Walk into a pharmacy, grocery store, or vitamin shop and you’re likely to see dozens, if not hundreds, of vitamins, herbal remedies, and other so-called dietary supplements. You might think that someone, somewhere, tests these pills and potions to make sure they contain what they say, improve health as advertised, and are safe. But that isn’t happening.

Under the terms of the Dietary Supplement Health and Education Act of 1994 (DSHEA), supplements with established ingredients (meaning those that had been sold in the United States before 1994) can be marketed without any evidence that they are effective or safe. For new supplement ingredients, the DSHEA requires manufacturers to give the FDA evidence that a new ingredient should be safe. “Regrettably, this aspect of DSHEA has thus far not been enforced,” writes Dr. Pieter A. Cohen in a commentary in today’s New England Journal of Medicine.

Compare this hands-off approach with the strict rules and regulations for drugs. No drug can be sold until the FDA has proof clear proof that it is safe and effective. And every FDA-approved drug must be made to strict specifications.

From the safety, effectiveness, and truth in advertising standpoint, DSHEA hasn’t been a good watchdog for public health. Take “natural supplements” for erectile dysfunction. Since 2004, the FDA has pulled off the shelves more than two dozen of these products, with names like Stiff Nights and True Man, because they contained sildenafil (the active ingredient in Viagra), or a chemical cousin of it. Sildenafil in a dietary supplement is a problem because 1) sildenafil isn’t a naturally occurring compound, 2) it is an FDA-regulated drug, and 3) when taken with heart drugs called nitrates, it can lower blood pressure to unsafe levels—but the supplements don’t carry a warning about this, as sildenafil does.

Last July, the FDA proposed some rules to help it test new ingredients. This is a good first step, but the FDA’s plan doesn’t go far enough, argues Dr. Cohen, an assistant professor of medicine at Harvard Medical School whose research has explored the use of dietary supplements. Under the FDA’s plan, companies can give the FDA historical data to support the safety of an ingredient. Data from clinical trials would be better, and easier to evaluate. The plan also doesn’t require companies to give the FDA unfavorable data (as is required for new drug applications).

Americans spend more than $ 25 billion a year on dietary supplements. Many people take supplements because they believe they are safer than drugs (since they are “natural”), or work better. The safer part has been challenged numerous times. Remember ephedra, a widely used weight-loss supplement that was banned after it was linked to deaths and adverse side effects? And solid clinical trials routinely knock down the effectiveness of dietary supplements for stopping the common cold (vitamin C), shrinking an enlarged prostate (saw palmetto), and preventing heart disease (beta carotene and vitamin E). In fact, high daily doses of vitamin E have been linked with an increased risk of prostate cancer, respiratory infection, and heart failure.

The dietary supplement industry is fighting the new FDA guidelines, saying they will be bad for business. I think they’ll be good for the health of anyone who chooses to take dietary supplements. What do you think?

Harvard Health Blog

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Pinched nerves usually occur in the neck, but can lead to pain and muscle spasms throughout the upper back and arm. Learn how to treat a pinched nerve in the neck and stay fit in this sports medicine video.

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Pretty much everyone is familiar with whiplash and the dangers that go along with it. It can cause nerve damage and lingering pain, and the exact cause of the damage is unknown, which make it an injury that is difficult to pin down. While it is most common in automotive accidents (specifically rear-end collisions), it is also commonly caused by amusement-park injuries and sports-related injuries.

Some doctors believe that the damage is caused by a tear in the anterior logitudinal ligament that runs down the spine, and that it is caused by sudden stretching of the spinal column. Whiplash is very frequently caused by other people; if you find that you are suffering from such an injury, you may be entitled to financial compensation from the person who injured you. Many people in similar positions find it useful to engage a personal injury attorney to represent their claim in court.

If you’re in an accident, it’s important for you to know the symptoms of whiplash in order to ascertain whether or not you’ve been injured.

While some of these may be vague, taken as a whole they can suggest that you have sustained a serious injury that should be examined by a medical professional. The most common signs of a whiplash injury include:
Aches and pains in the back of the neck
Pain extending through the shoulders and upper back
Sense delusions in the extremities, such as the sensation of pins and needles or occasional numbness in the arms and legs
Frequent and chronic headaches

One of the problems in detecting a spine-related injury like this is that there is frequently a delay in the onset of tell-tale symptoms and pain, which can make it confusing to the uninitiated.

Whiplash is specifically felt along the spinal cord, primarily in the neck and extending down to the middle of the neck. If you are suffering from pains that extend through the spine past this region, you may have another, possibly more serious back injury and should also seek immediate medical attention.

Although most people who suffer from whiplash report only mild pain which dissipates in a few days, some cases result in severe disability and a limited range of motion in the head mixed with chronic pain. Spinal cord injuries are serious, and if you have received one, you should act quickly before the condition gets more serious.

