A Painful Reminder of Shingles?
Provided by: DrWeil.com
Q: Do you have any advice for dealing with postherpetic neuralgia? -- Reg W.
A: Postherpetic neuralgia is a complication of shingles that affects the nerve fibers and skin and can be extremely painful.
The symptoms are usually confined to the area where the shingles occurred and may include a sharp, burning or deep, aching pain, extreme sensitivity to touch and temperature change, or itching and numbness. These problems can go on for months, in some cases years, and are most likely to occur among older people. In fact, the older you are when you develop shingles, the more likely you are to develop postherpetic neuralgia. This complication rarely occurs before the age of 50 but does develop in at least 50 percent of shingles patients over 60 and in almost 75 percent of those 70 or older.
Conventional medicine treats postherpetic neuralgia with skin patches that release the pain killer lidocaine and relieve pain for four to 12 hours. Antidepressants, in doses smaller than those used to treat depression, especially tricyclics like amitryptaline (Elavil), seem to make the pain easier to tolerate.
Other allopathic options are anticonvulsant drugs such as neurontin, prescription pain medications, and TENS units (transcutaneous electrical nerve stimulation), which involves placing electrodes in the painful area to deliver tiny electrical impulses to nearby nerve pathways.
I suggest trying acupuncture or hypnosis, both of which can help relieve the pain of postherpetic neuralgia. You can also use topical capsaicin, a cream made from hot chili peppers. This medication depletes nerve cells of "substance P," a natural chemical that is involved in sending pain signals to the brain. You rub the cream on the affected area of skin three times a day. Capsaicin cream is sold over-the-counter as Zostrix or Capzasin-P.
Andrew Weil, M.D. –
Author of:
Saturday, May 27, 2006
A Blood Test for Breast Cancer?
A Blood Test for Breast Cancer?
Provided by: DrWeil.com
Q: I understand that there's a new blood test for breast cancer that is a big breakthrough. Who should have it? When? -- Glenda R. A:
A promising new test for breast cancer patients can count malignant cells in the bloodstream and thus tell doctors whether or not treatment is working. The fewer cancer cells found, the better the outlook, and vice versa. The test is not for screening healthy women for the disease. At this time, it is intended only to assess the status of women who are already being treated in order to help make decisions about whether additional treatment is needed.
The test method was studied at 20 medical centers in the United States, and results were published in the August 19, 2004 issue of the New England Journal of Medicine. A total of 177 women took part, all of whom already had stage 4 breast cancer, the most advanced form of the disease.
Until now, doctor and their patients typically had to wait months before doing bone scans or x-rays to see if a particular treatment was working. The new test reportedly will reduce the waiting time to just weeks.
Cells from malignant tumors can break off and travel through lymphatic and blood vessels. Cancer spreads when these cells begin to grow in other areas of the body far from the spot where the disease originated, a process called metastasis. Once this happens, cancer becomes much harder to treat, and the chances for a cure decrease. If the new test shows that a woman has no circulating cancer cells, she may not need further treatment. If the test shows that lots of cells are circulating, more aggressive treatment is indicated.
Researchers also plan to investigate whether the new test also works for patients with colon, lung and Prostate cancer.
Andrew Weil, MD
Provided by: DrWeil.com
Q: I understand that there's a new blood test for breast cancer that is a big breakthrough. Who should have it? When? -- Glenda R. A:
A promising new test for breast cancer patients can count malignant cells in the bloodstream and thus tell doctors whether or not treatment is working. The fewer cancer cells found, the better the outlook, and vice versa. The test is not for screening healthy women for the disease. At this time, it is intended only to assess the status of women who are already being treated in order to help make decisions about whether additional treatment is needed.
The test method was studied at 20 medical centers in the United States, and results were published in the August 19, 2004 issue of the New England Journal of Medicine. A total of 177 women took part, all of whom already had stage 4 breast cancer, the most advanced form of the disease.
Until now, doctor and their patients typically had to wait months before doing bone scans or x-rays to see if a particular treatment was working. The new test reportedly will reduce the waiting time to just weeks.
Cells from malignant tumors can break off and travel through lymphatic and blood vessels. Cancer spreads when these cells begin to grow in other areas of the body far from the spot where the disease originated, a process called metastasis. Once this happens, cancer becomes much harder to treat, and the chances for a cure decrease. If the new test shows that a woman has no circulating cancer cells, she may not need further treatment. If the test shows that lots of cells are circulating, more aggressive treatment is indicated.
Researchers also plan to investigate whether the new test also works for patients with colon, lung and Prostate cancer.
Andrew Weil, MD
The Safest Way to Cut Fat?
The Safest Way to Cut Fat?
Provided by: DrWeil.com
Q: Are no-fat sprays such as PAM safe? -- Nelly
A: Cooking sprays were introduced in the 1950s and have since been used as a way to cut the amount of fat used in preparing food. While these sprays are safe, I strongly recommend that you buy them in pump bottles rather than as aerosol sprays. In 1978 the United States government banned the use of chlorofluorocarbons (CFCs), propellants commonly used in aerosol sprays of all kinds because of evidence that they were causing holes in the ozone layer. Today's propellants aren't as damaging to the environment, but there is evidence that some of the replacement propellants (not necessarily those in cooking sprays) may contain chemicals that pose health risks if inhaled.
On the plus side, cooking sprays can cut the amount of fat you use in baking, grilling and stovetop cooking, but you do have to be careful not to spray too liberally. For example, if you spray for five seconds, you could add as much as 35 calories to your food. The trick to using these sprays is to follow directions on the can and spray for the amount of time specified, often a third of a second (which can be difficult to calculate).
Incidentally, you can make your own cooking spray by pouring olive oil in a pump bottle or combining olive oil with lecithin (derived from soy), which acts as an emulsifier. If you just want to cut back on the amount of oil you use, instead of pouring it, apply it to pans with a pastry brush.
You also have to be careful about how you store cooking sprays. Be sure to keep them away from light and heat (but don't refrigerate) and, although some manufacturers say these products are good for two years, you're better off replacing a can after six months. Over time, the oil will go rancid.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: Are no-fat sprays such as PAM safe? -- Nelly
A: Cooking sprays were introduced in the 1950s and have since been used as a way to cut the amount of fat used in preparing food. While these sprays are safe, I strongly recommend that you buy them in pump bottles rather than as aerosol sprays. In 1978 the United States government banned the use of chlorofluorocarbons (CFCs), propellants commonly used in aerosol sprays of all kinds because of evidence that they were causing holes in the ozone layer. Today's propellants aren't as damaging to the environment, but there is evidence that some of the replacement propellants (not necessarily those in cooking sprays) may contain chemicals that pose health risks if inhaled.
On the plus side, cooking sprays can cut the amount of fat you use in baking, grilling and stovetop cooking, but you do have to be careful not to spray too liberally. For example, if you spray for five seconds, you could add as much as 35 calories to your food. The trick to using these sprays is to follow directions on the can and spray for the amount of time specified, often a third of a second (which can be difficult to calculate).
Incidentally, you can make your own cooking spray by pouring olive oil in a pump bottle or combining olive oil with lecithin (derived from soy), which acts as an emulsifier. If you just want to cut back on the amount of oil you use, instead of pouring it, apply it to pans with a pastry brush.
You also have to be careful about how you store cooking sprays. Be sure to keep them away from light and heat (but don't refrigerate) and, although some manufacturers say these products are good for two years, you're better off replacing a can after six months. Over time, the oil will go rancid.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Preventing Kidney Disease?
Preventing Kidney Disease?
Provided by: DrWeil.com
Q: I have been told I have a high reading of protein in my urine. My doctor prescribed lisinopril. I don't like the side effects. Is there anything natural I can take to decrease the protein level? -- Anonymous
A: Proteinuria - protein in the urine (determined by urinalysis) - often indicates some type of kidney disease. The first thing you have to determine is what is causing the problem. Normally, the kidneys filter waste products out of the blood so they can be eliminated from the body. Most proteins are too big to pass through the kidneys' filtering system unless the filters have been damaged in some way.
Among the possibilities: some variety of nephritis, a group of diseases, usually autoimmune, that cause inflammatory damage to the kidneys. Diabetes can also result in kidney damage, as can high blood pressure. In fact, elevated blood pressure often accompanies kidney disease and accelerates it.
If you have proteinuria and high blood pressure, you do need drug treatment to bring it down. The drug you were prescribed, lisinopril, is an ACE (angiotensin-converting enzyme) inhibitor, a type of blood pressure medication that works better than other drugs to reduce the pressure in blood vessels in the kidneys and increase the flow of urine, which helps lower blood pressure. I know of no natural alternative to drug treatment for this problem. Jonathan Dranov, MD, a nephrologist in State College, PA, tells me that 15 to 20 percent of patients taking ACE inhibitors develop a cough as a side effect. Unfortunately, if this happens to you as a result of taking this medication, you'll likely have the same cough with other ACE inhibitors. In that case, an option would be to try angiotensin receptor blockers (ARB), another type of medication. These two types of drugs appear to work to protect kidney function better than other medications used to treat high blood pressure.
It is very important to work with your doctor to find a treatment that you can tolerate that is effective for the kidney problem causing proteinuria. Otherwise, it is likely that your kidney function will deteriorate, and you'll be in very big trouble, eventually requiring dialysis.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I have been told I have a high reading of protein in my urine. My doctor prescribed lisinopril. I don't like the side effects. Is there anything natural I can take to decrease the protein level? -- Anonymous
A: Proteinuria - protein in the urine (determined by urinalysis) - often indicates some type of kidney disease. The first thing you have to determine is what is causing the problem. Normally, the kidneys filter waste products out of the blood so they can be eliminated from the body. Most proteins are too big to pass through the kidneys' filtering system unless the filters have been damaged in some way.
Among the possibilities: some variety of nephritis, a group of diseases, usually autoimmune, that cause inflammatory damage to the kidneys. Diabetes can also result in kidney damage, as can high blood pressure. In fact, elevated blood pressure often accompanies kidney disease and accelerates it.
If you have proteinuria and high blood pressure, you do need drug treatment to bring it down. The drug you were prescribed, lisinopril, is an ACE (angiotensin-converting enzyme) inhibitor, a type of blood pressure medication that works better than other drugs to reduce the pressure in blood vessels in the kidneys and increase the flow of urine, which helps lower blood pressure. I know of no natural alternative to drug treatment for this problem. Jonathan Dranov, MD, a nephrologist in State College, PA, tells me that 15 to 20 percent of patients taking ACE inhibitors develop a cough as a side effect. Unfortunately, if this happens to you as a result of taking this medication, you'll likely have the same cough with other ACE inhibitors. In that case, an option would be to try angiotensin receptor blockers (ARB), another type of medication. These two types of drugs appear to work to protect kidney function better than other medications used to treat high blood pressure.
