Welcome to Dr. Paz’s Newsletter #11 This newsletter will focus on timely topics that can have a direct impact on your health. If you are interested in sending a question, you can send it to drpaz@drpaz.com. Please remember, your questions should be of general medical interest and should not include any patient-specific information since this is not a HIPAA compliant email. |
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Supplement Recommendations and Full Disclosure I have started to recommend specific brands of supplements. The supplements I recommend are only available through healthcare practitioners. As you may know, the supplement industry is not regulated in the same fashion as the pharmaceutical industry. As a result, it is possible to purchase supplements that are very poorly made, contain contaminants and have little or none of the expected ingredients. By way of an example, here are a few recent headlines from Consumerlab.com, which independently purchases supplements and reviews them for quality: 31% of Protein Powders & Drinks Fail ConsumerLab.com Review ConsumerLab.com finds quality problems in 7 of 24 omega-3 supplements Majority of Nutrition Bars Fail ConsumerLab.com Testing Because of this, I have chosen several manufacturers that I have personally vetted and I believe produce extremely reliable products. These are not always the cheapest available of a given type, but the old adage "you get what you pay for" certainly applies here. Clicking on links in the newsletter, or going to my website will get you to these products. The cost to maintain a website, produce a newsletter and maintain malpractice insurance has steadily risen. (Yes, I need malpractice insurance to write a medical newsletter.) By purchasing supplements through my website and newsletter, a small portion is returned to me so that I can continue with the work of keeping you informed on important medical issues. This does not increase your cost in any way. It does ensure that you will be purchasing a high-quality supplement to help accomplish your health goals. |
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Medical News and Commentary |
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Is the flu shot working this year? It’s about 50:50. The flu shot has been readily available for all ages and the CDC recommends everyone 6 months and older receive it. There are four types (or strains) of influenza viruses: A, B, C or D. Types A and B cause severe disease in humans, and each year the seasonal flu vaccine protects against two A and two B strains. The experts take an ‘educated guess’ as to which strains will show up each year and place these in the vaccine. Some years they are right, other years, like 2014-2015, they fail miserably. Therefore, in some years the flu vaccine is more effective than others depending on the strain. It is a “good” season if the vaccine is 40% to 60% effective. Effectiveness means that percent of those vaccinated that are less likely to become seriously ill or die from influenza. This year’s flu shot has a nearly 50% efficacy against hospitalization from the major strain of the flu, according to the CDC. Even if infected, the flu vaccine may make the symptoms less severe. Dr Paz comments. Clearly, the flu vaccine is not perfect. However it can definitely help. Adequate rest and good nutrition can go a long way. Some of the same supplement recommendations I have made for Covid in previous newsletters may also be helpful. Because this vaccine has been used for decades, we know its safety record is good. I would encourage any high-risk person or those who come in contact with high-risk persons to get it. When I was working for the hospital system, I was forced to get this vaccine under threat of job termination. Now that I am over 65 and no longer employed, I opt to get it voluntarily. Isn’t that the way it should be? https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm https://www.goodrx.com/conditions/flu-vaccination/flu-shot-effectiveness-does-it-work |
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When is the best time to exercise? Ben Franklin was right. Ben was quoted as saying ”Early to bed and early to rise makes a man healthy, wealthy and wise”. Now science has proven him right, at least the healthy part. A study published in the European Journal of Preventive Cardiology reveals that physical activity in the morning, particularly between 8 a.m. and 11 a.m., has the most positive impact on a person’s risk of cardiovascular diseases and stroke in comparison to physical activity at any other time of day. The researchers observed and analyzed data from 86,657 participants in the UK Biobank. The average age of the individuals was 62. Compared with individuals who were active midday, those most active around 8 a.m. or 10 a.m. had 11 percent and 16 percent lower risks of coronary artery disease, respectively. For women, risks were reduced by 22 percent and 24 percent at these times. https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwac239/6814439?searchresult=1 |
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Want to reduce Covid mortality by 100,000 people? Take your Vitamin D. A new study of vitamin D treatment lead by a Johns Hopkins researcher purports to show at least 116,000 people could have been saved. Those numbers are likely a fraction of the overall benefit with a preventive regimen of vitamin D to elevate serum levels above 50. The results in reduced mortality from COVID-associated death were with vitamin D3 supplementation, the most common vitamin D supplementation on the market, resulting in a 33% reduction in mortality. The prescription form of vitamin D, vitamin D2, DID NOT result in lowered mortality. Dr Paz comments: Vitamin D2 is available by prescription. It is not metabolized by the liver in the same fashion as Vitamin D3, resulting in much lower levels of active compound. This is most likely why D2 failed in this trial. Stick with Vitamin D3 as a supplement, but DO NOT take prolonged high doses(>2000iu or 50mcg/day) without having your doctor measure your levels. By the way, food fortified with Vitamin D are usually fortified with D2 because it is cheaper. https://www.nature.com/articles/s41598-022-24053-4#MOESM1 https://www.healthline.com/nutrition/vitamin-d2-vs-d3 |
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Motrin/NSAIDs for knee arthritis? It might not be a good idea. Osteoarthritis is the most common type of arthritis, usually affecting the hands, hips or knees. It occurs when the cartilage in a joint erodes and the bone changes, causing pain, stiffness and swelling. About 32.5 million American adults are living with the condition. Researchers at the annual meeting of the Radiological Society of North America reported that long-term use of NSAIDs (non-steroidal anti-inflammatory drugs) may lead to increased joint inflammation and damage to cartilage. This was based on MRI scans from more than 1,000 patients with osteoarthritis in their knees. The results are contrary to what would be expected, given that NSAIDS like Motrin(ibuprofen), Aleve and Naprosyn(naproxen) and Mobic(meloxicam) are thought to be anti-inflammatory. Dr Paz comments: More natural approaches such as physical therapy, high dose fish oil, CBD and SAMe may be viable alternatives. I’ll discuss alternative pain management in an upcoming newsletter. https://www.prnewswire.com/news-releases/nsaids-may-worsen-arthritis-inflammation-301681834.html |
