Buyers of Herbal Medicines – BEWARE! - P2

In this blog I will pull together some of the errors made by doctors in dealing with herbal medicines. Be aware that the American Medical Association has a public position against herbal medications and supplements and most doctors do follow this position.

This section is not meant as a diatribe against doctors, but to just list some of the reactions I have seen and had people tell me about how their doctors have reacted to their list of herbal medications or supplements. Doctors are aware of herbal medicines and supplements. It is their actions that determine how successful they are in dealing with these.

The first reaction I saw was total disinterest and a comment that I should not be taking any of them. When he got to vitamin D, I was told that I got enough of that from the sun and enriched foods. I was not aware that he had requested a test for this and when he showed me that the reading was 25 and more than enough to stop taking vitamin D, I almost believed him. I was fortunate to have been reading several medical blogs that felt that a reading of 25 was the lowest anyone should have and if they are that low they should be taking vitamin D supplements.

Another doctor just pooh-poohed the necessity of herbal supplements, or minerals and said that if I was eating the right foods they were totally unnecessary. In fact he basically warned me to stop. This reinforces what other people have told me about reactions their doctors have had to herbal medicines and supplements.

This comprises the largest mistake by doctors – totally ignoring or advocating against taking them at all. Most people do take some and many people take a lot of herbal supplements. Doctors need to recognize this if they want cooperation in the future from patients, they should just make note of these and if necessary ask about others that are not listed. Their reactions to patients taking herbal supplements will determine future problems that the patients may face. The patient may need to take precautions since the doctor is not willing consider or discuss anything herbal or berates the patient for using them. In these circumstances, I would suggest locating a different doctor.

One comment I have had from others points out a second mistake by doctors. This is just writing a prescription without reviewing the list or asking the patient if they were taking any of the herbal medicines that would react unfavorably with the prescription. In this case the patient had an excellent pharmacist that did ask and advised the patient correctly to stop taking the herbal supplement while on the prescription and explained what could happen if the patient did not stop.

Another mistake a friend had the doctor make was prescribing a supplement that was about 15 times more expensive than could be purchased over the counter in most stores and pharmacies. Again a pharmacist saved the day. These types of mistakes are commonly made by doctors that do not recognize herbal supplements and medicines.

My next blog will cover mistakes of manufacturers.

Buyers of Herbal Medicines – BEWARE! - P1

While I try to respect both sides on the debate about herbal medicines, there are some facts that cannot be escaped and must be discussed to enlighten the general public. Neither side is blameless and public safety still needs to be front and center. Most herbal medicines are in fact fairly safe – on the surface. It is when we get below all the hype and misinformation that we can sometimes see some real causes for concern and even sometimes find real dangers.

Most, but not all of the dangers arise from abuse and overuse of herbal medicines in situations where prescription medications are also taken at the same time as herbal medicines. Who is at fault? There is plenty to go around - physicians, herbal medicine manufacturers, and patients are all at blame. Much depends on the particular circumstances. Then the final piece of the puzzle is governmental actions that make the picture grim for all concerned.

Since I am a patient, I start where I have the most knowledge and experience. Patients as a whole do quite well with most herbal medicines and are not abusing them in most cases. Where most patients go wrong is not having a list of which ones they are taking and sharing this with their doctors. Most feel that since they are herbal and from nature that there is no reason to be concerned and their doctors do not need to know what they use.. This is the first mistake – and a huge one. Some herbal medications do react unfavorably with prescription medications and some can even cause death.

The second mistake some patients make is taking either too large a dose or too small of a dose. Of course, there are instructions on the packaging for the herbal medications, but they can sometimes be misleading as they are for the “average” patient and not necessarily for the patient taking them. This is when the doctor can be a valuable resource to discuss this with and the doctor may be able to do some tests to determine the appropriate dosage. Sometimes this will not be of help, but the patient has more to gain than lose.

The third mistake patients make is not researching the herbal medications they take. For many this involves just reading the paper that comes with the packaging. Then when these papers of instructions are not part of the packaging, patients need to make sure that they ask for information from the sellers, the manufacturers, and not take them until all questions have been answered.

The forth mistake patients are prone to make is not rechecking the information when prescriptions are added to the mix or when herbal treatments are added to the prescription mix. Both can have severe consequences when this is neglected.

The last mistake many patients make do have conflict potential and must be handled diplomatically or not – depending on how the doctor reacts to herbal medicines and supplements. The American Medical Association has an adverse policy to herbal medications and supplements. Some doctors have the same attitude while other doctors respect herbal medicines and the patients' right to use them.

In the next blog I will discuss mistakes by doctors. Please read the following article about some of the many problems patients often ignore and the dangers.

When Will Cardiologists Learn – Eliminate Wheat

I am happy that cardiologists are investigating alternative ways to lower blood pressure, but most are not considering the elimination of modern wheat from their patient's food. The good thing, and a big step in the right direction, is that they are investigating ways to help patients instead of automatically prescribing statins or other medications.

