Are Neti-Pots Safe?

There have been concerns over some deaths caused by infection in patients using Neti-Pots or nasal irrigation devices. 

Should you be concerned?

Nasal irrigation can improve symptoms when you have a cold or allergies. If properly used, a neti-pot or nasal irrigation's benefits out way the risk of causing an infection.

If you get frequent sinus infections and you use nasal irrigation, make sure you are using the product correctly. You should always wash out the irrigation device after each use with soap and hot water. You should never share the device with anyone else. If you correctly use the device and still get frequent sinus infections, discontinue use for a period of time and to see if the infections stop occurring. For some people irritation caused by use of a neti-pot can cause more sinus infections.  

Talk to your Doctor our Pharmacist about nasal irrigation and how to do it properly.

Are You "D-ficient"?

As many as one billion people worldwide are thought to have too little vitamin D in their blood. This has become a bigger concern lately. That's because "D-ficiency" is now linked to more than just bone health and muscle strength. Infectious diseases such as tuberculosis and even the flu and common colds may be connected to a lack of this vitamin.¹ And, it's increasingly associated with chronic diseases such as:

• Heart disease
• Certain cancers
• Multiple sclerosis, type 1 diabetes, and other autoimmune diseases
• Osteoporosis
• Parkinson's disease^1,2

            Vitamin D is a hormone your body makes from cholesterol. This is a process triggered by the interaction of sun on skin. Vitamin D is also a nutrient you can get from certain foods such as fatty salmon, tuna, and mackerel. Some foods are fortified with this vitamin. Examples include certain breakfast cereals, yogurt, juice, and milk.³ But it's hard to get enough vitamin D from foods or by being in the sun, especially with concerns about skin cancer. That's where supplements come into play.¹

            If you live at a higher altitude, shun the sun, have darker skin, are obese, or are older, you may be particularly deficient in vitamin D. The only way to know for sure is to have your blood tested.⁴ You can ask your doctor about this.

            In case you've missed it, there's an ongoing debate about how much you need to take to make up for any deficiency. In 2010, the Institute of Medicine (IOM) came out with new recommendations:

• 400 IU for infants
• 600 IU for people ages 1 to 70
• 800 IU for people older than 70¹

            But many scientists still feel this is too low to be fully protective. Doubling or tripling these numbers for those over age 2 may be optimal.¹ Even this may be too conservative. A new study reported that daily intake of vitamin D needs to be somewhere between 1,000 and 2,000 IU to maintain blood levels high enough to prevent major diseases such as cancer.⁵

            Are you considering doses higher than those recommended? Be sure to talk this over first with your doctor, as well as about potential interactions. Vitamin D can interact or interfere with certain medicines or supplements. Examples include prednisone, the weight-loss drug orlistat, cholesterol-lowering drugs and drugs used to control seizures.³

                Which type of Vitamin D is best – vitamin D2 or vitamin D3? Some scientists recommend D3 as it is closer to that produced in your body. However, others say the two are quite similar.  Talk to our pharmacist to help you to decide what is best for you and your family.⁶

                The jury is still out about exactly how much vitamin D you need to prevent serious diseases. But with so much research pointing in the direction of its benefits, surely vitamin D has earned its time in the sun.

Written March 2011

Sources

1. Harvard School of Public Health: "Vitamin D and Health." http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-d/index.html

2. MedlinePlus: "Vitamin D May Precede Onset of Parkinson's." http://www.nlm.nih.gov/medlineplus/news/fullstory_109815.html

3. NIH Office of Dietary Supplements: "Vitamin D." http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/

4. Harvard School of Public Health: "Comment on the IOM Vitamin D and Calcium Recommendations." http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-d-fracture-prevention/index.html

5. Harvard Website http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-d/index.html#iom-vitamin-d

6. Harvard School of Public Health: "Vitamins." http://www.hsph.harvard.edu/nutritionsource/questions/vitamin-questions/index.html#what-type-of-vitamind

Stop Winter germs in their tracks

Colds and flu – no big deal, right?  Well, yes and no. They usually don't last a really long time or cause serious problems.

                Colds can plague you with everything from a stuffy and runny nose to a scratchy throat and watery eyes – and nonstop sneezing that can even put your cat on edge. Flu bugs bring symptoms that can look a lot like a cold. But the flu tends to ambush you suddenly, last longer, and pile on other "treats" such as fever, fatigue, headache, chills, and achiness.

                Some people who get the flu, though, are at risk for pretty serious health problems. In fact, flu-related complications send more than 200,000 Americans to the hospital each year with thousands dying. Even the common cold takes a toll, accounting for 22 million lost school days in the U.S. each year.

                Prevention is looking better and better, isn't it?

                The number-one thing you can do to prevent the flu? Get a flu vaccine, which protects against the three most likely flu viruses to strike each season. The Centers for Disease Control and Prevention (CDC) now recommends that everyone six months and older get a flu vaccine. Get the vaccine as soon as it is available if you are at high risk – you are pregnant, 65 or older, or have a chronic disease. It's also more important if you are a health care worker or care for someone who is at increased risk.

                Available as a shot or nasal spray, the flu vaccine is best received in October or November, although you may still benefit in December or January. Ask your doctor or me if you have questions about this.

                Colds and flu are spread mostly by droplets in the air or by touching a contaminated surface, then touching your eyes or nose. So some other simple steps may go a long way toward helping you prevent these common diseases.

                Wash your hands often with warm, soapy water for about 15 to 20 seconds.  If you're away from soap and water, an alcohol-based hand rub will do. Avoid touching your eyes, mouth, and nose as much as you can. No free rides for these germs! Set a good example for your kids and encourage them to do the same. Also, try to limit being around people who are infected.

