August 11th, 2007 by Dr. Val Jones in Health Tips, Quackery Exposed
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How do we know when a drug, supplement, or herbal remedy causes harm? Most people assume that clinical trials provide the only mechanism for determining adverse outcomes but actually, consumers can report concerns directly to the FDA as well.
Did you know that the FDA accepts reports from consumers and healthcare professionals alike on their website, MedWatch Online Reporting?
Herbs, supplements, and “natural” medicines are bioactive substances that many people use to treat diseases and conditions. They are not regulated for safety and efficacy, and are only now being scrutinized for accuracy of their contents. Since we’re behind the ball on rigorously testing supplements (though it’s great that NCCAM is evaluating as many of them as their resources allow), it’s important for consumers of herbs and supplements to report adverse outcomes (like allergic reactions, harmful side effects, etc.) to the FDA. How else will your fellow consumers find out about these unwanted side effects?
MedWatch also welcomes reports about adverse outcomes from prescription and OTC medications, medical devices, or cosmetic products. I think this is an underutilized resource and could greatly improve public safety if we all pitched in and reported concerning events when they happen.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 10th, 2007 by Dr. Val Jones in News
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I rarely get too excited about mouse studies, but this one is pretty amazing. Researchers at my alma mater have discovered that osteoblasts (cells that create bone) secrete a certain protein that affects the health of the pancreas. The protein (osteocalcin) stimulates the pancreas to create more insulin-secreting beta cells. When people don’t secrete enough insulin, the result is often type 2 diabetes. So a healthy pancreas with a good insulin secreting capacity is critical to regulating blood sugar.
The researchers also discovered that mice who were bred to have no osteocalcin gene had abnormal amounts of fat in their bodies. So this means that bones may have something to do with energy metabolism and weight gain.
Of course it’s too early to speculate on the implications of all this (what’s true for mice is not necessarily true for humans – but I’m going to anyway). Since bone cells (osteoblasts) are sensitive to gravity, and increase their activity with weight bearing, this could explain why exercise (especially weight lifting) is important in weight loss. The new ACSM guidelines recommend weight training as part of a healthy exercise regimen, and the underlying mechanism for this may be that bone cells rev up metabolism and insulin secreting capacity in response to weight lifting.
So, if you want to lose weight – make sure you stimulate those bone cells with some good weight bearing exercises. They may just help to reduce your risk of type 2 diabetes as well!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 8th, 2007 by Dr. Val Jones in News
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The New York Times exposed an interesting counter-culture phenomenon today: drinking raw milk. Grocery store milk has been heated and packaged in a nearly sterile fashion so that no harmful bacteria are in it. Farmers collect raw milk from cows, then pasteurize (a heat treatment) and homogenize (blend the creamy part with the skim part) it before packaging the milk for human consumption. This process has virtually eliminated milk borne illness in this country, including the transmission of Tuberculosis, Salmonella, E. coli, and Listeria.
So why are people fascinated with raw milk and seeking out farmers who will sell them milk prior to heat treatment? Raw milk does taste slightly different (I think it’s a little bit more “gamey”) and there’s no doubt that the creamy layer that floats on the top is delicious. In New York City raw milk has a black market, cult following. Should you jump on the bandwagon?
As my regular readers know, I grew up on an organic dairy farm, and had the pleasure of handling cows up close and personal for at least a decade. In fact, their sweet-smelling grass breath, and not so sweet-smelling cow patties are etched permanently in my mind. Cows are curious, somewhat dim witted, and generally oblivious to the terrain upon which they tread.
Cows will stand in manure for hours without a moment’s regret, should you present them with fresh hay to eat or some nice shortfeed. They drop patties on the ground, in their troughs, and occasionally on one other. Their flicking tails often get caked with manure as they swish flies away and they scratch their udders with dirty hooves as well.
This is why when it comes time to milk them, farmers need to wipe their udders carefully with a disinfectant scrub before applying the milk machine. Mastitis (or infection of the udder teets) is not uncommon, and is a reason for ceasing to milk a cow until the infection has cleared.
And so, the cleanliness of raw milk depends upon whether or not the farmer removes all the excrement carefully, scrubs the teets well, and remembers not to milk the cows with mastitits. It also matters whether or not the cows are harboring certain strains of bacteria – which often don’t harm the cow, but cause very serious problems for humans.
Did I drink raw milk as a kid? Occasionally, yes. Were my parents super-careful about the cleanliness of the milk? Yes. Did I ever get sick from raw milk? No. Would I give raw milk to my kids? No.
