Wednesday, June 29, 2016
Wisdom Wednesday: Alternative Medicine Taking Hold Among Americans
Americans spend a good chunk of their health care dollars on alternative medicine, such as acupuncture, yoga, chiropractic care and natural supplements, a new government report shows.
In fact, they paid more than $30 billion out of pocket in 2012 on chiropractors and other complementary health practitioners, as well as supplements and other forms of alternative medicine.
“Substantial numbers of Americans spent billions of dollars out-of-pocket on these approaches – an indication that users believe enough in the value of these approaches to pay for them,” said study co-author Richard Nahin. He is lead epidemiologist at the U.S. National Center for Complementary and Integrative Health.
Overall, spending on complementary medicine amounted to just over 9% of out-of-pocket health care expenditures and about 1% of all money spent on health care in the United States, the researchers found.
Even people with lower incomes spend quite a bit on complementary medicine, according to the report published June 22 in the National Health Statistics Reports.
Nahin and his colleagues found that families making less than $25,000 a year spent, on average, $314 out-of-pocket on visits to complementary health practitioners in 2012, and an average of $389 on natural supplements.
According to Stephanie Romanoff, communications director for the Academy of Integrative Health & Medicine, consumer demand for complementary medicine has caused more researchers to look into how well these approaches work, which in turn has provided consumers with better information.
Monday, June 27, 2016
Aspirin Often Wrongly Prescribed for Atrial Fibrillation
More than one-third of U.S. patients with the abnormal heartbeat atrial fibrillation (AF) who need a blood thinner to prevent strokes aren’t getting one, researchers say.
About 40% of AF patients deemed at moderate to severe risk of stroke because of age or other conditions are prescribed aspirin alone rather than recommended blood thinners such as Xarelto or warfarin, according to a new study.
“Despite clear guideline recommendations that patients at risk for stroke that have atrial fibrillation should be given blood thinners, many of these patients are not prescribed these potentially lifesaving medications,” said lead researcher Dr. Jonathan Hsu. He is an assistant professor of medicine, cardiology and cardiac electrophysiology at the University of California, San Diego.
In atrial fibrillation, the upper chambers of the heart beat rapidly and not in sync. The consequence of this irregular heart beat is that blood clots can form and travel to the brain, causing a stroke. Blood thinners are used to help prevent clots.
This study – based on patients from 123 cardiology practices in the United States – highlights inappropriate prescribing practices, Hsu said. His team used an American College of Cardiology registry to review medical records of more than 210,000 at-risk AF patients. They also conducted a secondary analysis of nearly 300,000 patients considered at-risk based on an updated guideline.
In both of these high-risk groups, roughly 40% were treated with aspirin and about 60% were prescribed a blood thinner, the investigators found.
Hsu suggested that some doctors may be unaware of current guidelines. Also, he said some patients may not want to take blood thinners – perhaps because of the risk for bleeding – or are unaware of their higher odds for stroke.
According to the latest guidelines, patients with atrial fibrillation who are 65 or older and those with at least one other condition – such as congestive heart failure, high blood pressure, diabetes or a prior stoke – should take a blood thinner. These factors are used by doctors to help assess stroke risk, Hsu said.
About 40% of AF patients deemed at moderate to severe risk of stroke because of age or other conditions are prescribed aspirin alone rather than recommended blood thinners such as Xarelto or warfarin, according to a new study.
“Despite clear guideline recommendations that patients at risk for stroke that have atrial fibrillation should be given blood thinners, many of these patients are not prescribed these potentially lifesaving medications,” said lead researcher Dr. Jonathan Hsu. He is an assistant professor of medicine, cardiology and cardiac electrophysiology at the University of California, San Diego.
In atrial fibrillation, the upper chambers of the heart beat rapidly and not in sync. The consequence of this irregular heart beat is that blood clots can form and travel to the brain, causing a stroke. Blood thinners are used to help prevent clots.
