Tag Archives: Cathy Rosenbaum

Nutrigenomics

We are what we eat, right?  Nutrigenomics is an upcoming  field of research that will give us more information about how our food can positively (or negatively) affect our health.

Did you know that our genes are connected to our nutrition?   In the future we will learn more about which nutrients, in what amounts, are needed to keep our genes healthy.  Now, that’s exciting and better than just depending on recommended daily intake values.

Do Americans get enough information on nutrition to make wise choices about the foods they eat now?  Why or why not?

Using Neti Pots – Be Safe!

Neti pots can be used to clean out mucus, allergens, and debris that build up on the nose and sinus cavity. They are safe if used correctly. A recent case report involving a woman who allegedly passed away from an amoeba acquired from unsterile water used in her neti pot over many months reminds us to do diligence when preparing saline water and cleaning pots to stay safe.

Please:

* Keep your neti pot clean regardless of whether it is made of plastic, ceramic, glass, or some other material.

* Use a safe water source for the saline solution you prepare for your pot (e.g., preferably sterile or distilled water).

* Use proper technique with your neti pot to get a good rinse. If you are unsure of how to use it, contact your favorite pharmacist for a quick demo.

The Center for Disease Control tells us to wash our neti pots after each use. Some of these pots are dishwasher safe, but not all. Please read the directions on the box.

Neti pots can be hand washed with dish soap and hot water and air dried. Don’t use hand towels that contain lint to dry them, as the lint can go up your nose and cause other issues.
If you think your neti pot is contaminated, you can use a chlorine bleach solution to cleanse it, but be careful to thoroughly rinse out any soap or bleach from the pot before you reuse it. This will prevent unwanted residue getting into your nostrils.

Don’t use tap water run through a Brita filter or any home filter unless you boil it for 3 to 5 minutes and then cool it down to room temperature first. Boiled water is storable for up to 24 hours.

For more information, please visit www.apha.us/CDCSafeNetiPots.

To schedule a one hour health & wellness consultation with Dr. Cathy Rosenbaum, please visit www.rxintegrativesolutions.com or email drcathy@rxintegrativesolutions.com. Be mind body spirit healthy.

Ethical Issues: Harvesting Your Non-Health Data in the Brave New World

Some would say that smaller health systems and major insurers will begin/continue to analyze your non-health data in the near future (e.g. from fitness trackers and your activity on social media to commercial genetic testing results [soon available without a doctor’s order]). Data is intended to be used to improve patient care/outcomes and set insurance rates. For perspective, HIPAA only protects your medical information. There are benefits and risks in such practices. Do you agree/disagree? Please share your thoughts.

https://lnkd.in/e4xatAF  #health #wellness #healthandwellness #holistichealth

“Get Healthy” Resources for Your New Year’s Resolutions

For Your New Year’s “Get Healthy’ Resolutions -> See These Links For Important Information:

*Food & Nutrition Information Center @ https://lnkd.in/eyudzcD
*North American Vegetarian Society @ http://www.navs-online.org
*Tufts University Health & Nutrition Letter @ https://lnkd.in/e_65Twz
*American Council on Exercise @ http://www.acefitness.com

Keep moving, be mind body spirit healthy!

To schedule an integrative health & wellness consultation, please visit www.rxintegrativesolutions.com or contact Dr. Cathy Rosenbaum at (513) 607-3495.

Energy Drinks – Are Those Shots Really Safe?

Beverages like Red Bull, Rockstar, Monster Energy, 5-Hour Energy, Mountain Dew Kickstart, and Full Throttle are touted to increase energy, improve mental alertness, and enhance physical endurance. Some of these products are marketed as beverages while others are marketed as dietary supplements.

According to the Center for Disease Control and Prevention, between 2007 and 2011, the number of energy drink-associated emergency room visits doubled. In 2011, one in 10 of them resulted in a hospitalization. Some college students will unsafely consume energy drinks along with alcohol or other products/drugs (e.g., marijuana, OTC or prescription medications).

Ever looked at the nutrition label on the back of one of these products? They contain more than just caffeine and sugar, namely B vitamins, amino acids (taurine and carnitine), and other dietary supplements -> green tea extract, guarana, yohimbine, green coffee bean extract, bitter orange, glucuronolactone, ginkgo biloba, and ginseng. A single 16-oz bottle may contain up to 62 grams of added sugar, more than the maximum amount recommended in one day (15 teaspoonfuls – 250 calories).