For more information about taking legal action as a result of a whiplash injury, visit habush.com.

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Rear-end car collisions are the leading cause of whiplash injury in the UK. While whiplash injuries are usually sustained in car accidents, there are many other ways  you can sustain a similar injury including: falls while skiing, falls from bicycles, horses, motorbikes and even skateboards.

Road accidents claims

If you cycle to work for example, how many times has a car veered into your lane, causing you to brake sharply. This can cause your body to snap violently backwards and forwards, causing whiplash injury. You may experience shooting pain down your neck and shoulders, and a case of whiplash will most likely be diagnosed at the doctor´s surgery.

Symptoms of whiplash include: stiffness in the neck, shooting pain in the neck and back, headaches, memory loss, blurred vision and irritability, particularly if your symptoms are prolonged.

When whiplash is diagnosed, medical care and treatment will be recommended, and it is worth remembering that not all whiplash symptoms show up immediately. You may not be able to return to work immediately, and medical expenses can add to your anguish.

New whiplash symptoms can emerge much later, so never leave whiplash untreated. You may only be suffering mild discomfort to begin with, but remember that if left untreated, the pain can become much worse. A doctor will look at your complete medical history if you suffer ongoing pain after a whiplash accident, in case there are underlying problems with your back and spine.

If you have suffered whiplash injuries which were caused by someone else, usually as a result of a car collision, you could claim compensation for pain, suffering, loss of income and medical expenses. Whiplash is the most claimed-for injury in the UK, and most cases are successful, and are concluded out-of-court. Millions of people have successfully claimed compensation for whiplash, and rightly so, if the accident which caused the injury was not your fault.

Whatever the cause of your whiplash injury, get a full medical report from  your doctor. Any injury which causes the head to be violently thrown backwards then forwards will most likely result in damage to the neck tissue, and can cause headaches and neck pain for up to two weeks.Whiplash can also be caused by sideways-on car collisions, sports injuries or even injury sustained during fairground rides, especially the dodgems. In child abuse cases, whiplash type injuries can be caused by a child being violently shaken, causing the head to whip backwards and forwards at speed.
You may find yourself unable to return to work after suffering a whiplash injury, and this can leave you short of money. If you have suffered a whiplash injury that was someone else´s fault, you should contact a no win, no fee solicitor as soon as possible, who will help you to claim compensation for your injuries.

Other whiplash symptoms may include: swelling of the neck, loss of memory, nervousness, fatigue, insomnia, pain in the jaw, upper arms or back and shooting pains across your neck and shoulders. Whiplash symptoms may not appear immediately, and discomfort may not be experienced for days or weeks after the accident, and in very rare cases, whiplash symptoms take years to manifest. Serious damage can include nerve damage, muscle tears and fractures, so however mild you think your injuries are, it is vital you seek medical help as soon as possible.

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Most people think that eating disorders afflict only adolescents and young women. Not so—they plague older women, too, and may be shrouded in even greater shame and secrecy. Many women don’t seek help, especially if they fear being forced to gain weight or stigmatized as having a “teenager’s disease.”

As we write in the February 2012 Harvard Women’s Health Watch, clinicians are reporting an upswing in requests from older women for help with eating disorders. For some of these women, the problem is new; others have struggled with anorexia, bulimia, binge eating, or another eating disorder for decades.

Surveys in Australia have charted a tripling or quadrupling of the percentage of people age 65 and older with an eating disorder. Researchers at Oregon Health & Science University have found that women ages 65 to 80 were just as likely as young adult women to feel fat or concerned about their body shape.

This dissatisfaction matters. People with eating disorders are usually intensely unhappy about their body shape and size. A negative body image can suggest or prefigure a full-blown eating disorder—or what doctors call a subclinical problem, in which a woman never becomes alarmingly thin but organizes her life around food and weight control.

Eating problems at midlife and beyond stem from a variety of causes. These range from grief and divorce to illness and shifting priorities. Heightened awareness of an aging body is another contributor. This can be especially problematic when a woman returns to school or work, or needs to keep working past the traditional retirement age, especially in fields where looks may be important.

“As our society values youth and as baby boomers reinvent what it means to be middle-aged, there are growing social forces that can undermine older women’s self-esteem and potentially lead to body dissatisfaction,” psychiatrist Anne E. Becker told us. “That, combined with health concerns about obesity, can make people feel bad about their bodies and, in turn, could result in eating strategies that undermine well-being,” says Becker, who directs the Eating Disorders Clinical and Research Program at Massachusetts General Hospital and president of the Academy for Eating Disorders.

Food and you

Could concerns about your body image or your relationship with food be crowding out other important parts of your life? Take a look at the questions below. If you answer yes to one or more of them, try to shift your conversations and mental energy away from food and body awareness. If this proves difficult, consider consulting a mental health professional.

