Thursday, August 12th, 2010
A recent study calls into question the wisdom of taking calcium supplements. What exactly did this study show and should you take calcium supplements?
The study was published in the British Medical Journal (Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis.Bolland MJ – BMJ – 01-JAN-2010; 341: c3691). This type of study is called a “meta-analysis” which means that rather than setting up an experiment in which they gave half of the participants calcium and the other half placebo, they instead reviewed OTHER studies previously done and reported on any correlations they found.
They looked only at trials that had been randomized placebo-controlled trials (the best kind of experiment) wherein the participants had a mean age of at least 40 years and took at least 500 mg of calcium daily.
One part of the analysis showed that 143 people who took supplemental calcium had a myocardial infarction (heart attack) while 111 people who did NOT take supplemental calcium had a myocardial infarction. The conclusion was that taking calcium supplements (without Vitamin D in this case) increased one’s risk of myocardial infarction.
Taking calcium supplements did NOT appear to increase the risk of stroke (lack of blood supply to part of the brain) nor the risk of death.
On the other hand, we do know that adequate calcium is key to preventing osteoplorosis (soft bones) and hence also in preventing broken bones which can be deadly in older folks (such as broken hips or compression fractures in the spine).
So what do we do? I think that the final word is still out on this topic. An earlier study in New Zealand seemed to indicate that calcium in one’s diet did NOT increase the risk of heart disease whereas calcium in the form of supplements DID tend to be riskier. At present I am recommending that people get adequate amounts of calcium in their diet if at all possible. If that is not possible (for example if you can’t take dairy products) then supplements of calcium (with Vit. D) are appropriate UNLESS you have a personal history of heart disease. In that situation I do NOT recommend calcium supplements at present.
I think there will be more information coming out on this, but for now, that’s how I see it!
DTD
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Tuesday, October 13th, 2009
So, why are we all out of influenza vaccine? Well, our particular clinic ordered our usual quantity, but received somewhere less than half of the doses. We keep being told by the supplier that we will receive more eventually. My understanding is that the companies have shifted over to providing the H1N1 vaccine and thus have not made as many of the seasonal flu shots yet.
Even the commercial pharmacies in town, by and large are out of flu shots. Here’s what I recommend: Don’t panic! We’ll get some more in eventually and in general this is a bit early for seasonal influenza based on prior years.
Regarding the H1N1 influenza shot (or nose spray), if you are pregnant or a child ages 2-9, we do recommend the influenza nose spray or the injection when it is available. We have some of the nose spray available for H1N1 right now. The shots are still to come.
If you are over 50 or so, you will not be getting the H1N1 on this first go ’round. After the younger population has received it, than the whole population will be eligible for it if you desire to get it.
I do recommend you receive the regular seasonal flu shot now (all patients) if you can find it.
DTD
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Thursday, August 13th, 2009
I was just at the Health Department yesterday to learn the latest about the H1N1 influenza. Predictions from the state and national groups are that we may have up to 20-40% of the population involved at some point. It likely will come in “waves” of people falling ill. Interestingly, this particular influenza is affecting younger folks (6 months to 24 years old) more than the elderly. It is also affecting pregnant women disproportionately.
The vaccine hopefully will be available in September sometime. You will need 3 different shots this year: 2 for the H1N1 flu, likely separated by 2-4 weeks and one for the “regular” or seasonal flu. We don’t have any vaccines available yet, but when they are available it will be publicized.
The CDC has establish a hierarchy of people who should be vaccinated first with the H1N1 vaccine. These include pregnant women, children between 6 months and 24 years of age and healthcare workers. Then people 24-64 years of age are to be vaccinated. During the “first wave” of vaccinations, it is my understanding that folks over 64 will NOT be vaccinated, because illness in that age group has not been as much of a problem. In addition if one is over 64, you may have immunity to some degree from prior exposure.
For the “regular” seasonal flu vaccine, it IS recommended that everyone get the shot, including those 65 and older.
Things change on a regular basis. You can check the CDC website for further info (http://www.cdc.gov/h1n1flu/general_info.htm)
Till next time,
DTD
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Monday, July 27th, 2009
Thanks for visiting this website! I plan to update this blog at least weekly, if not more often, so please check back frequently. In addition I welcome your feedback and comments, which you can leave below by clicking the appropriate link.
To start, I’d like to share with you a couple of items in the news. First, we have the pandemic influenza (H1N1) which continues to be of concern to epidemiologists and governments alike. In one week alone recently in Britain there were 100,000 new cases! It looks like this may be a significant public health issue this fall as children return to classes in school and people don’t get outdoors as much. The current recommendation from the Health Department is for anyone with flu-like symptoms (achiness, fever, headache, cough) to stay home, away from school and work for at least 7 days. Who should be tested for the flu? Unfortunately, the current nasal swabs available are not reliable for the novel H1N1 influenza. There is a special nasal swab we can do to test you, but it is sent to the state (KDHE) for testing. They are NOT accepting nasal swabs from outpatients; only from people ill enough to be hospitalized.
Who should take the mediation for influenza (Tamiful or Relenza)? The CDC recommends ONLY those who have other serious illnesses be tested or those in whom complications of influenza (pneumonia for example) would be especially difficult. For the vast majority of people, H1N1 appears to not be terribly serious … so far!
Secondly, what do you think about the Obama health plan currently being debated? I’d urge you to check out the bill yourself — that’s right all 1000 pages of it — to see what all it entails. The name of it is HR 3200 which you can Google and read about. Let me know your thoughts! — DTD
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