We know that in cases of arterial blockage, cholesterol is a significant constituent of the material that builds up. The conventional medical wisdom recognizes that the severity and frequency of such blockages are statistically greater with higher serum levels of LDL cholesterol. Many health professionals believe that that the culprit is actually damage that occurs to the lining of the blood vessels to which the cholesterol adheres. They believe that the vessel damage is but one manifestation of a more systemic pro-inflammatory condition and that the maintenance of high serum cholesterol levels is the body's reaction to that systemic inflammation. In other words, if your entire body is at in elevated inflammatory state, then the inflammation in the lining of the blood vessels actually attracts cholesterol as a sort of self defense mechanism and ultimately results in clogging of the affected vessels. But we should understand that this happens along with a host of other problems occurring simultaneously in other organ systems elsewhere in the body. Clearly, we all know by now that clogging arteries is not the only bad thing going on in this scenario. So my picking this apart is intened to provide you with a clearer picture of what is happening than to simply attribute this to some faceless pesky cholesterol generator gone awry.
This, by the way, reminds me of a story that was attributed to the developer of Chiropractic, Dr. BJ Palmer. In this story, he told of a time when he had occasion to see the carcass of a dead cow in a field. Upon inspection, he observed that the body cavity was full of fly larvae and reached the only logical conclusion... That the cow had died of a maggot attack. - LOL
Yes, I do believe that the cholesterol issue is more of a chicken or egg question than the medical establishment purports it to be (pardon the pun :). Conveniently, though, the non-pharmaceutical action steps you should take to correct the situation are identical whether your intent is to reduce your systemic inflammatory state or to lower your serum cholesterol levels. In fact, were it not for the medical industry's "solution" of prescribing statin drugs to force the cholesterol numbers down, I would say that the question is moot. But since cholesterol is a primary component of the the cell membrane, the "brains" of every single living cell of your body, blindly forcing cholesterol numbers down will eventually be shown to be another well-intentioned but not entirely correct approach to improving overall health.
It is with this background, that I present you with an edited version of "11 Tips to Cut Your Cholesterol Fast", which was originally written by David Freeman and published on MedPage Today. You can get the unedited version on MedPage where you will find that I removed their suggestion for statin drug prescription, "Tip #2", and a statement that "if your cardiovascular risk is high, you may need to take a cholesterol lowering drug." I'm not saying that there is no place for drug therapy, only that every single individual should only consult an MD about drug therapy for high cholesterol after attempting to address the other risk factors such as obesity, smoking, high blood pressure and poor dietary habits.
10 Tips to Cut Your Cholesterol Fast
Got high cholesterol? Learn what you can do to lower it quickly -- starting today.
If you think that the normal reading you got back in 2004 (or earlier) means you're in the clear, think again: Cholesterol levels often rise with age, and cardiologists say everyone 20 or older should be screened for high cholesterol at least once every five years, with more frequent screenings for anyone deemed to be at high risk for heart disease. If it's been awhile since your last cholesterol screening, now's a good time to ask your doctor if you're due for one.
The good news? If your fasting total cholesterol level exceeds the desirable level of 200, or if your low-density lipoprotein (LDL, or "bad”) cholesterol is above 100, getting it down to a safer level could be easier than you think. In fact, with simple lifestyle modifications people often see significant reductions in cholesterol within six weeks.
Here are 10 tips from WebMD health experts on how to cut high cholesterol fast:
Get Your Personalized Cholesterol Health Assessment
1. Set a target.
You know you've got to get your cholesterol number down, but how low do you need to go? That depends on several factors, including your personal and family history of heart disease, as well as whether you have cardiovascular risk factors, such as obesity, high blood pressure, diabetes, and smoking.
If your risk is deemed high, "most doctors will treat for a target LDL of less than 70," says James Beckerman, MD, a cardiologist in private practice in Portland, Ore. If your risk is moderate, a target LDL of under 130 is generally OK, Beckerman says. If your risk is low, less than 160 is a reasonable target. "The trend now is to treat people earlier, especially if they have two or more risk factors," he says.
2. Get moving.
In addition to lowering LDL "bad" cholesterol, regular physical activity can raise HDL "good" cholesterol by up to 10%. The benefits come even with moderate exercise, such as brisk walking.
Robert Harrington, MD, professor of medicine at Duke University School of Medicine in Durham, N.C., urges his patients to go for a 45-minute walk after supper.
Peeke tells WebMD, "I ask people to get a pedometer and aim for 10,000 steps a day. If you work at a desk, get up and walk around for five minutes every hour."
Whatever form your exercise takes, the key is to do it with regularity. "Some experts recommend seven days a week, although I think five days is more realistic," Richman says.
3. Reduce your consumption of saturated fat.
Doctors used to think that the key to lowering high cholesterol was to cut back on eggs and other cholesterol-rich foods. But now it's clear that dietary cholesterol isn't the main culprit. "Eggs don't do all that much to raise cholesterol," Beckerman says. Recent data suggests that excessive consumption of saturated fat correlates with higher cholesterol levels.