This study – based on patients from 123 cardiology practices in the United States – highlights inappropriate prescribing practices, Hsu said. His team used an American College of Cardiology registry to review medical records of more than 210,000 at-risk AF patients. They also conducted a secondary analysis of nearly 300,000 patients considered at-risk based on an updated guideline.
In both of these high-risk groups, roughly 40% were treated with aspirin and about 60% were prescribed a blood thinner, the investigators found.
Hsu suggested that some doctors may be unaware of current guidelines. Also, he said some patients may not want to take blood thinners – perhaps because of the risk for bleeding – or are unaware of their higher odds for stroke.
According to the latest guidelines, patients with atrial fibrillation who are 65 or older and those with at least one other condition – such as congestive heart failure, high blood pressure, diabetes or a prior stoke – should take a blood thinner. These factors are used by doctors to help assess stroke risk, Hsu said.
Friday, June 24, 2016
Could Eating More Whole Grains Help You Live Longer?
Health experts have long urged people to swap their processed white grains for the whole-grain variety, and new research suggests that advice might help you live longer.
Researchers found that people who ate three or more servings of whole grains a day had a 20% reduced risk of premature death during the study period, compared to those who ate fewer or no servings of whole grains.
“The higher the whole grain intake, the lower the death rate, especially deaths from cardiovascular disease,” said study author Dr. Qi Sun. He is an assistant professor of nutrition at the Harvard T.H. Chan School of Public Health in Boston.
Whole grains are so named because they contain the entire grain kernel, including bran (outer husk), germ (nutrient-rich core) and endosperm (middle layer). Whole-grain foods include whole-wheat flour, oatmeal, brown rice and whole cornmeal.
When grains are refined, they have been milled and that process removes the bran and germ, as well as fiber, iron and many of the B vitamins. White breads, white rice and white flour are all refined grains, according to the U.S. Department of Agriculture (USDA).
Sun and his colleagues reviewed the findings of 12 published studies as well as data from the National Health and Nutrition Examination Surveys (NHANES). The studies included nearly 800,000 men and women. The study populations were from the United States, the United Kingdom and Scandinavian countries. The studies covered 1971 to 2010. Over the study periods, there were almost 98,000 deaths recorded.
Researchers found that people who ate three or more servings of whole grains a day had a 20% reduced risk of premature death during the study period, compared to those who ate fewer or no servings of whole grains.
“The higher the whole grain intake, the lower the death rate, especially deaths from cardiovascular disease,” said study author Dr. Qi Sun. He is an assistant professor of nutrition at the Harvard T.H. Chan School of Public Health in Boston.
Whole grains are so named because they contain the entire grain kernel, including bran (outer husk), germ (nutrient-rich core) and endosperm (middle layer). Whole-grain foods include whole-wheat flour, oatmeal, brown rice and whole cornmeal.
When grains are refined, they have been milled and that process removes the bran and germ, as well as fiber, iron and many of the B vitamins. White breads, white rice and white flour are all refined grains, according to the U.S. Department of Agriculture (USDA).
Sun and his colleagues reviewed the findings of 12 published studies as well as data from the National Health and Nutrition Examination Surveys (NHANES). The studies included nearly 800,000 men and women. The study populations were from the United States, the United Kingdom and Scandinavian countries. The studies covered 1971 to 2010. Over the study periods, there were almost 98,000 deaths recorded.
Wednesday, June 22, 2016
Wisdom Wednesday: Organic Eggs
This information comes from Dr. Ronda Nelson, a nutritionist in California. I have been attending her seminars for the last few years.
Buying eggs has become a complex process. There are ever increasing options at the grocery store and the creative marketing is designed to entice the buyer, rather than inform. Every style claims to be the healthiest and best tasting. However, as we have often seen in the health food world, legal loopholes, lack of accountability by government agencies and corporate profits often determine the final quality of what we buy.
