Americans Need More Sleep

Most of Americans sleep less than recommended by experts.

The Center for Disease Control surveyed 19589 adults in the states of Delaware, Hawaii, New York and Rhode Island. They were questioned about how many days within the past month they slept less than needed. The survey found that 70% of questioned adults lack daily sleep. 10% reported lack of sleep for every single day of the past month. 38% reported lack of sleep for 7 days of the past month.

13.3% of questioned younger adults aged from 18 to 34 reported lack of sleep, compared to 7.3% adults of age of 55 and older. Surveyed adults from Hawaii appeared to have less sleepless nights, compared to the rest of surveyed people. However, the survey didn't ask how many hours a day adults sleep.

CDC also examined data during the period from 1985 to 2006 about how many hours adults lack in sleep. Data showed that Americans lacking sleep increased during this period from 1985's 20% to 2006's 30%. These adults were having an average of 6 hours or even less daily sleep.

The survey showed no difference in sleep graphic between genders and different racial groups. All of them suffer from sleep disorders equally. However, those who have retired or are not able to work because of health conditions have better sleeping habits. Most of them reported to sleep normally every night.

National Sleep Foundation recommends from 7 to 9 hours of daily sleep for adults, from 8.5 to 9.5 hours for those aged from 11 to 17, and from 9 to 11 hours for those aged from 5 to 12.

Experts worn that sleep disorders may lead to 'obesity, diabetes, high blood pressure, stroke, cardiovascular disease, depression, cigarette smoking, excessive drinking.'

Experts urge everyone to sleep the recommended hours daily, because sleep is an important factor affecting health. Everyone must consider healthy sleeping as an important part of healthy lifestyle.

Insomnia patients with mental conditions often denied sleep treatment

Patients with insomnia who are diagnosed with accompanying mental health ailments often are not prescribed medication that will help them sleep - which could then make related anxiety or depression worse, new research suggests.

Scientists examining treatment patterns for insomniacs say that their findings suggest that many doctors appear to be reluctant to prescribe sleep aids, even those that pose no risk of dependence, if patients also have depression, anxiety or mood disorders. An exception is psychiatrists, who were found to be twice as likely as primary care physicians to prescribe medication for insomnia.

“Insomnia can cause you to have anxiety and depression, and depression and anxiety can cause you to have insomnia. It’s a chicken-and-egg type of story. But research has shown that if one of the conditions is left untreated it can exacerbate the other condition,” said senior study author Rajesh Balkrishnan, the Merrell Dow professor of pharmacy at Ohio State University.

“What this calls for is specific guidelines related to the treatment of insomnia that takes into consideration these different types of patients, because insomnia has become such a big public health problem.”

An estimated 20 percent of Americans have occasional sleep problems, with about one in 10 suffering from chronic insomnia.
Balkrishnan acknowledges concerns that physicians might have about prescribing certain medications that can cause dependence, especially to patients with mental health disorders. Older sleep aids, a class of drugs called benzodiazepines, are muscle relaxants with addictive properties and high potential for abuse. However, since the early 1990s, a new class of drugs for insomnia called non-benzodiazepines has been on the market. They are effective sleep aids that don’t carry the risk of addiction, Balkrishnan said, and for that reason, patients should have ready access to these medications.

“This research highlights the need to take into account that many patients who see their doctors with complaints of insomnia also have a psychiatric condition. But the presence of those mental conditions should not preclude them from being appropriately treated for their insomnia,” he said.

The study is published in the January issue of the Journal of Medical Economics.

Balkrishnan and colleagues collected data from the National Ambulatory Medical Care Survey, which tracks Americans’ annual outpatient medical visits. The researchers identified 5,487 physician visits by patients with insomnia between 1995 and 2004, which was calculated to represent about 161 million U.S. patients over that 10-year period.

According to the analysis, an estimated 6.5 million Americans who saw a doctor for insomnia also were diagnosed with a mental health disorder. Of the visits examined, 38 percent of patients with insomnia were diagnosed with at least one other condition, and at least four of every 10 of those accompanying conditions related to mental health. The most common additional condition was anxiety (15.6 percent), followed by episodic mood disorders (14.9 percent), high blood pressure (10.1 percent), depression (7 percent) and diabetes (3.5 percent).

The study showed that insomnia patients with mental health disorders were 36 percent less likely to receive medication for their sleeping problems than were patients without the mental health diagnosis. Those with anxiety were the least likely to receive a sleep aid, with a 45 percent decreased likelihood of receiving medication for insomnia compared to patients without anxiety.

Balkrishnan said that with generic forms of nonaddictive insomnia medication available by prescription, even patients taking antidepressants and anti-anxiety drugs can safely – and affordably – add a sleep aid to their regimen. The most common forms of antidepressants prescribed in the United States are a class of drugs called selective serotonin reuptake inhibitors (SSRIs).

“Physicians might perceive that drowsiness is induced by medications such as SSRIs so there might be a general fear about combining them with insomnia medications,” Balkrishnan said. “But I think those fears are somewhat unfounded because we found that psychiatrists don’t have any problems prescribing sleep medications in patients who have accompanying mental conditions; they know there is no danger of a drug-to-drug interaction.”

According to the analysis, patients visiting psychiatrists had two times higher odds of receiving medication for insomnia than patients visiting family practice or internal medicine physicians. The study showed that 33 percent of patients with insomnia saw family practice or internal medicine physicians, 30 percent visited psychiatrists and 9 percent went to neurologists.

The study identified other factors associated with insomnia medication prescribing patterns – for example, older and established patients were more likely to receive insomnia medications than were younger patients or those seeing the doctor for the first time. But Balkrishnan said a clear theme emerged from the analysis.

“There is a divide in who gets appropriate medication and who is not appropriately medicated,” he said. “It might not be happening willfully, but it points to a knowledge gap between different types of physicians and the need to develop widely accepted insomnia treatment guidelines. And the guidelines should be ratified by essentially all physicians treating the condition.”

Snoozing Worms Help Researchers Explain Evolution Of Sleep

The roundworm C. elegans, a staple of laboratory research, may be key in unlocking one of the central biological mysteries: why we sleep. Researchers at the University of Pennsylvania School of Medicine report in this week's advanced online edition of Nature that the round worm has a sleep-like state, joining most of the animal kingdom in displaying this physiology. This research has implications for explaining the evolution and purpose of sleep and sleep-like states in animals.

In addition, genetic work associated with the study provides new prospects for the use of C. elegans to identify sleep-regulatory genes and drug targets for sleep disorders.

First author David M. Raizen, MD, PhD, Assistant Professor of Neurology, in collaboration with other researchers at the Penn Center for Sleep, showed that there is a period of behavioral quiescence during the worm's development called lethargus that has sleep-like properties. "Just as humans are less responsive during sleep, so is the worm during lethargus," explains Raizen. "And, just as humans fall asleep faster and sleep deeper following sleep deprivation, so does the worm."

By demonstrating that worms sleep, Raizen and colleagues have not only demonstrated the ubiquity of sleep in nature, but also propose a compelling hypothesis for the purpose for sleep.

Because the time of lethargus coincides with a time in the round worms' life cycle when synaptic changes occur in the nervous system, they propose that sleep is a state required for nervous system plasticity. In other words, in order for the nervous system to grow and change, there must be down time of active behavior. Other researchers at Penn have shown that, in mammals, synaptic changes occur during sleep and that deprivation of sleep results in a disruption of these synaptic changes.

In addition, the research team used C. elegans as a model system to identify a gene that regulates sleep. This gene, which encodes a protein kinase and is regulated by a small molecule called cyclic GMP, has been previously studied but not suspected to play a role in sleep regulation. The findings suggest a potential role for this gene in regulating human sleep and may provide an avenue for developing new drugs for sleep disorders.

"It opens up an entire new line of inquiry into the functions of sleep," notes Penn Center for Sleep Director and co-author Allan I. Pack, MB, Chb, PhD.

AASM On Sleep Medications And Insomnia Treatment

Insomnia and Sleep Medications

Insomnia occurs when people have trouble falling asleep or staying asleep, and it is a common sleep compliant. While a brief case of insomnia can arise due to temporary stress, excitement or other emotion, more than 20 million Americans report having a chronic form of insomnia that keeps them from sleeping well nearly every night. As a result, the insomnia, which is a serious and often debilitating condition, can lead to severe daytime fatigue, poor performance at school and work, physical symptoms such as headaches, and in some cases depression.

People suffering from insomnia need to know that there are effective insomnia treatments and their sleep can improve. The American Academy of Sleep Medicine recommends that people who experience insomnia see a sleep medicine specialist or primary care physician for proper diagnosis and to discuss treatment options before treatment with medications is undertaken. This evaluation should also look for specific causes of insomnia such as restless legs syndrome or depression.

Sleep medications are often used for the short-term treatment of insomnia and, on occasion, for more chronic insomnia. Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration and/or reducing the number of awakenings during sleep. While modern hypnotics are considered safe, individuals should be aware that, like all medications, side effects may occur in a minority of patients. These side effects can include sleep walking, sleep eating and other complex sleep behaviors as well as difficulty with memory.

RECOMMENDATIONS FOR PATIENTSBehavioral therapies and medications have been shown to be effective therapies for insomnia. Behavioral therapies use nonpharmacologic methods to improve sleep and are effective and long lasting. Sleep medications are effective and safe treatments for insomnia when used properly and judiciously by a patient who is under the supervision of a sleep medicine or primary care physician.
The American Academy of Sleep Medicine offers the following recommendations for individuals who use sleep medications:

• Read carefully the package insert and all information provided by your physician and pharmacist for your sleep medication. This information will help guide you in the safe use of the medication.