"One of the first things to do when you're trying to lower your cholesterol level is to take saturated fat down a few notches," says Elaine Magee, MPH, RD, the author of several nutrition books, including the forthcoming Tell Me What to Eat If I Have Heart Disease. "The second thing to do is to start eating more 'smart' fats," Magee says. She recommends substituting canola oil or olive oil for vegetable oil, butter, stick margarine, lard, or shortening while cutting back on fatty meats while eating more fish.
4. Eat more fiber.
Fruits and vegetables, including whole grains, are good sources not only of heart-healthy antioxidants but also cholesterol-lowering dietary fiber. Soluble fiber, in particular, can help lower cholesterol. Beckerman says it "acts like a sponge to absorb cholesterol "in the digestive tract. Good sources of soluble fiber include dried beans, oats, and barley, as well as fiber products containing psyllium. [This seems to contradict the finding that "dietary cholesterol is not the main culprit". But if you look at the reduction of saturated animal fats which are known to be raw materials that lead to the overproduction of the primary inflammatory agent, arachidonic acid, you can see that shifting the diet towards more anti-oxidant-rich fruits and vegetables will certainly help counteract that inflammation, and, thus, lower blood cholesterol as well - Dr. H].
5. Go fish.
Fish and fish oil are a great source of cholesterol-lowering omega-3 fatty acids. "Fish oil supplements can have a profound effect on cholesterol and triglycerides," Beckerman says. "There's a lot of scientific evidence to support their use." Fish oil is considered to be quite safe, but check with your doctor first if you are taking an anti-clotting medication. [Their beneficial effect is understood to shift the balance of fat metabolism away from the production of arachidonic acid, thus lowering system inflammation, and subsequently, reducing the maintenance of high serum cholesterol levels. - Dr. H]
Magee recommends eating fish two or three times a week. "Salmon is great, as it has lots of omega-3s,"she says. But even canned tuna has omega-3s, and it's more consumer-friendly. The American Heart Association also recommends fish as the preferable source of omega-3s, but fish oil capsule supplements can be considered after consultation with your physician. Plant sources of omega-3s include soybeans, canola, flaxseeds, walnuts, and their oils, but they don't provide the same omega-3s as fish. The biggest heart benefits have been linked to omega-3s found in fish. [ Beware of the fact that eating too much fish can expose you to additional mercury, which is a bad thing, so do this in moderation. - Dr. H ]
6. Drink up.
Moderate consumption of alcohol can raise levels of HDL "good" cholesterol by as much as 10%. Doctors say up to one drink a day makes sense for women, up to two a day for men. But given the risks of excessive drinking, the American Heart Association cautions against increasing your alcohol intake or starting to drink if you don't already.
7. Drink green.
Magee suggests green tea as a healthier alternative to sodas and sugary beverages. Indeed, research in both animals and humans has shown that green tea contains compounds that can help lower LDL cholesterol. In a small-scale study conducted recently in Brazil, people who took capsules containing a green tea extract experienced a 4.5% reduction in LDL cholesterol.
8. Eat nuts.
Extensive research has demonstrated that regular consumption of nuts can bring modest reductions in cholesterol. Walnuts and almonds seem particularly beneficial. But nuts are high in calories, so limit yourself to a handful a day, experts say.
9. Switch spreads.
Recent years have seen the introduction of margarine-like spreads and other foods fortified with cholesterol-lowering plant compounds known as stanols. [I haven't removed this item, but I will say that you're better off just eating less butter than adding hydrogenated fats, stanols or no stanols. Bottom line is that if it is a vegetable oil product that is solid at room temperature, you're better off sticking with the butter. Just try to eat less of it. - Dr. H]
10. Don't smoke.
Smoking lowers levels of HDL "good" cholesterol and is a major risk factor for heart disease.
Thursday, March 4, 2010
Maternal Folate Supplementation Culprit in Childhood Asthma?
Dr. Harriott's Comment:
If you know someone who is pregnant, please share this information with them. Typically, folate supplementation has been recommended as part of prenatal vitamins for years to prevent congenital developmental spinal disorders, such as spina bifida. OB's will likely continue to recommend supplementation. However, with a 66% increase in asthma risk, this is a conversation an expectant mother wants to have with her OB regarding supplementation levels and timing. Apparently, the recommendations are still a work in progress.
=======================================
AAAAI: Folate-Asthma Link Depends on Timing
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: March 03, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
NEW ORLEANS -- High folate levels in utero may increase a child's future asthma risk, while those in the child's early years make little difference, according to two studies reported here.
In a Norwegian cohort, second trimester maternal folate levels over 17.84 nmol/L -- a level that might be expected with supplementation -- were associated with 66% elevated risk of the child having asthma at age 3 years (95% CI 16% to 237%).
