Archive for February, 2011

Early Hair Loss May Put Men At Risk For Prostate Cancer

February 16, 2011

Men Who Experience Balding In Their 20s May Be At Risk For Developing Prostate Cancer.


CNN (2/16, Falco) in its “The Chart” blog reports, “Men who start losing their hair at 20 may be twice as likely to get prostate cancer later in life,” according to a study in the Annals of Oncology. The researchers studied “388 men with prostate cancer and 281 healthy men and asked how bald they were at age 20, 30 and 40.” They found that when a “man’s hair began to thin in his 30s or 40s, the risk for prostate cancer did not go up.” But any “type of balding [at age 20] is a risk factor for prostate cancer,” suggested lead author Dr. Michael Yassa of the Maisonneuve-Rosemont Hospital in Montreal, Canada.

Bloomberg News (2/16, Von Schaper) adds that early hair loss was associated with prostate cancer risk, but not with “earlier onset of cancer or a more severe course of the disease,” the study found.

MedPage Today (2/15, Smith) pointed out that the study did not control for “other prostate cancer risk factors, ‘such as African heritage or dietary differences,'” although the researchers said having a “family history of prostate cancer was comparable in cases and controls.”

Meanwhile, according to HealthDay (2/15, Mozes), the study authors said more research is needed to determine whether “men who experience youthful hair loss may benefit from prostate cancer screening. … ‘At present, there is no hard evidence to show any benefit from screening the general population for prostate cancer,'” said study author Dr. Philippe Giraud from the European Georges Pompidou Hospital in Paris. Medscape (2/15, Osterweil) noted that Dr. Yassa said further research should focus on “finding the exact link between hair loss, androgens, and prostate cancer — what exactly links those three together.”

Reuters (2/16, Kelland) and the UK’s Press Association (2/16) and Telegraph (2/16, Adams) also cover the study

Water-Wet and Wonderful

February 15, 2011

Water is one of life’s best elixirs; there are few things as available, inexpensive and health-giving –so, drink up.

Even though it is readily available, tasteless and free, most Americans do not drink enough water.  And water remains one of nature’s most perfect mediations.  In fact, water is the most essential component of your diet.

While you can live for several weeks without food, you can live only a few days without water.  Water loss of three percent of the body weight or approximately two quarts without replacement can result in weakness and lethargy.  A 15-20 percent water loss can be fatal.

Nearly half the total body weight consists of water.  To ensure good health, the average person requires two to three quarts of water per day because this is the volume that is lost in perspiration, urine, feces and breath.  Nearly half of a the food we at consists of water.

Water is necessary for nearly all bodily functions such as digestion, circulation, excretion, nutrient transmission and temperature regulation.

More specifically, there are thirteen ways that water works in the human body:

1.Water quenches thirst.  There is no better liquid to quench your thirst than water.  Many people are incorrectly informed that you only need to drink water in hot weather.  The truth is large volumes water are lost through your breath in cold, dry weather.  Although you can substitute other beverages such as colas, coffee and electrolyte drinks, there is no other drink that contains fewer calories and more nutrients than water.  In fact, affricated beverages can act as diuretics and cause the body to excrete water and important chemicals like potassium.

2. Water aids digestion.  Water dilutes the acidity in the stomach and causes the release of enzymes necessary for digestion.  Water is also a natural laxative and relieves constipation.

3. Water cools the body during exercise.  As the body heats up during exercise, the internal thermostat promotes perspiration.  Internal body temperature can be decreased with the consumption of cold water.  Cold water is best because it is absorbed into t he circulation more quickly than warm water.

4.  Water promotes waste excretion.  The kidneys are the paired organs used to remove metabolic bodily water material.  Water is essential for these incredible filters to do their work an flush out the body’s waste products.

5. Water carries nutrients to the cells.  All of the body’[s cells are bathed in a saltwater solution.  Blood moves nutrients to the cells and removes the waste products to the kidneys and liver.  Water is necessary to maintain the blood volume to carry out these vital functions.

6. Water reduces kidney stones.  If too much calcium, oxalate or uric acid is excreted in the urine, crystals will form and start the growth of kidney stones.  The best treatment to reduce kidney stones is to drink enough water to keep the particles from hitting one another and staring the crystallization process.

7. Water lubricates the joints.  The bones glide against one another with minimal friction because of a lubricant called synovial fluid.  Drinking plenty of water incases the synovial fluid and reduces e4h wear and tar on the joints.

8. Water promotes good skin tone.  Skin elasticity is maintained when the body is well hydrated.  Chronic fluid loss lead to dry, wrinkled skin.

9. Water dilutes alcohol and relieves headaches.  There is no better remedy for a hangover than several glasses of water.  Water dilutes the alcohol content in the blood stream and decreases its effect on the brain and decreases its effect on the brain and central nervous system alleviating headache and hangover associated with excessive alcohol consumption.

