but cystoscopic bladder ulcer resection may help some. Sacral nerve root stimulation has been used with some degree of success. Bladder removal and urinary diversion is provided as a last resort for those with unrelenting pain. No non-prescription supplements have been shown to reliably prevent or improve this condition.
Lifestyle changes may be very helpful. Avoid tobacco products, spicy foods, alcohol, and foods high in potassium, which include fruits, tomatoes, bananas, chocolate, and caffeinated drinks.
Oral treatments are useful and include pentosan (a heparin-like product that helps restore the bladders protective lining), and antihistamines.
A number of topical bladder lining treatments are provided by installation of various solutions into the bladder (i.e. BCG, DMSO, pentosan solution, etc), usually after a cystoscopy are used with varying degrees of success, so allow your urologist to offer these early.
Bladder pain is managed by low doses of anti-depressants (often tricyclic agents such as imipramine) and NSAID medications.
Interstitial cystitis is associated with an increase risk of bladder malignancy (remember that chronic inflammatory states often precede malignant cell transformation). Regular cystoscopic surveillance and biopsy for malignant change is advised.
What Causes High Protein Levels?
Question: I've been told that I have high protein. I have no idea what it is or why I'm being checked for this. I am 66 years old.
Dr. Hibberd's Answer:
The investigation for elevated protein levels is fairly simple. You need to understand that while low protein levels are usually associated with malabsorption or poor diet, high protein levels are also problematic.
Protein in our diet is not directly absorbed. It is broken down into amino-acid building blocks, then absorbed and reconstituted into different proteins by various parts of our bodies. All our various digestive enzymes, for example, are proteins, as are our immuno-globulins (antibodies).
Overproduction of protein signifies problems and usually needs correction. Occasionally overproduction occurs, which can lead to problems with our bone marrow and kidney function, as well as adversely affecting our circulation (placing us at risk for disorders associated with circulation compromise).
While malignant disease may be present with elevated protein levels (myeloma, etc.), there are many benign, non-malignant disorders that also elevate protein levels and have their own associated conditions.
Overproduction of antibodies may be in response to infection or inflammation, or it may reflect a cell line that has escaped the usual growth controls within our bodies. Be sure your doctor considers a protein electrophoresis to classify your protein elevation, and a protein immuno-electrophoresis to graph out your immuno-globulins. Usually a urine analysis will be needed.
For example, if your globulins are elevated, an analysis will isolate the individual types and help in localizing the source to help guide treatment recommendations.
Occasionally a bone marrow sample is needed when blood and urine studies need more clarification.
Because of the various associations with underlying disorder, I recommend you discuss your investigations further with your doctor. If you need a second opinion, you will need to ask to see a hematologist.
Dr. Hibberd's Answer:
The investigation for elevated protein levels is fairly simple. You need to understand that while low protein levels are usually associated with malabsorption or poor diet, high protein levels are also problematic.
Protein in our diet is not directly absorbed. It is broken down into amino-acid building blocks, then absorbed and reconstituted into different proteins by various parts of our bodies. All our various digestive enzymes, for example, are proteins, as are our immuno-globulins (antibodies).
Overproduction of protein signifies problems and usually needs correction. Occasionally overproduction occurs, which can lead to problems with our bone marrow and kidney function, as well as adversely affecting our circulation (placing us at risk for disorders associated with circulation compromise).
While malignant disease may be present with elevated protein levels (myeloma, etc.), there are many benign, non-malignant disorders that also elevate protein levels and have their own associated conditions.
Overproduction of antibodies may be in response to infection or inflammation, or it may reflect a cell line that has escaped the usual growth controls within our bodies. Be sure your doctor considers a protein electrophoresis to classify your protein elevation, and a protein immuno-electrophoresis to graph out your immuno-globulins. Usually a urine analysis will be needed.
For example, if your globulins are elevated, an analysis will isolate the individual types and help in localizing the source to help guide treatment recommendations.
Occasionally a bone marrow sample is needed when blood and urine studies need more clarification.
Because of the various associations with underlying disorder, I recommend you discuss your investigations further with your doctor. If you need a second opinion, you will need to ask to see a hematologist.
Help for a Weak Heart
Question: My husband just had a stress test. He has no blood vessel blockage, but he was told that his heart is weak. What does that mean for him?
Dr. Hibberd's Answer:
Our heart is a pump. When it functions efficiently, it offers good blood circulation to our brain, lungs, and vital organs, and that usually translates to good tissue and organ function and general well-being.
A stress evaluation simply loads up the pump and assesses it for reserve capacity. The tests offers an indirect estimate of blood supply to the heart under stress.
A deficient heart will not tolerate load, will beat more frequently, and produce EKG findings to support ischemic (lack of blood supply) changes that reverse when the heart is at rest.
The presence of silent coronary artery disease does not usually render the pump weak until it is placed under a stress load. At that point the pump may show irritability, not work efficiently, or show signs of a lack of oxygen delivery. It may not pump well but will rarely stop beating (cardiac arrest).
Restoration of adequate blood supply to a normal heart usually renders it back to desirable pumping function. No blockage implies that circulation to the heart muscle is good, but I am concerned about what else your husband’s doctor had to say.
A normal heart needs an intact specialized conducting system to propagate blood. It also needs an intact electrical pacemaker to coordinate chamber contraction, as well as healthy valves to guide the blood in the right direction without backflow.
Your doctor may be suggesting that your husband may be at risk for future heart problems or even heart failure not related to coronary artery disease. He should ask his doctor the following questions:
• Do I have a disease of the heart muscle (cardiomyopathy)?
• Has my heart become enlarged from uncontrolled hypertension or lung disease (ventricular hypertrophy)?
• Do I have conducting system disease of the heart (heart block)?
• Will I need a pacemaker one day?
• Do I have any valvular heart disease or malfunction (valve regurgitation, stenosis, or insufficiency)?
• Do I need an imaging study such as a 2-D echocardiogram or a MUGA scan to further assess my heart function and structure?
Above all, it is important for your husband to understand why his heart muscle is weak and what should be done to improve it. If you do not get answers with good supporting evidence, request a referral and cardiology consultation.
Dr. Hibberd's Answer:
Our heart is a pump. When it functions efficiently, it offers good blood circulation to our brain, lungs, and vital organs, and that usually translates to good tissue and organ function and general well-being.
A stress evaluation simply loads up the pump and assesses it for reserve capacity. The tests offers an indirect estimate of blood supply to the heart under stress.
A deficient heart will not tolerate load, will beat more frequently, and produce EKG findings to support ischemic (lack of blood supply) changes that reverse when the heart is at rest.
The presence of silent coronary artery disease does not usually render the pump weak until it is placed under a stress load. At that point the pump may show irritability, not work efficiently, or show signs of a lack of oxygen delivery. It may not pump well but will rarely stop beating (cardiac arrest).
Restoration of adequate blood supply to a normal heart usually renders it back to desirable pumping function. No blockage implies that circulation to the heart muscle is good, but I am concerned about what else your husband’s doctor had to say.
A normal heart needs an intact specialized conducting system to propagate blood. It also needs an intact electrical pacemaker to coordinate chamber contraction, as well as healthy valves to guide the blood in the right direction without backflow.
Your doctor may be suggesting that your husband may be at risk for future heart problems or even heart failure not related to coronary artery disease. He should ask his doctor the following questions:
• Do I have a disease of the heart muscle (cardiomyopathy)?
• Has my heart become enlarged from uncontrolled hypertension or lung disease (ventricular hypertrophy)?
• Do I have conducting system disease of the heart (heart block)?
• Will I need a pacemaker one day?
• Do I have any valvular heart disease or malfunction (valve regurgitation, stenosis, or insufficiency)?
• Do I need an imaging study such as a 2-D echocardiogram or a MUGA scan to further assess my heart function and structure?
Above all, it is important for your husband to understand why his heart muscle is weak and what should be done to improve it. If you do not get answers with good supporting evidence, request a referral and cardiology consultation.
FUN FACTS
*Shakespeare invented the words "assassination" and "bump". *
* In England, the Speaker of the House is not allowed to speak. *
* "Stewardesses" is the longest word that is typed with only the left hand. *
* Mosquito repellents don't repel. They hide you. The spray blocks the mosquito's sensors so they don't know you're there. *
* The citrus soda 7-UP was created in 1929; "7" was selected because the original containers were 7 ounces. "UP" indicated the direction of the bubbles.
* In England, the Speaker of the House is not allowed to speak. *
* "Stewardesses" is the longest word that is typed with only the left hand. *
* Mosquito repellents don't repel. They hide you. The spray blocks the mosquito's sensors so they don't know you're there. *
* The citrus soda 7-UP was created in 1929; "7" was selected because the original containers were 7 ounces. "UP" indicated the direction of the bubbles.
PLEASE READ THIS AND PASS IT ALONG FOR OTHERS TO PASS ALONG!!! THANK YOU!!
You're a 19 year old kid.
You're critically wounded and dying in
the jungle somewhere in the Central Highlands of Viet Nam .
It's November 11, 1967.
LZ (landing zone) X-ray.
Your unit is outnumbered 8-1 and the enemy fire is so intense from 100 yards away, that your CO (commanding officer) has ordered the MedEvac helicopters to stop coming in. You're lying there, listening to the enemy machine guns and you know you're not getting out. Your family is half way around the world, 12,000 miles away, and you'll never see them again. As the world starts to fade in and out, you know this is the day. Then - over the machine gun noise - you faintly hear that sound of a helicopter. You look up to see a Huey coming in. But.. It doesn't seem real because no MedEvac markings are on it.
Captain Ed Freeman is coming in for you.
He's not MedEvac so it's not his job, but he heard the radio call and decided he's flying his Huey down into the machine gun fire anyway.
Even after the MedEvacs were ordered not to come. He's coming anyway.
And he drops it in and sits there in the machine gun fire, as they load 3 of you at a time on board.
hen he flies you up and out through the gunfire to the doctors and nurses and safety.
And, he kept coming back !! 13 more times!!
Until all the wounded were out. No one knew until the mission was over that the Captain had been hit 4 times in the legs and left arm.
He took 29 of you and your buddies out that day. Some would not have made it without the Captain and his Huey.
Medal of Honor Recipient, Captain Ed Freeman, United States Air Force, died last Wednesday at the age of 70, in Boise , Idaho
May God Bless and Rest His Soul.
I bet you didn't hear about this hero's passing, but we've sure seen a whole bunch about Charlie Sheen.
Medal of Honor Winner Captain Ed Freeman
Shame on the American media !!!
Now... YOU pass this along to YOUR
mailing list. Honor this real American, Please.
You're critically wounded and dying in
the jungle somewhere in the Central Highlands of Viet Nam .
It's November 11, 1967.
LZ (landing zone) X-ray.
Your unit is outnumbered 8-1 and the enemy fire is so intense from 100 yards away, that your CO (commanding officer) has ordered the MedEvac helicopters to stop coming in. You're lying there, listening to the enemy machine guns and you know you're not getting out. Your family is half way around the world, 12,000 miles away, and you'll never see them again. As the world starts to fade in and out, you know this is the day. Then - over the machine gun noise - you faintly hear that sound of a helicopter. You look up to see a Huey coming in. But.. It doesn't seem real because no MedEvac markings are on it.
Captain Ed Freeman is coming in for you.
He's not MedEvac so it's not his job, but he heard the radio call and decided he's flying his Huey down into the machine gun fire anyway.
Even after the MedEvacs were ordered not to come. He's coming anyway.
And he drops it in and sits there in the machine gun fire, as they load 3 of you at a time on board.
hen he flies you up and out through the gunfire to the doctors and nurses and safety.
And, he kept coming back !! 13 more times!!
Until all the wounded were out. No one knew until the mission was over that the Captain had been hit 4 times in the legs and left arm.
He took 29 of you and your buddies out that day. Some would not have made it without the Captain and his Huey.
Medal of Honor Recipient, Captain Ed Freeman, United States Air Force, died last Wednesday at the age of 70, in Boise , Idaho
May God Bless and Rest His Soul.
I bet you didn't hear about this hero's passing, but we've sure seen a whole bunch about Charlie Sheen.
Medal of Honor Winner Captain Ed Freeman
Shame on the American media !!!
Now... YOU pass this along to YOUR
mailing list. Honor this real American, Please.
Wednesday, March 30, 2011
THOUGHT FOR THE DAY
Truth allows you to live every day with integrity. Everything you do and say shows the world who you really are—let it be the truth.
Is Your Weight Gain Age-Related?
Most people do gain weight as they get older. That’s good news because we don’t have to wonder if we’re suddenly doing something wrong. But it’s bad news because we need to constantly adjust our eating habits and exercise routine as we age.
As we get older, our activity levels usually change to less strenuous exercise naturally. Those in the 20- to 30-year-old age group tend to jog, play tennis, work out at health clubs, etc., says the American Diabetes Association (ADA).
In later years, people tend to engage in activities like golf, bowling and watching TV. As these activities change, we burn fewer calories, of course. If we’re still eating the same amount of food we always have, weight gain will follow.
Unfortunately, older people are more efficient at storing food as fat, say recent studies. This means that for the same amount of food eaten, more exercise is needed to use it up.
To stay in a healthy weight range during the aging process, people should gradually decrease the amount of food eaten.
In general, the leaner you are, the longer you’ll live, says the ADA.
Compiled from 101 Tips for Staying Healthy with Diabetes (and Avoiding Complications). Copyright by the American Diabetes Association. Used by permission. All rights reserved.
As we get older, our activity levels usually change to less strenuous exercise naturally. Those in the 20- to 30-year-old age group tend to jog, play tennis, work out at health clubs, etc., says the American Diabetes Association (ADA).
In later years, people tend to engage in activities like golf, bowling and watching TV. As these activities change, we burn fewer calories, of course. If we’re still eating the same amount of food we always have, weight gain will follow.
Unfortunately, older people are more efficient at storing food as fat, say recent studies. This means that for the same amount of food eaten, more exercise is needed to use it up.
To stay in a healthy weight range during the aging process, people should gradually decrease the amount of food eaten.
In general, the leaner you are, the longer you’ll live, says the ADA.
Compiled from 101 Tips for Staying Healthy with Diabetes (and Avoiding Complications). Copyright by the American Diabetes Association. Used by permission. All rights reserved.
Search On for Better Radiation Treatment
Japan's nuclear emergency highlights a big medical gap: Few treatments exist to help people exposed to large amounts of radiation.
But some possibilities are in the pipeline — development of drugs to treat radiation poisoning, and the first rapid tests to tell who in a panicked crowd would really need them.
The United States calls these potential products "countermeasures," and they're part of the nation's preparations against a terrorist attack, such as a dirty bomb. But if they work, they could be useful in any kind of radiation emergency.
"Thinking of terrorist events is what drives us. Mother Nature can be much of a terror, too," says Dr. Robin Robinson, who heads the federal Biomedical Advanced Research and Development Authority, or BARDA, that funds late-stage research of products the government deems most likely to pan out.
BARDA has invested $164 million for research into anti-radiation treatment candidates since 2008, and $44 million for radiation testing — in hopes of adding such products to the nation's emergency medical stockpile soon. That's in addition to research dollars from the National Institutes of Health and the Defense Department.
The crisis in Japan, where last week two nuclear plant workers were hospitalized for radiation burns, is sure to renew attention to a field that's long been overshadowed by the hunt for protections against bioterrorism, not radiological emergencies. Among the radiation projects considered furthest along in development:
• Rapid tests that could spot dangerous radiation doses with mere finger pricks of blood. Already, a prototype machine sits at New York's Columbia University that could check thousands of people.
• Some drugs now used to help cancer patients boost their infection-fighting blood cells, sold under such names as Neupogen. They may do the same thing for radiation victims.
• An injection that saved monkeys from highly lethal beams. It seems to protect the body's two most radiation-sensitive spots, the bone marrow and lining of the gut.