I appreciate that gourmands want to experience the flavor of raw foods, but for me, the risks are simply not worth it when it comes to milk. There is no appreciable nutritional benefit to drinking raw milk (in fact, store bought milk is fortified with Vitamin D, which is critical for healthy bones), and it caries a small risk of serious infection. If adults want to take that risk, they may do so – but I would strongly encourage them not to put their kids at risk. I agree with the FDA’s ban on interstate sales of unpasteurized milk, and would not want to see raw milk available widely for general consumption. Of course, to get around this ban, some companies are selling raw milk and cheese under the label “pet food.”
It’s a crazy country we live in – anti-bacterial hand wipes, soaps, gels, plastics and an insatiable appetite for raw milk. As a doctor, I throw up my hands. What do you think?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 6th, 2007 by Dr. Val Jones in Expert Interviews, Health Tips
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A new study in the Journal of the American College of Cardiology (August 14th issue by Bangalore et al.) questions the evidence behind using beta blockers as fist line therapy for high blood pressure. It seems that these medications may actually increase the risk of stroke, especially in the elderly population. The following drugs are all beta blockers:
- Atenolol (Tenormin)
- Metoprolol (Lopressor, Toprol-XL)
- Propranolol (Inderal, Inderal LA)
- Carvedilol (Coreg)
As many as 60 million Americans have high blood pressure, and many of them are currently taking beta blockers. I asked Dr. Frank Smart, chairman of the department of cardiovascular medicine at Atlantic Health in New Jersey, what he thought of this new study.
1. What is a beta
blocker?
Beta blockers are a class of drugs that exert their effects on the heart by blocking the effects of adrenaline. This results in a slower heart rate and reduced blood pressure. They can also protect you from rhythm disturbances.
2. What did this study show?
Beta blockers have a lot of important uses, but this analysis shows that they’re not as effective as (and may have more side effects than) other therapies for the treatment of high blood pressure. In the past, we physicians thought, “Well, shucks, if beta blockers are good to use after a heart attack, and people with high blood pressure are at risk for having heart attacks, then maybe we should use a beta blocker to treat the blood pressure.” This study contradicts this thinking, suggesting that the beta blockers are inferior to other therapies. In other words, we should use beta blockers for the conditions that they’re known to be good for, but we should not infer that they are best for blood pressure management when there are better drugs available.
3. Will the findings of this study
change your practice?
Yes they will. I’m one of those people who have used beta blockers on occasion to treat high blood pressure in patients whom I thought were also at high risk for heart attack. I probably won’t use beta blockers as first line treatment in those individuals anymore. I’m going to stick with diuretics or renin-angiotensin system blockers.
4. What do these findings mean for
people with high blood pressure?
It means that they should follow the guidelines indicated for the treatment of high blood pressure. It involves a step-wise approach, with diuretics being that first step. Any therapy is better than no therapy, and controlling high blood pressure is critically important, but beta blockers (as a monotherapy) are probably not as good as other treatments.
5. When would you recommend the use of
beta blockers?
Beta blockers are a very important class of drugs for many cardiovascular diseases. Anyone who’s had a heart attack needs to be on a beta blocker, anyone who has congestive heart failure (CHF) and can tolerate a beta blocker should be on one, and hypertrophic cardiomyopathy requires treatment with beta blockers. Beta blockers can control certain heart rhythm disturbances, and can reduce the risk of adverse cardiovascular events during surgery.
6. What’s the take home message from
this study?
When treating high blood pressure, we should use drugs that have been shown to have the greatest reduction in mortality. Don’t assume that the valuable effects of beta blockers (for people who’ve had heart attacks) automatically translate into benefits for people with high blood pressure.
Want to hear the full conversation? Listen to the podcast with Dr. Smart
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 5th, 2007 by Dr. Val Jones in News
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Russia has been promoting a new sport: the stiletto heels sprint. Although I’d heard of this a couple of months ago, I just noticed some video footage on Yahoo! In this particular race, over 200 women turned out to run 1 kilometer (about 2/3 of a mile) in heels that are at least 3.5 inches high.
It is well known that regularly wearing high heels can result in foot deformities such as bunions and corns. And yet women continue to wear them as they never seem to go out of fashion. If you’re unwilling to give up those heels, but would like to avoid having feet that look like this, here are some tips for you:
1. Minimize the distance you walk in heels. Carry your shoes to work with you and wear flats or sneakers during most of your walking.
2. Wear shoes that are wide in the toe box and do not squeeze your toes together.
3. Put metatarsal pads in your high heeled shoes, to keep your foot from sliding forward (especially if they are closed-toe).
4. Don’t wait too long to see a rehabilitation medicine specialist or podiatrist if you think you’re developing a bunion. Corrective action should be taken as early as possible.
5. If you’re working at your desk, remember to slip off your shoes to reduce the pressure on your toes. Every lit bit helps when it comes to reducing toe joint stress. If your relatives have bunions, you may be at higher risk for developing them too.
As for those Russian women who race in their stilettos, all I can say is that they’ll be keeping the rehab docs, orthopedists and podiatrists in business!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