It is very important to work with your doctor to find a treatment that you can tolerate that is effective for the kidney problem causing proteinuria. Otherwise, it is likely that your kidney function will deteriorate, and you'll be in very big trouble, eventually requiring dialysis.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Lost Your Sense of Smell?
Lost Your Sense of Smell?
Provided by: DrWeil.com
Q: I just heard of lawsuits being brought against manufacturers of various nasal sprays containing zinc gluconate. The lawsuits charge that the zinc gluconate is causing the loss of sense of smell in certain people. What is your take on this? -- Willis P.
A: It is true that a number of lawsuits have been filed against manufacturers of two nasal-spray cold remedies containing zinc gluconate, claiming that use of these products caused a loss of the sense of smell, a condition called anosmia. These incidents and the suits were first brought to light by a television station in Denver which has reported that consumers in five states have targeted the manufacturers of Zicam nasal spray and Cold-Eeze nasal spray, both of which contain zinc gluconate.
I understand that the FDA is looking into the complaints. Anyone with a loss of sense of smell (or any other adverse reaction) related to the use of these products (or any drug, prescription or over-the-counter) should report the problem to the FDA's Medwatch program.
So far, the companies that manufacture the nasal sprays in question have denied an association between use of their products as recommended and the anosmia reported by users. However, the company that makes Zicam has admitted that there have been no studies examining the connection between use of its product and a loss of the ability to smell. Physicians at the University of Colorado's Taste and Smell Clinic have been tracking reports that use of zinc gluconate nasal sprays are linked to cases of anosmia. No such claims have been made with respect to other, non-spray cold remedies containing zinc gluconate, which studies suggest can shorten the duration and severity of colds if taken at the first sign.
Until this question is carefully examined in scientific studies, there's no way to prove that the nasal sprays actually are responsible for the problem. However, zinc in other forms has been used to eliminate the sense of smell in lab animals, and some specialists have speculated that the anosmia reported may stem from misusing the nasal sprays by sniffing too deeply while spraying.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I just heard of lawsuits being brought against manufacturers of various nasal sprays containing zinc gluconate. The lawsuits charge that the zinc gluconate is causing the loss of sense of smell in certain people. What is your take on this? -- Willis P.
A: It is true that a number of lawsuits have been filed against manufacturers of two nasal-spray cold remedies containing zinc gluconate, claiming that use of these products caused a loss of the sense of smell, a condition called anosmia. These incidents and the suits were first brought to light by a television station in Denver which has reported that consumers in five states have targeted the manufacturers of Zicam nasal spray and Cold-Eeze nasal spray, both of which contain zinc gluconate.
I understand that the FDA is looking into the complaints. Anyone with a loss of sense of smell (or any other adverse reaction) related to the use of these products (or any drug, prescription or over-the-counter) should report the problem to the FDA's Medwatch program.
So far, the companies that manufacture the nasal sprays in question have denied an association between use of their products as recommended and the anosmia reported by users. However, the company that makes Zicam has admitted that there have been no studies examining the connection between use of its product and a loss of the ability to smell. Physicians at the University of Colorado's Taste and Smell Clinic have been tracking reports that use of zinc gluconate nasal sprays are linked to cases of anosmia. No such claims have been made with respect to other, non-spray cold remedies containing zinc gluconate, which studies suggest can shorten the duration and severity of colds if taken at the first sign.
Until this question is carefully examined in scientific studies, there's no way to prove that the nasal sprays actually are responsible for the problem. However, zinc in other forms has been used to eliminate the sense of smell in lab animals, and some specialists have speculated that the anosmia reported may stem from misusing the nasal sprays by sniffing too deeply while spraying.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Friday, May 26, 2006
Combating Cravings?
Combating Cravings?
Provided by: DrWeil.com
Q: I've been able to give up meat, dairy, even smoking cigarettes, but sugar is the one that gets away. What can I do to curb my cravings? Why do some people have a sweet tooth and others don't? -- Connie
A: I don't know why some people have a sweet tooth while others can resist sugary snacks. Part of the problem may be that sweets are often given to us as treats when we're young, developing our taste for sugar and associating sweets with rewards. In some people, sugar has an effect on mood, which is another factor that may underlie cravings. Eating sweets can increase levels of the neurotransmitter serotonin, which can help you relax, suggesting that some cravings are stress-related. In fact, researchers at the University of California, San Francisco, reported in 2003 that chronic stress may explain why some people crave comfort foods. In studies with rats, the researchers found that chronic stress prompted the animals to engage in pleasure-seeking activities, including eating high-energy foods (in the rats' case, sucrose and lard). The study was published in the Sept. 30, 2003 issue of the Proceedings of the National Academy of Sciences.
You can try a number of different strategies to try to overcome your sugar craving:
Try to satisfy your cravings with fruits that falls low on the glycemic index (berries, cherries, apples, pears), which are healthier than other sources of sugar and give you the added benefit of fiber.
Experiment with the Chinese strategy of eating more bitter foods to balance your craving for sweets (curly endive, radicchio, cooked greens, some olives, etc.)
Try the Ayurvedic herb gurmar (Gymnema sylvestre). Known as the "destroyer of sugar" gurmar is reputed to slow both the absorption of sugar into the blood stream and the conversion of sugar into fat. It also may help curb your appetite for sweets.
Working with a hypnotherapist in an effort to reduce your sugar cravings might be helpful.
Practice breathing techniques, progressive relaxation and exercise as a means of reducing the chronic stress that may underlie your cravings.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I've been able to give up meat, dairy, even smoking cigarettes, but sugar is the one that gets away. What can I do to curb my cravings? Why do some people have a sweet tooth and others don't? -- Connie
A: I don't know why some people have a sweet tooth while others can resist sugary snacks. Part of the problem may be that sweets are often given to us as treats when we're young, developing our taste for sugar and associating sweets with rewards. In some people, sugar has an effect on mood, which is another factor that may underlie cravings. Eating sweets can increase levels of the neurotransmitter serotonin, which can help you relax, suggesting that some cravings are stress-related. In fact, researchers at the University of California, San Francisco, reported in 2003 that chronic stress may explain why some people crave comfort foods. In studies with rats, the researchers found that chronic stress prompted the animals to engage in pleasure-seeking activities, including eating high-energy foods (in the rats' case, sucrose and lard). The study was published in the Sept. 30, 2003 issue of the Proceedings of the National Academy of Sciences.
You can try a number of different strategies to try to overcome your sugar craving:
Try to satisfy your cravings with fruits that falls low on the glycemic index (berries, cherries, apples, pears), which are healthier than other sources of sugar and give you the added benefit of fiber.
Experiment with the Chinese strategy of eating more bitter foods to balance your craving for sweets (curly endive, radicchio, cooked greens, some olives, etc.)
Try the Ayurvedic herb gurmar (Gymnema sylvestre). Known as the "destroyer of sugar" gurmar is reputed to slow both the absorption of sugar into the blood stream and the conversion of sugar into fat. It also may help curb your appetite for sweets.
Working with a hypnotherapist in an effort to reduce your sugar cravings might be helpful.
Practice breathing techniques, progressive relaxation and exercise as a means of reducing the chronic stress that may underlie your cravings.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Believing Cancer Myths?
Believing Cancer Myths?
Provided by: DrWeil.com
Q: I have been told that the smell of burnt coffee means you have cancer. I've also heard other cancer myths. Can you debunk some common ones? -- Georgie J.
A: I've never heard the one about burnt coffee and haven't been able to track it down. But there are plenty of other cancer myths in circulation:
Cancer spreads when exposed to air during surgery: This is false but widely believed. A survey by researchers at the Philadelphia Veterans Affairs (VA) Medical Center among patients with lung cancer and with other types of pulmonary disease in five hospitals across the United States showed that 45 percent had heard this myth and 37 percent believed it to be true. Results of the study were published in the October 7, 2003 Annals of Medicine.
Drug companies are withholding the cure for cancer because they would lose the money that they get from treating patients with today's drugs: This conspiracy theory is nonsense. First of all, cancer is not one disease but many. It is unlikely that any single "cure" would work for all of them. Besides, there has been impressive progress. The American Cancer Society notes that only a few decades ago, fewer than one in 10 children with leukemia survived 10 years after diagnosis. Today's treatment has raised the cure rate to almost 80%. Similar advances have been made in curing Hodgkin's lymphoma, bone and kidney cancers in children, and testicular cancer. Just ask Lance Armstrong.
Injuries can lead to cancer: This old wives tale has been around for more than a century. It was disproved a long time ago. The only known instances where cancer can stem from injuries are related to chemical burns. Swallowing caustic liquids is a risk factor for cancer of the esophagus, and skin cancer sometimes develops in scars caused by chemical or thermal burns.
Antiperspirants cause breast cancer: This persistent Internet hoax warns that antiperspirants or deodorants contain substances that can be absorbed through the skin or enter the body through nicks caused by shaving. There's no evidence to support this idea, and, in fact a study published in the Oct. 16, 2002 issue of the Journal of the National Cancer Institute found no increased breast cancer risk among women who reported using underarm deodorants or antiperspirants, those who used these products after shaving with a blade razor and those who used the products within one hour after shaving with a blade razor. Other studies have reported similar results.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I have been told that the smell of burnt coffee means you have cancer. I've also heard other cancer myths. Can you debunk some common ones? -- Georgie J.
A: I've never heard the one about burnt coffee and haven't been able to track it down. But there are plenty of other cancer myths in circulation:
Cancer spreads when exposed to air during surgery: This is false but widely believed. A survey by researchers at the Philadelphia Veterans Affairs (VA) Medical Center among patients with lung cancer and with other types of pulmonary disease in five hospitals across the United States showed that 45 percent had heard this myth and 37 percent believed it to be true. Results of the study were published in the October 7, 2003 Annals of Medicine.
Drug companies are withholding the cure for cancer because they would lose the money that they get from treating patients with today's drugs: This conspiracy theory is nonsense. First of all, cancer is not one disease but many. It is unlikely that any single "cure" would work for all of them. Besides, there has been impressive progress. The American Cancer Society notes that only a few decades ago, fewer than one in 10 children with leukemia survived 10 years after diagnosis. Today's treatment has raised the cure rate to almost 80%. Similar advances have been made in curing Hodgkin's lymphoma, bone and kidney cancers in children, and testicular cancer. Just ask Lance Armstrong.
Injuries can lead to cancer: This old wives tale has been around for more than a century. It was disproved a long time ago. The only known instances where cancer can stem from injuries are related to chemical burns. Swallowing caustic liquids is a risk factor for cancer of the esophagus, and skin cancer sometimes develops in scars caused by chemical or thermal burns.
Antiperspirants cause breast cancer: This persistent Internet hoax warns that antiperspirants or deodorants contain substances that can be absorbed through the skin or enter the body through nicks caused by shaving. There's no evidence to support this idea, and, in fact a study published in the Oct. 16, 2002 issue of the Journal of the National Cancer Institute found no increased breast cancer risk among women who reported using underarm deodorants or antiperspirants, those who used these products after shaving with a blade razor and those who used the products within one hour after shaving with a blade razor. Other studies have reported similar results.