• Especially read the package insert and all information to learn the side effects of the medication.

• Adhere strictly to the indicated use of your sleep medication. Do not take it for purposes other than to sleep.

• Follow the prescription carefully and do not take more than the dosage your doctor prescribes.

• Allow time for a full night of sleep when using sleep medication to avoid morning or daytime drowsiness.

• Avoid combining sleep medication with alcohol.

• Ask your doctor any questions you have about the intended use, dosage and side effects. Communication with your physician will help ensure safe use of the medication.

• Inform your doctor right away of any problems you have while taking a sleep medication.

• Make your doctor aware of any other medications, prescriptions or over-the-counter, that you use. Mixing medications may cause adverse effects.

• Make your doctor aware of other medical conditions, including other sleep disorders, you may have. Sleep medications can be dangerous when treating sleep disruption that may arise from another disorder.

• Visit www.SleepEducation.com for more information about insomnia, treatment options and to find a sleep center.

RECOMMENDATIONS FOR PHYSICIANS The American Academy of Sleep Medicine is committed to educating sleep medicine and primary care physicians about treatment options for insomnia. Behavioral therapies and medications have been shown to be effective therapies for insomnia. The American Academy of Sleep Medicine offers the following recommendations for primary care physicians who see patients with insomnia :

• Read the practice guidelines for chronic insomnia created by the American Academy of Sleep Medicine.

• Become intimately familiar with sleep medications you prescribe, including the indications for use and side effects.

• Educate your patients about the sleep medicine you are prescribing to them, including the indications for use, dosage and side effects. Ensure your patients fully understand the intended use and potential effects.

Risk Factors For Severe RSV Infection Found In Immunocompromised Children

St. Jude Children's Research Hospital investigators and collaborators have shown how to predict if a child who is infected with respiratory syncytial virus (RSV) while being treated for cancer or another catastrophic disease is at high risk for developing severe infection. The finding will help clinicians improve guidelines for managing these infected children.

RSV is a common cause of pneumonia among infants, children and adults during winter, frequently causing fever, runny nose and coughs. It can be much more severe in patients who are undergoing cancer treatments and whose immune systems are suppressed. In these patients, the virus can move into the deep lung, causing pneumonia and other respiratory problems that can be fatal. However, it is difficult to predict which infected patient is likely to develop a serious lower respiratory tract illness and which one will continue to simply have a mild runny nose and cough.

The St. Jude team and collaborators found that if these children are under 2 years old and have very low levels of immune system cells in their blood called lymphocytes, they are at high risk for the RSV infection to become serious by moving into the lung. Such infections are especially dangerous because they can be fatal in some immunocompromised children, and there is no standard effective treatment for these infections, the researchers said. A report on the retrospective findings appears in the February issue of the journal "Pediatrics."

The new information is important because it helps identify children who are most at risk for severe disease using easily available clinical information," said Aditya Gaur, M.D., assistant member of the St. Jude Department of Infectious Diseases and the paper's senior author. "This narrows down the patient population who needs to be considered for antiviral therapy, which is costly and often inconvenient to receive from a child's perspective. For example, one treatment for RSV infection is to have the child breathe an aerosolized form of the antiviral drug ribavirin for 12 to 18 hours, which is tough for the child and the parent."

The findings of this study require confirmation in prospective studies, Gaur said. Results of the study also help define which children should receive medications that can help prevent RSV infection.

Another significant finding was that--unlike some previous reports in immunocompromised adults with RSV--neutropenia is not a risk factor for lower respiratory track infection, Gaur said. Neutropenia is an abnormally low level of neutrophils, immune system cells that engulf and digest germs.

"This finding is important because with cancer patients, clinicians are used to identifying those at risk for bacterial and fungal infections based on a patient having neutropenia," Gaur said. This study shows that for RSV, which is a viral infection, lymphopenia and not neutropenia is what identifies children at risk.

Previous studies have shown that lower respiratory track infection, is more common in children whose immune system is suppressed, who are receiving chemotherapy or who have received a hematopoietic stem cell transplant (HSCT). However, while some studies report that lower respiratory track infection, due to RSV is fatal in 50 to 100 percent of infected adults, there is little information about this type of infection in immunocompromised children. "We decided to analyze the course of RSV infection in children being treated for cancer to identify factors that could help us predict which ones were at highest risk for severe disease or death due to a lower respiratory tract infection with this virus," Gaur said. HSCT is the transplantation of special cells from the blood or bone marrow that can give rise to all the blood cells of the body (red and white cells and platelets).

The St. Jude team studied clinical and laboratory information from the records of 58 patients who had tested positive for RSV infection. Among these children, 23 (40 percent) had acute lymphoblastic leukemia, 11 (19 percent) had solid tumors and 24 patients (41 percent) had acute myeloid leukemia (AML), severe combined immunodeficiency syndrome (SCIDS), or had undergone bone marrow transplantation. RSV disease in these infected children was classified as upper respiratory track infection only or lower respiratory tract infection; and children with both upper and lower respiratory track infections, were defined as having lower respiratory track infection.

Overall, 16 (28 percent) of these children developed lower respiratory track infection, due to RSV. The frequency of this type of infection was highest (42 percent) in patients who had undergone HSCT or who had AML or SCIDS. Five patients (31 percent) with LRTI died, an overall mortality rate of 8.6 percent. All deaths occurred in lower respiratory track infection patients who were severely immunocompromised from their cancer, from chemotherapy or from the HSCT.

Sex Life Still Alive For Physically Challenged
Sexuality does not end when a person experiences the effects of a spinal cord injury. Issues of meeting potential partners, building self confidences and enhancing sexual function are an essential part of adjusting to life after an injury. Many physical and emotional changes take place during the rehabilitation process and the matter of being able to perform sexually usually becomes an issue of importance. The truth is that as time passes, those with spinal cord injury find a greater appreciation for sexuality and many will move on to find greater emotional closeness with their partner.

Often times those with spinal cord injuries focus on simple pleasures to please one another, by caressing their partners erogenous zone, holding hands, hugging and kissing. Many couples still enjoy sexual intercourse. Yet, this act can be a challenge, especially in certain positions. Most couples will tell you that they are always interested in ways to add more fun and variety to their love life and there are items available to enhance sexual performance but few deal with the issues of boosting sexual motion. One such product that does address enhanced sexual movement is the IntimateRider from HealthPostures.

IntimateRider can make sexual activity easy and comfortable again. It offers a method of support where balance, strength and coordination may be poor, while also assisting by means of a natural gliding motion to enhance sexual relations. IntimateRider also offers a number of options with positioning in order to deal with loss of lower body muscle control. Couples now can focus on being gentle, caring and romantic again as they move forward in their relationship.

Matthew, C6-7 quadriplegic says, "Life after my injury has been a challenge but I am fortunate enough to have found a wonderful relationship with an understanding and caring woman who is also my best friend. We are open in our communication about sex and when we heard about the IntimateRider it did not take us long to figure out this is something that would change our sex life for the better. We are able to please each other now in ways that were just not physically possible before."

A number of other physical conditions can get in the way of sexual performance due to limited movement or fear of pain from uncomfortable positioning. Multiple sclerosis, cerebral palsy, stroke, arthritis and chronic back pain are among the most common conditions that may hinder a more enjoyable sex life. Research also finds that senior citizens still enjoy the act of love making but find that time has taken away the sexual Olympics of their youth. People with these conditions have a strong need to find something to accommodate sexual positioning and also provide natural movement that may be difficult to achieve.

Everything from the softness of the fabric to the fluid gliding motion of the IntimateRider has been given a great deal of consideration to assure the most comfortable and enjoyable sexual experience possible. Adjustable legs, back support height, optional transfer set and selection of colorful slip-covers provide a means to a rewarding sex life and improved relationship.

So rejoice! The sex lives of the physically challenged are still alive and well and in fact have just gotten better. Each individual has their own way of finding what works best for them in their personal relationship. Advancements with products like the IntimateRider enhance an already gratifying love life and will give couples a way to enjoy the best sex possible.

Hand Washing Puts Health Care Workers At Increased Risk For Irritant Contact Dermatitis

Dermatitis

For the millions of health care workers in the United States, repeated hand washing may not seem like an occupational hazard at first glance. In fact, good hand hygiene is essential in health care workers to stop the spread of potentially serious infections, such as staphylococcus and clostridium. However, new research examining the risk factors for irritant contact dermatitis -- a common skin condition marked by scaling, redness, itching and burning due to a chemical substance on the skin -- among health care workers finds that those who washed their hands more than 10 times per day were more likely to develop the condition than those who washed their hands less frequently.

Speaking today at the 66th Annual Meeting of the American Academy of Dermatology, dermatologist Susan T. Nedorost, MD, FAAD, associate professor of dermatology at University Hospitals Case Medical Center in Cleveland, Ohio, presented findings that demonstrated a positive link between frequent hand washing and irritant contact dermatitis, or hand dermatitis, among health care workers.

