It seems like every time I turn around there is a new threat of a pandemic flu that is sure to kill us al off.  Isn’t that fun?  It’s always something new, something inevitably scary, and something that makes waves in the news, thus people run to their HCP to find out their risk and get vaccinated. So, I figured despite it being way prior to flu season, I wanted to get the scoop out there, so you are informed when it is time to get vaccinated.

What is the Seal Flu?

Last September through December, New England harbor seals were found either dead or dying all over harbors, and it was unknown why.  It was found that the seals were infected by a highly virulent form of the flu that was transmitted by sea birds (such as seagulls), which quickly spread from seal to seal (so was able to mutate to spread between mammals), and infected their airways and destroyed lung tissues, leading to death.  The flu strain, over the course of being studied, appeared to have become more virulent (stronger and easier to spread), which is not good news at all.  This strain of flu is the H3N8, and is not a new strain, as it infected canines (dogs) and equines (horses) in the past, but was unable to mutate to be able to infect humans.  The difference with this strain is that it seems to mutate much faster and become more virulent, than those in the past.  And, the deadly flu that sea birds carry is H5N1, and scientists are worried that this flu strain will combine and mutate with the H3N8 and then become a super strain of flu that can infect all mammals, including humans.

What is my risk?

Well, the good news?  This is all just worry/concern by a few scientists, that are currently studying this strain, but nothing has been shown and many scientists believe that this theory is pretty far fetched as the other H3N8 strains have not become infective to humans in the past.  Thus far, many experts think that there is very low risk of transmission to humans, as many humans have been handling and working with this virus for months and no one has had any side effects or been infected by a mutation of the virus.  It may be a little bit of conspiracy theory at this point, as it seems like everyone is waiting for the next big pandemic that we need to worry about.

Is there a vaccine?

Since it hasn’t been shown to be a virus to actually mutate to humans, it is only a theory, there is no vaccine.  This form of flu has only mutated to affect sea lions and seals, in the New England area.

So, I would rest easy that seal flu isn’t going to kill you any time soon, and the media is merely reporting on a theory that many scientists feel falls flat. Scientists do warn that if you are swimming in New England, and see a dead seal in the water, they request that you stay away, and report it immediately to local resources. If there is any proof of this seal flu mutating, I will be sure to update everyone, but as of now, you can ease your worries and just plan on getting your regular flu shot this fall, with no worries about the seal flu!

Yours in Good Health

B

I know that I have a lot of friends that eat energy bars during long workouts, and I see people training, constantly squirting energy gels down their gullets whilst working out.  I, on the other hand, am more of a purist and drink water before I workout and after, and as a treat, I may chew gum…..I know, probably not how the Olympians train.  But, an interesting study was performed recently to study the actual difference in athletes when they ate energy bars/gels, raisins, or just had water during endurance workouts. I was not sure what the results would show, and I was rather impressed with the results.

What are raisins?

Raisins are dried dark grapes (golden raisins are dried green grapes and are known as sultanas outside of the US), and they are full of antioxidants.  They consist of about 70% fructose (natural sugars), and they have some fiber and a small amount of proteins available.  They have been shown in some recent studies to aid in decreasing blood pressure for those with hypertension (high blood pressure). A lot of people have total aversions to raisins….I happen to think they are a tasty treat!

What are energy bars?

Energy bars are supplemental foods that usually contain grains and cereals (carbohydrates), along with proteins, and sugars.  They are created for a quick burst of energy through food source when your body needs it, with a low glycemic index to give fuel over a longer period of time than a super sugar rush that will make you crash later. They are created as a food source for immediate release energy when your body needs it to refuel and to keep the body fueled for a longer amount of time.

What did the research show?

Well, in thinking about the idea behind energy bars and the idea of eating them to rejuvenate a workout versus raisins or just plain old water to rehydrate, the assumption would be that energy bars would be the winner, right?  Well, I was wrong! The study that was performed at the University of California, Davis had some interesting results.  The researchers took a group of endurance runners, and ran three different trials with a full 7 day break between trials; they were asked to run for 80 minutes (to deplete their glycogen stores- the readily available energy in the body) then either eat an energy bar/chew, raisins, or just have some water, then run a timed 5K.  It was found that the runners had over a minute faster time in the 5K after eating energy chews or raisins versus just rehydrating with water. Interesting, right?

Energy bars are supposed to be created specifically for the purpose of giving immediate energy for workouts, but if the fructose from raisins can do the exact same thing and boost your immediate energy source, they are a much cheaper alternative, so unless you hate raisins, why wouldn’t you give it a try? Plus with raisins you are getting the benefit of antioxidants, eating a totally natural food source, along with some fiber, vitamins, and some protein.  For the price difference?  I’d ditch the bars and get some raisins….as a raisin lover.  If you hate them, then back to the drawing board, or stick with the expensive energy bars!