Today, there are only a few proven therapies for radiation injuries. Good supportive care — lots of fluids, infusions of blood-clotting platelets, and infection-fighting antibiotics — is key for acute radiation syndrome, an overall poisoning that can begin causing symptoms days to weeks after a super-high exposure. To guard against longer-term harm, doses of potassium iodide can protect against future thyroid cancer by shielding the thyroid from one type of fallout, radioactive iodine. A few other treatments can help the body eliminate radioactive cesium and a few other isotopes.
Part of the challenge is radiation's variety of injuries: burns, bone marrow and gastrointestinal damage, lung scarring, and the later-in-life cancer risk. Yet outside of an immediate blast zone where open wounds and burns make injury clear, there's no fast way to tell who got a huge dose.
Those Geiger counter-style monitors used on power-plant workers in Japan? They detect contamination on clothing or skin that might not enter the body, not what the body has absorbed, says medical physicist David Brenner, director of Columbia's Center for Radiological Research.
Moreover, previous emergencies have shown that sheer stress can cause nausea and diarrhea that mimic some early symptoms of radiation sickness in people who weren't exposed, he adds.
"Before you can start to treat people, you need to know what radiation doses they got," Brenner says. "If you take a guess and get it wrong, you might do more harm than good."
So his team developed a way to detect early, DNA-based signs of radiation damage that estimated dose by using a drop of blood like diabetics use to test their blood sugar.
Brenner's team built a robotic machine named RABiT — for "rapid automated biodosimetry tool" — that can analyze those blood spots quickly. The eventual goal is to be able to test 30,000 blood samples in a day. Brenner is working with Northrop Grumman to make the machinery smaller, even portable.
Brenner says federal approval is still a few years away but that the prototype could be used in an emergency if health officials shipped blood samples to his lab.
What about treatments?
Cells in the bone marrow and gastrointestinal tract are extremely vulnerable to radiation. They overreact to what should be reparable damage and commit cellular suicide, says Dr. Andrei Gudkov of the Roswell Park Cancer Institute.
Gudkov's team created a drug based on a protein from normal gut bacteria, named flagellin, that blocks some of the cellular destruction and also stimulates recovery of remaining cells. It dramatically improved the survival of monkeys treated up to 48 hours after they were zapped. And safety testing in 150 healthy people so far suggests the main side effect is a flulike reaction, Gudkov says. Cleveland BioLabs Inc. is doing further work needed for Food and Drug Administration evaluation.
BARDA's Robinson says that closest to the emergency stockpile may be those cancer drugs that spur growth of infection-fighting blood cells. Later this year, his agency will begin a push for research to prove they could work similarly in a radiation emergency.
"There isn't going to be a simple solution to any of this," cautions Dr. Nelson Chao of Duke University's countermeasures program, who also co-chairs the Radiation Injury Treatment Network. "There will be a lot of little steps to address the plethora of toxicities that come from radiation."
But some possibilities are in the pipeline — development of drugs to treat radiation poisoning, and the first rapid tests to tell who in a panicked crowd would really need them.
The United States calls these potential products "countermeasures," and they're part of the nation's preparations against a terrorist attack, such as a dirty bomb. But if they work, they could be useful in any kind of radiation emergency.
"Thinking of terrorist events is what drives us. Mother Nature can be much of a terror, too," says Dr. Robin Robinson, who heads the federal Biomedical Advanced Research and Development Authority, or BARDA, that funds late-stage research of products the government deems most likely to pan out.
BARDA has invested $164 million for research into anti-radiation treatment candidates since 2008, and $44 million for radiation testing — in hopes of adding such products to the nation's emergency medical stockpile soon. That's in addition to research dollars from the National Institutes of Health and the Defense Department.
The crisis in Japan, where last week two nuclear plant workers were hospitalized for radiation burns, is sure to renew attention to a field that's long been overshadowed by the hunt for protections against bioterrorism, not radiological emergencies. Among the radiation projects considered furthest along in development:
• Rapid tests that could spot dangerous radiation doses with mere finger pricks of blood. Already, a prototype machine sits at New York's Columbia University that could check thousands of people.
• Some drugs now used to help cancer patients boost their infection-fighting blood cells, sold under such names as Neupogen. They may do the same thing for radiation victims.
• An injection that saved monkeys from highly lethal beams. It seems to protect the body's two most radiation-sensitive spots, the bone marrow and lining of the gut.
Today, there are only a few proven therapies for radiation injuries. Good supportive care — lots of fluids, infusions of blood-clotting platelets, and infection-fighting antibiotics — is key for acute radiation syndrome, an overall poisoning that can begin causing symptoms days to weeks after a super-high exposure. To guard against longer-term harm, doses of potassium iodide can protect against future thyroid cancer by shielding the thyroid from one type of fallout, radioactive iodine. A few other treatments can help the body eliminate radioactive cesium and a few other isotopes.
Part of the challenge is radiation's variety of injuries: burns, bone marrow and gastrointestinal damage, lung scarring, and the later-in-life cancer risk. Yet outside of an immediate blast zone where open wounds and burns make injury clear, there's no fast way to tell who got a huge dose.
Those Geiger counter-style monitors used on power-plant workers in Japan? They detect contamination on clothing or skin that might not enter the body, not what the body has absorbed, says medical physicist David Brenner, director of Columbia's Center for Radiological Research.
Moreover, previous emergencies have shown that sheer stress can cause nausea and diarrhea that mimic some early symptoms of radiation sickness in people who weren't exposed, he adds.
"Before you can start to treat people, you need to know what radiation doses they got," Brenner says. "If you take a guess and get it wrong, you might do more harm than good."
So his team developed a way to detect early, DNA-based signs of radiation damage that estimated dose by using a drop of blood like diabetics use to test their blood sugar.
Brenner's team built a robotic machine named RABiT — for "rapid automated biodosimetry tool" — that can analyze those blood spots quickly. The eventual goal is to be able to test 30,000 blood samples in a day. Brenner is working with Northrop Grumman to make the machinery smaller, even portable.
Brenner says federal approval is still a few years away but that the prototype could be used in an emergency if health officials shipped blood samples to his lab.
What about treatments?
Cells in the bone marrow and gastrointestinal tract are extremely vulnerable to radiation. They overreact to what should be reparable damage and commit cellular suicide, says Dr. Andrei Gudkov of the Roswell Park Cancer Institute.
Gudkov's team created a drug based on a protein from normal gut bacteria, named flagellin, that blocks some of the cellular destruction and also stimulates recovery of remaining cells. It dramatically improved the survival of monkeys treated up to 48 hours after they were zapped. And safety testing in 150 healthy people so far suggests the main side effect is a flulike reaction, Gudkov says. Cleveland BioLabs Inc. is doing further work needed for Food and Drug Administration evaluation.
BARDA's Robinson says that closest to the emergency stockpile may be those cancer drugs that spur growth of infection-fighting blood cells. Later this year, his agency will begin a push for research to prove they could work similarly in a radiation emergency.
"There isn't going to be a simple solution to any of this," cautions Dr. Nelson Chao of Duke University's countermeasures program, who also co-chairs the Radiation Injury Treatment Network. "There will be a lot of little steps to address the plethora of toxicities that come from radiation."
6 Simple Ways to Slash Sugar, Fat
We all know there are certain foods we shouldn’t eat because they contain lots of fat, sugar, and calories. But do you really want to give up your favorite brownie recipe? And who wants to swear off their afternoon special coffee drink?
There are ways to continue to enjoy those less-than-healthy treats. It just means changing up that beloved cookie recipe a bit, and tweaking that scrumptious Caffé Mocha order slightly.
You can do it. Here’s how.
1. Slim down drinks
High-calorie drinks like fruit juices and specialty coffees can come with lots of sugar and/or fat, just like solid foods do. Cut back on the sugar and calories in a bottle of juice by emptying half and storing it, then refilling the bottle with water, suggests Men’s Health. (Eight ounces of 100 percent orange juice contain 110 calories and 22 grams of sugar.) Request to have that coffee drink made with nonfat milk and sugar-free syrup. (A Starbucks 16-ounce Caffé Mocha made with 2 percent milk and topped with whipped cream contains 330 calories and 15 grams of fat. Substitute nonfat milk and skip the whipped cream, and it drops to 220 calories and just 2.5 grams of fat.)
2. Cut fat in dessert
Instead of using oil when making cookies, brownies, and other baked goodies, use applesauce or baby-food prunes and cut up to half the fat, the American Dietetic Association says. When enjoying a full-fat dessert, share a piece with a friend to decrease the amount you eat. If it’s a cake you are enjoying, scrape off the sugary frosting; with other desserts, forgo the whipped cream topping. A fan of canned fruit? Rinse off the syrup or juice it’s usually packed in; you’ll still get the benefits of its soluble fiber without the extra sugar.
3. Substitute sugar
When baking at home, you often can substitute up to half the sugar with artificial sweeteners such as sucralose (Splenda), one of the easiest to work with, the American Diabetes Association says. Be sure to read packaging instructions for artificial sweeteners carefully, and consult manufacturers’ websites, the ADA advises. You also can find additional recipes at those.
Another way of cutting back on sugar in recipes is to instead use more sweet spices and flavorings such as vanilla, nutmeg, and cinnamon.
4. Skim the top
Have you ever noticed that when you refrigerate gravy, soups, stews, and other meat and poultry dishes the fat rises to the top? A good way to cut back on the fat in those foods is to skim it off. Remember this at Thanksgiving when skimming the fat off refrigerated turkey gravy can save a whopping 56 grams of fat per cup, according to the Utah State University Cooperative Extension.
Another good cooking habit to acquire: trimming all fat from pork, beef, and chicken before cooking, and removing skin from poultry.
5. Soften butter, eat less
Set your butter out at room temperature or soften it up a bit in the microwave and you’ll likely use less of it than when it is cold, Men’s Health suggests. Another thought: Try a buttery spread fortified with plant sterols and stanols. These are LDL cholesterol-lowering substances that occur naturally in the cell membranes of fruits, vegetables, nuts, legumes, seeds, and grains. They work by blocking the absorption of “bad” cholesterol into the bloodstream.
6. Choose nuts
It’s not enough to simply eliminate unhealthy, saturated fats that block arteries and contribute to heart disease, researchers reported in the journal PLoS Medicine last week. Replacing these fats with healthier, polyunsaturated fats found in nuts, fish, vegetable oils, and other foods is critical for heart-healthy benefits. Swapping bad fats for good can lower risk of heart disease by up to 19 percent, scientists found.
Good choices include nuts such as walnuts, pecans, and almonds; avocados; and fish like tuna, salmon, and mackerel, which are high in omega-3 fatty acids.
There are ways to continue to enjoy those less-than-healthy treats. It just means changing up that beloved cookie recipe a bit, and tweaking that scrumptious Caffé Mocha order slightly.
You can do it. Here’s how.
1. Slim down drinks
High-calorie drinks like fruit juices and specialty coffees can come with lots of sugar and/or fat, just like solid foods do. Cut back on the sugar and calories in a bottle of juice by emptying half and storing it, then refilling the bottle with water, suggests Men’s Health. (Eight ounces of 100 percent orange juice contain 110 calories and 22 grams of sugar.) Request to have that coffee drink made with nonfat milk and sugar-free syrup. (A Starbucks 16-ounce Caffé Mocha made with 2 percent milk and topped with whipped cream contains 330 calories and 15 grams of fat. Substitute nonfat milk and skip the whipped cream, and it drops to 220 calories and just 2.5 grams of fat.)
2. Cut fat in dessert
Instead of using oil when making cookies, brownies, and other baked goodies, use applesauce or baby-food prunes and cut up to half the fat, the American Dietetic Association says. When enjoying a full-fat dessert, share a piece with a friend to decrease the amount you eat. If it’s a cake you are enjoying, scrape off the sugary frosting; with other desserts, forgo the whipped cream topping. A fan of canned fruit? Rinse off the syrup or juice it’s usually packed in; you’ll still get the benefits of its soluble fiber without the extra sugar.
3. Substitute sugar
When baking at home, you often can substitute up to half the sugar with artificial sweeteners such as sucralose (Splenda), one of the easiest to work with, the American Diabetes Association says. Be sure to read packaging instructions for artificial sweeteners carefully, and consult manufacturers’ websites, the ADA advises. You also can find additional recipes at those.
Another way of cutting back on sugar in recipes is to instead use more sweet spices and flavorings such as vanilla, nutmeg, and cinnamon.
4. Skim the top
Have you ever noticed that when you refrigerate gravy, soups, stews, and other meat and poultry dishes the fat rises to the top? A good way to cut back on the fat in those foods is to skim it off. Remember this at Thanksgiving when skimming the fat off refrigerated turkey gravy can save a whopping 56 grams of fat per cup, according to the Utah State University Cooperative Extension.
Another good cooking habit to acquire: trimming all fat from pork, beef, and chicken before cooking, and removing skin from poultry.
5. Soften butter, eat less
Set your butter out at room temperature or soften it up a bit in the microwave and you’ll likely use less of it than when it is cold, Men’s Health suggests. Another thought: Try a buttery spread fortified with plant sterols and stanols. These are LDL cholesterol-lowering substances that occur naturally in the cell membranes of fruits, vegetables, nuts, legumes, seeds, and grains. They work by blocking the absorption of “bad” cholesterol into the bloodstream.
6. Choose nuts
It’s not enough to simply eliminate unhealthy, saturated fats that block arteries and contribute to heart disease, researchers reported in the journal PLoS Medicine last week. Replacing these fats with healthier, polyunsaturated fats found in nuts, fish, vegetable oils, and other foods is critical for heart-healthy benefits. Swapping bad fats for good can lower risk of heart disease by up to 19 percent, scientists found.
Good choices include nuts such as walnuts, pecans, and almonds; avocados; and fish like tuna, salmon, and mackerel, which are high in omega-3 fatty acids.
Fewer fill 'dispense as written' prescriptions
NEW YORK (Reuters Health) - Patients are less likely to fill prescriptions when their doctors specify that brand name drugs can't be substituted with generics, according to a new study.
Along with leaving patients without their medications, that practice could be costing the health system almost $8 billion a year, the authors of the study in the American Journal of Medicine calculated.
Despite evidence that generic drugs work just as well and are just as safe as brand name drugs, "there's a small population of doctors that still express concern about generics," Dr. William Shrank, the lead author of the study from Harvard Medical School in Boston told Reuters Health.
And, Shrank added, "it's really hard for either patients or doctors to anticipate the cost of the medication when the patient goes to the pharmacy."
During the health care reform debate, policymakers have been pushing for widespread use of generic drugs, which may cost 2 to 3 times less than brand name drugs when they are available.
However, doctors are able to prevent pharmacies from giving patients generic drugs by writing "dispense as written" on a prescription. Patients can also request brand name drugs themselves.
In this study, Shrank and his colleagues analyzed all prescriptions that were filled by CVS Caremark at CVS stores and online over the course of 1 month. In total, there were 5.6 million prescriptions filled by 2 million patients. CVS Caremark funded the study.
Almost 3 percent of prescriptions were labeled "dispense as written" by doctors, and another 2 percent were marked by patients who wanted brand name drugs.
But even when patients were the ones who had requested a brand name drug, they were less likely to fill the prescription when they couldn't substitute generics.
When there was no "dispense as written" label on a new prescription for patients with chronic disease, about 8 percent went unfilled.
That compared to close to 12 percent when patients themselves said they didn't want a generic.
Older patients and doctors were both more likely to require that a prescription be filled with brand name drugs.
When the authors scaled the results to the 3.6 billion prescriptions that are filled annually in the U.S., Shrank and his colleagues found that patients could save $1.2 billion if doctors did away with "dispense as written" - and the health system could save $7.7 billion.
The findings show that "it's important that physicians think very carefully about whether or not the patient needs that particular brand of medication," Dr. Alex Federman, of the Mount Sinai School of Medicine in New York City, told Reuters Health.
"And, they've got to keep working that message about generics as being a perfectly cost-effective substitute for brand name medications," said Federman, who has studied how people use generics but was not involved in the current report.
Shrank said that while some doctors and patients may like the idea of prescribing and taking brand name drugs, patients might not realize how much extra those drugs will cost them. He and his colleagues found that patients in the study paid an average of about $18 for a generic prescription and $44.50 for brand name drugs that had a generic alternative.