John Bisognano, M.D., PhD, and Kevin Woolf, M.D., a cardiology fellow at the University of Rochester Medical Center, conducted a comprehensive review of the evidence behind a wide range of non-prescription drug interventions for the treatment of high blood pressure. The review is featured in the September issue of the Journal of Clinical Hypertension.

One of the best statements made is this one – Quote Woolf said” “There is not enough data to recommend any of these alternative options on a routine basis, but on an individual basis he thinks they are useful. Patients have different backgrounds and different approaches to living their lives. This is where the art of medicine comes in; getting to know patients and what they will and will not embrace can help physicians identify different therapies that suit their patients' habits and that will hopefully make a difference for them." Unquote

If only more physicians would see this and do this to help their patients. If physicians got to know their patients and what they will or will not embrace, they just might learn how to become better physicians. While most cardiologists will not listen to the the ideas put forth by cardiologist Dr. William Davis, you should take time to read this blog (link now broken) and search his blogs for more information about high blood pressure, cholesterol, and blood glucose.

Dr. Davis has had some wonderful results in his efforts to reduce these and most revolve around the elimination of modern wheat from our diets. Dr. Davis has many blogs about wheat and what it does to our bodies. His book “Wheat Belly” is an excellent book and you should read an excellent review in this blog by Tom Naughton.

Read this article for the supplements, herbal medicines and other ways reviewed to improve high blood pressure.

From Joslin – Proper Way to Inject Insulin

This has been an interesting topic for several years, but along the way, many people have dropped the ball and it is just now that some organizations are realizing that there are better ways to inject insulin. According to a workshop in Athens (TITAN) in September 2009 there is a proper way to inject insulin.

Why it took so many organizations so long to evaluate this report is still a mystery. Why health practitioners have taken so long to adopt the methods in this report make me wonder about the knowledge of many health practitioners. True, there was little consensus prior to this report and most like to use evidence-based guidelines to support what they tell their patients.

At least Joslin Diabetes Center has recognized that there is evidence to be looked at and is in the process of reviewing their own procedures in light of the report and consensus reports available. They report the following from an injection survey: 21% of patients admitted injecting into the same site for a whole day or even for a few days, 50% of patients had symptoms suggestive of lipohypertrophy (a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin), and 35% of patients using NPH don’t remix it prior to use. These findings are important as lipohypertrophy can also cause changes in the action or timing of insulin delivery.

Another factor that should help most people with the potential new standards is the use of shorter needles instead of the half an inch needles most of us are used to. The new recommendations remove the classic pinch most of us have been taught as the shorter needles will not require this. It is also not necessary to use an angle shot unless you are still needing to use the pinch method in areas with little fat and muscle near the surface. Straight-in is now the preferred injection angle except as last mentioned.

This does not affect me, but for anyone using a pen for injecting insulin, please read Joslin's findings for proper use of a pen. A few of their recommendations are something to adapt to and I have even been taught to do with my needles. Never remove the pen needle from the injection site immediately. They recommend counting to 10 before withdrawing the pen to prevent back leakage which can reduce the amount of insulin available.

This blog should be read by everyone that injects insulin and for anyone on oral medications that is considering the switch to insulin. Expect to see or read more as other healthcare organizations adopt new standards.

Are There Six Million Dollar Guinea Pigs?

No, I don't think you will be that valuable. When they start talking electronics in or on humans all I can think about is the six million dollar man – Lee Majors. I do not anticipate the “electronic tattoos” will be that expensive. There are some interesting ideas being proposed for electronic tattoos that may well have some very real health benefits for many people. Whether something for diabetes will be among them in the near future remains to be seen.

Ultra-thin electronics are being experimented with that may in the near future have applications for monitoring patients that will do away with some of the bulky equipment that is being used today. Some applications may be a little futuristic; however, some real applications are possible in the near future, the FDA doing its job.

One of the applications that may be near is a patch that can be applied to the chest and give doctors access to heart monitoring that is remarkably close to information produced by the electrocardiogram.

John Rogers, PhD, and colleagues at the University of Illinois and other institutions in the U.S., Singapore, and China, have developed a system "of epidermal electronics" that almost exactly match the properties of the skin.

The patch contains electronic monitors that are integrated onto a water-soluble polyester backing (elastomer). It is attached to the body by brushing it with water. Weak forces of attraction between the skin and the backing cause the patch to stick to the skin like super-adhesive cling film. The patch is extremely thin -- less than the diameter of a human hair.

Since the skin represents one of the most natural places to integrate electronics, the researchers note the the patch has been used effectively for 24 hours without skin irritation. The present problem is that the surface skin cells of the skin are shed and renewed, a new patch would have to be attached at least every two weeks. The patch has yet to be tested with a range of skin conditions, from dry to sweaty.

What is interesting is this technology will work in non-medical applications such as a patch attached to the throat incorporating an microphone. This is being developed for the possible use for people with some disabilities so that they can use computers. Read the article here.

Zinc Can Assist in Preventing Diabetes Damage

Because of the toxic nature of zinc, please do not do any supplemental zinc intake without knowledge of a doctor and only on his advice. For information on zinc and health problems read this – a little more than half way down the page under the heading “Health Risks from Excessive Zinc”. The rest of the article is good also. Bookmark it and go back to it after you read the following.