This appeared to be a dose-dependent relationship (P<0.01), said Siri E. Haberg, MD, PhD, of the Norwegian Institute of Public Health in Oslo, who presented the results at the American Academy of Allergy, Asthma & Immunology meeting.Action Points
Explain to interested patients that high folate levels in utero may increase a child's future asthma risk, while those in the child's early years make little difference, according to two studies reported here.
Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
In an American cohort, children's own folate levels at age 4 held little correlation with development of asthma by age 6, according to a second group led by Adesua Y. Okupa, MD, of the University of Wisconsin at Madison.
Timing may be important, Haberg noted.
Any mild deleterious effects on asthma risk from folate use wouldn't outweigh the benefit of preventing life-threatening congenital defects, said Haberg's co-author Stephanie J. London, MD, DrPH, of the U.S. National Institute of Environmental Sciences in Research Triangle Park, N.C.
Women of childbearing age should not stop taking folic acid supplements -- recommended to prevent neural tube defects -- based on these observational results, agreed Stanley J. Szefler, MD, of National Jewish Health in Denver, who was not involved in either study.
But the findings seem to fit with emerging evidence in animal studies that more is not always better, he said.
"Giving too much folate can also have effects on DNA methylation, which may trigger off genes to work maybe the way you don't want them to," Szefler told MedPage Today.
There may be an optimal level of folate to maximize neurological and congenital development of an infant, but minimize harmful epigenetic effects, he said.
Until studies determine what that is, women should take the amount deemed necessary but avoid taking excessive amounts, Szefler recommended.
Haberg's group analyzed outcomes for 507 children with athsma and 1,455 without it at age 3, all of whose mothers had provided blood samples at around 18 weeks' gestation as part of the larger, population-based Norwegian Mother and Child Study.
Norway is a good place to look for folate effects because it does not fortify the food supply with folic acid and thus has a greater range of levels among the population, London noted.
Overall, women in the highest folate quintile had the significant 66% elevated risk of their child having asthma as a toddler, after adjustment for maternal atopy, smoking, and other confounders.
Those in the intermediate quintiles conferred 16% to 48% higher adjusted risk to their child as well compared with the lowest 5.54-nmol/L and under group, although only significant for the third quintile with folate levels of 7.68 to 10.60 nmol/L.
In a sensitivity analysis of 422 women not on folic acid supplements at the time of their second trimester blood test, the adjusted risk of asthma in the child rose again with folate exposure in utero (P=0.011). The adjusted odds were significant for women over the 70th percentile (odds ratio 1.34 at 7.297 to 15.835 nmol/L) and those over the 95th percentile (OR 1.44 for above 15.835 nmol/L).
Okupa's study was an analysis of the prospective Childhood Origins of Asthma study of a high-risk birth cohort.
Among 220 kids with folate measured at age 4, 30% developed asthma and 49% were positive for allergic sensitization by age 6 years.
Allergies appeared to be more common in children with higher folate levels (P=0.01), whereas asthma showed no such association (P=0.81). Adjustment for socioeconomic status and other confounders didn't impact these results.
"It is possible that there is a critical period where folic acid supplement dosages may be manipulated to maximize neuroprotective effects yet minimize the adverse respiratory effects," Okupa said at the session where she presented the results.
Haberg's group cautioned that, despite adjustment for important variables, confounding remained a possible explanation for the modest effects seen in their study. The study was also limited by follow-up only to 3 years at this point, which may not be old enough to establish a diagnosis of asthma, Haberg said in an interview.
Szefler noted that folate levels fluctuate from day to day based on diet, so a single blood measurement may not have accurately conveyed exposure.
"It's very hard to make those comparisons," he said in an interview. "Right now there's not a standard level that you should have."
Okupa's study was funded by the National Institutes of Health and the National Institute of Allergy and Infectious Diseases.
Okupa reported no conflicts of interest.
London's study was supported by the Norwegian Research Council. The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health Division of Intramural Research, NEIHS/NIH, NIH/NINDS, and the Norwegian Research Council/FUGE.
Szefler reported no relevant conflicts of interest.
Primary source: American Academy of Allergy, Asthma & Immunology
Source reference:
Haberg SE, et al "Maternal folate levels in pregnancy and asthma at 3 years of age" AAAAI 2010; Abstract 505.
Additional source: American Academy of Allergy, Asthma & Immunology
Source reference:
Okupa AY, et al "Relationships among folate, allergic sensitization, wheezing, and asthma" AAAAI 2010; Abstract 217.
If you know someone who is pregnant, please share this information with them. Typically, folate supplementation has been recommended as part of prenatal vitamins for years to prevent congenital developmental spinal disorders, such as spina bifida. OB's will likely continue to recommend supplementation. However, with a 66% increase in asthma risk, this is a conversation an expectant mother wants to have with her OB regarding supplementation levels and timing. Apparently, the recommendations are still a work in progress.
=======================================
AAAAI: Folate-Asthma Link Depends on Timing
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: March 03, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
NEW ORLEANS -- High folate levels in utero may increase a child's future asthma risk, while those in the child's early years make little difference, according to two studies reported here.
