October 14th, 2010
Yesterday, TV personality Glenn Beck reported on his radio show that his doctors “believe” that he has Small Fiber Neuropathy. Since then, I have received many requests to explain what this means:
Small Fiber Neuropathy is an impairment of small nerve fibers that affect the skin and the involuntary muscles. Patients usually experience pain, burning, tingling, and numbness (sensory symptoms) but they can also experience dry eyes, dry mouth, orthostatic dizziness, constipation, bladder incontinence, sexual dysfunction, trouble sweating, or red or white skin discoloration (autonomic nervous system symptoms). Symptoms usually starts in the feet, slowly go up the legs, and then move into the hands.
So what causes Small Fiber Neuropathy? The condition can occur as a result of diabetes, autoimmune diseases (eg. Lupus), thyroid problems, vitamin B12 deficiency, paraproteinemia (eg. amyloid), AIDS, hepatitis C, celiac disease, restless legs syndrome, neurotoxic drug exposure, rare hereditary diseases (Fabry disease, Tangier disease, hereditary sensory autonomic neuropathy, and hereditary amyloidosis) and cancer.
Oftentimes, physical examination and tests, such as Nerve Conduction Studies and Electromyograms, are normal or show mild loss of sensation, so Small Fiber Neuropathy is diagnosed by skin biopsy to evaluate the density of nerve fibers in the skin. Most patients with small fiber neuropathy experience a slowly progressive course, with symptoms and signs spreading to the center of the body over time. Most of these patients will also require chronic pain management.
Treatment of small fiber neuropathy should target the underlying cause and neuropathic pain. Cause-specific treatment is key in preventing or slowing the progression of the disease. First-line choices of pain medications are the anticonvulsants gabapentin (Neurontin) and pregabalin (Lyrica), the tricyclic antidepressants amitriptyline (Elavil) and nortriptyline (Aventyl), a 5% lidocaine patch (Lidoderm), and the semisynthetic opioid analgesic tramadol (Ultram). These can be used alone or in combination, at the direction of your doctor.
If you suffer from the symptoms listed above, and your doctor has been unable to find a cause, ask if they’ve tested you for Small Fiber Neuropathy.
Tags: AIDS, autoimmune disease, burning, cancer, celiac disease, conditions, diabetes, Glenn Beck, hepatitis C, hereditary disease, nerve disorders, neurotoxins, numbness, restless leg syndrome, thyroid, tingling, treatment, vitamin B12
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June 25th, 2010
Vitamin D is a hot topic lately, with a slew of news articles touting the benefits of this nutrient — and the dangers of being Vitamin-D deficient. Many are turning to supplements for themselves, and even their children, but be careful if giving your infant vitamin D drops.
The FDA is warning parents and caregivers of infants that some liquid vitamin D supplement products sold with droppers could allow excessive doses to be given to babies, which could be harmful. Talk to your doctor before giving any kind of supplement to your infant, and be sure you know the safe dosage and how best to administer the liquid to your baby.
(FDA, 6/15/10)
Tags: family health, FDA, infants, pediatric health, supplements, vitamin D, vitamins
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June 17th, 2010
If you suffer from a loss of bone density after menopause, there may be a new treatment option available to you. The Food and Drug Administration has approved Amgen’s Prolia, to increase bone mass and strength in postmenopausal women at risk for fractures. This drug is given by injection once every six months, with each injection costing around $825.
Common side effects of the drug included back pain, high cholesterol and urinary bladder infections.
If you suffer from post-menopausal osteoporosis, you may want to talk to your doctor about whether Prolia, or other treatment options, are right for you.
(FDA, 6/1/10)
Tags: breaking news, menopause, new treatments, osteoporosis, women's health
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June 9th, 2010
If you supplement your workout routine with protein shakes, you may want to think twice about how many you consume on a regular basis. A recent investigation published in Consumer Reports studied 15 different protein powders and drinks, and found that they can increase the risk of toxic heavy metal poisoning if consumed too frequently. The heavy metals in question include arsenic, cadmium, mercury, and lead.
The drinks causing the most concern are EAS Myoplex Original Rich Dark Chocolate Shake, and two Muscle Milk powders – Vanilla Crème and Chocolate. It may take less than you think to reach your safe daily limit with these products. It takes only three servings of the Muscle Milk powders a day to put you over the limit – and remember that’s servings according to the packaging, not simply the number of whole glasses you may consume. Be sure to check the labels and count “servings,” not glasses, when you consider how much of these protein shakes to consume.
Tags: arsenic, cadmium, fitness, health risks, lead, mercury, protein drinks, toxic metals
Posted in Uncategorized | 160 Comments »
June 3rd, 2010
Summer is here, and with the longer days can often come a rise in evening barbeques and bonfires, but don’t let late summer nights rob you of too much sleep – you could pay for it in the long run.
It’s not surprise that those who regularly enjoy a good night’s sleep also enjoy overall better health and longevity. What may come as a surprise, though, is that people who get less than six hours of sleep per night actually have an increased risk of dying prematurely. Even more surprisingly – too much rest can be a detriment as well. Sleeping more than nine hours per night has also been linked to premature death.
So what does this mean for you? Aim to catch seven to eight hours of sleep each night – no more, no less – to optimize your health.