This is an interesting study about zinc and does deserve some attention as the National Institutes of Health provided funding for the research. The University of Michigan did the research and the findings appear in the July 8 issue of the Journal of Molecular Biology.

The findings showed that Amylin can display two characteristics. In people that have normal levels of zinc and are otherwise healthy, amylin assists in blood glucose management. An analog of amylin, named Symlin is used with insulin to manage blood glucose levels in people with diabetes. In molecular language, zinc prevents amylin, which is also known as Islet Amyloid Polypeptide, from forming clumps which can lead to the formation of ribbon-like structures called fibrils.

This happens in an environment that is zinc-starved and the fibrils become linked to some human diseases, many of them in the area of dementia. The important part is that zinc binds to amylin, at a point near the middle of the amylin molecule, the amylin molecule kinks, which interferes with the formation of toxic clumps. In the current work, they show that the binding of zinc in the middle makes one end of the amylin molecule, called the N-terminus, become more orderly.

In addition, the researchers found that before amylin can begin forming fibrils, zinc must be rousted from its nesting place. This eviction is costly in energetic terms, and the sheer expense of it discourages fibril formation. And because a single zinc molecule can bind to several amylin molecules, it ties up the amylin in assemblages that, unlike certain other aggregations, are not intermediates in the pathway that leads to fibril formation.

However zinc, like amylin, has a dual nature. At conditions similar to those outside islet cells, where even a tiny amount of amylin aggregates in the blink of an eye, zinc inhibits fibril formation. But in conditions resembling the inside of the cell, the inhibitory effect begins to wane and other factors, like insulin, take on zinc's security guard duties.

Amylin has not one, but two binding sites for zinc. Zinc prefers to bind at the first site -- the one in the middle of the amylin molecule, where its binding discourages fibril formation. But when there's too much zinc around, all the binding sites in the middle positions are occupied and zinc must attach to amylin at the second site, which counteracts the effect of the first site. This may explain why decreased levels of insulin -- the backup security guard -- inside islet cells of diabetics result in islet cell death.

Also read this blog about natural sources of zinc.

Portfolio Diet Better Than Low-Fat Diet

This is difficult topic for me to write about, but people still need to know about the Portfolio diet and that it is better for you than the low-fat diet. I hesitate to recommend this diet since I do not like soy or soy based products and margarine of any type. The portfolio-diet over the low fat diet helps lower cholesterol by 13 percent after six months on the diet whereas the results of the traditional low-fat diet can only give a three percent decrease in cholesterol.

The Portfolio-diet is a plant based diet and for some people will serve them well. Since cardiovascular disease is a major killer, researcher David Jenkins, MD, Canada Research Chair at the University of Toronto says, “If we let people know that they can control their own cholesterol levels themselves, we're putting some of the responsibility but also the power back into the hands of ordinary citizens." Jenkins also says, “The study suggests that the mix of plant-based foods included in the portfolio diet can achieve cholesterol-lowering results similar to what can be achieved through drugs.”

Several others have commented that motivation is key and that going from animal to plant based protein is a change, counseling sessions seemed to work very well and these type of results are very good and people are staying with it. They are hoping the results will continue beyond the six months with more counseling sessions.

In the study, 351 people with high cholesterol were divided in three groups. One group on the portfolio diet received two counseling sections and another group on the portfolio diets received seven sessions over a six month period and the third group followed a standard low-fat diet for six months.

People tend to respond to the positive dietary messages and the nuts, legumes, and plant sterols was well received as being proactive over just taking saturated fat out of the diet.

The second article in Medscape is a little more descriptive and does say that the portfolio diet may well alleviate the need for statins early on and may reduce the dosage of statins needed for many people. All positive steps in reducing the dependance on some medications.

Read about the study in WebMD here and the Medscape article here.

Inactivity Linked to Risk for Type 2 Diabetes

I wish I could comprehend some items with the ability of Tom Ross. He has a sense of humor and skepticism that make reading him blog very enjoyable for me. He can rant and vent with the best of them and you will not even know it by the way he writes. That is another reason to read his blog.

Since his blog is not one that you can link to for a specific post, I will just tell you that you need to read his post from Thursday, August 25, 2011. I like the way he boiled done the relationship between obesity and diabetes and then took us to the study which is the topic of this blog – inactivity. You will need to scroll down the page to find the blog, and I think you will enjoy his presentation. He packs a lot of good sense into his discussion and at the same time makes excellent points.

Quote I doubt very much that we are ever going to narrow this down to a simple cause-and-effect relationship between a single issue and diabetes; it is far more likely to be a tangled interaction between multiple factors.

But one factor which could be as important as obesity tends to be mentioned far less often than obesity is, as a possible cause of diabetes: physical inactivity. Unquote.

That is one of the best ways to describe much of the discussion from many articles about diabetes and obesity.

So rather that cover the topic again, it is well worth your time to read Tom's blog and then read two articles covering the topic – here from Science Daily and Medical News Today here.