Can Advil Increase the Risk of a Heart Attack?

0 31 May 2013

A patient of mine was recently put on high-dose ibuprofen to reduce progression of his osteoarthritis (OA), which in his case appears to be genetic in origin. His dose is 800mg three times per day. That’s pretty much the max dose and he was asked to be on that indefinitely since some research indicates that it can help in the outcome of his osteoarthritis. Today, I was alerted to a study published in The Lancet that showed elevated cardiovascular events in patients taking common anti-inflammatory drugs such as Celebrex, diclofenac and ibuprofen. The study was a meta-analysis that looked at data from over 600 trials. Meta-analyses are good studies, but they do have their limits. While I wouldn’t hang my hat on them, they are helpful in gaining a better understanding. The study found that for diclofenac (Cambia, Voltaren) and cox-inhibitors like Celebrex, the risk of a major vascular event and coronary event was about one-third higher. Ibuprofen (Advil, Motrin) had double the risk of coronary events. Naproxen (Aleve) did not have an increase in cardiovascular risk. Of course, I let my patient know that he may want to switch to naproxen instead of ibuprofen based on this new study. Having said that, I have moved most people away from these medications in general (except for short t

Posted in Blog, Health and Wellness, Vitamins by admin
0 21 April 2013

Thiamine is a B-vitamin that is extremely important for the functioning of the Central Nervous system. The CNS is responsible for integrative and interpretive function of the body. It is essentially comprised of the brain and the spinal cord. These two structures are responsible for receiving all the inputs from your senses, interpreting them, and then acting on them. Without a properly functioning CNS, your body cannot send the right signals to the rest of the body for proper functiioning. When people have insufficient levels of thiamine, they can experience fatigue, memory loss, depression, headache, confusion and muscle weakness. In severe forms of thiamine deficiency, such as in the starvation disease Beri Beri, people can experience anorexia, weight loss, gastrointestinal problems, enlarged heart, and nerve pain. In medical school, we always thought of thiamine deficiency as something that happened to starving kids in Africa or in alcoholics. But it turns out that diets that are high in bad fat and sugar can lead to a low level of thiamine. In addition, sulfites (a common food additive) destroys thiamine. So does moist heat, especially when combined with alkalis such as baking soda. Makes you think differently about that muffin at Starbucks, doesn’t it? Even that Power Bagel at Einstein’s isn’t safe. Because thiamine is vital for energy production, you need more wher

Posted in Blog, Vitamins by admin
0 20 April 2013

I just finished reading a great essay by Gary Taubes, author of Good Calories, Bad Calories that was just published in the April 2013 issue of the British Medical Journal. In the essay, Taubes discusses the competing theories of what makes us fat. Many of us have known that all calories are not created equal, despite the prevailing attitude that weight loss or gain is a simple calorie intake vs. calorie expended equation. If someone got fat, it’s because they could control themselves and ate too much, or didn’t work out enough. It turns out that this belief wasn’t always so. In the early part of the 20th century, many academics believed in an endocrine based hypothesis — that the mechanism processing the calories is disturbed, causing weight gain and increased caloric intake. It also considered the underlying physiology of how the type of calorie would  affect the body’s metabolic response.

The Energy Balance Hypothesis

This is the prevalent model today that simply states that we need to eat less calories than we burn. This model was largely brought to the forefront by Louis Newburgh in 1920 at the University of Michigan and downranked other potenti

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0 20 April 2013

In 2006, the Walk-in-Care department of Dreyer Medical Group took a look at itself from the inside out to change whatever was necessary to truly change the patient experience.  With thousands of visits and wait times running into several hours, we knew that to serve our patients better we had to change the way we did things. We wanted to provide excellent care and an excellent patient experience. Using lessons from The Disney Way and Good to Great, Charles Ireland, MD spearheaded the effort and I was fortunate to have the opportunity to help lead it. We did a Dream Retreat and examined everything about how we operated — and we dreamt about where we wanted to be. Seven years later, the results are stunning as seen in the video below. The techniques we started spread to other departments, and Dr. Ireland will soon be giving a talk to a large hospital system in Michigan. It’s great to see to how impactful this cultural change has become. [vimeo][/vimeo]

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0 17 April 2013

Dr. Jack Kruse has just published his first book, Epi-Paleo Rx, which is an excellent compendium of knowledge. It covers a broad range of topics including epigenetics (describing the small genetic difference we all have between each other), osteoporosis, diabetes, heart disease and more. But instead of discussing medications to fix these problems, he delves into root causes that, often times, if corrected, can result in correction and reversal of these disease states. He also references other excellent work in the field and synthesizes a broad range of topics into something digestible and useful. Read my whole review at Amazon, and if inclined, buy the book! I just reviewed: ‘Epi-paleo Rx: The Prescription for Disease Reversal and Optimal Health’ by Dr. Jack Kruse 

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0 4 April 2013

Breaking bread. It hearkens back to ancient times when all was good. Unfortunately, bread isn’t so good in modern society. Not only do most people get too much of it, it may be the cause of many of the ailments we suffer from. Everything from diabetes to heart disease to Alzheimer’s to irritable bowel syndrome may be linked too too much consumption of bread. Bread is made up of carbohydrates, which are sugars. And too much sugar is one of the main reasons our bodies suffer from both acute and chronic illnesses. Moreover, most bread is not very nutritious. While there is a huge calorie spike with bread, there is not much nutrition associated with it. “Ah hah, Dr. Patel,” you say. “But what about multigrain bread that has not been refined? Isn’t that OK to eat?” To which I would have to reply, “Pull up a chair. Here’s the thinking on breads.”  

