Acetaminophen is Getting a Closer Look

June 30, 2009

Acetaminophen (ACM) is the most popular over the counter drug for pain relief in the United States. There was an estimated twenty nine billion units sold in 2005. Twenty nine BILLION! Whoa, that is a lot.

The FDA recently released a report urging stronger warnings and stricter dose limits for drugs, like Tylenol® that contain ACM. The concern here is the apparent liver failure that people are experiencing after taking drugs with ACM in it. Research has shown that hundreds of people are experiencing liver failure and approximately 100 die each year from overdose whether intentional or unintentional.

One of the major problems is that people don’t realize how many products contain ACM. There are currently over 200 products that you may not even think about. Products like….Robituson®, Alka Seltzer Plus® and Sudafed®.

When the max recommended amount is 4,000 milligrams, one can see how it is not too hard to exceed that when one isn’t feeling well.

Now onto the rant portion of the blog.

I am not licensed to dispense drugs, I cannot legally give you advice, etc. What I am about to share is my opinion and should no way be construed as advice from an MD.

In my humble opinion most of this stuff is crap. It is bad for you, it covers up symptoms and does damage to vital organs. Do I understand there are situations where you need to take it…of course.

However, there is a large portion of the population that are taking these drugs for the completely wrong reason. If you need to take 4 Tylenol® before tennis and 4 Tylenol® after tennis just so you can play….STOP PLAYING.

Let’s assume that it is your neck that is bugging you. If you take the 4 Tylenol&reg before and after, you can swing the racket pain free. If you don’t you can’t. Now we know the pills aren’t fixing the problem, they are just covering it up.

One question then, “What is causing the pain?”

Shouldn’t we look into that?

“Oh, Doc I don’t have the time”….”It will go away”……”I think it is genetic, my mom used to get this when she played tennis”

Look you may not have the time now, but I can assure you, if you keep covering this problem up, you will have time in the future……your body will make sure you get it fixed.  I have seen this too many times.  What starts out as a small problem, can very easily escalate into a major problem if you keep patching it up.

End rant.

The experts say these drugs are safe if taken as they are intended and I don’t doubt them. When you sell 29 million units and only a small number of people get real sick from them, the problem is small. What I am more worried about is the prevailing attitude that we can just patch stuff up and it will go away.

Sometimes it will, sometimes it won’t, do you want to gamble with your liver, kidneys, etc?


Marijuana May Cause Cancer

June 24, 2009

There has been a long held belief that marijuana, while known to cause certain conditions, did not cause cancer. A ruling from California and a latest study are challenging that belief.

The state of California recently added marijuana smoke to the list of chemicals that regulators claim causes cancer. A spokesman for the state said that says the state agency found marijuana (cannabis) smoke contains 33 of the same harmful chemicals as tobacco smoke. Where many studies have shown that tobacco smoke damages DNA in a way that boosts risk for lung and other cancers, until now, it’s been unclear whether cannabis smoke could do the same.

Quick physiology lesson. Cancer is any malignant growth or tumor caused by abnormal and uncontrolled cell division. See when a healthy cell DNA divides everything is cool, when a cell DNA divides abnormally, there is now a problem.

A recent study by Scientists at the University of Leicester contends that marijuana (cannabis) smoke alters DNA, the genetic material located in cells of the human body. Some forms of DNA damage can lead to cancer.

Using newer chemistry techniques, researchers showed that a dangerous chemical, acetaldehyde, is now found in marijuana smoke. It was previously thought that it was only found in tobacco smoke. In a lab setting this chemical caused DNA damage.

The discovery suggests that marijuana smoke may be as harmful, or perhaps even more toxic, than tobacco smoke. In fact, study researchers say that smoking three to four marijuana cigarettes a day causes as much airway damage as smoking 20 or more cigarettes a day.

The state of Massachusetts recently “decriminalized” marijuana. If you get caught with less than an ounce, you get a fine, much like a building code infraction. Where I work with an eclectic group of people, including a lot of 18-24 year olds, I asked them if this decriminalization would make it more likely they would smoke pot.

For the most part people said they wouldn’t change their habits, based whether or not it was decriminalized. These same people did believe, however, that smoking marijuana was not that bad for you.

If you smoke pot or have a friend, child, etc., make sure they take a look at this article. They may be doing more harm to themselves than they think.

The findings of the study I mention above appear in this month’s issue of Chemical Research in Toxicology.

ADHD Drugs May Be Linked to Rare Deaths

June 16, 2009

Currently there are approximately 2.5 million children and 1.5 million adults taking stimulant medication.  The two most popular meds are Ritalin and Concerta, with ADHD being the most common condition that they treat.

For those of you who may not know ADHD is short for attention deficit hyperactivity disorder, which can best be characterized by a persistent pattern of impulsiveness and inattention.  It is diagnosed twice as much in boys as it is in girls and  a popular treatment method is to put the child on either Ritalin or Concerta.

After years of speculation and rare case reports, a study suggests that this stimulant medication may have played a role in a handful of cases of sudden, unexplained death in children and adolescents.

This is the first study to suggest that these stimulants may pose a risk to children, albeit a very remote one, without pre existing heart problems.

What these drugs do is cause an increase in blood pressure and heart rate.  In the past this was thought to be no big deal to children, they may be starting to rethink that.