10. Water decreases pre-menstrual fluid retention.  Some women experience salt retention during their menstrual periods.  This leads to excess water retention as well.  Diuretics or water pills only offer a temporary solution.  Paradoxically, you can promote salt excretion by drinking more water.  As the water is passed through the kidneys, it excretes the excess salt as well as the excess water.

11. Water is a diet aid.  Drinking a glass of water before each meal leads to a sensation of fullness before you sit down to the table, thus acting as a natural appetite suppressant.  Water helps the body metabolize stored fat.  If there is not adequate water to rid the body of waste through the kidneys, then the liver must be called in to do the kidney’s work.  If the liver is doing the kidney’s work, it cannot metabolize body fat and weight loss is slowed or stopped.

12. Water is a natural relaxer.  Water is an excellent way to wash away tension.  Swimming induces a feeling of calmness and exhilarates the body, similar to a jogger’s high.

13. Water aids pregnant women.  A pregnant woman should be especially conscious of getting eight to ten glasses of water a day.  Water will clear her system of added metabolic body waste contributed by the fetus.  It will also help prevent dehydration that may result from morning sickness.

How much water is enough?  The time-honored advice of drinking eight to ten glasses of water a day still holds true.  However, the more you exercise, the more you need to drink.  A good rule of thumb is to drink approximately one quart of water for each hour of exercise.

Drinking too much water is rarely a problem.  Too much water, more than six quarts a day, can dilute body minerals and electrolytes producing lethargy, confusion and if not corrected, convulsions and coma.  The treatment is simple: Decrease the water intake and allow the kidneys to flush out the excess.

Bottom Line: Water remains one of life’s greatest medicinal drinks.  It really does keep you healthy and fit and it is good for most of life’s ailments.  Drink up!


Want to Improve Your ZZZZZZZZs? Take Vitamin D and Snooze

February 5, 2011

I love it when a medical mystery is revealed, or at least partially explained.

A case study in the Journal of Clinical Sleep Medicine and it helped confirm about the importance of vitamins to your sleep.

But a recent case study has shown that a patient with severe sleepiness and a vitamin D deficiency, vitamin D supplementation improved daytime sleepiness dramatically. The patient was a 28 year old female. She was suffering for about four months with excessive sleepiness. Her symptoms started slowly and continued to progress. She kept a standard bedtime between 10 and 11 pm, and she reported falling asleep within minutes. She would wake at 7:30 am and reported that she did not think that she was sleeping poorly. She would get her kids ready for school and then be back in bed by 8am until noon. She would then nap from 4 pm to 7 pm. She reported about 14 hours of sleep per day.

Her sleep study showed no signs of sleep apnea or other sleep disorder. During her clinic visit she showed no signs of narcolepsy, depression or anxiety. Her next day nap study was unremarkable. She reported muscle fatigue and pain, as well as headaches. Her lab work showed a thyroid in the low but normal range and she had low levels of vitamin D.

She was started on a vitamin D supplementation at 50,000 units once per week (IV) and within 2 weeks she started to see a decrease in her sleepiness and fatigue.

Vitamin D is actually considered a fat soluble hormone that can be received in foods (dietary sources and fish) or is self-manufactured by the skin after exposure to UVB light. A vitamin D deficiency has been noticed as a global issue and recently found in underserved populations, patients in northern latitudes, people with darker skin tones, the elderly, obese and pregnant or lactating women. Also very common in areas with a high degree of sunshine (this seems counter-intuitive, but think about all that sunblock!). Recent studies have linked vitamin D deficiency to metabolic syndrome, muscle pain, and even type 2 diabetes.

So why do we think it helped her sleepiness? It is really hard to say, but I have seen this in some of my patients. It could be linked to a decrease in sleep disturbing pain. Or vitamin D may be something that will help decrease a person’s drive for sleep. Only more research in this exciting new area can tell us.

Check with your doctor about vitamin supplementation. We all work hard, and eating right isn’t always easy – and even when we do, we may not get what we need from the food we eat. Our bodies actually make vitamin D, but we have to get enough sunlight to make that happen effectively.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™



Getting Up At Night To Pee Doesn’t Have To Be

February 5, 2011

NEW YORK(Reuters Health) – A new study finds that one in five U.S. men have to get up at least twice a night to empty their bladders — which for some could signal an underlying medical problem or even contribute to poorer health.

Known as nocturia, those frequent overnight trips to the bathroom can be a sign of a health condition, ranging from a urinary tract infection to diabetes to chronic heart failure. In men, a benign enlargement of the prostate can also be a cause.

For some people, the constant sleep disruptions can themselves cause problems — contributing to depression symptoms or, particularly in older adults, falls.

On the other hand, getting up during the night to urinate can also be normal. If you drink a lot of fluids close to bedtime, for example, don’t be surprised if your bladder wakes you up at night.

Nocturia also becomes more common with age. Part of that is related to older adults’ higher rate of medical conditions. But it could also result from a decrease in bladder capacity that comes with age.

The researchers found that  men age 20 and up, 21 percent said they had gotten up at least twice per night to urinate.