The Paleo Camp

  One of the major movements in nutrition currently is the Paleo movement. Well researched and described by pioneers like Robb Wolf and his mentor, Dr. Lauren Cordain, the premise is that as we humans evolved over hundreds of thousands of years, we were hunters and gatherers. We ate what we killed and what we found. Modern agriculture has only been around for 3000 − 10,000 years (estimates vary, but nowhere near

Posted in Blog, Food by admin
0 4 April 2013

We hear about B-vitamins all the time. We hear about them as B-12 shots, as B-complex vitamins, as energy drinks with B-vitamins. Most people know that the B-vitamins are very important for energy. But they are also important for almost every function in the body. In fact, because so many body systems are involved, many vague complaints can be related to low levels of some or all of the B-vitamins. So what are the B-vitamins, anyway? Once thought to be a single vitamin, the B-vitamins are actually a group of water soluble molecules that are found together in the same foods. They function at such an important, basic, cellular level that deficiencies in any of them can have an impact on many biochemical and physiological processes. And while the levels may not be low enough to cause the classics signs of true deficiency, low levels can make it so that your body just doesn’t work as good as it should. Patients can experience fatigue, irritability, depression, muscle weakness, skin issues, memory issues, nervous system issues… the list goes on and on. The B-vitamins are important in the metabolism of sugars, lipids, cholesterol, hormones, nervous system function, and many other important processes. Because B-vitamins are water soluble, your body doesn’t store much of them. They are excreted into the urine. Thus, it is important to get B-vitamins from food and supplements regu

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0 27 March 2013

I often encourage my patients to Google “Endocrine disruptors” or “Endocrine disrupting agents (or ‘chemicals’)”  — Choose your weapon. What you’ll find are tons of reports regarding environmental toxins and substances that are changing how our bodies operate. It only takes a little bit of hormone to have a profound impact on your body’s signaling and transcription pathways. These EDCs (Endocrine Disrupting Chemicals) have been linked to undescended testes in the male, breast cancer, prostate cancer, thyroid cancer, and developmental effects on the nervous system in children. I wanted to collate a few of the important facts, followed by some links to further reading if you’re so inclined. In fact, the topic is really too broad to cover in a single, coherent post. In the future, I may put together a longer read on all of this. Please note while EDCs suggest related disease states, there’s isn’t direct causal evidence in humans, but there is some in animals. Some people with vested interests would definitely criticize the studies.

  • Endocrine disruptors mimic or interfere with the function of hormones in the body. They can be natural or synthetic.
  • There has been a huge increase in endocrine related health conditions over the last fifty years. In addition to the above mentioned conditions, there has been an increase in ectopic pregnancies, as well as a

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0 27 March 2013

Hypothyroidism is one of the most commonly unrecognized conditions that people face today. By some estimates, up to 40% of the population may be subclinically hypothyroid. Thyroid hormone is a little bit like “how fast is the engine revving?” — too little, and you have trouble with energy, losing weight, sluggishness and a number of other physical signs and symptoms. Too much, and you may have trouble gaining weight and experience muscle wasting. Because simple lab values can be misleading, it’s very important to consider the clinical picture of symptoms to see if your thyroid gland is underperforming and preventing you from optimal health and happiness. One way to do this is to check your Basal Body Temperature. This the temperature of your body as soon as you wake up. Here’s how to do it:

  1. Get a glass or Mercury based thermometer for the readings. You’ll want to shake it down and put it by your bedside as you go to sleep. You’ll want to sleep alone so that your body doesn’t pick up heat from your spouse (you can still be in the same bed).
  2. Upon awakening, place the thermometer underneath your armpit for 10 minutes and record the temperature.
  3. Check the basal body temperature for 3 – 5 consecutive days. Women who are still menstruating should check the temperature on the first 3 days of their period. Men and post-menopausal women can check it at anytim

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0 6 October 2011

Jaime Scholz, MS Vitamin B12 is an important nutrient required for growth and repair of tissue. It also helps decrease inflammation and homocysteine levels, and there is some scientific evidence that combining B12 with fish oil may help reduce total serum cholesterol and triglyceride levels. Homocysteine generates reactive oxygen species, which increases the risk for atherosclerosis . As vegetarian diets become more restrictive, homocysteine concentrations increase, peaking in vegan groups, which may counteract the known health benefits of vegetarian diets . In addition to elevated inflammation, prolonged deficiency manifests in neurologic and gastrointestinal disorders as well as anemia2. One of the challenges for vegetarians is to find food sources with bioavailable B12. Typically, plant sources do not contain adequate amounts of bioavailable B12, and often the only reliable source for vegetarians and vegans is dietary supplements . Plant foods with the highest bioavailable B12 are purple and green algae, which are optimal for supplementation . Though used frequently, spirulina contains large amounts of the biologically inactive B12 and is not considered a suitable source for supplementation. For Lacto-ovo vegetarians best food sources of bioavailable B12 include dairy products (eggs, yogurt, milk), while pescatarian sources include shellfish (oyster muscle, short-necked clam

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