"We demonstrated that some people are predisposed to skin reactions to irritant detergents, and those who do 'wet' work in low humidity conditions where frequent hand washing is an essential part of the job are very susceptible to hand dermatitis," said Dr. Nedorost. "Our findings confirm that health care workers who wash their hands repeatedly are at an increased risk of developing hand dermatitis, which can take months to heal. This knowledge can help workers at risk for the condition to practice good hand care and follow preventative tips to decrease their risk factors on the job." Conducted in collaboration with the National Institute of Occupational Safety and Health (NIOSH), the study included a total of 100 health care workers in Cleveland, Ohio, who washed their hands at least eight times daily. Study participants were asked to complete a questionnaire to identify frequency of hand washing, use of alcohol-based cleansers, history of specific medical conditions (including asthma, eczema, and psoriasis, among others), and family history of dermatitis or eczema.

Patch tests to determine how easily the skin was irritated by detergents also were conducted on the study participants. Low concentrations of three common detergents were patch tested to predict which patients were at risk for hand dermatitis.

Data from the questionnaires and patch tests that were analyzed from 60 subjects who completed the study to date found that 63 percent of participants developed hand dermatitis. Specifically, 22 percent of participants who washed their hands more than 10 times per day developed hand dermatitis compared to only 13 percent of those who washed their hands less than 10 times daily. The researchers determined that neither the use of an alcohol-based cleanser nor the use of gloves significantly influenced the development of hand dermatitis, and the other variables assessed in the questionnaire did not significantly alter susceptibility to hand dermatitis.

Some study participants had reactions to even low concentrations of detergent when patch tested, indicating that they were at increased risk for hand dermatitis likely due to genetic factors. In addition, in analyzing the patch testing data, Dr. Nedorost determined that the most important factor in predicting those at risk for hand dermatitis was a reaction to the detergent sodium lauryl sulfate (SLS). Specifically, the large percentage of participants who reacted positively to SLS and developed hand dermatitis far outweighed the number of participants who did not react positively to SLS, but subsequently developed hand dermatitis.

A secondary goal of this study was to investigate possible associations of genetic variations in genes susceptible to hand dermatitis. The genetic analysis is not yet complete, but an example of a candidate gene that may play a role in hand dermatitis is filaggrin.

"Recently, genetic variants in the gene encoding filaggrin -- a protein that binds to cells in the outermost layer of skin known as the epidermis -- have been shown to be strong predisposing factors for atopic eczema, in which impaired skin barrier function plays a key role," explained Dr. Nedorost. "Variations in the filaggrin gene may cause a disturbance of the top layer of the skin, which serves as a barrier against environmental exposures -- such as frequent wetting and drying of the skin. Once the top layer of the skin cracks due to frequent wet/dry cycles, especially in conditions of low humidity where drying occurs rapidly, it results in inflammation. This is how irritant hand dermatitis begins."

Since environmental factors such as humidity and the need for good hand hygiene at work are beyond health care workers' control, prevention is the key to warding off hand dermatitis. Dr. Nedorost recommended the following tips for health care workers to help prevent hand dermatitis:

-- Cotton gloves should be worn under rubber or vinyl gloves for wet work to prevent perspiration from dampening the skin. The cotton gloves should be changed frequently if wet work is prolonged.

-- When appropriate, alcohol-based hand cleansers should be substituted for hand washing. These cleansers are well tolerated, but may cause temporary stinging when in contact with skin cracks.

-- A cream or ointment-based emollient should be applied immediately after water exposure before the skin is completely dry. The goal is to prevent rapid drying and cracking, so applying the emollient after the skin is dry is not nearly as beneficial.

Although patients often receive prescriptions for topical corticosteroids to treat symptoms of hand dermatitis, Dr. Nedorost cautions that evidence suggests that chronic use of topical steroids may reduce the skin's ability to tolerate irritants, thins the skin, and increases bruising and tearing.

"Topical steroids should never be used long term as a substitute for emollients," added Dr. Nedorost. "Patients should consult a dermatologist for the proper treatment of hand dermatitis, particularly those who suspect their work environment may be the culprit."

Top Tips To Help Keep Lips In Tip-Top Shape


While winter's harsh, windy weather is often to blame for dry, cracked lips, sometimes the cause of lip irritation is harder to pinpoint. In fact, several types of foods, cosmetic products, medications or even bad habits have been linked to dry lips. The key is determining the source of the irritation and modifying your daily regimen to eliminate the problem.

Speaking today at the 66th Annual Meeting of the American Academy of Dermatology, dermatologist Margaret E. Parsons, MD, FAAD, assistant clinical professor of dermatology at the University of California at Davis, discussed the most common causes of lip irritation, available treatments and preventative measures to keep lips healthy.

"When I treat a patient for dry lips, the first thing I try to determine is what this patient might be doing or not doing that could be contributing to the problem," said Dr. Parsons. "In some cases, it might be a new lipstick that contains an ingredient irritating to the skin or an anti-aging facial product that inadvertently comes in contact with the lips that could be the culprit. Or, someone might be working outdoors or participating in sports and not protecting their lips from wind and sun damage with a lip balm, especially one with sunscreen. Once we determine the cause, there are some simple, tried-and-true treatments that work well for most patients."

Mother Nature

Dr. Parsons noted that not only can winter's outdoor elements contribute to dry, cracked lips, but the conditions indoors during this season can play a role in irritating the lips. Heat used to warm the indoor temperature dries out the air and lowers the humidity level, which can lead to dry skin and lips. At the other end of the weather spectrum, the intense summer sun can lead to sunburned or sun-irritated lips.

"When working outdoors or engaging in sports, men and women should apply a lip balm with an SPF of 15 or higher year-round to protect their lips from sun damage," said Dr. Parsons. "By wearing lipstick -- particularly the products in recent years with sunscreen -- women have protected their lips better than men, which could explain why men have significantly more skin cancers on their lips than women."

Cosmetics

In some cases, products that you put on your lips -- lipsticks, lip balms or the newer lip plumpers, which are applied topically to make lips appear fuller -- can cause dry or irritated lips.

"Lip plumpers often contain chemicals used to intentionally irritate the lips and make them appear fuller, such as capsaicin (derived from chili peppers), mint, or menthol, among others," explained Dr. Parsons. "For some, this irritation is mild, causing a slight swelling and fuller appearance. For others, this irritation is significant and causes painful swelling and redness."

Dr. Parsons added that the ingredient phenol used in some of the traditional lip balms and other lip products can irritate and actually contribute to further drying out the lips. Even though phenol is used in low concentrations in lip products, it is the same chemical used in deep-penetrating facial peels that removes the top layer of skin.

Foods

Spicy foods, the acid found in citrus foods and even the cut edge of a mango peel (which contains the chemical toxicodendron found in poison ivy) can burn the lips and lead to dryness and irritation. In addition, people with nut allergies could react to lip products that contain nut-based products, such as shea butter.

Medications

Although many people might not suspect their medications to be the root of their lip problems, Dr. Parsons explained that patients who cannot attribute their dry or irritated lips to other common factors should take a close look at their medicine cabinet. For example, some oral acne medications, such as isotretinoin, can cause considerable lip dryness even though they do not come into direct contact with the lips. Products applied topically, such as acne medications containing benzoyl peroxide or retinoids and anti-aging products such as alpha-hydroxy acids or retinoids, could cause considerable lip dryness when they come into contact with the lip area. Vitamin E and aloe vera gel also can be irritating to many people with sensitive skin.

Similarly, patients with eczema or other skin conditions that make the skin more sensitive could be more susceptible to allergic reactions from lip products. Dr. Parsons advised patients with any underlying skin conditions or who regularly use medications to check with their dermatologist to determine if these are contributing factors to their lip problems.

"Lip-Smacking"

Another cause of dry, chapped lips that is common in younger children is what dermatologists refer to as "lip-smacking." This habit, which can be hard to break the more the lips become irritated, can be formed when children are nervous about something, such as starting school. In particularly bothersome cases, a mild prescription product may be needed to accelerate the healing process.

Tips and Treatments

In most cases, applying petroleum jelly or a lip product containing petrolatum or mineral oil will soothe and heal irritated lips. Dr. Parsons also recommends the following tips to prevent lip irritations and to keep lips healthy and moisturized:

-- Opt for lip products, such as lipsticks or lip moisturizers, which contain sunscreen whenever possible to protect lips from harmful sun exposure.

-- Be smart about what you put on your lips. Avoid lip plumpers or other products that intentionally irritate lips to make them appear fuller, as the chemicals they contain can be irritating to some people.

-- Apply a petrolatum-based product at bedtime, which Dr. Parsons refers to as the perfect time for patients to "grease up" their lips.

-- Choose a simple product with few additives to minimize possible irritation.

-- See a dermatologist if lips are not getting better with simple at-home treatments or if new symptoms develop.

"Caring for your lips shouldn't be an after-thought," added Dr. Parsons. "By incorporating good lip care into your overall skin care regimen, you can maintain healthy lips, avoid some of the common sources of irritation and protect your lip area from possible skin cancers."

Most NYC Hospitals Provide Uninsured Patients With Information On Financial Assistance

Most New York City hospitals are in compliance with a new state law that requires them to inform low-income, uninsured patients about financial assistance for medical treatment, according to an investigation by the New York City Council, the New York Times reports.

Under the law, which took effect in January, all New York hospitals must inform uninsured patients verbally, in writing or prominently placed signage, that they could be eligible for state financial aid from an $847 billion charity care hospital fund. Uninsured patients with incomes at or below the federal poverty level are eligible for lower health care costs, including a maximum payment of $150 for surgery and $15 for emergency department and clinic visits. Patients with higher incomes are eligible for medical care on a sliding fee scale set by each hospital.