Andrew Weil, M.D. –
Author of:
Aching with Arthritis?
Aching with Arthritis?
Provided by: DrWeil.com
Q: What is polyarthritis, and what tests are needed to diagnose it? -- Anonymous
A: Polyarthritis means inflammation of more than one joint and is most often associated with rheumatoid arthritis, an autoimmune disease (one that occurs when the immune system mistakenly attacks the body's own tissues). Polyarthritis is also associated with lupus, polymyalgia rheumatica, and sarcoidosis. All of these autoimmune disorders can be triggered by infection, tissue injury, or emotional trauma in people who are genetically predisposed to these conditions.
Polyarthritis, as well as its underlying cause, can be diagnosed by physical exam (the affected joints are swollen, stiff, painful or tender, and may feel warm and appear reddened) as well as by a variety of blood tests.
These would include a measure of your erythocyte sedimentation rate (sed rate). A high sed rate suggests the presence of acute inflammation and occurs with rheumatoid arthritis and other immune-mediated connective tissue diseases such as lupus. Conventional medicine treats autoimmune diseases including rheumatoid arthritis with steroids and other immunosuppressive medications, most of which are toxic when used long-term.
Patients dependent on these strong drugs are less likely to respond to natural treatments, which can moderate autoimmunity and help control symptoms.
Here are my recommendations:
Follow a low-protein, high-carbohydrate diet; minimize consumption of foods of animal origin.
Eliminate milk and milk products including commercial foods made with milk.
Avoid polyunsaturated vegetable oils, margarine, vegetable shortening and products made with partially hydrogenated oils of any kind.
Increase your intake of omega-3 fatty acids (eat more cold water fish, walnuts or freshly ground flaxseeds). Consider taking a fish oil supplement to help keep your protein intake low.
Eliminate or reduce intake of coffee and tobacco - both have been linked to an increased risk for rheumatoid arthritis.
Get regular aerobic exercise (swimming is best for those with rheumatoid arthritis).
Practice relaxation techniques. In addition, visualization can help moderate autoimmune responses, and psychotherapy can help alter emotional states that keep the immune system off balance.
Try hypnotherapy or guided imagery. Look for a therapist willing to take on an autoimmune disease. Meditation and yoga can help, too.
Avoid health care practitioners who make you feel pessimistic about your condition.
Take aspirin and other over-the-counter anti-inflammatory drugs to help relieve symptoms.
Take the anti-inflammatory herbs ginger and turmeric. I recommend Zyflamend, made by New Chapter Company, which includes both. You can safely take these herbs indefinitely.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: What is polyarthritis, and what tests are needed to diagnose it? -- Anonymous
A: Polyarthritis means inflammation of more than one joint and is most often associated with rheumatoid arthritis, an autoimmune disease (one that occurs when the immune system mistakenly attacks the body's own tissues). Polyarthritis is also associated with lupus, polymyalgia rheumatica, and sarcoidosis. All of these autoimmune disorders can be triggered by infection, tissue injury, or emotional trauma in people who are genetically predisposed to these conditions.
Polyarthritis, as well as its underlying cause, can be diagnosed by physical exam (the affected joints are swollen, stiff, painful or tender, and may feel warm and appear reddened) as well as by a variety of blood tests.
These would include a measure of your erythocyte sedimentation rate (sed rate). A high sed rate suggests the presence of acute inflammation and occurs with rheumatoid arthritis and other immune-mediated connective tissue diseases such as lupus. Conventional medicine treats autoimmune diseases including rheumatoid arthritis with steroids and other immunosuppressive medications, most of which are toxic when used long-term.
Patients dependent on these strong drugs are less likely to respond to natural treatments, which can moderate autoimmunity and help control symptoms.
Here are my recommendations:
Follow a low-protein, high-carbohydrate diet; minimize consumption of foods of animal origin.
Eliminate milk and milk products including commercial foods made with milk.
Avoid polyunsaturated vegetable oils, margarine, vegetable shortening and products made with partially hydrogenated oils of any kind.
Increase your intake of omega-3 fatty acids (eat more cold water fish, walnuts or freshly ground flaxseeds). Consider taking a fish oil supplement to help keep your protein intake low.
Eliminate or reduce intake of coffee and tobacco - both have been linked to an increased risk for rheumatoid arthritis.
Get regular aerobic exercise (swimming is best for those with rheumatoid arthritis).
Practice relaxation techniques. In addition, visualization can help moderate autoimmune responses, and psychotherapy can help alter emotional states that keep the immune system off balance.
Try hypnotherapy or guided imagery. Look for a therapist willing to take on an autoimmune disease. Meditation and yoga can help, too.
Avoid health care practitioners who make you feel pessimistic about your condition.
Take aspirin and other over-the-counter anti-inflammatory drugs to help relieve symptoms.
Take the anti-inflammatory herbs ginger and turmeric. I recommend Zyflamend, made by New Chapter Company, which includes both. You can safely take these herbs indefinitely.
Andrew Weil, M.D. –
Author of:
An Antioxidant Update?
An Antioxidant Update?
Provided by: DrWeil.com
Q: I just bought some supplements and the clerk at the health food store told me I needed to take 6,000 mg of vitamin C per day. That sounds like an awful lot. What do you recommend? -- Barbara B.
A: I used to recommend taking 2,000 to 6,000 mg of vitamin C daily (divided into three doses). However, I changed my recommendation in 1999 to 200 mg daily after examining two well-designed studies showing that lower levels of vitamin C more than saturate the body's tissues, and thus are sufficient to protect against cancer, heart disease and other chronic illnesses.
One of the studies that influenced my decision was a review of clinical trials published in the April 21, 1999, issue of the Journal of the American Medical Association. It concluded that 200 mg a day is the maximum amount of vitamin C that human cells can absorb, making higher doses a waste.
The second study came from the Linus Pauling Institute (Pauling himself took 18,000 mg of vitamin C per day) and was published in the June 1999 issue of the American Journal of Clinical Nutrition. It identified a similar dose, 120 to 200 mg, as the optimal amount for reducing the risk of cardiovascular disease, cancer, cataracts and other chronic conditions. I wouldn't worry if you've been taking higher doses. Vitamin C is water soluble and anything not used by the body quickly passes out. In fact, I still recommend higher dosages - up to 1,000 mg a day if you are coming down with a cold.
The rest of my antioxidant recommendations are as follows:
Vitamin E: 400 IUs of mixed natural tocopherols (or 80 mg of mixed tocopherols and tocotrienols) a day. Since vitamin E is fat soluble, it must be taken with food to be absorbed. Also, choose natural forms of vitamin E (d-alpha tocopherol with mixed tocopherols, or better yet, mixed tocopherols and tocotrienols) instead of the synthetic form (dl-alpha-tocopherol).
Selenium: 200 micrograms a day of a yeast-bound form. Selenium is a trace mineral with antioxidant and anticancer properties.
Selenium and vitamin E facilitate each other's absorption, so take them together. Doses of selenium above 400 micrograms a day may not be healthy.
Mixed carotenes: 10, 000 - 15,000 IUs a day of beta carotene with other carotenoids, such as alpha carotene, astaxanthin, and zeaxanthin. Make sure the mix gives you lycopene, the red pigment in tomatoes that helps prevent Prostate cancer, and lutein, which protects against cataracts and macular degeneration.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I just bought some supplements and the clerk at the health food store told me I needed to take 6,000 mg of vitamin C per day. That sounds like an awful lot. What do you recommend? -- Barbara B.
A: I used to recommend taking 2,000 to 6,000 mg of vitamin C daily (divided into three doses). However, I changed my recommendation in 1999 to 200 mg daily after examining two well-designed studies showing that lower levels of vitamin C more than saturate the body's tissues, and thus are sufficient to protect against cancer, heart disease and other chronic illnesses.
One of the studies that influenced my decision was a review of clinical trials published in the April 21, 1999, issue of the Journal of the American Medical Association. It concluded that 200 mg a day is the maximum amount of vitamin C that human cells can absorb, making higher doses a waste.
The second study came from the Linus Pauling Institute (Pauling himself took 18,000 mg of vitamin C per day) and was published in the June 1999 issue of the American Journal of Clinical Nutrition. It identified a similar dose, 120 to 200 mg, as the optimal amount for reducing the risk of cardiovascular disease, cancer, cataracts and other chronic conditions. I wouldn't worry if you've been taking higher doses. Vitamin C is water soluble and anything not used by the body quickly passes out. In fact, I still recommend higher dosages - up to 1,000 mg a day if you are coming down with a cold.
The rest of my antioxidant recommendations are as follows:
Vitamin E: 400 IUs of mixed natural tocopherols (or 80 mg of mixed tocopherols and tocotrienols) a day. Since vitamin E is fat soluble, it must be taken with food to be absorbed. Also, choose natural forms of vitamin E (d-alpha tocopherol with mixed tocopherols, or better yet, mixed tocopherols and tocotrienols) instead of the synthetic form (dl-alpha-tocopherol).
Selenium: 200 micrograms a day of a yeast-bound form. Selenium is a trace mineral with antioxidant and anticancer properties.
Selenium and vitamin E facilitate each other's absorption, so take them together. Doses of selenium above 400 micrograms a day may not be healthy.
Mixed carotenes: 10, 000 - 15,000 IUs a day of beta carotene with other carotenoids, such as alpha carotene, astaxanthin, and zeaxanthin. Make sure the mix gives you lycopene, the red pigment in tomatoes that helps prevent Prostate cancer, and lutein, which protects against cataracts and macular degeneration.
Andrew Weil, M.D. –
Author of:
Thursday, May 25, 2006
Battling Ulcers?
Battling Ulcers?
Provided by: DrWeil.com
Q: A friend of mine is a 25-year-old male who has been diagnosed with an ulcer and has chronic stomach issues. He has been taking various medications including Nexium, Prevacid, Trimox and Biaxin. Can you recommend any natural remedies he could try? -- Lauro
A: We now know that many ulcers are caused by a bacterium called Helicobacter pylori (H. pylori). The treatment is a combination of antibiotics (the Trimox and Biaxin you mention) plus drugs to reduce or neutralize stomach acid (including Prevacid and Nexium). While these drugs are effective, they're not recommended for long-term use. Other causes of ulcers include excess digestive acids that burn the digestive tract and, sometimes, long-term use of anti-inflammatory drugs.
In addition to the drugs he has been prescribed, your friend might consider increasing consumption of foods high in vitamin C. Results of a study reported in the Aug. 1, 2003 issue of the Journal of the American College of Nutrition showed that infection with H. pylori is more likely if you have low blood levels of vitamin C.