The “specialty egg” market (vegetarian, cage-free, organic, omega-3, etc.) is seeing incredible gains in the marketplace. Existing egg production companies want to cash-in on their profits and many of them have figured out ways to do so without really changing their production methods.
Organic eggs are produced in one of four basic ways. Although each operating and production style has various interpretations of the organic standards, all are labeled and sold as “organic.”
Monday, June 20, 2016
Want New Knowledge to Stick? Head Straight to a Workout
Exercising after you learn new things might help you remember them, a small study suggests. But the workout has to be done within a specific time window, and it can’t be immediately after the learning, Dutch researchers said.
Their study involved 72 people who learned a series of picture-location associations. The participants were then assigned to one of three groups: exercising immediately after the learning session; exercising four hours after learning, and not exercising at all.
The workout involved 35 minutes of interval training on an exercise bike at an intensity of up to 80% of the participants’ maximum heart rates.
The study volunteers returned two days later to see how much they remembered.
Those who exercised four hours after the learning session retained the new information better than those who exercised immediately after learning or those who didn’t exercise at all.
The study was published June 16 in the journal Current Biology.
“[Our findings show] that we can improve memory consolidation by doing sports after learning,” researcher Guillen Fernandez said in a journal news release. Fernandez is with the Donders Institute for Brain, Cognition and Behavior at Radboud University Medical Center, in the Netherlands.
Their study involved 72 people who learned a series of picture-location associations. The participants were then assigned to one of three groups: exercising immediately after the learning session; exercising four hours after learning, and not exercising at all.
The workout involved 35 minutes of interval training on an exercise bike at an intensity of up to 80% of the participants’ maximum heart rates.
The study volunteers returned two days later to see how much they remembered.
Those who exercised four hours after the learning session retained the new information better than those who exercised immediately after learning or those who didn’t exercise at all.
The study was published June 16 in the journal Current Biology.
“[Our findings show] that we can improve memory consolidation by doing sports after learning,” researcher Guillen Fernandez said in a journal news release. Fernandez is with the Donders Institute for Brain, Cognition and Behavior at Radboud University Medical Center, in the Netherlands.
Friday, June 17, 2016
Antibiotics, Formula Feeding Might Change Baby’s ‘Microbiome’
When babies are born, the birth process covers their bodies with countless microbes that play crucial roles in their future health. But a new study suggests that these “microbiomes” are altered by cesarean births, antibiotics and formula feeding.
“The microbiome is really important in how a baby develops normally. We are doing things that are disrupting them,” said Dr. Martin Blaser, director of Human Microbiome Program at New York University Langone Medical Center.
Microbiomes evolved with humans and are mostly helpful, explained Annie Gatewood Hoen. She’s an assistant professor of epidemiology and biomedical data science at the Geisel School of Medicine at Dartmouth, in New Hampshire.
“These organisms help digest our food, train our immune system and out-compete disease-causing microbes,” she said. But, there’s still a lot of mystery about how they work.
“They’re very complex and everyone’s is slightly different,” Hoen said, and it’s not entirely clear what healthy ones should look like.
“There is a lot left to discover about how subtle variations in the makeup of these communities might be more or less optimal for health and, importantly, how we can manipulate them so they’re most beneficial to us,” she added.
The new study examined the microbiomes of newborns after they left the sterile environment of the womb.
“The microbiome is really important in how a baby develops normally. We are doing things that are disrupting them,” said Dr. Martin Blaser, director of Human Microbiome Program at New York University Langone Medical Center.
Microbiomes evolved with humans and are mostly helpful, explained Annie Gatewood Hoen. She’s an assistant professor of epidemiology and biomedical data science at the Geisel School of Medicine at Dartmouth, in New Hampshire.
“These organisms help digest our food, train our immune system and out-compete disease-causing microbes,” she said. But, there’s still a lot of mystery about how they work.
“They’re very complex and everyone’s is slightly different,” Hoen said, and it’s not entirely clear what healthy ones should look like.