Knowing that beforehand might help both doctors and patients make more educated decisions, Shrank said.
"There has to be more open discussion between doctors and patients about medication costs (because) cost ends up being an important barrier for many patients," he said.
SOURCE: http://bit.ly/eZZjHh The American Journal of Medicine, April 2011.
Along with leaving patients without their medications, that practice could be costing the health system almost $8 billion a year, the authors of the study in the American Journal of Medicine calculated.
Despite evidence that generic drugs work just as well and are just as safe as brand name drugs, "there's a small population of doctors that still express concern about generics," Dr. William Shrank, the lead author of the study from Harvard Medical School in Boston told Reuters Health.
And, Shrank added, "it's really hard for either patients or doctors to anticipate the cost of the medication when the patient goes to the pharmacy."
During the health care reform debate, policymakers have been pushing for widespread use of generic drugs, which may cost 2 to 3 times less than brand name drugs when they are available.
However, doctors are able to prevent pharmacies from giving patients generic drugs by writing "dispense as written" on a prescription. Patients can also request brand name drugs themselves.
In this study, Shrank and his colleagues analyzed all prescriptions that were filled by CVS Caremark at CVS stores and online over the course of 1 month. In total, there were 5.6 million prescriptions filled by 2 million patients. CVS Caremark funded the study.
Almost 3 percent of prescriptions were labeled "dispense as written" by doctors, and another 2 percent were marked by patients who wanted brand name drugs.
But even when patients were the ones who had requested a brand name drug, they were less likely to fill the prescription when they couldn't substitute generics.
When there was no "dispense as written" label on a new prescription for patients with chronic disease, about 8 percent went unfilled.
That compared to close to 12 percent when patients themselves said they didn't want a generic.
Older patients and doctors were both more likely to require that a prescription be filled with brand name drugs.
When the authors scaled the results to the 3.6 billion prescriptions that are filled annually in the U.S., Shrank and his colleagues found that patients could save $1.2 billion if doctors did away with "dispense as written" - and the health system could save $7.7 billion.
The findings show that "it's important that physicians think very carefully about whether or not the patient needs that particular brand of medication," Dr. Alex Federman, of the Mount Sinai School of Medicine in New York City, told Reuters Health.
"And, they've got to keep working that message about generics as being a perfectly cost-effective substitute for brand name medications," said Federman, who has studied how people use generics but was not involved in the current report.
Shrank said that while some doctors and patients may like the idea of prescribing and taking brand name drugs, patients might not realize how much extra those drugs will cost them. He and his colleagues found that patients in the study paid an average of about $18 for a generic prescription and $44.50 for brand name drugs that had a generic alternative.
Knowing that beforehand might help both doctors and patients make more educated decisions, Shrank said.
"There has to be more open discussion between doctors and patients about medication costs (because) cost ends up being an important barrier for many patients," he said.
SOURCE: http://bit.ly/eZZjHh The American Journal of Medicine, April 2011.
FUN FACTS
*Almonds are a member of the peach family. *
* Winston Churchill was born in a ladies' room during a dance. *
* Maine is the only state whose name is just one syllable. *
* Los Angeles' full name is "El Pueblo de Nuestra Senora la Reina de los Angeles de Porciuncula" *
* A cat has 32 muscles in each ear. *
* Winston Churchill was born in a ladies' room during a dance. *
* Maine is the only state whose name is just one syllable. *
* Los Angeles' full name is "El Pueblo de Nuestra Senora la Reina de los Angeles de Porciuncula" *
* A cat has 32 muscles in each ear. *
Hormone health is just one of the many important topics
You can look much younger than you are.
It’s just a matter of getting your hormones under control.
Our hormones regulate everything from our sex drive to our metabolism and stress levels. As you get older they start to decline and go out of balance.
This happens because of the foods we eat, the air we breathe, and the products we use. And, when your hormones are out of balance, it can play havoc with our overall health.
But it doesn’t have to be this way.
Your body can stay fit and trim like you were in your 20s. You can sleep like a baby every night and wake up feeling refreshed and focused. You can always be energetic, whether at work or play.
Let me explain…
The Key to Youthful Vitality
When you’re young, your skin is smooth, clear and has a natural elasticity. But as you age, your face takes on a new look. It gains crow’s feet and worry lines. Once taut muscles start to relax and your skin begins to sag.
Not only that, but every area of your health is affected. You begin to store more fat and build less muscle. Your energy levels drop. And you’re more susceptible to infection, disease and illness.
You can tell your hormones are out of sync when you experience:
• Mood swings
• Low energy
• Cravings for sugar or salt
• Restless sleep
• Waning libido
• Weight gain
• Changes in skin tone
For example, the hormone ghrelin normally tells you when you’re hungry. It’s triggered by an empty stomach. When you’ve had enough to eat, fat cells release leptin. This hormone tells your brain it’s time to stop eating. But if your leptin levels become unbalanced, they won’t send that signal. As a result, you’ll always feel hungry, probably eat more, and start packing on the pounds.
But it’s never too late to reverse the trend. By balancing your hormones, you can restore the looks and vitality you had when you were younger. Here’s what you can do:
Eat foods that support energy and weight hormones – These include natural, organic, and whole foods such as raw fruit, vegetables, and whole grains. Also stick with hormone-free dairy products and eat fish – including salmon, tuna and mackerel – about three times a week. If you don’t like seafood, take a fish oil supplement.1
Steer clear of high-fat and highly-processed foods. Pre-packaged meats, white bread, cookies and frozen dinners contain chemicals that adversely affect hormone levels.
Manage stress hormones with exercise and relaxation –In stressful situations, your hormones release cortisol and adrenaline. When that happens, glucose is released into your blood to provide energy. Constant stress elevates cortisol, which disrupts your metabolic system, signals your cells to store fat, and ultimately disables your brain cells. You can lower cortisol levels in your body by reducing stress.
Breathing techniques and meditation can help calm your body. Sit or lie in a comfortable position. Listen to your breathing and follow it. Or repeat a word or short phrase that means something. You can speak it or just think it in a rhythm that is comfortable. Clear your mind of worries, and focus on relaxing. Take 10 or 15 minutes out of your day to this. You can even meditate as you lie in bed at night. 2
Another way to manage stress is through exercise. Physical activity helps boost the product of endorphins, your brain’s feel-good neurotransmitters. After a fast-paced game of tennis or several laps in the pool, your mood will improve and you’ll forget your worries as you focus on your body’s movements.3
Clean up your environment – Replace chemically harmful items in your home or office with non-toxic products.
Potentially dangerous household items include air fresheners, carpet and upholstery shampoo, dishwasher detergents, furniture polish, oven and toiler bowl cleaners, and laundry detergents. Also avoid using insecticides and herbicides.4
Be selective about beauty products as well. Many items such as cosmetics, shampoos, conditioners, lotions and nail polish contain toxins.5
Also, store food in glass, ceramic or metal containers rather than in toxic plastics. Drink filtered water out of glass jars instead of plastic bottles.
Get a good night’s sleep every night – Sleep helps regulate the hormones that affect your appetite. Studies show that when your body is deprived of sleep, normal hormone balances are interrupted and your appetite increases.6 Sleep also helps lower elevated levels of stress hormones. So be sure to get 7-8 hours of sleep each night.
A Different Perspective
Hormone health is just one of the many important topics addressed in Natural Health Dossier. This cutting-edge newsletter goes beyond the limited scope of most health publications to provide you with medical news and solutions you won’t find elsewhere.
In fact, their eye-opening report entitled “11 Breakthrough Cures From Around the World” blows the lid off natural remedies the mainstream medical community doesn’t want you to know about.
To Your Good Health,
Al Sears, MD
It’s just a matter of getting your hormones under control.
Our hormones regulate everything from our sex drive to our metabolism and stress levels. As you get older they start to decline and go out of balance.
This happens because of the foods we eat, the air we breathe, and the products we use. And, when your hormones are out of balance, it can play havoc with our overall health.
But it doesn’t have to be this way.
Your body can stay fit and trim like you were in your 20s. You can sleep like a baby every night and wake up feeling refreshed and focused. You can always be energetic, whether at work or play.
Let me explain…
The Key to Youthful Vitality
When you’re young, your skin is smooth, clear and has a natural elasticity. But as you age, your face takes on a new look. It gains crow’s feet and worry lines. Once taut muscles start to relax and your skin begins to sag.
Not only that, but every area of your health is affected. You begin to store more fat and build less muscle. Your energy levels drop. And you’re more susceptible to infection, disease and illness.
You can tell your hormones are out of sync when you experience:
• Mood swings
• Low energy
• Cravings for sugar or salt
• Restless sleep
• Waning libido
• Weight gain
• Changes in skin tone
For example, the hormone ghrelin normally tells you when you’re hungry. It’s triggered by an empty stomach. When you’ve had enough to eat, fat cells release leptin. This hormone tells your brain it’s time to stop eating. But if your leptin levels become unbalanced, they won’t send that signal. As a result, you’ll always feel hungry, probably eat more, and start packing on the pounds.
But it’s never too late to reverse the trend. By balancing your hormones, you can restore the looks and vitality you had when you were younger. Here’s what you can do:
Eat foods that support energy and weight hormones – These include natural, organic, and whole foods such as raw fruit, vegetables, and whole grains. Also stick with hormone-free dairy products and eat fish – including salmon, tuna and mackerel – about three times a week. If you don’t like seafood, take a fish oil supplement.1
Steer clear of high-fat and highly-processed foods. Pre-packaged meats, white bread, cookies and frozen dinners contain chemicals that adversely affect hormone levels.
Manage stress hormones with exercise and relaxation –In stressful situations, your hormones release cortisol and adrenaline. When that happens, glucose is released into your blood to provide energy. Constant stress elevates cortisol, which disrupts your metabolic system, signals your cells to store fat, and ultimately disables your brain cells. You can lower cortisol levels in your body by reducing stress.
Breathing techniques and meditation can help calm your body. Sit or lie in a comfortable position. Listen to your breathing and follow it. Or repeat a word or short phrase that means something. You can speak it or just think it in a rhythm that is comfortable. Clear your mind of worries, and focus on relaxing. Take 10 or 15 minutes out of your day to this. You can even meditate as you lie in bed at night. 2
Another way to manage stress is through exercise. Physical activity helps boost the product of endorphins, your brain’s feel-good neurotransmitters. After a fast-paced game of tennis or several laps in the pool, your mood will improve and you’ll forget your worries as you focus on your body’s movements.3
Clean up your environment – Replace chemically harmful items in your home or office with non-toxic products.
Potentially dangerous household items include air fresheners, carpet and upholstery shampoo, dishwasher detergents, furniture polish, oven and toiler bowl cleaners, and laundry detergents. Also avoid using insecticides and herbicides.4
Be selective about beauty products as well. Many items such as cosmetics, shampoos, conditioners, lotions and nail polish contain toxins.5
Also, store food in glass, ceramic or metal containers rather than in toxic plastics. Drink filtered water out of glass jars instead of plastic bottles.
Get a good night’s sleep every night – Sleep helps regulate the hormones that affect your appetite. Studies show that when your body is deprived of sleep, normal hormone balances are interrupted and your appetite increases.6 Sleep also helps lower elevated levels of stress hormones. So be sure to get 7-8 hours of sleep each night.
A Different Perspective
Hormone health is just one of the many important topics addressed in Natural Health Dossier. This cutting-edge newsletter goes beyond the limited scope of most health publications to provide you with medical news and solutions you won’t find elsewhere.
In fact, their eye-opening report entitled “11 Breakthrough Cures From Around the World” blows the lid off natural remedies the mainstream medical community doesn’t want you to know about.
To Your Good Health,
Al Sears, MD
Tuesday, March 29, 2011
THOUGHT FOR THE DAY
The way to choose happiness is to follow what is right and real and the truth for you.
FDA Ponders: Food Dye Makes Kids Hyper?
U.S. regulators are weighing a question parents have asked since the 1970s: Do artificial food dyes make children hyperactive?
A consumer group has petitioned the government to ban blue, green, orange, red, and yellow food colorings. The synthetic dyes are common in food and drinks ranging from PepsiCo's Gatorade, Cheetos, and Doritos to Kellogg's Eggo waffles and Kraft's Jell-O desserts.
Manufacturers say reviews by regulators around the world confirm the dyes are safe. The Center for Science in the Public Interest argues, however, there is plenty of data showing the dyes trigger hyperactivity in kids who are predisposed to it.
"There is convincing evidence that food dyes impair the behavior of some children," said Michael Jacobson, head of the consumer group famous for exposing the fat and calories in movie-theater popcorn and fast food.
Jacobson and others will testify this week before a Food and Drug Administration advisory committee that will consider the question on Wednesday and Thursday. The FDA will hear the advisers' views before deciding whether to take any action, which could take months or years.
FDA reviewers, in documents prepared for the advisory panel, said scientific research so far suggested some children with attention deficit and hyperactivity disorder (ADHD) may be affected by food coloring. The disorder affects up to 5 percent of U.S. children, according to government statistics.
"For certain susceptible children with ADHD and other problem behaviors, the data suggest their condition may be exacerbated" by substances in food including artificial colors, the FDA staff wrote in a preliminary analysis.
For the general population, the FDA "concludes that a causal relationship" between the dyes and hyperactivity "has not been established," the agency staff said.
At the panel meeting this week, the FDA will ask outside experts if they agree with the agency's conclusions or if they think more studies are needed.
Concerns about food dyes erupted in the 1970s when a pediatrician, Dr. Ben Feingold, claimed the colors were linked to hyperactive behavior and proposed a diet eliminating them.
Questions flared again after a 2007 British study of kids who drank fruit drinks with food colorings and preservatives.
The scientists concluded the colorings worsened hyperactive behavior and also affected kids not previously diagnosed with ADHD.
Other researchers said the study had limitations. A 2009 review by European authorities concluded all data available at the time did not support a link between food colorings and hyperactivity.
The 2008 petition from CSPI asked the FDA to ban all but one of the dyes, calling them "dangerous and unnecessary." The exception, Citrus Red No. 2, is used only on orange skins. Companies could substitute natural colors, fruit, or fruit juices, CSPI said.
The group also asked the FDA to require a warning on products containing dyes until a ban takes effect.
The Grocery Manufacturers Association, which represents food producers and packagers, said "extensive review" by the FDA and European authorities showed the dyes were safe.
"All of the major safety bodies globally have reviewed the available science and have determined that there is no demonstrable link between artificial colors and hyperactivity among children," the group said in a statement.
A consumer group has petitioned the government to ban blue, green, orange, red, and yellow food colorings. The synthetic dyes are common in food and drinks ranging from PepsiCo's Gatorade, Cheetos, and Doritos to Kellogg's Eggo waffles and Kraft's Jell-O desserts.
Manufacturers say reviews by regulators around the world confirm the dyes are safe. The Center for Science in the Public Interest argues, however, there is plenty of data showing the dyes trigger hyperactivity in kids who are predisposed to it.
"There is convincing evidence that food dyes impair the behavior of some children," said Michael Jacobson, head of the consumer group famous for exposing the fat and calories in movie-theater popcorn and fast food.
Jacobson and others will testify this week before a Food and Drug Administration advisory committee that will consider the question on Wednesday and Thursday. The FDA will hear the advisers' views before deciding whether to take any action, which could take months or years.
FDA reviewers, in documents prepared for the advisory panel, said scientific research so far suggested some children with attention deficit and hyperactivity disorder (ADHD) may be affected by food coloring. The disorder affects up to 5 percent of U.S. children, according to government statistics.
"For certain susceptible children with ADHD and other problem behaviors, the data suggest their condition may be exacerbated" by substances in food including artificial colors, the FDA staff wrote in a preliminary analysis.
For the general population, the FDA "concludes that a causal relationship" between the dyes and hyperactivity "has not been established," the agency staff said.
At the panel meeting this week, the FDA will ask outside experts if they agree with the agency's conclusions or if they think more studies are needed.