In smaller quantities, caffeine may boost energy and alertness. In larger quantities, caffeine can negatively affect the cardiovascular system. Taurine may boost metabolism. In theory, extra carnitine may impact fat burn. The body is typically not deficient in endogenous carnitine, so it’s a waste of your money. Guarana contains caffeine. Green tea extract contains caffeine and the antioxidant EGCG. Green coffee bean extract contains caffeine. Yohimbine and bitter orange are central nervous system stimulants.

Ginseng does not impact energy and may lower blood sugar in diabetics – diabetics should be careful with its use. Ginkgo biloba has not been clinical proven to improve energy. Water soluble B vitamins protect nerves but may not improve energy. Thankfully, they will be eliminated by the kidney if taken in excess.

Glucuronolactone, a component of connective tissue, is metabolized into glucuronic acid and is touted to ‘detoxify’ (what?) in the body, a nebulous claim that is unproven in humans. It has no impact on energy.

Possible side effects from energy drinks include, but are not limited to, rapid heartbeat, heart palpitations, heart attack, and headaches. Caffeine and other stimulants may also be associated with anxiety, sleep problems, digestive problems, and dehydration.

If you feel you need to consume energy drinks, a good health rule is to consume them in moderation and remember that there may be negative outcomes. Talk it over with your primary care physician. Be healthy, eat whole foods, get ample restorative sleep, and stay safe.

REFERENCES:

Higgins. Energy beverages: content and safety. May Clin Proc 2010:85:1033-1941.
Sankararaman. Impact of energy drinks on health and well-being. Current Nutrition Reports 2018;7:121-130.
Uliah. Energy drinks and myocardial infarction. Cureus 2018;10;e2658

___________________________________________

Cathy Rosenbaum PharmD RPh MBA CHC 10/12/18©

 

 

Overview of Biofeedback

By Dr. Cathy Rosenbaum, Holistic Clinical Pharmacist, Founder & CEO, Rx Integrative Solutions, www.rxintegrativesolutions.com

By tapping into our mind body connection, we can learn how to heal! Biofeedback is a non-pharmacologic mind body technique taught by a trained practitioner that can help a person improve her/his physiological function (e.g., heart rate, blood pressure, breathing rate, skin temperature, muscle tone).  This practice can be used to help manage conditions such as headaches, anxiety, high blood pressure, and stress, among others.

Certified biofeedback practitioners follow a standard of care based on scientific evidence.  They can use different methods involving electrodes and sensors in their 30-minute to one-hour session (e.g., electrodermal test, thermal biofeedback, and electromyogram for muscles).  It may take several sessions before progress is seen.  One could learn how to relax using deep breathing, progressive muscle relaxation, guided imagery, and/or mindful meditation.

Computer graphics help visually guide relaxation so one can see progress made toward the health goal.  Wearable devices with sensors worn around the waist are also available. RESPeRATE is an FDA approved device for decreasing stress and lowering blood pressure that uses a downloadable app. Not all home use biofeedback devices are regulated by the FDA, so buyer be ware!

Consider adding biofeedback to your health tool kit.

Blessings for better health.

References:

McKee. Biofeedback: an overview in the context of heart-brain medicine. Cleve Clin J Med 2008;73(Suppl 2): S31-S34.

Gevirtz.  The promise of heart rate variability biofeedback: evidence-based applications. Biofeedback 2013;41(3):110-120.

Mayo Clinic. Biofeedback. www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664.  Accessed September 1, 2018.

 

Lyme Disease

Background

Lyme disease is caused by a spirochete  called Borrelia burgdorferi  that is carried by blacklegged ticks (vector) found on deer (reservoir host).  The Center for Disease Control (CDC) tells us that more of these ticks are expected this summer due to reforestation and climate change across the country, including in Ohio.  While the majority of reported cases are from the Northeast and Upper Midwest, other cases have been reported as far south as Florida. Adult blacklegged ticks (Ixodes scapularis)  are the size of an apple seed so they are visible to the naked eye.

Symptoms

Symptoms can occur within 3 to 30 days after a bite. Ticks must be attached to the human for at least 36-48 hours to transmit disease.  If the human removes the tick within 48 hours, he/she probably won’t get the disease. Lyme disease is diagnosed by symptoms which can include chills, fever, headache, muscle and joint pain, and swollen lymph nodes. For many infected individuals, the classic red bull’s-eye round rash is one of the first symptoms.  Up to 30% of those bitten will not get a rash.

There are three stages to the disease:

  1. Early Localized – flu-like symptoms and rash
  2. Early Disseminated – flu-like symptoms with pain, numbness in arms/legs, Bell’s palsy
  3. Late Disseminated- arthritis, fatigue, dizziness, sleep disturbances, mental confusion

Treatment

Lyme disease is treated with antibiotics like doxycycline or others, depending on the patient and upon the physician’s preference, for a period of 2-3 weeks.

