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Hi doc,i am female of 21 my weight is 80kgs my dietary intke is also very balancd. I eat all healthy things but stil my weigh is not shedding. hlp me?

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I was taking a medicine for a month that made my testosterone raise and I experienced hair loss so I quit taking it. will my hair grow back?

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My eyes is blurred . How can i get a better vision .

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I got conjucntivitis?

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Kindly explain me the difference between Sustained Release & Extended Release in drugs?

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Is der is any exercise to improve the length of pennies?

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USPSTF Gives D Grade to Vitamin D

Clever title, huh?  Kinda made you want to read this post, right?  We're living in such a fast-paced world that we learn via sound bites and 140 characters at a time.  We want & need every morsel of information summarized neatly into easily digestible bits.  Unfortunately, truth & science aren't always so malleable to this way of learning.

Case in point is the United States Preventive Services Task Force's Clinical Guideline regarding vitamin D & calcium supplementation to prevent fractures in adults as published early online yesterday in the Annals of Internal Medicine.  Up until recently, we lumped everything & everyone together stating that calcium 500-1,000mg daily + vitamin D 400-800 units was good, regardless of age, gender, and risk factors.

Well, as the USPSTF attempted to explain in their guidelines, the evidence for primary fracture prevention in both men and premenopausal women is woefully scant.  Thus, they weren't able to analyze risks vs benefits.  And when it comes to noninstitionalized postmenopausal women, the data for benefit in primary fracture reduction using calcium doses greater than 1,000mg daily and vitamin D greater than 400 units daily, was inadequate to analyze risks vs benefits.

Before I get to the USPSTF's D grade, let's be clear as to how finely they're dividing the population & parsing their words, almost as if in legalese.  For instance, this Recommendation Statement only addresses primary fracture prevention, that is in those men & women who've never had an osteoporotic fracture before.  In this statement getting all the press, there's no attempt to address secondary prevention in those who've already sustained a hip or vertebral or wrist fracture.  Furthermore, there's no mention of institutionalized postmenopausal women, just noninstitutionalized postmenopausal women & premenopausal women (along w/men).  

So it's for those non-institutionalized postmenopausal women who take less than 1,000mg daily of calcium and/or less than 400 units daily of vitamin D for whom the USPSTF was unable to find any benefit.  Worse there was some concern over an increase risk for kidney stones.  Thus they recommended against this dose in this group since they can't recommend something that offers no benefit while putting that person at risk, no matter how small.  Check out the editorial for more info.

If this appears to be an about-face from their December 2011 meta-analysis & June 2012 draft, both published in the Annals of Internal Medicine, read the conclusion carefully: Combined vitamin D and calcium supplementation can reduce fracture risk, but the effects may be smaller among community-dwelling older adults than among institutionalized elderly persons. Appropriate dose and dosing regimens, however, require further study (italics mine).

Bottom line: as much as I want to be able to make a blanket statement about vitamin D & calcium, the evidence doesn't allow for it.  So if you're a community-dwelling postmenopausal female, don't take small doses of calcium (less than 1,000mg daily) or vitamin D (less than 400 units daily).  But what about larger doses? What about men, institutionalized postmenopausal women, and premenopausal women?  What do they do?  Either wait for studies to be published (if they're more concerned about potential side effects) or "Go Big or Go Home".

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How can I get more duration in sex?

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I am 163cm and 70kg, am i obecite?

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I am 21 years old and my height isnt satisfactory..I know itz difficult now to increase my height..but what can I do anyway just to try and increase?

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Mediterranean Diet Prevents Heart Disease in Those at High Risk

Before getting to the good stuff today, let's remind ourselves about the difference between observational studies (in all their various guises) and randomized controlled trials.  The former can only assist in developing hypotheses; they can only make associations & demonstrate links.  They're the medical version of hearsay evidence (in my non-legal mind).  Contrast that w/RCTs which actually demonstrate cause & effect, which is what any good prosecutor or district attorney wants to do, prove that the defendant committed the crime beyond a shadow of a doubt.  At the conclusion of the trial, there should be no doubt in the jury's minds that perhaps the defendant was just in the wrong place at the wrong time.

Along those lines, all prior evidence regarding the benefit of the Mediterranean diet has been observational in nature.  We monitor a bunch of folks as to what they claim to eat and see what happens to them after some given period of time.  We may ask them at the start how they eat (prospective observational study) or at the end (retrospective observational study).  We can look specifically for a cohort of those cases who eat a Mediterranean diet and then compare them to controls, those who are similar in every way except nutrition to the cases.  