Although they couldn't say whether H. pylori is responsible for the low vitamin C levels or the other way around, the researchers who conducted the study said it would be a good idea for everyone to increase consumption of foods high in vitamin C. This might prevent infection or reduce the effects of infection, and perhaps prevent peptic ulcers.
I also recommend that anyone prone to ulcers take the following preventive and healing measures:
Provided by: DrWeil.com
Q: A friend of mine is a 25-year-old male who has been diagnosed with an ulcer and has chronic stomach issues. He has been taking various medications including Nexium, Prevacid, Trimox and Biaxin. Can you recommend any natural remedies he could try? -- Lauro
A: We now know that many ulcers are caused by a bacterium called Helicobacter pylori (H. pylori). The treatment is a combination of antibiotics (the Trimox and Biaxin you mention) plus drugs to reduce or neutralize stomach acid (including Prevacid and Nexium). While these drugs are effective, they're not recommended for long-term use. Other causes of ulcers include excess digestive acids that burn the digestive tract and, sometimes, long-term use of anti-inflammatory drugs.
In addition to the drugs he has been prescribed, your friend might consider increasing consumption of foods high in vitamin C. Results of a study reported in the Aug. 1, 2003 issue of the Journal of the American College of Nutrition showed that infection with H. pylori is more likely if you have low blood levels of vitamin C.
Although they couldn't say whether H. pylori is responsible for the low vitamin C levels or the other way around, the researchers who conducted the study said it would be a good idea for everyone to increase consumption of foods high in vitamin C. This might prevent infection or reduce the effects of infection, and perhaps prevent peptic ulcers.
I also recommend that anyone prone to ulcers take the following preventive and healing measures:
- Avoid all coffee, decaffeinated coffee and other sources of caffeine, alcohol and tobacco.
- Avoid all aspirin and other salicylates and all nonsteroidal anti-inflammatory drugs. Use acetaminophen (Tylenol) or an herbal anti-inflammatory like Zyflamend instead. Don't take any steroids.
- Drink peppermint tea and chamomile teas frequently. Both soothe the lining of the digestive tract.
- Avoid milk and milk products - they increase acid secretion.
- Eat smaller amounts of foods more frequently. Don't let your stomach go empty for long periods.
To protect the lining of your stomach and duodenum (the first section of the small intestine where ulcers usually form) take deglycyrrhizinated licorice (DGL), which has excellent soothing and healing properties. The dose is one half teaspoon of DGL powder or two tablets of DGL extract (chew these slowly) before or between meals. You can continue taking DGL as long as you have symptoms.
Try taking one teaspoon of aloe vera juice after meals. It helps heal ulcers. Sip red pepper tea (one quarter teaspoon of cayenne pepper steeped in a cup of hot water) or a small capsule of the powder. Cayenne pepper has a good local anesthetic effect.
Make serious efforts to neutralize stress in your life by practicing breathing exercises, learning visualization or hypnotherapy (or both) to heal your ulcer, or taking a course of biofeedback training.
If necessary, change whatever in your life causes you the most stress - your job, living situation, or relationships.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Can Chocolate Cure Coughs?
Can Chocolate Cure Coughs?
Provided by: DrWeil.com
Q: I've been coughing constantly after a terrible cold, and a friend told me that I should eat chocolate for the cough. She said she read that it really helps. True? -- Betsy
A: Your friend probably is referring to a study from London about the effects on coughs of theobromine, an ingredient found in cocoa. British researchers conducted a small study (including only 10 volunteers) in which they tested theobromine against codeine (used in the most effective prescription cough medicines) and a placebo on coughs induced by capsaicin (the hot compound in red pepper).
They found that higher amounts of capsaicin were needed to produce coughs in the group treated with theobromine and that the theobromine proved more effective than codeine as a cough-suppressant. The researchers theorized that theobromine worked by acting on the vagus nerve, which is responsible for coughing.
The study results were published in the online Federation of American Societies for Experimental Biology Journal on Nov. 17, 2004.
Based on the results of this small study I can't tell you to rush out and buy lots of chocolate to cure your cough. The researchers suggested that their findings might lead to more effective cough remedies since those currently available for persistent coughs commonly cause drowsiness and constipation (some people experience nausea and vomiting from codeine.)
The amount of theobromine used in the study was equivalent to what you would get from two cups of cocoa so, if you can afford the calories, you might try drinking cocoa made from good quality chocolate to see if it helps your cough, though my preference would be to eat an ounce or two of dark chocolate with at least a 70 percent cocoa content.
I'm not surprised to hear that chocolate may yield yet another health benefit. In addition to theobromine, it provides polyphenols, the same kinds of antioxidants found in red wine, and the fat it contains is stearic acid, which doesn't affect cholesterol levels. What's more, recent research suggests that flavonoids in dark chocolate are good for your heart - they reduce the stickiness of platelets and the tendency of blood to clot, lowering risk of a heart attack.
A no-cal herbal remedy for cough is tincture of mullein (Verbascum thapsus). Take a teaspoon in a little warm water every four hours.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I've been coughing constantly after a terrible cold, and a friend told me that I should eat chocolate for the cough. She said she read that it really helps. True? -- Betsy
A: Your friend probably is referring to a study from London about the effects on coughs of theobromine, an ingredient found in cocoa. British researchers conducted a small study (including only 10 volunteers) in which they tested theobromine against codeine (used in the most effective prescription cough medicines) and a placebo on coughs induced by capsaicin (the hot compound in red pepper).
They found that higher amounts of capsaicin were needed to produce coughs in the group treated with theobromine and that the theobromine proved more effective than codeine as a cough-suppressant. The researchers theorized that theobromine worked by acting on the vagus nerve, which is responsible for coughing.
The study results were published in the online Federation of American Societies for Experimental Biology Journal on Nov. 17, 2004.
Based on the results of this small study I can't tell you to rush out and buy lots of chocolate to cure your cough. The researchers suggested that their findings might lead to more effective cough remedies since those currently available for persistent coughs commonly cause drowsiness and constipation (some people experience nausea and vomiting from codeine.)
The amount of theobromine used in the study was equivalent to what you would get from two cups of cocoa so, if you can afford the calories, you might try drinking cocoa made from good quality chocolate to see if it helps your cough, though my preference would be to eat an ounce or two of dark chocolate with at least a 70 percent cocoa content.
I'm not surprised to hear that chocolate may yield yet another health benefit. In addition to theobromine, it provides polyphenols, the same kinds of antioxidants found in red wine, and the fat it contains is stearic acid, which doesn't affect cholesterol levels. What's more, recent research suggests that flavonoids in dark chocolate are good for your heart - they reduce the stickiness of platelets and the tendency of blood to clot, lowering risk of a heart attack.
A no-cal herbal remedy for cough is tincture of mullein (Verbascum thapsus). Take a teaspoon in a little warm water every four hours.
Andrew Weil, M.D. –
Author of:
Pouring Salt on Heartburn?
Pouring Salt on Heartburn?
Provided by: DrWeil.com
Q: I just heard that salt causes heartburn. True? -- Barry
A: Maybe so. Results of a recently published study from Sweden suggest that salting food increases the risk of gastroesophageal reflux disease (GERD), the backflow of acid from the stomach into the esophagus that leads to heartburn.
Specifically, the Swedish study found that people who habitually add salt to their food at the table were 70 percent more likely to develop GERD than people who never use extra salt. Eating salted fish or meat more than twice a month increased the risk by 50 percent.
The study was a large one. It included 3,153 people who had symptoms of reflux and more than 40,000 people with no symptoms. In addition to what they learned about the role of salt, the researchers also confirmed previous findings showing that smoking increases the risk of GERD.
Here, results showed that smoking for one to five years increased the risk of developing reflux by 20 percent; smoking for longer than 20 years increased the risk by 70 percent.
And, surprisingly, they found that coffee consumption correlated with lower risk, although the researchers suggested that this may reflect the fact that people prone to heartburn tend to avoid coffee. Drinking coffee has long been linked with an increased risk of GERD.
This study also found that drinking tea and alcohol did not increase risk, contradicting earlier research findings.
Note, however, that there is some question about how valid these results are, since the diagnosis of heartburn was determined by patients' perceptions rather than by any standardized, objective criteria.
When they looked at factors that seem to protect against reflux, the Swedish researchers found that exercising for 30 minutes at least once a week and eating high-fiber bread were both influential. Results of the study were published in the December 2004 issue of the medical journal Gut.
If you're bothered by GERD symptoms, you might try cutting back on salt to see if that helps. In addition, I still think the following lifestyle changes are worthwhile:
Provided by: DrWeil.com
Q: I just heard that salt causes heartburn. True? -- Barry
A: Maybe so. Results of a recently published study from Sweden suggest that salting food increases the risk of gastroesophageal reflux disease (GERD), the backflow of acid from the stomach into the esophagus that leads to heartburn.
Specifically, the Swedish study found that people who habitually add salt to their food at the table were 70 percent more likely to develop GERD than people who never use extra salt. Eating salted fish or meat more than twice a month increased the risk by 50 percent.
The study was a large one. It included 3,153 people who had symptoms of reflux and more than 40,000 people with no symptoms. In addition to what they learned about the role of salt, the researchers also confirmed previous findings showing that smoking increases the risk of GERD.
Here, results showed that smoking for one to five years increased the risk of developing reflux by 20 percent; smoking for longer than 20 years increased the risk by 70 percent.
And, surprisingly, they found that coffee consumption correlated with lower risk, although the researchers suggested that this may reflect the fact that people prone to heartburn tend to avoid coffee. Drinking coffee has long been linked with an increased risk of GERD.
This study also found that drinking tea and alcohol did not increase risk, contradicting earlier research findings.
Note, however, that there is some question about how valid these results are, since the diagnosis of heartburn was determined by patients' perceptions rather than by any standardized, objective criteria.
When they looked at factors that seem to protect against reflux, the Swedish researchers found that exercising for 30 minutes at least once a week and eating high-fiber bread were both influential. Results of the study were published in the December 2004 issue of the medical journal Gut.
If you're bothered by GERD symptoms, you might try cutting back on salt to see if that helps. In addition, I still think the following lifestyle changes are worthwhile:
- Reduce or eliminate alcohol consumption.
- Stop smoking.
- Avoid coffee and decaffeinated coffee.
- Pay attention to the foods that make your stomach unhappy and avoid eating them.
- Don't eat within two to three hours of bedtime, and avoid lying down after meals.
Take the antioxidant vitamin formula I recommend.
To sooth the esophageal lining take deglycyrrhizinated licorice (DGL). Chew two tablets slowly before each meal or between meals, or take one-half teaspoon of the powder before meals. Use DGL as long as you have symptoms.
Andrew Weil, M.D. –
Author of:
Too Much Sweat?
Too Much Sweat?