Source: (Sleep, 5/10)
Tags: sleep
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May 25th, 2010
Did you ever think your habits could cut 12 years off your life? A recent study reported in the Archives of Internal Medicine identified four common bad habits that when combined can do just that. The risky behaviors included: smoking tobacco; downing more than three alcoholic drinks per day for men and more than two daily for women; getting less than two hours of physical activity per week; and eating fruits and vegetables fewer than three times daily. If you’re guilty of any of these these bad habits, you may want to consider screening to prevent the most common causes of death, such as heart attack, cancer and stroke.
And, of course, it should go without saying that you should try to eliminate these bad habits from your lifestyle. Remember, before beginning a new exercise program you should first talk to your physician, to discover any health problems that may be aggravated by a workout routine. While you’re there, talk to your doctor about a plan to quit smoking as well.
(Archives of Internal Medicine, 4/26/10)
Tags: cancer, exercise, heart attack, lifestyle, smoking, stroke
Posted in Uncategorized | 51 Comments »
May 19th, 2010
Lately, it seems like you can’t open a medical journal or browse the health section of the newspaper without seeing some mention of vitamin D – and for good reason. Vitamin D has been shown to benefit health in a number of ways, from maintaining healthy bones to optimizing immune system function, lowering the risk of developing multiple sclerosis to maintaining ideal body weight. It not only reduces the severity and frequency of asthma symptoms, but also lowers the risk of developing cancer, heart disease and stroke. It is especially important for women, reducing their risk of developing rheumatoid arthritis, and their risk of pregnancy complications.
It has been shown to help the brain work better later in life, and in a recent study, older adults with higher vitamin D also demonstrated improved mobility (Experimental Biology 2010 Meeting). It even helps protect us from low levels of radiation.
You’d think with all these benefits, we’d be falling over ourselves to get as much exposure as possible, but that is not the case. Unfortunately, many of us don’t get adequate vitamin D, largely for one reason: its source. Vitamin D is created in the body by exposure to sunlight, something we’ve been warned against getting too much of, lest we end up developing skin cancer.
Fortunately, there is a safe amount of sun exposure, that will still help you increase your vitamin D intake. Most adults can safely tolerate ten to fifteen minutes of unprotected sun exposure per day without suffering any ill effects. I recommend adding a quick walk outside to your lunch routine, if you can spare the time. A little fresh air, exercise, and sunlight can help recharge your mental batteries for the afternoon ahead, as well as help you soak up that vitamin D.
I recommend all adults have their physician check their vitamin D level and aim for a total level at least greater than 30 ng/ml. Recent evidence indicates there may even be circulatory benefits up to a total level of 43 ng/ml.
If brief sun exposure doesn’t seem to be helping, Vitamin D supplements can also be beneficial, if needed. However, these supplement should only be used with the assistance of your physician to avoid toxicity, especially if you want to exceed 2000 IUs per day.
From time to time, you may need an additional boost. Even after taking supplements and getting 10-15 minutes of unprotected sunlight each day, many of my patients are unable to get their levels of vitamin D up. My suggestion: always take your vitamin D supplement with the largest meal of the day, which may boost its absorption by 50%. Why the uptick of absorption at mealtime? Vitamin D is fat soluble, which means the body accepts it more readily when food is present to aid absorption. (Journal of Bone and Mineral Research, 4/10)
Tags: diet, seniors, sun exposure, supplements, vitamin D, vitamins, women's health
Posted in Uncategorized | 185 Comments »
May 15th, 2010
On my show this weekend, I received a question from a caller about potential health problems that can be caused by consuming a vegetarian or vegan diet.
This article from MedicineNet.com gives a good overview of potential health problems from consuming a vegetarian or vegan diet. It also provides a quick list of vegan sources for the nutrients you must be sure to replace in your diet when you stop consuming animal-derived foods.
Tags: vegan diet, vegetarian diet
Posted in Uncategorized | 24 Comments »
May 12th, 2010
Please check your medicine cabinets and get rid of all liquid medicines for children and infants made by McNeil Consumer Healthcare including liquid Tylenol, Motrin, Benadryl and Zyrtec. Bacterial contamination was identified by the FDA in ingredients used to make the liquid cold and allergy products. The company has closed its plant in Fort Washington, Pa., where the contaminated products were made, and cannot reopen without FDA approval. In the meantime, turn to the generic versions of these medications. The recall does not include non-branded versions of these same products, and the generics are often just as effective as the name brand medications.
A full list of the over 40 affected products is available at http://www.mcneilproductrecall.com.
Posted in Uncategorized | 61 Comments »
May 4th, 2010
I have some good news for anyone who suffers from severe asthma that has been resistant to conventional drug treatment.
The FDA has approved the first non-drug, device-based treatment for adults with severe asthma whose medications aren’t providing enough relief. The device, called an Alair Bronchial Thermoplasty System, uses a catheter with a tip that delivers a form of thermal energy to the airways. The catheter delivers radiofrequency energy, heating lung tissue and reducing the thickness of smooth muscle, which improves the asthmatic’s ability to breathe.
Please spread the word to anyone you know who could be helped by this. Not being able to breathe can be an incredibly frightening experience. Hopefully this new therapy will help prevent that experience for many asthmatics.
Tags: asthma, breaking news, FDA, new treatments
Posted in Uncategorized | 116 Comments »
