Health News
Cholesterol Medication Increases Risk of Muscle Injury
-The popular cholesterol medication Simvastatin (Zocor) can increase the risk of muscle injury when used at the highest dose; 80 mg. This is according to an alert released by the United States Food and Drug Administration.
The agency reported on data from the recent large clinical trial named SEARCH (Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine). The SEARCH trial evaluated the number of major cardiac events such as heart attack, heart bypass surgery and death from heart attack in 6031 patients who were taking 80 mg of simvastatin (Zocor) verses 6033 patients taking 20 mg of simvastatin (Zocor) and followed the study subjects for over six years.
According to the alert, more patients in this trial who were taking the higher 80 mg dose of simvastatin (Zocor) developed muscle injury compared with patients taking the lower dose. There were 52 people who had cases of muscle injury out of the 6,033 people who were taking the higher dose. There was only one cases of muscle injury in the patients taking the lower 20 mg dose.
Additionally, in the group taking the higher dose medication, there were 11 cases of rhabdomyolysis, a condition of generalized muscle breakdown that can lead to kidney failure.
This warning is not a surprise. Muscle breakdown and rhabdomyolysis are known complications of these cholesterol medications known as Statins. These include the popular cholesterol medication Lipitor (Atorvastatin), and Crestor. However, this study was unique in that it showed a dose-related risk for the medication. We also suspect that certain patients are more likely than others to experience muscle pain. This will sometimes improve with a lower dose of a stronger statin medication. We also suspect that adequate hydration is helpful at preventing muscle pain from the statin medications.
Cristopher Geiler, MD
Reference
http://www.fda.gov/medwatch
Read more – March 23, 2010
Infertility Associated With Prostate Cancer
Infertility likely increases the risk of developing prostate cancer in men. This is according to a recent study published in the Journal of the American Cancer Society.
Researchers analyzed data from over 22,000 men from fertility centers in California from 1967 to 1998. The study authors identified 168 cases of prostate cancer that developed in men who were reviewed for infertility. Men who were found to be infertile were 2.6 times more likely to be diagnosed with high grade prostate cancer than men who were were not found to be infertile.
This study showed that infertility was associated with the development of prostate cancer but did not offer an explanation for this association.
Reference
www.cancer.org
Read more – March 4, 2010
Food Poisoning, Infectious Diarrhea Raises Risk For Irritable Bowel Syndrome
- Infectious gastroenteritis will increase the risk of developing certain function bowel disorders such as irritable bowel syndrome, heart burn and functional dyspepsia. This is according to a new study published in the latest issue do the medical journal Gastroenterology
· Study authors report that gastroenteritis can lead to heartburn or IBS years later. Infectious gastroenteritis may cause chronic low-grade inflammation of the intestinal track which can lead to symptoms of functional bowels disorders.
· The current study analyzed people from a small community in Canada where there was an outbreak of bacterial gastroenteritis in the year 2000. Over 2,300 people were infected and seven people died from the infection.
· Researchers studied approximately 1,088 participants from this community six year period.
Over 50% of the study participants who had been infected during the outbreak reported symptoms of dyspepsia which included heart burn, nonspecific abdominal pain and discomfort. Only 30% of the people who were not infected during the outbreak had dyspepsia symptoms
· Given the higher rate of gastrointestinal complaints in the affected study population, researchers concluded that bacterial gastroenteritis plays a role in the development of chronic functional bowel disorders.
Cristopher Geiler, MD
Gastroenterology 2010
Read more – March 3, 2010
Weekly Vitamin D3 Improves Vitamin D Deficiencies, Not Neuromuscular Dysfunctions
- Weekly supplementation with vitamin D3 raises blood levels of vitamin D in elderly people who are vitamin D deficient but did not improvement balance and neuromuscular function. This is according to a study published in the latest issue of the American Journal of Clinical Nutrition.
Study authors report that “Vitamin D insufficiency, which is prevalent in older individuals, is associated with bone and muscle weakness and falls.” This study examined the effects of a weekly dose of 8400 IU vitamin D3 on balance problems, muscle strength, and safety in older individuals.
Researchers analyzed participants who were 70 years and older with deficient levels of vitamin D and randomly assigned them to receive a weekly dose of 8400 IU of vitamin D3 or placebo.
The main endpoint of the study was to assess improvements in balance and stability along with vitamin D levels.