For the survey, City Council personnel posed as patients or their relatives and made one call and one visit to 59 hospitals in the city. The investigation found that staff at 42 of the hospitals gave information about financial aid without prompting, while staff at nine hospitals did not offer the information even after being prompted. Staff at five of those nine hospitals said patients who were unable to pay would not receive medical attention. In addition, the investigation found that 63% of hospitals had posters about financial assistance in two or more locations, while 22% of hospitals had no signs posted.

Council Speaker Christine Quinn said, "We saw a significant amount of compliance, for this early in a law's existence," adding, "But the thing about a public health law is that if one person is forgotten, it creates the real possibility that that one person might not get the lifesaving information they need" (Kershaw, New York Times, 10/31).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Expression Patterns of microRNAs Appear Altered in Colon Cancer
Preliminary research has found an association between certain microRNA expression patterns and poor survival and treatment outcomes for colon cancer, according to a study in the January 30 issue of JAMA.

Colon cancer is a major cause of cancer death worldwide. Colorectal cancer is the third most common and second leading cause of cancer death in the United States. "Even though 5-year mortality rates have modestly declined over the last 3 decades, there is still a need to identify new prognostic biomarkers and therapeutic targets for this disease," the authors write. They add that microRNAs have potential as diagnostic biomarkers and therapeutic targets in cancer.

MicroRNAs are 18 to 25 nucleotide, noncoding RNA (ribonucleic acid) molecules that have been found to regulate a variety of cellular processes and may also have a role in the development of cancer cells. The prognostic potential of microRNAs has been demonstrated for chronic lymphocytic leukemia, lung cancer and pancreatic cancer, according to background information in the article. No study has evaluated the association between microRNA expression patterns and colon cancer prognosis or therapeutic outcomes.

Aaron J. Schetter, Ph.D., M.P.H., and Curtis C. Harris, M.D., of the National Cancer Institute, National Institutes of Health, Bethesda, Md., and colleagues evaluated microRNA profiles of colon tumors and paired nontumorous tissue to study their potential role in tumor formation, diagnosis and therapeutic outcome in colon cancer. The study included 84 patients from Maryland; associations were validated in a second, independent group of 113 patients from Hong Kong.

Thirty-seven microRNAs were differentially expressed in tumor tissues by microRNA microarray analysis in the Maryland test cohort. Expression patterns of five tested microRNAs were validated in the Hong Kong cohort. "The discriminatory power of 5 microRNAs to differentiate between tumor and nontumorous tissue suggests that predictable and systematic changes of microRNA expression patterns may occur during tumorigenesis and may be representative of sporadic colon adenocarcinomas," the authors write.

"...we found systematic differences in microRNA expression patterns between colon tumors and paired nontumorous tissue. Tumors with high expression of miR-21 [a microRNA] was associated with poor survival outcome and poor response to adjuvant chemotherapy in 2 independent cohorts, independent of staging and other clinical covariates suggesting that miR-21 may be a useful diagnostic biomarker for colon adenocarcinomas and survival prognosis including response to therapy."

Nektar's Clinical Trial To Evaluate NKTR-102 Efficacy In Colorectal Cancer
Nektar Therapeutics starts Phase 2 clinical development program to evaluate NKTR-102 (PEG-irinotecan) as a potential treatment for colorectal cancer.

NKTR-102 is Nektar's lead oncolytic candidate using the company's innovative small molecule PEGylation technology platform.

"The start of the Phase 2 program for NKTR-102 in colorectal cancer is a major achievement for Nektar," said Howard W. Robin, Nektar President and Chief Executive Officer. "Our Phase 2 program has the potential to demonstrate Nektar's ability to generate innovative and important PEGylated small molecule therapeutics. Based on our positive Phase 1 study findings, we also plan to initiate Phase 2 studies this year to evaluate NKTR-102 in multiple solid tumor settings."

Results from the Phase 1 study for NKTR-102 are expected to be presented at major oncology conferences in 2008.

About the Phase 2 Clinical Development Program for NKTR-102 (PEG-irinotecan)

The Phase 2 program is designed to evaluate the safety and efficacy of NKTR-102 (PEG-irinotecan) for the treatment of patients with solid tumors. The first study in the program will investigate NKTR-102 in combination with cetuximab as a second-line colorectal cancer treatment in irinotecan-naive patients as compared to treatment with standard irinotecan in combination with cetuximab.

The colorectal study is comprised of two sequential stages. The Phase 2a is an open-label, dose-finding trial in multiple solid tumor types that are refractory to standard curative or palliative therapies. The Phase 2b is an open-label, randomized, double-arm study in patients with second-line metastatic colorectal cancer and study participants will be randomized in one of two arms of the trial (1:1), to receive either NKTR-102 and cetuximab or standard irinotecan and cetuximab. The Phase 2b stage is expected to begin in mid-year 2008 and will be conducted in over 40 centers worldwide. The primary endpoint of the Phase 2b trial is progression-free survival. Secondary endpoints include response rate, response duration, overall survival, standard pharmacokinetics, and incidence of toxicities, including diarrhea and neutropenia.

Genomic Health Identifies Genes Associated With Colon Cancer Recurrence
Genomic Health announced results of studies that have identified genes that could help predict the likelihood of recurrence and chemotherapy benefit for early-stage (stage II and III) colon cancer. The company is conducting detailed analyses of these studies to select a final gene set for a clinical assay to quantify the risk of recurrence and likelihood of chemotherapy benefit, which will be evaluated in an independent validation study.

Results of the studies were presented January 26, 2008 at ASCO GI, the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, in Orlando, Florida.

"These results allow us to conclude that quantitative gene expression using methods developed by Genomic Health can identify genes that may predict the likelihood of colon cancer recurrence and chemotherapy benefit," said Steven Shak, M.D., chief medical officer of Genomic Health. "This marks an important step in our effort to develop a test to personalize treatment decisions for early-stage colon cancer patients using the same rigorous clinical development and validation process as we did with Oncotype DX for breast cancer."

Both study reports used Genomic Health's quantitative RT-PCR to analyze RNA expression for 375 cancer-related and reference genes from colon tumors of patients who were treated with surgery alone or with surgery and adjuvant 5-fluorouracil/leucovorin (5-FU/LV) chemotherapy.

The first report evaluated colon cancers from patients treated with surgery alone, including 270 patients from the National Surgical Adjuvant Breast & Bowel Project (NSABP) C-01/C-02 study and 765 patients who were treated at the Cleveland Clinic. Researchers identified 65 genes significantly associated with colon cancer recurrence across both patient populations. The range of individual gene expression was associated with an up to 11-fold difference in risk of disease recurrence.

The second report analyzed colon cancers from an additional 508 patients who were treated with surgery plus 5-FU/LV chemotherapy in NSABP study C-06. Of the 375 genes, the researchers identified 56 that were significantly associated with disease prognosis for stage II and III colon cancer in this study as well as in patients treated with surgery alone in NSABP C-01/C-02 and at the Cleveland Clinic. Furthermore, the collaborators used 15 of the 56 genes as a preliminary model to stratify patients into recurrence risk categories.

Genomic Health has completed four independent studies involving 1,851 colon cancer patients to evaluate a total of 761 genes. These data will support the selection of the final gene set, which will undergo clinical validation of its utility in guiding treatment decisions with adjuvant 5-FU/LV chemotherapy.


If You Are 50 And Over, Get Screened For Colorectal Cancer
As a new year approaches, the American Society for Gastrointestinal Endoscopy (ASGE) encourages all men and women age 50 and over to add getting screened for colorectal cancer to their list of New Year's resolutions for 2008. Recent studies have confirmed that a majority of Americans who should be screened for colorectal cancer are not. Colorectal cancer is a preventable and treatable disease when caught in its early stages. If you are age 50 or over, talk to your doctor about the colorectal cancer screening method that is best for you.

Colorectal cancer almost always develops from abnormal growths, called polyps, in the colon or rectum. Screening through colonoscopy saves lives by detecting and removing the precancerous polyps before they become cancerous.

Colorectal cancer is the third most commonly diagnosed cancer in men and women and the second leading cause of cancer-related deaths in the United States, killing nearly 56,000 people each year. Many of those deaths could be prevented with earlier detection. The five-year relative survival rate for people whose colorectal cancer is treated in an early stage is greater than 90 percent. Unfortunately, only 39 percent of colorectal cancers are found at that early stage. Once the cancer has spread to nearby organs or lymph nodes, the five-year relative survival rate decreases dramatically.

ASGE screening guidelines recommend that, beginning at age 50, men and women at average risk for developing colorectal cancer should begin colorectal cancer screening. People with risk factors, such as a family history of colorectal cancer, should begin at an earlier age. Patients are advised to discuss their risk factors with their physician to determine when to begin routine colorectal cancer screening and how often they should be screened. Colonoscopy is a procedure which looks at the entire colon and plays a very important role in colorectal cancer prevention because it is the only method that is both diagnostic and therapeutic. Not only does colonoscopy view the entire colon, but it also removes polyps before they turn into cancer.

Colorectal cancer can be present in people without symptoms, known family history, or predisposing conditions, such as inflammatory bowel disease.

While common in other benign conditions, the following symptoms might indicate colorectal cancer:

-- Unexplained change in bowel habits

-- Unexplained weight loss

-- Blood in the stool

-- Unexplained anemia

Food Combining Science

Serving You Proudly Since 1997

Is there such thing as Food Combining Science? Does enough science exist to back up the theory of food combining? If that is true, then why do food combining diets like the one actress and spokesperson Suzanne Somers stole from author and activist Michel Montignac (promoted as Somersizing) leave people with saggy skin (or in her case, bad enough shape she felt the need to get liposuction and blame her obesity on a cancer she failed to prove she had)?