In a Norwegian cohort, second trimester maternal folate levels over 17.84 nmol/L -- a level that might be expected with supplementation -- were associated with 66% elevated risk of the child having asthma at age 3 years (95% CI 16% to 237%).
This appeared to be a dose-dependent relationship (P<0.01), said Siri E. Haberg, MD, PhD, of the Norwegian Institute of Public Health in Oslo, who presented the results at the American Academy of Allergy, Asthma & Immunology meeting.Action Points
Explain to interested patients that high folate levels in utero may increase a child's future asthma risk, while those in the child's early years make little difference, according to two studies reported here.
Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
In an American cohort, children's own folate levels at age 4 held little correlation with development of asthma by age 6, according to a second group led by Adesua Y. Okupa, MD, of the University of Wisconsin at Madison.
Timing may be important, Haberg noted.
Any mild deleterious effects on asthma risk from folate use wouldn't outweigh the benefit of preventing life-threatening congenital defects, said Haberg's co-author Stephanie J. London, MD, DrPH, of the U.S. National Institute of Environmental Sciences in Research Triangle Park, N.C.
Women of childbearing age should not stop taking folic acid supplements -- recommended to prevent neural tube defects -- based on these observational results, agreed Stanley J. Szefler, MD, of National Jewish Health in Denver, who was not involved in either study.
But the findings seem to fit with emerging evidence in animal studies that more is not always better, he said.
"Giving too much folate can also have effects on DNA methylation, which may trigger off genes to work maybe the way you don't want them to," Szefler told MedPage Today.
There may be an optimal level of folate to maximize neurological and congenital development of an infant, but minimize harmful epigenetic effects, he said.
Until studies determine what that is, women should take the amount deemed necessary but avoid taking excessive amounts, Szefler recommended.
Haberg's group analyzed outcomes for 507 children with athsma and 1,455 without it at age 3, all of whose mothers had provided blood samples at around 18 weeks' gestation as part of the larger, population-based Norwegian Mother and Child Study.
Norway is a good place to look for folate effects because it does not fortify the food supply with folic acid and thus has a greater range of levels among the population, London noted.
Overall, women in the highest folate quintile had the significant 66% elevated risk of their child having asthma as a toddler, after adjustment for maternal atopy, smoking, and other confounders.
Those in the intermediate quintiles conferred 16% to 48% higher adjusted risk to their child as well compared with the lowest 5.54-nmol/L and under group, although only significant for the third quintile with folate levels of 7.68 to 10.60 nmol/L.
In a sensitivity analysis of 422 women not on folic acid supplements at the time of their second trimester blood test, the adjusted risk of asthma in the child rose again with folate exposure in utero (P=0.011). The adjusted odds were significant for women over the 70th percentile (odds ratio 1.34 at 7.297 to 15.835 nmol/L) and those over the 95th percentile (OR 1.44 for above 15.835 nmol/L).
Okupa's study was an analysis of the prospective Childhood Origins of Asthma study of a high-risk birth cohort.
Among 220 kids with folate measured at age 4, 30% developed asthma and 49% were positive for allergic sensitization by age 6 years.
Allergies appeared to be more common in children with higher folate levels (P=0.01), whereas asthma showed no such association (P=0.81). Adjustment for socioeconomic status and other confounders didn't impact these results.
"It is possible that there is a critical period where folic acid supplement dosages may be manipulated to maximize neuroprotective effects yet minimize the adverse respiratory effects," Okupa said at the session where she presented the results.
Haberg's group cautioned that, despite adjustment for important variables, confounding remained a possible explanation for the modest effects seen in their study. The study was also limited by follow-up only to 3 years at this point, which may not be old enough to establish a diagnosis of asthma, Haberg said in an interview.
Szefler noted that folate levels fluctuate from day to day based on diet, so a single blood measurement may not have accurately conveyed exposure.
"It's very hard to make those comparisons," he said in an interview. "Right now there's not a standard level that you should have."
Okupa's study was funded by the National Institutes of Health and the National Institute of Allergy and Infectious Diseases.
Okupa reported no conflicts of interest.
London's study was supported by the Norwegian Research Council. The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health Division of Intramural Research, NEIHS/NIH, NIH/NINDS, and the Norwegian Research Council/FUGE.
Szefler reported no relevant conflicts of interest.
Primary source: American Academy of Allergy, Asthma & Immunology
Source reference:
Haberg SE, et al "Maternal folate levels in pregnancy and asthma at 3 years of age" AAAAI 2010; Abstract 505.
Additional source: American Academy of Allergy, Asthma & Immunology
Source reference:
Okupa AY, et al "Relationships among folate, allergic sensitization, wheezing, and asthma" AAAAI 2010; Abstract 217.
Is Dad Going Deaf From Aspirin & Tylenol?