The study authors reported that patients who were treated with supplemental vitamin D 8400 IU once a week had a significant increase in vitamin D blood levels, increasing from 13.9 to 26.2 ng/mL. Researchers reported that there was no improvement in balance or neuromuscular function according to their tests after 16 weeks of treatment.
Although low levels of vitamin D appear to be associated with imbalance and neuromuscular dysfunction, replacement of vitamin D3 did not appear to help. However, this study did show that weekly vitamin D3 dosing was helpful in raising blood levels of vitamin D.
Cristopher Geiler, MD
Reference
Am J Clin Nutr. February 2010
Read more – February 19, 2010
Postmenopausal Hormone Replacement May or May Not Help With Heart Disease
- Hormone Replacement Therapy (HRT) with Estrogen and Progesterone may or may not change the risk of developing heart disease in postmenopausal women. This is according to a study published in the February issue of the Annals of Internal Medicine.
According to a new analysis of the ‘Women’s Health Initiative’ study, menopausal women, who took estrogen and progesterone hormone replacement therapy, had a slightly increased risk of coronary heart disease within the first few years of treatment. The caveat is that the slightly increased risk was not statistically significant.
The study analyzed recently menopausal women and showed a slightly increased but insignificant risk of about 29% during the first two years of hormone use. This risk disappeared after six years of use. In fact, the researchers showed a possible protective effect against heart disease in women who used hormone replacement therapy for more than six years.
Hormone replacement therapy in postmenopausal women remains controversial and this most recent analysis does not clarify the issues. The current recommendations by the FDA for women to take hormone replacement therapy, if required, is to relieve symptoms of menopause, but to use it at the lowest dose and for the shortest time possible.
Cristopher Geiler, MD
Arch Intern Med. 2010;170(3):226.
Read more – February 17, 2010
Selenium poisoning from Dietary Supplements
- Dietary supplements containing toxic levels of Selenium have caused widespread outbreaks of Selenium poisoning across the United States. This is according to a recent article in the February 8th issue of journal Archives of Internal Medicine.
· Researchers began to investigate outbreaks of acute selenium toxicity after reports of cases of Selenium poisoning began in March 2008.
· Selenium is a naturally occurring mineral that is usually obtained from a balanced diet. Selenium is required for good health and the recommended dietary allowance is 55mcg per day for adults.
· The cause of the outbreaks were identified as liquid dietary supplements which were labeled as containing 200mcg of selenium per fluid ounce in the form of sodium selenite, an inorganic form of selenium. The actual Selenium concentration was 200 times the amount on the label. When the US Food and Drug Administration (FDA) tested the supplements, they found the selenium concentration of 40,800mcg/ounce.
· The authors report that about 200 cases of Selenium poisoning were found and one case required hospitalization.
· Symptoms of Selenium poisoning include diarrhea, nausea and vomiting along with fatigue, joint pain, hair loss and foul breath.
· Although 201 cases were found, the actual number of people affected with Selenium toxicity was likely higher because of the associated symptoms. Selenium toxicity can be nonspecific, making the association with the supplement difficult.
· When the affected patients were interviewed by their doctors, they had not suspected the supplement had made them ill nor mentioned the fact that they were taking the dietary supplements.
· This article highlights the importance of patients communicating with their doctors about all dietary supplements, herbs, and over-the-counter medications that they are taking.
Cristopher Geiler, M.D.
Arch Intern Med. 2010;170:256-261, 262-263.
Read more – February 10, 2010
Anti-Aging Effects of Fish Oil
· Omega 3 fish oil may slow the “biologic clock” of cells. This is according to a recent article published in the January 20, 2010 issue of the Journal of the American Medical Association.
· Researchers have found that higher blood levels of the omega 3 fish oils are associated with a slowing of the cellular time clock. Cells use the redundant DNA at the end of chromosomes as a biologic clock. Every time a cell divides, it loses some of this redundant DNA called a ‘Telomere‘. When the telomere runs out, the cell stops dividing and dies.
· Authors of this study showed that higher levels of omega 3 fish oils were associated with a decrease in the shortening of the telemere over a five year study. Researchers studied over 600 patients who participated in the Heart and Soul Study between the years 2000 and 2002. Researchers measured the telomere length and omega-3 fish oils docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) of the patients at the beginning and the end of the study. The participants were divided into four quartiles based on the amount of omega 3 fish oils in their blood. The group with the lowest levels of Omega 3 fish oils were noted to have the fastest rate of telomere shortening. The group with the highest blood levels of Omega 3 fish oils had the slowest rate of telomere shortening.
