Best Supplements: What to Take and What to Trash

Approximately 80% of Americans take over the counter supplements, buy they not be taking the best supplements.   I recommend calcium, vitamin D3, omega 3 fatty acids and a multivitamin to many of my patients and as a mother, caregiver and health care advocate, I am obligated to check on the quality of products. I subscribe to Consumer labs, www.consumerlabs.com, and for a reasonable fee,    they provide lists of products that they have tested for quality. Consistently, 30% of supplements are “not approved” for one of three reasons:

1) Less of the ingredient than claimed
2) Too much of the ingredient (above recommended limit)
3) Contaminated due to poor manufacturing practices or lack of quality controls during production

Third party testing has found lead in calcium, mercury in fish oil, chalk fillers and “bed pan” vitamins. The later name came from the nurses who knew which brands did not stand a chance of being digested.

We are often told that our supplements should not contain fillers, binders or artificial colors. A pharmacist friend told me fillers and binders come under the names rice flour, xanthum gum, corn starch, lactose and other sugars. Coatings and artificial colors may include acrylic resin, (yuck like the nails?), titanium dioxide, and iron oxides.

A do it at home test for bed pan vitamins: get a glass of warm water and add a little vinegar. Drop in your vitamin and if it does not dissolve in 15-30 minutes take it to the trash.

The other source that I use is Nutrisearch Comparative Guide to Nutritional Supplements written for health care providers, www.nutrisearch.ca. Warning, this is not an easy read for most. Of course, the limitation to all third-party testing is the number of supplements on the market because they cannot all be tested.

If you have a great resource please share the information with me. This week I am inviting you to clean out your pantry and send me the brand and names of your supplements! I will do your research and let you know what to take and what to trash.

be well,
Caroline Abruzese Read the rest of this entry »

Insulin Resistance; What is Diabetes Mellitus?

As a primary care physician I often get questions about insulin resistance; what is diabetes? I’m a doctor devoted to health, wellness and prevention and have noticed and increase in the frequency of  insulin resistance in the American population.  If you have ever wondered about insulin resistance; what is diabetes mellitus? what is insulin resistance?  or asked why you”can’t lose weight”? or  do not know the difference between insulin resistance, metabolic syndrome pre diabetes and diabetes mellitus, then this article is for you.

Insulin resistance=metabolic syndrome= pre diabetes; these are all names for the same condition.  Whatever you choose to call it, this condition makes it makes weight loss difficult, promotes weight gain and will eventually lead to diabetes mellitus.  Diabetes mellitus, more commonly known as diabetes, has two forms.  Type I diabetes mellitus is usually diagnosed in childhood and requires insulin injections because the pancreas doe not produce enough insulin. Type II diabetes mellitus is a condition where the pancreas produces insulin normally, but the body is resistant to insulin.  Glucose (sugar) levels are normal or mildly raised and insulin levels are higher than in non diabetics.  This form is also known as adult onset diabetes.   In the first type insulin levels are low in the second type the body does not respond to the insulin present.  The rest of this article will be about diabetes mellitus type II because is becoming an overwhelming health problem in our society and it is preventable!  For clarity, let me say that again in almost all cases,….Diabetes Mellitus Type II Is Preventable!

The good news is…..it can be reversed!   Insulin resistance is the condition begins before diabetes and be reversed.  Approximately 1/3 of American adults and children will develop this in the next decade.   Insulin resistance is an inflammatory state associated with an increased risk of heart disease, stroke, cancer, diabetes and obesity.  Now consider all the health problems related to heart disease, stroke, cancer, diabetes and obesity and you will realize the likelihood of developing many other medical conditions and maladies that will impair health and function and cause a lot of suffering.

Insulin Resistance=3 or more of the following 5 criteria

 1.  Waist Circumference female>35 inches or for  males>40 inches

2. Triglycerides>150 or on medication to lower triglycerides

3.  HDL<40 or on medication to increase  HDL

4.  BP=130/85 or taking medication for high blood pressure

5.  Glucose>100

Why Does Insulin Resistance Occur?   How Does Diabetes Mellitus II (aka diabetes) Develop?

If 1/3 of  American children and adults will become insulin resistant and many will then develop diabetes over the next decade do to our eating habits and sedentary lifestyles.  Lifestyle choices cause 70% of adult illnesses and diabetes II is no exception.   A genetics contributes to the risk of developing insulin resistance, but that only make developing diabetes possible…choices determine the outcome.

Consider this cycle….we eat too many carbohydrates, don’t do much activity and gain some weight, hormonal changes occur insulin resistance is a hormonal abnormality.  The body becomes resistant to  insulin.  Insulin is a hormone produced and released into the blood stream after a meal.  Carbohydrates are sugar molecules linked together.  When the blood sugar increases the pancreas and releases insulin  into the blood stream.  When the cells are resistant to insulin, the pancreas must continue to release insulin to lower blood glucose levels.

What does the extra insulin do?  

