Dear Patients,
Happy New Year!
There are changes underway in my office. I hope to have my own multiple vitamin formulation available by the end of the winter. My website is undergoing a much-needed revision. In the past two months four of the ten offices in our building have been burglarized. So we have a brand new alarm system for the first time. 2007 is off to a flying start!
I’ve learned that some of you have been watching too much television because you’ve called about the Bottom Line Health TV commercial I was part of. From our vacation hotel room I finally saw it myself. Although the book is good, lets just say that the commercial was not my best TV work of all time.
I do not want to send these emails to you if you do not want to receive them. Although I enjoy writing them for you, they take a good deal of time and the last thing I want to do is expend effort that simply annoys you. Please tell me if you no longer wish to receive this newsletter so I can shorten the list.
Best
Michael Carlston, MD
www.carlstonmd.com
Homeopathy Increasingly Mainstream
Adverse Effects of Heartburn Drugs
Vitamin D
NSAIDs and Birth Defects
FDA Conflict of Interest?
Homeopathy Increasingly Mainstream
Catching up on some reading, the November 15, 2006 issue of FAMILY PRACTICE NEWS gave me an indication of the changes in medicine. Like all publications for medical doctors, this weekly newspaper contains many ads for medications. It was striking and refreshing to see a full page ad from a homeopathic pharmacy for a homeopathic remedy (Oscillococcinum) for influenza. I turned that page and beneath an article on genetic determinance of response to one drug for migraines, I saw an ad for a glucosamine/chondroitin combination. Going mainstream also includes marketing, apparently.
Adverse Effects of Heartburn Drugs
Among the most common drugs people use are those intended to relieve acid reflux. Originally, these drugs were approved for anywhere between 10 days and a month. After many, many people had used them for much longer stretches of time, the FDA approved them for long-term use. I was concerned because it seemed likely that drugs whose principle action was to alter digestion would in fact alter digestion. In other words, they might impair the body’s ability to absorb nutrients. Studies are starting to appear that justify my concern.
In a huge study of 145,000 English patients, those who took acid blocking drugs (Prilosec, Nexxium, Prevacid, Tagamet, Pepsid) had an increased risk of breaking their hip. Those who took one of the drugs for more than a year had a 44% increased risk. Taking more of the medication and for a longer time increased the risk. Those who took high doses had a 250% increased risk. The proton pump inhibitors (Prilosec, Nexxium, Prevacid) had the strongest association. This could be a coincidence, but the dose proportional effect strongly suggests a causative link.
Other studies show that these acid-suppressing medications make you more vulnerable to infection. They are associated with an increased risk of pneumonia. They make it easier for nasty antibiotic-resistant bacteria to grow in your body. The acid not only digests food, it digests many bacteria. Dropping the acidity of the stomach opens the door to the bacteria. Try to limit your use of these medications.
Vitamin D
No matter what you think, I am NOT obsessed with vitamin D. Well, maybe I am but it is completely justifiable and well reasoned. There are just so very many important findings about this vitamin. Vitamin D is like Vitamin C was in the days of Linus Pauling.
Vitamin D lowers the risk of insulin dependant diabetes in children. Despite that accepted fact and the awareness that breast fed infants should be supplemented with vitamin D, very few currently are. The highest incidence of deficiency is among infants 2 – 9 months of age. Certainly the winter months are even worse. Tell those you know who wisely breastfeed their babies, that they should consider providing 200 iu of vitamin D supplementation daily to their infants.
Jumping to life’s opposite end, evidence is accumulating that vitamin D levels are inversely correlated with cardiovascular disease risk. The evidence is strongest among noninsulin dependant diabetics who show significant artery thickening if their vitamin D levels are low.
NSAIDs and Birth Defects
Nonsteroidal anti-inflammatory drugs are the most widely used class of nonprescription medication. People have grown very comfortable with them. Reports of liver and kidney damage reminded us that we had gotten too comfortable. We are again reminded that anything that can help can cause harm. A series of studies from around the world convince me that these drugs can cause heart defects and probably cleft lip/palate when pregnant women take them early in pregnancy.
FDA Conflict of Interest?
As the title tells us, the FDA regulates food and drugs. Among specific responsibilities, the FDA must approve advertisements drug companies use to sell their products to you, the lay consumer. The review process takes time. The FDA has worked out a deal with manufacturers so that the petitioning company can pay more to get more rapid attention. A former FDA associate commissioner for legislative affairs said these fees “would violate a fundamental understanding between industry and FDA that industry will not pay for FDA compliance actions”