But no matter how fancy the statistics, in the end, these studies only demonstrate support of the idea that eating a Mediterranean diet is good for your heart.  It doesn't matter how many of these studies are published, how many participants are involved, how long the studies last, none of these observational studies prove that Mediterranean diet prevents heart disease (the Lyon Diet Heart Study did demonstrate benefit in those w/known heart disease but that's secondary prevention).

Until yesterday, when a randomized controlled study was published in the New England Journal of Medicine in which the authors demonstrated that a Mediterranean diet supplement with either extra-virgin olive oil or with mixed nuts lowered risk for cardiovascular events compared to those who consumed a control diet (basically advised to reduce fat intake).

The authors found 7,447 participants (55-80yo of whom 57% were female) who were at high risk for but had no evidence of cardiovascular disease at study onset and randomized them to either a control diet (advised to reduce fat intake) or to Mediterranean diet supplemented by either extra-virgin olive oil or mixed nuts.  Due to the dramatic reduction in heart attacks, strokes & death from cardiovascular causes, the trial was stopped early after just under 5yrs.

So here's a reasonable RCT demonstrating cause & effect, that eating a Mediterranean diet supplemented with either extra-virgin olive oil or mixed nuts can prevent heart disease in those at high risk but w/o actual known disease.  Let's all start eating this way!  But wait, what is this Mediterranean diet?  Besides the high intake of olive oil, it's also high in fruit, nuts, vegetables & cereals; moderate in fish & poultry; and low in dairy products, red meat, processed meats & sweets.  The oenophiles will love this part: wine is consumed in moderation with all meals!

Is this the end of the story?  No, because it's the first of its kind.  Furthermore, it was performed on a group at high risk for heart disease.  Would it work for those at lower risk?  And as the study was of Spanish nationals, would the results be generalizable to non-Spanish men & women.  And what of the age group?  Would this diet work in a younger cohort?  After all, why wait until middle age to start eating in a health fashion?  So while we now have proof of cause & effect that the Mediterranean diet can prevent heart disease in middle-age Spanish men & women, we've only touched the tip of the iceberg.  We now have to explore all that exists under the water.

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Lab:LDL:159,Cholesterol:267,Triglycerides:347,HDL:39,CHOL/HDL:6.8,TSH:9.79,Free T4:0.80,Testosterone:Total:78/Free:3.1, Eosinophil:7.1.Recommendation?

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Is there anything out there that can help my husband to want to have more sex or to last longer in bed? Like pills??

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What if I miss Yasmin for 5 days , can I have sex ?

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Tender nipples , viens in breast . Breast feel heavy , terrible mood swings . What could this be ?

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Can gerd cause insomnia?

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Hello sir hope u are right I have ejeculation problem when I touch my girl friend I cum I don't enjoy my sex life after long time I don't like sex?

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Can my synthroid medicine affect how well my depo provera shot works?

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Is a male condom more likely to break if female is virgin because of the tightness?

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How many benadryl pills can I take at one time?

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Is memory loss from dementia caused by multiple mini strokes different from the type caused by Alzheimer's? In what way?

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Is it possible to develope std even if a person is not having sex for a year already?

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Im getting pain on my ride side of my eye off an on?

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A recent pets can revealed that an 82 year old has significant brain loss and the brain is about 29% functioning. Is that normal for that age?

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Ive been trying to loss weight now for 5yrs ive tried everything from gym, medication, herbal, teas... Ect nothing seems to work. Help!!

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So I had tooken plan b and I got my period but I'm feeling plan on my stomach .feels empty even though I eat does it mean I'm pregnant?

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How long after taking birth control pills can I have unprotected sex?

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Middle of lower back hurts very bad why? It started hurting me bad today at school, so bad that it hurts to bend. Haven't dont exercise lately. 16yrs.

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Creatinine 1.3 Is it bad?

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My nipples are really sore what does this mean?

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So what choices does a 45yr old do if she finds out that she is pregnant and guezsing4 to mi. Along with no doctor yet and is not in best of health?

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Can altabax be used on a dog?

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I have a pituitary tumor which led to amenorrea,diabetes,early menopause, fatigue,inability to lose weight hair thin an dr. Not helping wat to do?help

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How can taking coreg 12.5mg 2 a day cause erectile dysfunction?

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Does mirtazapine cause itching all over the body?

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I m a smoker, at least 3-5 cigg per day and go on smoke at age of 46. Is it ok?

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After using walgrees saline nasal spray, I still have sinus pressure. Should I switch to Afrin nasal spray? I didn't really use the nasal spray often.

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