Prevention

Clothes treated with permethrin 0.5% make it hard for blacklegged ticks to bite you or stick to your clothes (Eisen. J Medical Entomology July 20, 2016).  In addition:

*Wear socks and pants when you walk in the woods

*Wear a tick repellent on skin and clothes that contains DEET, lemon oil, eucalyptus, or (better still) permethrin

*Take a shower within two hours of coming inside after possible exposure to blacklegged ticks

*Remove ticks from your skin with a pair of tweezers, then clean the area with 70% rubbing alcohol or soap and water

*Check your skin and hair, and wash ticks out of your hair ASAP after walking in the woods

*Place exposed clothing in a hot dryer to kill whatever ticks remain

 

Restless Leg Syndrome

Restless Leg Syndrome

By Cathy Rosenbaum PharmD MBA RPh CHC
Founder & CEO, Rx Integrative Solutions

Introduction
Restless leg syndrome (RLS) was first described over 70 years ago. Symptoms can show up as achy or crawling sensations in the resting leg that oftentimes go away with leg movement. RLS can be caused by iron or folate deficiency, kidney problems, pregnancy, rheumatoid arthritis, fibromyalgia, thyroid issues, Parkinson’s disease, and depression, among others. A family history of RLS is common in individuals with idiopathic RLS. Individuals with RLS can have trouble getting a refreshing REM sleep. RLS is often misdiagnosed as a vascular problem in the veins, and that’s why it’s important to get an accurate diagnosis from your PCP first before treating the condition.

Factors that may make RLS symptoms worse include cold, heat, fatigue, and stress. RLS prescription medication treatments can include, but are not limited to, benzodiazepines, gabapentin, clonidine, propranolol, and narcotics, each of which have significant side effects. The use of opioids and benzodiazepines together (e.g., Valium, Ativan, Xanax, clonazepam) is not safe. For perspective, benzodiazepines as a medication class are best avoided in seniors due to drowsiness and increased risk of falls and dementia. Depending on the type of RLS diagnosed, non-prescription medication and/or non-invasive alternatives can be considered to treat symptoms.

Iron Deficiency
Interestingly, there might be less iron in the brain of an RLS individual compared to non-RLS individuals. People with iron deficiency RLS respond well to iron supplementation. Improvement is most often seen in those with the lowest initial serum ferritin levels.

Pregnancy
Pregnant women are more likely to develop RLS than non-pregnant women due to reduced folate levels in the former population. In most instances, symptoms are mild and resolve after delivery. Treatment involves folate supplementation, reassurance, and appropriate food intake.

Medication-Induced RLS
Different medications can either cause or worsen RLS symptoms. Antidepressants like Prozac, Paxil, and Zoloft are three such culprits. One study showed that use of non-opioid analgesics is associated with an increased risk of RLS in individuals on long-term antidepressant therapy (Leutgeb. Eur J Med Res 2002;7:368-379).

Vitamin D and Magnesium Deficiency
Published literature (J Sleep Breath 2016) indicates that low vitamin D levels and/or low magnesium levels may be associated with RLS. Magnesium supplementation makes it easier for leg muscles to relax. Treatment with vitamin D or magnesium dietary supplements with the advice and consent of your PCP or pharmacist are two options to consider if you are suffering from these types of RLS.

Holistic Therapies
For individuals with mild RLS symptoms, other holistic options include relaxation/stress management therapy, acupuncture, and abstaining from caffeine and caffeinated products, nicotine, and alcohol to help improve sleep, help reduce stress, and indirectly lessen symptoms.

Summary
If you are experiencing RLS-like symptoms and are concerned about what to do, the first step is to schedule an office visit with your PCP to get an accurate diagnosis. It is unwise and unsafe to self-diagnose and try various remedies without your PCP’s knowledge.

Finding Gluten-Free Nutrition, Dietary Supplements, and Medications

Non-celiac gluten intolerance and celiac disease are becoming more common. Celiac disease is a chronic autoimmune disorder caused by a genetic intolerance to gluten. Non-celiac gluten intolerance is diagnosed in people who do not have celiac disease, but have intestinal or extra-intestinal symptoms related to ingestion of gluten-containing grains.

Both conditions are treated by avoiding gluten containing foods. Finding ‘gluten free’ nutrition is becoming easier to do, but eliminating gluten from one’s diet can be a complex and time-consuming process.

Gluten is the protein component of wheat (e.g., including spelt, kamut, semolina, and triticale), barley (e.g., including malt), and rye. When a person with celiac disease or non-celiac intolerance ingests gluten, specifically the antigenic gluten constituent called gliadin, it can cause intestinal inflammation, diarrhea, abdominal pain, bloating, weight loss, fatigue, and iron deficiency anemia. Food malabsorption and nutritional deficiencies result.

