The USA and Switzerland are the only 2 countries that I know allow direct pharmaceutical to consumer advertising in the media. This controversial approach[1] is being revisited as drug companies advertise on the internet, particularly on Facebook and Twitter.[2] As long as there is money to be made, ads will be a part of American life; but, hopefully, regulators will be looking at the inherent problems with the pharmaceutical approach as they review this issue. (See below.)
Hugo Rodier, MD
Drug problems in the medical literature for this month
It is well known that antipsychotics (seroquel, geodon, etc,) disrupt our metabolism, causing weight gain and at times diabetes. Now we see that they also raise the risk of blood clots.[3]
“Hormone Therapy and Breast Cancer.” The National Institute of Health 2002 report that hormonal therapy increases the risk of breast cancer is now solidly proven correct.[4]
“Prolonged Bisphosphonate Use Linked to Rare Fractures, Esophageal Cancer.” Drugs for osteoporosis have not been shown to be that helpful for hip fractures. But, they are associated with esophageal problems ranging from heartburn to cancer.[5]
“NSAI Drug (like ibuprofen) Use Linked to Elevated Risk of Stroke.” NSAIDs have been shown to also increase the risk of heart attacks, ulcers, kidney and liver damage; now they raise the risk of strokes by 30-80%.[6] And, “Long-term Use of Anti-inflammatory Drugs and Risk of Atrial Fibrillation,” which also increase the risk of strokes.[7]
n a related note, the notion that the Medicare drug coverage (Part D) was originally pushed through by the pharmaceutical industry to maximize sales, while refusing to allow the Feds to buy in bulk, like Canada does, has been repeatedly proven correct with articles like “Ambulatory Antibiotic Use and Prescription Drug Coverage in Older Adults: the good the bad and the unknown.”[8] Part D has resulted in higher use of expensive antibiotics when cheaper alternatives would have sufficed.
Drugs and testing are overused, in my opinion, in 80% of cases. On the subject of tests, we need more clarity in “Discussing Radiation Risks Associated With CT Scans With Patients.”[9] Use of CT scans is associated with 2% of cancers in the future.[10] Not surprising, when we remember that radiation like a Total Body Scan in asymptomatic people raise cancer risk the same as low-dose atomic bomb survivors in Hiroshima, Nagasaki.[11] Also, Dentists seem to rely heavily on antiquated X-ray machines that emit too much radiation. Those dentists who innovate tend to get a Cone CT scan that the makers of the devise claim, with very little, if any independent confirmation, that their new toy is as safe as an airport scanner; however, many experts feel the Cone CT radiation is 100 times stronger.[12]
Gall Bladder stones
As discussed in previous issues, Gall Bladder stones are associated with insulin resistance or Pre Diabetes. Unfortunately, a significant number of people lose their Gall Bladder without hearing what precipitated the problem. The only diet advice they get is to avoid greasy foods, which often translates into even more sugary foods, the very ones that created the problem. Consequently, people continue to make thick bile in the liver, due to the extra insulin required to metabolize refined foods. This is why many post surgical patients continue to have discomfort in the liver area (right upper quadrant of abdomen.) Avoiding processed foods and replacing digestive enzymes with bile salts would be helpful.
The study “Regression of preestablished cholesterol gallstones by dietary garlic and onion in experimental mice“[13] not only shows that garlic and onions not only reduce the incidence and severity of Gall Bladder stones, but also regressed or shrunk stones already present by 53-59%. Many of these patients may be able to avoid surgery with this simple dietary approach.
4 Brazil nuts and selenium
Selenium is a vital trace mineral that is often lacking in our diets, since few people eat adequate amounts of vegetables, fish, shellfish, whole grains, eggs, chicken, liver, garlic, brewer’s yeast, wheat germ, and enriched breads. We need about 100-200 mcg of selenium per day to fuel many enzymes that are key to maintain health. That amount is more or less found in 4 Brazil nuts.