                Sneezing and coughing yourself? You know the drill: Cover your nose and mouth with a tissue, then throw it in the trash. If there's no tissue in sight, cough or sneeze into your elbow or upper sleeve. Be sure to pass this tip on to your kids. If you've got a fever, stay home for at last 24 hours after the fever is gone – that is, gone without the use of a fever-lowering medicine.

                Don't forget that other all-around healthy habits – a balanced diet, sleep, exercise, and stress control – can help prevent colds and flu. And, remember that exposure to tobacco – firsthand or secondhand – makes you more prone to respiratory illnesses.

The Intriguing Link Between Diabetes and Alzheimer's

Did you know that having diabetes before age 65 more than doubles your risk of developing Alzheimer's disease? A study of nearly 14,000 Swedish twins helped to confirm this link. Given that more than 23 million Americans have diabetes and 57 million more have pre-diabetes, this is a bit of a concern. But the link between these two diseases may be stronger still. In fact, some now think of Alzheimer's as a form of diabetes. They call it type 3 diabetes.

            But first, a review. What exactly are diabetes and Alzheimer's?

            Diabetes is a chronic disease where your body has high levels of sugar. That's true for one of two main reasons: Your body doesn't make enough of a hormone called insulin (type 1 diabetes). Or, your body doesn't respond well to insulin (type 2 diabetes). Diabetes can cause frequent urination, unusual thirst, and a wide range of other symptoms. It can cause serious – even fatal – complications. People with pre-diabetes also have high glucose levels. But they're not as high as with full-blown diabetes.

            Alzheimer's is a common type of dementia that worsens over time. It causes memory loss, confusion, and many other changes. It eventually leads to death. Scientists have long debated about the changes in the brain that lead to Alzheimer's. But now they are paying closer attention to the role of insulin. Not only are people at increased risk for Alzheimer's if they have diabetes. But many people with Alzheimer's are also resistant to insulin.

            Could low insulin or insulin resistance in the brain be the cause of Alzheimer's in some cases? Lower insulin islinked with mental decline. By helping cells take up energy in the brain, insulin likely plays a key role in the growth and survival of nerve cells and memories. Researchers are now experimenting with inhaled insulin as a treatment for Alzheimer's. It has improved memory in patients with early stages of Alzheimer's but it appears to have limitations.

            So, rather than diabetes simply being a cause of brain changes, both diabetes and Alzheimer's may result from similar causes. The idea that one disease can affect many organs is certainly not new. After all, atherosclerosis affects the kidneys, brain and heart. Now, we know that diabetes and Alzheimer's may be a part of the same disease process.

            Before you become too discouraged about the threat of all these diseases, though, remember this: Many of the factors that contribute to both Alzheimer's and diabetes (and atherosclerosis, for that matter) are within your control. Weight loss, exercise, stress management, and a healthy diet can help prevent or help keep diabetes in check. And, it's possible these lifestyle changes could play an even bigger role with Alzheimer's than once thought.

            For a wealth of information on these diseases, go to www.healthmart.com/. And, don’t forget: If you need any guidance on diabetes management, I'm here to help. Or, be sure to ask me if you have questions about your loved one's Alzheimer's medications.

Keeping a Watchful Eye on Aging Parents

As your parents enter their twilight years, you may feel as though you don't want to meddle in their affairs. But when it comes to their health and safety, try not to stay in the dark. By paying attention to any warning signs, you'll be in a better place to take steps that can help them stay independent as long as possible.

                Here are a few things to watch for.

                Parent trap? Has a parent suffered a fall at home? Or, is one of them about to undergo a major surgery such as a hip replacement? If so, it's likely time to view your parents' home through a new "lens." The loose throw rugs that were once no big deal may now be a set-up for trouble. See if other adjustments are needed, such as a raised toilet seat, extra handrail, or shower chair, for example.

                Mysterious weight loss. This is a red flag at any age, and is worth checking out. Often, it's the result of an underlying medical condition. But it can also mean something's "brewing" in the kitchen. Maybe the chef of the family is now having trouble with cooking tasks. Or, problems with taste or smell may have developed due to aging, illness, or a medication.

                Declining self care and home care. Is your normally fastidious father letting himself go – wearing the same clothes for three days in a row? Do you increasingly find rotten food in the fridge or an overgrown garden that was once your mother's pride and joy? These can be signs of Alzheimer's or depression. Or, there may be another underlying health condition that's partly to blame.

                Shifting behaviors. Have neighbors or friends noticed a change in one of your parents' behaviors? Maybe they've become unusually noisy, more agitated, or up at strange hours of the night. Maybe finances are in disarray or a large number of magazines are now showing up in the mailbox. Has a parent become unwilling to get out and see friends or to keep up with hobbies and activities? These could be signs of Alzheimer's or depression. But don't rule out physical sources for some of these problems.

                If you notice signs of a problem, where should you begin? Start by expressing your concerns with your parents. You might do this together with other loved ones or maybe a clergy. Or, offer to take your parent to a doctor appointment. Take an inventory of the house to see which safety issues need to be addressed first. Is it possible to hire someone to handle household chores or to run errands? Or, can you arrange for meals to be delivered or for a home health care aide to help with daily activities? If these measures are not enough, it may be time to suggest a move to an assisted living facility.

                If you don't know where to find resources, try the Eldercare Locator at eldercare.gov. It can connect you with services in the area where your parents live. And, remember that I'm always glad to consult with you about any concerns you have about your parents' medications.

                These can be challenging times, but with the right support, you can do it.