January, 2013
Two new Alzheimer's treatments offer hope. One is the drug PBT2, which prevents brain metals from driving production of plaques and tangles. The other is Neuro AD, a therapy combining electromagnetic brain stimulation with cognitive training.
People with a 70% blockage in the carotid artery and symptoms such as a mini-stroke may want to have surgery to unblock the artery sooner rather than later. Other options include angioplasty with stent placement and blood-thinning medicines.
Living at 6,000 feet of altitude causes the heart to work more efficiently. It results in more oxygen-carrying red blood cells and less fluid in the blood.
High-tech imaging tests that use computed tomography (CT) scans to determine heart health may play a valuable role in patients who are at intermediate risk. If the imaging test results are abnormal, that can push a person into a high-risk group.
Depression and obesity are linked. Obesity affects parts of the brain that regulate mood. Low energy and low motivation from depression can translate into less activity and exercise. The result may be weight gain.
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) can bring weeks of pain relief without the risks of oral NSAIDs. Topicals are best for people who have occasional joint pain, when other methods of treatment have failed.
Fiber can help reduce risk for cardiovascular disease, diabetes, and obesity. To fit more fiber into the daily diet, experts advise eating whole grains, fruits, and vegetables, and eliminating prepackaged and processed food.
Testosterone therapy is popular but controversial. Treatment makes men feel better. But diagnosing low testosterone is tricky, and doctors debate whether T therapy raises risk for blood clots, heart disease, and prostate cancer.
Prostate cancer screening should not be offered routinely to all men. For some men, the resulting treatment-which can produce side effects-is worse than the disease.
Blepharoplasty removes drooping excess skin and fat around the eye that comes with aging. The surgery is meant to change a person's appearance to create a more youthful look or to improve a person's vision.
Actinic keratoses look minor, but they can progress to skin cancer. Treatment involves freezing, scraping, chemical peels, medicated creams, or photodynamic therapy. Treatment is almost always successful.
Vitamin is necessary for bone health, iron absorption, skin integrity, and immune function. Evidence shows vitamin C doesn't prevent the common cold, but it may help reduce the length of a cold when taken preventively.
Multivitamins may reduce the risk of cancer in men by 8%. The benefits of multivitamin supplements may mirror those found in vitamin-rich fruits and vegetables, which also have been associated with lower cancer rates in previous studies.
A cup of beans or lentils each day, when combined with a low-glycemic diet, may help lower blood sugar levels and coronary artery disease risk in patients with type 2 diabetes. Legumes help dampen blood sugar responses and lower blood pressure.
It appears that colon cancer patients whose tumors have a mutated form of the PIK3CA gene may live longer if they take aspirin. Aspirin may also help fight other kinds of cancers and protect heart health.
The commonly used bone-strengthening drugs called bisphosphonates may provide the same level of benefit for men as they do for women. It appears the drug zoledronic acid (Reclast) significantly reduced spinal fractures in men with osteoporosis.
February, 2013
Can we detect cancer earlier?
Harvard researchers have developed a new way to detect signs of cancer early. They've invented a hand-held device that quickly determines the number of microvesicles-shed by tumors-in a drop of blood.
Ask the doctor: Treatment for high systolic pressure?
When it comes to blood pressure readings, systolic pressure matters more than diastolic pressure, and older people clearly benefit from treatment.
Ask the doctor: Why quit smoking at an older age?
Even if you've smoked for many years, quitting smoking at any age will reduce your risk of the many diseases caused by smoking, and it will lengthen your life.
Reduce your stroke risk
It's important to get obstructive sleep apnea (OSA) diagnosed and under control. A person with untreated OSA has an increased risk of having a stroke, a fatal stroke, and a second stroke compared to those without sleep apnea.
Game changer: An easier way to replace a heart valve
Transcatheter aortic valve replacement (TAVR) is a new procedure for people with aortic stenosis who are unable to have a valve replaced with open-heart surgery. With TAVR, a catheter takes the replacement valve through the leg artery to the heart.
Tomatoes and stroke protection
Tomatoes may help lower your risk of ischemic stroke. Lycopene is a powerful antioxidant that may reduce inflammation and cholesterol, improve immune function, and prevent blood from clotting.
Bad backs: Are you happy with your treatment?
A new tool called a decision aid can help make sure people with a herniated disc understand all aspects of treatment. The tool is a questionnaire with multiple-choice questions. A doctor can then take the results and address any knowledge gaps.
Is hormone therapy safe again?
New guidelines make hormone therapy acceptable for short-term use in healthy women up to age 59 or within 10 years of menopause with marked menopausal symptoms. It's not acceptable for long-term use.
Advances in eye surgery
Ophthalmologists can now perform cataract surgery using lasers instead of scalpels to make incisions. Three-dimensional imaging provides the precise measurements needed for laser use.
Latest Mohs skin cancer surgery guidelines
Dermatologists now have official guidelines for Mohs surgery, a procedure that removes skin cancer while minimizing damage to surrounding healthy tissue. Smaller, more superficial skin growths may not be right for Mohs surgery.
What you should know about: PPIs
Proton-pump inhibitors (PPIs) are drugs that are often prescribed for people who suffer from chronic heartburn or another digestive disorder. They are available over the counter and by prescription. They work by reducing the production of stomach acid.
News briefs: Exercise can add years to your life
People who engage in leisure-time physical activity can extend their lives by as much as four years, compared with similar-weight people who do no such activity. Being active and also maintaining a healthy weight boosts longevity by more than seven years.
News briefs: Combination therapy may be better for one common lung cancer
For people with non-small cell lung cancer that carries a mutation in the gene KRAS, a combination of the drug selumetinib and the chemotherapy drug docetaxel may be more effective than chemotherapy alone.
News briefs: Chronic kidney disease raises the risk of death regardless of age
Chronic kidney disease (CKD) is associated with a higher risk of death at any age. Preventing CKD or at least slowing its progress is not only possible but should be a priority for everybody.
March, 2013
Fighting back against allergy season
Allergy seasons are worsening, possibly because of climate change. Fighting back against allergy symptoms involves medications and other strategies, such as starting a nasal steroid spray weeks before the spring and wearing a mask for outdoor yard duties.
Ask the doctor: Understanding the value of multivitamins
While foods rich in vitamins are indisputably good for health, vitamin pills do not provide benefits to everyone. Some exceptions are pregnant women who need folic acid, older adults who need vitamin D, and people with certain physical conditions.
Ask the doctor: Prediabetes: signaling a need for lifestyle change
People with a fasting blood glucose level of 100 to 125 mg/dL have a condition called prediabetes. They are at risk for type 2 diabetes. The risk can be reduced with regular moderate exercise and maintaining a healthy weight.
Vascular stent now, stable later?
For stable coronary artery disease, standard drug therapy plus angioplasty and stent placement reduces the need for emergency interventions later.
Brain plaque vs. Alzheimer's gene
Two tests are available to determine if you are at increased risk for getting Alzheimer's disease: a test for a gene known as APOE4 and a brain imaging test called a PET scan. Research shows that the brain scan is a better predictor.
Weight loss for better sleep
Losing weight, especially in the belly, improves the quality of sleep for overweight and obese people. The best way to lose weight is with exercise and a healthy diet.
High tech ways to better shoe fit
High-tech machines in specialty shoe stores can provide information that leads to buying a better-fitting shoe. Foot scanners help determine a person's arch type. Gait analyzers record the characteristics and support needs of feet in motion.
Lift weights for diabetes protection
For people who are unable to do aerobic activity, weight training is an effective way to reduce diabetes risk. That's because muscles use glucose, and by creating more muscle that needs more glucose, weight training decreases blood glucose levels.
Boost your hearing aid success
When buying a hearing aid, it's easy to be distracted by price and technology. The help and advice of a qualified audiologist can ensure the proper fit and function.
Researchers explore psoriasis-diabetes link
People with the chronic irritated, flaky skin condition called psoriasis may also be at risk for type 2 diabetes. The same cells that trigger the inflammation of psoriasis are also associated with insulin resistance and type 2 diabetes.
What you should know about: The latest blood thinners
New anticoagulants for stroke prevention in atrial fibrillation-dabigatran (Pradaxa), apixaban (Eliquis), and rivaroxaban (Xarelto)-are at least as effective as warfarin in preventing stroke and have a reduced risk of bleeding into the brain.
News briefs: Long-term aspirin use linked to vision loss
Regular aspirin use may slightly increase the risk of age-related macular degeneration (AMD), which causes vision loss in the macula, the part of the eye that controls central vision. But that should not stop the use of aspirin for heart disease.
News briefs: Killing cancer by fixing cell metabolism
Research shows that regulating cancer cell metabolism may help inhibit cancer growth. This finding suggests an entirely new target for the treatment of many cancers.
News briefs: Inflammation and depression link may lead to treatment
Research shows that inflammation, marked by elevated blood levels of C-reactive protein, is linked to risk for depression. This raises the question of whether adding anti-inflammatory drugs to antidepressants will improve depression treatment.
April, 2013
Considering a gluten-free diet
People with celiac disease must avoid all foods that contain the protein gluten, found in wheat, barley, rye, and other grains. Those with nonceliac gluten sensitivity can also benefit from a gluten-free diet.
Ask the doctor: What to take for shingles pain
People who have shingles can take famciclovir and valacyclovir to kill the virus and alleviate pain. Nonsteroidal anti-inflammatory drugs and acetaminophen may also be added. The use of glucocorticoid medicines for pain is debated.
Ask the doctor: Supplements for age-related macular degeneration
Vitamin C, vitamin E, beta carotene, zinc, and copper appear to discourage the progression of age-related macular degeneration (AMD). Vitamin B supplements might reduce the risk of developing AMD. It's best to get the vitamins and antioxidants from food.
Physical vs. mental activity
Physical activity and mental stimulation are both vital for protecting mental skills. A modest amount of aerobic exercise is sufficient to produce positive cognitive results. For mental activity, doctors recommend activities requiring active engagement.
Bypass better than stenting for diabetics?
For people with diabetes and several blocked heart arteries, rerouting blood flow around clogged arteries with bypass surgery may result in fewer heart attacks and deaths than opening the arteries by inserting stent through the blockages.
Arthroscopic shoulder surgery
Arthroscopy is a popular technique for shoulder surgery. It's recommended to repair torn rotator cuff tendons (which keep the arm bone in the shoulder socket), dislocated shoulders, and torn ligaments, as well as to remove bone spurs and cartilage.
Watch out for the "salty six"
Stay away from foods with high sodium content, including canned soup, breads and rolls, cold cuts and cured meats, pizza, poultry, and sandwiches. To cut out sodium, read food labels and eat less restaurant and packaged foods. Stick to fresh foods.
Prevent peripheral artery disease
Peripheral artery disease has four main risk factors: smoking, high cholesterol, high blood pressure, and type 2 diabetes. The more risk factors one accumulates, the higher the risk, and the severity of risk factors increases risk.
New pill better targets rheumatoid arthritis
In November 2012 the FDA approved a new treatment for people with rheumatoid arthritis called tofacitinib (Xeljanz). Unlike previous biologic treatments, the new drug is a pill, not an injection, and it targets another type of inflammatory molecule.
Stop leg wounds that don't heal
Venous leg ulcers are the final stage in the progression of venous disease. Treatment involves compressing the swelling out of the leg using either bandages or compression stockings with dressings on top of the broken skin.
Are painkillers also killing your hearing?
Frequent and long-term use of pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), may be a risk factor for hearing loss. Researchers say the drugs may damage the cochlea, the snail-shaped hearing mechanism in the inner ear.
What you should know about: Magnesium
The main reason to take a magnesium supplement is a documented low body magnesium, usually identified by a low blood level. A normal blood level range is 1.7 to 2.2 milligrams per deciliter. For most healthy people, it's best to get magnesium from food.
News briefs: New thinking on migraine triggers
Suspected triggers for migraine with aura may not be as strong as some people think. Research suggests that a person who experiences migraines with aura can cross a trigger off the list if exposure to it for three months doesn't cause a problem.
News briefs: Smartphone applications not always reliable to assess skin cancer
Phone applications that monitor suspicious moles for the deadly skin cancer melanoma may not be reliable. In a study, three out of four applications incorrectly classified 30% or more melanomas as unconcerning.
News briefs: Sugary beverages raise diabetes risk; coffee and tea don't
Sugar-sweetened beverages, whether caffeinated or decaffeinated, appear to be associated with higher risks of developing type 2 diabetes in both men and women. Coffee and tea appear to reduce the risk of developing type 2 diabetes.
News briefs: Hearing loss may be related to cognitive decline
Older adults with hearing loss may be at risk for cognitive problems. Research shows that people with hearing loss have a 24% greater risk for cognitive impairment than do people with normal hearing.
May, 2013
Avoid back pain and improve balance by strengthening core muscles
Strengthening the body's core muscles reduces strain on the back and helps relieve or prevent pain. Strenuous core exercises can lead to serious injury for older people. Gentle stretches and exercises can be just as effective at core strengthening.
Ask the doctor: Restless leg treatments
Restless legs syndrome causes unpleasant sensations in, and sudden spontaneous movements of, the legs-typically during sleep or when at rest during the day. Exercises, heating pads, hot tubs, and several medicines may provide sufficient relief.
Ask the doctor: The Mediterranean diet difference
Scientists continue to prove that the Mediterranean diet is good for your heart and brain. The diet is rich in olive oil, fruits, vegetables, nuts, and fish, and low in red meats and processed meats, with a moderate amount of cheese and wine.
Migraines: Can dementia, stroke or heart attack be next?
It appears that migraine headaches with aura may signal an increased risk of heart attacks and stroke. However, migraines will not hurt thinking skills.
Heart: Implantable defibrillators: Simple fix may save lives
Small changes to the setting of an implantable cardioverter-defibrillator (ICD) can reduce inappropriate shocks and the risk of death. People with ICDs are advised to check with their doctors to find out if they need adjustments to their ICDs.
Some computer downloads for better health should be avoided
Health applications (apps) for mobile health are not yet regulated. That means there's no way to know which apps are accurate and reliable. Harvard experts warn against using cellphones to diagnose or treat any conditions.
Easy way to stop knee arthritis from progressing
Soda appears to be associated with the progression of knee osteoarthritis in men. People who have knee osteoarthritis are advised to reduce soda intake to less than five drinks per week.
Caution: Cancer risk elevated in women with dense breasts
It appears the risk of dying from breast cancer is not greater in women with dense breasts who get breast cancer. That may be because women with breast cancer often are treated with medicines that lower estrogen levels and block the effects of estrogen.