Nocturia was more common among African-American men (30 percent) than those of other races and ethnicities (20 percent). Not surprisingly, it also increased with age: Just 8 percent of men ages 20 to 34 reported it, compared with 56 percent of men age 75 or older.

Other factors linked to an increased risk of nocturia included prostate enlargement, a history of prostate cancer, high blood pressure and depression.

Nocturia can also be a side effect of some medications, such as diuretics used to treat high blood pressure. This study did not have information on men’s medication use.

Avoiding caffeine and a large fluid intake at night may help as may other lifestyle tactics, like adjusting your sleep habits.

One recent study of 56 older adults with nocturia found that lifestyle changes — including fluid restriction, limiting any excess hours in bed, moderate daily exercise, and keeping warm while sleeping — helped more than half of the patients significantly cut down their overnight trips to the bathroom.

There are also medications available specifically for overactive bladder and nocturia. Those include a synthetic version of a hormone, anti-diuretic hormone,  that keeps the body from making urine at night, a drug that blocks the ability of the bladder muscles to contract, and antidepressants that make it harder to urinate by increasing tension at the bladder neck.

The bottom line for men is that bothersome nocturia is something they should bring up to their doctor.

SOURCE: Journal of Urology, online January 19, 2011

Vaccinations for the Penis

February 5, 2011

You may have heard of the common STD condyloma or veneral warts which are caused by the human papilloma virus (HPV).  Women have a vaccine (Gardisil) to reduce the risk of condyloma and cervical cancer. HPV can cause certain cancers of the anus and penis in men, although those diseases are far less common than cervical cancer in women. An estimated 20 million Americans, men and women, are currently infected with HPV. Symptoms are rare, however, so most people have the virus — and pass it on — without realizing it.

Now boys and young men who receive the human papillomavirus vaccine appear to be at reduced risk of contracting the virus and developing the genital warts associated with the common sexually transmitted disease, according to a large international study published this week in the New England Journal of Medicine. Vaccinating men provides a benefit in that fewer men with HPV will also mean that fewer women are exposed to the cancer causing virus.

In an effort to prevent cervical cancer, which can be caused by HPV, public health officials have been encouraging young women to get vaccinated since the Food and Drug Administration approved the first HPV vaccine, Gardasil, in 2006. The vaccine has been approved for boys and men since 2009.

Gardasil is given in a series of three injections. In the study, which included more than 4,000 sexually active males between the ages of 16 and 26, roughly 0.5 percent of the boys and men who received all three shots developed genital warts during the subsequent 2 to 3 years. By contrast, about 2.8 percent of the study participants who received a placebo vaccine developed warts.

Earlier this week, for the first time, the American Academy of Pediatrics included the HPV vaccine on its list of recommended vaccines for boys.  Most health insurance plans cover HPV vaccination for both males and females.

Bottom Line:  HPV is a common STD.  Vaccines are now available to prevent the development of the lesions in men and reduce the risk of cervical cancer in men.  If you are a young man or have young sexually active boys, contact your doctor or pediatrician for more information.

Can Your Wallet Cause Back Pain?

February 1, 2011

Today I was providing care for a chiropracter.  I turned my back on him and he asked me if I had a wallet in my back pocket of my scrub suit?  When I told him it was he said, “That keeps me in business!”  I asked him to explain and he said that the thick wallets in men who sit most of the day on their buttocks and on their wallets causes a discrepancy that can contribute to back pain.  I thought that was absurd and then I Googled the topic on the Internet and found this article from the New York Times in 2006 by Anahad O’Conner which confirmed his comment.

THE CLAIM Keeping a wallet in your back pocket can cause sciatica. 

Ms. O’Conner said that a wallet stuffed with business cards or scraps of paper might seem like more of an eyesore than a health hazard.

But one old bromide holds that a thick wallet — or even one that’s not so thick — can harm the lower back for those sit on it for too long. And while experts says the fears are probably exaggerated, the wallet can definitely carry some hazards.

Although it was popularized by an episode of the ”Seinfeld” series in the 1990’s, the phenomenon was first described in a brief article in The New England Journal of Medicine in 1966, when credit cards were beginning to proliferate.

The report, about a lawyer who suffered aches and pains in the left leg, not far from a wallet growing thick with charge cards, referred to the condition as ”credit-carditis.”

Although that term never quite caught on, doctors say the condition has become increasingly common. Its onset is gradual, caused by an object that presses on the piriformis muscle in the buttocks, which is connected to the sciatic nerve, which runs down the leg.

Over time, a person can develop radiating pain in the back and hip area.

”Just the other day, I had to tell one patient with back pain to remove at least 20 years of stored data from his wallet,” said Dr. Gerard P. Varlotta of the New York University School of Medicine.

Wallets are not the only culprits. Numerous case reports have linked the condition to various back-pocket objects like large handkerchiefs and golf balls.

THE BOTTOM LINE — Keeping a thick wallet or object in the back pocket can gradually cause sciatica.