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.
Thursday, March 4, 2010
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
Friday, February 26, 2010
The Latest Published Research on Effectiveness of Spinal Manipulation
First, I should say that my favorite quote from the commentary on this review was:
"Thus, it is important when reading this report to remember that absence of evidence of effectiveness is NOT the same as evidence of absence of effectiveness."
So what is not new is that chiropractic is found to be CLEARLY EFFECTIVE and worthy of trial for
low back pain, neck pain, migraine, cervicogenic headache or dizziness, and extremities.
So what is new is that chiropractic is found to be CLEARLY INEFFECTIVE for
asthma, menstrual cramps, stage 1 hypertension, and infantile colic.
And the jury is still out on everything else....
Anyway, what I offer in my office is a natural approach to total health. I don't work on symptoms, I work on PEOPLE. And what this study can't touch is the profound impact that chiropractic has on quality of life. I offer a chiropractic lifestyle that is far more powerful in improving the average person's quality of life than what they get from their MD. So I will stay here for you and I will offer you the truth at any cost. That said, here is the latest info: go to...
http://mvchiro.com/MissionChiroPages/Effectiveness.asp
"Thus, it is important when reading this report to remember that absence of evidence of effectiveness is NOT the same as evidence of absence of effectiveness."
So what is not new is that chiropractic is found to be CLEARLY EFFECTIVE and worthy of trial for
low back pain, neck pain, migraine, cervicogenic headache or dizziness, and extremities.
So what is new is that chiropractic is found to be CLEARLY INEFFECTIVE for
asthma, menstrual cramps, stage 1 hypertension, and infantile colic.
And the jury is still out on everything else....
Anyway, what I offer in my office is a natural approach to total health. I don't work on symptoms, I work on PEOPLE. And what this study can't touch is the profound impact that chiropractic has on quality of life. I offer a chiropractic lifestyle that is far more powerful in improving the average person's quality of life than what they get from their MD. So I will stay here for you and I will offer you the truth at any cost. That said, here is the latest info: go to...
http://mvchiro.com/MissionChiroPages/Effectiveness.asp
Chiropractic First!
In Mission Viejo, it's Choropractic First!
http://www.squidoo.com/mvchirodotcom
from mvchiro.com
Monday, February 22, 2010
Living Well News
Mission Viejo Chiropractic's February 2010 edition of the "Living Well
News" has just been posted: http://tinyurl.com/ylk2x72
News" has just been posted: http://tinyurl.com/ylk2x72
from mvchiro.com
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