If you wonder where I “get off” being so brash, at least consider my background before getting into this industry first. All Suzanne Somers did was agree to promote ThighMasters when she began. But so many “suckers born every minute” bought them. That lead to her endorsers to the realization that women would probably flock to buy a diet book with Suzanne Somers name on it too.

If you happen to review the books released in her name, you will be able to note a trend of inconsistency. It is no wonder at all why her followers remain overweight as long as many have. The programs are confusing! With that said, if you 'food combine' the Somersizing way or any other method, know right now that it isn't what foods are eaten together but what foods are kept separate from one another that makes it all work.

To anyone who says otherwise, “Tsk, tsk, tsk!” It is an established scientific fact in Western medicine that in order to initiate efficient digestion of any concentrated animal protein, the stomach must secrete pepsin. But it is also a well-known fact that pepsin can function only in a highly acidic medium, which must be maintained for several hours for complete digestion of proteins.

It is an equally well established fact of science that when we chew a piece of bread or potato or any other carbohydrate/starch, ptyalin and other alkaline juices are immediately secreted into the food by the saliva in the mouth. When swallowed, the alkalized starches require an alkaline medium in the stomach in order to complete digestion. Anyone should be able to figure out what therefore happens when you ingest protein and starch together.

Acid and alkaline juices are secreted simultaneously in response to the incoming protein and starch, promptly neutralizing one another and leaving a weak, watery solution in the stomach that digests neither protein nor starch properly. Instead proteins putrefy and starches ferment owing to the constant presence of bacteria in the digestive tract.

This putrefaction and fermentation are the primary cause of all sorts of digestive stress, including gas, heartburn, cramps, bloating, constipation, foul stools, colitis, and so forth. Don Lemmon's KNOW HOW will set you straight...

Multivitamins – A Ticket to Daily Health

Multivitamins – A Ticket to Daily Health. An increasingly number of the world’s population is now eager and interested in looking after their health and in keeping tune with their well-being. It is important to note that this awareness is progressively contributing to the creation of several health supplements to benefit both the adults and the young ones. Dietary and vitamin supplements have constantly proven their worth to health conscious individuals.

An excellent daily multivitamin supplement does not only develop your general bodily functions but also improves your mental and physical condition and well being. Occasionally specification is needed in appropriately supplementing nutrients to deal with any individual needs. An example would be in heart disease patients, they would have to take in CoQ10 in preventing the said condition. Alzheimer’s disease can be effectively prevented by a regular combination of Vitamin C and E intake.

Multivitamin supplements necessarily include all the vitamins and nutrients essential for recommended daily dosage. Multivitamin supplements may also be formulated to meet the needs of individual conditions like pregnancy and specific age brackets. It is a well settled fact that multivitamins in liquid form are more efficient than the ordinary pill forms. This is due to the fact that the body can easily absorb liquid nutrients five times more than ordinary multivitamins in tablet or capsule form.

Basically, the body needs 13 essential vitamins to function properly. In regulating the crucial performance of the body, it has to have vitamins A, B, C, D, E, K, B12, and the 7 B-complex vitamins. Majority of these vitamins are obtained by our body through the food that we eat. The danger of illness or even mortality is in the deficiency of some of the essential vitamins. This is where vitamin supplementation comes in. It counteracts the illness caused by such deficiency. With this fact, it is very unlikely for someone to refuse vitamin supplementation on a daily basis. So the question now is, why is it necessary for individuals to take multivitamins when majority of our daily diet can provide us with the basic nutrients we need? It may not be compulsory, but everyone can profit from daily multivitamins.

As previously mentioned, the clear benefit of daily intake of multivitamins it to prevent vitamin/nutrient deficiency. Some personal circumstances may increase dietary needs. Pregnant women, during their first trimester, are recommended by their doctors to take multivitamins. This does not only provide the mothers with sufficient nutrition but also proper vitamins to benefit the unborn child inside their womb. Taking multivitamins everyday reduces the risk of transmitting malnutrition from a pregnant woman to her unborn baby. Other conditions such as old age, alcoholism, smoking, and exposure to excessive pollution have long-term detrimental effects to the body system which can be successfully counteracted by multivitamins.

Stress is also one risk factor which needs serious supplementation that multivitamins can provide. Especially with people who have so much to do and have a hard time in keeping up with their health needs, multivitamins are a must to keep them always on the go without any health complications in the long run. Stress formulations benefit both your mental ability and daily endurance. Aside from the mentioned benefits, daily multivitamins also minimize the risk of cancer or any cardiovascular disease.

Several people, if not all, testify to have a feeling of comfortable health in regularly taking in multivitamins. This is due to the synergistic or combined effects of the supplemental ingredients found in multivitamins. A fat-soluble antioxidant vitamin, like the Vitamin E, works to neutralize probable harmful free agents in the body. This vitamin also maintains healthy skin through protection of cell membranes, blood circulation, heart, nerves, red blood cells, and muscles. Another antioxidant is the Vitamin C which effectively fights blood cell infection and is vital in collagen formation, wound healing, and formation of bone structures, capillaries, and teeth. Vitamin is also helpful in the iron absorption from plant sources. Vitamins A, D, K and other supplemental nutrients found in multivitamins have specific functions that benefit the bodily functions.

While daily intake of multivitamins may have proven beneficial, it is not a 100% guarantee to be free of serious illness attributed to other factors. It is often a misconception that symptoms of disease may always be cured by taking multivitamins. Health experts have the better opinion of immediate medical assistance rather than resorting to multivitamins alone.

Traveling Alternative Roads: Other Options for Health Care

Health insurance can be expensive if you are not lucky enough to have it provided by your employer. Even shopping around for the best quotes may not be within your budget. Luckily there are alternatives to health insurance that you can take advantage of so that you and your family will be safe even if an emergency situation comes up. You can apply for the prescription discount card program, which is a low monthly cost and works at most of the of corporation drug stores that we all use. There are also programs that give you health care but are not considered "health insurance".

The prescription discount card is great for anyone who has regular prescriptions that need to be filled over a long period of time. The cost of prescriptions without insurance is high and always rising. If you cannot afford health insurance, there is no way that buying these full priced prescriptions will come without difficulty. You can enroll in a discount card program on the Internet or you can call around to try and find one locally. The reported savings for each person is estimated to be at least 50%, and some programs will enroll you for under $5 a month.

Health care programs are another popular alternative to expensive health insurance. BeniCard, for example, is a highly acclaimed health care program, and for a small monthly fee, you can have your immediate family covered. You will not be turned down because there is no limit to who is eligible, even if you have a pre-existing condition. It is not health insurance, but you will be able to save money on doctor visits, vision and hearing care, dental services, and prescription drugs. This is just one of the programs that can help you if you cannot get health insurance due to expense or because you have been turned down due to an illness.

No one should go without health care of some sort. Prescriptions are extremely costly without insurance, and if you or someone in your family has an emergency health situation, you could be left with a large debt for years. Insurance companies are hesitant to accept anyone with a pre-existing illness because it will definitely cost them plenty of money. For anyone who has been turned down for health insurance or simply cannot afford to pay a deductible, health care programs and prescription discounts are a low-cost alternative that could save you money.

What Are the Main Allergy Symptoms?

The symptoms play an important role in the diagnosis of every disease in this world. In this particular case, knowing which the allergy symptoms are is the fact that determines people to look after medical advice. The tests that are performed during the diagnosis help doctor to realize the connection between the symptoms and a certain disease. In the diagnosis of allergy, the main problem is not whether the patient is allergic or not. Instead, doctors try to find out what allergen has caused the allergic reaction.

The allergy symptoms are generic. In other words, the symptoms of a certain type of allergy do not differ from the ones of another type. In addition, the signs that are believed to be allergy symptoms may indicate another health problem. This is why the diagnosis is so important. In order to diagnose allergy, doctors usually perform two tests: a blood test and a skin test. Prior to performing the tests, people may confuse these symptoms to the ones of cold. However, there are some elements that help people to make a distinction between these two health conditions. First, the cause of the symptoms is different, as cold is provoked by viruses while allergy is determined by allergens. Next, the duration differs, as the cold is cured after a period of time that ranges from 2 to 14 days. Allergies may be observed even for a few months, if they are provoked by allergens that are present only during certain seasons. In addition, the treatment and the prevention methods are different between cold and allergy.

First of all, people must know what determines the allergy symptoms to appear. When exposed to an allergen, the immune system sets free histamine into the body. This is a chemical substance that is supposed to fight the presumed intruders. As soon as this chemical substance is released into the body, the allergic reaction is triggered and the allergy symptoms become visible.

The main allergy symptom, and also one of the first to be observed, is the itch of the skin. The intensity may not increase, but the duration of this allergy symptom is equal to the exposure time to the allergens. The itch usually affects the nose, too. In addition, people may experience stuffed nose and watery eyes. Furthermore, the respiratory tract is affected in most types of allergy, while food allergies affect the gastrointestinal tract. Regarding the respiratory tract, the allergy symptoms include lung congestion, cough and wheezing. In rather seldom cases, people may also experience allergy asthma.