Doctor Harriott's Comment: This is a case in point about the use of drugs for relief only. We need to know the cost of "pharmaceutical comfort" and the healthy alternatives.
If you have an acute injury, and take acetominophen or aspirin to reduce inflammation, well, that is a simple protocol to be discussed between you and your medical doctor.
But if you regularly take a baby aspirin because you think it is "good for you", do a little more research. Or you take a daily dose of aspirin or tylenol because you regularly come home sore after a long day at work or have your "regular" daily headache... that is a whole different story. You need to come see me or your own chiropractor or functional medicine doctor to try to figure out what is really going on. (See my previous post re: chiropractors and drugs: http://drharriott.blogspot.com/2010/03/chiropractic-position-on-drugs.html#links)
=========================================
Reprint from
The American Journal of Medicine
Volume 123, Issue 3, Pages 231-237 (March 2010)
Analgesic Use and the Risk of Hearing Loss in Men
Sharon G. Curhan, MD, ScMaCorresponding Author Informationemail address, Roland Eavey, MDb, Josef Shargorodsky, MDac, Gary C. Curhan, MD, ScDad
Abstract
Background
Hearing loss is a common sensory disorder, yet prospective data on potentially modifiable risk factors are limited. Regularly used analgesics, the most commonly used drugs in the US, may be ototoxic and contribute to hearing loss.
Methods
We examined the independent association between self-reported professionally diagnosed hearing loss and regular use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen in 26,917 men aged 40-74 years at baseline in 1986. Study participants completed detailed questionnaires at baseline and every 2 years thereafter. Incident cases of new-onset hearing loss were defined as those diagnosed after 1986. Cox proportional hazards multivariate regression was used to adjust for potential confounding factors.
Results
During 369,079 person-years of follow-up, 3488 incident cases of hearing loss were reported. Regular use of each analgesic was independently associated with an increased risk of hearing loss. Multivariate-adjusted hazard ratios of hearing loss in regular users (2+ times/week) compared with men who used the specified analgesic <2 times/week were 1.12 (95% confidence interval [CI], 1.04-1.20) for aspirin, 1.21 (95% CI, 1.11-1.33) for NSAIDs, and 1.22 (95% CI, 1.07-1.39) for acetaminophen. For NSAIDs and acetaminophen, the risk increased with longer duration of regular use. The magnitude of the association was substantially higher in younger men. For men younger than age 50 years, the hazard ratio for hearing loss was 1.33 for regular aspirin use, 1.61 for NSAIDs, and 1.99 for acetaminophen.
Conclusions
Regular use of aspirin, NSAIDs, or acetaminophen increases the risk of hearing loss in men, and the impact is larger on younger individuals.
If you have an acute injury, and take acetominophen or aspirin to reduce inflammation, well, that is a simple protocol to be discussed between you and your medical doctor.
But if you regularly take a baby aspirin because you think it is "good for you", do a little more research. Or you take a daily dose of aspirin or tylenol because you regularly come home sore after a long day at work or have your "regular" daily headache... that is a whole different story. You need to come see me or your own chiropractor or functional medicine doctor to try to figure out what is really going on. (See my previous post re: chiropractors and drugs: http://drharriott.blogspot.com/2010/03/chiropractic-position-on-drugs.html#links)
=========================================
Reprint from
The American Journal of Medicine
Volume 123, Issue 3, Pages 231-237 (March 2010)
Analgesic Use and the Risk of Hearing Loss in Men
Sharon G. Curhan, MD, ScMaCorresponding Author Informationemail address, Roland Eavey, MDb, Josef Shargorodsky, MDac, Gary C. Curhan, MD, ScDad
Abstract
Background
Hearing loss is a common sensory disorder, yet prospective data on potentially modifiable risk factors are limited. Regularly used analgesics, the most commonly used drugs in the US, may be ototoxic and contribute to hearing loss.
Methods
We examined the independent association between self-reported professionally diagnosed hearing loss and regular use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen in 26,917 men aged 40-74 years at baseline in 1986. Study participants completed detailed questionnaires at baseline and every 2 years thereafter. Incident cases of new-onset hearing loss were defined as those diagnosed after 1986. Cox proportional hazards multivariate regression was used to adjust for potential confounding factors.
Results
During 369,079 person-years of follow-up, 3488 incident cases of hearing loss were reported. Regular use of each analgesic was independently associated with an increased risk of hearing loss. Multivariate-adjusted hazard ratios of hearing loss in regular users (2+ times/week) compared with men who used the specified analgesic <2 times/week were 1.12 (95% confidence interval [CI], 1.04-1.20) for aspirin, 1.21 (95% CI, 1.11-1.33) for NSAIDs, and 1.22 (95% CI, 1.07-1.39) for acetaminophen. For NSAIDs and acetaminophen, the risk increased with longer duration of regular use. The magnitude of the association was substantially higher in younger men. For men younger than age 50 years, the hazard ratio for hearing loss was 1.33 for regular aspirin use, 1.61 for NSAIDs, and 1.99 for acetaminophen.