Dodging skin irritations from problem plants
Many plants can cause rash, so it's important to learn how to take precautions against them. The easiest way is to wear long sleeves and pants when gardening or spending time near potentially poisonous plants, as well as a thick pair of work gloves.
Medication Manager: What you need to know about: Inhalers
Inhaled medications aim to reduce airway inflammation, improve airflow, and decrease or relieve shortness of breath. They are available as dry powders and as liquids that are delivered in metered doses in spray form.
News Briefs: Harvard study says yes to eggs
It appears that eating one egg a day is not associated with an increased risk of heart disease or stroke. Although eggs are high in cholesterol, researchers say the effects of dietary cholesterol on blood cholesterol levels are small.
News Briefs: Brain scan shows best time to treat plaque
The best time to treat brain plaques may be the 15-year period when they are first developing. These plaques are found in Alzheimer's disease and are linked to a decline in memory and thinking abilities.
News Briefs: Inflammation linked to vision loss
Inflammation may predict a person's risk of developing age-related macular degeneration. People who are concerned about this risk can help lower inflammation levels with weight loss and exercise.
June, 2013
Taking charge of your health
People can take charge of their health by being more proactive. That includes keeping track of health information, speaking up about health concerns, exercising for the physiological benefits, and improving diet.
Ask the doctor: When does fatigue indicate illness?
Fatigue has many possible causes. People who experience fatigue should share symptoms with their doctors to help pinpoint any underlying disease that may be causing the fatigue.
Ask the doctor: Which fats should be eliminated from the diet?
Avoid foods rich in saturated fats (e.g., whole dairy products and red meat), and trans fats (e.g., in prepackaged baked goods and deep-fried fast foods). Consume limited amounts of monounsaturated and polyunsaturated fats (e.g., fish and olive oil).
How to cope with drug-resistant hypertension
Resistant hypertension is the term for high blood pressure that can't be controlled. It's often caused by nonadherence to medication regimens, too much salt in the diet, or side effects from other conditions, such as a lack of sleep or kidney problems.
Cognitive behavioral therapy helps depression
Cognitive behavioral therapy is effective at treating depression. It's based on the idea that our thoughts make us suffer as much as external things do. Changing unhealthy thinking can bring relief.
Avoiding knee or hip surgery
Weight loss and muscle strengthening may help stave off joint replacement. Stronger muscles are better able to absorb pressure placed on the joints. Weight loss can also reduce the amount of pressure on the joints.
Silent urinary infections, serious consequences
Older women and men are susceptible to urinary tract infections. Symptoms include painful and frequent urination, a sense of urgency to urinate, and pain in the area of the bladder. In older people, symptoms may take the form of behavioral changes only.
Specks in your vision can signal serious eye conditions
The tiny specks or "floaters" that drift across one's field of vision are usually harmless and often disappear or become less noticeable on their own. But sometimes they indicate a condition that can lead to vision loss.
What to look for in sunscreen:
Sunscreen labels must follow new rules. To make claims that a sunscreen is water resistant, that it can prevent sunburn, or that it can prevent skin cancer, the product must pass government tests.
What you need to know about: Calcium supplements
Doctors recommend that adults try to get 1,000 to 1,200 milligrams of calcium per day from foods. Most people get about 700 milligrams of calcium in the diet. A low-dose calcium supplement pill can make up the difference.
News briefs: Best way to prevent advanced colon cancer
A colonoscopy can help prevent the diagnosis of late-stage colon cancer. Research suggests that the test can reduce the likelihood of advanced colorectal cancer diagnosis by 70% in adults with average risk.
News briefs: Harvard study: Benefits of quitting smoking trump subsequent weight gain
Quitting smoking is associated with a lower risk of cardiovascular disease, despite subsequent weight gain. Researchers say quitters who gain a few pounds still have about a 50% lower cardiovascular disease risk than smokers, even if they have diabetes.
News briefs: Aspirin linked to preventing deadly skin cancer
Aspirin appears to be associated with a lowered risk of melanoma in postmenopausal women. It does not appear to cause melanoma risk to decrease. It is only associated with a decrease in risk.
July, 2013
Taking charge of your health
People can take charge of their health by being more proactive. That includes keeping track of health information, speaking up about health concerns, exercising for the physiological benefits, and improving diet.
Ask the doctor: When does fatigue indicate illness?
Fatigue has many possible causes. People who experience fatigue should share symptoms with their doctors to help pinpoint any underlying disease that may be causing the fatigue.
Ask the doctor: Which fats should be eliminated from the diet?
Avoid foods rich in saturated fats (e.g., whole dairy products and red meat), and trans fats (e.g., in prepackaged baked goods and deep-fried fast foods). Consume limited amounts of monounsaturated and polyunsaturated fats (e.g., fish and olive oil).
How to cope with drug-resistant hypertension
Resistant hypertension is the term for high blood pressure that can't be controlled. It's often caused by nonadherence to medication regimens, too much salt in the diet, or side effects from other conditions, such as a lack of sleep or kidney problems.
Cognitive behavioral therapy helps depression
Cognitive behavioral therapy is effective at treating depression. It's based on the idea that our thoughts make us suffer as much as external things do. Changing unhealthy thinking can bring relief.
Avoiding knee or hip surgery
Weight loss and muscle strengthening may help stave off joint replacement. Stronger muscles are better able to absorb pressure placed on the joints. Weight loss can also reduce the amount of pressure on the joints.
Silent urinary infections, serious consequences
Older women and men are susceptible to urinary tract infections. Symptoms include painful and frequent urination, a sense of urgency to urinate, and pain in the area of the bladder. In older people, symptoms may take the form of behavioral changes only.
Specks in your vision can signal serious eye conditions
The tiny specks or "floaters" that drift across one's field of vision are usually harmless and often disappear or become less noticeable on their own. But sometimes they indicate a condition that can lead to vision loss.
What to look for in sunscreen: Understanding the new rules for sunscreen labels.
Sunscreen labels must follow new rules. To make claims that a sunscreen is water resistant, that it can prevent sunburn, or that it can prevent skin cancer, the product must pass government tests.
What you need to know about: Calcium supplements
Doctors recommend that adults try to get 1,000 to 1,200 milligrams of calcium per day from foods. Most people get about 700 milligrams of calcium in the diet. A low-dose calcium supplement pill can make up the difference.
News briefs: Best way to prevent advanced colon cancer
A colonoscopy can help prevent the diagnosis of late-stage colon cancer. Research suggests that the test can reduce the likelihood of advanced colorectal cancer diagnosis by 70% in adults with average risk.
News briefs: Harvard study: Benefits of quitting smoking trump subsequent weight gain
Quitting smoking is associated with a lower risk of cardiovascular disease, despite subsequent weight gain. Researchers say quitters who gain a few pounds still have about a 50% lower cardiovascular disease risk than smokers, even if they have diabetes.
News briefs: Aspirin linked to preventing deadly skin cancer
Aspirin appears to be associated with a lowered risk of melanoma in postmenopausal women. It does not appear to cause melanoma risk to decrease. It is only associated with a decrease in risk.
January, 2012
While the number of cases of pancreatic cancer has been increasing, new types of targeted medications point toward the possible future of cancer treatment.
Evidence of coffee's health benefits continues to grow, but researchers now believe that some of the good may be due to other substances besides caffeine.
A headache specialist discusses the causes of and treatments for migraines.
Two studies showed that people with back pain who took yoga classes experienced some degree of relief.
Identity thieves are targeting medical businesses to deceptively acquire billing information.
Drinking tea or coffee with fish may prevent the body from absorbing mercury in the fish.
Winter's cold temperatures contribute to heart problems.
I take Avodart for my enlarged prostate. But I heard that Avodart increases prostate cancer risk. Is that true? Should I quit taking Avodart?
February, 2012
Here's a trio of suggestions for enjoying good health
The Health Letter offers three specific strategies that can help you lead a healthier life.
A good grilling: Answering FAQs about our Healthy Eating Plate
Dr. Walter Willett, chair of the nutrition department at the Harvard School of Public Health, answers questions about the Healthy Eating Plate.
Warfarin, diabetes drugs cause emergency hospitalization among the elderly
Researchers found that the drugs responsible for the most emergency hospitalizations among older people were warfarin and insulins.
Cold out? Why you need to wear a hat!
An explanation of why you can get cold without a hat, even if the rest of you is bundled up well.
What is a tailor's bunion?
As with the big toe, pressure from shoes can cause a bunion on the little toe.
&%!!# helps when you're hurting
British researchers found a correlation between cursing and increased tolerance of pain.
Conversation with a Harvard doctor: Talking about heart failure
The Health Letter talks with a cardiovascular expert about the two types of heart failure and the available treatment options.
Niacin + a statin does not add up to benefit
Adding niacin to a statin may boost HDL cholesterol, but this does not necessarily lead to a reduction in risk for a heart attack or stroke.
Ask the doctor: Is there a connection between diabetes and sleep apnea?
I have been diagnosed with type 2 diabetes and sleep apnea. Is there any connection between the two?
Ask the doctor: Are generics as good as brand-name drugs?
My doctor says I should switch to the generic version of Lipitor, but is it really the same as Lipitor?
March, 2012
Putting more brain in the bank
Mental and physical activity seem to be equally important in keeping the brain active to ward off cognitive decline in older age.
Medications: No more than necessary
Taking a thyroid medication or a proton-pump inhibitor for too long may lead to bone problems or increased susceptibility to certain infections.
Pot smokers can maybe breathe a little easier
Regular marijuana use does not appear to have a negative effect on lung function.
Another reason to get out there and get moving!
Middle-aged people may be able to reduce their risk of developing Parkinson's disease later in life by exercising vigorously.
Can anxiety cause a heart attack?
The link between depression and heart disease has been explored in research, but anxiety may factor in as well.
Q&A about the Healthy Eating Plate
Are processed meats really that bad for you? What if I eat them only in small amounts?
Red, brown, green: Urine colors and what they might mean
Deviation from the normal yellow color of urine can indicate a number of possible conditions, some serious, but most harmless.
A possible brain food that you've probably never heard of
The amino acid choline may be important to maintaining cognitive ability.
Ask the doctor: Is my LDL cholesterol too low?
I'm 80, I exercise and eat a healthy diet. My internist says my LDL is too low and that I should cut my statin from 40 mg to 20 mg a day. I also take 2,000 mg of niacin daily. Is there general agreement that one's LDL should not go below a certain point?
Ask the doctor: Can vitamin B6 cause tingling?
Is it true that you can get a tingling feeling from taking too much vitamin B6?
April, 2012
Putting the placebo effect to work
While the mechanisms of the placebo effect are far from being fully understood, the patient's expectation of improvement and changes in brain chemistry appear to be important factors.
In Brief: Vigorous exercise produces 'afterburn' bonus
An extended period of vigorous exercise produces a boost in metabolism that lasts for several hours afterward and burns additional calories.
In Brief: Tai chi helps Parkinson's patients with balance, movement
A study of patients with Parkinson's disease found that participating in regular tai chi sessions improved their balance and control of their movements.
6 ways to tame the modern muffin
Muffins can be improved by adjusting the recipes to use healthier ingredients, and by making them smaller.
Update on cataract surgery and replacement lenses
Some ophthalmologists are now using lasers to perform cataract surgery, but the additional cost may not be worth the slight improvement in the results.
Ask the doctor: Should I be worried about the side effects from cortisone shots?
I'm in my late 70s and have been getting about four cortisone shots a year for the past several years for the arthritis in my left knee. They really help with the pain, but I've heard that, long-term, there could be bad side effects. Should I be worried?
Ask the doctor: Is Vaseline a good face cream?
I know someone who swears by Vaseline as a face cream. What do you think?
May, 2012
Food for thought
The heart-healthy Meditterranean diet also seems to be good for the brain.
Does colonoscopy save lives?
Does colonoscopy save lives?
Blue light has a dark side
Light at night is bad for your health, and exposure to blue light emitted by electronics and energy-efficient lightbulbs may be especially so.
Changes to the statin label: What they really mean
The real meaning of the statin label changes.
More show, less tell
Dr. Angelo Volandes, an assistant professor at Harvard Medical School, is producing videos to educate patients and help them make informed medical decisions.
Raising your conscientiousness
Becoming more conscientious could be your ticket to better health and longer life.
Ask the doctor: Will cataract surgery worsen macular degeneration?
I have been diagnosed with macular degeneration and cataracts in both eyes. Could cataract surgery worsen my macular degeneration?
Ask the doctor: Should I drink orange juice with added calcium and vitamin D?
Should I be drinking the orange juice that has calcium and vitamin D added to it?
June, 2012
Major fat-burning discovery
Harvard researchers discover a hormone released by exercise.
Ask the doctor: Analyzing those pesky leg pains
Analyzing those pesky leg pains.
Ask the doctor: Pay attention to skin irregularities
Pay attention to skin irregularities.
Overeating may reduce brain function
High caloric intake could raise the risk of memory loss.
Grieving may trigger heart attack
Grieving may trigger heart attack
New knee helps your heart
Today's knee high-tech procedure offers more benefits.
Dieting? Have some cake
Could your favorite treat help you lose weight?
Sex after heart attack
Sex and your heart.
Triglycerides may predict stroke
Triglycerides predict stroke?
Eye surgery and post-op pain
Contact lenses with vitamin E deliver long-lasting anesthetic.
Better way to apply sun screen
A Harvard expert says most people don't use enough sun screen.
Beta blockers
What you need to know about Beta Blockers.
News brief: Flavonoids may help protect against Parkinson's disease
Flavonoids may help protect against Parkinson's disease.
News brief: Metal-on-metal hip replacements don't increase cancer
Metal-on-metal hip replacements don't increase cancer
News brief: Low blood pressure when standing could signal heart failure
Low blood pressure when standing could signal heart failure
News brief: Combination therapy no advantage in Alzheimer's treatment
Combination therapy no advantage in Alzheimer's treatment
News brief: New study highlights value of colon cancer screenings
New study highlights value of colon cancer screenings
July, 2012
Update: Stem cell benefits getting closer
Scientists are transforming stem cell benefits getting closer.
Ask the doctor: Asthma at any age
Asthma at any age.
Ask the doctor: The problem with your night vision
The problem with your night vision
No weight loss with exercise?
Fitness versus fatness.
Discovery may lessen depression stigma
Depression blood test.
Is Vitamin E bad for your bones?
Normal doses of Vitamin E are okay; megadoses can be dangerous.
Healthier oils make fried food safer
Research clears vegetable oils, but use them wisely.
Healthy heart, healthy prostate
Excercise and wight loss may also protect against cancer.