• Do you worry about your body and aging more than your friends do? What efforts do you make to hide these changes?
• If you had the choice between living an extra five years and attaining your perfect weight, would you pick attaining your perfect weight?
• Do you and your friends spend a lot of time discussing diets, weight, your looks, gym routines, etc.?
• Does the number on the scale determine your mood for the day?
• Do you spend an inordinate amount of time planning what to eat and not to eat and how to get enough exercise?
• Do you gravitate toward health regimens that involve purging or restricting food—for example, going gluten- or yeast-free, becoming a vegan, fasting, or doing colonics or cleanses?

You can read the complete article on eating disorders in midlife and beyond on the Harvard Women’s Health Watch Web site. It covers types of eating disorders, explores possible causes, looks at treatment options, and provides resources for more information.

If you developed an eating disorder in middle age, let us know how you noticed it and how you are handling it.

Harvard Health Blog

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Spine-Health – Back Pain, Neck Pain, Lower Back Pain

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Whiplash 12 of 20 Deep Fascia Release, Massage with Lubrication Whiplash injury occurs as a result of rear end car collisions or at the time of sports activities; being hit/pushed from rear with force. Due to whiplash a person can sustain multiple region injuries such as pain in neck and upper back, shoulder, chest and other regions, could experience severe headaches and many other painful symptoms. This type of severe sprain strain injuries, in many cases leads to partial or even total rotator cuff tears, multiple level of disk herniathions, rib rotation, acute inflammations. If not addressed appropriately, these injuries could become chronic inflammation, which with time can cripple a person. But even with no so significant structural damages, this type of soft tissue injuries must be addressed by adequate treatment, that includes myofacial release techniques, trigger point therapy, ice and cold applications, post-isometric relaxation techniques, lymph drainage for lymphedema size management and more. Otherwise with time one can develop not proportional to age osteoarthritis, as well as other degenerative not reversible diseases of spine and joints. At this series of videos, Boris teaching how to assess injuries and proposes hands-on techniques, on all painful areas. These techniques were scientifically and clinically proven to be safe and effective. Boris also stresses, why not to use painkillers, non-steroid and steroids anti-inflammatory drugs only, but also to …
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Every now and then, I email one of my doctors or they email me. The communications aren’t anything fancy, mind you—requests for prescription refills, test results, and the like. Apparently, these electronic exchanges put me squarely in the middle of a hot debate among doctors.

The Wall Street Journal offered a peek into the controversy by asking two doctors to write about why they do, and don’t, use email to communicate with their patients.

Writing in favor of email was Dr. Joseph C. Kvedar, a dermatologist and founder of the Center for Connected Health, a Harvard-affiliated organization that aims to move health care from the hospital and doctor’s office into the day-to-day lives of people who need help. Taking the opposite side was Dr. Sam Bierstock, an ophthalmologist who is now the president of Champions in Healthcare, an information technology consulting group.

Kvedar believes that using email improves efficiency and avoids the frustration of phone tag. He also says that

making myself available via email gives my patients a sense of direct access to me. It sends a message that I care and that I’m available to answer questions in a timely manner. It builds a bond between us that has tangible benefits for my patients’ health.

Bierstock agrees that email may be useful for basic communication such as scheduling appointments or prescription refills. But he worries about the possible liability and legal ramifications. He also says that email is

no way to practice medicine. Providing care includes an ability to interpret body language, facial expressions and other silent forms of communication that allow doctors to assess patient reactions to information about their health (apprehension, fear, anxiety) and the accuracy of their responses to questions. Online communications eliminate the ability to interpret these important signals.

Both doctors make good points (you can read the entire article on the WSJ site), making me think that, at least for a while, the use of email will probably come down to personal preference, for doctors and the rest of us.

What’s your preference? Do you email your doctor, or wish you could? What do you think is appropriate to discuss with him or her by email, and what isn’t?

Harvard Health Blog

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Spondylosis is a term used to describe degeneration in the spine. Two specific conditions may develop from this degeneration – degenerative disc disease and spinal osteoarthritis – depending on if the degeneration occurs in the discs or in the facet joints, respectively. The development of bone spurs may also occur as part of the degeneration of the spine with spondylosis and with either of the degenerative conditions.

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Spine-Health – Back Pain, Neck Pain, Lower Back Pain

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More than half of all car accidents involve rear end collisions, leaving about two million new patients each year – in the United States alone – suffering from whiplash. Sport and Spine Physical Therapy in Brighton, CO employs the BTE MCU Multi-Certical Unit to safely and effectively rehabilitate and restore this whiplash patient’s injured cervical spine, resulting in dramatic relief from 8 years of lingering neck pain. Visit www.btetech.com today to learn more.
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Physical therapy for the recovery and rehabilitation of Cervical Whiplash

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