A lack of selenium has been associated with prostate cancer, particularly in those with genetic susceptibility.[14] Also, selenium lowers the risk of cataracts, particularly in those who have been exposed to higher levels of methylmercury.[15]
Coffee update
The date is mixed on coffee because the amounts consumed differ and because of liver detoxification and stomach sensitivity issues from person to person. If we look at coffee as we do alcohol we may come pretty close to a sensible and flexible view of coffee. Since both of these drinks are also addictive, I do not advice people to start these drinks, unless they know themselves to have non-addicting personality. So, when kept to one serving a day, both alcohol and coffee have substantial studies to back up their salutary effects, like cancer prevention, treatment of asthma, insulin resistance, etc. This month I found the following articles:
“Greek-Style Coffee May Aid Arterial Elasticity,”[16]
“Coffee and tea intake and risk of brain tumors in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study,”[17] and
“Coffee Mannooligosaccharides, Consumed As Part of a Free-Living, Weight-Maintaining Diet, Increase the Proportional Reduction in Body Volume in Overweight Men.”[18]
Environmental Update
“Although the risks of developing chronic diseases are attributed to both genetic and environmental factors, 70 to 90% of disease risks are probably due to differences in environments.”[19]
“Association of Cumulative Lead Exposure with Parkinson’s Disease.”[20]
“Air Pollution and Emergency Department Visits for Otitis Media.”[21]
“Exhaled Carbon Monoxide and Risk of Metabolic Syndrome and Cardiovascular Disease in the Community;” it contributes to weight gain and diabetes.[22]
“Environmental Factors Associated with Childhood Onset Type I Diabetes: an exploration of the hygiene and overload hypotheses.”[23]
“Diminished Protection? Early Childhood PCB Exposure and Reduced Immune Response to Vaccinations.”[24]
“Thyroid Insult: Flame Retardants Linked to Alterations in Pregnant Women’s TSH Levels.”[25]
“Particulate Air Pollution, Metabolic Syndrome, and Heart Rate Variability: The Multi-Ethnic Study of Atherosclerosis (MESA).”[26]
“Childhood Exposure to Phthalates: Associations with Thyroid Function, Insulin-like Growth Factor I, and Growth.”[27]
“Second Hand Smoke May Raise CRP,” a marker of inflammation.[28]
“Smoke-free Legislation and Hospitalizations for Childhood Asthma.”[29]
Telegraphed articles
“Resveratrol Improves Myocardial Perfusion in a Swine Model of Hypercholesterolemia and Chronic Myocardial Ischemia.”[30] Resveratrol is an antioxidant in grapes.
“Ginseng Sharpened Memory in Young Adults.”[31]
“Expressive Writing Is a Promising Therapeutic Modality for the Management of IBS.”[32]
“Effect of mother’s weight on infant’s microbiota acquisition, composition, and activity during early infancy: a prospective follow-up study initiated in early pregnancy.”[33]
[1] “To inform or persuade? Direct to consumer advertising of prescription drugs,” NEJM 2005;352:325
[2] “Pharmaceutical Marketing and the New Social Media,” New England J. of Medicine 2010;363:2087
[3] British Medical Journal, Sep 21th 2010
[4] JAMA 2010;304:1684
[5] JAMA 2010;304:2114
[6] J. Family Practice News October 1st 2010, page 48
[7] J. Arch Intern Med 2010;170(16):1450
[8] J. Archives Internal Medicine 2010;170:1308
[9] JAMA 2010;304:2170.
[10] “Computed Tomography: an increasing source of radiation exposure,” NEJM 2007;357:2277
[11] J. Radiology 2004;232:735
[12] New York Times, front page November 23rd 2010
[13] Journal Metabolism Clinical and Experimental 2010;59:1402
[14] “Effects of Selenium Status and Polymorphisms in Selenoprotein Genes on Prostate Cancer Risk in a Prospective Study of European Men,” J. Cancer Epidemiology Biomarkers Prevention 2010;19:2958
[15] “A Balanced Diet? Selenium May Offset the Effects of Methylmercury on Cataract Development,”
J. Environmental Health Perspectives 2010;118:a491 &
“Selenium and Mercury in the Brazilian Amazon: Opposing Influences
on Age-Related Cataracts,”
J. Environmental Health Perspectives 2010;118:1584
[16] J. Family Practice News, Oct 15th 2010, 24
[17] Am J Clin Nutr 2010 92: 1145
[18] J. Nutrition 2010 140: 1943
[19] “Environment and Disease Risks,” J. Science, 22 October 2010: 460
[20] J. Environmental Health Perspectives 2010;118:1609
[21] J. Environmental Health Perspectives 2010;118:1631
[22] J. Circulation. 2010;122:1470
[23] J. Archives of Pediatrics & Adolescent Medicine 2010;164:732
[24] J. Environmental Health Perspectives 2010; 118:a445
[25] J. Environmental Health Perspectives 2010;118:a445
[26] J. Environmental Health Perspectives 2010;118:1406
[27] J. Environmental Health Perspectives 2010118:1458
[28] J. Am Coll Cardiology 2010;56:18
[29] NEJM 2010;363:1139
[30] J. Circulation. 2010;122:S142
[31] J. Psychopharmacology 2010 July 31st
[32] Am J. Gastroenterology 105: 2440
[33] Am J. Clin Nutr 2010 92: 1023
