Health© 2000 Richard C. Rhodes
Click on a Topic to go directly to that topic. Vitamin E - The Whipping Boy of Supplements I can think of no other vitamin or supplement that gets more confused press than Vitamin E. How ludicrous it was when ABC News ran a story about how Vitamin E might cause heart attacks. On ABC Online for March 17, 2005, was this: ".... researchers found that not only did vitamin E supplements fail to prevent heart attacks and cancer, but that they may actually increase the risk of heart failure. All patients had vascular disease or diabetes and were given either a placebo or a daily dose of 400 IU of natural source Vitamin E." I think it was this report that caused Dr. Tim Johnson of ABC News to come on the evening news and say that he was no longer going to take Vitamin E. Every month there is a "study" that says Vitamin E may cause Cancer, lung Cancer - whatever.
On January 22, 2008, Dr. Jay Adlersberg, the resident doc on WABC-TV in New York City, reported on a study that indicated that low levels of Vitamin E may account for a decline in physical abilities. The researchers from Yale compared nutrient levels in blood with the ability to perform basic skills such as walking, standing up from a chair and balancing. Out of nearly 700 people studied, about half experienced a decline in physical function within three years. The study found low levels of Vitamin E were associated with this decline. This Vit E bashing is curious. The PDR for nutritional supplements devotes more pages to studies that show a variety of benefits of Vit E than any other entry in the book. June 29, 2007 Store-brand Health-Care Products Versus Name-brand In "The View From the Outback" for March 15, 2003, I wrote an article: "Why Are You Buying Name-Brand Aspirin?" In that article, I wrote: "Most of the generics in major retail outlets conform to the USP standard, which ensures that the ingredients and the safety of the manufacturing process are essentially the same." In recent months, I have noticed that many store-brand products I checked, such as aspirin, ibuprofen, acetaminophen, etc., did not have the USP marking on the box or bottle. I did some digging. Perrigo Co. has about a 65% share of the market for "store-brand" products. They have about 100 customers! Some of their accounts are Wal-Mart (look for the Perrigo name on Equate products), Walgreen, CVS, Kroger, and Albertsons. In a conference call (some time back) to financial analysts, Perrigo CEO Joseph C. Papa told the analysts that Perrigo has about a 65% market share in store-brand health-care products and that every adult and child in the United States takes a Perrigo-made tablet once every four days. So, I e-mailed Perrigo and asked why I now seldom see the USP marking on store-brand items like aspirin and ibuprofen (the generic for Advil, Motrin, etc.) Here is the answer I received from Perrigo: "The labeling of the products we manufacture is determined by the stores who purchase our products. Although Perrigo manufactures store-brand products that meet or exceed quality standards set by the Food and Drug Administration, the USP information is not required to be on the product labeling. We may offer a general packaging layout but stores determine if items such as 'USP' will be included." I am satisfied with that answer and now tell people that I still feel safe in buying "store brand" aspirin, ibuprofen, acetaminophen, and so on, from the major retailers. My purchases of pain killers is far less than the national average, I am sure. I take a store-brand 81mg aspirin every day for heart attack protection. I practically never get headaches, and seldom bother to take standard pain killers for my many muscle aches and pains. Perrigo did recall 11 million bottles of acetaminophen (the generic for Tylenol) in 2006 after finding small metal particles in 200 caplets during a test at the plant. No injuries were reported from anyone ingesting pills from the batch(es) that was recalled.
I also e-mailed USP asking why I did not see many store-brand health-care products these days with the USP legend on the box or bottle. So far, USP has not responded and probably never will. You win some. You lose some. Here is a list of common pain killers: Active Ingredient - Advertised Brand - Equivalent Store Brand Ibuprofen - Advil, Motrin IB, etc. - Ibuprofen The name "Aspirin" has an interesting background. Bayer registered the name Aspirin as a Trademark in 1899. In 1921, a U.S. federal court ruled that "Aspirin" was a generic name. "Aspirin" is still a Trademark in Canada and several countries in Europe, for example. St. Joseph Aspirin has a long history in the U.S. and now sells only the 81mg version (the dose recommended for heart protection by most doctors) in a chewable and "enteric-safety-coated" version. The "enteric coating" is used on several brands of aspirin to delay the dissolution of the aspirin in the stomach, thus supposedly tending to less chance of internal bleeding or stomach upset. St. Joseph's Web page only says that the enteric-coated aspirin is "easy to swallow and help protect against stomach upset." The definition on MedicineNet.com is: "Enteric-coated: Coated with a material that permits transit through the stomach