HealthTap + Avvo = HealthTap

Wow!  Over 1,451 links on my website just went poof!  Back in January 2011, I started answering health-related questions on a newish website, www.avvo.com, that was originally focused on rating attorneys but had decided to expand into the physician arena.  Every weekend, I'd try to spend some time composing thoughtful (so I hoped) answers to folks who'd posted online.  More recently, I stumbled onto www.healthtap.com and started answering health-related questions there, too.  Instantly, my stress doubled (I'd made the executive decision to stop posting directly on a 3rd site) since I had twice as many answers to compose.  

But I'm just an unpaid volunteer who has no idea of the machinations behind the scenes so you can imagine my surprise when I received an email 2 days ago stating that Avvo was dropping its physician ratings in order to focus on attorneys.  Instead, they had handed off their physicians to HealthTap, the new kid on the block.  I didn't think anything of it until I receive a confirmatory email from HealthTap yesterday stating that they'd acquired Avvo Health.

So you can imagine my surprise when I went to click on one of my Avvo answers only to find that it lead to nothing but a page directing me to HealthTap.  In fact, all 1,451 of my Avvo answer links lead to this same page.  If I conservatively estimate that each answer (I didn't post the 1st 88 answers) takes 5 minutes to compose, type & post, that's 120+ hours down the drain.  Truthfully, it takes much more than that since Avvo allowed me to add links to my answers (plus it takes time to post the questions to this website and then sum it up in a 140 character tweet).  And you know me - I like to have published proof to support my recommendations so most of my Avvo answers required additional time to find requisite links.  Obviously I'm not a happy camper right now!  RIP Avvo Health.

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Q&A Session at HealthTap.com

Please help clear this argument between my friend and I...can some one have Erectile disfunction when he is coinfected with hiv and hepatits same day?

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Q&A Session at HealthTap.com

can you fly with asthma?

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Q&A Session at HealthTap.com

My weight is 110kg and height is 6 feet.Ijust want to reduce my weight to 90 kg .can u sugest a diet plan to do it?

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Q&A Session at HealthTap.com

i have very serious cold and has taken me months to cure but to no avail what do i do or can u give me a prescription,am dying pls?

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Diabetes Risk: Caffeine or No Caffeine?

I've spent the last 3 days reviewing studies of non-pharmacologic options based upon human outcomes, so I thought I'd end the week looking at the effect of beverage choices on diabetes risk.  Given that the risk (prevalance) of diabetes continues to increase, it seems appropriate to consider what we can easily do to minimize risk, since no one seems to be interested in healthy eating & regular physical activity, but rather in quick fixes such as pills & dietary supplements.

It turns out that an observational study was published early online 2 weeks ago in the American Journal of Clinical Nutrition in which the authors concluded that sugar-sweetened beverages were associated with higher risk of diabetes while coffee, regardless of caffeine content, was associated w/lower risk of diabetes.  To arrive at their conclusions, the authors followed 74,749 women from the Nurses' Healthy Study & 39,059 men from the Professionals Follow-Up Study for over two decades.  Beverage consumption was divided into caffeine vs caffeine-free as well as sub-groupings of sugar-sweetened vs artificially sweetened beverages, basically a 2x2 analysis performed separately for both men & women.

When all was said and done, the only anomalous finding that stood out was the consumption of caffeine-free artificially sweetened beverages being associated with higher risk of diabetes in women.  Bottom line: caffeine vs caffeine-free isn't as important a distinction as sugar-sweetened vs artificially sweetened beverages when it comes to diabetes risk in both men & women.  But remember that this was an observational study and as such, is only good for developing hypotheses as it cannot prove cause & effect.  Regardless, I think it prudent to err on the side of caution and consider switching to coffee (not Starbucks' frappuccinos).  And in case you've forgotten, don't forget that coffee consumption has also been linked to lower risk of heart failure, prostate cancer and basal cell skin cancer!

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Q&A Session at HealthTap.com

ive been coughing up phlegm all night and finally coughed up vomit and black phlegm? i have been a smoker for 5 years now

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Q&A Session at HealthTap.com

Are there any home remedies to get rid of acne that are safe and make your skin much more smoother?

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Q&A Session at HealthTap.com

I'm 31 weeks pregnant and has been in labor twice. What can I do to jump start my labor. I'm already 3 cm dilated?

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Is Fish Really Brain Food?

One of the biggest complaints about or against traditional allopathic medicine is that it's reactive & defensive, that all traditional physicians do is treat disease, rather than prevent it, that we only prescribe medications produced by those evil pharmaceutical companies.  Instead, these non-traditional physicians & health care providers offer you private labeled nutraceuticals w/miraculous claims but w/o support of human data.  So I started out this week thinking about all the non-prescription options that might improve our health.

Well, when you get down to it, the two things that have been proven to improve our health is better nutrition and regular physical activity.  Yet, despite this vocal anti-medicine minority, the vast majority are still looking for a quick fix.  That's why it was so serendipitous that I stumbled upon those two B vitamin studies looking at their effect against diabetic neuropathy and association w/decline in physical function.