Conclusions
Regular use of aspirin, NSAIDs, or acetaminophen increases the risk of hearing loss in men, and the impact is larger on younger individuals.
Chiropractic Position on Drugs...
Chiropractors say this all the time: "Medication is not part of a healthy lifestyle". What do they mean by this? This often causes defensive reactions from those who need medication and those who prescribe it. Well, I want my patients to understand my position on drug therapies because understanding this will greatly improve your life and ideally will clarify the different role that chiropractors play in the health care system as compared with medical doctors.
Drugs are a means to achieve short term symptomatic relief. The use of medication typically is in the following applications:
1) In the most ideal of circumstances, it is a matter of the patient knowing what to do to correct the cause of the dysfunction (and subsequently the symptoms), but needing short term relief and/or to reduce or avoid collateral organic damage as the necessary correction is undertaken.
2) Other times, in persistent chronic disease, when the patient and health professionals are unable to identify and/or address the root cause, this is all someone is left with as a last effort to improve quality of life.
3) And then there are those cases where the patient has been told and knows what to do but won't do it, for various reasons.
For clarification, chiropractors do not, or at least should not, make a blanket proclamation that drugs are bad. The problem, as I see it, is when people are misinformed about the drug use. Specifically, and again, according to the use applications as detailed above...
Case #1, above: The patient is misled to believe that the prescribed drug is "all good" and, like a laser, the drug(s) acts only on the "sick part". Patients need to be wary of taking a drug simply for relief. Patients need to remain vigilant and aware of the total effect that drugs have on their bodies. They need to acquaint themselves with side effects, interactions, complications (one good resource: http://www.rxlist.com). They should also fully recognize the toxic load placed on their bodies, even from the "good" drugs. And patients need to figure out why the disease process occurred in the first place. My ongoing concern is when, for example, a patient is "cured" of a bacterial infection through the proper use of an antibiotic, prescribed by an MD, but that MD fails to inform them, and it never occurs to them on their own that perhaps there is an underlying reason why that infection successfully invaded and took hold in their body in the first place. With the help of a "functional medicine" doctor, patients need to learn what they can do to fortify their bodies so as to reduce susceptibility to the same problem in the future. And they need to educate their friends and family to help them make similar functional and lifestyle corrections.
Case #2, above: The patient often gives up trying to find or working towards a solution. They resolve themselves to taking medications for the rest of their lives and lose motivation to continue to strive for better health. It may turn out to be necessary to continue drug therapies indefinitely - ultimately, that is a decision to be made on a continuous and ongoing basis between the patient and their medical doctor. But these persons must absolutely re-double their efforts to incorporate healthy lifestyle changes and maintain them forever, including exercise, stress & psychologic management, diet, chiropractic, massage, etc. "Spontaneous Remissions" occur all the time, for unknown reasons, but almost never result from neglect and ignorance. And in long term chronic disease, healthy lifestyle choices are known to SIGNIFICANTLY improve the quality and quantity of life and "fortifying the host" has been shown to delay progression of most disease processes.
Case #3, above: For these people, I believe it is much like a smoker. Deep down, it is self-destructive behavior to knowingly participate in an activity that is stealing your health away. And, if you are knowingly taking medications to allow you to engage in that behavior more comfortably... well, it is just more of the same thing. In this situation, the medical doctor is like a co-dependant facilitating another's addiction. Hardly of model of good health.
Drugs are a means to achieve short term symptomatic relief. The use of medication typically is in the following applications:
1) In the most ideal of circumstances, it is a matter of the patient knowing what to do to correct the cause of the dysfunction (and subsequently the symptoms), but needing short term relief and/or to reduce or avoid collateral organic damage as the necessary correction is undertaken.
2) Other times, in persistent chronic disease, when the patient and health professionals are unable to identify and/or address the root cause, this is all someone is left with as a last effort to improve quality of life.
3) And then there are those cases where the patient has been told and knows what to do but won't do it, for various reasons.
For clarification, chiropractors do not, or at least should not, make a blanket proclamation that drugs are bad. The problem, as I see it, is when people are misinformed about the drug use. Specifically, and again, according to the use applications as detailed above...
Case #1, above: The patient is misled to believe that the prescribed drug is "all good" and, like a laser, the drug(s) acts only on the "sick part". Patients need to be wary of taking a drug simply for relief. Patients need to remain vigilant and aware of the total effect that drugs have on their bodies. They need to acquaint themselves with side effects, interactions, complications (one good resource: http://www.rxlist.com). They should also fully recognize the toxic load placed on their bodies, even from the "good" drugs. And patients need to figure out why the disease process occurred in the first place. My ongoing concern is when, for example, a patient is "cured" of a bacterial infection through the proper use of an antibiotic, prescribed by an MD, but that MD fails to inform them, and it never occurs to them on their own that perhaps there is an underlying reason why that infection successfully invaded and took hold in their body in the first place. With the help of a "functional medicine" doctor, patients need to learn what they can do to fortify their bodies so as to reduce susceptibility to the same problem in the future. And they need to educate their friends and family to help them make similar functional and lifestyle corrections.