to the small intestine before the medication is released." I can find no medical consensus that "enteric-coated aspirin" is less likely to cause internal bleeding, especially if all you take is one 81mg tablet a day - but perhaps I have not looked hard enough. Enteric coating is used on a variety of pain killers and health-care supplements, including some fish oil capsules. Some medical sources question whether enteric-coated aspirin may not partially defeat the anti-platelet action that is touted to prevent heart attacks. Of the three 81mg aspirin bottles in my home, two are "enteric-coated," and the Equate 81mg (Wal-Mart store-brand) says "delayed release." Hmmm. Enteric-coated seemingly without doubt. At Kroger, I found Bayer chewable 81mg, St. Joseph 81mg chewable, and Kroger store-brand chewable 81mg. Somewhat surprising, the St. Joseph 81mg x 36 tablets cost more than Bayer - $2.79. The Bayer chewable 81mg x 36 tablets sells for $2.19. The Kroger store-brand has a 3-pack of 81mg x 36 tablets for $4.19. So, two bottles of Bayer 81mg x 60 would cost $4.38. That means you get the 3-pack of Kroger store brand (an extra 36 tablets) for less than two packs of Bayer. Not a huge savings, like you can find with Bayer versus store-brands in the uncoated 325mg standard aspirin format. But with the added saving on my Kroger card for buying a Kroger brand, it is a slam dunk on which brand of chewable 81mg aspirin I will buy at Kroger. I will carry my magnifying glass into other stores, but expect to find similar pricing on name-brand 81mg chewable aspirin and store brands. If I thought I was having a heart attack, I would chew up about four 81mg non-coated chewable aspirin - or chew at least one 325mg uncoated aspirin tablet. The Harvard Health guide says that if you think you are having a heart attack, chew an uncoated 325mg aspirin tablet - since chewing the tablet works faster than swallowing it. In a recent article in the Journal of the American Medical Association are comments about aspirin dosage for heart-attack prevention (JAMA. 2007;297:2018-2024): "Currently available clinical data do not support the routine, long-term use of aspirin dosages greater than 75 to 81 mg/d in the setting of cardiovascular disease prevention. Higher dosages, which may be commonly prescribed, do not better prevent events but are associated with increased risks of gastrointestinal bleeding." The Harvard Heart Letter for Aug. 2007 has a very long article about taking aspirin. They repeat the advice given above that 81 mg-per-day is adequate for heart attack and stroke protection (if your doctor has told you to take aspirin). In two places, they say that Enteric-coated aspirin does little to protect you from stomach and intestinal problems. In fact, they urge to not take Enteric-coated aspirin for your heart since it delivers less aspirin into your blood stream. One quote: "If you take an 81 mg aspirin each day, make sure it isn't an enteric-coated one, urges Dr. Campbell. With low-dose aspirin, you want to get as much of it into your system as possible, something coated aspirin doesn't accomplish. What's more, taking coated aspirin does relatively little to prevent stomach and intestinal problems." (Dr. Charles L. Campbell and colleagues published a review in JAMA regarding 81 mg of aspirin being the optimum dose for stroke and heart-attack prevention.) I suspect that as the evidence mounts that Enteric-coating does not help with stomach problems and that it actually inhibits the assimilation of aspirin, Enteric coatings will fade away. For now, Enteric-coated aspirin is widely offered by name-brand and generic store-brands alike. Store brands are usually displayed next to the name-brands. Compare the labels on the boxes and you will see that they contain the same active ingredient(s). Some binders, coloring, and other inert ingredients may be different in the store-brand. You can find other name-brand health-care products and their store-brand names at: www.truststorebrands.com Of course, generic prescription drugs are subjected to the same FDA requirements as the name-brand equivalent. That is why, for example, Pfizer is trying to sell as much Lipitor as they possibly can before the patent runs out. Because, then Pfizer will have to look for another cash cow that can generate billions of dollars in sales each year. Major drug plans, the VA, etc. will buy the generic the day it is available. The Dangers of Overdoses of Tylenol (Acetaminophen) I find that relatively few people are aware of the dangers of taking too much Acetaminophen (Tylenol), especially the potential liver damage. From Medline at the National Institutes of Health: "Acetaminophen overdose is one of the most common poisonings worldwide. People often think that acetaminophen, a pain-relieving medicine, is extremely safe. However, it may be deadly if taken in large doses. You should not take more than 4000mg of acetaminophen a day. Taking more, especially 7000mg or more, can lead to a severe overdose if not treated. If treatment is received within 8 hours of the overdose, there is a very good chance of recovery. However, without rapid treatment, a very large overdose of acetaminophen can lead to liver failure and death in a few days."