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Test-tube chicken? Coming to a store near you. More Frankenfood is on the way courtesy of Upside Foods. A recent decision by the Food and Drug Administration(FDA) means that a company called Upside Foods will soon be able to sell chicken made from real animal cells grown in bioreactors instead of requiring the slaughter of live animals. Different startups are focusing on a range of cultivated meats, including beef, chicken, salmon, and tuna. So, let’s see. We now have apples that won’t rot, salmon that grows at three times the normal rate and tomatoes that don’t get soft. Not to mention genetically modified soy, corn and wheat. Yum,Yum. https://www.wired.com/story/lab-grown-meat-approval/ |
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Best sweetener for your coffee? Try some honey. Researchers at the University of Toronto have found that honey significantly improves blood sugar and cholesterol levels—especially if the honey is raw and from a single floral source. The study was recently published in Nutrition Reviews. "These results are surprising, because honey is about 80 percent sugar," said Tauseef Khan, a senior researcher on the study and a research associate in nutritional sciences at U of T's Temerty Faculty of Medicine. "But honey is also a complex composition of common and rare sugars, proteins, organic acids and other bioactive compounds that very likely have health benefits." The median daily dose of honey in the trials was 40 grams, or about two tablespoons. So if you must add something sweet to food or drink, honey may be preferable over sugar or artificial sweeteners. Dr Paz's supplement recommendation: Fullscript B. Powered Superfood Honey https://medicalxpress.com/news/2022-11-sweet-systematic-honey-cardiometabolic.html |
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Want to prevent Alzheimer's? Have a beer. A new study, published in the journal ACS Chemical Neuroscience, arrived at a surprising conclusion - beer may ward off Alzheimer’s disease. A key component of a beer's aroma and flavour, hops offer more than the beloved acquired taste. Recent studies have suggested that the little flower can improve cognition, attention and even mitigate Alzheimer’s disease in mice. The new study elaborates on this research by adding their finding that hops were able to prevent the clumping of protein plaques linked to Alzheimer's disease in lab dishes. Dr Paz comments: I am not advocating that you drink beer to prevent dementia. The downside of too much alcohol would far out way the benefits in this case. However, Hops supplements may become a viable alternative. For instance, Metagenics makes a natural pain reliever, KAPREX, that contains the same hops- Humulus lupulus, that were used in this study. https://pubs.acs.org/doi/pdf/10.1021/acschemneuro.2c00444 https://www.express.co.uk/life-style/health/1694176/dementia-alzheimers-disease-beer-hops-lowers-risk |
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Do you like coffee? You’re in luck! A study published on September 27, 2022 in the European Journal of Preventive Cardiology looked at habitual coffee consumption and its impact on incidents of arrhythmia(irregular heart rhythm), cardiovascular disease, and mortality. What did they find? A significant reduction in arrhythmia was found for those who drank one to five cups of either ground or instant coffee, with the lowest risks being for those who drank four to five cups of ground coffee or two to three cups of instant coffee a day. Those who drank decaffeinated coffee did not see a reduced risk of arrhythmia.
https://www.suggest.com/coffee-consumption-heart-health-mortality-study/2686817/ |
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Want to e-mail your doctor? That’ll be $50 please. Cleveland Clinic plans to bill e-mail messages through their electronic health record(HER) for any interactions taking five or more minutes for providers to respond and will bill insurance companies. Medicare patients with secondary insurance will not have copays, but some Medicare beneficiaries may see a $3 to $8 fee. Many privately insured patients will not have a copay, but if they have a deductible or their plan does not cover e-mail messaging, patients could be billed $33 to $50 per message. Dr Paz Comments: I suspect this will be a significant revenue stream for hospital systems. Other hospital systems will be following this closely. When I was in practice, it would not be unusual to answer 10-20 e-mails per day. But is charging for this service the ethical thing to do? I’m not sure. https://www.beckershospitalreview.com/healthcare-information-technology/cleveland-clinic-to-bill-up-to-50-for-mychart-messages.html |
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Next time you read a medical study, think about this. A new study has found that the reporting of "harms" – adverse events – in clinical trials are often inadequate. The paper which has been published in the Medical Journal of Australia, took a global view by looking at hundreds of trials, or policy documents, to get an understanding of the scale of the problem. “At the moment clinical trials do quite a good job at reporting on the benefits, but not such a good job reporting on the harms.” Dr Paz comments: I think the average layperson has suspected this for quite some time. As a profession, I feel we are doing a terrible job of giving patients honest information about treatment options. As a result, we are losing credibility. This was made much worse by the Covid pandemic and the frequent contradictory information given by “medical experts”. We need more independent medical research, i.e. not sponsored by drug companies. Doctors also need to be more honest about the actual benefits(often overstated) and potential risks(often understated) of any given treatment, be it drug, supplement or procedure. https://cosmosmagazine.com/science/clinical-trials-harms-adverse-reactions/ |
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IT’S JUST MY OPINION. The opinions in my newsletter are based on my interpretation of the literature and my personal experience from tens of thousands of medical visits over the last 37 years. TALK TO YOUR DOCTOR. The information I share in this newsletter is meant for general medical information purposes and is not specific to your medical care. Before you initiate any therapy you should discuss it with your doctor. If your doctor is not open to discussing nutritional therapies, maybe it is time to find a new doctor….. |
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