Coping better after breast cancer
Complementary breast cancer therapies help pyschological recovery.
Hearing loss: Time to get proactive
Millions may be suffering from hearing loss needlessly.
Your bonus from fruits and veggies
Three servings of vegetables a day may lead to rosier complexions.
What you should know about: Metformin
What you should know about Metformin.
News briefs: Study shows aspirin as effective as warfarin for people with heart failure
Study shows aspirin as effective as warfarin for people with heart failure.
News briefs: Omega-3 fatty acids may help protect against Alzheimer's disease
Omega-3 fatty acids may help protect against Alzheimer's disease.
News briefs: Study links long-term air pollution exposure to heart, lung problems
Study links long-term air pollution exposure to heart, lung problems.
News briefs: Fungus mimics cancer in American southwest
Fungus mimics cancer in American southwest.
News briefs: Asthma treatment underutilized among older adults
Asthma treatment underutilized among older adults.
August, 2012
Stop migraines before they start
Effective treatments are available to prevent migraine headaches from happening. Yet the majority of people who could benefit from these medications don't use them.
Ask the doctor: Exercise and sodium
You may need extra salt in your diet if you exercise hard and sweat a lot; a moderate daily workout usually doesn't require more salt.
Ask the doctor: Side effects of anxiety medications
SSRIs are generally safe drugs but, like all medicines, can cause side effects. Common ones include insomnia, rash, headache, stomach upset, and diminished interest in sex.
Preserving brain function
Engaging in meaningful activities like volunteering, caring for others, or pursuing a hobby promotes helps preserve and promote memory and brain health in old age.
Heart health and antibiotics safety: Z-Pak update
An uncommon side effect of the antibiotic azithromycin is triggering irregular heart rhythms. For people with certain types of heart rhythm problems, it's best to avoid this antibiotic when possible.
Drop pounds to relieve back pain
Carrying extra pounds contributes to disc degeneration in the spine, particularly in the lower back region. Losing weight can take pressure off the discs and ease back pain.
Do you really need that diet soda?
People who drink diet soda are at increased risk for heart attack and stroke. It probably isn't the soda itself- -people who drink diet soda may also be consuming other foods and drinks that contain lots of sweet but empty calories.
Men: Pay attention to osteoporosis
Although osteoporosis is often thought of as a woman's disease, an estimated two million American men have this bone-thinning condition and another 12 million are at risk for it.
Breast cancer risk and alcohol
New breast cancer study confirms that women should limit alcohol to no more than one serving a day.
Omega-3 for your eyes
Omega-3 fatty acids, long linked to heart health, may also help prevent age-related vision loss.
Psoriasis and vitamin D deficiency
New research linking psoriasis, an irritating skin condition, with too little vitamin D suggests a possible new treatment: a skin cream or gel containing vitamin D.
What you should know about: Staying on your meds
Simple steps such as phone calls and rewards can help people take their medications as prescribed.
News Briefs: Stop sitting, get moving, to lower diabetes risk
Breaking up periods of sitting by standing up every so often and walking or performing some other exercise for a few minutes can help prevent diabetes.
News Briefs: Be careful mixing OTC medications with prescription drugs
Combining over-the-counter (OTC) medications, especially those containing acetaminophen, with prescription drugs can be dangerous.
News Briefs: Extra vitamin D may keep you mobile in later years
Older adults who don't get enough vitamin D, either from sun exposure, dietary sources, or supplements, face higher risks of mobility problems.
News Briefs: Study finds bananas a good energy source for exercisers
Bananas beat sports drinks an energy source for exercisers.
September, 2012
Alert: Hepatitis C screening could be critical
All baby boomers-everyone born between 1945 and 1965-should be tested for hepatitis C. That's because an estimated 1.5 million of them have hepatitis C, which can cause liver failure or liver cancer, but don't know it.
Ask the doctor: Shin splints at any age
Shin splints are caused by injuring muscles in the inner part of the lower leg. They can occur at any age. The best way to prevent shin splints is to warm up thoroughly before exercising.
Ask the doctor: Canola oil and prostate health
Using canola oil, and unsaturated fat, does not cause prostate cancer or make it worse. A diet rich in saturated fat, from red meat and other sources, however may increase the risk of prostate cancer.
Protect your brain from stroke
Too much salt can boost blood pressure and increase the risk for heart disease. Now a new study has linked a high-salt diet with increased risk for stroke.
Counting calories to keep your heart young
Drastically reducing the calories you take in, a strategy known as caloric restriction, may keep your heart acting like it's 20 years younger.
Easier way to help your hip?
A procedure known as hip resurfacing is emerging as an alternative to hip replacement. But not everyone has the right anatomy for hip resurfacing, and because of its track record, total hip replacement is best for people over 65.
Can coffee help you live longer?
: Coffee may be part of a longer, healthier life. In a new study, older adults who drank coffee (caffeinated or decaf ) had a lower risk of dying from diabetes, heart disease, respiratory disease, and other conditions than non-coffee drinkers.
Best options for prostate surgery
When it comes to prostate removal, traditional surgery and robot-assisted surgery appear to be equals. What's important is the expertise of the surgeon, whether he or she is doing the operation directly or is controlling the robot doing it.
Protect your brain with "good" fat
Foods that harm the heart, especially those rich in saturated fat, may also harm the brain. Women with the highest consumption of saturated fat had worse memory and cognition over time than those who consumed the least saturated fat.
Tips for living with tinnitus
Millions of Americans live with tinnitus, a constant ringing or sound in the ears. Most treatments aim to minimize the symptom, mask the sound, or deemphasize one's negative response to the sound.
New ways to treat varicose veins
Treating varicose veins used to mean a trip to the operating room and general anesthesia. Now it is usually an office procedure that involves using heat to make the vein collapse.
What you should know about: Probiotics
"Good" bacteria found in food and dietary supplements may help ward off illness. Called probiotics, these bacteria been shown to secrete protective substances that turn on the immune system and prevent pathogens from taking hold.
News brief: Living alone linked to higher risk of cardiovascular death
Older people who have heart disease may die sooner if they live alone.
News brief: Prediabetes is associated with stroke risk
People with prediabetes may be at a higher risk of stroke. A diagnosis of prediabetes should sound a warning to better manage weight, diet, and exercise, which may contribute to diabetes and stroke.
News brief: Fewer eyesight problems reported among older adults
Improved prevention efforts and protective behaviors (like not smoking) have reduced eye health problems faced by older adults by 23% since 1984.
News brief: Vegetables may help prevent pancreatitis
October, 2012
The new medicine: Muscle strength
Aerobic exercise is not enough to maintain good health in your older years. Strength training in older adults is very important because it can slow and reverse age-related declines in muscle mass and muscle endurance.
Ask the doctor: Is coconut oil good for you?
Coconut oil is getting attention for its health properties. It raises HDL, the "good" cholesterol. However, it has lots of saturated fat, which can raise LDL (or "bad") cholesterol, so you're better off with vegetable oils.
Ask the doctor: Calf pain may signal nerve and circulatory problems.
Calf pain that begins after a few minutes of walking may be attributable to a few different conditions. One is atherosclerosis in the arteries that provide blood to your legs; another is spinal stenosis. Both should be checked by a doctor.
Best way to get your calcium
Although calcium supplements are under attack for a possible link to heart attack risk, Harvard experts question the link and note that such risks haven't been found with calcium-rich foods. They recommend that you get most of your calcium from food.
Reduce Parkinson's symptoms
Researchers now have better evidence that deep brain stimulation improves the motor symptoms of Parkinson's disease for up to three years after implantation.
Prevent pain from computer use
Using a tablet computer your lap can cause you to bend your neck forward too much and cause strain and injuries. It's better to view a tablet on a table, propped at a comfortable angle.
Dark chocolate protects arteries?
Consuming 1 to 2 ounces of dark chocolate can help prevent cardiovascular disease over the long term. Flavonoids in dark chocolate are good for the lining of arteries. But chocolate is no replacement for meaningful cardiovascular disease prevention.
Breakthrough breast cancer drug
A new drug for advanced-stage HER2-positive breast cancer is providing hope. T-DM1 is effective in women who've already had their cancer progress despite prior therapies and it's remarkably low in side effects.
Yet another risk of heart failure
Depression is more common in women with heart failure, but it is more severe in men with heart failure. The connection is a two-way street: heart failure can lead to depression and depression can worsen heart failure.
Dilated eye exams are critical
The American Academy of Ophthalmology is urging everyone to have regular dilated eye exams, which allow physicians to see clearly into the back of the eye. This is critical to prevent vision loss, which can be irreversible.
Build a better skin barrier
Moisturizing is key to keeping your skin hydrated when the temperatures drop. Use an oil-based cream after washing your hands or taking a bath or shower, and before going outside in the cold, dry air.
What you should know about: Statins
Statins are effective at lowering low-density lipoprotein (LDL, or "bad") cholesterol levels and lowering the risk of heart attack and stroke. However, conflicting literature debates whether statins are right for everyone.
News briefs: Colorectal cancer genes identified
A huge new study has identified many new genetic changes that appear to be involved in causing colorectal cancer. Each of these newly identified genetic changes is a target for drug therapy.
News briefs: ACE inhibitors may lower pneumonia risk
ACE inhibitors relax blood vessels and can help lower blood pressure. They may also reduce the risk of developing pneumonia.
News briefs: Cataract surgery may help lower hip fracture risk
Cataract surgery can help prevent hip fractures that result from falls. In a recent study, researchers noted that clear vision contributes significantly to postural balance and stability.
News briefs: Study shows corticosteroids ineffective in treating acute sinusitis
Inflammation-fighting corticosteroids don't offer much help fighting sinus infections, though they may provide relief for individuals dealing with allergy-related sinusitis.
November, 2012
Choosing good carbs with the glycemic index
A rating system called the glycemic index can help you choose healthy sources of carbohydrates. Focus on foods with a low glycemic index (55 or less), and try to limit those with a high glycemic index (70 or higher).
Ask the doctor: Finding fiber in wheat-free diets
Wheat is a good source of fiber, but it contains a protein called gluten. Sensitivity to gluten can cause gas, bloating, belly cramps, milder diarrhea, and fatigue, and severe cases can lead to celiac disease.
Ask the doctor: When to call the doctor about headaches
When debating how long to let a headache last before seeing a doctor, start by comparing it with past headaches. If the headache is longer than usual, more severe, awakens you at night, or accompanied by dizziness, call your doctor.
Hypertension? You're not alone
Uncontrolled blood pressure is a major problem in the U.S. This is because many people do not have a primary care physician or health insurance, and because blood pressures are often not routinely measured in doctors' offices.
Fool your brain, reduce your pain
You can reduce chronic pain by fooling your brain. Distractions, including any activity in which you are focused or absorbed, may release natural painkillers that block incoming pain signals as they enter the spinal cord.
Alternative treatments for knee pain
When trying to avoid a knee replacement, treatments such as supplement therapy, acupuncture, and viscosupplementation can be effective. There is not enough evidence to show that platelet-rich plasma therapy (PRP) and prolotherapy are effective.
Avoid landing back in the hospital
Men who are socially isolated may be at a significantly higher risk than women for returning for urgent care within a month of being discharged from the hospital. Everyone needs a caregiver present for discharge instructions and for care at home.
You may not need a Pap smear
Health organizations have revised screening guidelines for cervical cancer. The new guidelines are based on evidence that annual Pap smears do not catch more cancers, but often lead to more invasive diagnostic procedures that can cause complications.
Soothing dry eyes
Caffeine may help us produce more tears, but doctors don't recommend it as a treatment for dry eye syndrome. Instead, use artificial tears, topical anti-inflammatory treatments, and sometimes procedures to plug tear ducts.
Preventing psoriasis with exercise
Extremely vigorous exercise may help reduce the risk of new cases of psoriasis. Doctors recommend at least 3-4 hours of vigorous exercise per week (such as tennis, swimming, or running), as long as your doctor says it's okay.
What you need to know about: vaccines
In addition to getting your flu shot each year, make sure your other vaccinations are up to date. Older people need tetanus boosters every 10 years, and they may also need a pneumonia and a shingles vaccination as well.
News briefs: Mid-life fitness lowers the risk of chronic conditions later in life
The greater your midlife fitness level, the lower your odds are of developing chronic diseases such as heart failure, stroke, diabetes, colon cancer, and Alzheimer's disease.
News briefs: Bariatric surgery reduces type 2 diabetes risk in obese individuals
Bariatric surgery may significantly reduce a person's odds of developing type 2 diabetes. This stomach procedure that restricts food intake may reduce the long-term incidence of type 2 diabetes in obese individuals.
News briefs: Parkinson's disease associated with higher risk of certain cancers
People with Parkinson's disease and their relatives may be more likely to develop prostate cancer and melanoma. Researchers believe neurodegenerative diseases may share common mechanisms with the cancers.
News briefs: Biologic therapy doesn't raise cancer risk in people with rheumatoid arthritis
Despite theoretical reasons to worry that biologic response modifiers may raise cancer risk, it appears they don't significantly raise the risk of malignancy. The drugs can dramatically improve inflammation in people with rheumatoid arthritis.
December, 2012
Better sleep means better health …
Prescription medicines may cause problems with sleep. The fix may be to adjust the type or dose of medication or seek sleep behavior therapy.
Ask the doctor: Alternative medicine: the inside scoop
In the past 20 years, the National Institutes of Health and many academic centers have begun to seriously put "alternative" therapies to the test. Some are flunking out, and some are passing the test.
Ask the doctor: Bariatric surgery and diabetes
Bariatric surgery can reduce the risk for type 2 diabetes. Bariatric surgery might not make type 1 diabetes easier to control, but it could help reduce the risk of heart disease.
Missing out on aspirin therapy?
Although aspirin is cheap and available over the counter, fewer than half of the people with cardiovascular disease in the United States are prescribed aspirin therapy. This may be because it can have side effects.
High blood sugar linked to brain shrinkage
Blood sugar on the high end of the normal range may be linked to brain shrinkage in areas associated with memory and thinking. It's not clear if blood sugar causes the problem.
Making peace with holiday buffets
The best way to navigate the holiday buffet is with advance planning. Dietitians advise eating before attending parties, using a salad plate instead of a dinner plate at buffets, and sipping water between bites.
In search of vitamin D
How much daily vitamin D is needed for bone health is controversial. Harvard experts recommend 1,000 international units (IU) of vitamin D per day (up to 2,000 IU in those at risk for vitamin D deficiency) plus 1,000 to 1,200 milligrams of calcium.
Do-it-yourself skin cancer checks
Using a computer-based tutorial to learn how to check for skin cancers can help you catch problems early. So can involving a partner to help check for skin irregularities and changes in moles.
