Thursday, July 2, 2015

Stents Have No Benefit Over Medical Therapy for Arterial Blockage with Minimal or No Symptoms

Do you have reduced blood flow to your heart but this is not giving you significant symptoms like prominent chest pain and shortness of breath?  The name for reduced blood flow is ischemia, and it is often found incidentally with stress EKG’s, stress echoes, and angiography.  The usual treatment is angioplasty plus stents, but this treatment is no better for reducing future cardiac events than taking standard cardiac meds.  On the other hand, taking chelation therapy does reduce future cardiac events.  Evidence-based medicine shows the difference clearly.  But most cardiologists are not yet abiding by the evidence.

See Dr. Kathleen Stergiopoulus from SUNY—Stoney Brook School of Medicine for a meta-analysis that included the MASS II, COURAGE, BARI 2D, and FAME 2 clinical trials and JAMA 2013;309:1241-1250.

Tuesday, June 30, 2015

Cholesterol in the Diet Appears Not to be the Bad Guy

The government’s Dietary Guidelines Advisory Committee has recommended that dietary avoidance of cholesterol is no longer needed for most patients.  We still want to avoid saturated fat and trans fats.  But foods such as eggs, which contain high levels of cholesterol, are no longer considered a problem.  Finally, a nutritional guideline that makes sense.

Reported in the Toledo Blade, Feb. 11, 2015, page 1.


Tuesday, June 23, 2015

Chronic Fatigue Syndrome has a Much Better Name

The Institute of Medicine proposed a new name for Chronic Fatigue Syndrome:  “Systemic Exertion Intolerance Disease”.  It is cumbersome but it better describes a problem that can devastate the victims.  Usually the illness is triggered by a virus, allergy, or environmental toxins.  It is marked by a profound depletion of energy following minimal physical or mental activity.  Drug therapy give little relief, but integrative treatment of a yeast imbalance, allergy desensitization, and thyroid and adrenal support can be very helpful.

Google the Institute of Medicine report on CFS, April, 2015.

Thursday, June 18, 2015

Medication Costs Skyrocket

An analysis by Express Scripts in March, 2015 showed that many patients in the U.S. spend $50,000 per year or more for medications.  One of the key factors is specialty meds.  For example, the new Hepatitis C drug, Sovaldi, which is very effective, costs $1000 a pill and must be taken daily for 3 months.  Even if you have insurance that pays for drugs, the portion of the bill that you are responsible for can be extremely expensive.  Half of elderly patients take 10 prescriptions or more. I have noticed that many doctors who give CME lectures are required to disclose that they hold stock in Big Pharma.  It really pays to lead a healthy lifestyle to stay well, and to take nutritional supplements instead of drugs whenever you can.

Reported in the Toledo Blade, May 18, 2015.



Thursday, June 11, 2015

Diabetes is Substantially Over-treated in Older Adults

A ten-year study by Dr. Kasia Lipska of Yale showed the alarming result that we are over-treating diabetic patients 65 years of age and older.  Oral and injectable hypoglycemic agents cause 25% of emergency hospitalizations for adverse drug events in this age group.  Tight control of the blood sugar with drugs can lead to low blood sugar, increased mortality, falls and accidents, cardiovascular disease, dementia, and poor health-related quality of life.  It makes sense to utilize lifestyle improvements and natural remedies that do not run the risk of hypoglycemia instead of multiple drugs, which are both expensive and dangerous.
See the Jan. 12, 2015 on-line issue of JAMA Internal Medicine.


Tuesday, June 9, 2015

Low-fat diets are a Nutritional Myth

Dietary guidelines commonly given to patients for weight loss and cholesterol control are not effective, according to a review article in American Family Physician.  Diets higher in fat produce and sustain as much or more weight loss than lower fat or calorie-restricted diets—this is supported by an A-level evidence rating.  The problem foods are simple carbohydrates, ultra-processed foods, junk foods, and preserved meats, which should be avoided, especially if you have pre-diabetes, diabetes, obesity, or the metabolic syndrome.

See the American Family Physician, May 1, 2015 issue, p. 635-636.

Thursday, June 4, 2015

Be Very Careful with Calcium Supplementation

A Cochrane review of calcium supplementation, which is a routine recommendation by most physicians, especially for women, shows that it may do more harm than good.  The number needed to treat to prevent one fracture was 302 and the number needed to treat to cause one major cardiovascular event was 178.  However, the obvious problem with treatment was not discussed.  Everywhere in the body, calcium interacts with magnesium.  If you take calcium supplements, you should always balance them with at least half as much magnesium.  It is dangerous not to do so.


See the American Family Physician, May 1, 2015 issue, p. 634-635.