Concerns about food dyes erupted in the 1970s when a pediatrician, Dr. Ben Feingold, claimed the colors were linked to hyperactive behavior and proposed a diet eliminating them.
Questions flared again after a 2007 British study of kids who drank fruit drinks with food colorings and preservatives.
The scientists concluded the colorings worsened hyperactive behavior and also affected kids not previously diagnosed with ADHD.
Other researchers said the study had limitations. A 2009 review by European authorities concluded all data available at the time did not support a link between food colorings and hyperactivity.
The 2008 petition from CSPI asked the FDA to ban all but one of the dyes, calling them "dangerous and unnecessary." The exception, Citrus Red No. 2, is used only on orange skins. Companies could substitute natural colors, fruit, or fruit juices, CSPI said.
The group also asked the FDA to require a warning on products containing dyes until a ban takes effect.
The Grocery Manufacturers Association, which represents food producers and packagers, said "extensive review" by the FDA and European authorities showed the dyes were safe.
"All of the major safety bodies globally have reviewed the available science and have determined that there is no demonstrable link between artificial colors and hyperactivity among children," the group said in a statement.
Life-Extending Melanoma Drug Approved
The Food and Drug Administration has approved a breakthrough cancer medication from Bristol-Myers Squibb Co. that researchers have heralded as the first drug shown to prolong the lives of patients with advanced skin cancer.
The federal health agency approved the injectable drug, called Yervoy, for late-stage or metastatic melanoma. Melanoma is the deadliest type of skin cancer, but the FDA has only approved two other drugs for advanced melanoma. The newest of those drugs was cleared more than 13 years ago. Neither drug has been shown to significantly extend patient lives.
Known chemically as ipilimumab, the biotech drug only worked in a small segment of patients studied, and on average they lived just four months longer than patients given older medications. But experts say the drug is an important milestone in treating melanoma, which is often unresponsive to therapy.
"Clearly this is not a home run, but it's a solid base hit," said Tim Turnham, director of the Melanoma Research Foundation. "And because we see other things in the pipeline, we think this the first in a series of important new therapies for melanoma."
Ipilimumab is part of a group of targeted cancer medicines that harness the body's immune system to fight off cancer, rather than attacking the disease with outside chemicals like chemotherapy. The drug works by blocking a molecule linked to melanoma called CTLA-4, which interferes with the protective activity of white blood cells. When the molecule is blocked, the cells behave normally and help fight off cancer.
Yervoy carries several side effects related to its impact on the immune system, including: diarrhea, swelling of the colon, rash, and fatigue. It can cause fatal immune system reactions. The most frequent severe reactions included inflammations of the colon and small intestine, liver, and skin, as well as nerve damage and endocrine disease. Those side effects usually occurred during treatment, but some occurred after treatment ended.
The FDA said severe to fatal immune reactions occurred in 12.9 percent of patients during clinical trials. The agency is requiring Bristol-Myers Squibb to create a risk evaluation strategy designed to identify and reduce the severe risks associated with the drug.
Mike Brockey of Frederick, Md., was diagnosed with late-stage melanoma in 2008 and tried both conventional and alternative medicines before starting therapy with ipilimumab last September. He received four infusions of the drug every three weeks through November, which is the recommended dosing regimen. Though the drug took time to work, he says his latest scans show that his tumors are inactive.
"This is the first time in two years I had a sense that anything was going in the right direction," Brockey said.
Melanoma is the fastest growing form of cancer in terms of new diagnoses. Researchers attribute the acceleration to longer life expectancies among the elderly and increased use of indoor tanning beds by the young.
About 68,000 people in the United States were diagnosed last year and 8,700 patients died, according to the American Cancer Society.
FDA approved the drug based on a Bristol-Myers study of 676 people with advanced, inoperable melanoma who had already failed two other treatments, giving them a very short life expectancy. They were given one of three treatments: ipilimumab by itself, ipilimumab combined with another immune-stimulating treatment, or the immune-stimulating treatment alone.
Average survival was 10 months with ipilimumab versus just more than six months for the others. But a very small group of patients survived longer than six years, suggesting that with more study the drug could be targeted to those who will respond the most.
About 85 percent of patients had little response to the drug. Researchers say the response rate should improve as the drug is used earlier in the disease cycle.
"I think the direction this is headed is toward intervening earlier, when patients' immune systems are still intact, rather than waiting until they are so sick," said Dr. Anna Pavlick, director of the New York University's melanoma program. Pavlick, a spokeswoman for the Skin Cancer Foundation, helped conduct several early-stage trials of ipilimumab.
On Monday Bristol-Myers reported that ipilimumab also improved survival times when used as a first-line treatment against advanced skin cancer in patients who hadn't taken any other treatments. These patients are generally less sick than those first studied by the company and could see even longer survival times. Bristol said it would release those findings at the annual meeting of the American Society of Clinical Oncology in June.
Bristol said it would disclose pricing details of the drug later.
Citi Investment Research analyst John Boris estimates ipilimumab could reach total sales of $960 million by 2015.
Ipilimumab is one of several key medications Bristol is counting on to sustain its business in coming years. Like most drugmakers, the New York-based company faces a wave of patent expirations that will expose key drugs to generic competition. The company will lose patent protection for both its blood thinner Plavix, the world's second-best-selling drug, and for the high blood pressure drug Avapro in the first half of 2012.
In Friday afternoon trading, shares of Bristol-Myers added 2.1 percent, or 56 cents, to $26.98.
The federal health agency approved the injectable drug, called Yervoy, for late-stage or metastatic melanoma. Melanoma is the deadliest type of skin cancer, but the FDA has only approved two other drugs for advanced melanoma. The newest of those drugs was cleared more than 13 years ago. Neither drug has been shown to significantly extend patient lives.
Known chemically as ipilimumab, the biotech drug only worked in a small segment of patients studied, and on average they lived just four months longer than patients given older medications. But experts say the drug is an important milestone in treating melanoma, which is often unresponsive to therapy.
"Clearly this is not a home run, but it's a solid base hit," said Tim Turnham, director of the Melanoma Research Foundation. "And because we see other things in the pipeline, we think this the first in a series of important new therapies for melanoma."
Ipilimumab is part of a group of targeted cancer medicines that harness the body's immune system to fight off cancer, rather than attacking the disease with outside chemicals like chemotherapy. The drug works by blocking a molecule linked to melanoma called CTLA-4, which interferes with the protective activity of white blood cells. When the molecule is blocked, the cells behave normally and help fight off cancer.
Yervoy carries several side effects related to its impact on the immune system, including: diarrhea, swelling of the colon, rash, and fatigue. It can cause fatal immune system reactions. The most frequent severe reactions included inflammations of the colon and small intestine, liver, and skin, as well as nerve damage and endocrine disease. Those side effects usually occurred during treatment, but some occurred after treatment ended.
The FDA said severe to fatal immune reactions occurred in 12.9 percent of patients during clinical trials. The agency is requiring Bristol-Myers Squibb to create a risk evaluation strategy designed to identify and reduce the severe risks associated with the drug.
Mike Brockey of Frederick, Md., was diagnosed with late-stage melanoma in 2008 and tried both conventional and alternative medicines before starting therapy with ipilimumab last September. He received four infusions of the drug every three weeks through November, which is the recommended dosing regimen. Though the drug took time to work, he says his latest scans show that his tumors are inactive.
"This is the first time in two years I had a sense that anything was going in the right direction," Brockey said.
Melanoma is the fastest growing form of cancer in terms of new diagnoses. Researchers attribute the acceleration to longer life expectancies among the elderly and increased use of indoor tanning beds by the young.
About 68,000 people in the United States were diagnosed last year and 8,700 patients died, according to the American Cancer Society.
FDA approved the drug based on a Bristol-Myers study of 676 people with advanced, inoperable melanoma who had already failed two other treatments, giving them a very short life expectancy. They were given one of three treatments: ipilimumab by itself, ipilimumab combined with another immune-stimulating treatment, or the immune-stimulating treatment alone.
Average survival was 10 months with ipilimumab versus just more than six months for the others. But a very small group of patients survived longer than six years, suggesting that with more study the drug could be targeted to those who will respond the most.
About 85 percent of patients had little response to the drug. Researchers say the response rate should improve as the drug is used earlier in the disease cycle.
"I think the direction this is headed is toward intervening earlier, when patients' immune systems are still intact, rather than waiting until they are so sick," said Dr. Anna Pavlick, director of the New York University's melanoma program. Pavlick, a spokeswoman for the Skin Cancer Foundation, helped conduct several early-stage trials of ipilimumab.
On Monday Bristol-Myers reported that ipilimumab also improved survival times when used as a first-line treatment against advanced skin cancer in patients who hadn't taken any other treatments. These patients are generally less sick than those first studied by the company and could see even longer survival times. Bristol said it would release those findings at the annual meeting of the American Society of Clinical Oncology in June.
Bristol said it would disclose pricing details of the drug later.
Citi Investment Research analyst John Boris estimates ipilimumab could reach total sales of $960 million by 2015.
Ipilimumab is one of several key medications Bristol is counting on to sustain its business in coming years. Like most drugmakers, the New York-based company faces a wave of patent expirations that will expose key drugs to generic competition. The company will lose patent protection for both its blood thinner Plavix, the world's second-best-selling drug, and for the high blood pressure drug Avapro in the first half of 2012.
In Friday afternoon trading, shares of Bristol-Myers added 2.1 percent, or 56 cents, to $26.98.
More States Report Radiation from Japan
Utilities in North and South Carolina are adding to the list of states in the United States reporting trace amounts of radiation from a nuclear reactor in Japan that was damaged by an earthquake and tsunami.
Progress Energy and Duke Energy in North Carolina and South Carolina Electric and Gas Co. all operate nuclear plants and say they've detected trace amounts of radiation.
Nuclear experts and health officials say there's no public health risk. The Environmental Protection Agency says people are exposed to much more radiation on an international airline flight.
Progress Energy says it picked up low levels of iodine-131, a radioactive byproduct of nuclear fission, at its nuclear plant in South Carolina and a Florida plant.
Massachusetts, Nevada, and other Western states also have reported minuscule amounts of radiation.
Nevada health officials have said they do not expect any risk to the state from Japanese radiation releases because of the distance the materials would have to travel.
"Any material released must travel 10,000 miles across the Pacific Ocean, during which time it will be dispersed and diluted in the atmosphere to levels that might eventually be detectable, but which will not present a health hazard nor require any protective actions," said Eric Matus, radiation physicist for the Nevada State Health Division.
Scientists say they weren't surprised that radioactive isotopes from Japan were detected in the Western states.
"They get caught up in the right wind pattern and they'll move across the ocean," said Jeff Daniels, an environmental scientist with Reno-based Desert Research Institute.
Tiny amounts of the radioactive isotope cesium-137 were detected at a University of Nevada, Las Vegas laboratory between March 17 and 21, but haven't been reported since then, Hartwell said.
The Desert Research Institute operates 29 stations that monitor the air for radioactivity around the Nevada National Security Site, formerly the Nevada Test Site, about 65 miles northwest of Las Vegas. The institute plans to release the results of testing at the other stations and post them online by late in the week, Hartwell said.
Progress Energy and Duke Energy in North Carolina and South Carolina Electric and Gas Co. all operate nuclear plants and say they've detected trace amounts of radiation.
Nuclear experts and health officials say there's no public health risk. The Environmental Protection Agency says people are exposed to much more radiation on an international airline flight.
Progress Energy says it picked up low levels of iodine-131, a radioactive byproduct of nuclear fission, at its nuclear plant in South Carolina and a Florida plant.
Massachusetts, Nevada, and other Western states also have reported minuscule amounts of radiation.
Nevada health officials have said they do not expect any risk to the state from Japanese radiation releases because of the distance the materials would have to travel.
"Any material released must travel 10,000 miles across the Pacific Ocean, during which time it will be dispersed and diluted in the atmosphere to levels that might eventually be detectable, but which will not present a health hazard nor require any protective actions," said Eric Matus, radiation physicist for the Nevada State Health Division.
Scientists say they weren't surprised that radioactive isotopes from Japan were detected in the Western states.
"They get caught up in the right wind pattern and they'll move across the ocean," said Jeff Daniels, an environmental scientist with Reno-based Desert Research Institute.
Tiny amounts of the radioactive isotope cesium-137 were detected at a University of Nevada, Las Vegas laboratory between March 17 and 21, but haven't been reported since then, Hartwell said.
The Desert Research Institute operates 29 stations that monitor the air for radioactivity around the Nevada National Security Site, formerly the Nevada Test Site, about 65 miles northwest of Las Vegas. The institute plans to release the results of testing at the other stations and post them online by late in the week, Hartwell said.
FUN FACTS
*The cruise line, Queen Elizabeth II, moves six inches for each gallon of diesel it burns. *
* The first Ford cars had Dodge engines. *
* Oak trees do not produce acorns until they are fifty years of age or older.*
* A Boeing 747s wingspan is longer than the Wright brother's first flight. *
* Venus is the only planet that rotates clockwise. *
* The first Ford cars had Dodge engines. *
* Oak trees do not produce acorns until they are fifty years of age or older.*
* A Boeing 747s wingspan is longer than the Wright brother's first flight. *
* Venus is the only planet that rotates clockwise. *
Rare disease means constant pain - PLEASE READ THIS AND IF YOU CAN PLEASE HELP HIM! I HAVE RSD/CRPS AND FIBROMYALGIA AND I KNOW WHAT THIS POOR CHILD IS LIVING THRU. IF YOU HAVE THIS PLEASE LET'S HELP HIM! THANK YOU!
Rare disease means constant pain -
Visiting 14-year-old Joseph Martinez in his home, it's difficult to believe that, just six months ago, he was a healthy boy who enjoyed Little League baseball, flag football and carousing with friends.
Now, the Torrance teen lies in bed on his stomach 24 hours a day, drugged on methadone, with his head facing the bedroom door but his face obscured by a mop of black hair, moaning and writhing from a pain that touches every region of his body.
Joseph is stricken by a mysterious disease called complex regional pain syndrome, characterized by severe and relentless pain due to misfiring nerves, which in turn send pain signals to the brain. It's a rare condition, afflicting between 200,000 and 1.2 million Americans, but is
Joseph Martinez in a fairly recent picture before he began suffering from chronic pain syndrome. family pic. becoming more prevalent in children, according to the Reflex Sympathetic Dystrophy Syndrome Association.
Joseph chooses to lie on his stomach because, for some reason, lying on his back is unbearable. The pain is such that he cannot put on a shirt or take a shower without screaming.
He has been in this state, and in this bed, for five months.
In October, he dropped out of school at the K-8 St. Catherine Laboure school in Torrance, where he once thrived and where his family has been a prominent fixture for years.
"He used to weigh 169 pounds," said his mother, Susan Martinez. "Now he's bones."
To their heartbreak, he has even asked them for death.
"He says it, `just kill me,' I can't go
on," said his father, Justin Martinez, who for years has volunteered at the school as a basketball coach. "Maybe three times, he's asked me to hug him, but he can't ask anymore because it hurts too much."
His parents are frantically trying to find a treatment. Thus far, their efforts have borne little fruit. They've battled their insurance company and listened to flawed advice from doctors unfamiliar with the disorder. Now, the entire family is stressed out and sleep-deprived, due to Joseph's round-the-clock wailing.
Their primary problem is that few hospitals - as few as three in the United States - are fully equipped to treat the condition, and the family's insurance coverage prohibits them from seeking help outside their network area in the South Bay.
But they've reached their wit's end, and plan to fly him to what they believe is the best of those hospitals, Cleveland Clinic Children's Hospital, costs be damned. They plan to pay the $45,000 out of pocket, and that doesn't include airfare or hotel expenses.
Meanwhile, moved by their friend's plight, Joseph's classmates at school have organized a weeklong event in honor of him. All this week, they've been wearing blue - Joseph's favorite color
Dozens of pain medications that have failed to relieve Joseph Martinez's chronic pain syndrome. Photo by Brad Graverson 3-21-11 - and holding bake sales.
The original idea was to raise a hundred or so dollars as a gesture of kindness. But Joseph's story struck a chord with parents, and the money has been pouring in. Already, the school has raised more than $10,000.