Breast Enhancement for Men

The trans-gender choices in our society have really opened the door to breast enhancement for men, particularly since there is no big difference from female situations. Soft, round, beautiful breasts like those of any woman, are very much within reach with the help of supplements and surgical procedures. Unfortunately, the latter solution is not applied to breast enhancement for men as it is for women. The problem lies in the anatomical configuration of the male chest that doesn't have too much extra tissue to work on, hence there is little chance to support large implants.

However, there has been successful breast enhancement surgery for men, with the adding of small silicone implants. The breast growth process was afterwards continued by the administration of hormones such as estrogen. This chemical is naturally secreted by the female body during puberty and pregnancy or even before the period, but it lack from the male body. By long-term administration, feminization aspects will develop and men breast enhancement is one of them. We could also mention skin changes, as the tissues grow softer, and an accelerated growth rhythm of the hair and nails.

Manufacturers have even launched products that are devoted to breast enhancement for men exclusively. Transfemme herbal supplement for male breast enlargement is one of the most popular supplements devoted to the trans-gender, and it is usually used in association with external massage creams that assure a maximum breast expansion. Many of the creams used for the purpose contain caffeine as an local stimulator and estrogen compounds that firm the area providing a more feminine curve. When some kind of breast enhancement for men treatment is used, a very balanced diet is highly recommended.

Most men who turn to hormonal treatments, don't ask for the doctor's advice as related to the risk of their administration. Information provided by web pages on the Internet is not enough when it comes to breast enhancement for men, particularly since it is a huge and complex transformation that we're talking about. Side effects of hormone intake are not to be neglected, as it may result in very serious unbalances of the entire body system. Furthermore, it is highly important that you be in a good health condition once you try the pill form of the breast enhancement for men, and even when results appear, regular medical health should not be overlooked.

Protein Diet: Do Your Home Work

 Research has suggested that Americans may be eating too many carbohydrates, especially simple carbohydrates, while not getting enough exercise. With the wave of the popular low-carbohydrate, high-protein diets sweeping the nation, one may find it convincing to experiment with such a diet.

Here is the reasoning: Excess intake of carbohydrates results in fat storage. Simple carbohydrates, such as sugar and white flour, rapidly spike insulin levels, thereby accelerating the conversion of carbohydrates to fat. By restricting carbohydrate intake altogether, the body is forced to rely on its fat stores for energy and hence the weight loss process begins.


However, it is important to realize that high-protein diets are not appropriate for everyone. In fact, these diets may do more harm than good and leave your intended weight loss sabotaged.

High-protein, low-carbohydrate diets are not appropriate for everyone. In fact, these diets may do more harm than good and leave your intended weight loss sabotaged. High-protein, low-carbohydrate diets trigger weight loss by inducing ketosis, a toxic state that also occurs in uncontrolled diabetes and during starvation. Ketones are by-products of the inefficient oxidation, or breakdown of fats. See also: Nutrition for a Ketogenic Diet and/or Low Carb Keytogenic Effects.

Definition of Ketosis by the Encyclopedia from NHS Direct Online:

Ketosis
Ketosis is the presence in the blood of abnormally high levels of acidic substances called ketones. The normal body fuel is glucose. Ketones are produced when there is not enough glucose in the bloodstream, and fats have to be used. When fats are used excessively as fuels, they are eventually converted to ketones. The real danger in ketosis is that ketones are acidic, and high levels of ketones make the blood abnormally acid.
Normally the blood ketone levels are low, but in starvation, untreated diabetes and when the diet is very high in fats and low in carbohydrates, the levels rise. Ironically, in diabetes, the blood contains large quantities of sugar, but because of the shortage of insulin, this glucose can't be used as fuel.
Mild ketosis may be a feature of excessive morning sickness in pregnancy and crash diets.

Ideally, fat burns in the flame of carbohydrates. When the body lacks sufficient carbohydrates to produce glucose for energy, it is forced to use stored fats for fuel. The brain and other organs are forced to rely on ketones as the primary energy source when the required carbohydrates are missing from the diet. (See also: BellyBytes.com: Carbohydrates)

Unfortunately, there are some not-so-pleasant side effects of ketosis -- among them constipation and bad breath. Short-term weight loss occurs quickly during the initial phase of the high-protein diet, partly because eliminating carbohydrates causes a loss of body fluids. The body is depleting liver and muscle glycogen (stored glucose) as well as excreting toxins via the urine.

This water loss occurs within the first seven to ten days, and many people mistakenly correlate this rapid weight loss with loss of body fat. The lost weight is really water loss caused by more frequent urination from restricting carbohydrates.

A study published last spring in the New England Journal of Medicine demonstrated the efficacy of short-term weight loss by means of a high-protein, low-carbohydrate diet. The researchers found that those people who followed such a diet lost more weight during the six-month period than those following a low-fat diet. So we now have medical evidence to support the short-term use of high-protein diets.

There is no long-term evidence showing that people maintain weight loss through the use of these diets. In the long run, the diet may contribute to the onset of chronic medical conditions such as osteoporosis, cancer, cardiovascular disease and kidney insufficiency.

The diet lacks milk and dairy products, major sources of dietary calcium, while causing people to excrete more calcium than normal through their urine, which may affect bone tissue. Conversely, high-carbohydrate diets -- containing dairy products, beans, leafy green vegetables and fortified juices -- provide adequate dietary calcium, helping to build bone tissue. See also: Keeping Your Bones Strong.

High-protein diets also promote intakes of red meat far above the six ounces per day as recommended by the American Heart Association (AHA). It is well-known that meats cooked at high temperatures, including grilling and frying, produce heterocyclic amines, chemical compounds that have been linked to breast and colon cancer.

High-protein diets also increase one's intake of fat, especially saturated fat, cholesterol and protein, to levels well above what is recommended. Fat is a concentrated source of calories in our diet, ounce for ounce providing more than double the calories consumed from protein and carbohydrates. Fat consumed from meat, eggs and cheese is not stored as muscle but instead as body fat. Saturated fat has been linked to cardiovascular disease and colon cancer and it continues to play a role in the growing obesity trend.

Burden on the Kidneys
The kidneys are responsible for clearing the body of waste products produced by protein metabolism. Eating large amounts of protein places a strain on the kidneys, which may lead to long-term consequences.

Finally, high-protein diets are generally low in fiber, as they omit all fruit within the first 14 days and restrict starchy vegetables. Dietary fiber is an essential component of the diet and offers several benefits: It helps lower cholesterol, and it facilitates the excretion of wastes from the body -- thereby maintaining a healthy colon. Therefore, the low-fiber content of the high-protein diets may contribute to cardiovascular disease and may increase one's risk of developing colon cancer.

In short, there is sufficient evidence to support the use of a high-protein diet over the long term. The AHA Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism recently stated in Circulation Journal:
High-protein diets are not recommended because they restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs. Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone and liver abnormalities overall.

Americans, on average, consume too much protein even without attempting a high-protein diet. To achieve long-term weight loss, a diet low in fat combined with physical activity is the best strategy. The AHA guidelines urge adults who are trying to lose weight and keep it off to eat no more than 30 percent of total daily calories from fat and less than ten percent from saturated fat. On the High-protein diets, meeting these goals is impossible.

A diet with a moderate carbohydrate content, containing fruits, vegetables, whole grains and non fat dairy products, is recommended. Fruits and vegetables are loaded with vitamins and minerals and of course, fiber.

Unfortunately there is no "quick fix" for losing weight and keeping it off. The weight loss equation is still a very simple one: Output must exceed input. You burn off calories by eating fewer calories and exercising more. The most successful weight loss strategies include watching portion sizes, being sensible about meals and snacks, and getting plenty of exercise.


The 3 Day DietIn truth, a diet called the "Three Day Diet" is nothing more than a very short term loss of bodily fluid. The basics of the diet: don't drink much water and eat around 600 calories a day. Lose up to 10 pounds quickly.

In short, and contrary to proponents of this diet, this is starving yourself for 3 or 4 days and is no solution to anything.

With this 3 Day Diet, you will more than likely gain the weight back quickly and probably end up adding some additional weight, to boot.


Having said that, and if you're still curious, here is what this diet is all about -- including it's own "claim to fame".
The Claim
The 3 Day Diet was developed for people who need to lose large amounts of weight.
The 3 Day Diet is chemically and enzyme balanced. If the diet is followed exactly, loss of 10 pounds in 3 days is possible.
The 3 Day Diet consists of ordinary foods found in your kitchen. No special expensive recipes or ingredients are required. No frozen diet meals to buy.
The 3 Day Diet is to be used for three days at a time. After three days of dieting you may return to your usual meals but, do not overeat. After four days of normal eating you may continue the 3 Day Diet.
This is not a starvation diet. In fact, you will be eating normal meals at normal times.
The Diet

DAY 1
Breakfast:
Black Coffee or Tea (if required, with 1-2 packets of Sweet and Low or equivalent)
1/2 a Grapefruit or Juice
1 Slice of Toast with 1 tablespoon Peanut Butter

Lunch
1/2 a Cup of Tuna
1 Slice of Toast
Black Coffee or Tea (if required, with 1-2 packets of Sweet and Low or equivalent)

Dinner
3 Oz. any lean red meat or chicken
1 cup each of:
green beans
carrots
regular vanilla ice cream
1 apple

DAY 2
Breakfast:
Black Coffee or Tea (if required, with 1-2 packets of Sweet and Low or equivalent)
1 Egg (boiled, scrambled, omlet)
1/2 a Banana
1 Slice of Toast

Lunch
1 cup of cottage cheese or tuna
8 regular saltine crackers

Dinner
2 beef franks
1 cup of broccoli or cabbage
1/2 a cup carrots
1/2 a banana
1/2 a cup of regular vanilla ice cream

DAY 3
Breakfast:
Black Coffee or Tea (if required, with 1-2 packets of Sweet and Low or equivalent)
5 regular saltine crackers
1 oz. cheddar cheese
1 apple

Lunch
1 boiled egg
1 slice of toast
Black Coffee or Tea (if required, with 1-2 packets of Sweet and Low or equivalent)

Dinner
1 cup each of:
tuna
carrots
cauliflower
melon
1/2 cup regular vanilla ice cream

How to Choose a Good Multivitamin

There are a lot of choices out there and looks can be deceiving. Some vitamins contain large quantities of the cheaper nutrients and none or almost none of the costly ones. Unfortunately your body needs those costly nutrients just as much as the other ones.

