My 2 Cents

Friday, August 23, 2013

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Q&A Session at HealthTap.com

LMP on July 9th month before that was June 11th (due date April 15th) when did I conceive?

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Q&A Session at HealthTap.com

Is it ok to take spironolactone, fenugreek and turmeric at the same time?

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Thursday, August 22, 2013

Q&A Session at HealthTap.com

I have a low testerone and low sperm cout is testim 1% good for my condition?

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Q&A Session at HealthTap.com

What other treatment options are there for hypogonadism if Androgel causes me urinary problems?

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Q&A Session at HealthTap.com

Hello, I recently had a testosterone test done which was 386ng. im taking Androgel 1.62% and now experiencing erection difficulties?

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Mirror, Mirror, On the Wall . . . Part 4

Wouldn't it be great if we had a mirror on the wall which could tell us who's the fairest of all? But then there'd be no need for television shows like America's Next Top Model. Personally, I'd prefer the crystal ball that could tell me which stock to buy or sell, and more importantly, when! Of course, neither of these prediction devices exists, at least not where I live. But we continue to be enamored as a society about developing models (no, not those kinds) to predict the future. Case in point was yesterday's look at diabetics' risk for developing dementia.

Well, one of the bigger risks for falling is living long enough, right? If it's a simple slip & trip w/o injury, then no big deal. But for our elderly, we worry about serious injuries especially conditions like hip fractures which portend tremendous disability. But there are those who recover amazingly quick to their premorbid condition. So of course, we want to know what sets them apart, right?

Well, in a prospective observational study published earlier this week in JAMA Internal Medicine, the authors concluded that post-fall recovery was linked to pre-fall function. No fecal matter, Sherlock! In other words, as if you couldn't already have guessed, the less disabled & therefore more functional you were prior to your fall, the better your chances of recovering quickly. To arrive at their conclusions, the authors followed for 14yrs 754 community-dwelling participants avg 86yo, all of whom were not disabled in their activities of daily living at baseline, and of whom 130 sustained a serious fall.

But as one can imagine, there's a tremendous variation even among those who can perform their basic ADLs. So the authors scored each participant according to 4 ADLs, 5 instrumental ADLs & 4 mobility tasks. Those with least disability were most likely to recover quickly & totally. Those with greatest disability were most likely not to recover. Mortality also appears to be associated w/disability.

One other point: aside from those with gradual disability over the year preceding the fall, most elderly are relatively stable in their functional status. But I would recommend that we should encourage them to exercise regularly, focusing not just on endurance (aerobics) but also strength, balance & flexibility. Better to prevent the fall than have to recover afterwards.

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Wednesday, August 21, 2013

Q&A Session at HealthTap.com

Recently per scribed androgel 1% how long before I feel more energy?

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Q&A Session at HealthTap.com

I switched from androgel to testosterone injections. Dr is only GI king 1 injection/month Should it be more often? T level is 290

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Q&A Session at HealthTap.com

Can use of antibiotics results in low testosterone levels?

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Mirror, Mirror, On the Wall . . . Part 3

Knowledge without action is futile. Abu Bakr

Do you really want to know your future? But if you now acted upon that knowledge in a manner in which you would not have, had you not known your future, haven't you just altered your future? It's a bit of a philosophical conundrum played over & over again in different movies under the guise of time travel. In it's most common form, the protagonist is warned not to change anything in the past during time travel lest s/he alter the present/future.

But with that said, what if you made use of the information for the better. Case in point is a study published this week in Lancet Diabetes & Endocrinology in which the authors report having developed & validated a 10 year risk calculator that predicts dementia risk in those with type 2 diabetes. Using a model derived from microvascular disease, diabetic foot, cerebrovascular disease, cardiovascular disease, acute metabolic events, depression, age & education, the authors were able to predict dementia risk with reasonable accuracy. Those with the lowest score had only 5.3% risk of developing dementia compared to those with the highest score who had a 73.3% risk.

My question is this: why go through the trouble of estimating/predicting your risk for developing dementia if you're not going to do anything to lower your risk? The calculator & prediction model is not immutable. You're not destined to repeat your errors if you learn from them. Improve your nutrition. Get physically active on a regular basis. Optimize your risk factors as noted above. Take control of your future.

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Tuesday, August 20, 2013

Q&A Session at HealthTap.com

Will 100mg of testosterone help me build a decent amount of muscle and burn fat?

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Q&A Session at HealthTap.com

How long does it take to build my testosterone?

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What could be "testolic testosterone propionate 100mg" side effects?

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Mediterranean Diet, Glycemic Load & Diabetes

We know from several recent posts that the Mediterranean Diet is good for your heart & your brain. It turns out that the more you adhere to the Mediterranean Diet, the lower your risk for developing diabetes, as demonstrated by an observation study published early online this month in Diabetologia. You remember the Mediterranean Diet, right? Plenty of fruits & vegetables. Nuts & legumes. Olive oil. Nuts & legumes. Whole grains & cereals. Some fish & chicken but minimal beef & dairy. And let's not forget the wine in moderation (averaging not allowed). What's so special about this particular "diet"? Especially because "Mediterranean" refers to a geographic region that is encompassed by multiple & varied ethnicities, religions & cultures such that each has its own variation on a theme.

So even as we attempt to figure out what makes this way of eating so healthy, others have looked at the glycemic index as a means to replicate benefit on a more global scale. Recall that glycemic index refers to a foods innate ability to raise blood sugar. This value doesn't change. Glycemic load, which is calculated as glycemic index multiplied by serving size, takes into account how much food one is consuming. Thus, this value can change. And as the 22,295 Greek participants followed for 11+yrs showed, glycemic load is associated risk for diabetes. So pay attention not only to what you eat but how much of it you consume. It's not just quality but quantity, too.

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