Over time, these conditions can cause liver disease, defective gallbladder emptying, and osteoporosis. Celiac disease may be a reversible cause of osteoporosis. Adherence to a gluten-free diet is one way to help suffers minimize overall symptoms and to maintain maximal bone mineral density.

For perspective, oats are considered a type of gluten grain, but do not have the antigen that other gluten grains above do. Thus, oats do not induce an immune reaction in the small intestine of people with celiac disease. However, many commercial oat products are contaminated with wheat, barley, or rye and it’s important to carefully read their labels. Look for products that are certified to contain less than 20 ppm of gluten (FDA’s ‘gluten free’ definition).

Consumption of as little as 10 mg-50 mg gluten daily can lead to a clinical relapse in people with these conditions. Celiac disease may increase the risk of developing some types of cancer (e.g., T cell lymphoma and intestinal adenocarcinoma) if gluten restrictions are not maintained or gluten intake is only partly restricted.

It is important to find out where gluten resides in foods. This means not only reading food labels on products you purchase for home but also on foods you consume from fast food establishments and restaurant dining. Soups, sausages, and ice cream may contain hidden amounts of gluten as fillers. Talk with your grocer and restaurant owners before you consume questionable food items.

Watch out for the gluten content in herbs, other dietary supplements, and medications.

Gluten-Free Foods
Consuming foods certified to be ‘gluten free’ will help keep the daily gluten total to under 50 mg and not cause symptoms for most people with celiac disease. Gluten-free grains include rice, millet, corn, quinoa, sorghum, and buckwheat. For more information, visit http://glutenfreecooking.about.com/od/gettingstarted/a/hiddengluten.htm
or http://www.glutenfreeliving.com/nutrition/ingredients.

Gluten-Free Herbs and Other Dietary Supplements
It would be impossible to find information about the gluten content in over 60,000 products on the worldwide market. One can contact dietary supplement manufacturers directly for more information on gluten content before taking any of these products, including vitamins.

Gluten-Free Medications
Over-the-counter and prescription medications may contain gluten in the list of inactive ingredients. For example, sweeteners used in medications may be hidden sources of gluten. Some manufacturers cannot guarantee their medications are gluten-free because the suppliers of raw materials can not do so, making it even more difficult for consumers to figure out what is safe to take and what is not.

A great resource for determining the overall ingredient content in medications, including whether or not gluten is present, can be found online at www.glutenfreedrugs.com .

Another online medication reference comes from the National Institutes of Health at www.dailymed.nlm.nih.gov. Go to the site, type in the generic name of the medication you want to review, then scroll down to the name of the manufacturer of that particular product, then click on ‘description.’ Scroll down to the inactive ingredients and look for gluten.

A third way to find more information about your medication’s gluten content is to call the medication manufacturer directly. Be sure to have the medication’s lot number available when you call.

Finally, click on https://www.ncbi.nlm.nih.gov/pubmed/?term=Gluten+content+of+the+top+200+medications+of+2009%3A+a+follow+up+to+the+influence+of+gluten+on+a+patient%E2%80%99s+medication+choices for “Gluten content of the top 200 medications: follow up to the influence of gluten on a patient’s medication choices” by AR King in Hosp Pharm 2013:48:736-43.

By Cathy Rosenbaum PharmD MBA RPh CHC

Grapefruit Interactions with Medication

Certain prescription and/or OTC medications and dietary supplements may negatively interact with grapefruit juice, grapefruit, Seville oranges, pomelos, and tangelos due to chemicals in the fruits.

Fruit chemicals are thought to block enzymes in the body that metabolize medication in the small intestine, thereby causing the medication to hang around longer than expected. Interestingly, these fruits may also interfere with transporters in the body, causing medication to be less well absorbed into the bloodstream, and may reduce medication or supplement effects. Sound confusing? It’s complicated.

Product classes involved in unwanted interactions include, but are not limited to:

-Antihistamines (e.g., Allegra)
-Antianxiety
-Antihypertensives
-Cholesterol-lowering ‘statins’
-Corticosteroids for Crohn’s disease and ulcerative colitis
Dietary supplements

Only some of the medications and supplements in each of the categories can be affected by the fruit/juices. Every person may react differently based on the amount of fruit they consume, the medication or supplement type/dose taken, and the individual’s natural ‘enzyme levels.’

Don’t worry, but do get educated about how and when to properly take your medications and supplements to be safe. Enjoy healthy nutrition. Talk with your pharmacist about what’s best for you!