Losing your sense of smell?
After age 65, many people lose some of their sense of smell, and we don't know exactly why. But if loss of smell lasts longer than a few weeks, it may indicate an underlying problem, and sometimes a serious neurological condition.
Pelvic organ prolapse
Pelvic organ prolapse is getting national attention because of complications from surgical mesh sometimes used in surgery. Finding a urogynecologic surgeon can ensure successful treatment.
What you should know about: Aspirin during a heart attack
Aspirin during a heart attack can help save your life. Chewing one regular-strength adult 325-milligram (mg) aspirin, and swallowing it, should be sufficient.
News briefs: Education, psychological support vital for ICD users
An implantable cardioverter-defibrillator (ICD) helps establish a healthy heart rhythm and prevent sudden cardiac death. But psychosocial support needed to adjust to life with an ICD is often overlooked after the devices are implanted.
News briefs: Understand your heightened risk of blood clots if you have rheumatoid arthritis
It appears that people with rheumatoid arthritis are at a higher risk of developing a venous thromboembolism (VTE). To avoid developing a VTE, quit smoking, become more physically active, and avoid prolonged bed rest if possible.
News briefs: Total knee replacements on the rise, despite high costs
The amount of total knee replacements in the United States has more than doubled since 1991. This may reflect an expanding pool of older adults and a desire to maintain a more active lifestyle that is possible only if arthritic knees are replaced.
News briefs: The secrets of longevity
Staying active and connected can extend optimal physical and mental health in the 90s. Pursuing leisure activities and not smoking are also key.
January, 2011
Finding lung cancer early
A large study evaluating the effectiveness of using CT scans to screen for lung cancer could lead to earlier detection and treatment, and possibly fewer deaths.
Let's go nuts
Nuts contain healthy unsaturated fats, protein, and important nutrients like potassium, and there is ample evidence that eating nuts regularly helps protect against heart disease.
When the liver gets fatty
The increase in obesity among Americans has led to an increase in fatty liver disease as a consequence of insulin resistance. Some researchers believe that this condition may lead to heart disease.
On the brain: Maybe more than one way to beat cognitive decline
Physical activity and mentally challenging and engaging activities may help prevent cognitive decline.
On the brain: The brainy omega-3 fails an Alzheimer's test
A study of patients with Alzheimer's disease found that taking the omega-3 fat DHA did not affect the progression of the disease.
In Brief: Good news about new macular degeneration drugs
A study of two drugs used to treat macular degeneration found no added risk of heart disease or death compared to older treatments.
In Brief: Old noses have more room inside
Researchers found that the nasal cavities of older people were larger than those of younger people.
In Brief: Sleep helps with fat reduction
Getting a full night's sleep may help the body lose more fat.
Ask the doctor: Should I be worried about my blood pressure medication causing cancer?
I heard about a study that found that ARBs can cause cancer. I am taking one, Cozaar, because of high blood pressure. Should I stop taking it?
Ask the doctor: Should I stop taking Avandia?
Because of the recent news about Avandia, my physician has advised me to stop taking it. Is that wise?
February, 2011
The vitamin D-cision brings surprises
A panel of experts acting at the request of the Institute of Medicine has determined that most Americans are in fact getting enough vitamin D from a combination of sun exposure, diet, and supplements.
Mindful eating
Research suggests that more deliberate and thoughtful eating habits could help some people lose weight.
Update from the cold front
There is still no cure for a cold, but you may be able to prevent one, or at least cut down on its duration.
Understanding the ECG: Reading the waves
The electrocardiogram is useful in diagnosing many heart conditions, and is receiving new attention due to its role in determining whether someone has had a heart attack.
Palliative care: Sooner may be better
Palliative care, which aims to improve a person's quality of life during a serious illness, may also result in prolonging life in certain cases.
Ask the doctor: What do you think of these so-called sunless tanning products?
My teenage daughter wants to be tan when we go to Florida for our winter vacation. I have suggested one of the so-called sunless tanning products, but she says they don't look natural and wants to go to an indoor tanning salon instead. What do you think?
March, 2011
Shocking news: Overdoing ICDs
Concern about possible overuse of implantable cardioverter-defibrillator devices has led to a reevaluation of their benefits and risks.
Talking of walking in three easy pieces
Studies examine various aspects of the health benefits of walking: gait speed, use of hiking poles, and type of footwear.
The shingles vaccine
For people who have had shingles, the question of whether or not to get the vaccine to prevent a recurrence is not easily answered.
A wash worth its while?
Certain ingredients in some brands of mouthwash may help prevent bad breath, but some experts think that using a toothbrush on the tongue is more effective.
Ask the doctor: Generic vs. brand-name drugs: Any difference?
Some doctors strongly advise against the use of generic drugs with the argument that manufacturing processes are better controlled in branded medicines. What is your view?
Ask the doctor: Nothing works for fullness in ears. Any suggestions?
I have a feeling of fullness in my ears that won't go away. I think it has been diagnosed as something called eustachian tube dysfunction. I have been to several otolaryngologists. Nothing has worked. Suggestions?
April, 2011
Four sob stories
Research on crying focuses on several different areas, including the chemicals in emotional tears and their purpose, and whether or not depressed people cry more.
The 2010 Dietary Guidelines
The government has released the latest version of its dietary guidelines, but some health care professionals are disappointed, because they feel that the recommendations regarding sugar-sweetened drinks and salt consumption are not strong enough.
Proton-pump inhibitors
Proton-pump inhibitors are the strongest type of medicine available for treating stomach acid. There is some concern about their potential side effects and interactions with other medications.
Accountable care organizations
A new type of health care organization aims to improve managed care by controlling costs and rewarding efficiency while maintaining high standards of care.
In Brief: Routine screening of the carotid arteries not recommended
An ultrasound screening can detect blockage in the carotid arteries, but a government task force is discouraging such screenings due to the very small percentage of the population at risk for such a stroke.
Ask the doctor: Creatine for muscle strength
I'm 70 and exercise 30 minutes a day. I've heard that creatine supplements might help build muscle strength. Is there anything to it?
Ask the doctor: Preventing and curing sarcoidosis
A friend has sarcoidosis. How bad a disease is it? Can it be prevented and treated effectively?
May, 2011
Editor's note
The editor in chief of the Harvard Health Letter introduces the 2011 edition of a special issue comprised entirely of "Ask the doctor" letters from readers.
Ask the doctor: Is robotic surgery better?
A hospital in the area is advertising robotic surgery. Is it really any better than having a surgeon do the operation?
Ask the doctor: Alternative to warfarin
For several years, I have been taking warfarin because of atrial fibrillation. I recently suffered nosebleeds, which took two days to control. The trauma of those episodes makes me want to swear off warfarin, but I am not sure what other options I have.
Ask the doctor: Do cataracts need to be ripe for surgery?
I think I may have cataracts. I heard somewhere that they need to be ripe before I get surgery. Is that true?
Ask the doctor: Seborrheic keratoses
I have a bad case of seborrheic keratoses on my back and chest. What can you tell me about this skin problem?
Ask the doctor: Nuclear stress tests
I recently had a nuclear stress test and the contrast agent got stuck in my gut, so the image couldn't be read. Is this a common problem, and is there anything that can be done about it?
Ask the doctor: Runny nose
Why does the nose run in cold weather?
Ask the doctor: 10% brain myth
Is it true that we use only 10% of our brains?
Ask the doctor: Baggy eyes
What causes bags and puffiness around the eyes and dark circles underneath them?
Ask the doctor: Heavy bleeding, fibroids, and polyps
I am 53 and have experienced heavy menstrual bleeding. An ultrasound showed fibroids and polyps. My doctor gave me three choices: monitor with ultrasound, get a hysterectomy, or freeze the fibroids and polyps. I am not sure what to do.
Ask the doctor: Coconut oil
I have started noticing more coconut oil at the grocery store and have heard it is better for you than a lot of other oils. Is that true?
Ask the doctor: Questioning the necessity of aspirin
My doctor advised me to start taking an 81-mg aspirin once a day. I am a physically active 62-year-old and have been a vegetarian - mostly vegan - for 35 years. I'd really rather not take aspirin. Am I being foolish in questioning my doctor's advice?
June, 2011
Are full-body airport scanners safe?
There is concern about radiation exposure from x-ray machines used for airport security scans, but the added risk is so small that it is insignificant.
Health by the numbers
Statistics on statin use show a decrease in LDL cholesterol levels in those who take the medications, but for people who don't want to or who cannot handle the possible side effects, dietary changes can have similar benefits.
Breaking the fast
Research reiterates the importance of eating breakfast every day, but carefully choosing what you eat in the morning, and how much, can optimize your breakfast's nutritional content.
Drugs in the water
Chemicals from medications and personal care products are making their way into streams, lakes, and other bodies of water, but water treatment facilities are not currently equipped to filter pharmaceutical waste from our water supply.
Ask the doctor: What is the upper limit for omega-3 fats?
There's a lot of publicity about omega-3 fats being beneficial for heart, mind, joints, eyes, and so on. There are over-the-counter products of varying size. So, this is my question: is there a daily upper limit on fish oil consumption?
July, 2011
Berry good for health
Berries contain antioxidants, vitamins, and a generous amount of fiber, making them an excellent component of a more healthful diet.
Following up: Deactivating the ICDs of hospice patients
Hospice patients with implantable cardioverter-defibrillators may choose to turn off the shock function of the devices to avoid a potentially painful shock.
A Q&A with our new board member
The Harvard Health Letter has a conversation with its newest board member, a physician who is involved with geriatric care issues.
Diagnosing Alzheimer's disease
New guidelines for diagnosing Alzheimer's disease aim to identify changes in the brain that are associated with the development of the disease.
In Brief: Why do vitamins keep on failing in clinical trials?
Two researchers theorize that trials of vitamins have not yielded more positive results because the test subjects already had ample levels of the nutrient being tested in their bodies.
9 things that can affect your vitamin D level
Many factors influence the body's production of vitamin D, including age, weight, and air quality.
Bypass vs. angioplasty
Studies comparing bypass surgery to angioplasty found that, for those with more serious heart disease, there is little difference in eventual outcome between the two methods.
Ask the doctor: Oral steroids for nasal polyps
I have chronic sinusitis and nasal polyps. I switched doctors and the new specialist suggested trying oral steroids, something that my previous doctor never mentioned. What do you think?
August, 2011
Niacin trial stopped early: Now what?
A clinical trial of niacin in combination with a statin to lower cholesterol was stopped early because of concerns that the combined medication could be associated with an increased risk of stroke.
Preventing cancer: Are we getting closer?
A drug now used in breast cancer treatment may have the potential to prevent the disease in some women.
Conversation with a Harvard expert
The Health Letter talks to a nutrition researcher specializing in the effects of high-glycemic-load foods.
With rising, a fall in blood pressure
With age, the heart and blood vessels weaken, leading to lower blood pressure when standing up. Insufficient blood to the brain can cause dizziness and blurred vision, and an increased risk of falls.
Happy - and healthy - trails to you
Vacaion planning should include these health planning and preparedness measures.
Moderate drinking - and how to keep it that way
Moderate alcohol consumption offers some clear health benefits, but it is important not to slip from moderation into riskier drinking.
Ask the doctor: Can I replace potassium pills with foods high in potassium?
I am taking furosemide (Lasix) once a day. I was told to also take potassium pills, but I don't like pills. Can I replace the potassium pill with foods high in potassium?
Ask the doctor: What can be done about a lump in the back of the throat?
I often feel like I have a lump of mucus in my throat. In the morning I spit some of it up, but the sensation doesn't go away. What can I do about it?
September, 2011
More than the usual forgetfulness
Age-related memory loss is common, but forgetting things like significant dates or events could be a sign of mild cognitive impairment, which increases the likelihood of progression to dementia.
Conversation with a Harvard expert
The Health Letter interviews a researcher and professor whose area of expertise is medications.
Adult food allergies
Sometimes adults suddenly develop allergies to foods they have eaten since they were children. Such reactions may be caused by a cross-reaction to another allergen.
Stress and overeating
Stress hormones trigger increased appetite in general, and cravings for fatty, sugary foods in particular.
In Brief: Fiber on a winning streak
Eating high-fiber foods helps lower cholesterol, and research is now suggesting that it may also help protect against respiratory and infectious diseases.
In Brief: Avoiding kidney stones
Ways to prevent kidney stones mainly revolve around dietary choices, along with drinking plenty of water.
Wake up and use the microwave, Health Letter, say our readers
Eating oatmeal is a great way to add fiber to your diet, and using a microwave oven is a convenient way to speed up the cooking time.
Ask the doctor: Is abdominal surgery riskier if I am overweight?
I am overweight and need abdominal surgery. Does being overweight make the surgery more difficult and add to the complication rate?
Ask the doctor: Have I given up steak for nothing?
I read that Harvard researchers found no association between eating red meat and developing heart disease and diabetes. Have I been depriving myself of steak for more than 20 years for no good reason?
October, 2011
Controlling what - and how much - we eat
Because humans have evolved to crave fat, salt, and sugar, it is difficult to shift away from them and toward a healthier diet, but it is possible to learn to like vegetables, fruits, and whole-grain foods more.
Preventing delirium in the hospital
Delirium occurs frequently in older people who are hospitalized. It can manifest as a state of confusion and agitation, or one of withdrawal and lethargy.
Conversation with a Harvard expert
The Health Letter talks with an orthopedic surgeon about joint replacement.
A matter of opinion
Getting a second opinion about a medical issue is a good idea. It can confirm a previous diagnosis or offer new insights, and it may help avoid costly or unnecessary treatment.
Novel therapy for C. difficile infections
An unusual treatment may help prevent the recurrence of a bacterial infection.
Ask the doctor: Is there a connection between antidepressants and cataracts?
I read something about antidepressants causing cataracts. Is there any truth to it?
Ask the doctor: Unconscious or subconscious: Which is the correct term?
I've always used the word subconscious when talking about thoughts that are buried. But someone corrected me recently and said unconscious is the correct term. Have I been using the wrong word?
November, 2011
Feet and falling
Research indicates that older people who fall are more likely to have foot pain, bunions, or other foot problems.
Now being served, better nutrition advice
The Harvard School of Public Health and Harvard Health Publications team up to produce a more substantive alternative to the government's MyPlate dietary recommendations.
Do antidepressants work in the damaged brain?
Antidepressants have not fared well in research on patients with Alzheimer's disease, but there is some evidence that they may benefit stroke victims.
Ask the doctor: Is there a better way to treat morphea?