"It speaks to the closeness of our school and parish community," said Mary Dell'Amico, St. Catherine's vice principal. "Many of our families struggle just to make tuition. To see the kind of donations coming in is just inspiring."
The third of four children, Joseph's two older siblings were standout athletes and scholars at St. Catherine, Dell'Amico said. He, too, was a decent athlete and student, and was always well liked by classmates.
"He was quiet but you knew he was there," she said. "He wasn't one of the boisterous kids that had to be the center of attention."
The Martinez family is a single-income household, with Susan holding down a job as a project dispatcher at Triumph Aerostructures in Hawthorne. Justin, who himself suffers from a spinal disease, is Joseph's primary caretaker during the day, and the home-schooler of their youngest child.
Even in the medical community, not much is known about complex regional pain syndrome. This means doctors are often at a loss about how to treat it.
This was certainly the case for the Martinez family, which dealt with one perplexed doctor after another at Torrance Memorial, Miller Children's Hospital in Long Beach, and Children's Hospital Los Angeles. One well-meaning doctor reasoned that the best remedy was to minimize the pain by prescribing a maximum dosage of heavy-duty painkillers, such as morphine and the fentanyl patches that are commonly used on cancer patients.
The powerful drugs left the boy in drowsy, but, to everyone's surprise, were useless in relieving pain. Instead, they simply turned him into an unwitting addict.
Other doctors concluded that the pain must be entirely psychological. One even asked the parents to leave the boy's hospital room and then, after they complied, ordered him to get out of bed and walk.
After cycling through 18 doctors, the family in January finally found hope in Dr. Lonnie Zeltzer, the renowned director of the pediatric pain program at Mattel Children's Hospital at UCLA.
"She was the only one who went to Joseph and said, `You are not faking it,"' Susan said.
Zeltzer said the family needed to send the boy to one of the three hospitals. (Zeltzer's program does not have the in-patient component that he needs. And even if it did, the insurance wouldn't cover it.)
Zeltzer, whose name appears frequently in national media outlets as a pain expert, said Joseph's condition has languished so long that it has morphed into "widespread central pain syndrome."
"I think that many doctors, if they do tests and can't find anything in their tests, they assume it's psychology or attention-getting," she said. "They sort of downplay the amount of suffering."
Adding to the misery, being bedridden has brought about secondary pain. The incessant moaning and screaming, for instance, has left Joseph with a sore throat. The inactivity has weakened his left arm to the point where he only uses his right. He will have to relearn how to walk.
Still, Zeltzer believes that, if treated correctly, Joseph will again throw a baseball, toss a football, haul his books to class and hang with friends - as early as next year.
When she treated him this winter, Zeltzer's first order of business was to wean him off the high-octane painkillers without triggering withdrawal. She put him on methadone, which is often prescribed to patients hooked on opioid drugs, as well as recovering heroin addicts. Now, she said, he needs to attend one of the three medical centers. (The other two are in Stanford and Seattle.)
There, a team of specialists in psychiatry, psychology and occupational therapy will help him retrain his brain, which has been re-networked in such a way that the pain receptors refuse to turn off. Physical therapists will get him moving again, strengthening his muscles.
Complex regional pain syndrome tends to be triggered by a traumatic event, such as a car accident or medical procedure. Often, the severity of the pain experienced by the victim exceeds what would be expected. The age of the average sufferer is 42, but experts say it is becoming more and more prevalent in children, usually girls.
In Joseph's case, the family believes the catalyst was an episode of food poisoning that left him with flu-like symptoms.
Zeltzer said one way to better understand CRPS is to think of the amputees who routinely suffer from what is known as phantom pain. Although the limb is gone, the receptors in the brain associated with it are still there, and oftentimes are still firing.
For amputees, the phantom pain usually subsides after a year, Zeltzer said. But sufferers such as Joseph must retrain their brain. This, she said, requires learning about how emotions and thoughts affect physical pain, and then using that knowledge to change thought patterns.
For instance, she said, signals of distress in the brain often set off a chain reaction that bathes the brain in stress hormones, which may disrupt a person's sleep schedule, which in turn often leads to a heightened sensory of pain.
"If you don't get good restorative sleep, your body starts to feel pain in general," she said. "It's like a snowball effect."
To help Joseph, a therapist may ask him to imagine an activity he enjoys, like playing baseball.
"They want them to really be there, to really feel it: the warmth of the sun, all the sensations," Zeltzer said. Once the muscles are relaxed, once the circuitry calms down, the patient is asked to take a moment to notice his current state of tranquility.
"In a sense, you're replacing the pain-image circuitry with developing a new circuitry of feeling really good," she said. "Your brain learns that bodily state of relaxation just like learning how to write the alphabet or ride a bike."
Last week, without prompting from the family, Zeltzer tried to intervene on Joseph's behalf. She called the medical director of their health care provider, THIPA, in an effort to get the child admitted to Stanford, with THIPA picking up the tab. They haven't heard back.
The Martinez family would prefer Cleveland to Stanford. However, they said should the health provider cover a trip to Stanford, they will gladly go. In that event, any unused proceeds from the school fundraiser - which they did not initiate - would be returned.
As for the food poisoning that may have provoked Joseph's condition, the family believes it was a meal of undercooked chicken in September. All six family members got sick, but for Joseph and his younger brother, the symptoms developed into something akin to the flu.
His younger brother recovered after a month, but the symptoms only worsened for Joseph.
"The virus by now, it's undetectable," said Justin, a 39-year-old graduate of North High School in Torrance. "It's long gone, but the damage is still there."
rob.kuznia@dailybreeze.com
How to Help
Anyone interested in contributing to St. Catherine Laboure's fundraiser for Joseph should call the school at 310-324-8732.
Visiting 14-year-old Joseph Martinez in his home, it's difficult to believe that, just six months ago, he was a healthy boy who enjoyed Little League baseball, flag football and carousing with friends.
Now, the Torrance teen lies in bed on his stomach 24 hours a day, drugged on methadone, with his head facing the bedroom door but his face obscured by a mop of black hair, moaning and writhing from a pain that touches every region of his body.
Joseph is stricken by a mysterious disease called complex regional pain syndrome, characterized by severe and relentless pain due to misfiring nerves, which in turn send pain signals to the brain. It's a rare condition, afflicting between 200,000 and 1.2 million Americans, but is
Joseph Martinez in a fairly recent picture before he began suffering from chronic pain syndrome. family pic. becoming more prevalent in children, according to the Reflex Sympathetic Dystrophy Syndrome Association.
Joseph chooses to lie on his stomach because, for some reason, lying on his back is unbearable. The pain is such that he cannot put on a shirt or take a shower without screaming.
He has been in this state, and in this bed, for five months.
In October, he dropped out of school at the K-8 St. Catherine Laboure school in Torrance, where he once thrived and where his family has been a prominent fixture for years.
"He used to weigh 169 pounds," said his mother, Susan Martinez. "Now he's bones."
To their heartbreak, he has even asked them for death.
"He says it, `just kill me,' I can't go
on," said his father, Justin Martinez, who for years has volunteered at the school as a basketball coach. "Maybe three times, he's asked me to hug him, but he can't ask anymore because it hurts too much."
His parents are frantically trying to find a treatment. Thus far, their efforts have borne little fruit. They've battled their insurance company and listened to flawed advice from doctors unfamiliar with the disorder. Now, the entire family is stressed out and sleep-deprived, due to Joseph's round-the-clock wailing.
Their primary problem is that few hospitals - as few as three in the United States - are fully equipped to treat the condition, and the family's insurance coverage prohibits them from seeking help outside their network area in the South Bay.
But they've reached their wit's end, and plan to fly him to what they believe is the best of those hospitals, Cleveland Clinic Children's Hospital, costs be damned. They plan to pay the $45,000 out of pocket, and that doesn't include airfare or hotel expenses.
Meanwhile, moved by their friend's plight, Joseph's classmates at school have organized a weeklong event in honor of him. All this week, they've been wearing blue - Joseph's favorite color
Dozens of pain medications that have failed to relieve Joseph Martinez's chronic pain syndrome. Photo by Brad Graverson 3-21-11 - and holding bake sales.
The original idea was to raise a hundred or so dollars as a gesture of kindness. But Joseph's story struck a chord with parents, and the money has been pouring in. Already, the school has raised more than $10,000.
"It speaks to the closeness of our school and parish community," said Mary Dell'Amico, St. Catherine's vice principal. "Many of our families struggle just to make tuition. To see the kind of donations coming in is just inspiring."
The third of four children, Joseph's two older siblings were standout athletes and scholars at St. Catherine, Dell'Amico said. He, too, was a decent athlete and student, and was always well liked by classmates.
"He was quiet but you knew he was there," she said. "He wasn't one of the boisterous kids that had to be the center of attention."
The Martinez family is a single-income household, with Susan holding down a job as a project dispatcher at Triumph Aerostructures in Hawthorne. Justin, who himself suffers from a spinal disease, is Joseph's primary caretaker during the day, and the home-schooler of their youngest child.
Even in the medical community, not much is known about complex regional pain syndrome. This means doctors are often at a loss about how to treat it.
This was certainly the case for the Martinez family, which dealt with one perplexed doctor after another at Torrance Memorial, Miller Children's Hospital in Long Beach, and Children's Hospital Los Angeles. One well-meaning doctor reasoned that the best remedy was to minimize the pain by prescribing a maximum dosage of heavy-duty painkillers, such as morphine and the fentanyl patches that are commonly used on cancer patients.
The powerful drugs left the boy in drowsy, but, to everyone's surprise, were useless in relieving pain. Instead, they simply turned him into an unwitting addict.
Other doctors concluded that the pain must be entirely psychological. One even asked the parents to leave the boy's hospital room and then, after they complied, ordered him to get out of bed and walk.
After cycling through 18 doctors, the family in January finally found hope in Dr. Lonnie Zeltzer, the renowned director of the pediatric pain program at Mattel Children's Hospital at UCLA.
"She was the only one who went to Joseph and said, `You are not faking it,"' Susan said.
Zeltzer said the family needed to send the boy to one of the three hospitals. (Zeltzer's program does not have the in-patient component that he needs. And even if it did, the insurance wouldn't cover it.)
Zeltzer, whose name appears frequently in national media outlets as a pain expert, said Joseph's condition has languished so long that it has morphed into "widespread central pain syndrome."
"I think that many doctors, if they do tests and can't find anything in their tests, they assume it's psychology or attention-getting," she said. "They sort of downplay the amount of suffering."
Adding to the misery, being bedridden has brought about secondary pain. The incessant moaning and screaming, for instance, has left Joseph with a sore throat. The inactivity has weakened his left arm to the point where he only uses his right. He will have to relearn how to walk.
Still, Zeltzer believes that, if treated correctly, Joseph will again throw a baseball, toss a football, haul his books to class and hang with friends - as early as next year.
When she treated him this winter, Zeltzer's first order of business was to wean him off the high-octane painkillers without triggering withdrawal. She put him on methadone, which is often prescribed to patients hooked on opioid drugs, as well as recovering heroin addicts. Now, she said, he needs to attend one of the three medical centers. (The other two are in Stanford and Seattle.)
There, a team of specialists in psychiatry, psychology and occupational therapy will help him retrain his brain, which has been re-networked in such a way that the pain receptors refuse to turn off. Physical therapists will get him moving again, strengthening his muscles.
Complex regional pain syndrome tends to be triggered by a traumatic event, such as a car accident or medical procedure. Often, the severity of the pain experienced by the victim exceeds what would be expected. The age of the average sufferer is 42, but experts say it is becoming more and more prevalent in children, usually girls.
In Joseph's case, the family believes the catalyst was an episode of food poisoning that left him with flu-like symptoms.
Zeltzer said one way to better understand CRPS is to think of the amputees who routinely suffer from what is known as phantom pain. Although the limb is gone, the receptors in the brain associated with it are still there, and oftentimes are still firing.
For amputees, the phantom pain usually subsides after a year, Zeltzer said. But sufferers such as Joseph must retrain their brain. This, she said, requires learning about how emotions and thoughts affect physical pain, and then using that knowledge to change thought patterns.
For instance, she said, signals of distress in the brain often set off a chain reaction that bathes the brain in stress hormones, which may disrupt a person's sleep schedule, which in turn often leads to a heightened sensory of pain.
"If you don't get good restorative sleep, your body starts to feel pain in general," she said. "It's like a snowball effect."
To help Joseph, a therapist may ask him to imagine an activity he enjoys, like playing baseball.
"They want them to really be there, to really feel it: the warmth of the sun, all the sensations," Zeltzer said. Once the muscles are relaxed, once the circuitry calms down, the patient is asked to take a moment to notice his current state of tranquility.
"In a sense, you're replacing the pain-image circuitry with developing a new circuitry of feeling really good," she said. "Your brain learns that bodily state of relaxation just like learning how to write the alphabet or ride a bike."
Last week, without prompting from the family, Zeltzer tried to intervene on Joseph's behalf. She called the medical director of their health care provider, THIPA, in an effort to get the child admitted to Stanford, with THIPA picking up the tab. They haven't heard back.
The Martinez family would prefer Cleveland to Stanford. However, they said should the health provider cover a trip to Stanford, they will gladly go. In that event, any unused proceeds from the school fundraiser - which they did not initiate - would be returned.
As for the food poisoning that may have provoked Joseph's condition, the family believes it was a meal of undercooked chicken in September. All six family members got sick, but for Joseph and his younger brother, the symptoms developed into something akin to the flu.
His younger brother recovered after a month, but the symptoms only worsened for Joseph.
"The virus by now, it's undetectable," said Justin, a 39-year-old graduate of North High School in Torrance. "It's long gone, but the damage is still there."
rob.kuznia@dailybreeze.com
How to Help
Anyone interested in contributing to St. Catherine Laboure's fundraiser for Joseph should call the school at 310-324-8732.
Take Time to Celebrate Your Successes - By Tony Calabrese
This coming weekend is one of celebration for me. My niece will be getting married on Friday evening. On Saturday we celebrate the birthdays of my brother's three children. Celebrations are wonderful occasions. Whether they are fancy and extravagant, or simply enjoying the company of friends, they help us to commemorate special events in our life.
One of the things I've observed, particularly about the events that tend to occur in our day to day life, is that we don't always take the time to celebrate the milestones we reach in completing them. That can be for several reasons. Some tasks we take for granted and feel we should be doing as part of our day to day life, so why celebrate them even if we are doing them well? Other items we are looking to accomplish have so many steps to them by the time we reach completion we're often exhausted from the journey that got us to the finishing point. Or if a project takes an exceptionally long time to complete, we may even forget why it was started in the first place and lose the sense of it being an accomplishment.
Accomplishing worthwhile goals isn't easy. Along the way to achieving what you seek, there may be complications. One can get easily discouraged and wonder why they decided to pursue the track they chose to follow in the first place. However, if you take the time to both celebrate accomplishments along the way to your ultimate goal, and honor yourself by giving yourself a chance to enjoy other aspects of your life, it helps to make the process not appear insurmountable.
After I married in late 2009, I moved into the home of my wife. This meant I still owned the condominium I had owned before I was married. Ultimately deciding what to do with my previous residence originally seemed like an awesome task. Both my place and that of my wife were fully furnished. There was no way that all of our possessions were going to be able to fit into her home. We liked the location of where she lived, and we had no desire to buy a larger home particularly just to fit all our possessions. The largest job in front of us was cleaning out the basement and adjoining storage room of my condominium. It contained twenty years worth of items that had been accumulated over my time there.
Early on my wife helped me develop a plan. We would separate the items in the condominium into those we would keep, those we would offer to family and friends, those we would donate and those we would throw away as not salvageable. Starting early in 2010, we began boxing and sorting items. Along the way, we allowed family and friends to view items and take what they might be able to use. Each time an item or set of items left the house, we celebrated, sometimes as simple as with a hug for each other. The point is, instead of looking at what was in front of us and realizing we had so much more to go, we stopped to enjoy what we acknowledged as "success" along the way.
