Tomorrow I will have minor knee surgery and will be unavailable until next week.

That is right, back on crutches again. Over the years many have told me that they date our contacts by my injuries ("Let's see, you were on crutches with a broken ankle the first time I saw you, then again with another broken ankle six months later, then I brought my son in a year later and you had a broken collarbone").  Embarrassingly, I insist that I AM doing better, but, at the very least, my personal health/medical experiences teach me how to take better care of you.

On another administrative matter, it has been brought to my attention that the compilation of the newsletters on the website has fallen a bit behind. My apologies if this has inconvenienced you.  I will get after my webmaster so that you can access the information ASAP.

Today's newsletter includes a couple of follow-up items. It is great to expand our knowledge base. Sometimes that is a refinement, sometimes the information allays old fears, other times it identifies new concerns.  I look at the process as one of course- correction, keeping us from getting too far off track.

Best, Michael Carlston, M.D.
www.carlstonmd.com

Remember all of the media panic about the flu last fall/winter?  Turns out that the flu was about the same as any other average year.  On top of that, the media/governmental push for vaccination was again misguided, because the vaccine contained the wrong strains.  Yep, they guessed wrong again.  A certain degree of skepticism is always wise.

For several years I have cautioned patients about this form of chromium.  Due to its highly reactive nature, there has been a great deal of concern about it's cancer-causing potential.  This was intensified by studies of living cells demonstrating cancerous alterations in cells exposed to chromium picolinate.  At the same time, this form of chromium is widely touted as possibly the best form of the supplement.

My conclusion was to recommend that patients avoid this form of chromium until we had evidence demonstrating its safety. More recent studies continue the controversy, with some echoing old case reports of adverse effects in people taking chromium picolinate as a high dosage supplement, while others explain that those ill effects were more likely the result of other medications used by those individuals.  Other recent research fails to confirm damaging effects of chromium picolinate.

My current conclusions are:

1- Using chromium picolinate may be fine, but keeping the dose under 1,000 mcg/day would be wise.
2- Chromium complexed with nicotinic acid is the most truly physiologic (body-like) form AND clearly the safest form.

According to a report in the American Journal of Psychiatry, an investigation of the effects of various medications on patients suffering with bipolar depression may have led to an accidental discovery.  The investigators, using a specialized form of MRI machine (echoplanar magnetic resonance spectroscopic imaging - EP-MRSI), found that many patients experienced a dramatic improvement in their moods immediately after the brief EP-MRSI scan.  They followed up on this finding with a systematic study.  In the formalized trial, depressive symptoms were immediately improved in 23 of 30 patients.

Although there are many, many questions (e.g., duration of effect, does it work for other forms of depression, long-term ill effects of the EP-MRSI treatment) this certainly raises some interesting possibilities.