My wife has morphea spots on many areas of her body. We are currently treating them with Dovonex, which seems to help a little but is expensive. Do you have a better way to treat this disease? We have been told very little is known about how to treat it.
December, 2011
Editor's note
The editor in chief of the Harvard Health Letter introduces a second 2011 edition of a special issue comprised entirely of "Ask the doctor" letters from readers.
Ask the doctor: Are artificial sweeteners a good alternative to sugar?
More and more nutrition advice seems to be anti-sugar these days. So are artificial sweeteners a good alternative?
Ask the doctor: Why is poultry a protein on your Healthy Eating Plate?
I saw Harvard's Healthy Eating Plate and noticed that poultry was listed as a healthy protein. I am not surprised that you're recommending fish, nuts, or beans. But why poultry?
Ask the doctor: Is it okay to keep on taking Ambien for my sleeping problems?
I am 70, have had sleep problems, and have started to take Ambien every night. It seems to be working very well. Is it okay if I keep on taking it?
Ask the doctor: Should I worry about health effects from BPA?
Is the chemical BPA just another health scare, or is it really something we should be worried about?
Ask the doctor: Why are waits in the emergency department so long?
I sprained my ankle pretty badly a few weeks ago and was taken to the emergency room. It took three hours before I saw a doctor. Why are emergency rooms so crowded and the waits so long just to be seen?
Ask the doctor: For macular degeneration, which is better, Avastin or Lucentis?
I have wet macular degeneration. I am trying to decide between Avastin and Lucentis. Which drug is better?
Ask the doctor: What is gastroparesis and how can it be treated?
A friend has a condition called gastroparesis. Please explain what it is and how it can be treated.
Ask the doctor: Is the alternative to warfarin safe and effective?
My wife's medication to treat atrial fibrillation recently was changed from warfarin to a new drug called Pradaxa. They say that the new medicine does not require regular INR tests and is just as effective. Is that so?
January, 2010
Out in the cold
Winter can be tough on the body, with increased rates of respiratory diseases and cardiac events, but cold weather also helps stimulate the body's calorie-burning fat.
In Brief: Vitamin D may prevent falls
Research appears to support the idea that a regular dose of vitamin D helps improve strength and balance in older people, which helps reduce the incidence of falls.
In Brief: How do you know whether it's flu?
It is not always easy to tell whether an oncoming illness is a cold or the flu, but the symptoms do differ, and this chart can help.
In Brief: Aspirin as colon cancer treatment?
Researchers from Harvard found that people with certain types of colon cancer who took aspirin were less likely to die of the disease.
The aging mouth - and how to keep it younger
Age brings increased likelihood of tooth decay, gum disease, and oral cancer. Proper oral care can keep the mouth healthy longer.
The prep is worse than the procedure
Prepping for a colonoscopy is unpleasant, but the bowel needs to be clear for the procedure to be effective. Some bowel-cleaning solutions now come in better-tasting flavors, and guidelines now recommend split dosage of the laxative.
By the way, doctor: Could aspirin cause hearing loss?
I am 85 and have taken an 81-mg aspirin each day for decades for heart attack prevention. Recently, I noticed these words on the label: "Stop using if you get ringing in your ears or loss of hearing." Should I be worried?
By the way, doctor: Is 60 too old to be treated for prostate cancer?
I have heard that doctors feel men over 60 shouldn't be treated for prostate cancer because they're old enough that they are going to die anyway. Is that so?
February, 2010
The respiratory tract and its infections
Respiratory tract infections include the common cold, sinusitis, pharyngitis, bronchitis, and pneumonia. Hand washing is the most effective action people can take to prevent getting one of these infections.
In brief: Acrylamide: No longer such a hot potato
The chemical acrylamide, which forms as a byproduct of cooking many baked and fried foods, was thought to cause cancer, but subsequent research has not supported this view.
Does stroke risk begin with the stork?
Researchers looking at stroke risk found that people who were born and spent their childhood years in states in the southeastern United States have a higher risk of stroke as adults.
Choices for hipsters
Hip replacements are common procedures, and their popularity is expected to increase as baby boomers age. Some younger patients opt for hip resurfacing, but it may make them more vulnerable to needing a full replacement later.
By the way, doctor: Do I need to take bile salts after gallbladder surgery?
I have read that people who have had their gallbladders removed should take bile salts. My gallbladder was removed many years ago, and no doctor has said I should take bile salts. Should I?
By the way, doctor: Should coenzyme Q10 be taken with statins?
I take a statin. Should I be taking coenzyme Q10 to protect myself against the muscle pain that statins can cause?
March, 2010
Cultivating your inner boss
Executive function is the part of our thinking that organizes, plans, decides, and inhibits inappropriate impulses. Healthy lifestyle habits such as exercising, controlling blood pressure, and getting enough sleep also work to preserve executive function.
Understanding migraine
Questions and answers about migraine headaches: what they are and are not, what causes them, prevention, and more.
Sleep apnea: Keeping up the positive pressure
Sleep apnea has been linked to many health problems. Obstructive sleep apnea can be treated effectively with a continuous positive airway pressure (CPAP) machine, though getting used to using it can be challenging.
From our follow-up files
Further information about recently published articles on bowel prep before colon surgery, Kegel exercises to strengthen pelvic muscles, and the results of a study on platelet-rich plasma therapy.
By the way, doctor: Can I go back to eating wheat once my celiac disease is under control?
I have a mild case of celiac disease. Do the villi ever recover after wheat gluten is given up? I am really tired of gluten-free food!
By the way, doctor: Are MRI contrast agents harmful?
Do the contrast agents used with MRI scans have side effects? I have had several MRIs and am wondering if there's reason to be worried.
April, 2010
All about gout
Many people think of gout as an archaic and uncommon affliction, but it is becoming more common, mainly among older men who eat a lot of meat and seafood and drink a lot of alcohol, particularly beer.
It's time to really get the ticks off
Deer tick nymphs are most active in the warmer spring and summer months. A tick bite can lead to Lyme disease or other illnesses.
Is hefty the new healthy?
Some studies have suggested that a little extra weight may be beneficial to older people, but increasing weight and fat around the waist in older age still mean a greater risk of a number of diseases.
From our follow-up files
Additional information about recently published articles on a possible alternative treatment for migraines, avoiding the need for hip replacement, and the effect of high blood pressure on executive function.
By the way, doctor: Is there a solution for watery eyes?
I am 63 and have tears running down my face at odd times. Most of the information I've found on the Internet is about infants with blocked tear ducts. Can you provide some information about tearing in adults?
May, 2010
Editor's note
The editor in chief of the Harvard Health Letter introduces this year's edition of a special issue comprised entirely of "By the way, doctor" letters from readers.
By the way, doctor: Is not washing your face good for your skin?
I wash my face very little because I have heard soaps, no matter how mild, dry out the skin. What do you think - what should I wash my face with?
By the way, doctor: Should I stop taking these vitamins?
In addition to a multivitamin, I have been taking vitamin B12 supplements (1,000 mcg) for a few years, hoping to increase my energy. My recent blood profile showed a high level of B12 (1,826 pg/ml). Should I stop taking B12? My energy is about the same.
By the way, doctor: When is the best time to check your own blood pressure?
I'm starting to check my blood pressure at home. When during the day should I do it?
By the way, doctor: Will a fiber supplement interfere with my medications?
I take a fiber supplement, but have heard that I shouldn't be taking it at the same time as medication. How far apart should I take fiber and medicines such as Plavix and Crestor?
By the way, doctor: Should boys be getting the HPV vaccine?
Why are parents not being urged to get their sons vaccinated for HPV?
By the way, doctor: How can caffeine help migraines?
If coffee constricts blood vessels, why would it help migraine sufferers, since the constriction curtails blood flow, which would seem to cause more pain?
By the way, doctor: Could swimming in cool water give me a heart attack?
When I attempt to go into the outdoor pool at my beach club, I gasp for breath, get dizzy and light-headed. I read that some people who are very sensitive to cold water may sustain a heart attack from submersion in cold water. Is this a possibility?
By the way, doctor: Will thiazide diuretics increase my chances of getting diabetes?
Thiazide diuretics are often recommended as the first medication to use to control blood pressure, but I've heard that a large study called ALLHAT found an association between thiazide diuretics and diabetes. Is this something to be concerned about?
By the way, doctor: Are gourmet salts better for you?
Do you know anything about the various fancy salts? I've heard that they deliver salty flavor but have a smaller dose of harmful sodium.
By the way, doctor: Is Avastin for macular degeneration a good choice?
My 78-year-old husband has wet macular degeneration. He is being treated with a drug called Avastin. Is that a good choice?
By the way, doctor: What can I do about excessive belching and feeling full?
I belch a lot and get a feeling of fullness in the upper abdomen. Is this a common condition? What are the causes and cures? I would prefer natural remedies.
By the way, doctor: Does an H. pylori infection without symptoms need to be treated?
I'm in my mid-80s and am infected with H. pylori, the "ulcer bacteria." I don't have any symptoms and have heard that half of everyone over age 60 tests positive for H. pylori and that many people never develop ulcers. Do I need to be treated?
By the way, doctor: Can even one fatty meal cause heart problems?
I'm in good health and have a good lipid profile but occasionally have a yearning for brisket or corned beef. I recently read that even one meal heavy in fat could cause atherosclerosis. What do you think?
June, 2010
An update on soy: It's just so-so
Soy's earlier promise as a health food has been dimmed somewhat by the results of more recent research.
War on cancer won't be won in the produce aisle
Results of the EPIC study show that consumption of fruits and vegetables has a much smaller effect on cancer risk than was previously believed, but including them in one's diet is still important for cardiovascular health.
Colon cancer risk: A refresher course
Colon cancer is highly preventable, and many factors influence a person's risk. Diet and exercise, unsurprisingly, factor heavily.
New (still proposed) rules for sunscreen
The FDA's proposed revisions to sunscreen labeling would provide more information to consumers and emphasize safety.
In Brief: Depression research: An objective view of gloomy outlook
Researchers are examining the possibility that at some point, depression may be objectively measureable through a retinal test.
In Brief: Looking for a panacea? Just keep on moving
Results of studies show that exercise or other physical activity has a beneficial effect on conditions ranging from mild cognitive impairment to Parkinson's disease.
By the way, doctor: Colonoscopy: Is it time to go virtual?
I read that President Obama had a virtual colonoscopy. Is this the colon cancer screening test that everybody should be getting instead of a regular colonoscopy? I thought it was kind of experimental.
July, 2010
A prescription for better health: go alfresco
Spending time outdoors is likely to improve your mood and concentration, encourage activity and fitness, and fuel your body's production of vitamin D.
Can aspirin do that, too?
In light of its success in reducing the risk of heart attack or stroke, researchers are investigating whether aspirin may offer protection against cancer.
When nerves get damaged
People with peripheral neuropathy may experience pain, numbness, tingling, and other unpleasant sensations. Often the cause cannot be determined, so the condition must be managed by attempting to treat the symptoms.
Elevating your HDL game
Taking niacin is an effective way to boost HDL cholesterol, but there are side effects to consider.
By the way, doctor: Is it okay to take ibuprofen p.m.?
I take ibuprofen p.m. on occasion - maybe once a month or so - to help me get to sleep. It seems to work. Is that okay?
By the way, doctor: Can you give me some advice about omega-3s?
I am confused about omega-3 fats. Are the different types equally good for you?
August, 2010
Storm's a-comin'
The dangers of lightning are generally well understood, but thunderstorms can also trigger asthma attacks, and they may be linked to other conditions as well.
Getting back on the bike
Bicycling is a great way to get to work while getting the benefits of aerobic exercise. Riding safely and comfortably will make bike excursions more enjoyable.
Is the heart attack going out of style?
Two studies show a decline in the number of hospitalizations for heart attacks, suggesting that efforts at prevention are effective.
From our follow-up files
Additional information about recently published articles on gout and migraine headaches.
By the way, doctor: Does removing blood increase the amount of iron in the body?
My brother has been told he has too much iron in his body. I've heard the treatment is removing blood every so often, but his doctor says that will just produce more iron in his blood. Can that be true?
By the way, doctor: Can I stop getting colonoscopies?
At age 60 I was treated for colon cancer. Since then I've had regular colonoscopies with no further sign of colon cancer. I'm now 84 and healthy. Does it make sense to get another colonoscopy?
September, 2010
The smoldering epidemic
Hepatitis C is caused by a virus, but it can go undetected for years or even decades because there are often no symptoms. If left untreated, the virus can cause inflammation of liver tissue that can lead to cirrhosis.
Tiny specks may add up to heaps of trouble
The dust in a typical house is likely to contain allrergens like pet hair and dander, or chemicals and poisons like lead or arsenic that make their way in from outdoors.
The aging face
People who want to look younger have a number of options for nonsurgical treatments for the face, such as injections of dermal fillers or laser treatments.
By the way, doctor: Should my mother get an angiogram?
My mother is having angina when she exerts herself. She is scheduled for an angiogram and maybe angioplasty. I've heard that women's heart disease is different from men's and that angioplasty may not be as effective in women. Should she get the angiogram?
By the way, doctor: Isn't quinoa a supplier of complete proteins?
I read in your June 2010 issue that soybeans are the only plant food that could serve as a person's sole source of protein because they contain all eight essential amino acids. I thought quinoa does too.
October, 2010
The simplification of CPR
Guidelines for CPR have eliminated the giving of mouth-to-mouth breaths, partly so people will be more likely to give CPR, and partly because blood flow slows during the time compressions are stopped to give breaths.
Keeping cancer from coming back
The question of whether or not cancer survivors should take vitamin or mineral supplements to prevent recurrence cannot be answered conclusively, because there have not been any studies in this area.
When eyes get dry and what you can try
Dry, irritated eyes can be caused by a number of conditions, such as certain autoimmune diseases, and are a side effect of certain medications. They are more common in women and older people.
Shingles: Prevention is the way to go
As the immune system weakens with age, the risk of shingles increases. Many doctors recommend that people over 60 get the shingles vaccine.
By the way, doctor: What is body dysmorphic disorder?
My niece has been diagnosed with body dysmorphic disorder. I've heard of it, but I'm not sure what it is exactly.
November, 2010
Smartphoning it in
There are a number of apps available for smartphones to help people with topics like dieting and fitness, blood pressure monitoring, stress management and reduction, first aid, and more.
You've torn your ACL. Now what?
People with ACL injuries in the knee may want to consider physical therapy to see how well the knee heals before deciding on difficult and expensive reconstruction surgery.
New caution about opioids
Abuse of prescription opioid medications has increased, resulting in overdoses and deaths. There is also evidence that long-term use of an opioid can affect the nervous system and cause other side effects.