After awhile, smaller milestones became major milestones. By mid-summer a large number of items were donated to a church rummage sale. In the fall, those pieces of furniture from my condominium that were destined to move to our place together arrived. Ultimately both the basement and the storage room were completely emptied out so that they could be refurbished with painting and repairs. We are now entering the period of putting my condominium up for sale. While we're just beginning the sales process, we know from our past experiences, and acknowledging our successes along the way, that we will reach a celebration point on this step also. It may happen fairly quickly or it may take awhile, but we know that there will be an event to honor at some point down the road.
So, what is that project in your life that seems insurmountable? Have you broken it up into smaller pieces and accomplished steps toward its ultimate completion? If you have accomplished some of what has to be done, pick an appropriate reward for yourself, because you deserve it. If not, then analyze what you have in front of you, and set a smaller goal for moving forward on your project. Try to accomplish something within the next week or two. When you do so, recognize reaching that point. The recognition does not have to be something major. Maybe it is seeing that movie you have been looking to see. Or perhaps it's treating oneself, by going out to dinner. The point is you'll provide that incentive to keep yourself going if you honor what you have accomplished along the way, as opposed to berating yourself for what you have not completed. The choice is yours.
One of the things I've observed, particularly about the events that tend to occur in our day to day life, is that we don't always take the time to celebrate the milestones we reach in completing them. That can be for several reasons. Some tasks we take for granted and feel we should be doing as part of our day to day life, so why celebrate them even if we are doing them well? Other items we are looking to accomplish have so many steps to them by the time we reach completion we're often exhausted from the journey that got us to the finishing point. Or if a project takes an exceptionally long time to complete, we may even forget why it was started in the first place and lose the sense of it being an accomplishment.
Accomplishing worthwhile goals isn't easy. Along the way to achieving what you seek, there may be complications. One can get easily discouraged and wonder why they decided to pursue the track they chose to follow in the first place. However, if you take the time to both celebrate accomplishments along the way to your ultimate goal, and honor yourself by giving yourself a chance to enjoy other aspects of your life, it helps to make the process not appear insurmountable.
After I married in late 2009, I moved into the home of my wife. This meant I still owned the condominium I had owned before I was married. Ultimately deciding what to do with my previous residence originally seemed like an awesome task. Both my place and that of my wife were fully furnished. There was no way that all of our possessions were going to be able to fit into her home. We liked the location of where she lived, and we had no desire to buy a larger home particularly just to fit all our possessions. The largest job in front of us was cleaning out the basement and adjoining storage room of my condominium. It contained twenty years worth of items that had been accumulated over my time there.
Early on my wife helped me develop a plan. We would separate the items in the condominium into those we would keep, those we would offer to family and friends, those we would donate and those we would throw away as not salvageable. Starting early in 2010, we began boxing and sorting items. Along the way, we allowed family and friends to view items and take what they might be able to use. Each time an item or set of items left the house, we celebrated, sometimes as simple as with a hug for each other. The point is, instead of looking at what was in front of us and realizing we had so much more to go, we stopped to enjoy what we acknowledged as "success" along the way.
After awhile, smaller milestones became major milestones. By mid-summer a large number of items were donated to a church rummage sale. In the fall, those pieces of furniture from my condominium that were destined to move to our place together arrived. Ultimately both the basement and the storage room were completely emptied out so that they could be refurbished with painting and repairs. We are now entering the period of putting my condominium up for sale. While we're just beginning the sales process, we know from our past experiences, and acknowledging our successes along the way, that we will reach a celebration point on this step also. It may happen fairly quickly or it may take awhile, but we know that there will be an event to honor at some point down the road.
So, what is that project in your life that seems insurmountable? Have you broken it up into smaller pieces and accomplished steps toward its ultimate completion? If you have accomplished some of what has to be done, pick an appropriate reward for yourself, because you deserve it. If not, then analyze what you have in front of you, and set a smaller goal for moving forward on your project. Try to accomplish something within the next week or two. When you do so, recognize reaching that point. The recognition does not have to be something major. Maybe it is seeing that movie you have been looking to see. Or perhaps it's treating oneself, by going out to dinner. The point is you'll provide that incentive to keep yourself going if you honor what you have accomplished along the way, as opposed to berating yourself for what you have not completed. The choice is yours.
Monday, March 28, 2011
THOUGHT FOR THE DAY
Loving someone liberates the lover as well as the beloved. And that kind of love comes with age.
Obesity-Mortality Link Called ‘Significantly Flawed’
Amid anti-obesity campaigns — including first lady Michelle Obama’s crusade against childhood obesity — comes a new report skeptical of assertions that weight problems are closely linked to early death.
The report states that there is little credible scientific evidence to support claims that being overweight or obese leads to an early death, and the science behind such claims is “frequently nonexistent or distorted,” according to report authors Patrick Basham and John Luik.
Several studies support the authors’ view, according to Basham, director of the Democracy Institute and a Cato Institute adjunct scholar, and Luik, a Democracy Institute senior fellow. Their report appears on the Spiked website.
For example, Katherine Flegal of the Centers for Disease Control and Prevention found that there were more premature deaths among Americans of normal weight than among the overweight, and in fact those who were overweight were most likely to live the longest.
An analysis by Jerome Gronniger in the American Journal of Public Health noted that men in the “normal” weight category had a mortality rate as high as men in the “moderately obese” category, and men in the “overweight” category had the lowest mortality risk.
A recent study published in the American Journal of Clinical Nutrition looked at various measures of obesity, such as percentage of body fat and waist circumference, and found that those high in body fat percentage and waist circumference had lower mortality rates than others.
And a study published this month in the prestigious medical journal The Lancet “has driven an empirical stake through the heart of the conventional wisdom that being ‘apple shaped’ [with fat concentrated around the waist] increased one’s risk of a heart attack,” Basham and Luik observed.
The 10-year study involving 220,000 people found that waist circumference is not a reliable predictor of cardiovascular disease.
Basham and Luik, authors of “Diet Nation: Exposing the Obesity Crusade,” state: “We continue to find that the case against obesity is significantly flawed.
“All of which should serve to remind us that the success of the obesity crusade rests not on the truth of its science, but on the way in which the obesity entrepreneurs use that science to change policy. Going forward, better policymaking will require, at a minimum, a far greater appreciation of the way in which science and its findings are both misrepresented and used by the obesity crusaders to distort the regulatory process.”
The report states that there is little credible scientific evidence to support claims that being overweight or obese leads to an early death, and the science behind such claims is “frequently nonexistent or distorted,” according to report authors Patrick Basham and John Luik.
Several studies support the authors’ view, according to Basham, director of the Democracy Institute and a Cato Institute adjunct scholar, and Luik, a Democracy Institute senior fellow. Their report appears on the Spiked website.
For example, Katherine Flegal of the Centers for Disease Control and Prevention found that there were more premature deaths among Americans of normal weight than among the overweight, and in fact those who were overweight were most likely to live the longest.
An analysis by Jerome Gronniger in the American Journal of Public Health noted that men in the “normal” weight category had a mortality rate as high as men in the “moderately obese” category, and men in the “overweight” category had the lowest mortality risk.
A recent study published in the American Journal of Clinical Nutrition looked at various measures of obesity, such as percentage of body fat and waist circumference, and found that those high in body fat percentage and waist circumference had lower mortality rates than others.
And a study published this month in the prestigious medical journal The Lancet “has driven an empirical stake through the heart of the conventional wisdom that being ‘apple shaped’ [with fat concentrated around the waist] increased one’s risk of a heart attack,” Basham and Luik observed.
The 10-year study involving 220,000 people found that waist circumference is not a reliable predictor of cardiovascular disease.
Basham and Luik, authors of “Diet Nation: Exposing the Obesity Crusade,” state: “We continue to find that the case against obesity is significantly flawed.
“All of which should serve to remind us that the success of the obesity crusade rests not on the truth of its science, but on the way in which the obesity entrepreneurs use that science to change policy. Going forward, better policymaking will require, at a minimum, a far greater appreciation of the way in which science and its findings are both misrepresented and used by the obesity crusaders to distort the regulatory process.”
Pollution and the Brain
Here is something that should get everyone’s attention: Recent studies found that damage in the brain from exposure to air pollution begins during childhood.
MRI scans have shown lesions in the prefrontal cortex, the most complex thinking area of the brain, in children exposed to heavy pollution in cities. More importantly, researchers have demonstrated impaired thinking and learning ability in these children — a result that was also reported in animals exposed to heavy concentrations of pollution particles.
Multiple sclerosis, stroke, and Parkinson’s disease are all increased in people exposed to these pollution particles, especially the ultrafine particles. A number of studies have shown that the ultrafine nanoparticles cause much greater inflammation and microglial activation — and hence immunoexcitotoxicity — than larger particles. This is primarily because these extremely small particles have a much larger reactive surface per volume than larger particles. They can also easily penetrate these sensitive areas:
• Lungs
• Skin
• Olfactory tract
• Brain
In addition, studies show that ultrafine particles easily penetrate cells and compartments within cells, such as the mitochondria. This makes the particles dramatically more toxic. It is also known that certain people are genetically at a greater risk from these metals than others.
For example, people who have the APOE4 allele (a particular DNA sequence associated with Alzheimer’s risk) are at much greater risk than those who do not have those genes. Also, those who have chronic illnesses, pre-existing brain disorders (including depression and other psychiatric disorders), and poor detoxification ability are at greater risk.
Studies involving experiments on both animals and humans have demonstrated that systemic inflammation (in the body, excluding the brain) can cause the brain to become inflamed and ultimately lead to degeneration of the brain.
For example, getting the flu makes you feel bad, makes you have trouble sleeping, impairs your memory, and makes you irritable. All of this happens because your brain is temporarily inflamed. With these particles, especially nanosized metal particles, the brain inflammation can go on for years, even a lifetime.
Most of these harmful particles will enter the brain by way of the olfactory nerves (in the nose) and the trigeminal nerves (in the lining of the mouth). From the olfactory nerves, the particles move toward the parts of the brain most seriously affected by Alzheimer’s disease — the entorhinal cortex and the hippocampus.
Once inside the brain, the particles trigger intense activation of the brain’s immune cells, the microglia, which release powerful inflammatory cytokines and excitotoxins that destroy brain-cell connections (synapses and dendrites).
These tiny particles can also be coated with other toxins, which are then carried into the brain like a Trojan horse. We see this with one major pollutant in cities: diesel fuel particles from exhaust fumes. Autopsy studies of people living in heavily polluted cities have demonstrated microglial activation and brain inflammation. Find more details on how you can keep your brain healthy, read my report "Save Your Brain."
When I see people jogging or riding their bikes along a heavily traveled street, I realize that these health enthusiasts are actually destroying their health, completely unaware of the danger.
When you exercise, your body is at its most vulnerable. This is because your tissues, including the brain, are low on oxygen, and free radicals are generated by the exercise and you may have low energy levels. Most of these pollution particles damage tissue through inflammation and high free-radical generation.
So, how can you protect yourself? Avoidance is always best, but often is not practical. Try not to spend too much time close to the side of a busy street, and never run or exercise by a heavily traveled roadway. People should restrict walking, jogging, and bike riding to isolated trails, away from the city’s pollution.
MRI scans have shown lesions in the prefrontal cortex, the most complex thinking area of the brain, in children exposed to heavy pollution in cities. More importantly, researchers have demonstrated impaired thinking and learning ability in these children — a result that was also reported in animals exposed to heavy concentrations of pollution particles.
Multiple sclerosis, stroke, and Parkinson’s disease are all increased in people exposed to these pollution particles, especially the ultrafine particles. A number of studies have shown that the ultrafine nanoparticles cause much greater inflammation and microglial activation — and hence immunoexcitotoxicity — than larger particles. This is primarily because these extremely small particles have a much larger reactive surface per volume than larger particles. They can also easily penetrate these sensitive areas:
• Lungs
• Skin
• Olfactory tract
• Brain
In addition, studies show that ultrafine particles easily penetrate cells and compartments within cells, such as the mitochondria. This makes the particles dramatically more toxic. It is also known that certain people are genetically at a greater risk from these metals than others.
For example, people who have the APOE4 allele (a particular DNA sequence associated with Alzheimer’s risk) are at much greater risk than those who do not have those genes. Also, those who have chronic illnesses, pre-existing brain disorders (including depression and other psychiatric disorders), and poor detoxification ability are at greater risk.
Studies involving experiments on both animals and humans have demonstrated that systemic inflammation (in the body, excluding the brain) can cause the brain to become inflamed and ultimately lead to degeneration of the brain.
For example, getting the flu makes you feel bad, makes you have trouble sleeping, impairs your memory, and makes you irritable. All of this happens because your brain is temporarily inflamed. With these particles, especially nanosized metal particles, the brain inflammation can go on for years, even a lifetime.
Most of these harmful particles will enter the brain by way of the olfactory nerves (in the nose) and the trigeminal nerves (in the lining of the mouth). From the olfactory nerves, the particles move toward the parts of the brain most seriously affected by Alzheimer’s disease — the entorhinal cortex and the hippocampus.
Once inside the brain, the particles trigger intense activation of the brain’s immune cells, the microglia, which release powerful inflammatory cytokines and excitotoxins that destroy brain-cell connections (synapses and dendrites).
These tiny particles can also be coated with other toxins, which are then carried into the brain like a Trojan horse. We see this with one major pollutant in cities: diesel fuel particles from exhaust fumes. Autopsy studies of people living in heavily polluted cities have demonstrated microglial activation and brain inflammation. Find more details on how you can keep your brain healthy, read my report "Save Your Brain."
When I see people jogging or riding their bikes along a heavily traveled street, I realize that these health enthusiasts are actually destroying their health, completely unaware of the danger.
When you exercise, your body is at its most vulnerable. This is because your tissues, including the brain, are low on oxygen, and free radicals are generated by the exercise and you may have low energy levels. Most of these pollution particles damage tissue through inflammation and high free-radical generation.
So, how can you protect yourself? Avoidance is always best, but often is not practical. Try not to spend too much time close to the side of a busy street, and never run or exercise by a heavily traveled roadway. People should restrict walking, jogging, and bike riding to isolated trails, away from the city’s pollution.
Can Vitamin C Harm the Liver?
Question: Is there any medical/scientific research that shows a negative impact that vitamin C can have on the liver?
Dr. Blaylock's Answer:
I am not aware of any liver toxicity from vitamin C itself when taken in reasonable doses. What you may be referring to is the danger of vitamin C in people with a hereditary condition called hemochromatosis, which causes the body to absorb too much iron from food. The excess iron is stored in organs, especially the liver, heart, and pancreas.
Vitamin C complicates this condition because it greatly enhances the absorption of iron from the gut. In people with hemochromatosis, iron levels in the liver and other tissues are already extremely high. These high iron levels result in severe damage to the liver and can lead to liver failure and/or liver cancer.
People with hemochromatosis should avoid vitamin C supplements. I also recommend that people take their vitamin C between meals to avoid excess iron absorption.
One recent study using mice found that very high doses of vitamin C, when combined with severe stress, damaged the liver of the animals. However, the dose of vitamin C used on the mice would be equal to 35 grams in humans — a massive dose. Lower doses in this study caused no damage. In general, I suggest buffered vitamin C — it is easier on the stomach, does not induce acidosis (excessive acid in body fluids), and is better absorbed. Interestingly, a number of new studies show that vitamin C protects the liver against damage by a number of toxins, such as alcohol.
Dr. Blaylock's Answer:
I am not aware of any liver toxicity from vitamin C itself when taken in reasonable doses. What you may be referring to is the danger of vitamin C in people with a hereditary condition called hemochromatosis, which causes the body to absorb too much iron from food. The excess iron is stored in organs, especially the liver, heart, and pancreas.
Vitamin C complicates this condition because it greatly enhances the absorption of iron from the gut. In people with hemochromatosis, iron levels in the liver and other tissues are already extremely high. These high iron levels result in severe damage to the liver and can lead to liver failure and/or liver cancer.