Tonight, I just stumbled upon yet another potential quick fix in a cross-over placebo controlled study published early online in Nutrition Journal in which the authors concluded that fish improved cognitive performance in healthy adults in just 5 short weeks compared to placebo.  They reached their conclusion by offering 3g/d of fish oil to 40 healthy middle-aged to elderly participants 51-72yo w/body mass index 20-30kg/m2 for 5 weeks, followed by a 5 week washout period in a randomized fashion.

For those of you interested in improving your cognitive function in just over a month by replicating this study, the participants took 5 capsules of fish oil daily which contained a total of 1,500mg EPA & 1050mg DHA along w/450mg unspecified omega 3 fatty acids.  Realize that your average 1g dose of fish oily is not nearly as concentrated and contains just 180mg EPA + 120mg DHA, so you'd need 8+ capsules to get an equivalent amount of EPA & DHA.  Think about that when you purchase your next bottle of fish oil!

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Q&A Session at HealthTap.com

my sister threw up, but felt fine after but the stomach aches keep coming back? what does she have? will staying away and washing hands keep mehealthy

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Q&A Session at HealthTap.com

I have sighns of pregnancy but still have negative hpt test. I will be 2 months tomorrow.?

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Q&A Session at HealthTap.com

Sugar over 600 severe nausea light abdominal pain little vommiting no ketones in urine dry mouth n lips taking insulin type 1 ??

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Quick Fix for Physical Function in Elderly?

Yesterday we looked at a study suggesting that MetaNx, a medical food comprised of L-methylfolate, pyridoxal-5'-phosphate, and methylcobalamin, led to a decrease hospitalization rate in those suffering from diabetic neuropathy.  Coincidentally, in a cross-sectional study to be published in print next month in the American Journal of Clinical Nutrition, the authors concluded that homocysteine & folate (but not vitamin B12) were linked to physical & functional decline.

Specifically the authors evaluated 796 participants (avg 65yo) in the Singapore Longitudinal Aging Study.  After taking into account just about everything, high homocysteine & low folate were linked to decrease in physical and functional ability, as measured by Performance Oriented Mobility Assessment and self-reports of instrumental activities of daily living.

However, we need to assess the link between homocysteine, folate & physical/functional decline since all the conclusions drawn suggest a decline but no proof as to which caused the other, eg did an increase homocysteine & folate decrease cause the decline in function or did the decline in physical function cause the increase in homocysteine & decrease in folate?  As an observational study, this can only suggest hypotheses for us to research but is clearly no proof of cause & effect.  Something to mull over . . .

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Q&A Session at HealthTap.com

What happens when your uvula gets stabbed by a fork?

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Q&A Session at HealthTap.com

If your having upper left stomach pains and trouble eating and drinking for mnths an the doc says there's nothing wrong what could it be then?

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Q&A Session at HealthTap.com

I was on nuva ring for about two months and I've been wanting to get pregnant for the past month, would being on nuva ring effect me getting pregnant?

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Q&A Session at Avvo.com

For 3 days now on the right side of my throat has been sore and i have white things on it and at times its hard to swallow

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Q&A Session at Avvo.com

Have severe constipation and pencil thin when i do go .Swelling on right side.I an a female 78 years old this has gotten worse

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Q&A Session at Avvo.com

Why drastic rise in triglycerides in just one year (from 129 to 241) , when HDL went down, LDL went up during same time period?

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Quick Fix for Diabetic Neuropathy?

We're all looking for that quick fix.  Manufacturers know that and inundate us daily, if not hourly, with promises of instant weight loss, age defiance & untold riches.  As I'm sure you're well aware, these miracles in a bottle do not exist, at least not for the average person.  Sure, if you're one of the very few for whom your weight gain is truly due to a grossly underactive thyroid, optimal supplementation w/levothyroxine should help you shed some unwanted weight.  Likewise, if you're that one in a hundred million who holds the winning lottery ticket, you can get rich quickly.  But for the rest of us?  Everything comes down to hard work.

But let's take a step back and look again, specifically at diabetic neuropathy, that incredibly painful & debilitating complication of poorly controlled diabetes due to high sugars' damaging effect on our nerves, giving us this numb yet tingly pain, sometime associated w/ice cold sensation, other times burning hot, still others described as electrical shock-like pain.  

Ignored long enough, this pain can lead to diabetic ulcers and can take a tremendous toll on the patient in terms of lost productivity as well as medical costs of evaluation, treatment & even hospitalization.  So it's welcome news that a case-control study was published in the September issue of the American Journal of Pharmacy Benefits in which the authors noted that regular consumption of L-methylfolate combination therapy was associated w/lower all-cause hospitalization as well as lower disease-related costs.

The authors arrived at their conclusion by comparing 814 patients w/diabetic neuropathy prescribed L-methylfolate combination vs 814 matched controls not prescribed L-methylfolate combination therapy.  Before you jump out of your chair and call your family doc or ask your local pharmacist about this medical food, know that the manufacturer sponsored the study and one of the authors worked for a research team that has a relationship with the funder.  None of this should disqualify the study, but it obviously affects your interpretation if you're especially cautious & cynical like me.  In the meantime, as we await an NIH sponsored randomized controlled trial, I think the benefit of avoiding a hospital stay overrides the risk of any potential side effect from these vitamins.

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