Case #2, above: The patient often gives up trying to find or working towards a solution. They resolve themselves to taking medications for the rest of their lives and lose motivation to continue to strive for better health. It may turn out to be necessary to continue drug therapies indefinitely - ultimately, that is a decision to be made on a continuous and ongoing basis between the patient and their medical doctor. But these persons must absolutely re-double their efforts to incorporate healthy lifestyle changes and maintain them forever, including exercise, stress & psychologic management, diet, chiropractic, massage, etc. "Spontaneous Remissions" occur all the time, for unknown reasons, but almost never result from neglect and ignorance. And in long term chronic disease, healthy lifestyle choices are known to SIGNIFICANTLY improve the quality and quantity of life and "fortifying the host" has been shown to delay progression of most disease processes.
Case #3, above: For these people, I believe it is much like a smoker. Deep down, it is self-destructive behavior to knowingly participate in an activity that is stealing your health away. And, if you are knowingly taking medications to allow you to engage in that behavior more comfortably... well, it is just more of the same thing. In this situation, the medical doctor is like a co-dependant facilitating another's addiction. Hardly of model of good health.
Tuesday, March 2, 2010
Vitamin D for Asthma
Dr. Harriott's comment:
Readers should pay particular attention to the preliminary nature of this report. Be aware that the data and conclusions in this paper were presented in conference and have not been published or subjected to peer review as of March, 2010. Also, causality has not been established in the relationship between Vitamin D and Asthma medication. In other words, we don't know from this information whether lower levels of vitamin D caused more severe asthma, or if use of steroid inhalers lowered vitamin D levels. In either case, supplementation to increase vitamin D for asthma sufferers appears prudent given its role in multiple areas of healthy immunological function. Lastly, please seek the advice of a qualified health professional as it pertains to supplementation dosage of Vitamin D, since this is a fat soluble vitamin and has the potential to accumulate to toxic levels with sustained excessive supplementation.
==========================
From http://www.medpagetoday.com
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: February 27, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Action Points
Caution interested patients that the study could not determine causality or whether supplementing vitamin D would have any effect on asthma medication efficacy or symptom control.
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
NEW ORLEANS -- Vitamin D may boost the anti-inflammatory efficacy of asthma medications but tends to be low in kids who need the drugs, researchers said.
Children taking oral or inhaled corticosteroids appeared to have lower vitamin D levels in a dose-related manner (P=0.001), Daniel A. Searing, MD, of National Jewish Health in Denver, and colleagues found.
In vitro experiments by the group showed that vitamin D improved anti-inflammatory markers MKP-1 and interleukin (IL)-10 and enhanced the activity of dexamethasone (Decadron, Dexpak) more than 10-fold.
"The implication is vitamin D could have a steroid-sparing effect in asthma," Searing said in an interview here at the American Academy of Allergy, Asthma & Immunology meeting where he presented the results.
However, whether vitamin D supplementation would translate to lower steroid doses or better asthma control remains to be seen, he cautioned.
Moreover, the researchers cautioned that the study could only suggest a correlation, not causality.
If there was causality involved, it's not clear which direction, Searing said -- whether steroid medications or simply more severe asthma reduced vitamin D levels in some way or whether low vitamin D might have caused more severe symptoms that necessitated treatment.
Nevertheless, treating vitamin D insufficiency may make sense given its links to a wide range of ill effects on health and the vitamin's important role in bone health, Searing said.
At his institution, "we tend to supplement patients if they are under 30 ng/mL," he told MedPage Today.
Vitamin D insufficiency rates affect an estimated 20% to 70% of American children, depending on the level at which insufficiency is defined.
In Searing's retrospective study, 47% of the 99 pediatric asthma patients seen at National Jewish Health had vitamin D levels below 30 ng/mL, considered insufficient.
Although this was similar to the prevalence in the overall pediatric population, lower vitamin D levels in the asthmatic children were associated with higher immunoglobulin E levels (P=0.01) and poorer lung function (P=0.33 to P=0.004).
Median vitamin D levels associated with medication use were significantly lower for children on:
Inhaled corticosteroids (29 versus 35 ng/mL, P=0.0475)
Oral corticosteroids (25 versus 32 ng/mL, P=0.02)
Long-acting beta agonists (25 versus 34 ng/mL, P=0.0007)
Higher total steroid doses (P=0.001 for trend)
When peripheral blood mononuclear cells from 11 of the children and four healthy controls were cultured, vitamin D significantly increased the levels of the anti-inflammatory marker MKP-1 (P<0.01 to P<0.001) and the anti-inflammatory cytokine IL-10 (P<0.05) with greater effects at a higher vitamin D dose.
"Whether or not that would correlate physiologically really cannot be inferred from our data," Searing warned in an interview.
