This week another dietary supplement moves from the "not proven to have any benefits" column to the "potentially harmful" column. A study in the Annals of Internal Medicine which was reported in this CNN article is the largest study yet to look at the effects of selenium on the dev...
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Chondrointin Doesn’t Help Arthritis Pain
I have many patients who swear by alternative therapies that are unproven or, worse, proven not to work. How should I counsel them? On the one hand, each individual is unique and it's possible that what applies to thousands of patients in a study shouldn't be generalized to the specific patient sitting in my office right now. On the other hand, we all (I included) have a staggering capacity for self-delusion, and it's possible that my patient is just engaging in wishful thinking because he si...
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Garlic Doesn’t Lower Cholesterol
Garlic is frequently touted as a natural treatment for high cholesterol, and many garlic extracts are sold with the suggestion that they improve cholesterol levels. The current issue of the Archives of Internal Medicine has an article reporting the most definitive study yet looking at the effects of garlic on cholesterol. Volunteers were randomized into four groups: raw garlic, powdered garlic suppl...
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Book Review: A New IBS Solution
In November I wrote about an important study in the Annals of Internal Medicine that demonstrated the effectiveness of an antibiotic for the symptoms of irritable bowel syndrome (IBS). Dr. Mark Pimentel, the author of the study, is the director of the Cedars-Sinai Medical Center Gastrointestinal Motility Program. Last year he published a book outlining his theories about the cause and treatment of IBS: A New IBS Solu...
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Growth Hormone Doesn’t Help Healthy Older Adults
I've written before about the popular antiaging trend in healthcare. Another medication that has been widely touted as an antiaging remedy is growth hormone (GH). It has been shown to be beneficial in certain diseases (especially GH deficiency) but has also been recommended by some to healthy older people to increase muscle mass, improve bone density, and "reverse aging".
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Black Cohosh, Other Herbs, or Soy for Symptoms of Menopause
I know I wrote about menopause only three weeks ago (and received some joking complaints from a few male patients about covering irrelevant topics) but I don't write the medical literature; I just report it.
A great study was published this week in the Annals of Internal Medicine, and the summary for patients is free without a subscription. ...
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Reclaiming the Q Word
A generation ago, in the bad old days, physicians were thought of as unquestioned experts who dispensed orders rather than advice, and expected dutiful compliance from their patients. Fortunately those days are long gone, and today the patient and the physician see each other as partners in the patient's healthcare, with the patient able to question and even challenge the doctor's recommendations. This keeps doctors smart and honest and keeps patients ultimately in control of their health. Bu...
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Management of Menopausal Symptoms
Yesterday's issue of the New England Journal of Medicine had a very helpful review article: Management of Menopausal Symptoms. (The full text is available even to non-subscribers.) The article reviews the existing evidence about the prevalence of symptoms related to menopause and the risks and benefits of various treatments. I summarize the article below.
The symptoms most associated with menopause are v...
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DHEA and Testosterone Don’t Help Elderly Patients
Antiaging is the latest wellness craze, with many supplements promising to turn back the clock and help people feel younger. Very few antiaging supplements have received rigorous attention.
Dehydroepiandrosteone (DHEA) and testosterone are two hormones widely promoted as antiaging supplements which were investigated in a randomized double-blind study published last month in the New England Journal of Medicin...
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Horse Chestnut Seed Extract Is Effective for Symptoms of Venous Insufficiency
Chronic venous insufficiency is a very common and very uncomfortable condition. It occurs when the valves in the veins of the legs become leaky, leading to leg swelling, pain and itching. When severe, skin breakdown can occur. The most effective treatment is compression stockings, which can be uncomfortable and difficult to use. An effective oral medication would be a major advance in terms of convenience.
Horse chestnut seed extract (HCSE) is a herbal remedy sometimes used for venous insuffici...
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