As mentioned, this extra insulin helps to get the blood glucose to normal when insulin resistance is present, but it is also the cause of metabolic syndrome.  Insulin decreases sugar levels, in part, by promoting fat storage. The more fat storage that occurs, the more the insulin resistant cells become.  In summary, weight gain (or difficulty losing weight) leads to more fat storage and more insulin resistance.  This cycle continues and causes diabetes mellitus type II.

Weight Gain & Artifial Sweeteners

How can a zero calorie soft drink cause weight gain? Isn’t Equal, Truvia, Splenda, Sweet n Low, etc supposed to help us stay thin? Won’t fewer calories result in weight loss?

The answer is “NO”, not if your body is preparing for calories that do not arrive. Has your mouth ever “watered” with the smell of food? If not, google “Pavlov’s dogs” and you will learn that the digestive process begins in the mouth. Enzymes in our saliva break down food in response to vision, smell and taste. Taste buds detect sweet and alert other parts of the digestive system; “INCOMING” or “SUGAR”! The release of insulin lowers sugar levels and this hormone also promotes fat storage. What happens when the insulin is elevated, but there is no increase in glucose?

Zero calorie, artificial sweeteners have no glucose so the release of insulin causes low glucose or hypoglycemia. Symptoms such as fatigue, irritability and carbohydrate cravings ensue. Glucose is fuel for the brain and the body interprets hypoglycemia as a threat to survival. In response to the threat an “eat out of the ice cream container” or “whole bag of chips” type of hunger begins to ensure that the real calories arrive. After the brain uses the glucose that it needs, the rest goes into storage. The next time you reach for the pink packet, consider that this “storage facility” is your abdomen, hips or thighs!

I truly appreciate the feedback! thanks and be well,
Caroline MD

7 Sunblock Tips Avoid Skin Cancer

In the Spring I plant my garden, buy new crocks for the kids and throw out last year’s sunblock. I commit myself to some light reading, namely environmental working group’s 1700 sunblock product review, to learn about all the chemicals that I do not want touching my children, patients or self. 7 sunblock tips avoid skin cancer and sunblock to avoid due to the chemicals they contain or lack of efficacy. As per the Environmental Working Group, EWG, in 2012:

“A quarter of this year’s products still contain vitamin A ingredients that accelerate the growth   of skin tumors and lesions on sun-exposed skin, according to recent government studies. Also,  56 of the products we reviewed had no active ingredients that protect against the sun’s damaging UVA rays. And the industry continues to load store shelves with sunscreens that claim misleading, sky-high SPF ratings that may protect against sunburn-causing UVB rays but leave skin vulnerable to UVA.”

Follow these tips:

1) Pick block with both UVA and UVB protection: damaging sun rays can lead to skin cancer, skin related disorders, and yes…wrinkles.

2) Block does not block all rays: Shade or protective clothing is good.

3) Need a gorgeous tan? Try a chemical free bronzer or spray tan. Warning, this requires a 2nd trip to the EWG website.

4) Reapply, reapply, reapply; nothing lasts forever.

5) Choose a block with zinc oxide or titanium dioxide, EWG lists it as the safest active ingredient.

6) Avoid sunscreens with vitamin A aka retinyl palmitate or retinol. This ingredient combined with the sun may actually be cancer promoting to the skin.

7) I use makeup or moisturizers with UVA and UVB on my face; many brands such as Physician’s Formula or Revlon have base powder and liquid foundations at drugstore prices.

To see EWGs top rated Sun Blocks go to http://bit.ly/KxFr6X.  They also have a free iphone, ipad or itouch app called EWG Sunscreen Guide.

Be Well,.
CarolineMD

Commentary: Patient & Physician Disconnect

A former presidential speech writer said of all there is to fear, a politician disconnecting from people topped the list. I have a similar fear for primary care doctoring. We want doctors who will listen to us, provide explanations, answer questions, advocate for us and serve as our quarterback to ensure continuity of care. We want time, more than the average 6 minutes per patient. We demand this from other professionals so why not the person who safeguards our health? The cost of health care and insurance is high and yet, when it comes to our PCP, we don’t feel we are getting value, the type of care we want or need.

Primary care doctors are exasperated, wanting to get off of the treadmill of having to see 25 plus patient a day because the first 15-20 just cover the overhead. They are running to hospitals to become employed and fear that private practice is no longer an economically viable option. Not wanting to use patient time addressing “non clinical issues” or engaging in “politics”, there is very little dialogue as to why or how we can make changes. Worst of all, there is a pervasive feeling of helplessness among those charged with helping who feel that they cannot change the system, the insurance companies or the government.

What are the causes? What are the solutions?

How to Save $ on Over the Counter Medication

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What You Need to Know if You Have Diabetes: HbAlC

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Why Do We Get Fatigued?

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Mother’s Day Week

I honor of my mother and yours I will be choosing topics this week that relate to mom.  Topics will be include Health Tips for Mom, Fatigue, and How to Save $ on Over the Counter Medication.

be well,  CarolineMD

cholesterol panel; the good and the bad

cholesterol; the good and the bad

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