Integrating CAM therapies into Mainstream Practice: Part v
Who needs Supplemental Vitamins?
Do supplemental vitamins deserve the ‘health halo’ they have enjoyed for a long time? According to several studies, we may have overestimated their importance as supplemental therapy. The industry has to take some blame with their promotional slogans such as ‘Regular intake of vitamins is an insurance policy against bad eating,” “Vitamins improve your vitality and energy,’ etc. There is no conclusive evidence that multivitamins lower the risk of cancer, heart disease or any other chronic health problems. “Regardless of the quality of a person’s diet, vitamins are not routinely recommended,” says the Federal office of Dietary supplements. Some of the fads such as antioxidant craze over Vitamin A and E may not be justified and taking too much of these is a health risk also.
Please note that correcting a vitamin deficiency to ensure you have the right amount in the body is different from supplementing beyond recommended levels.
Who needs supplements?
Certain groups of people need more of these nutritional supplements than others. This population includes:
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Breast-fed infants and sometimes other infants also who may be deficient in vitamin D;
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Pregnant women who need extra iron and folic acid because of anemia. Folates seem to play a role in preventing birth defects;
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Post menopausal women may need Calcium and vitamin D to protect their bones; they tend to develop osteoporosis;
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People over the age of 50 and pure vegetarians (vegans) need vitamin B12. Older people generally have less acid in the stomach that helps with the absorption of B12;
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Most of us will need vitamin D for one reason or other. D deficiency can lead to bone problems like osteoporosis and fractures. It can also increase the risk for Diabetes Mellitus and hypertension. As you know, ultraviolet rays of the sun help the synthesis of D in the body. While we Floridians are lucky with abundant sunshine, Scandinavian countries get only a few hours of sunlight in winter. Finland has the highest incidence of Type 1 Diabetes. Also, infants who get vitamin enough D are less likely to develop Diabetes in later life. Patients with kidney diseases often need supplemental D therapy. It is good to get your D level checked periodically. Current daily recommendations suggest: 200 U daily for people below 50, 400 IU daily for 51-69 and 800 IU for 70+ age group.
Some suggestions
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Be careful with supplemental combos that have several ingredients. Some may contain ingredients you don’t need. Discuss with your doctor and take a supplement that is specifically tailored to your body needs; older people need more calcium and D, pregnant ladies need more iron and folic acid, vegans need B12, etc.
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Vitamin D is best taken with dinner. It will absorb better.
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Be careful about the vitamin K content since it can negate the effects of blood thinners such as warfarin.
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Early research has shown that vitamin E may lower the risk of heart disease and stroke and may help with aging. However, supplemental vitamin E intake has not been conclusively proven to significantly reduce this risk. Nor it reduces the risk of cancer or wrinkles on the skin.
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Those who are current or ex-smokers are advised to stay away from products that contain vitamin A, beta-carotene, etc., because of the slightly increased risk of lung cancer tied to this vitamin.
Now you are familiar with the A, B, Cs of multivitamin. I know shopping for dietary supplements is not a simple matter anymore. Not everybody needs vitamin and mineral supplements. ‘At least it won’t hurt you’ may not be true also. What you need is a well-balanced diet that includes dairy products like milk, cheese and yogurt, fruits, nuts, fortified cereals, legumes and a lot of green leafy and colorful vegetables along with fish and some white meat for non-vegetarians. Eating a healthier diet is better than a pill.
Reference: “The Smart Guide to Vitamins and Minerals,” a special report from Harvard Medical School.
Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.
GUEST COLUMN
An EYE for an EYE: A LENS for a LENS
In this New Year, cataract surgery continues to undergo a revolution in the form of techniques, technology and options
I have previously described my concepts of cataract surgery (Khaasbaat) wherein it should no longer be considered routine surgery or done on a conveyer belt where the patient is just a number resulting in mediocre vision that they are relegated to for the rest of their life. “Cataract surgery instead should be approached as a unique opportunity to improve each patient's vision to their best capacity for the rest of their life.”
To briefly recapitulate our previous article, cataract is a naturally occurring, age-related, clouding of our crystalline lens in the eye. Therefore, when a cataract is removed during surgery it has to be replaced with an artificial lens.