Since telomere length is directly related to cellular aging, a longer telomere, or slowing the telomere loss, will increase cellular longevity and, in essence, slow the aging of your cells.
Omega 3 fatty acids are not produced in your body. Omega 3 fatty acids need to be obtained by eating certain fish or a supplement of fish oil capsules or liquid form.
Cristopher Geiler, M.D.
Read more – February 3, 2010
Vitamin D Improves Heart Function
-People with higher levels of vitamin D appear to have hearts that function better than people with lower 
Vitamin D levels. This is according to a new study published in the latest issue of the American Journal of Cardiology.
Additionally, recent research studies have shown that vitamin D may protect against cardiovascular disease. In the current study, researchers showed that low levels of vitamin D are linked to an increase in heart rate and blood pressure.
Study authors examined data from more than 27,000 adults who took part in the National Health and Nutrition Examination Surveys conducted from 1988 to 1994 and from 2001 to 2006.
The participants with Vitamin D blood levels of 10 ng/ml or less had a heart rate that was about two beats per minute faster, and blood pressure readings that was 1.9 points higher, than those with people with vitamin D in the normal range of at least 35 ng/mL.
Why does vitamin D help the heart? Nobody knows. The primary function of vitamin D is to regulate calcium metabolism. It is likely that vitamin D has additional and undiscovered functions that affect human metabolism.
This observational study suggests that people with higher vitamin D levels have hearts that work more efficiently. This is intriguing information and additional research is needed to clarify how vitamin D affects the heart. Additionally, we do not know the optimal dose of vitamin D nor the best source for obtaining vitamin D.
Cristopher Geiler, MD
Am J Cardiol 2010.
Read more – December 21, 2009
Post menopausal Women Have higher Cholesterol Levels
As women go through menopause, they develop a significant increase in the levels bad cholesterol.
Researchers reported this finding in the December issue of the medical journal American College of Cardiology.
The study authors report that their study identifies that the year that women have their last menstrual cycle, they develop a very sharp increase in the LDL, or “bad,” cholesterol. Researchers studied 1,054 women who were enrolled in the prospective medical study entitled Study of Women’s Health Across the Nation (SWAN) in which they analyzed their data for 10 years. The women were approximately 47 years old at baseline and, on average, had their natural final menstrual period approximately three years after study entry. The final menstrual period was defined as 12 consecutive months without a period.
Study authors report that in the year before and after the final menstrual period, women experienced rapid increases in LDL cholesterol.
The LDL “bad” cholesterol levels appeared to remain high.
Additionally, study authors reported that the women participants had no changes in blood pressure, insulin, glucose, lipoprotein(a) levels or evidence of inflammation or clotting related to menopausal transition.
This is the first study to show that menopause is associated with worsening in cholesterol levels. Although we have been suspicious that postmenopausal women will develop higher cholesterol, this study proves it.
Untreated high levels of bad cholesterol is directly related to heart attacks and strokes. This is an important finding and should serve as a wakeup call for postmenopausal women to check their cholesterol levels and review the information with their doctor.
Cristopher Geiler, MD
J Am College Cardiol. 2009;54:2366-2373 and 2374-2375
Read more – December 13, 2009
Depression and Anxiety Linked to Minor Lead Exposure
Lead is ubiquitous in our environment and is known to be toxic to the brain.
Researchers report that exposure to lead has been linked to Depression and Anxiety disorders.
This was reported in the December issue of the medical journal Archives of General Psychiatry.
Researchers studied data from almost 2000 adults aged 20 to 39 years who participated in the National Health and Nutrition Examination Survey between 1999 and 2004. The study authors examined the young adults for evidence of Major Depression, Panic Disorder or Anxiety Disorder. The participants were also evaluated for blood lead levels.
The researchers report that the young adults in this study who had lead levels of 2.11 ?g/dL or more in their blood were 2.3 times more likely to be diagnosed with Major Depression and five times more likely to be diagnosed with Panic Disorder or Anxiety Disorder compared with lead blood levels of 0.7 ?g/dL or less.
Lead exposure is not uncommon. Exposure to lead can come from contaminated water, pottery, tobacco smoke, leaded gasoline or paint.
Previous medical studies have indicated that lead blood levels above 6.3 ?g/dL were toxic and were associated with depression and anxiety disorders. This is an important new finding in that it is teaching us that even very low levels of lead can cause disease and we should be very cautious of any exposure to environmental lead.
Cristopher Geiler, MD
Arch Gen Psychiatry. 2009;66:1313-1319.