Provided by: DrWeil.com
Q: What can I do about cold, sweaty feet? This happens especially in the winter or cold months. (It's not as bad with sandals because my feet can breathe.) It's driving me mad! I can't think properly when my feet are soaked and freezing all the time! -- Zanyfox
A: A sweat gland disorder called hyperhidrosis leads to excess perspiration. While the cause is unknown, the problem has been related to a higher than normal reaction of the sweat glands to both changes in temperatures and to physical and emotional stress. Hyperhidrosis can affect the feet, palms, underarms or the whole body. A 2003 survey found that nearly three percent of the American public suffers from excess sweating but that only 38 percent of those affected have sought medical help.
Effective treatment is available. If I were you, I would consult your physician and also try the measures listed below:
Apply an antiperspirant to your feet in the evening. You can try a drugstore brand but if that doesn't help, your physician may prescribe something stronger.
Use absorbent foot powder.
Rotate your shoes. The pair you wear one day may not dry thoroughly overnight so be sure to switch to a dry pair the next morning.
Wear moisture-wicking athletic socks. You can get them made of merino wool or a synthetic blend called "polypro."
Change your socks once or twice a day and dry your feet thoroughly before putting on a clean pair.
Go barefoot whenever possible - air your feet by slipping off your shoes as often as you can.
Explore using the mind/body connection to improve the condition. Consult a practitioner of clinical hypnosis, guided imagery, or biofeedback to help you in this work.
If antiperspirants don't help, your physician may suggest a treatment called "tap water iontophoresis," which involves soaking your feet in an electrolyte solution while a generator supplies a low intensity electrical current. You can get a device to use at home. You'll need several treatments per week for about three weeks. This method seems to block the activity of sweat glands in the top layer of the skin. Unfortunately, the effects wear off over time so you have to maintain the treatments. If this doesn't work, your physician may suggest Botox injections, which can also be effective.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: What can I do about cold, sweaty feet? This happens especially in the winter or cold months. (It's not as bad with sandals because my feet can breathe.) It's driving me mad! I can't think properly when my feet are soaked and freezing all the time! -- Zanyfox
A: A sweat gland disorder called hyperhidrosis leads to excess perspiration. While the cause is unknown, the problem has been related to a higher than normal reaction of the sweat glands to both changes in temperatures and to physical and emotional stress. Hyperhidrosis can affect the feet, palms, underarms or the whole body. A 2003 survey found that nearly three percent of the American public suffers from excess sweating but that only 38 percent of those affected have sought medical help.
Effective treatment is available. If I were you, I would consult your physician and also try the measures listed below:
Apply an antiperspirant to your feet in the evening. You can try a drugstore brand but if that doesn't help, your physician may prescribe something stronger.
Use absorbent foot powder.
Rotate your shoes. The pair you wear one day may not dry thoroughly overnight so be sure to switch to a dry pair the next morning.
Wear moisture-wicking athletic socks. You can get them made of merino wool or a synthetic blend called "polypro."
Change your socks once or twice a day and dry your feet thoroughly before putting on a clean pair.
Go barefoot whenever possible - air your feet by slipping off your shoes as often as you can.
Explore using the mind/body connection to improve the condition. Consult a practitioner of clinical hypnosis, guided imagery, or biofeedback to help you in this work.
If antiperspirants don't help, your physician may suggest a treatment called "tap water iontophoresis," which involves soaking your feet in an electrolyte solution while a generator supplies a low intensity electrical current. You can get a device to use at home. You'll need several treatments per week for about three weeks. This method seems to block the activity of sweat glands in the top layer of the skin. Unfortunately, the effects wear off over time so you have to maintain the treatments. If this doesn't work, your physician may suggest Botox injections, which can also be effective.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Migraines in Children?
Migraines in Children?
Provided by: DrWeil.com
Q: My eight-year-old child suffers from variant migraines. To help prevent them I would like to try a natural anti-inflammatory supplement such as Zyflamend, which you have recommended. Is it safe for a child of this age, and if so, what dosage would be appropriate? Or, is an anti-inflammatory diet a better choice? -- Karl J.
A: Variant migraines are not necessarily headaches - although they can be - but they are related, physiologically, to more typical migraines and are set off by the same triggers. Some affect the stomach causing nausea and vomiting; others produce dizziness and vertigo, and some cause confusion, all with or without headache. These migraine variants tend to be brief and are made worse by movement. They're most likely to develop in children with a family history of migraine and may suggest that affected youngsters eventually will develop more typical migraines.
Fortunately, these episodes can be relieved by deep sleep or by medications, but it is important to try to determine what sets off the symptoms so that kids can avoid the triggers. I urge you to track the foods associated with your child's variant migraines. Typically, triggers include aged cheeses and processed meats (including pizza and hot dogs); peanuts; bread and crackers containing cheese; broad beans, peas, and lentils; and beverages containing caffeine and chocolate. Other foods that have been linked to migraines include avocados, bananas, citrus fruits, figs, raisins, red plums, and raspberries. Food additives that may play a role include nitrates and nitrites (in processed meats), yellow food coloring, and monosodium glutamate (MSG) used in some canned or processed foods as well as in Chinese foods and in soy sauce. In addition, watch out for non-food triggers such as stress, fatigue, lack of sleep (or sleeping too much), missing meals, weather-related changes in barometric pressure, and changes in altitude. Strong smells, such as paint, gasoline or heavy perfumes, and bright flashing lights can also trigger migraine symptoms.
Anti-inflammatory drugs are very useful in relieving migraines in children, and I definitely would recommend an anti-inflammatory diet. I suggest trying the diet first and then adding Zyflamend. The proper amount for an eight-year-old child is half the adult dose. You may also introduce your child to mind-body interventions like hypnosis or biofeedback which can be quite beneficial for relief of migraine symptoms.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: My eight-year-old child suffers from variant migraines. To help prevent them I would like to try a natural anti-inflammatory supplement such as Zyflamend, which you have recommended. Is it safe for a child of this age, and if so, what dosage would be appropriate? Or, is an anti-inflammatory diet a better choice? -- Karl J.
A: Variant migraines are not necessarily headaches - although they can be - but they are related, physiologically, to more typical migraines and are set off by the same triggers. Some affect the stomach causing nausea and vomiting; others produce dizziness and vertigo, and some cause confusion, all with or without headache. These migraine variants tend to be brief and are made worse by movement. They're most likely to develop in children with a family history of migraine and may suggest that affected youngsters eventually will develop more typical migraines.
Fortunately, these episodes can be relieved by deep sleep or by medications, but it is important to try to determine what sets off the symptoms so that kids can avoid the triggers. I urge you to track the foods associated with your child's variant migraines. Typically, triggers include aged cheeses and processed meats (including pizza and hot dogs); peanuts; bread and crackers containing cheese; broad beans, peas, and lentils; and beverages containing caffeine and chocolate. Other foods that have been linked to migraines include avocados, bananas, citrus fruits, figs, raisins, red plums, and raspberries. Food additives that may play a role include nitrates and nitrites (in processed meats), yellow food coloring, and monosodium glutamate (MSG) used in some canned or processed foods as well as in Chinese foods and in soy sauce. In addition, watch out for non-food triggers such as stress, fatigue, lack of sleep (or sleeping too much), missing meals, weather-related changes in barometric pressure, and changes in altitude. Strong smells, such as paint, gasoline or heavy perfumes, and bright flashing lights can also trigger migraine symptoms.
Anti-inflammatory drugs are very useful in relieving migraines in children, and I definitely would recommend an anti-inflammatory diet. I suggest trying the diet first and then adding Zyflamend. The proper amount for an eight-year-old child is half the adult dose. You may also introduce your child to mind-body interventions like hypnosis or biofeedback which can be quite beneficial for relief of migraine symptoms.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Wednesday, May 24, 2006
Ears Popping Too Often?
Ears Popping Too Often?
Provided by: DrWeil.com
Q: My ears periodically "pop." Especially when I am nervous or talking. It is very frustrating and irritating. What causes this? Is the only way to clear it to "sniff" and then yawn or swallow? -- Ray
A: Ear popping (the medical name if you damage the ear drum is barotrauma) is caused by pressure differences between the inside and outside of the eardrum. Air pressure in the middle ear usually is the same as the air pressure outside the body. Most people are familiar with the pressure changes (relieved by ear popping) that occur when you fly, travel to high altitudes, or dive underwater. Swallowing or yawning helps relieve the pressure by opening the eustachian tube, which connects the middle ear to the back of the nose and upper throat. Opening the tube allows air to flow into or out of the middle ear and equalizes pressure on the eardrum. While annoying, this problem usually isn't serious. Rarely, if it persists and worsens, it can lead to a perforated eardrum, an acute ear infection, and even loss of hearing. Be sure to see your doctor if you develop fever, severe ear pain, or drainage from an ear.
Your "ear popping" problem could stem from nasal congestion related to allergy, a sinus condition, or a chronic upper respiratory infection. In addition to sniffing, yawning or swallowing, you may be able to relieve the pressure by gargling with warm salt water, which can help clear the eustachian tubes. Sucking on candy or chewing gum may also help. You also could consider using a nasal decongestant or an antihistamine before flying or other changes in altitude. Try to avoid flying when you have a cold or flare-up of an allergy.
If the problem continues, see a physician who can examine your ear to see if the eardrum is pulled inwards, indicating unbalanced pressure. The doctor will also check to see if there is fluid behind your eardrum and if you have a perforated eardrum. The medical treatment for ear barotrauma involves decongestant nasal sprays, oral decongestants, or oral antihistamines. If an ear infection develops, your doctor probably will prescribe an antibiotic. A perforated eardrum usually heals on its own; sometimes, fluid behind the eardrum has to be drained.
You may also want to consider cranial osteopathy to help relieve pressure changes or fluid in the middle ear. Acupuncture can be an effective treatment for sinus congestion.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: My ears periodically "pop." Especially when I am nervous or talking. It is very frustrating and irritating. What causes this? Is the only way to clear it to "sniff" and then yawn or swallow? -- Ray
A: Ear popping (the medical name if you damage the ear drum is barotrauma) is caused by pressure differences between the inside and outside of the eardrum. Air pressure in the middle ear usually is the same as the air pressure outside the body. Most people are familiar with the pressure changes (relieved by ear popping) that occur when you fly, travel to high altitudes, or dive underwater. Swallowing or yawning helps relieve the pressure by opening the eustachian tube, which connects the middle ear to the back of the nose and upper throat. Opening the tube allows air to flow into or out of the middle ear and equalizes pressure on the eardrum. While annoying, this problem usually isn't serious. Rarely, if it persists and worsens, it can lead to a perforated eardrum, an acute ear infection, and even loss of hearing. Be sure to see your doctor if you develop fever, severe ear pain, or drainage from an ear.