Yours in Good Health

B

Grapefruit seed extract (or GSE as some call it) is touted as an antimicrobial, antifungal type of cure-all, but it is actually very controversial.  The beloved grapefruit seed extract may not be as awesome as we think, it may have some help from modern-day chemicals…not making it a holistic alternative therapy at all!!

What does GSE do?

Grapefruit seed extract is a liquid formed from the seeds, pulp, and white matter in the grapefruit, grinding it down to create a liquid and adding glycerine to create the extraction.   In theory, this extract is touted by alternative medicine practitioners as having antimicrobial, antiviral, and antifungal effects.  And many practitioners suggest GSE to treat earaches, sore throats, diarrhea, and some oral infections like thrush.  It was first utilized as an antimicrobial in the 1700’s and in the 1960’s it was supposedly studied and was found to have all of these amazing properties, thus the GSE obsession took off!  It can be taken as a food supplement, and it is also added to many products for the antimicrobial properties.

Where is the controversy?

So, since so many people were suing GSE as an alternative therapy, and just as many holistic and or alternative therapies are now being researched more and more, because people want to know what is the basis and the science behind the effects of these treatments.  I think that many people will be bummed about the results of the studies on GSE, unfortunately. It was thought that the GSE had its antimicrobial properties from the ethanol formed within the GSE, when a few of the commercial brand GSEs commonly sold in health food stores were tested, they were found to have antimicrobial properties but from added synthetic antimicrobials!  Most commonly, benzethonium chloride was found as an additive to GSE.  Benzethonium chloride is an antimicrobial that is present in many over the counter first aid creams, sprays, etc as well as cosmetics, anti-itch treatments, some mouth washes, and it is used as a cleanser/disinfectant in some cleaning products.  The rub is that it is approved in neither the US or the EU as an additive to food, and it has even been classified as a poison in some countries, but when added to GSE, that is exactly what it is being used as; an additive.  Many of the studies found that pure GSE was ineffective as an antimicrobial and the only ones that had antimicrobial effects were commercial GSE samples that were found to have pretty high levels of benzethonium chloride.  Yikes.

What’s the bottom line?

Basically, I really do hate to break the hype, but I don’t buy it that GSE is as strong an antimicrobial as people think, without the additives.  Benzethonium chloride has never been approved as safe for oral ingestion, and I really do not think it is safe to ingest an additive that has been only approved for topical treatment and for commercial cleaning products.  The choice is up to you, but the true side effects of ingesting benzethonium chloride is unknown, and taking unregulated supplements run the risk of making you sick, or interacting with other medications. So you do what you feel is best for your health, but please disclose these supplements to your HCP so they can assess you and make sure there are no ill effects on your long-term health.

Yours in Good Health

B

Unfortunately bug bites (and the ones I am referring to are from mosquitos) are a part of the warm weather.  GOod times, sun, warmth, and the dreaded mosquito bites that come along with it!  When Mosquitos bite you, they are looking to feed off of your blood, and the way they do that is by injecting an anticoagulant to thin the blood at the site to make it easier for them to suck into their little straw like mouths.  That anticoagulation that they inject tends to cause the redness, bumps, and itchiness that we all know and dread.  But the good news is that there are plenty of at home remedies to take the itch out those bites right at home.

What are some at home remedies?

-As with anything where a reaction had occurred, antihistamines (such as oral Benadryl or Benadryl gel topically) can help to decrease the allergic reaction response, thus squelch the itch.

-Cold, damp green tea bags can help to  decrease the itch by being cold, and the green tea leaves can help decrease inflammation.

-Oatmeal baths can help to decrease the inflammation and soothe the skin if you get multiple bites.

-If you itch and the skin is broken, honey can help to prevent infection, if you put a drop over the site, the antibacterial effects can help to stave off any lurking bacteria from entering the broken skin.

-Cold fresh Aloe gel can help to both decrease inflammation (due to the aloe) and decrease the itch (because it’s cold)

-Preparation H can help prevent inflammation of the bug bite (or if you have bags under your eyes!)

-Hydrocortisone cream can help to decrease inflammation and relieve the itch due to ceasing the immune response.

-Applying Tea Tree Oil can help to prevent infection and decrease inflammation in the affected area.

-Rubbing basil on a bug bite can decrease inflammation and decrease the itch, and it can also ward off further bug bites….you might want to coat yourself in basil essence to prevent bug bites in the first place!