By the way, doctor: Why don't statins damage the heart muscle?
I've heard that statin drugs can cause muscle damage. Since the heart is a muscle, why don't statins cause heart damage?
By the way, doctor: Is there an environmentally friendly way to get omega-3s?
Omega-3 fats may be good for you, but I worry about overfishing. Is there a way of getting omega-3s without contributing to this problem?
December, 2010
H1N1 and this flu season
The H1Ni flu pandemic was not as serious as had been expected, but children and pregnant women were disproportionately affected, and those groups are still at higher risk of getting the H1N1 flu this winter.
Rules to eat by
The federal government's dietary guidelines are likely to Include recommendations to reduce sodium intake, take vitamin D, avoid solid fats, and more.
Sex in the second half
Older Americans are remaining sexually active in greater numbers, due in part to continued good health and the prevalence of erectile dysfunction drugs.
Creative thinking and the brain
Excerpts from an interview with the author of a book on the psychology and neuroscience of creativity.
By the way, doctor: Is anterior hip replacement better?
I have a severely arthritic hip. It's pretty clear that I'm a candidate for hip replacement. When I looked on the Internet, there were a lot of Web sites promoting "anterior hip replacement." What is it, and is it any better than the traditional approach?
By the way, doctor: Will wearing glasses make my eyesight worse?
I am starting to have trouble reading. But I have heard that wearing glasses to help me read will make my eyesight worse. Is that true?
January, 2009
Measuring how fat we are
Body mass index is the most well-known way of measuring fat stored in the body, but waist circumference and waist-to-hip ratio measure different types of fat that may increase the risk of certain health problems.
Do PPIs have long-term side effects?
Proton-pump inhibitors relieve acid reflux, but people who take them long-term may be more susceptible to certain bacterial infections, pneumonia, and bone fractures.
Changing the cardiovascular prevention game
Results of the JUPITER trial showed that people with low LDL cholesterol but with a high C-reactive protein level who took the statin rosuvastatin had a dramatic decrease in risk of serious cardiovascular events.
What's up… and what's not
Results of drug trials and studies: selenium does not lower prostate cancer risk, lifestyle factors have a definite effect on longevity, and a possible correlation between physical warmth and opinion of warmth of personality.
By the way, doctor: What should an exam for skin cancer include?
Since having a carcinoma removed, I've gotten a full-body examination by a dermatologist every six months. I recently went to a new dermatologist, who just took a quick look at my back, arms, and legs. I wonder what the standard is for a full-body exam.
February, 2009
Learning to walk: A graduate course
Aging, or a condition such as arthritis, can negatively affect your gait. Focusing on the mechanics of walking can improve your stride, making it healthier.
A new way for TMJ
In the past, dentists and doctors were quick to treat temporomandibular joint (TMJ) problems with dental work and surgery. Now it is understood that TMJ pain may have many different causes, and surgery is not always the best course of action.
Getting a leg up on sciatica
The pain of sciatica can be relieved through surgery, but evidence suggests that over time, conservative treatment (NSAIDs, physical therapy, perhaps a steroid injection) provides equivalent relief.
By the way, doctor: Why two anti-inflammatories?
I read about statins having anti-inflammatory effects and lowering CRP levels. So why are we now being told that some people need to take two anti-inflammatories - aspirin and a statin?
By the way, doctor: Is there any drawback to hyaluronic acid capsules?
I have been taking capsules containing hyaluronic acid for my knees. Is there any downside to this medication?
March, 2009
12 ways to cut health care costs
Individuals can reduce their health care costs by following these suggestions, which include developing a consistent relationship with a primary care physician, taking generic medications when possible, and discussing end-of-life issues ahead of time.
In brief: The shoulds - and the shouldn'ts - of getting your shots
The immunization schedule for adults has changed, and many people may not be up to date on their vaccinations. Talk with your doctor about what shots you may need.
All the pretty pictures
The prevalence of CT scanning has had a marked impact on medical diagnosis, but the radiation from a CT scan is much higher than from a traditional x-ray, and people who undergo repeated scans may be at increased risk for cancer.
Weighing on our minds
It was previously believed that heavier people were less likely to develop dementia than thinner people, but recent evidence has shown that people with more abdominal fat in middle age are more likely to develop dementia later in life.
By the way, doctor: What might have caused my sister and brother-in-law's pulmonary embolisms?
Within a three-month period, both my sister and her husband (both in their 40s) were hospitalized with pulmonary embolisms. Any thoughts on the cause? Could it be something in the air?
April, 2009
Putting the joie de vivre back into health
Following the now-established benefits of moderate alcohol consumption, research now shows that chocolate and coffee also provide some measure of benefit to health, as do sleep, sex, and a strong social network.
The Whipple procedure
About 20 percent of people with pancreatic cancer are candidates for a surgery called the Whipple procedure that removes the part of the organ where most of this type of cancer originates.
Vitamins: Benefit of the doubt vs. doubts about benefit
The argument for taking a daily multivitamin is not as strong as it used to be. Research continues to accumulate showing that vitamins do not provide the benefits they were once believed to, and sometimes can be harmful.
By the way, doctor: Can cutting calories help my memory?
I'm 65, and I don't think my memory is as good as it once was. I read about a study that says you can improve your memory by eating less. Is there any truth to it? It sounds too good to be true.
By the way, doctor: Should I be concerned about omega-3 fats and bleeding?
I've been taking omega-3 fats and have two big bruises. Even small doses of aspirin cause me to bruise. My doctor is not concerned, but should I be?
May, 2009
Editor's note
The editor in chief of the Harvard Health Letter introduces this year's edition of a special issue comprised entirely of "By the way, doctor" letters from readers.
By the way, doctor: Children and soy milk
Is it safe for children to drink soy milk?
By the way, doctor: Screening for pancreatic cancer
We have screening tests for other cancers. How about pancreatic cancer?
By the way, doctor: PET-CT scans for finding breast cancer
I've been having PET-CT scans to look for any growth or spread of previously removed tumors. Are they as reliable in detecting breast cancer as a regular mammogram?
By the way, doctor: Diabetes treatment
I've had type 2 diabetes for 12 years; I'm now 81. I take metformin plus Januvia. My doctor has never suggested that I monitor myself with a meter. My hemoglobin A1c has been creeping up and is now 7. Should I be getting more aggressive in my treatment?
By the way, doctor: A very fishy diet
I read in the Health Letter that one of the nutrition experts eats five servings of fish a week. Why so much? And isn't there a risk from the contaminants?
By the way, doctor: Hammertoe woes
I have been told by a podiatrist that because of hammertoes, the fat pads on the ball of my foot have dissipated, causing pain when I walk or stand for long periods. I like to walk for exercise so this is a real bother.
By the way, doctor: Plugged-up feeling in an ear
I have a plugged left ear problem. It usually starts about 4 p.m. and lasts about three to four hours. I cough, clear my throat, yawn, close my nostrils and blow - nothing seems to help.
By the way, doctor: Tremors
I am curious about tremors in adults. I know that people with Parkinson's disease get them, but I am not sure about other conditions.
By the way, doctor: Ginkgo biloba and dementia
You published an article saying that ginkgo biloba might slow down dementia. I was 59, and I started taking it. I think it has helped me and know others who think likewise. But I read that a recent study says it doesn't help. Your thoughts?
June, 2009
Getting out the gluten
Doctors are diagnosing more cases of celiac disease, leading to an increased interest in gluten-free foods, although not everyone who has difficulty digesting gluten has celiac disease.
Calcium curious
Concerns about calcium are addressed by answering some commonly asked questions about this nutrient.
The principles of conservative prescribing
A patient-safety research organization has compiled a list of principles intended as guidelines for conservative prescribing of medications.
By the way, doctor: Will Levitra overcome the problems caused by finasteride?
Finasteride has been prescribed for my BPH. I think that the most frequent side effect is erectile dysfunction or loss of sexual desire. Would Levitra or a similar drug (like Viagra or Cialis) overcome the side effects of finasteride?
July, 2009
Angina
Angina is pain that radiates from the chest, caused by blockage of a coronary artery. Stable angina is not immediately life-threatening and can be treated effectively with medication, but unstable angina is a medical emergency.
Time to put some muscle into it
Aerobic exercise has clear cardiovascular benefits, but with aging, strength training is equally important. Building and maintaining muscle helps with balance and mobility, and helps older people stay healthy.
Nutrition's dynamic duos
Certain nutrients, such as calcium and vitamin D or potassium and sodium, work better in pairs, which is useful information when making nutritional choices.
By the way, doctor: Emergency care for chest pain
If you have chest pain or discomfort, how do you know if it is serious enough to warrant emergency medical attention?
August, 2009
Editor's note
The editor in chief of the Harvard Health Letter introduces a special section in this month's issue focusing on feet.
Coming out of its shell
Concerns about shrinking fish populations may move health-conscious eaters to choose more shellfish. Informed shoppers should be aware of the differences in nutritional value and potential toxins among various types of shellfish.
Overdoing acetaminophen
Accidental overdoses and potential liver damage have raised concerns about the safety of acetaminophen. As a result, the FDA is considering lowering the recommended safe daily limit.
Special section: Feet: How your feet work - and three steps for keeping them healthy
Our feet are marvels of anatomical engineering, but they can also cause problems. Common sense when choosing footwear can ease the pain and pressure on feet.
Special section: Feet: Agonies of the feet: Four common foot problems
Some people have a tendency to develop certain foot conditions, while others can occur because of poor shoe choices or excess weight.
Special section: Feet: A guided tour down the foot aisle
Guest editor Dr. James Ioli evaluates the effectiveness of some of the foot care products available in drugstores.
By the way, doctor: Flip-flops - how bad are they?
I read your article about hammertoes. Are flip-flops really that bad for your feet?
By the way, doctor: A second bunion operation?
I had bunion surgery five years ago. I thought it would fix the problem. Now the bunion has come back. Should I get bunion surgery again?
By the way, doctor: Switching from heels to flats
I know high heels are bad for the feet, but when I switched to flats, my feet started to hurt. Why?
September, 2009
His and hers heart disease
It is now understood that heart disease affects men and women differently, so doctors should consider these gender differences in diagnosis and treatment.
Counting every step you take
A pedometer is an inexpensive tool that can be an effective motivator to encourage walking more.
Whiplash
The abrupt movement of the neck during a whiplash injury can cause strains or sprains that do not show on standard imaging tests.
By the way, doctor: Cinnamon as treatment for diabetes?
I've heard that you can treat diabetes by taking an extract from cinnamon. I suspect this is snake oil, but is there anything to it?
By the way, doctor: Should I have seen a doctor sooner for a dog bite?
Recently, my dog bit me on the hand. When I showed up at my doctor's office several days later, he told me I had waited too long. Should I have gone to the doctor sooner?
October, 2009
H1N1 and its descendents
The H1N1 flu outbreak is linked to earlier versions of the virus. So far the 2009 pandemic has not been as severe as some health officials expected, but it is still a good idea to take basic precautions.
Game on
Research into how video games affect children is complicated by other factors that influence a child's behavior, such as personality and home life. Parents should consider limiting the type of games played or the amount of time spent playing.
Platelet-rich plasma therapy
Platelet-rich plasma therapy is a procedure used to treat joint pain, but even though the technique has been approved by the FDA, little research has been done on its effectiveness in people.
By the way, doctor: Cut off from toenail fungus medicine too soon?
Penlac didn't work to cure my toenail fungus. I took an oral medication, terbinafine, and saw some improvement, but my insurance company won't approve more than a few months of treatment. It's frustrating to finally have a solution and then be cut off.
By the way, doctor: Why three blood thinners at once?
I am currently on Coumadin because I had atrial fibrillation after my bypass, Plavix because of my stent, and a baby aspirin. Why do I need to take three blood thinners?
November, 2009
Napping may not be such a no-no
A nap in the afternoon can help a person regain mental focus and retain information better, and may help people who work night shifts remain alert.
The male face of osteoporosis
As death rates from heart disease and other conditions decline, more men are living long enough to lose bone mass, making osteoporosis more of a male problem than it had been considered in the past.
A sport for all seasons
Swimming is an excellent form of exercise for almost anyone. It tones larger muscles, eases arthritis pain, and lowers blood pressure, while the cushion of the water greatly reduces the risk of injury.
Side effects: Minor can add up to major
Many medications have anticholinergic side effects, meaning they block the action of a key nervous system chemical. If a person takes a number of these medications for a period of time, the effects can build up and cause problems with thinking and memory.
By the way, doctor: Why did my doctor prescribe steroids?
I have been diagnosed with temporal arteritis and am being treated with prednisone, which the doctor says is a steroid. I know athletes use steroids to bulk up, and I can't see how that would have anything to do with temporal arteritis. Can you explain?
By the way, doctor: Can the brain grow new neurons?
A recent Health Letter urged us seniors to stay mentally active because that causes the growth of new neurons (brain cells). When my husband had a stroke 40 years ago, the doctors told me the brain cannot make new cells in later life. What's the truth?
December, 2009
The top 10 health stories of 2009
The Health Letter reviews the major health news of the year, including health care reform, the H1N1 flu pandemic, a possible alternative to warfarin that has fewer side effects, and questions about the need for testing for certain cancers.
Regaining control of your bladder
Urinary incontinence can be treated with medication or, if necessary, surgery, but people with this problem should first try pelvic floor exercises, moderation of fluid intake, and bladder retraining.
Vitamin's value to be D-termined
A five-year study funded by the National Institutes of Health hopes to determine whether vitamin D and omega-3 fats have an effect on rates of cardiovascular disease or cancer.
By the way, doctor: Is the difference between the two blood pressure numbers important?
I'm 72 and my systolic blood pressure has been steady between 115 and 125. The diastolic number is low (55-65) and seems to be falling. Is the difference between these two numbers important, and is the falling diastolic number something to worry about?
More on toenail fungus
After Dr. Kenneth Arndt answered a question about toenail fungus, a number of readers sent us their favorite remedies. We asked Dr. Arndt to comment on several of them.
January, 2008
Cold comfort
There is still no cure for a cold, and cold medications have come under scrutiny and criticism. Some people may get better results taking separate medications for fever, cough, and congestion, rather than a combination product.
Human growth hormone
Used by athletes to build muscle, human growth hormone may in fact make muscles bigger, but not necessarily stronger. HGH is also marketed as an anti-aging treatment, but there are no data about possible side effects from long-term use.
A SAD story: Seasonal affective disorder
Seasonal affective disorder is thought to be caused by decreased exposure to sunlight during the winter months. Light therapy helps some people, and the FDA has approved the antidepressant bupropion for treatment as well.