Your "ear popping" problem could stem from nasal congestion related to allergy, a sinus condition, or a chronic upper respiratory infection. In addition to sniffing, yawning or swallowing, you may be able to relieve the pressure by gargling with warm salt water, which can help clear the eustachian tubes. Sucking on candy or chewing gum may also help. You also could consider using a nasal decongestant or an antihistamine before flying or other changes in altitude. Try to avoid flying when you have a cold or flare-up of an allergy.
If the problem continues, see a physician who can examine your ear to see if the eardrum is pulled inwards, indicating unbalanced pressure. The doctor will also check to see if there is fluid behind your eardrum and if you have a perforated eardrum. The medical treatment for ear barotrauma involves decongestant nasal sprays, oral decongestants, or oral antihistamines. If an ear infection develops, your doctor probably will prescribe an antibiotic. A perforated eardrum usually heals on its own; sometimes, fluid behind the eardrum has to be drained.
You may also want to consider cranial osteopathy to help relieve pressure changes or fluid in the middle ear. Acupuncture can be an effective treatment for sinus congestion.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Alternatives to Estrogen?
Alternatives to Estrogen?
Provided by: DrWeil.com
Q: Is there any data on the safety of bio-identical hormones for someone whose mother had breast cancer post-menopause that was contained and estrogen-receptor positive? Also, what is considered short-term therapy when using bio-identical hormones? -- Peggy D.
A: Bio-identical estrogen is a plant-based hormone that closely approximates a woman's natural estrogen and is believed safer and more natural than traditional estrogen replacement therapy for such menopausal symptoms as hot flashes and vaginal dryness. As you may know, in 2002 the National Institutes of Health (NIH) shut down a huge study on the risks and benefits of post-menopausal hormone replacement therapy because preliminary results revealed an unacceptable risk of breast cancer, strokes and heart attacks. These risks were associated with therapy that included both estrogen and the hormone progestin. Two years later, the NIH shut down another arm of the study that was looking into the benefits and risks of estrogen replacement therapy (no progestin was used) after preliminary findings showed that the hormone increased the risk of stroke. Estrogen alone did not increase the risk of breast cancer, at least not for the duration of the study.
Although I have never believed that menopause is a disease, or that all postmenopausal women need hormone replacement therapy, I have recommended low doses of bio-identical hormones such as Estrace, Bi-Est, and Tri-Est to women who need reliable short-term relief from frequent and intense hot flashes and from vaginal dryness that makes sex uncomfortable. While bio-identical hormones are assumed to be safer than traditional hormone replacement therapy, they still provide estrogen and may increase the risk of breast cancer. To put your personal risk into perspective: If your mother was the only woman in your family to have breast cancer and developed it after menopause, your personal risk is 50 percent higher than what it would be normally. That sounds much more alarming than it is. Here's an example: of all the women age 50 with only one first-degree relative - mother, sister or daughter - who had breast cancer, 9.8 percent will develop the disease by age 80. That means more than 90 percent of those with a single affected relative won't get breast cancer - not bad odds. Compare that with the fact that of all 50 year-old women with no affected relatives, 6.1 percent will develop breast cancer by age 80.
Still, if I were you, I would avoid any form of estrogen. Instead, you could try black cohosh (Cimicifuga racemosa), which appears to be safe for women who have had breast cancer or have a family history of the disease. Studies so far have not found that black cohosh has estrogenic effects. While it seems to work well to quell hot flashes in some women, it doesn't help everyone.
On the conventional medicine front, a study published in the January 2005 issue of Obstetrics and Gynecology found that the antidepressant Effexor seems to be effective in treating hot flashes in healthy women. An earlier study from the Mayo Clinic found that the anti-seizure drug gabapentin relieved the frequency of hot flashes by 66 percent and also lessened their intensity.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: Is there any data on the safety of bio-identical hormones for someone whose mother had breast cancer post-menopause that was contained and estrogen-receptor positive? Also, what is considered short-term therapy when using bio-identical hormones? -- Peggy D.
A: Bio-identical estrogen is a plant-based hormone that closely approximates a woman's natural estrogen and is believed safer and more natural than traditional estrogen replacement therapy for such menopausal symptoms as hot flashes and vaginal dryness. As you may know, in 2002 the National Institutes of Health (NIH) shut down a huge study on the risks and benefits of post-menopausal hormone replacement therapy because preliminary results revealed an unacceptable risk of breast cancer, strokes and heart attacks. These risks were associated with therapy that included both estrogen and the hormone progestin. Two years later, the NIH shut down another arm of the study that was looking into the benefits and risks of estrogen replacement therapy (no progestin was used) after preliminary findings showed that the hormone increased the risk of stroke. Estrogen alone did not increase the risk of breast cancer, at least not for the duration of the study.
Although I have never believed that menopause is a disease, or that all postmenopausal women need hormone replacement therapy, I have recommended low doses of bio-identical hormones such as Estrace, Bi-Est, and Tri-Est to women who need reliable short-term relief from frequent and intense hot flashes and from vaginal dryness that makes sex uncomfortable. While bio-identical hormones are assumed to be safer than traditional hormone replacement therapy, they still provide estrogen and may increase the risk of breast cancer. To put your personal risk into perspective: If your mother was the only woman in your family to have breast cancer and developed it after menopause, your personal risk is 50 percent higher than what it would be normally. That sounds much more alarming than it is. Here's an example: of all the women age 50 with only one first-degree relative - mother, sister or daughter - who had breast cancer, 9.8 percent will develop the disease by age 80. That means more than 90 percent of those with a single affected relative won't get breast cancer - not bad odds. Compare that with the fact that of all 50 year-old women with no affected relatives, 6.1 percent will develop breast cancer by age 80.
Still, if I were you, I would avoid any form of estrogen. Instead, you could try black cohosh (Cimicifuga racemosa), which appears to be safe for women who have had breast cancer or have a family history of the disease. Studies so far have not found that black cohosh has estrogenic effects. While it seems to work well to quell hot flashes in some women, it doesn't help everyone.
On the conventional medicine front, a study published in the January 2005 issue of Obstetrics and Gynecology found that the antidepressant Effexor seems to be effective in treating hot flashes in healthy women. An earlier study from the Mayo Clinic found that the anti-seizure drug gabapentin relieved the frequency of hot flashes by 66 percent and also lessened their intensity.
Andrew Weil, M.D. –
Author of:
Getting Enough Omega-3?
Getting Enough Omega-3?
Provided by: DrWeil.com
Q: Your recent article mentioned one's "omega-3 level." How do I measure mine or find what my level is? I'm trying to increase my intake of omega-3s with flaxseed (ground), fish and lentils. -- Shirley
A: Omega-3 fatty acids are special unsaturated fats our bodies need for optimum health. Unfortunately, most Americans are deficient in omega-3s, and as a result are more likely to develop cardiovascular disease, cancer, inflammatory disorders, and mental and emotional problems. Eating foods rich in omega-3s can reduce these risks and also help treat depression, bipolar disorder, autism, and attention deficit hyperactivity disorder.
I don't think there is any practical way to measure your omega-3 levels. If there were, and if they were low, the solution would be to do what you should do anyway: increase your intake. Instead of worrying about what your levels are, try to calculate how much omega-3s your diet provides.
These fatty acids are found principally in oily fish that live in cold water, primarily wild salmon, mackerel, herring, and sardines. Bluefish is also rich in omega-3s as is - to a lesser extent - albacore tuna, but both of these tasty fish are contaminated by mercury and should be avoided.
Other dietary sources of omega-3s include walnuts, flaxseeds and hemp seeds - and the oils extracted from them - as well as soy and canola oils and specially fortified eggs. If you're eating three ounces of fish two to three times a week, as I recommend, snacking on walnuts and adding flaxseeds to cereals and salads you're probably getting enough omega 3s.
A 3-ounce serving of Alaskan salmon or herring contains about 2 grams of omega-3 fatty acids, while 3 ounces of sardines has about 1.3 grams. You can substitute one ounce of walnuts for a serving of fish, or add a tablespoon or two of freshly ground flaxseed or hemp oil to your diet.
These plant sources provide you with alpha linolenic acid, which the body converts to the omega-3s the body needs. The only problem with plant sources of these nutrients is that some people may not be able to convert alpha-linolenic acid to the longer-chain forms that occur in fish, the forms the body needs.
If you are not getting adequate amounts of omega-3 fatty acids in your diet, I recommend taking a good quality fish oil supplement. This is particularly important if you have high cholesterol, diabetes, symptoms of PMS, coronary artery disease or a family history of heart attack or sudden cardiac death, breast cancer, memory loss, depression, insulin resistance, high cholesterol, or rheumatoid arthritis. Distilled fish oils are free of mercury and other contaminants, and some taste quite good. Start with one to two grams a day.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: Your recent article mentioned one's "omega-3 level." How do I measure mine or find what my level is? I'm trying to increase my intake of omega-3s with flaxseed (ground), fish and lentils. -- Shirley
A: Omega-3 fatty acids are special unsaturated fats our bodies need for optimum health. Unfortunately, most Americans are deficient in omega-3s, and as a result are more likely to develop cardiovascular disease, cancer, inflammatory disorders, and mental and emotional problems. Eating foods rich in omega-3s can reduce these risks and also help treat depression, bipolar disorder, autism, and attention deficit hyperactivity disorder.
I don't think there is any practical way to measure your omega-3 levels. If there were, and if they were low, the solution would be to do what you should do anyway: increase your intake. Instead of worrying about what your levels are, try to calculate how much omega-3s your diet provides.
These fatty acids are found principally in oily fish that live in cold water, primarily wild salmon, mackerel, herring, and sardines. Bluefish is also rich in omega-3s as is - to a lesser extent - albacore tuna, but both of these tasty fish are contaminated by mercury and should be avoided.
Other dietary sources of omega-3s include walnuts, flaxseeds and hemp seeds - and the oils extracted from them - as well as soy and canola oils and specially fortified eggs. If you're eating three ounces of fish two to three times a week, as I recommend, snacking on walnuts and adding flaxseeds to cereals and salads you're probably getting enough omega 3s.
A 3-ounce serving of Alaskan salmon or herring contains about 2 grams of omega-3 fatty acids, while 3 ounces of sardines has about 1.3 grams. You can substitute one ounce of walnuts for a serving of fish, or add a tablespoon or two of freshly ground flaxseed or hemp oil to your diet.
These plant sources provide you with alpha linolenic acid, which the body converts to the omega-3s the body needs. The only problem with plant sources of these nutrients is that some people may not be able to convert alpha-linolenic acid to the longer-chain forms that occur in fish, the forms the body needs.
If you are not getting adequate amounts of omega-3 fatty acids in your diet, I recommend taking a good quality fish oil supplement. This is particularly important if you have high cholesterol, diabetes, symptoms of PMS, coronary artery disease or a family history of heart attack or sudden cardiac death, breast cancer, memory loss, depression, insulin resistance, high cholesterol, or rheumatoid arthritis. Distilled fish oils are free of mercury and other contaminants, and some taste quite good. Start with one to two grams a day.