“There is a lot left to discover about how subtle variations in the makeup of these communities might be more or less optimal for health and, importantly, how we can manipulate them so they’re most beneficial to us,” she added.
The new study examined the microbiomes of newborns after they left the sterile environment of the womb.
Wednesday, June 15, 2016
Wisdom Wednesday: Crataeva
This Ayurvedic herb is native to India and Bangladesh. It comes from the varuna tree which grows to a height of 50 feet. It is frequently grown around the temples of India. Although the leaves, bark and root bark all have medicinal uses, I am only familiar with the therapeutic properties of the bark.
Traditionally, Indians have been using this tree for several centuries to help discharge surplus water from the body as well as to invigorate the functions of the liver. The bark contains lupeol, a chemical that neutralizes enzymes associated with BPH (benign prostatic hypertrophy). In addition, crataeva also possesses diuretic and stimulant (tonic) features.
In Hindi, varuna is known as ‘barun’ but it is also called three-leaved caper from the dense canopy the leaves provide. In fact, when I was searching for a source of crataeva as a single herb, I keep reaching dead ends until I searched for varuna.
For many years I have used crataeva in combination with other herbs for UTI (urinary tract infection), kidney stones, gout, and BPH. However, it was my interest in the tonic qualities of this herb that sent me on a quest to find the pure herb.
This tonic effect is most apparent on the bladder but it effects all smooth muscle. So you might have guessed that I now use it to treat urinary incontinence. Obviously, in the absence of UTI, kidney stones, etc., I did not want to use the herbal combinations specifically designed for those purposes and regardless, the dosage is too low.
Monday, June 13, 2016
Medication Disposal
Opioid medications bind to the area of the brain that control pain and emotions, driving up levels of dopamine in the brain’s reward areas and producing an intense feeling of euphoria. As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.
Opioids like Vicodin and Percocet are commonly prescribed to dull pain after medical procedures and to treat chronic pain. They also commonly languish in medicine cabinets, sometimes for years, making easy pickings for someone with an addiction.
What are consumers to do if they want a safe alternative to flushing unwanted drugs down the toilet or tossing them into the garbage? Drugs that are flushed can taint our rivers, lakes and water supplies. Drugs in the trash also may harm the environment, and can be found by children, pets – and even adults looking for a high.
National Prescription Drug Take-Back Day now occurs twice a year. But what can we do the rest of the year? There are a growing number of year-round disposal site in California, but the rest of the country is lagging behind.
To find take-back sites that definitely accept controlled drugs, check the federal Drug Enforcement Administration’s website at www.deadiversion.sudoj.gov/drug.disposal/ or call 800-882-9539.
The drugstore chain Walgreens has announced plans to install medication disposal bins at 500 stores nationwide. The effort began last month in California with 50 stores, says Walgreens spokesman Phil Caruso.
Opioids like Vicodin and Percocet are commonly prescribed to dull pain after medical procedures and to treat chronic pain. They also commonly languish in medicine cabinets, sometimes for years, making easy pickings for someone with an addiction.
What are consumers to do if they want a safe alternative to flushing unwanted drugs down the toilet or tossing them into the garbage? Drugs that are flushed can taint our rivers, lakes and water supplies. Drugs in the trash also may harm the environment, and can be found by children, pets – and even adults looking for a high.
National Prescription Drug Take-Back Day now occurs twice a year. But what can we do the rest of the year? There are a growing number of year-round disposal site in California, but the rest of the country is lagging behind.
To find take-back sites that definitely accept controlled drugs, check the federal Drug Enforcement Administration’s website at www.deadiversion.sudoj.gov/drug.disposal/ or call 800-882-9539.
The drugstore chain Walgreens has announced plans to install medication disposal bins at 500 stores nationwide. The effort began last month in California with 50 stores, says Walgreens spokesman Phil Caruso.
Wednesday, June 8, 2016
Wisdom Wednesday: Antibiotic Countermeasures
So you took that antibiotic. Maybe you needed it, maybe not but that boat has sailed. Now what do you do?