Vitamin E: Separate and unequal?
Expectations for vitamin E's ability to protect the body against illness and disease have not been met, but certain types of vitamin E may have more effective antioxidant properties than others.
In Brief: Getting well after Bell's
Bell's palsy is the paralysis of one side of the face caused by inflammation of the facial nerve. Treatment with a steroidal anti-inflammatory medication usually eliminates the condition.
In Brief: Low-carb dieting: Slimmer but sadder?
Research suggests that a diet low in carbohydrates could lead to lower levels of serotonin in the body, which in turn may cause an increase in bad moods.
By the way, doctor: Should my father go back to taking Coumadin?
My father caught a bad case of pneumonia. He's recovered, but it seems to have left him confused, and he uses a walker now. Before the pneumonia he was taking Coumadin for atrial fibrillation. Now that he's feeling better, should he start taking it again?
February, 2008
Moisturizers: Do they work?
Moisturizers work by trapping and holding water in the skin, in combination with some oily substance that binds the moisture to the skin. While ingredients vary, almost any moisturizer will help with dry skin.
Too much of a good thing
Researchers have compiled data regarding patterns and variations of medical care throughout the US. They found that differences in standards of care tend to be due to doctors' personal preferences more than any other reason.
Nutrition: Conversation with an expert
Dr. Walter Willett, the head of the nutrition department at the Harvard School of Public Health, discusses nutrition-related questions and issues.
HDL: Good and brainy
HDL, the "good" cholesterol, helps prevent heart disease, but there is some evidence that suggests it may also help protect against strokes, and possibly dementia as well.
Heads in the game
Research has found links between incidences of concussions among professional football players and depression. Players who experienced more than one concussion had a higher likelihood of being diagnosed with depression.
By the way, doctor: Should I continue to take Fosamax?
I've taken Fosamax for 11 years. My bone density has improved. One doctor I consulted told me to continue taking it, but another said it would be dangerous to do so. What should I do?
By the way, doctor: Will Boniva make my bones weaker?
I am taking Boniva for osteoporosis. I read that an alleged women's health expert said that osteoporosis drugs like the one I'm taking actually make bones weaker by stopping the body from breaking down old bone, and causing jaw disease. Is this true?
March, 2008
Pain relief, opioids, and constipation
Opioid drugs like morphine are the most effective pain relievers, but constipation is a typical side effect. it is therefore advisable to take a stool softener and a laxative when taking an opioid.
Finding ovarian cancer early
Ovarian cancer is highly treatable if diagnosed early enough, but it is often difficult to detect. Women who experience unusual abdominal pain, bloating, or digestive problems over a period of two or three weeks should see a doctor.
A recipe for long life and good health: Mediterranean eating
An accumulation of research shows that following a Mediterranean diet, by eating vegetables, fruits, whole grains, fish, poultry, small amounts of meat and dairy, and moderate amounts of wine, lowers the risk of heart disease and cancer.
Do we really need all that calcium?
While calcium is essential for bone strength, some experts believe that Americans are getting too much calcium, which can actually lead to an increased risk of a hip fracture.
Tattoos: Leaving their mark
As tattoos become more common, the desire to have them removed has also increased. Lasers are generally safe and can be effective, but often cannot remove the entire tattoo.
By the way, doctor: Is Vytorin safe?
I'm taking Vytorin. After the news about a negative study a couple of months ago, I am wondering if it's safe.
By the way, doctor: Can I get a pill to help me quit smoking?
Is there a prescription medication to help me stop smoking? My doctor says no.
April, 2008
You don't have to take a pill
It is often easier to treat a condition with medication rather than making lifestyle changes, and some people cannot or do not want to take drugs. But there are ways to manage certain conditions without drugs.
Olfaction subtraction
Temporary loss of smell, which affects the ability to taste, can be caused by a cold, allergies, head injury, or viral respiratory infection. A short course of an anti-inflammatory corticosteroid medication can sometimes resolve the problem.
Our pet causes
Household pets can carry bacteria on their fur or in their waste that can transfer to humans, but the overall risk of infection is small, and can be further mitigated by getting in the habit of washing your hands after touching your pet or its waste.
By the way, doctor: Is that too much vitamin D?
My doctor gave me a prescription for 50,000 units of vitamin D to be taken every two weeks. But I've read that the recommended dose is more like 1,000 IU a day, and that more than 2,000 IU a day is unsafe. I don't want to do more harm than good!
By the way, doctor: Why is my mitral valve leaking?
I had cardiac bypass surgery three years ago. I didn't have a heart attack none of my heart muscle was killed. But two months ago, a stress test showed that the mitral valve in my heart is leaking. What could have caused it, and what can I do about it?
May, 2008
Editor's note
The editor in chief of the Harvard Health Letter introduces a special issue comprised entirely of "By the way, doctor" letters from readers.
By the way, doctor: Microwave cooking and nutrition
Does cooking with a microwave take nutrients out of food?
By the way, doctor: What is burning mouth syndrome?
My husband was diagnosed with burning mouth syndrome. This seems to be a mystery syndrome. What can you tell us about it?
By the way, doctor: How much Imitrex is too much?
My doctor suggested switching to a low-dose antidepressant like Elavil to take prophylactically rather than taking too much Imitrex, but I don't remember what the "too much" cutoff amount is.
By the way, doctor: Should I get the cervical cancer vaccine?
I am in a monogamous relationship and get Pap smears. Do I need to get the cervical cancer vaccine?
By the way, doctor: Do birth control pills disguise menopause?
How do I know whether I'm approaching menopause if I'm taking birth control pills?
By the way, doctor: Are the guidelines for taking statins different for women?
I've heard that men are supposed to take a statin if they're at high risk of getting heart disease, but that women are only supposed to after they actually get it. Is that true?
By the way, doctor: Why does skin wrinkle after being underwater?
Why do our hands and feet wrinkle up when immersed in water? Your article about moisturizers said they work by trapping water in the skin, so why don't we wrinkle up after applying moisturizer?
By the way, doctor: Is it okay to take a stool softener long-term?
I have been taking a stool softener daily for two months. It's helped with my constipation. Are there any risks to taking a stool softener on a long-term basis?
By the way, doctor: HGH after surgery
I heard that human growth hormone can help people after surgery. Is that true?
By the way, doctor: Minimally invasive knee replacement
I need a knee replacement and am trying to decide between a minimally invasive operation and a traditional one. What do you think?
By the way, doctor: Do I need to go to the ER after fainting?
I tend to faint when I get sick. Do I need to go to the emergency department (or call 911) when I faint? My doctor said I should, but that seems so unnecessary.
By the way, doctor: Cancer of the small intestine
We hear a lot about colon cancer, and sometimes about stomach cancer, but hardly ever anything about cancer of the small intestine. Why? Is it rare?
By the way, doctor: Tamoxifen versus aromatase inhibitors
I've had an ER-positive breast cancer tumor removed. Now I am getting ready for follow-up therapy. I've heard that the aromatase inhibitors are better than tamoxifen. What is your opinion?
By the way, doctor: Calcium supplements and heart attack risk
I read in the newspapers about a study that said older women taking calcium supplements are at increased risk for experiencing a heart attack, stroke, or sudden death. Should I be concerned?
By the way, doctor: Celebrex and bleeding
I take Celebrex for arthritis. I learned that it and the other NSAID medicines increase the risk of bleeding. If that's true, is my risk for hemorrhagic stroke higher?
June, 2008
When walking makes your legs hurt
There are other conditions besides arthritis that can make walking difficult and even painful, such as peripheral artery disease, chronic venous insufficiency, lumbar spinal stenosis, and diabetic neuropathy.
A good old age
Two books examine the health issues around aging and caregiving from different points of view, and offer advice and suggestions on how the United States health care system could be improved.
Masculinity and men's health
Men are more likely than women to engage in unhealthy behavior, and less likely than women to seek or heed medical advice. This may be due to masculine notions about how men are supposed to behave.
Brushing up on brushing
Many people think their toothbrushing skills are better than they really are. Tooth brushing tips include brushing for at least two minutes, using a soft brush with bristles of varying heights, and replacing your brush at least every three months.
By the way, doctor: Should I back off from getting my blood sugar down?
I read about the study suggesting that tight control of diabetes led to more deaths. My hemoglobin A1c level has been right around 7 to 7.5 for years. Should I back off? Or keep pushing for even lower glucose levels?
July, 2008
Cancer screening as we age
There is some controversy about whether or not people should continue to get screening tests for certain cancers after age 75. Variables include the person's overall health and whether or not additional life expectancy can be achieved.
Hospice care
Hospice care for terminally ill patients is increasing in popularity. This type of care is primarily a service, rather than a place, and may be administered in a hospital setting, at a patient's home, or in a nursing home.
Egg-cellent news for most, but not those with diabetes
Long criticized for their high cholesterol content, eggs have once again earned consideration as a healthy food, due primarily to their protein. But people with diabetes should still limit their egg consumption.
In Brief: Smokers: The formers versus the nevers
People who quit smoking can expect their risk of related illness to decrease to about the same level as that of people who have never smoked, although it can take several years for this to happen.
In Brief: Trans fat, au naturel
Meat and dairy products contain naturally occurring trans fat, and studies are suggesting that the small amounts of this fat in animal products may actually be good for us.
By the way, doctor: Should I stop taking a stomach acid blocker?
I was treated for two weeks with antibiotics and a proton pump inhibitor when I had an H. pylori infection. I've continued with the proton pump inhibitor to cut down on stomach acid. Could that be harmful?
By the way, doctor: Is it okay to switch from Avodart to finasteride for BPH?
I have been taking Avodart for my BPH, along with Flomax, but finasteride may be less expensive. Should I switch?
August, 2008
Hair today, more hair tomorrow?
Progress has been made in the field of hair regrowth, but the treatments, whether medication or surgery, are expensive, and there is no guarantee of success.
Surviving the Medicare maze
Negotiating the complications of Medicare insurance requires patience and a good deal of research, but the effort is necessary in order to have adequate coverage when it's needed.
The sunshine D-lemma
Ultraviolet light causes skin cancer, but it also triggers the body's production of vitamin D, which seems to counteract it. Limited sun exposure can boost levels of vitamin D, or it can be obtained through a vitamin supplement.
By the way, doctor: Should my daughter get a breast cancer gene test?
Both of my father's sisters died of breast cancer years ago, one before menopause, the other just after. I have an 18-year-old daughter. I've been wondering if I should talk to her about getting tested for the breast cancer gene. I'm the dad.
September, 2008
Editor's note
Anthony L. Komaroff, M.D., editor in chief of the Harvard Health Letter, introduces a special issue focused on exercise.
Why we should exercise - and why we don't
It's easy to find reasons not to exercise, but it's also relatively easy to meet the recommended guidelines for physical activity. Here are 27 suggestions for ways to be more physically active.
Can a gadget get you going?
The Heart Letter evaluates three devices that provide information and feedback about physical activity: a pedometer, a heart rate monitor, and an activity monitor.
Meet the METs
A MET is a metabolic equivalent, a measure of how much energy is expended doing a given exercise or activity. Researchers gauge levels of physical activity in METs. A chart shows various activities and how many METs they expend.
Good for the mind, but how about the body?
Whether mild or strenuous, a youg workout provides fitness benefits to almost anyone, even older people and those who have physical limitations.
The gender divide
Women are at higher risk than men of tearing the anterior cruciate ligament of the knee. Part of this disparity may be due to anatomical differences, and hormones may play a role as well.
Let's talk to an expert
Dr. I-Min Lee, a member of the government committee that helped establish new guidelines for recommended amounts of physical activity, discusses fitness and exercise.
October, 2008
Virtual hitchhiker's guide to the medical universe
The health Web sites of various other countries offer an intriguing glimpse of how governments present health information to their citizens in other parts of the world.
The election-year physical
Americans have become accustomed to the practice of presidential candidates releasing their health records to prove their fitness for holding office.
Drug-herb interactions
The American Academy of Family Physicians has published a summary of some of the potential risks of interaction between certain herbal supplements and mainstream medications.
Should you get the shingles vaccine?
An immunization committee recommends that adults 60 and over should get the shingles vaccine. It should prevent about half those who receive it from getting shingles, and about two-thirds of those who have already had shingles from getting it again.
By the way, doctor: Does a colonoscopy reach the ileum?
I am scheduled to have a colonoscopy soon. Does the examination reach the ileum?
By the way, doctor: Can I take a pill instead of B12 injections?
I have pernicious anemia, and I get a monthly injection of vitamin B12. I have heard that there may be a pill that I could take instead. Is that true?
November, 2008
What is normal?
For tests such as blood pressure, cholesterol, and blood sugar, the range that is defined as normal may change over time, as more information becomes known about the health of people whose results were considered to be in the normal range.
Got an ear full? Here's some advice.
Earwax helps keep the ear canal clean, but if it dries out it can clump together and cause a blockage. A few drops of water held in the ear canal for a minute or so will usually dislodge the wax.
Rubbing it in
Topical pain-relief products provide quick relief for sore muscles and joints, but they vary in effectiveness. People whose stomachs are sensitive to oral pain relief medications may prefer to use a cream or ointment.
Fishing out some answers
Eating fish has clear health benefits, but not all kinds of fish are healthy. Broiled or baked fish is better than breaded, fried fish. And fish is not a healthy choice for everyone. Pregnant women and some heart patients should watch their fish intake.
By the way, doctor: How can a stress test be wrong?
How is it possible for someone with significant coronary artery disease to perform well on a cardiac stress test? Wouldn't there be some signs of trouble?
By the way, doctor: What is the healthiest amount of sleep?
I heard about a study that found people who sleep six and a half to seven hours a night will live longer than those sleeping eight to nine. What is the right amount of sleep?
December, 2008
The top 10 health stories of 2008
A review of the major health news of the year, including: the ongoing debate over blood sugar level in type 2 diabetics, a new source of stem cells, genetic testing marketed to the general public, a new type of CT scanning, and health care reform.
What's up…and what's down
Studies reinforce the benefits of hand washing in preventing illness, and suggest that red wine may provide protection from lung cancer in some people, but B vitamins do not appear to offer any help against Alzheimer's disease.
The no-name cancer
Non-Hodgkin's lymphoma is a cancer of the immune system. There are several varieties, some more aggressive than others. Depending on the type, if detected early enough it is often treatable, and sometimes curable.
By the way, doctor: Is ankle fusion my only option?
I have injury-related osteoarthritis in my right ankle. My orthopedic surgeon said, in essence, that it's ankle fusion or nothing for me - and that there are no means of surgically restoring cartilage. What do you think?