-Menthol/mint can decrease the inflammation, and help with the itch.

Are there any other risks from bug bites?

Aside from causing bumps and itchiness, you can contract the West Nile virus, which is a virus that can be without symptoms or cause severe full body symptoms, Malaria, which again can be without symptoms and then start causing issues months later and cause severe illness, and Anaphylaxis a life threatening allergic reaction, to which you must call 911 immediately.

Usually, it is just an irritating bite that we can sure with some remedies in our kitchen or bathroom cabinets, but they can also spread viruses that can cause longer term problems.  Also try not to scratch those pesky bites, if you open the skin, there is a much higher risk of a skin infection….one trick since so many people scratch in their sleep, cover the bites with tape or band aids so that you can’t rip them open!!  If you do open up a bite, just watch for signs of infection (redness, swelling, pain, heat) if you have any of these symptoms, go to see your HCP and/or try an over the counter antibacterial (like bactine or neosporin).  But if it is severe, spreading, or you have fevers or any other generalized symptoms, see your HCP ASAP.

Yours in Good Health

B

There are plenty of times when you don’t feel well, have swollen lymph nodes that may come and go, symptoms that are here and there, but nothing that would send you running to see your HCP.  But it could be a little something more lurking, sarcoidosis.

What is Sarcoidosis?

Sarcoidosis is basically an abnormal immune response, for an unknown reason, that causes clumps of inflammatory cells throughout your body, known as granulomas.  They are usually found in the lungs, eyes, lymph nodes, and skin but can be found in almost any organ in the body. Sometimes the symptoms come and go, sometimes they last a lifetime, and the source (or the cause) is truly unknown!

What are the Symptoms?

Unfortunately the symptoms can vary from person to person due to how long you have been affected by the disease and what organs are mainly affected.  In general, people can have unexplained fever, weight loss, swollen lymph nodes, and exhaustion, which are all pretty bland symptoms, especially if they come and go.  When the skin is affected, you might see rashes, color changes of the skin (come and go), growths under the skin (bumps may come and go, resurface especially around scars or tattoos), and lesions (can occur on the skin of your ears, nose, etc).  Again these symptoms can leave just as quickly as they come, so by the time you get ready to go to see your HCP, the symptoms have disappeared!  If your lungs are affected, you can have wheezing, dry cough, shortness of breath, and possible chest pain when taking deep breaths.  If your eyes are the source of the inflammation, you are likely to have blurred vision, eye pain, and light sensitivity.  Based  on these symptoms, you can see how it would be easy for these symptoms to mask another disease, i.e. a cough and wheezing with a fever might be bronchitis, or light sensitivity with fatigue could be a migraine.  If you persistently seem to have these symptoms you should talk to your HCP, especially if your prescribed treatment isn’t helping at all and the symptoms still come and go.

Are there any Risk Factors?

Well, women between the ages of 20 to 40 appear to me the highest sex/age group at risk, and black Americans tend to have higher rates of sarcoidosis, and worse cases than white Americans.  Although overall, Northern European heritage (like Scandinavians) tend to have the highest rates of sarcoidosis, the Japanese tend to have more complications with eye and cardiac disease related to sarcoidosis.  And really the highest risk factor?  Family history, much like anything else, if someone in your family has sarcoidosis, you are at a much higher risk.

What are long-term risks?

The chronic inflammation in your lungs can cause long-term damage and chronic lung disease, making breathing very difficult later in life, and with the inflammation in your eyes, you can have blindness.  If the disease goes into your kidneys, you can have trouble with the filtering mechanism and go into renal failure, due to this chronic inflammation.  If the granulomas (the areas of inflammation) are found in your heart or your central nervous system (like your pineal cord or nerve pathways) it can be bad; in your heart it can interfere with the electrical pathways causing abnormal heart rates/rhythms and int he nerves it can cause paralysis, tingling, or decreased motor strength.  And for both men and women, if it occurs in the testes or uterus, it can cause infertility or decreased fertility, for women, the issue can become worse after birth (if they are able to conceive once).

How is sarcoidosis Diagnosed?

It is usually diagnosed based on your history, physical exam, along with a Chest X-Ray or CT scan (based on where the areas affected are assumed to be), by finding enlarged lymph nodes or other evidence of granulomas.  Your HCP will draw labs to see if you have an active infection, how your immune system is acting currently, and also how your kidneys and liver are functioning, just to get a baseline.  If your lungs are a complaint, you may be sent to have PFT’s (pulmonary function tests) where your lungs are assess for how well you breathe, lung volumes of air, and if your breathing gets better or worse with medicated treatments.  And finally, you will most likely have a biopsy taken (a small sample of cells removed) to look at under the microscope to assess for granulomas or evidence of sarcoidosis.