This is a frequent issue in my office. The sooner you take steps to undo any potential damage, the better. Antibiotics often disrupt the microbiome. This can lead to dysbiosis, IBS, autoimmune disease and even death through overgrowth of C. difficle.
First, has the infection you were treating with antibiotics resolved? If it was an upper respiratory infection (URI) about 90% of URIs are viral and will not respond to antibiotic therapy. That’s a common complaint on entry for many of my patients – the antibiotic didn’t work.
Colloidal silver is a good place to start. It is effective against bacterial, viral and fungal infections. I am a big fan of the Netti Pot, a device designed to irrigate the sinuses with Kosher salt in distilled water. I just substitute colloidal silver for the Kosher salt. Use 1-part silver to 10-parts distilled water. It burns like hell fire for a minute or two, but relief from the congestion is immediate. Patients often report that they can feel they are healing immediately after the first application. It is vital that you use distilled water, tap water may contain nematodes that can grow in the sinus cavities. Why people continue to drink that stuff is beyond me.
Monday, June 6, 2016
Genetically Modified Crops Are Safe
Crops created through genetic engineering are as safe to eat as crops developed through traditional plant-breeding methods, according to the National Academies of Sciences, Engineering and Medicine panel.
The panel could find no link between consumption of genetically modified crops and rates of cancer, kidney disease, obesity, type 2 diabetes, gastrointestinal diseases, celiac disease, food allergies or autism, the report stated.
“We compared the patterns in the U.S. and Canada to the patterns in the U.K. and E.U. (European Union), because in those countries people are not eating genetically engineered foods,” said panel chairman Fred Gould, a professor of agriculture at North Carolina State University. “We did not see a difference [in health risks] in those patterns.”
Because of this, there is “no justification for labeling for food safety purposes” any produce in the supermarket as a genetically modified product, said committee member Michael Rodemeyer, an expert on food and biotechnology who is retired from the University of Virginia.
Genetically engineered crops have been planted on about 12% of the world’s total cropland, the experts found.
The 388-page report, requested by the National Academies to review the scientific evidence, represented an attempt to clear up a “confusing landscape for the public and policy makers.” Gould said.
The creation of new crops through genetic manipulation is something that predates modern laboratory genetic tinkering, noted Joan Salge Blade, as spokeswoman for the Academy of Nutrition and Dietetics. She cited the tangelo, which is a crossbreed between a tangerine and a grapefruit.
The panel could find no link between consumption of genetically modified crops and rates of cancer, kidney disease, obesity, type 2 diabetes, gastrointestinal diseases, celiac disease, food allergies or autism, the report stated.
“We compared the patterns in the U.S. and Canada to the patterns in the U.K. and E.U. (European Union), because in those countries people are not eating genetically engineered foods,” said panel chairman Fred Gould, a professor of agriculture at North Carolina State University. “We did not see a difference [in health risks] in those patterns.”
Because of this, there is “no justification for labeling for food safety purposes” any produce in the supermarket as a genetically modified product, said committee member Michael Rodemeyer, an expert on food and biotechnology who is retired from the University of Virginia.
Genetically engineered crops have been planted on about 12% of the world’s total cropland, the experts found.
The 388-page report, requested by the National Academies to review the scientific evidence, represented an attempt to clear up a “confusing landscape for the public and policy makers.” Gould said.
The creation of new crops through genetic manipulation is something that predates modern laboratory genetic tinkering, noted Joan Salge Blade, as spokeswoman for the Academy of Nutrition and Dietetics. She cited the tangelo, which is a crossbreed between a tangerine and a grapefruit.
Friday, June 3, 2016
U.S Officials Confirm Superbug Resistant to All Antibiotics
U.S. researchers have identified the nation’s first patient with an infection resistant to all existing antibiotics.