Look for all-natural ingredients without added chemicals. Since heat destroys nutrients you should find supplements that are processed with low or no heat. Look for a manufacturer who does extensive research and …this is important…publishes its clinical studies. A company that has been in business for a number of years should have a proven track record of integrity.

There are several other good indicators of the quality of a multivitamin/ multimineral supplement. Does it contain all 8 B vitamins? These are Thiamin, Riboflavin, Niacin, Vitamin B6, Folate (Folic Acid), Vitamin B12, Biotin, and Pantothenic Acid. Biotin and Folate are expensive nutrients. Many supplements shortchange the consumer on these. Your multi should contain 400 mcg of Folate, which is essential for prevention of birth defects.

Calcium is another good indicator. It is a bulky nutrient and difficult to include in a one or two tablet multi serving. Yours should have at least 450 mg which is 45% of suggested daily value. You may want to add a calcium supplement if you don’t consume enough dairy to reach the 1000 mg suggested value.

A vitamin that meets these criteria will cost more than drugstore vitamins but if you want better health it is the only choice to make.

Article Source: DirectoryArticles.com - Article Directory

Protein for Health
High protein diets have made a name for themselves when it comes to weight loss. But even for those with no need to lose weight, the issue of protein is critical. Although protein is the essence of life itself (our muscles, skin and bones contain it and every cell of our body utilizes it), recent research suggests the current recommended daily allowance (RDA) for healthy adults over 50 may not be adequate.

Your body relies on protein to build and repair body organs, muscles and bones and to make enzymes, antibodies and hormones, all of which are needed to keep your body running smoothly. Protein is made up of amino acids. Of the 20 amino acids that your body needs, eight must be obtained from the food you eat and are considered essential, while the remaining 12 are made by your body and are "nonessential".

About 75-percent of the protein you eat should be high quality, as determined by its amino acid makeup. "Complete" or high quality proteins contain all eight essential amino acids and come from animal sources (milk, eggs, meat, poultry and fish) and foods made from soy (tofu and tempeh). Most plant proteins (legumes, nuts, rice and other grains) are "incomplete" because they do not contain all the essential amino acids. But by combining incomplete proteins in a meal, you can amass protein of sufficient quality to be considered complete (beans and rice, peanut butter on whole grain bread, milk with cereal).

Protein requirements may increase with age. That is because changes in the function and capacity of all body systems occur with aging, including a gradual loss of lean body mass, like muscle. Although this loss means your body needs fewer calories, your protein needs are unchanged or perhaps increased. This challenges older individuals to consume enough protein without consuming extra calories.

So, How Much Protein is Enough?

The RDA for protein is based on body weight. Recent research indicates that the current recommendation (0.36 grams per pound of body weight) may not be sufficient to maintain muscle mass in healthy people over 50, and that an increase (to 0.45 grams per pound of body weight) may be recommended. A 125-pound woman would need approximately 56 grams of protein daily to maintain her muscle mass. Unless you are ill or recovering from surgery or injury, you do not need a high-protein diet. But it would be wise to discuss your protein needs with your doctor or dietitian.

Getting the right amount of protein plays a vital role in your health. Do you know what your protein needs are? Calculate them with the equation and peruse the following table for suggested foods for protein consumption. Calculate your daily requirement, keeping in mind 75-percent must be high quality protein.

Multiply your weight in pounds by 0.36 grams. Example: 125 x 0.36 grams of protein equals 45 grams of protein per day.

Commonly Eaten Foods and their protein content in grams  :
3 ounces chicken breast (no skin): 26g

1 ounce cheddar cheese: 7g

3 ounces beef, veal or pork: 25g

1 medium-sized egg: 7g

3 ounces white fish: 18g

1/2 cup cooked pinto beans: 7g

1/2 cup cottage cheese: 13g

1 ounce nuts: 6g

8 ounces 1-percent milk: 9g

1 slice wheat bread: 4g

2 tablespoons peanut butter: 8g

1/2 cup white rice: 2g



Protein for Health: Part Two
Protein is a part of every cell in your body, and no other nutrient plays as many different roles in keeping you alive and healthy. It is important for the growth and repair of your muscles, bones, skin, tendons, ligaments, hair, eyes and other tissues. Without it, you would lack the enzymes and hormones you need for metabolism, digestion and other important processes.

When you have an infection, you should eat more protein because it helps create the antibodies your immune system needs to fight disease. If you are injured, you may need more, as well, to help your blood clot and make repairs.

Your body can use protein for energy, if necessary, but it is best to eat plenty of carbohydrates for that purpose and save your protein for the important jobs other nutrients cannot do.

Pick Your Protein Carefully

Your body needs many different proteins for various purposes. It makes them from about 20 "building blocks" called amino acids. Nine of these are essential amino acid, which means you must get them from food. The others are nonessential. This does not mean you do not need them. You just do not have to eat them because your body can produce them.

It is easiest to get protein from meat, chicken, turkey, fish and dairy foods. Cooked meat is about 15 to 40 percent protein. Foods from animal sources provide complete protein, which means they contain all the essential amino acids.

Next to meat, legumes -- beans, peas and peanuts -- have the most protein. But they are called incomplete proteins because they are lacking some essential amino acids. You can get complete protein if you combine them with plant foods from one of these categories -- grains, seeds and nuts, and vegetables. Eat any two or more of these plant foods, with or without beans, and you get complete protein.

You do not have to eat these foods in the same dish, or even in the same meal. But many cultures have created combinations that work well -- like corn and beans in Mexico, or rice and split peas in India. Many Americans enjoy legumes and grains in a peanut butter sandwich.

Make Digestion Easier

Your body can digest and use animal protein more easily than plant protein. But be sure to avoid excess fat by choosing lean meats and low-fat dairy products. Legumes are next easiest to digest, followed by grains and other plant sources.

Cooking protein foods with moist rather than dry heat, perhaps boiled in a stew rather than fried, or soaking meat in a marinade using wine, lemon juice, or vinegar makes it easier to digest.

Set Healthy Limits

Since protein is so important to your body's survival, you may think you need to eat a lot of it. Fortunately, your body actually recycles protein from tissues that break down and uses it to make new ones. So you do not need more than 10 to 15 percent of your total calories from protein.

Protein deficiencies are common in poor, undeveloped countries. Even in modern nations, they sometimes occur in certain groups. In fact, vegetarians need to be very careful about eating the right combinations of plant foods to get enough complete protein.

The chances are far greater that you eat too much protein, especially from meat sources. The typical Western diet includes about 100 grams of protein, while 50 grams is closer to what your body needs.

If you are healthy, with no liver or kidney problems, you can get rid of any excess with little trouble. Yet, meat protein can be expensive and high in fat, two good reasons not to eat more than your body can use.

Beware the Dangers of a High-Protein Diet

If you are looking for a quick way to lose weight, it is easy to get fired up about a high-protein diet. Unfortunately, the American Heart Association, the American Dietetic Association and other health organizations advise against it.

An initial drop in weight is common with a high-protein diet, but it is due primarily to water loss. These diets do not work very well in the long run -- nor do they build muscles as they claim. Most important, they can be dangerous, increasing your risk of heart disease, kidney disease and artery damage, and bone loss.

While most high-protein foods contain plenty of vitamin B12 and iron, they are low in other vitamins and minerals. Only a diet with lots of fruits, vegetables, and grains supplies the other nutrients that keep you healthy.

Multivitamins Nutrition and Antiretroviral Therapy for HIV Disease in Africa

Readers could be forgiven for being confused by the literature on micronutrients and the pathogenesis of human immunodeficiency virus (HIV) disease. Micronutrients play important roles in maintaining immune function and neutralizing the reactive oxygen intermediates produced by activated macrophages and neutrophils in their response to microorganisms. Serum and plasma measurements of vitamins and trace elements, which are imperfect indicators of body stores, have shown that deficiencies are common among HIV-infected persons, especially those who are underprivileged, such as women in developing countries, and injection-drug users. A vicious cycle has been envisaged in which undernourished HIV-infected persons have micronutrient deficiencies, leading to further immunosuppression and oxidative stress and subsequent acceleration of HIV replication and CD4+ T-cell depletion.1

It has been difficult, however, to show causal associations between specific deficiencies and adverse clinical outcomes in HIV-infected persons, and data linking replacement or supplementation of specific micronutrients with a clinical benefit have been sparse and inconsistent. In this issue of the Journal, Fawzi and colleagues report the results of a controlled trial of multivitamin supplementation among HIV-infected pregnant women in Tanzania.2 Their report prompts important questions about the plausibility of the findings but also raises broader issues concerning the role of nutrition in the public health response to HIV infection and AIDS in Africa in this era of increasing access to antiretroviral therapy.