What is the Treatment?

Steroids are frequently used as the help to suppress the immune system and decrease inflammation quite quickly, although if they do not work, or you do not see optimal results, your HCP may add and anti-rejection medication that also will significantly suppress the immune system.  These drugs work by stopping your bodies immune response, of course that means you are at higher risk for infections from everyday bacteria and viruses you run into because your immune system is being squelched. Steroids can cause gastric irritation and bleeding, along with mood swings, weight gain, and insomnia while anti rejection medications can increase your risk for infection but also some are linked to an increase risk of certain types of cancers. Anti-Malarial drugs can be used for the treatment of skin and nervous system based sarcoidosis, but they can have some serious long-term effects on your vision, so you need to be careful and have eye exams performed regularly.  TNF-alpha (tumor necrosis factor) inhibitors are used to treat rheumatoid arthritis primarily but a few studies have shown benefits in the treatment of sarcoidosis, again there are risks such as lymphomas from the use of this drug.  If your organs are so severely damaged, like your kidneys from chronic inflammation, one last treatment would be an organ transplant, in which you would be on steroids and anti-rejection medications for life to decrease your immune system.

Bottom Line: 

There is no treatment to cure sarcoidosis, and we have no idea what causes it or why it occurs differently in different people.  The important thing is to know the symptoms, and if you have had symptoms on and off with no long-term relief of symptoms, talk to your HCP about sarcoidosis, and your risks.  It is worth the work up I you can get earlier treatment and prevent long-term damage to your organs, right? Knowledge is power, especially in healthcare!

Yours in Good Health

B

Hiking, camping, going to excluded beaches, and enjoying the amazing sunny weather unfortunately also leads to a lot of unfortunate exposures to plants that can be irritants and cause rashes, just like Poison Ivy, Poison Sumac, and Poison Oak. What are the symptoms of the rashes?  The at home treatments and when to go see a Healthcare Practitioner (HCP).

What is a Poison Ivy, Sumac, and Oak reaction?

Poison Ivy, Sumac, and Oak all have an oil on their leaves that causes a contact dermatitis for most people. The reaction usually occurs where the oil, urushiol, from leaves directly comes in contact with the skin.  The reaction can spread though, if you do not know that you have been in contact with the plants, with your hand, then rub your face, for example, the rash may spread, until you wash your hands and wash the oils off.  And, the good news is that the rashes are usually pretty self-limiting, and pending a few specific circumstances, you can treat with home remedies and are better before you know it!  There are a couple of circumstances in which you will want to see a Healthcare Practitioner (HCP)….but no need to rush to the Emergency Department, so your wallet can breathe a sigh of relief.

What are the symptoms?

These rashes are generally red and itchy, but they can also be swollen and blister as well. The reaction can take 12 to 48 hours to occur, and can last up to a total of 8 weeks until it completely clears up, but it usually goes away within 2 to 4 weeks.  It all depends on how much of that urushiol oil your skin is exposed to, the more oils, the longer you will have the rash, unfortunately.  And, as I said earlier, there are a few reasons why you would want to see an HCP:

-If the reaction is severe and covers a good percentage of your body

-If the rash is IN your eyes or in/around your genitals (watch out when using leaves to wipe when you camp!)

-If the blisters start oozing pus or appear to be infected, and are not showing signs of improvement in a couple of weeks.

-If you get a fever of 100.4F or higher, and generally don’t feel well.

What is the treatment?

Usually the “treatments” are methods to prevent discomfort from the reaction. You can always take an antihistamine, such as Benadryl, which can help to decrease the reaction and help with the swelling and itching.  Oatmeal baths can help to soothe the skin, and decrease the itchiness.  Benadryl Gel or Calamine lotions are sold over the counter at pharmacies and help with the itchiness of the rashes.  If you have blistering, cold compresses can help to soothe the skin.  If you have a widespread rash, and it is severe, your HCP may prescribe prednisone, a steroid, which can help reduce swelling and itching. Also there is a plant called Jewelweed that the Native Americans used as a treatment for poison ivy rashes, a large study found that it was ineffective in helping diminish the rashes BUT a large study in the 1970’s found that 5% Bovine Cartilage Cream is very effective in treating the rashes when applied daily.

How can you prevent it?

Know what the plants look like and stay away!

Poison Oak 

Poison Sumac

Poison Ivy

Also, a study found that if you spray your clothes and skin with spray deodorant that contains aluminum cholorohydrate, it can prevent the urushiol from getting onto your skin and causing a reaction.  It’s like a clear skin barrier!  But always make sure to wash your hands and clothes if you suspect that you have been exposed!