But, he speculated, low vitamin D may have greater implications for the health of children with asthma than those who don't have it.
The study was supported in part by grants from the National Institutes of Health.
The researchers reported no conflicts of interest.
Primary source: American Academy of Allergy, Asthma & Immunology
Source reference:
Searing DA, et al "Vitamin D Levels in Children with Asthma, Atopic Dermatitis, and Food Allergy" AAAAI 2010; Abstract 176.
Related Article(s):
Millions of Children May Need Vitamin D Supplements
U.S. Children Lack Vitamin D
Readers should pay particular attention to the preliminary nature of this report. Be aware that the data and conclusions in this paper were presented in conference and have not been published or subjected to peer review as of March, 2010. Also, causality has not been established in the relationship between Vitamin D and Asthma medication. In other words, we don't know from this information whether lower levels of vitamin D caused more severe asthma, or if use of steroid inhalers lowered vitamin D levels. In either case, supplementation to increase vitamin D for asthma sufferers appears prudent given its role in multiple areas of healthy immunological function. Lastly, please seek the advice of a qualified health professional as it pertains to supplementation dosage of Vitamin D, since this is a fat soluble vitamin and has the potential to accumulate to toxic levels with sustained excessive supplementation.
==========================
From http://www.medpagetoday.com
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: February 27, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Action Points
Caution interested patients that the study could not determine causality or whether supplementing vitamin D would have any effect on asthma medication efficacy or symptom control.
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
NEW ORLEANS -- Vitamin D may boost the anti-inflammatory efficacy of asthma medications but tends to be low in kids who need the drugs, researchers said.
Children taking oral or inhaled corticosteroids appeared to have lower vitamin D levels in a dose-related manner (P=0.001), Daniel A. Searing, MD, of National Jewish Health in Denver, and colleagues found.
In vitro experiments by the group showed that vitamin D improved anti-inflammatory markers MKP-1 and interleukin (IL)-10 and enhanced the activity of dexamethasone (Decadron, Dexpak) more than 10-fold.
"The implication is vitamin D could have a steroid-sparing effect in asthma," Searing said in an interview here at the American Academy of Allergy, Asthma & Immunology meeting where he presented the results.
However, whether vitamin D supplementation would translate to lower steroid doses or better asthma control remains to be seen, he cautioned.
Moreover, the researchers cautioned that the study could only suggest a correlation, not causality.
If there was causality involved, it's not clear which direction, Searing said -- whether steroid medications or simply more severe asthma reduced vitamin D levels in some way or whether low vitamin D might have caused more severe symptoms that necessitated treatment.
Nevertheless, treating vitamin D insufficiency may make sense given its links to a wide range of ill effects on health and the vitamin's important role in bone health, Searing said.
At his institution, "we tend to supplement patients if they are under 30 ng/mL," he told MedPage Today.
Vitamin D insufficiency rates affect an estimated 20% to 70% of American children, depending on the level at which insufficiency is defined.
In Searing's retrospective study, 47% of the 99 pediatric asthma patients seen at National Jewish Health had vitamin D levels below 30 ng/mL, considered insufficient.
Although this was similar to the prevalence in the overall pediatric population, lower vitamin D levels in the asthmatic children were associated with higher immunoglobulin E levels (P=0.01) and poorer lung function (P=0.33 to P=0.004).
Median vitamin D levels associated with medication use were significantly lower for children on:
Inhaled corticosteroids (29 versus 35 ng/mL, P=0.0475)
Oral corticosteroids (25 versus 32 ng/mL, P=0.02)
Long-acting beta agonists (25 versus 34 ng/mL, P=0.0007)
Higher total steroid doses (P=0.001 for trend)
When peripheral blood mononuclear cells from 11 of the children and four healthy controls were cultured, vitamin D significantly increased the levels of the anti-inflammatory marker MKP-1 (P<0.01 to P<0.001) and the anti-inflammatory cytokine IL-10 (P<0.05) with greater effects at a higher vitamin D dose.
"Whether or not that would correlate physiologically really cannot be inferred from our data," Searing warned in an interview.
But, he speculated, low vitamin D may have greater implications for the health of children with asthma than those who don't have it.
The study was supported in part by grants from the National Institutes of Health.
The researchers reported no conflicts of interest.
Primary source: American Academy of Allergy, Asthma & Immunology
Source reference:
Searing DA, et al "Vitamin D Levels in Children with Asthma, Atopic Dermatitis, and Food Allergy" AAAAI 2010; Abstract 176.
Related Article(s):
Millions of Children May Need Vitamin D Supplements
U.S. Children Lack Vitamin D
Monday, March 1, 2010
MissionViejoAcupuncture.com
My congratulations go out to Richard Bishop of Mission Viejo
Acupuncture. http://MissionViejoAcupuncture.com just went live today.
Acupuncture. http://MissionViejoAcupuncture.com just went live today.
Again, congratulations Richard!
from mvchiro.com
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