People with hemochromatosis should avoid vitamin C supplements. I also recommend that people take their vitamin C between meals to avoid excess iron absorption.
One recent study using mice found that very high doses of vitamin C, when combined with severe stress, damaged the liver of the animals. However, the dose of vitamin C used on the mice would be equal to 35 grams in humans — a massive dose. Lower doses in this study caused no damage. In general, I suggest buffered vitamin C — it is easier on the stomach, does not induce acidosis (excessive acid in body fluids), and is better absorbed. Interestingly, a number of new studies show that vitamin C protects the liver against damage by a number of toxins, such as alcohol.
The Truth About Cholesterol
Most physicians and many cardiologists tell their patients that a higher HDL cholesterol level is “heart healthy.” But, is this really true? Is a high HDL level always protective? In the past, I have warned readers that sometimes a high HDL level might be harmful, as harmful as a high level of LDL cholesterol.
What most doctors do not understand is that HDL is not only a carrier of cholesterol, but is also part of the immune system. When we are infected with bacteria or a virus, our HDL level goes up and switches from a protective, anti-inflammatory molecule to a highly inflammatory, free-radical producing molecule. In this way it helps the immune system rid the body of the infection. For a detailed discussion on inflammation and its role in many diseases, see my newsletter "Inflammation: The Real Cause of Most Diseases."
Once the infection is over, HDL switches back to a protective molecule. But does it always?
Recent evidence suggests that it can become stuck in a harmful mode. This explains studies that show a number of people with high HDL cholesterol levels who have a high risk of heart attack and a high incidence of severe atherosclerosis. It maybe that these people have undiagnosed, smoldering infections or a loss of the protective antioxidant enzymes (called paraoxonase or PON) normally found within HDL.
Diet, antioxidant supplements (especially flavonoids), and exercise have been shown to correct this HDL problem.
While we’re on the subject of cholesterol, I want to say that there also is more to the story about LDL or so-called “bad” cholesterol and the statin drugs prescribed to lower it.
Evidence suggests that elevated LDL cholesterol by itself does not cause atherosclerosis (which leads to heart attacks and strokes). The real cause of atherosclerosis is chronic inflammation in the wall of the blood vessels. Statins do not work by reducing cholesterol — they reduce inflammation and suppress immunity.
When statin drugs were first developed and released, the makers knew that they decreased production of coenzyme Q10 (CoQ10), a vital energy molecule used in every cell in the body, especially muscle and brain cells. Manufacturers also knew that statin drugs could cause levels of CoQ10 in muscles to drop so low that a highly fatal condition called rhabdomyolysis could result.
Initially, they added CoQ10 to the statin drugs to prevent this, but then they reasoned that this might terrify patients and doctors alike, so they quietly removed it. Still, a great many doctors are not aware of this development and do not suggest CoQ10 supplements to their patients.
There is evidence that the widespread use of statins is causing an epidemic of heart failure in this country, because CoQ10 is absolutely essential to the heart. It is known that low levels of CoQ10 can cause heart failure and that supplementing with CoQ10 can improve the condition of some patients who suffer from heart failure.
For the latest information on how to protect your heart, see my report "New Heart Revelations."
What most doctors do not understand is that HDL is not only a carrier of cholesterol, but is also part of the immune system. When we are infected with bacteria or a virus, our HDL level goes up and switches from a protective, anti-inflammatory molecule to a highly inflammatory, free-radical producing molecule. In this way it helps the immune system rid the body of the infection. For a detailed discussion on inflammation and its role in many diseases, see my newsletter "Inflammation: The Real Cause of Most Diseases."
Once the infection is over, HDL switches back to a protective molecule. But does it always?
Recent evidence suggests that it can become stuck in a harmful mode. This explains studies that show a number of people with high HDL cholesterol levels who have a high risk of heart attack and a high incidence of severe atherosclerosis. It maybe that these people have undiagnosed, smoldering infections or a loss of the protective antioxidant enzymes (called paraoxonase or PON) normally found within HDL.
Diet, antioxidant supplements (especially flavonoids), and exercise have been shown to correct this HDL problem.
While we’re on the subject of cholesterol, I want to say that there also is more to the story about LDL or so-called “bad” cholesterol and the statin drugs prescribed to lower it.
Evidence suggests that elevated LDL cholesterol by itself does not cause atherosclerosis (which leads to heart attacks and strokes). The real cause of atherosclerosis is chronic inflammation in the wall of the blood vessels. Statins do not work by reducing cholesterol — they reduce inflammation and suppress immunity.
When statin drugs were first developed and released, the makers knew that they decreased production of coenzyme Q10 (CoQ10), a vital energy molecule used in every cell in the body, especially muscle and brain cells. Manufacturers also knew that statin drugs could cause levels of CoQ10 in muscles to drop so low that a highly fatal condition called rhabdomyolysis could result.
Initially, they added CoQ10 to the statin drugs to prevent this, but then they reasoned that this might terrify patients and doctors alike, so they quietly removed it. Still, a great many doctors are not aware of this development and do not suggest CoQ10 supplements to their patients.
There is evidence that the widespread use of statins is causing an epidemic of heart failure in this country, because CoQ10 is absolutely essential to the heart. It is known that low levels of CoQ10 can cause heart failure and that supplementing with CoQ10 can improve the condition of some patients who suffer from heart failure.
For the latest information on how to protect your heart, see my report "New Heart Revelations."
Testosterone gel shows effects on diabetes
NEW YORK (Reuters Health) - Testosterone treatment appears to improve the underlying problem in some men with type 2 diabetes, according to a study funded by UK drugmaker ProStrakan.
The problem -- called "insulin resistance" -- is that the body doesn't know how to use insulin to process sugar. Researchers found that applying testosterone in a gel reduced this problem in diabetic men who had low levels of testosterone to begin with, or in similar men without diabetes but with a cluster of heart disease risk factors called metabolic syndrome.
It also lowered their cholesterol levels and had some impact on their sexual function, as compared with a gel that looked the same but had no testosterone in it.
Writing in the journal Diabetes Care, Dr. T. Hugh Jones of Barnsley Hospital in the UK and colleagues say their findings support testosterone treatment in men with low testosterone and type 2 diabetes or metabolic syndrome.
In the new study, the researchers tested ProStrakan's testosterone gel Tostran against a dummy gel in 220 middle-aged and older men. The men used the gel once a day for a year.
The insulin resistance went down by 16 percent in men on Tostran, despite the fact that many were already taking metformin, a drug that helps control blood sugar levels.
Still, there was no difference overall between the fake gel and testosterone in terms of blood sugar control, the ultimate goal in diabetes care.
The researchers also found the general sexual function improved slightly with the testosterone gel, but there was no difference in erectile dysfunction or overall sexual satisfaction.
The side effects were similar between the dummy gel and Tostran, although testosterone may sometimes cause swelling around the joints and in the breasts.
Testosterone is already used to treat sexual problems in men whose levels of the hormone are lower than normal. The gels can cost more than $250 per month, and experts disagree about how low testosterone levels in the body should drop before they prescribe treatment.
With millions of prescriptions every year in the U.S., some experts believe it's being overused.
"We need a lot less testosterone for sexual function than people used to think," Dr. Michael Marberger, who heads the urology department at the University of Vienna Medical School in Austria, told Reuters Health last year. "Obesity impacts sexual function much more."
SOURCE: http://bit.ly/eupgBd Diabetes Care, online March 8, 2011.
The problem -- called "insulin resistance" -- is that the body doesn't know how to use insulin to process sugar. Researchers found that applying testosterone in a gel reduced this problem in diabetic men who had low levels of testosterone to begin with, or in similar men without diabetes but with a cluster of heart disease risk factors called metabolic syndrome.
It also lowered their cholesterol levels and had some impact on their sexual function, as compared with a gel that looked the same but had no testosterone in it.
Writing in the journal Diabetes Care, Dr. T. Hugh Jones of Barnsley Hospital in the UK and colleagues say their findings support testosterone treatment in men with low testosterone and type 2 diabetes or metabolic syndrome.
In the new study, the researchers tested ProStrakan's testosterone gel Tostran against a dummy gel in 220 middle-aged and older men. The men used the gel once a day for a year.
The insulin resistance went down by 16 percent in men on Tostran, despite the fact that many were already taking metformin, a drug that helps control blood sugar levels.
Still, there was no difference overall between the fake gel and testosterone in terms of blood sugar control, the ultimate goal in diabetes care.
The researchers also found the general sexual function improved slightly with the testosterone gel, but there was no difference in erectile dysfunction or overall sexual satisfaction.
The side effects were similar between the dummy gel and Tostran, although testosterone may sometimes cause swelling around the joints and in the breasts.
Testosterone is already used to treat sexual problems in men whose levels of the hormone are lower than normal. The gels can cost more than $250 per month, and experts disagree about how low testosterone levels in the body should drop before they prescribe treatment.
With millions of prescriptions every year in the U.S., some experts believe it's being overused.
"We need a lot less testosterone for sexual function than people used to think," Dr. Michael Marberger, who heads the urology department at the University of Vienna Medical School in Austria, told Reuters Health last year. "Obesity impacts sexual function much more."
SOURCE: http://bit.ly/eupgBd Diabetes Care, online March 8, 2011.
Cholesterol levels might influence cancer risk
NEW YORK (Reuters Health) - High cholesterol may be linked to an increased risk of some cancers but a lower risk of others, according to a new Korean study.
"We do not have a clear understanding" of how cholesterol might directly influence cancer risk, said Dr. Cari Kitahara from the U.S. National Cancer Institute in an email to Reuters Health.
Kitahara, the lead author of a report on the study, added that the cholesterol itself might not be what's affecting people's cancer risk. Instead, lifestyle choices or other heath conditions might make people with high cholesterol more or less likely to get certain cancers.
Previous smaller studies have given conflicting answers to the question of whether cholesterol levels might affect a person's chance of getting cancer.
The current study, published in the Journal of Clinical Oncology, included about 1.2 million Korean men and women who had a standard cholesterol test after fasting overnight.
The investigators calculated everyone's "total cholesterol" level - a combination of their "bad" LDL cholesterol and "good" HDL cholesterol. Then they kept track of all study participants for an average of almost 13 years, using a cancer database and hospital admission files to determine which of them developed cancer later on.
At the start of the study, the men's average age was 45, and their average total cholesterol level was 191 milligrams per deciliter (mg/dL) of blood. The women's average age was 49, and their average cholesterol level was 194 mg/dL.
According to the U.S. National Institutes of Health, a "desirable" total cholesterol level is one that's below 200 mg/dL. Levels between 200 and 239 mg/dL are considered "borderline," and levels of 240 mg/dL or above are "high."
Overall, about seven of every 100 people in the study developed some form of cancer. The most common type was stomach cancer (about two of every 100 people), followed by lung cancer and liver cancer (each in about one of every 100 participants).
When the researchers analyzed everyone who developed cancer, regardless of the type, they found that people with a high total cholesterol level were more likely to get the disease.
The extra risk wasn't very large, though. In men, the odds of getting cancer were 7.9 percent for those with the highest total cholesterol, compared to 7.1 percent for those with the lowest cholesterol; in other words, a difference of less than one percent.
Women with high cholesterol had a 6.3 chance of getting cancer, while women with low cholesterol had a 5.1 percent chance - slightly more than a one percent difference in risk.
Looking more closely, the researchers also saw that the relationship of cholesterol and cancer risk varied in different parts of the body. For example, compared to men with low total cholesterol levels (less than 160 mg/dL), men with high levels were more likely to develop prostate cancer and colon cancer but less likely to get liver cancer, stomach cancer or lung cancer.
And compared to women with low cholesterol, women with high cholesterol were more likely to get breast cancer and less likely to get liver cancer.
But when the authors took into account a range of health-related factors, including people's weight, blood pressure, cigarette smoking and alcohol consumption, high cholesterol seemed to have the opposite effect - overall, it lowered people's cancer risk. In that analysis, people with the highest levels of cholesterol were between 9 and 16 percent less likely to get cancer.
Cholesterol plays an important role in determining what flows in and out of cells in the body and is also involved in the body's production of hormones such as estrogen and testosterone. It could be through these processes that cholesterol increases or decreases the risk of different kinds of cancer, Kitahara said.
Another possible explanation for the link between cholesterol and cancer is that people with high cholesterol are more likely to be taking cholesterol-lowering drugs, such as statins, to lower their risk of heart problems. These drugs themselves may increase or decrease the risk of certain cancers. But Kitahara said that was unlikely to explain this study's findings because not many people were taking statins.
The results don't mean that people can lower their risk of cancer by lowering their cholesterol with drugs or diet changes, though.
Kitahara said that "more studies are needed to confirm or refute these findings" - and in the meantime, people with questions about their cholesterol should talk with their doctor.
SOURCE: http://bit.ly/gIETVt Journal of Clinical Oncology, online March 21, 2011.
"We do not have a clear understanding" of how cholesterol might directly influence cancer risk, said Dr. Cari Kitahara from the U.S. National Cancer Institute in an email to Reuters Health.
Kitahara, the lead author of a report on the study, added that the cholesterol itself might not be what's affecting people's cancer risk. Instead, lifestyle choices or other heath conditions might make people with high cholesterol more or less likely to get certain cancers.
Previous smaller studies have given conflicting answers to the question of whether cholesterol levels might affect a person's chance of getting cancer.
The current study, published in the Journal of Clinical Oncology, included about 1.2 million Korean men and women who had a standard cholesterol test after fasting overnight.
The investigators calculated everyone's "total cholesterol" level - a combination of their "bad" LDL cholesterol and "good" HDL cholesterol. Then they kept track of all study participants for an average of almost 13 years, using a cancer database and hospital admission files to determine which of them developed cancer later on.
At the start of the study, the men's average age was 45, and their average total cholesterol level was 191 milligrams per deciliter (mg/dL) of blood. The women's average age was 49, and their average cholesterol level was 194 mg/dL.
According to the U.S. National Institutes of Health, a "desirable" total cholesterol level is one that's below 200 mg/dL. Levels between 200 and 239 mg/dL are considered "borderline," and levels of 240 mg/dL or above are "high."
Overall, about seven of every 100 people in the study developed some form of cancer. The most common type was stomach cancer (about two of every 100 people), followed by lung cancer and liver cancer (each in about one of every 100 participants).
When the researchers analyzed everyone who developed cancer, regardless of the type, they found that people with a high total cholesterol level were more likely to get the disease.
The extra risk wasn't very large, though. In men, the odds of getting cancer were 7.9 percent for those with the highest total cholesterol, compared to 7.1 percent for those with the lowest cholesterol; in other words, a difference of less than one percent.
Women with high cholesterol had a 6.3 chance of getting cancer, while women with low cholesterol had a 5.1 percent chance - slightly more than a one percent difference in risk.
Looking more closely, the researchers also saw that the relationship of cholesterol and cancer risk varied in different parts of the body. For example, compared to men with low total cholesterol levels (less than 160 mg/dL), men with high levels were more likely to develop prostate cancer and colon cancer but less likely to get liver cancer, stomach cancer or lung cancer.
And compared to women with low cholesterol, women with high cholesterol were more likely to get breast cancer and less likely to get liver cancer.
But when the authors took into account a range of health-related factors, including people's weight, blood pressure, cigarette smoking and alcohol consumption, high cholesterol seemed to have the opposite effect - overall, it lowered people's cancer risk. In that analysis, people with the highest levels of cholesterol were between 9 and 16 percent less likely to get cancer.
Cholesterol plays an important role in determining what flows in and out of cells in the body and is also involved in the body's production of hormones such as estrogen and testosterone. It could be through these processes that cholesterol increases or decreases the risk of different kinds of cancer, Kitahara said.
Another possible explanation for the link between cholesterol and cancer is that people with high cholesterol are more likely to be taking cholesterol-lowering drugs, such as statins, to lower their risk of heart problems. These drugs themselves may increase or decrease the risk of certain cancers. But Kitahara said that was unlikely to explain this study's findings because not many people were taking statins.
The results don't mean that people can lower their risk of cancer by lowering their cholesterol with drugs or diet changes, though.