Until recently, there were few options for these artificial lens technologies and most patient ended with clear vision after surgery but dependent on glasses for distance and or for near vision.
Cataract enhancement surgery, one of the most common procedure in entire medicine, is a relatively safe procedure involving a sutureless (No-Stitch) micro-incision, no injections and no patch techniques.
As of late last year and early this year, the bar on the surgery has further been raised by introducing lasers in cataract surgery.
Though cataract surgery is a safe procedure, it is still dependent on each surgeon's personal techniques, experience and approach. The technology used to remove the cataract is high- speed ultrasound (phacoemulsification). With introduction of lasers in cataract surgery, the procedure will become much more standardized, consistent, predictable and safe so we could truly customize not only the technique and technology but also define the outcomes for this surgery with high predictability.
Laser technology will also allow maximal optimization of the optics of each individual eye in today's time and age where we have lens options, which can correct the refractive errors for each eye effectively.
The artificial lens options available today for cataract surgery range from lenses that can correct nearsightedness, farsightedness, astigmatism and even presbyopia (reading vision for patients over 40). The lens options further can be individualized based on the optical properties, shape, size and design.
Some of the premium lens technologies available in the United States are ReStor, Rezoom, Tecnis, Crystalens and Synchrony lenses. Add further innovations that are in the pipeline such as artificial lenses that even change shades of dark (just like for the cell sunglasses) depending on the sunlight levels, which the patient is exposed to or those that can be tweaked to correct prescription even after surgery
Additionally, lens technologies can be combined with advanced LASIK surgery too.
These are exciting times where cataract surgery (everybody who lives long enough will at some point need cataract surgery) can improve vision such that most cases would result in excellent distance and reading vision without glasses. The surge in innovation and technology, including new-generation lens implants and laser techniques, further raises the bar in performance and planned outcomes.
This will eventually lead to the lowering of the age of cataract surgery, which will become the hallmark of this generation seeking excellent vision for an unrestricted lifestyle, early in their lifetime for a longer span.
For a condition that everyone will face at some point, every human effort to make it easy, flawless, safe and predictable is most welcome.
So, congratulations if you have cataracts. Please make sure your eye surgeons look you in the eye and offer a lens best suited for you.
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at gulanivision@gulani.com or visit www.gulanivision.com
NEWS RELEASE
Home Sleep Test CAN SAVE LIVES
Obstructive Sleep Apnea (OSA) is a chronic disorder characterized by a lack of breathing due to blocked airways, often caused by relaxed throat muscles during sleep. OSA, as common as Type 2 diabetes, may cause daytime sleepiness, morning headaches and/or loud snoring. It’s estimated that 40 million Americans are suffering from OSA, many of them never being diagnosed. If left untreated, OSA may cause high blood pressure, heart disease, diabetes, obesity, stroke and depression. In addition, OSA activates the release of stress hormones, the largest risk associated with heart failure.
About Home Sleep Testing:
Home Sleep Testing (HST), a substitute for completing studies at a sleep facility, establishes a practical diagnostic pathway for OSA patients with co-existing conditions, such as congestive heart failure and diabetes.
Using cloud-based technology through a cell phone-sized device measuring respiratory efforts, nasal flow, blood oxygen levels and pulse, patients can complete a home-based sleep study at a significantly lower price.
But HST doesn’t only benefit patients. Blackstone Medical Services, a market leader in home sleep testing and telehealth solutions, provides for better access, quality and cost for both providers and physicians through HST. It offers an alternative way to identify OSA, a condition in which breathing stops for at least 10 seconds during sleep.
“OSA is a life-threating health condition,” said Vick Tipnes, president of Blackstone Medical Services. “Everyone should be tested if you’re having symptoms. Blackstone’s HST option provides for better access, quality and cost for both providers and physicians.”
Blackstone Medical Services, a Medicare-approved, JCAHO-accredited and nationally recognized IDTF for home sleep testing and telehealth solutions based in Tampa, has more than 12 million covered lives. It is focused on serving those suffering from Obstructive Sleep Apnea (OSA) and its services eliminate and significantly reduce hospital re-admissions and urgent care visits. If you or a loved one suffers from fatigue or daytime sleepiness, call toll-free at 1-888-710-2727 or visit www.blackstonemedicalservices.com