A study compared children who died unexpectedly vs. children who died in an auto accident.  What they found was 1.8% of the children from the unexpected death group were on a stimulant drug.  In the group of children who died from an auto accident, the number of children on that drug was 0.4%.

What the doctors are now recommending is two fold if your child is told they need to be put on a stimulant drug like Ritalin or Concerta:

  1. Please give your doctor a detailed family history; do not gloss over this.  A ton of useful information comes out of these conversations.  Please make sure you pay particular attention to heart attacks, strokes or any form of heart disease.
  2. Ask your doctor for an EKG for your child.  A recent study of 1100 children found that 2% of those children screened had an abnormality.

In 2008, the American Heart Association recommended that doctors consider routine electrocardiograms before starting children with ADHD on stimulants or other psychotropic medications.  These EKG’s may help to detect cardiac abnormalities that would increase a child’s vulnerability to sudden heart problems.

Shameless chiropractic plug.  If you are considering putting your child on one of these drugs, please give chiropractic a shot first.  I cannot tell you how many times I have seen children get helped by going to the chiropractor.  I have teachers at school now who proactively seek parents out and tell them to get their children adjusted.

If you currently have a chiropractor, ask them if they will check your child.  If you need help finding a chiropractor near you, shoot me an email and I will help you find someone.

Doctors Ghost Writing Articles. Is That Unethical?

June 13, 2009

The practice of hiring someone to write an article and you put your name on it as if you wrote it is called ghost writing.

Recently the large drug company Eli Lilly (EL), inventor of Prozac amongst other things, has come under fire for using ghost writers to market a drug.   According to unsealed company files they hired scientists to write these articles for publication and then asked doctors to put their name on them, passing them off as their own.

Sleazy, maybe a little….unethical, I don’t know, it is a tough one.

EL is getting accused of hiring scientists to write favorable articles.  If that bears out to be true, then yes that is extremely unethical.  Now if they hired non biased scientists and asked them to write articles on the up and up then the situation gets a little murkier.

Here in Boston we have had a bunch of journalists get fired over not citing sources when reporting something.  They passed the info off as theirs when it clearly wasn’t.  It is called plagiarism.  Now we appear to have the same thing going on with drug marketing.

As a total aside, is anyone else horrified at how much of this marketing goes on?  Aren’t our doctors supposed to be the experts at this?  Could you imagine being an MD and having people show-up with ads from some magazine that promises them better…….  and they have to explain to them why this drug may or may not be good for them.  Way to bog the system down.

What is the solution?  Transparency in all medical marketing and advertising.  If a ghost writer wrote an article, don’t let a Doctor pass off that he or she wrote the article.  Why not have it stated clearly that Doctor X reviewed the article but didn’t write it.

This of course brings up one other question.  If Doctor X endorses an article for a drug that turns out to harm people should Dr. X be held liable?

For that I vote yes.

TV Reduces Young Kids’ Language Development

June 8, 2009
Child spellbound by TV

Child spellbound by TV

So TV reduces children’s language development?  Funny, some of the words that have come out of my young son’s mouth are 100% attributed to TV.  I mean where else can a 6 year old learn about priapism?  Well I am sure that erectile dysfunction is a popular topic around the dinner table, most people I know stick to school and sports when talking to their children.

The gist of this article is that the more a child watches TV the less they are interacting with their parents or siblings. No doubt that is true.  They followed a bunch of children around with a digital listening device and measured how much they spoke or heard people speaking while watching TV.  The results showed that each additional hour of television exposure by the child was associated with a decrease in 770 words (7%) that the child heard from an adult during the recording session.  The study also showed less speaking while watching TV.

The moral of the story is, in case you don’t already know, turn the TV off and watch your interactions with your children go up.  Unless it’s NASCAR, then crank the volume, the race is on!!!

Can Overtraining Your Knees Lead to Hip Pain

June 2, 2009

Hip Labrum

In the last year some of baseball’s biggest stars have had to spend time on the disabled list with torn hip labrums.  This injury did not exist 10 years ago prompting baseball’s medical staffs to scramble to come up with the reasons behind this.

One trainer was quoted as saying he has never seen anything like the rash in hip injuries like he has seen in the last two years. 

While the studies aren’t out yet, there is no shortage of debate as to what is causing this sudden increase in labrum surgeries.  Some believe that due to the prevalence of ACL tears many sports medicine people recommended strengthening the legs which would in turn strengthen the knee, thus preventing tears.  These experts think that the overtraining of the legs could be leaving the hips more vulnerable to injury.

There is also speculation that children may be playing sports too early, leading to improper bone development.  As a hockey coach I insist that my players take at least a couple of months off per year….no excuses, you need the rest.

Let’s take this one step further.  As a chiropractor one of the things I despise is the baby walker or exersaucer.  These two products force babies into upright positions long before they are ready for them.  Could this lead to abnormal bone development?  Absolutely no doubt.  See the body grows bone where it senses stress, this is known as Wolf’s Law.  This Wolf’s Law is the same reason we tell older people to exercise to prevent osteoporosis.

If your hips are starting to bother you and you are working out, especially your legs, make sure you talk to me about it and together we can come up with a strategy to keep you off the operating room table.