Andrew Weil, M.D. –
Author of:
Feeding Kids Fiber?
Feeding Kids Fiber?
Provided by: DrWeil.com
Q: I recently heard that most youngsters don't get enough fiber. How much do they need? -- Jane J.
A: It's true: most kids don't get enough fiber. Researchers from Penn State University recently asked parents of 5,437 young children to report what their kids ate over a two-day period. The youngsters' main sources of fiber turned out to be applesauce, fruit cocktail, and pizza! Results of the survey were published in the February 2005 issue of the Journal of the American Dietetic Association.
Kids need fiber for the same reasons adults do: to prevent constipation and to protect against heart disease, diabetes, obesity, and some types of cancer later in life. You get fiber from fruits, vegetables, whole grains and cereals (look for products providing four to five grams of fiber per serving). In addition to fiber, these foods also provide such important nutrients as iron, folate and vitamins A and C.
The National Academy of Sciences recommends eating 14 grams of fiber for each 1,000 calories consumed. That may be hard for parents to calculate on an every- day basis.
The American Heart Association has a simpler formula, a fiber guideline of age plus 5. Here's the way it works: a five year old should consume 5 (his age) plus 5 for a total of 10 grams.
The Heart Association recommends that the parents of all kids over age two should make an effort to ensure that their children get the recommended amount of fiber for their age. Once a child starts consuming an adult level of calories (1,500 per day) his fiber intake should be 25 grams, the amount recommended for adults.
Andrew Weil, M.D. –
Author of:
Provided by: DrWeil.com
Q: I recently heard that most youngsters don't get enough fiber. How much do they need? -- Jane J.
A: It's true: most kids don't get enough fiber. Researchers from Penn State University recently asked parents of 5,437 young children to report what their kids ate over a two-day period. The youngsters' main sources of fiber turned out to be applesauce, fruit cocktail, and pizza! Results of the survey were published in the February 2005 issue of the Journal of the American Dietetic Association.
Kids need fiber for the same reasons adults do: to prevent constipation and to protect against heart disease, diabetes, obesity, and some types of cancer later in life. You get fiber from fruits, vegetables, whole grains and cereals (look for products providing four to five grams of fiber per serving). In addition to fiber, these foods also provide such important nutrients as iron, folate and vitamins A and C.
The National Academy of Sciences recommends eating 14 grams of fiber for each 1,000 calories consumed. That may be hard for parents to calculate on an every- day basis.
The American Heart Association has a simpler formula, a fiber guideline of age plus 5. Here's the way it works: a five year old should consume 5 (his age) plus 5 for a total of 10 grams.
The Heart Association recommends that the parents of all kids over age two should make an effort to ensure that their children get the recommended amount of fiber for their age. Once a child starts consuming an adult level of calories (1,500 per day) his fiber intake should be 25 grams, the amount recommended for adults.
Andrew Weil, M.D. –
Author of:
- Eight Weeks to Optimum Health
- Spontaneous Healing
- The Natural Mind
- The Marriage of the Sun and Moon
- Health and Healing
- Natural Health, Natural Medicine
- From Chocolate to Morphine (with Winifred Rosen)
Weight Loss Plan Kit$172.80  Includes: Oxy-Powder, Slimirex (180 Count), Weight Loss Secrets Revealed, Ten Super Secrets for Weight Loss |
Tuesday, May 23, 2006
Poor Water Quality Can Make a Pedicure Deadly
A middle-age paraplegic woman recently lost her life as a result of a staph infection she contracted after being cut during her once-a-month pedicure almost a year ago. After her heel was cut by a pumice stone, the Texas woman developed a wound that wouldn't heal in spite of multiple treatments. She died seven months later from a heart attack caused by the infection that wouldn't go away.
Evidently, bad news travels fast: Over the past nine months, the state has reported nearly 900 complaints against nail salons and nearly 10 percent of them have been penalized with fines or orders to improve their sanitation practices.
That's why the state commission enacted tougher laws to regulate whirlpool foot spas, including soaking basins with bleach and disinfectants, perhaps like chlorine that may be just as toxic to your health.
MSNBC May 19, 2006
Evidently, bad news travels fast: Over the past nine months, the state has reported nearly 900 complaints against nail salons and nearly 10 percent of them have been penalized with fines or orders to improve their sanitation practices.
That's why the state commission enacted tougher laws to regulate whirlpool foot spas, including soaking basins with bleach and disinfectants, perhaps like chlorine that may be just as toxic to your health.
MSNBC May 19, 2006
Monday, May 01, 2006
Raloxifene as Good as Tamoxifen to Prevent Breast Cancer
Both Drugs Cut Risk in Half for High-Risk Women
The bone drug raloxifene (Evista) is just as good as tamoxifen in preventing invasive breast cancer in high-risk women, federal health officials announced today. Both drugs cut the risk of breast cancer in half.
That could give women another option to safeguard their health, experts said, if the Food and Drug Administration approves raloxifene for breast cancer prevention. But which drug a woman chooses will depend on her particular situation, since the 2 medications are slightly different.
"Although no drugs are without side effects, tamoxifen and raloxifene are vital options for women who are at increased risk of breast cancer and want to take action," said Leslie Ford, MD, associate director for clinical research at the National Cancer Institute's Division of Cancer Prevention. "For many women, raloxifene's benefits will outweigh its risks in a way that tamoxifen's benefits do not."
Ford joined other researchers in an afternoon telephone conference to release the first findings from the Study of Tamoxifen and Raloxifene, known as the STAR trial. It involved nearly 20,000 women who had a higher-than-average risk for breast cancer because of factors like their age, family history of the disease, personal medical history, age at which they began menstruating, or the age they had their first child. The women had to be at least 35 years old and already past menopause. Nearly half of the women in the study were 50-59 years old, and another 41% were 60 or older.
Half of the women were randomly assigned to take raloxifene, and half were assigned to tamoxifen. They took the drugs every day for 5 years. Both drugs are pills.
Differences in Uterine, Noninvasive Breast Cancers
Tamoxifen and raloxifene lowered the risk of invasive breast cancer by about the same amount, the researchers said. Previous studies have shown tamoxifen reduces risk by about 50%. The women on both drugs had similar risks for strokes and heart attacks, and both drugs seemed to reduce the risk of bone breaks by about the same extent.
But there were also some important differences.
Women on raloxifene had 36% fewer uterine cancersr than women on tamoxifen, which is known to increase the risk of these cancers. Both drugs are known to increase the risk of blood clots in major veins and the lungs, but women on raloxifene had 29% fewer of either type than women on tamoxifen. Both of those results were just shy of statistical significance. In addition, raloxifene did not appear to raise the risk of cataracts, which tamoxifen does appear to do. That difference was statistically significant.
However, tamoxifen protected women better from non-invasive breast cancers. Tamoxifen is known to reduce the risk of developing lobular carcinoma in situ (LCIS) and ductal carcinoma in situ (DCIS) by about half. Although similar numbers of women were taking each drug, 57 women on tamoxifen developed LCIS or DCIS, while 81 women on raloxifene did.
"The outcome of the study is not as clear cut as we might have hoped for," said Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society. "It will take some time for experts to review the data to determine which of the two treatments is preferable."
Although LCIS and DCIS are not life-threatening, they do require treatment and women who develop either condition (and particularly DCIS) have a higher risk of developing breast cancer later.
"It's an important consideration," Lichtenfeld said.
But Lawrence Wickerham, MD, one of the researchers involved with the study, said, "We feel raloxifene is the winner of this study, given its equivalence to tamoxifen in prevention of invasive breast cancer with fewer life-threatening side effects."
Wickerham is protocol officer for the STAR trial and associate chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP), which ran the study.
Researchers plan to release more data from the trial at a large cancer conference in June.
Raloxifene Not Yet Approved for Breast Cancer Prevention
Raloxifene is not yet approved by the Food and Drug Administration (FDA) as a breast cancer prevention drug. But about half a million women past menopause already take the drug to prevent or treat osteoporosis. The researchers said they expect raloxifene's manufacturer, Eli Lilly and Co., to ask the FDA to approve it for breast cancer prevention.
Tamoxifen is most commonly used as a treatment for women with breast cancer whose tumors have estrogen receptors. It was approved to prevent breast cancer in high-risk women in 1998. The FDA has specific criteria for figuring out if a woman is eligible to take tamoxifen for this purpose. It is estimated that about 15% of all women over age 35 would be eligible to use tamoxifen in this way, but not every woman who could take it for breast cancer prevention does.
The side effects have frightened many women away from using tamoxifen for this purpose, noted Norman Wolmark, MD, NSABP chairman.
"Women who are considering breast cancer prevention therapy should talk with their health care provider," the NCI said in a question-and-answer document about the new study findings. That's because each woman's personal health history is important in determining whether this type of drug is right for her.
Lichtenfeld echoed that advice.
"For now it will be very important for women an increased risk of breast cancer to make an informed decision with the advice of their physician as to which approach is best for them," he said. "It is also important to note that while both drugs can prevent many breast cancers, neither has been shown to reduce the risk of death due to the disease."
The bone drug raloxifene (Evista) is just as good as tamoxifen in preventing invasive breast cancer in high-risk women, federal health officials announced today. Both drugs cut the risk of breast cancer in half.
That could give women another option to safeguard their health, experts said, if the Food and Drug Administration approves raloxifene for breast cancer prevention. But which drug a woman chooses will depend on her particular situation, since the 2 medications are slightly different.
"Although no drugs are without side effects, tamoxifen and raloxifene are vital options for women who are at increased risk of breast cancer and want to take action," said Leslie Ford, MD, associate director for clinical research at the National Cancer Institute's Division of Cancer Prevention. "For many women, raloxifene's benefits will outweigh its risks in a way that tamoxifen's benefits do not."
Ford joined other researchers in an afternoon telephone conference to release the first findings from the Study of Tamoxifen and Raloxifene, known as the STAR trial. It involved nearly 20,000 women who had a higher-than-average risk for breast cancer because of factors like their age, family history of the disease, personal medical history, age at which they began menstruating, or the age they had their first child. The women had to be at least 35 years old and already past menopause. Nearly half of the women in the study were 50-59 years old, and another 41% were 60 or older.
Half of the women were randomly assigned to take raloxifene, and half were assigned to tamoxifen. They took the drugs every day for 5 years. Both drugs are pills.
Differences in Uterine, Noninvasive Breast Cancers
Tamoxifen and raloxifene lowered the risk of invasive breast cancer by about the same amount, the researchers said. Previous studies have shown tamoxifen reduces risk by about 50%. The women on both drugs had similar risks for strokes and heart attacks, and both drugs seemed to reduce the risk of bone breaks by about the same extent.
But there were also some important differences.