So, obviously prevention is key, but if you are exposed, get that calamine lotion (which is chalky and white) or the clear Benadryl gel to help with the itchiness, take those oatmeal baths, and try not to itch!!

Yours in Good Health

B

There have been multiple new stories and articles about the popular hair loss treatment medication, Propecia, has been reported to cause sexual dysfunction, to which it is not reversible.  Yikes!  But, is that really true?  Does this drug that have a few different medical uses cause this irreversible sexual dysfunction?  I want to make sure that people understand the uses of the drug, the side effects, and long-term effects.

What is Propecia used for?

Most people know about Propecia as a treatment for male pattern hair loss; a gradual thinning of the hair over the scalp leading to a receding hairline and/or balding at the top of the head.  It has never been shown as effective with other hair loss, such as around temples, but it has been very effective with male pattern hair loss.  It is also used for the treatment of BPH (Benign Prostatic Hypertrophy); a swelling/inflammation of the prostate gland that occurs naturally with age in some men.  It can help to treat BPH and prevent surgery from being necessary as well as treat the symptoms of BPH, such as frequent urination (due to inability to fully empty the bladder), and acute urinary retention (the sudden inability to urinate at all.)  The way the drug works in BPH is that it blocks the body’s production of testosterone.  And in male pattern hair loss, the drug prevents the body’s production of testosterone in the scalp, which stops hair loss.  Propecia actually reverses the effects of testosterone, by stopping it, at the source of the issue.

What are the side effects?

First, women who are pregnant (or intending to be pregnant) should not be around this drug at all, even touching the pill with a bare hand can cause pretty significant birth defects in a maturing fetus, especially causing problems if it is male. So that ‘s more of a warning, than side effect, but something people really ned to be aware of because of the devastation that could occur. Otherwise, there are side effects as in an allergic reaction, like: swelling, rashes, hives, itching, difficultly breathing or swallowing, which need immediate medical attention because you are reacting to the drug and we would need to reverse the effects.  If you notice that you have breast swelling, tenderness, or nipple discharge,this can also be a serious side effect and you ned to see your HCP (health care practitioner) as soon as you can.  Due to the effects of blocking/decreasing testosterone, it may also cause a decrease in sexual desire, pain in the testicles, and depression.  The company does warn that it may cause difficulty obtaining and maintaining an erection as well as difficulty ejaculating, but that was mandated by the FDA after all of these alleged incidences of sexual dysfunction with the drug.

What does the research show?

The study that all of the news shows were talking about and referring to, is a study from George Washington University.  Now, I am not at all saying that the study is without merit, but there are some significant limitations, such as they only studied 54 men, and they considered side effects with sexual dysfunction, greater than 3 months; the way the news spins it, it makes it seem as if you have sexual dysfunction for life (that was found in one rat study in rats that took a similar drug in extremely high doses).  Also, it was reported that the men, prior to taking Propecia, had no sexual dysfunction, psychological disorders (i.e. depression, etc) but the men for the study were recruited through a website called propeciahelp.com, thus they clearly were having some side effects front he medication (that they noticed) and were looking for help/research on the topic.  Obviously, you don’t just want to start someone on a medication to see what it does to them, but that would be the only clear answer here: did these men have some sort of sexual dysfunction and/or depression due to the fact that they were having male pattern hair loss and now taking a medication to treat it OR is the drug causing that reaction?  With this study we will not know.  Even the conclusion for the study is very weak saying that they are unsure if there is a link but people should be aware that there may be a n increased risk of sexual dysfunction with this drug; that is NOT a strong statement, and not one that everyone should freak out and stop taking Propecia, especially if it works for you and you don’t have side effects.

What does this mean for me?

Well, there are risks and side effects with every drug, the sexual dysfunction with Propecia is a risk, but I don’t think it is as big of a risk as everyone is making it seem.  It is worth the discussion with your HCP if you are about to start taking Propecia to treat your hair loss, there may be other options for you, especially if you have a current history of sexual dysfunction. As we know, sexual dysfunction can be caused by many different factors, but obviously a medication that stops testosterone production will have some effect on your masculine health, but you need to weigh the risks vs. benefits.  Some people may have improved sexual function because they feel better about themselves once they have that luscious, full head of hair!

Bottom line: talk to your HCP and it is not a medication that you should jump into taking without a conversation and some thought.  There will be further studies at this point, so we should stay tuned, but I would not stop a medication that is working for you, especially if you have no/few side effects.

Yours in Good Health

B