Kitahara said that "more studies are needed to confirm or refute these findings" - and in the meantime, people with questions about their cholesterol should talk with their doctor.
SOURCE: http://bit.ly/gIETVt Journal of Clinical Oncology, online March 21, 2011.
Sunday, March 27, 2011
THOUGHT FOR THE DAY
I have learned this at least by my experiment:
that if one advances confidently in the direction
of his dreams, and endeavors to live the life he
has imagined, he will meet with success unexpected
in common hours.
that if one advances confidently in the direction
of his dreams, and endeavors to live the life he
has imagined, he will meet with success unexpected
in common hours.
Magnet Therapy for Tinnitus Misses Mark
constant annoying ringing in the ears — called tinnitus — didn't go away when researchers tried zapping patients' heads with magnetic waves in a recent study.
The researchers still think magnetic therapy could work, if they can find the right part of the brain to apply it to.
"We haven't found the sweet spot yet," said Dr. Jay Piccirillo, the lead author of the study and a professor of ear, nose, and throat surgery at Washington University School of Medicine in St Louis, Missouri.
Tinnitus is caused by a "phantom" sound, thought to be the result of mis-wired brain cells.
The condition is common. One study estimated that 50 million Americans experience chronic ringing in their ears at some point in their lives.
Piccirillo said most people are not bothered by the ringing. A very small fraction of people are crippled by the sound, however. Some become depressed, or even suicidal.
Doctors who treated the patients in the current study generated magnetic waves outside each person's head that traveled through the skull into the brain; the waves would temporarily rewire the brain's circuits. Several studies in Europe have found that sessions of such magnetic therapy can help relieve ear ringing.
In the United States, sending magnetic waves to the brain is approved for use in patients with depression, but it is only experimental for tinnitus.
Piccirillo and his colleagues recruited 14 patients who were severely bothered by the ringing in their ears.
All of them received 10 treatments with a magnet over a two-week period, and another 10 sessions over another two weeks using a fake magnet. The order of the two-week periods was flipped in half of the patients.
After the treatments, the ringing was no better than before.
And when Piccirillo's team asked participants which treatment they thought they received first — the real magnet or the fake magnet - the answers were right only half the time — a result just as good as chance.
Piccirillo told Reuters Health he's not giving up on magnetic therapy. "There's no doubt these magnets work to reorganize brain connections. But we don't know where to put the magnet, and for how long."
In this study, the magnet was placed near the patients' left ear, by the part of the brain that processes sound.
Dr. Robert Folmer, a professor of ear, nose, and throat surgery at the Oregon Health and Science University, reviewed the study for Reuters Health.
Folmer, who was not involved in the research, suggested some reasons that could explain why Piccirillo's study didn't work, when previous studies have successfully used magnets to relieve ear ringing.
Two weeks of treatment could be too brief to allow the brain to correct the ringing, he said. And perhaps the left side of the skull is not the correct place to put the magnetic coil in every patient.
"Mostly I was kind of surprised to see how many people were in this study," Folmer said. Fourteen is "a very small number of people."
Piccirillo said his team had planned to include 55 people, but when they realized the treatment wasn't working they decided to stop.
"It's extremely unlikely that you would have seen an effect if we had continued the study," Piccirillo said.
He agreed that the treatment might have been too short. His group is starting a new experiment with four weeks of treatments instead of two weeks.
Folmer, too, is soon starting a study of magnetic therapy, in 160 patients with tinnitus. His group will apply the magnet to the left side of the head in some patients, and the right side in others.
The appeal of magnetic therapy is that it is expected to actually reduce the ringing in people's ears.
Currently, the available treatments — such as talk therapy and antidepressant medications — don't get rid of the noise; they only help people cope with it.
Piccirillo's federally funded study is published in the March issue of the Archives of Otolaryngology-Head and Neck Surgery.
The researchers still think magnetic therapy could work, if they can find the right part of the brain to apply it to.
"We haven't found the sweet spot yet," said Dr. Jay Piccirillo, the lead author of the study and a professor of ear, nose, and throat surgery at Washington University School of Medicine in St Louis, Missouri.
Tinnitus is caused by a "phantom" sound, thought to be the result of mis-wired brain cells.
The condition is common. One study estimated that 50 million Americans experience chronic ringing in their ears at some point in their lives.
Piccirillo said most people are not bothered by the ringing. A very small fraction of people are crippled by the sound, however. Some become depressed, or even suicidal.
Doctors who treated the patients in the current study generated magnetic waves outside each person's head that traveled through the skull into the brain; the waves would temporarily rewire the brain's circuits. Several studies in Europe have found that sessions of such magnetic therapy can help relieve ear ringing.
In the United States, sending magnetic waves to the brain is approved for use in patients with depression, but it is only experimental for tinnitus.
Piccirillo and his colleagues recruited 14 patients who were severely bothered by the ringing in their ears.
All of them received 10 treatments with a magnet over a two-week period, and another 10 sessions over another two weeks using a fake magnet. The order of the two-week periods was flipped in half of the patients.
After the treatments, the ringing was no better than before.
And when Piccirillo's team asked participants which treatment they thought they received first — the real magnet or the fake magnet - the answers were right only half the time — a result just as good as chance.
Piccirillo told Reuters Health he's not giving up on magnetic therapy. "There's no doubt these magnets work to reorganize brain connections. But we don't know where to put the magnet, and for how long."
In this study, the magnet was placed near the patients' left ear, by the part of the brain that processes sound.
Dr. Robert Folmer, a professor of ear, nose, and throat surgery at the Oregon Health and Science University, reviewed the study for Reuters Health.
Folmer, who was not involved in the research, suggested some reasons that could explain why Piccirillo's study didn't work, when previous studies have successfully used magnets to relieve ear ringing.
Two weeks of treatment could be too brief to allow the brain to correct the ringing, he said. And perhaps the left side of the skull is not the correct place to put the magnetic coil in every patient.
"Mostly I was kind of surprised to see how many people were in this study," Folmer said. Fourteen is "a very small number of people."
Piccirillo said his team had planned to include 55 people, but when they realized the treatment wasn't working they decided to stop.
"It's extremely unlikely that you would have seen an effect if we had continued the study," Piccirillo said.
He agreed that the treatment might have been too short. His group is starting a new experiment with four weeks of treatments instead of two weeks.
Folmer, too, is soon starting a study of magnetic therapy, in 160 patients with tinnitus. His group will apply the magnet to the left side of the head in some patients, and the right side in others.
The appeal of magnetic therapy is that it is expected to actually reduce the ringing in people's ears.
Currently, the available treatments — such as talk therapy and antidepressant medications — don't get rid of the noise; they only help people cope with it.
Piccirillo's federally funded study is published in the March issue of the Archives of Otolaryngology-Head and Neck Surgery.
Work Problems from Arthritis Common, But Not Constant
Many people with arthritis have periodic difficulties on the job, but the problems might not make them less productive, a new study suggests.
And in many cases, simple changes in the workplace can be helpful.
It's known that people with arthritis often deal with work limitations. A U.S. government study found that one-third of working-age Americans with arthritis said their condition interfered with their jobs.
But the new study, which followed nearly 500 working people with arthritis, found that while work difficulties are common, they are not constant.
Over four and a half years, three-quarters of the study participants reported occasional, rather than continuous, difficulty with work. Only nine of every 100 people in the study had consistently severe difficulties — the types of problems that might prevent them from getting their job tasks done, or force them to cut down on work hours.
Work limitation due to arthritis has "tended to be discussed as something that is constant. But I think it's more episodic," said Dr. Monique A.M. Gignac, an associate professor at the University of Toronto in Canada, and the lead researcher on the study.
And that, she said in an interview, is important for employers, insurers, and workers with arthritis to know.
"There is a belief that people with arthritis are often a liability in the workplace, but that's not the case," Gignac said.
Still, many workers with arthritic conditions do, at some point, have problems at work. In this study, the most common issues included problems with lifting, carrying, kneeling, and standing for long periods — all experienced by anywhere from one-half to three-quarters of study participants.
When it came to easing those problems, workers most often took simple measures, like using "gadgets" or furniture changes to make their work easier.
Having a better chair, a stool under the feet, or a special computer keyboard, Gignac noted, can be helpful. So too, she said, can cost-free steps like organizing your desk to put everything in easy reach, or getting up periodically to move and stretch.
"There are things you can do to sustain your energy and reduce pain," Gignac said.
Relatively few people in the study took more significant steps, like changing their work schedule. Over the course of the study, no more than 17 of every 100 people made schedule changes.
The findings, reported in the journal Arthritis Care & Research, are based on surveys of 490 working adults with either osteoarthritis — the common "wear-and-tear" form of joint problems often associated with aging or heavy sports activities — or inflammatory arthritis. Most people in that second group had rheumatoid arthritis, a disease in which the immune system mistakenly attacks the lining of the joints.
The participants worked in a range of fields, including transportation, sales, teaching, and business, and were surveyed four times over the four and a half years of the study.
The fact that people's work limitations waxed and waned over time may be due to the nature of the arthritis itself, according to Gignac. For some people, changes in treatment or their work might have made a difference.
Gignac suggested that workers with arthritis symptoms act sooner rather than later — which, first of all, means seeing a doctor to get a diagnosis and start treatment.
Some people might be reluctant to tell their employer they have arthritis, and that is a "personal decision," Gignac noted. But she also pointed out that there are many people in the workforce with arthritis or other chronic health conditions.
"There are a lot of you," she said. "You are not alone."
In workplaces with a human resources department, Gignac noted, people with arthritis can anonymously ask about any job accommodations that are available to them.
And if people are reluctant to bring up their health at work, she said, they can also ask their doctors for advice on work adjustments that might make their jobs easier.
And in many cases, simple changes in the workplace can be helpful.
It's known that people with arthritis often deal with work limitations. A U.S. government study found that one-third of working-age Americans with arthritis said their condition interfered with their jobs.
But the new study, which followed nearly 500 working people with arthritis, found that while work difficulties are common, they are not constant.
Over four and a half years, three-quarters of the study participants reported occasional, rather than continuous, difficulty with work. Only nine of every 100 people in the study had consistently severe difficulties — the types of problems that might prevent them from getting their job tasks done, or force them to cut down on work hours.
Work limitation due to arthritis has "tended to be discussed as something that is constant. But I think it's more episodic," said Dr. Monique A.M. Gignac, an associate professor at the University of Toronto in Canada, and the lead researcher on the study.
And that, she said in an interview, is important for employers, insurers, and workers with arthritis to know.
"There is a belief that people with arthritis are often a liability in the workplace, but that's not the case," Gignac said.
Still, many workers with arthritic conditions do, at some point, have problems at work. In this study, the most common issues included problems with lifting, carrying, kneeling, and standing for long periods — all experienced by anywhere from one-half to three-quarters of study participants.
When it came to easing those problems, workers most often took simple measures, like using "gadgets" or furniture changes to make their work easier.
Having a better chair, a stool under the feet, or a special computer keyboard, Gignac noted, can be helpful. So too, she said, can cost-free steps like organizing your desk to put everything in easy reach, or getting up periodically to move and stretch.
"There are things you can do to sustain your energy and reduce pain," Gignac said.
Relatively few people in the study took more significant steps, like changing their work schedule. Over the course of the study, no more than 17 of every 100 people made schedule changes.
The findings, reported in the journal Arthritis Care & Research, are based on surveys of 490 working adults with either osteoarthritis — the common "wear-and-tear" form of joint problems often associated with aging or heavy sports activities — or inflammatory arthritis. Most people in that second group had rheumatoid arthritis, a disease in which the immune system mistakenly attacks the lining of the joints.
The participants worked in a range of fields, including transportation, sales, teaching, and business, and were surveyed four times over the four and a half years of the study.
The fact that people's work limitations waxed and waned over time may be due to the nature of the arthritis itself, according to Gignac. For some people, changes in treatment or their work might have made a difference.
Gignac suggested that workers with arthritis symptoms act sooner rather than later — which, first of all, means seeing a doctor to get a diagnosis and start treatment.
Some people might be reluctant to tell their employer they have arthritis, and that is a "personal decision," Gignac noted. But she also pointed out that there are many people in the workforce with arthritis or other chronic health conditions.
"There are a lot of you," she said. "You are not alone."
In workplaces with a human resources department, Gignac noted, people with arthritis can anonymously ask about any job accommodations that are available to them.
And if people are reluctant to bring up their health at work, she said, they can also ask their doctors for advice on work adjustments that might make their jobs easier.
Testosterone Benefits Some Diabetic Men
Testosterone treatment appears to improve the underlying problem in some men with Type 2 diabetes, according to a study funded by UK drugmaker ProStrakan.
The problem — called "insulin resistance" — is that the body doesn't know how to use insulin to process sugar. Researchers found that applying testosterone in a gel reduced this problem in diabetic men who had low levels of testosterone to begin with, or in similar men without diabetes but with a cluster of heart disease risk factors called metabolic syndrome.
It also lowered their cholesterol levels and had some impact on their sexual function, as compared with a gel that looked the same but had no testosterone in it.
Writing in the journal Diabetes Care, Dr. T. Hugh Jones of Barnsley Hospital in the UK and colleagues say their findings support testosterone treatment in men with low testosterone and Type 2 diabetes or metabolic syndrome.
In the new study, the researchers tested ProStrakan's testosterone gel Tostran against a dummy gel in 220 middle-aged and older men. The men used the gel once a day for a year.
The insulin resistance went down by 16 percent in men on Tostran, despite the fact that many were already taking metformin, a drug that helps control blood sugar levels.
Still, there was no difference overall between the fake gel and testosterone in terms of blood sugar control, the ultimate goal in diabetes care.
The researchers also found the general sexual function improved slightly with the testosterone gel, but there was no difference in erectile dysfunction or overall sexual satisfaction.
The side effects were similar between the dummy gel and Tostran, although testosterone may sometimes cause swelling around the joints and in the breasts.
Testosterone is already used to treat sexual problems in men whose levels of the hormone are lower than normal. The gels can cost more than $250 per month, and experts disagree about how low testosterone levels in the body should drop before they prescribe treatment.
With millions of prescriptions every year in the United States, some experts believe it's being overused.
"We need a lot less testosterone for sexual function than people used to think," Dr. Michael Marberger, who heads the urology department at the University of Vienna Medical School in Austria, told Reuters Health last year. "Obesity impacts sexual function much more."
The problem — called "insulin resistance" — is that the body doesn't know how to use insulin to process sugar. Researchers found that applying testosterone in a gel reduced this problem in diabetic men who had low levels of testosterone to begin with, or in similar men without diabetes but with a cluster of heart disease risk factors called metabolic syndrome.
It also lowered their cholesterol levels and had some impact on their sexual function, as compared with a gel that looked the same but had no testosterone in it.
Writing in the journal Diabetes Care, Dr. T. Hugh Jones of Barnsley Hospital in the UK and colleagues say their findings support testosterone treatment in men with low testosterone and Type 2 diabetes or metabolic syndrome.
In the new study, the researchers tested ProStrakan's testosterone gel Tostran against a dummy gel in 220 middle-aged and older men. The men used the gel once a day for a year.
The insulin resistance went down by 16 percent in men on Tostran, despite the fact that many were already taking metformin, a drug that helps control blood sugar levels.
Still, there was no difference overall between the fake gel and testosterone in terms of blood sugar control, the ultimate goal in diabetes care.
The researchers also found the general sexual function improved slightly with the testosterone gel, but there was no difference in erectile dysfunction or overall sexual satisfaction.
The side effects were similar between the dummy gel and Tostran, although testosterone may sometimes cause swelling around the joints and in the breasts.
Testosterone is already used to treat sexual problems in men whose levels of the hormone are lower than normal. The gels can cost more than $250 per month, and experts disagree about how low testosterone levels in the body should drop before they prescribe treatment.
With millions of prescriptions every year in the United States, some experts believe it's being overused.
"We need a lot less testosterone for sexual function than people used to think," Dr. Michael Marberger, who heads the urology department at the University of Vienna Medical School in Austria, told Reuters Health last year. "Obesity impacts sexual function much more."
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