Women on raloxifene had 36% fewer uterine cancersr than women on tamoxifen, which is known to increase the risk of these cancers. Both drugs are known to increase the risk of blood clots in major veins and the lungs, but women on raloxifene had 29% fewer of either type than women on tamoxifen. Both of those results were just shy of statistical significance. In addition, raloxifene did not appear to raise the risk of cataracts, which tamoxifen does appear to do. That difference was statistically significant.
However, tamoxifen protected women better from non-invasive breast cancers. Tamoxifen is known to reduce the risk of developing lobular carcinoma in situ (LCIS) and ductal carcinoma in situ (DCIS) by about half. Although similar numbers of women were taking each drug, 57 women on tamoxifen developed LCIS or DCIS, while 81 women on raloxifene did.
"The outcome of the study is not as clear cut as we might have hoped for," said Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society. "It will take some time for experts to review the data to determine which of the two treatments is preferable."
Although LCIS and DCIS are not life-threatening, they do require treatment and women who develop either condition (and particularly DCIS) have a higher risk of developing breast cancer later.
"It's an important consideration," Lichtenfeld said.
But Lawrence Wickerham, MD, one of the researchers involved with the study, said, "We feel raloxifene is the winner of this study, given its equivalence to tamoxifen in prevention of invasive breast cancer with fewer life-threatening side effects."
Wickerham is protocol officer for the STAR trial and associate chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP), which ran the study.
Researchers plan to release more data from the trial at a large cancer conference in June.
Raloxifene Not Yet Approved for Breast Cancer Prevention
Raloxifene is not yet approved by the Food and Drug Administration (FDA) as a breast cancer prevention drug. But about half a million women past menopause already take the drug to prevent or treat osteoporosis. The researchers said they expect raloxifene's manufacturer, Eli Lilly and Co., to ask the FDA to approve it for breast cancer prevention.
Tamoxifen is most commonly used as a treatment for women with breast cancer whose tumors have estrogen receptors. It was approved to prevent breast cancer in high-risk women in 1998. The FDA has specific criteria for figuring out if a woman is eligible to take tamoxifen for this purpose. It is estimated that about 15% of all women over age 35 would be eligible to use tamoxifen in this way, but not every woman who could take it for breast cancer prevention does.
The side effects have frightened many women away from using tamoxifen for this purpose, noted Norman Wolmark, MD, NSABP chairman.
"Women who are considering breast cancer prevention therapy should talk with their health care provider," the NCI said in a question-and-answer document about the new study findings. That's because each woman's personal health history is important in determining whether this type of drug is right for her.
Lichtenfeld echoed that advice.
"For now it will be very important for women an increased risk of breast cancer to make an informed decision with the advice of their physician as to which approach is best for them," he said. "It is also important to note that while both drugs can prevent many breast cancers, neither has been shown to reduce the risk of death due to the disease."
Newer Chemotherapies Improve Breast Cancer Outlook
Summary: Newer chemotherapy regimens have improved the outlook for breast cancer patients, according to a report in the Journal of the American Medical Association. The results were best in women whose cancers lacked hormone receptors and therefore could not be helped by hormonal treatments such as tamoxifen. The finding is based on a review of 3 successive national studies of post-operative chemotherapy in women with advanced early stage breast cancer -- cancer that has spread to nearby lymph nodes, but no further.
Why it's important: Although early breast cancers are often treated successfully, the disease can be fatal if the cancer comes back after surgery. In 2006, the American Cancer Society estimates that 41,000 women will die of this disease (more than 200,000 women will develop it). Beginning in the 1970s, doctors found that new drugs and new ways of giving these drugs could help prevent recurrence and death. Even more effective treatments have been introduced in recent years, as this study shows. Thanks to these advances, today's women have a better chance of surviving this disease than did women in the past -- even if their tumors are the more difficult type to treat, which don't respond to hormone therapies like tamoxifen or aromatase inhibitors.
"This tells us that breast oncology has made enormous strides in treating patients with [hormone-negative] tumors," said lead study author Donald Berry, PhD, chair of the Department of Biostatistics and Applied Mathematics at The University of Texas M.D. Anderson Cancer Center.
What's already known: Women whose breast cancer has spread to their lymph nodes are at risk of having the cancer come back -- most commonly in their bones, liver, and lungs. When this happens, the cancer may eventually be fatal. More than 30 years ago, doctors found that giving chemotherapy or hormone therapy to these women after their breast cancer surgery would prevent a recurrence in some of them. After years of study, it became clear that women whose cancers contained hormone receptors (about two-thirds of breast cancers have them) were especially helped by the hormone-like drug tamoxifen, even though these women often received chemotherapy also. But women whose cancers did not have hormone receptors did not respond to tamoxifen and needed chemotherapy, which became their main treatment.
How this study was done: The researchers examined the results of three large clinical trials that were carried out from 1985-1991, 1994-1997, and 1997-1999. The trials tested different chemotherapy regimens in women who had surgery for breast cancer that had spread to underarm lymph nodes. They included women with both hormone-positive and hormone-negative cancers. Each successive study matched a new regimen (either a new drug combination or a new way of giving the drugs) against the best regimen of the previous study.
What was found: Each new chemotherapy regimen proved better than the earlier one. The women who got the best-performing treatment in the most recent clinical trial had a lower chance of recurrence and a greater chance of survival than the women in the earliest trial. But this benefit was seen mainly in women whose cancers were hormone receptor-negative -- that is, the cancers lacked estrogen receptors (ER-negative). Women with ER-negative tumors had a nearly 17% improvement in their overall survival if they received chemotherapy, while those with ER-positive tumors had a 4% improvement.
Why the difference? The authors say it has to do with drugs like tamoxifen. The hormone treatments are so effective for women with ER-positive cancers that the chemotherapy adds only a little to their overall improvement. Chemotherapy shows a much greater effect in ER-negative women because they don't benefit from hormonal therapies.
"All in all, this is good news because it shows that the benefit of chemotherapy for ER-negative tumors is surprisingly dramatic in the same way that tamoxifen's effect is substantial for ER-positive tumors," Berry said.
The bottom line: Clinical trials of new chemotherapy regimens for women who have had surgery for breast cancer are helping doctors fine-tune the way they treat these patients and helping more women survive the disease. This is especially true for women with harder-to-treat ER-negative tumors.
That doesn't mean ER-positive women won't benefit from chemotherapy at all, cautioned the study's senior author, Eric Winer, MD. He is director of the Dana-Farber Breast Oncology Center and associate professor of medicine at Harvard Medical School. But it does mean there's more fine-tuning to be done.
"Women with ER-negative and ER-positive cancer should be approached differently when it comes to making a decision about [post-operative] chemotherapy," Winer said in a statement. "We need to work to identify which patients with ER-positive tumors get the largest benefit from chemotherapy."
All that speaks to the need for support and encouragement of new clinical trials to improve breast cancer treatments even more and to give each woman only the most effective treatments for her particular situation.
Citation: "Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer." Published in the April 12, 2006, Journal of the American Medical Association (Vol. 295, No.14: 1658-1667). First author: Donald Berry PhD, M.D. Anderson Cancer Center, Houston, Texas.
Why it's important: Although early breast cancers are often treated successfully, the disease can be fatal if the cancer comes back after surgery. In 2006, the American Cancer Society estimates that 41,000 women will die of this disease (more than 200,000 women will develop it). Beginning in the 1970s, doctors found that new drugs and new ways of giving these drugs could help prevent recurrence and death. Even more effective treatments have been introduced in recent years, as this study shows. Thanks to these advances, today's women have a better chance of surviving this disease than did women in the past -- even if their tumors are the more difficult type to treat, which don't respond to hormone therapies like tamoxifen or aromatase inhibitors.
"This tells us that breast oncology has made enormous strides in treating patients with [hormone-negative] tumors," said lead study author Donald Berry, PhD, chair of the Department of Biostatistics and Applied Mathematics at The University of Texas M.D. Anderson Cancer Center.
What's already known: Women whose breast cancer has spread to their lymph nodes are at risk of having the cancer come back -- most commonly in their bones, liver, and lungs. When this happens, the cancer may eventually be fatal. More than 30 years ago, doctors found that giving chemotherapy or hormone therapy to these women after their breast cancer surgery would prevent a recurrence in some of them. After years of study, it became clear that women whose cancers contained hormone receptors (about two-thirds of breast cancers have them) were especially helped by the hormone-like drug tamoxifen, even though these women often received chemotherapy also. But women whose cancers did not have hormone receptors did not respond to tamoxifen and needed chemotherapy, which became their main treatment.
How this study was done: The researchers examined the results of three large clinical trials that were carried out from 1985-1991, 1994-1997, and 1997-1999. The trials tested different chemotherapy regimens in women who had surgery for breast cancer that had spread to underarm lymph nodes. They included women with both hormone-positive and hormone-negative cancers. Each successive study matched a new regimen (either a new drug combination or a new way of giving the drugs) against the best regimen of the previous study.
What was found: Each new chemotherapy regimen proved better than the earlier one. The women who got the best-performing treatment in the most recent clinical trial had a lower chance of recurrence and a greater chance of survival than the women in the earliest trial. But this benefit was seen mainly in women whose cancers were hormone receptor-negative -- that is, the cancers lacked estrogen receptors (ER-negative). Women with ER-negative tumors had a nearly 17% improvement in their overall survival if they received chemotherapy, while those with ER-positive tumors had a 4% improvement.
Why the difference? The authors say it has to do with drugs like tamoxifen. The hormone treatments are so effective for women with ER-positive cancers that the chemotherapy adds only a little to their overall improvement. Chemotherapy shows a much greater effect in ER-negative women because they don't benefit from hormonal therapies.
"All in all, this is good news because it shows that the benefit of chemotherapy for ER-negative tumors is surprisingly dramatic in the same way that tamoxifen's effect is substantial for ER-positive tumors," Berry said.
The bottom line: Clinical trials of new chemotherapy regimens for women who have had surgery for breast cancer are helping doctors fine-tune the way they treat these patients and helping more women survive the disease. This is especially true for women with harder-to-treat ER-negative tumors.
That doesn't mean ER-positive women won't benefit from chemotherapy at all, cautioned the study's senior author, Eric Winer, MD. He is director of the Dana-Farber Breast Oncology Center and associate professor of medicine at Harvard Medical School. But it does mean there's more fine-tuning to be done.
"Women with ER-negative and ER-positive cancer should be approached differently when it comes to making a decision about [post-operative] chemotherapy," Winer said in a statement. "We need to work to identify which patients with ER-positive tumors get the largest benefit from chemotherapy."
All that speaks to the need for support and encouragement of new clinical trials to improve breast cancer treatments even more and to give each woman only the most effective treatments for her particular situation.
Citation: "Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer." Published in the April 12, 2006, Journal of the American Medical Association (Vol. 295, No.14: 1658-1667). First author: Donald Berry PhD, M.D. Anderson Cancer Center, Houston, Texas.
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