Scientists have warned for years the day could come when “superbugs” resisted all last-resort antibiotics. This new case, involving a 49-year-old Pennsylvania woman, suggests that day may soon be here.
“It is the end of the road for antibiotics unless we act urgently,” Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said at a National Press Club event in Washington, D.C., on Thursday.
Although the patient survived, it’s feared the resistance could spread to other bacteria, according to media reports.
The woman was treated last month for a urinary tract infection at a military clinic in Pennsylvania. The culprit was identified as E. coli bacteria. It’s a common type of germ. But in this case, tests showed it was resistant to first-line antibiotics – those usually used for these infections.
Another kind of antibiotic proved successful in treating the infection. However, subsequent testing revealed that the particular E. coli was genetically resistant to the drug colistin.
Colistin, an older antibiotic, fell out of favor in the 1970s because of nasty side effects, the Associated Press reported. Now, however, it’s used to fight difficult-to-treat bacteria resistant to a class of antibiotics called carbapenems. Carbapenems are one of the last lines of defense, the AP said.
Experts say that if carbapenems-resistant bacteria also gain resistance to colistin, it could leave doctors with no treatment options for infections.
Scientists have warned for years the day could come when “superbugs” resisted all last-resort antibiotics. This new case, involving a 49-year-old Pennsylvania woman, suggests that day may soon be here.
“It is the end of the road for antibiotics unless we act urgently,” Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said at a National Press Club event in Washington, D.C., on Thursday.
Although the patient survived, it’s feared the resistance could spread to other bacteria, according to media reports.
The woman was treated last month for a urinary tract infection at a military clinic in Pennsylvania. The culprit was identified as E. coli bacteria. It’s a common type of germ. But in this case, tests showed it was resistant to first-line antibiotics – those usually used for these infections.
Another kind of antibiotic proved successful in treating the infection. However, subsequent testing revealed that the particular E. coli was genetically resistant to the drug colistin.
Colistin, an older antibiotic, fell out of favor in the 1970s because of nasty side effects, the Associated Press reported. Now, however, it’s used to fight difficult-to-treat bacteria resistant to a class of antibiotics called carbapenems. Carbapenems are one of the last lines of defense, the AP said.
Experts say that if carbapenems-resistant bacteria also gain resistance to colistin, it could leave doctors with no treatment options for infections.
Wednesday, June 1, 2016
Wisdom Wednesday: Hypertension and Congestive Heart Failure
High blood pressure is an all too common condition as we age. About 29% of Americans have high blood pressure and only half have it under control. By age 55 more than 50% of us suffer from the condition. The health care costs of hypertension are estimated to be in excess of 46 billion dollars a year.
Traditional treatment is medication to reduce the force of the heart contraction. Beta-blockers, calcium channel blockers and ACE inhibitors are commonly used alone or in combination to reduce high blood pressure.
Unfortunately, the most common side effect of these medications is congestive heart failure. Of note, an Internet search for the causes of congestive heart failure will not list medication side effect as a cause.
So you take one or more of these medications to reduce the hypertension but your ankles begin to swell, especially at the end of the day – that’s early congestive heart failure. By reducing the force of the heart contraction, the blood begins to pool in the legs, kidneys, and lungs as pump efficiency drops. Your doctor adds a diuretic to pull off more of the fluid. The swelling goes down but now your legs are cramping or your heart rate becomes erratic from the loss of potassium. So a potassium supplement is added, but that upsets your stomach. A proton-pump inhibitor is next (Nexium or Prilosec) and you’ve reached polypharmacy. Welcome to health care in America.
What is the alternative? Although modern health care considers blood pressure and heart rate as independent variables, the rate, rhythm, and force of the heart contraction are all balanced by input from the brain to the heart. Three of the B vitamins are key players in this complex communication.
Vitamin B1, thiamine is generally stimulatory. I am firmly convinced that the fortification of our grains with thiamine is an ignored factor in both hypertension and heart rhythm disorders like tachycardia and AF (atrial fibrillation).
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