The authors compared supplementation consisting of multivitamins alone, vitamin A alone, or both with placebo. They found that women who were randomly assigned to receive multivitamin supplementation were less likely to have progression to advanced stages of HIV disease, had better preservation of CD4+ T-cell counts and lower viral loads, and had lower HIV-related morbidity and mortality rates than women who received placebo. Vitamin A appeared to reduce the effect of multivitamins and, when given alone, had some negative effects.

The credibility of these data is supported by sound study design and methods, appropriate analyses, and compatibility with the limited existing data, such as those showing decreased mortality among HIV-infected Thai adults who received multivitamins.3 Fawzi and colleagues have previously shown that multivitamin use is associated with improved pregnancy outcomes, including reduced rates of low birth weight, prematurity, and fetal death.4 Although some observational data have associated vitamin A deficiency with increased risks of perinatal transmission and other adverse outcomes,5 vitamin A supplementation has reportedly been followed by increased rates of mother-to-child transmission of infection.6 On the basis of these previous data as well as the current findings, there seems to be no justification for pursuing vitamin A supplementation as an intervention for HIV infection.

There has been little prior experience with extensive use of multivitamins in African populations, and long-term multivitamin administration has not been considered sustainable. Moreover, there are no solid data regarding the value of multivitamins among HIV-infected adults in the industrialized world, although routine supplementation is often practiced. Thus, before definitive recommendations can be made about routine use of multivitamins in the treatment of persons with HIV infection and AIDS, there is a clear need to confirm the new findings and to evaluate the effects of multivitamins in larger populations, particularly among persons with more advanced HIV disease or more serious nutritional deficiencies.

As a consequence of the recent substantial increase in funding and support for HIV and AIDS treatment programs, the treatment options for HIV disease and AIDS in Africa have changed fundamentally since the study under discussion was initiated. Needing to interpret their results against this altered landscape, Fawzi and colleagues speculate that by reducing the progression of HIV disease, the use of multivitamins may delay the need to institute antiretroviral-drug therapy, thus saving resources as well as preserving therapeutic options.

Individual, small clinical trials rarely form an adequate basis for policy formulation, and they are unlikely to answer convincingly the important questions now raised — specifically, whether multivitamin supplementation can reduce mortality in the context of increased access to antiretroviral-drug therapy and whether the initiation of such therapy can be delayed. These critical questions could potentially be answered in Africa by a so-called large, simple trial.7 Involving very large populations and assessing only hard end points such as mortality, large, simple trials are especially suitable for evaluating simple treatments that probably have moderate efficacy for common diseases. At a population level, such treatments can have a considerable effect on public health. Without such a study, it is unlikely that adequate evidence will become available to provide scientifically based recommendations concerning the use of multivitamin supplementation for patients with HIV disease and AIDS and for treatment programs in Africa.

Although definitive policy recommendations concerning multivitamin supplementation must await the appropriate evidence (ideally from a large, simple trial in a population with access to antiretroviral drugs), individual treatment programs and clinicians would be justified in routinely prescribing this nutritional support, since it may provide a benefit and does no harm. Multivitamins offer safe opportunities for patients to become accustomed to taking regular medication before beginning antiretroviral therapy. Multivitamins could be offered through home-based care programs that until now have too often ignored even basic biomedical interventions such as HIV testing, the need to rule out tuberculosis, and the provision of trimethoprim–sulfamethoxazole to HIV-infected persons.

Fawzi and colleagues' study of multivitamin supplementation should stimulate broader discussion of the role of nutrition in patients with AIDS in the developing world. With its effects on morbidity, mortality, and poverty, the epidemic of HIV infection and AIDS has worsened food security in Africa, especially in the southern part of the continent, the area most affected by HIV. HIV disease increases metabolic requirements, suppresses appetite, may impair swallowing by causing oral and esophageal opportunistic infections, may be associated with malabsorption due to various gastroenteropathies, and perhaps most important, results in progressive disability and impoverishment, with a consequent inability to raise or afford food. Undernutrition also interacts with HIV in a variety of ways. Undernutrition may promote HIV transmission, for example, when sex is exchanged for money to buy food for oneself and one's family. The clinical picture of the HIV wasting syndrome (also known as the "slim disease"), a characteristic manifestation of AIDS in Africa, results in large part from undernutrition in the face of opportunistic illnesses, especially tuberculosis, which itself may be made more likely by inadequate food intake.8,9 Whatever its cause, a reduced body-mass index is a strong predictor of death.

As donor-funded initiatives expand in Africa, it has become clear that nutrition will have to be addressed in the treatment of HIV disease and AIDS. In the focus-group discussions that we conducted when starting an antiretroviral treatment program in a large Nairobi slum, every group interviewed listed the lack of food as the most likely cause of nonadherence to antiretroviral (ARV) drug therapy. One participant succinctly stated, "If you give us ARVs, please give us food, just food." There truly is irony, not captured in the language of treatment advocacy, in providing antiretroviral drugs to populations that lack access to safe water or food.

The possibility that a relatively inexpensive intervention such as multivitamin supplementation could reduce the risk of or delay HIV-associated disease and death raises the question of how other basic interventions need to be integrated into our nascent HIV and AIDS treatment programs. Africa's health needs extend beyond the treatment of HIV disease and AIDS; HIV-infected persons are at great risk from other threats, as well. For example, programs to prevent mother-to-child transmission of HIV will not fulfill their potential if ineffective maternal and child health services fail to prevent the many competing causes of death in women and children.

An obvious approach is the promotion of simple but important public health interventions alongside and as part of HIV and AIDS treatment initiatives. One example is malaria prevention through the provision of insecticide-impregnated bed nets. In western Kenya's Nyanza Province, an area where the prevalence of antenatal HIV infection is approximately 25 percent, the provision of insecticide-treated nets reduced infant mortality by up to 25 percent at a time when no program existed to prevent mother-to-child transmission of HIV.10 Another example is the promotion of point-of-use chlorination to provide safe drinking water; implementation of this system reduced the incidence of diarrhea among HIV-infected adults in Tororo, Uganda, by 30 percent.11

Innovative schemes will have to be developed to address the need for food supplementation within HIV and AIDS treatment programs. One such scheme exists near Eldoret, in western Kenya, where a farm has been developed on donated land and is tended by some of the patients who receive care at the local clinic. In addition to antiretroviral drugs, food from the farm can be "prescribed" by health care providers for HIV-infected patients and their families.

A final word of caution is required with respect to the implementation of clinical and public health measures in Africa. A fine balance is required between the search for "simple" and "appropriate" interventions and efforts to institute the effective measures that we in the industrialized world take for granted. "Cost-effective" should not be a polite term for cheap, nor should "simple" mean not very effective. As attractive and important as simple interventions are and as massive as the shortage of basic public health infrastructure is, the need for antiretroviral therapy in Africa is real and compelling. The international community must continue to expand its efforts to meet this need.

The opinions and statements expressed in this article are those of the authors and do not represent the official policy, endorsement, or views of the Centers for Disease Control and Prevention, the U.S. Public Health Service, or the Department of Health and Human Services.

Source Information

From the Centers for Disease Control and Prevention, Nairobi, Kenya.

by Barbara Marston, M.D., and Kevin M. De Cock, M.D.

How should I take multivitamins?

Use this medication as directed on the label, or as your doctor has prescribed. Do not use the medication in larger amounts or for longer than recommended.
Never take more than the recommended dose of a multivitamin. Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar vitamin products together can result in a vitamin overdose or serious side effects.

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.
Take your multivitamin with a full glass of water.

The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing.

Measure the liquid form of multivitamins using a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Liquid multivitamins may sometimes be mixed with water, fruit juice, or infant formula (but not milk or other dairy products). Follow the directions on the medicine label.

It is important to take multivitamins regularly to get the most benefit.
Store this medication at room temperature away from moisture and heat. Keep the liquid medicine from freezing.

Store multivitamins in their original container. Storing multivitamins in a glass container can ruin the medication.

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects. Certain minerals contained in a multivitamin may also cause serious overdose symptoms if you take too much.

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

What should I avoid while taking multivitamins?

Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar vitamin products together can result in a vitamin overdose or serious side effects.

Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement.
Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.

What are the possible side effects of multivitamins?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

When taken as directed, multivitamins are not expected to cause serious side effects. Less serious side effects may include:

upset stomach;

headache; or

unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What is the most important information I should know about multivitamins?

Never take more than the recommended dose of a multivitamin. Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar vitamin products together can result in a vitamin overdose or serious side effects.

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects. Certain minerals contained in a multivitamin may also cause serious overdose symptoms if you take too much.

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.

What is multivitamin?

Multivitamins are a combination of many different vitamins that are normally found in foods and other natural sources.

Multivitamins are used to provide vitamins that are not taken in through the diet. Multivitamins are also used to treat vitamin deficiencies (lack of vitamins) caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions.

Multivitamins may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking multivitamins?

Many vitamins can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medication than directed on the label or prescribed by your doctor.

If you have any medical conditions, ask your doctor before taking a multivitamin. If you have certain conditions, you may need a certain vitamin formulation or special tests while taking a multivitamin.

Do not take multivitamins without telling your doctor if you are pregnant or plan to become pregnant. Some vitamins and minerals can harm an unborn baby if taken in large doses. You may need to use a prenatal vitamin specially formulated for pregnant women. Multivitamins can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.