February, 2007
Back surgery: to have or not to have
Some back pain cannot be relieved by surgery, but even if it is an option it should be weighed carefully. A prudent course of action is to wait several weeks after symptoms begin to see if they improve on their own.
12 things you should know about pain relievers
A collection of information and advice on pain relievers, including watching the dosage of acetaminophen to avoid liver damage, heart risk from NSAID use, and warnings about blood pressure and kidneys.
The dish on fish
Research affirms that the health benefits of eating seafood are much more significant than any risk due to the presence of toxins such as mercury and PCBs.
By the way, doctor: B vitamins and homocysteine
How do B vitamins lower your homocysteine level, and how important is it to have a normal level?
By the way, doctor: Celiac disease and thin bones
I have celiac disease, and the disease has weakened my bones. But I'm male. I thought thin bones were primarily a problem for women? And why should a disease of my intestines affect my bones? Finally, what can be done about it?
March, 2007
Air ambulance services take off
Air ambulance services are growing in popularity, but because the industry is new, it is relatively unregulated. Those considering using such a service should do research, ask questions, and look for certification.
Reaching for the anti-salt
Potassium helps balance the sodium in our diets. It is relatively easy to get the necessary amount by eating a varied diet with plenty of plant-based foods.
Pancreatic cancer: An update on a 'stealth' cancer
Pancreatic cancer is difficult to diagnose because there are few outward symptoms, and it does not show in traditional imaging tests. It is hoped that ongoing research may reveal a mutated gene or some other sort of genetic marker.
Toenail fungus: Drill to kill
Toenail fungus is difficult to treat, but two new types of treatment in testing may make it easier. One uses short-wavelength light, and the other requires drilling tiny holes in the affected nail.
In Brief: Sing along for health
Research finds that group singing can boost the mood, relieve stress, promote relaxation, and enhance the immune system. Singing along with a group may also be beneficial for people with certain speech disorders.
In Brief: Of pets and pounds
Researchers looked at overweight people who also had overweight dogs. Those who exercised with their pets lost a small amount of weight, but the dogs lost a bigger percentage of their body weight.
By the way, doctor: Can you tell me about the tests for liver and muscle side effects from statins?
I am 80 and am taking a 40-milligram Crestor pill every day. Recently I saw a Crestor ad that said blood tests should be done to monitor for the possible side effects of liver or muscle injury. Can you tell me something about these tests?
April, 2007
9 tips for your health and the planet's
A selection of health advice that is also good for the environment, including biking or walking to work, using less energy by going to bed earlier, setting the thermostat a little higher, and buying locally grown produce when possible.
'Never been the same since'
Delirium is usually temporary, but older people who experience delirium may suffer permanent damage. It is believed that delirium is linked to dementia, but more research must be done before any conclusions can be made.
Protecting hearts, saving minds?
Researchers are exploring the possibility of a connection between cardiovascular disease and Alzheimer's disease and dememtia. The general advice for keeping the heart healthy may prove to keep the mind healthy as well.
Niacin into the void
There is evidence to suggest that niacin, a B vitamin, can help raise HDL cholesterol when taken in larger doses, but there are side effects to be considered.
In Brief: Could estrogen help colon cancer patients?
While estrogen therapy after menopause has been criticized for its negative side effects, some research is suggesting that the hormone may help reduce the risk of colon cancer in women.
In Brief: Patient, manage thyself (but coaching may be available)
Patient self-management programs may encourage patients to take more initiative regarding their health and medical care, but even if it only makes them feel more in control of their course of treatment, that is still beneficial.
By the way, doctor: What can be done for sudden hearing loss in one ear?
My 47-year-old son suddenly lost hearing in one ear. They did some blood tests and he was given steroids and a medication called Valtrex. Now they are saying nothing can be done. Can you please address this issue?
May, 2007
A better hearing aid?
An open-fit hearing aid, which leaves the ear canal open instead of covering the opening, helps eliminate distortion caused by sound waves, and may be more comfortable for wearers.
Is fructose bad for you?
A diet heavy in high-fructose corn syrup may cause people to overeat, but the real problem is more likely the high amount of sugar that people consume in their everyday diets overall, rather than one specific kind of sugar.
Tests for breast cancer
Digital mammography is poised to replace the standard version, but studies show them to be about equal in effectiveness at detecting cancers, depending on age and breast density. Ultrasound and MRI are also useful tools for detection in some women.
Protein is a problem…
OTC disorder, a genetic anomaly that affects the body's ability to properly metabolize protein, is most commonly seen in children, where it can be fatal, but less severe forms of it can affect adults as well.
…but it does help some people lose weight.
A study comparing popular diet programs found that women lost the most weight with a high-protein diet that also had the benefits of helping to raise HDL cholesterol and lower triglycerides. But whatever the diet, consuming less fat is still a key.
By the way, doctor: Can exercise and diet cure diabetes?
I read about a study at UCLA in which men with type 2 diabetes were in a program combining aerobic exercise, low-fat diets, and relatively high amounts of "good" carbohydrates. Half of them cured their diabetes. Is this possible?
By the way, doctor: Does asthma go away?
I was diagnosed with asthma five years ago, and my doctor prescribed an inhaler to use daily. I haven't had any symptoms for a year now, even though I stopped using my inhaler. Can asthma go away?
June, 2007
Meat in the hot seat
There is evidence that grilling meat releases potentially cancer-causing substances. Meat lovers can take steps to reduce their risk, such as cooking smaller pieces at a lower temperature, or precooking the meat for two minutes in a mictowave oven.
A more D-manding diet
Vitamin D is crucial to bone growth, but studies are finding that it may help protect against other diseases such as diabetes and colon cancer. Most adults do not get enough vitamin D, but a daily multivitamin and limited sun exposure can help.
Who needs to be taking aspirin for cardiovascular protection?
The benefits of aspirin for those at risk for heart disease are clear, but for women under 65 who are not at risk, there is no benefit to a daily aspirin. There is evidence that taking aspirin regularly may reduce the risk of stroke, regardless of age.
The not-soy-good results
Once soy was believed to have many health benefits, but studies found that it was not the wonder food some claimed. But other research finds that soy can in fact be beneficial, particularly in place of red meat.
In Brief: Tai chi gives immune system a boost
The body's ability to fight off illness declines with age. A study found that participating in regular tai chi sessions boosted the immune system responses of older people.
In Brief: Cocoa beats tea
A comparison of studies found that drinking cocoa lowered blood pressure approximately as much as blood pressure medication did, while drinking tea did not produce any change.
In Brief: Prescription fish oil
A prescription fish oil product is intended to be used in combination with a special diet for people with very high triglyceride levels.
By the way, doctor: Does grapefruit juice affect aspirin?
I am 78, and for about 10 years, I have been taking an 81-mg aspirin every morning with a glass of grapefruit juice. I heard that it's not a good idea to drink grapefruit juice with some blood-thinning drugs. Is that true of aspirin too?
By the way, doctor: Should I worry about this irregular heartbeat?
At 86, I'm still competitively racing frostbite dinghies. I've noticed that my heartbeat becomes irregular during the races and for hours afterward. It feels like a weak beat after every two normal heartbeats. Is this a normal exercise reaction?
July, 2007
In search of the safe suntan
Research has found that having a tan may provide some protection from skin cancer, but tanning is not safe, so you should not try to tan just to gain this protection.
In Brief: Blood pressure checks at the barbershop
To address the serious problem of high blood pressure among African-American men, researchers gave out information and held screenings at community barbershops.
In Brief: Mint conditions
Some studies have found that peppermint oil may help relieve the symptoms of irritable bowel syndrome, and could help with other conditions as well.
Hormone therapy: The risk-benefit tightrope
The risks and benefits of hormone use in postmenopausal women vary depending on when a woman starts taking the drugs. The risk of heart disease seems to be lower in women who begin taking hormones close to the onset of menopause.
Duct tape, warts and all
A study found that duct tape could help get rid of warts, but subsequent studies have not been able to replicate the results. There are other treatments that are more effective, and sometimes warts go away on their own.
An update on the "old man's friend"
While pneumonia is still a serious illness, flu shots and the pneumococcal vaccine may help protect against it, particularly for older people or those at high risk of infection.
More on niacin: No flush, no good
No-flush niacin may eliminate the flushing that is a typical side effect of the drug, but at the expense of its ability to lower cholesterol and triglyceride levels, thereby making it ineffective.
By the way, doctor: Must I take aspirin?
I have ulcerative colitis and diabetes. My new doctor has been pushing aspirin therapy. My gastroenterologist feels that I should consider aspirin if and when there are signs that I would benefit from it and not to risk having problems with my colitis.
August, 2007
The shingles vaccine: Why hasn't it caught on?
The shingles vaccine Zostavax has not turned out to be as popular as was expected, due in part to its high cost and questions about its effectiveness.
Betting on beta blockers
Beta blockers are used to treat a variety of conditions, but some studies have questioned their effectiveness. Those already taking a bta blocker for high blood pressure do not necessarily need to switch to a different medication.
Migraine as a withdrawal symptom
Women get more migraine headaches than men, possibly because migraines have been linked to the fluctuation of estrogen levels related to the menstrual cycle.
Taking silver could give you the blues
Silver is sometimes used as an antibacterial agent, but products containing silver are being sold as supplements meant to be taken internally. This can cause stomach problems, kidney damage, or argyria (blue spots on the skin).
In Brief: Exercise without losing weight
Exercise that does not result in weight loss is probably just as beneficial to the body in other ways.
By the way, doctor: Why aren't drugs safe when they are approved?
First it was Vioxx and now Avandia. Why can't doctors and the government screen out unsafe medicines?
By the way, doctor: Should I get the prostate cancer test I've heard about?
I heard about a new test for prostate cancer that's better than the PSA test. Should I get this test?
September, 2007
Time to fatten up our diets
Doctors and nutritionists have long warned of the dangers of saturated and trans fats. But unsaturated fats are beneficial, particularly if eaten in place of carbohydrates.
Cataract surgery update: Taking a look at the lenses
People who undergo cataract surgery now have different types of replacement lenses to choose from, including ones that can change focus with the eye's muscles, but these are much more expensive than standard lenses.
Thyroid hormone: Slim fast, but will it last?
Doctors sometimes prescribe thyroid hormone for weight loss, but the increase in metabolism caused by the hormone leads to an increased appetite, which can cause weight gain after all.
Music to their ears it is not
People who are tone deaf, or amusic, are unable to distinguish differences in pitch, and may have a similar difficulty with rhythm. Research suggests this may be due to weak connections between the parts of the brain responsible for processing music.
By the way, doctor: I quit, so why am I coughing?
I stopped smoking several weeks ago, and now I find that I'm coughing a lot. Is that normal?
By the way, doctor: Can you tell me more about cellulitis?
I developed cellulitis in my arm and didn't realize it was such a serious infection. It took three months to heal without treatment. Can you tell me more about cellulitis?
October, 2007
Prescriptions for confusion
Many people have difficulty understanding the instructions for taking their medications. Some retailers have redesigned their pill bottles to make the directions clearer.
How you can limit your gas production
These suggestions may help reduce your production of flatulence.
Radon revisited
Prolonged exposure to radon gas may lead to an increased risk of lung cancer. Combined with smoking, the risk is much higher. Testing can reveal if there is an unsafe level of radon in a home's air.
In Brief: Cranberry juice and warfarin: Okay together?
According to researchers, concerns about cranberry juice interfering with the anticoagulant medication warfarin are unfounded.
In Brief: Selenium: Maybe this mineral isn't such a gem after all
The mineral selenium may halp reduce a man's risk of prostate cancer, but it may also slightly increase his risk for diabetes.
In Brief: Something to sink your teeth into: Sugarless gum
Chewing sugarless gum is a good way to neutralize the cavity-causing bacteria that live on teeth, but all sugarless gum is not created equal.
In Brief: Seat belts: A crash course in staying healthy
Seat belts protect those wearing them in the event of an accident, but they also protect others in the vehicle, as unrestrained riders can be thrown in a crash.
By the way, doctor: What can I do about my snoring?
My wife says I snore a lot. I don't think I have sleep apnea, but I'm not sure. Is there anything I can do for a serious snoring problem?
November, 2007
How to lower your risk for colon cancer
To reduce the risk of colon cancer, people should cut back on red meat, get regular exercise, maintain a healthy weight, and get a first colonoscopy at age 50.
Bipolar disorder
Bipolar disorder is difficult to diagnose because its cycles of mania and depression may be mistaken for other psychological conditions. Medications can treat the symptoms, but finding the proper combination for each patient can be a lengthy process.
In Brief: Great expectations
Statistics on life expectancy among Americans show an overall trend of increasing longevity, due to better screening for and treatment of diseases such as cancer and heart disease. But death rates from some other causes are increasing.
In Brief: You don't smoke it, but it's still tobacco
While some believe smokeless tobacco is a safer alternative to cigarettes, research found that smokeless users had higher levels than smokers of a cancer-causing substance found in tobacco.
In Brief: Giving pneumonia the brush-off
There is growing evidence of a link between gum disease and heart disease and pneumonia. Hospital patients on ventilators seem particularly vulnerable to pneumonia infections.
In Brief: Cholesterol: Beyond good and bad, there's big
Lipoproteins come in different sizes. Larger HDL particles remove cholesterol from the body more effectively. A researcher contends that the larger particles are an indicator of longevity, and that this trait can be passed to offspring.
By the way, doctor: Should I worry about giant platelets?
My platelet count has always been on the low side - 110,000. I don't have any symptoms. But a recent lab report mentioned "giant platelets." Is this something to worry about?
By the way, doctor: Is it okay for me to take L-arginine?
I am 92 and have poor blood circulation and an irregular heartbeat. Is it okay for me to take 500 milligrams of L-arginine a day?
December, 2007
The top 10 health stories of 2007
A summary of the major health news of the year, including: more evidence of the hazards of not getting enough sleep, inexpensive genome sequencing, new avenues for treating inflammation, improving health insurance coverage, and breast MRI scans.
To catch a thief may stop a heart
Security devices used for inventory control in stores may interfere with the operation of pacemakers or implantable cardioverter-defibrillators (ICDs).
Screening to prevent stroke
Ultrasound carotid screening for stroke risk is being promoted as a simple detection tool, but the test does not always identify those at risk, and some doctors feel that treating the factors that contribute to risk is more beneficial to overall health.
By the way, doctor: Should I get a partial knee replacement?
I am 55 and have a bad right knee from playing lots of sports. I am interested in getting a partial knee replacement. I've heard that the recovery is shorter and the result is better than a total replacement. What do you think?