Hospitals routinely give Tylenol (acetaminophen) to patients for pain relief. They have their reasons, which I will not delve into here. I wonder if they caution patients about the potential dangers of an overdose once they are discharged. I would imagine that most people think that because they were given Tylenol in the hospital, it is safe. In low doses, that is likely the case. I checked one store-brand and its label says that the dose of 500mg acetaminophen should be no more than 8 caplets in 24 hours. And that children under 12 should not be given "adult-strength" caplets. Eight 500mg caplets is 4000mg, and that is the maximum dosage per day suggested by the NIH - and noted above. Personally, I would never take more than four 500mg caplets a day, and then only for a short period. But, I read too much medical information! Search the Web for "acetaminophen overdose." In an AP article dated Dec. 27, 2005 was the following: "Acetaminophen is in hundreds of products, from the over-the-counter remedies Theraflu and Excedrin to the prescription narcotics Vicodin and Percocet.... The Food and Drug Administration has long wrestled with the liver risk, warning two years ago that more than 56,000 emergency-room visits a year are because of acetaminophen overdoses and that 100 people die annually from unintentionally taking too much." June 8, 2007 Malaysian Researchers Create Walnut 'Viagra' Researchers in Malaysia have created a capsule based on walnut extract that is claimed to help with erectile dysfunction (ED). The active ingredient is an amino acid called Arginine, which converts in the body to Nitric Oxide. Nitric Oxide is known to dilate blood vessels - facilitating blood flow - thus its action on ED. Many people take the natural supplement L-arginine to help with blood vessel dilation, especially those who have had bypass surgery or stent implantation. One study of L-arginine did caution against its use by heart-attack survivors, as there were six deaths among heart-attack survivors in an NIH-sponsored study about the efficacy of L-arginine. Viagra also increases the amount of Nitric Oxide in the bloodstream. Although the evidence I have come across is largely anecdotal regarding taking L-arginine for ED (there are a few clinical studies), one could assume that eating walnuts every day and taking a few grams of L-arginine (along with other supplements that tend to increase blood flow) would have about the same effect as taking Viagra. I eat walnuts nearly every day, take at least 3 grams of L-arginine, and some Ginko Boloba, among other supplements that facilitate blood flow - and exercise regularly. Draw your own conclusions. I suspect that if men with ED would lose excess weigth, exercise more, eat walnuts, eat more fatty fish or take fish-oil caps, take L-arginine and other supplements (Ginko Biloba) that increase blood flow - and reduce alcohol intake prior to impending intimate encounters, they would not need to resort to Viagra, with all it potential side effects. Have you listened carefully to the admonitions on the TV ads for Viagra? Scary. Incidentally, walnuts are a good source of the heart-friendly Omega-3 fatty acid, also found in fatty fish, fish oil caps, and so on. Of course, I must now raid the pantry for my walnut-fix. Our Obsession With Bottled Water
July 27, 2007 Aquafina bottled water (PepsiCo, Inc.) will note on their bottles that the water is "purified" water from municipal water sources. Dasani bottled water (Coca-Cola) is also "purified" water from tap-water sources. The National Sanitation Foundation (NSF) defines Purified Water: "This type of water has been produced by distillation, deionization, reverse osmosis, or other suitable processes...." Many bottled waters on the shelves frankly state "From the Municipal Water Supply of XXXXX city." Some don't even claim to be "purified." The NSF is an independent organization (since 1944) who certify the purity of water products, water-treatment systems, food service equipment, and a host of other products. I know from personal experience how hard it is to obtain the NSF seal on a food service product, for example. Years ago, I tried to find gallon jugs of pre-packaged water on supermarket shelves with the NSF label. I could find only one! I drank that water until I discovered the Culligan in-store water-treatment refill towers (originally owned by a Minnesota company and bought by Culligan). My mantra for years has been that anybody who pays a dollar or more for a small bottle of "bottled water" is misguided, if not bordering on stupid. My solution for nearly 20 years has been to use the water-dispensing towers found in many supermarkets (and now owned by Culligan). It costs an average of 33 cents/gallon. I never drink tap water here in the sticks, even though the local water utility sends out reports telling how clean their water is, complete with percentage of particulates, etc. Also, I fill up a pint-size plastic bottle with my Culligan store-tower-water and keep it in the truck. In the Culligan water-refill machines found in Kroger, Albertsons, and Wal-Mart in NE Texas, the local city water is filtered through a sediment filter, next through a charcoal filter, then filtered by reverse-osmosis, and treated with UV light to kill germs. The filtering system and the dispensers are checked periodically by a Culligan technician and an inspection signoff card is posted at the dispenser, with the date of the checkup. People are often advised to boil their water if they suspect that it is contaminated. Samantha Heller, a Clinical Nutritionist at NYU Medical Center, pointed out in a CBS interview that boiling your water will kill bacteria and other parasites, but if anything, boiling your water can actually concentrate the amount of lead in your water. She suggests running cold water for 30-60 seconds (to flush your lines) before you use or drink water from your home faucets. There are many home water-purification systems that do multiple filtering and some that add UV light to kill germs. The ones that you clamp on your faucet cannot do as thorough a job of filtering your water as the full-blown models. There are units available that connect with your water supply pipe at the point it enters the house. So, even your shower and laundry water is purified, and the water that fills your ice-cube maker in the fridge - to name a few spots. Part of the problem is the massive PR campaign the bottled-water companies have mounted to convince us that we need to sip from a water bottle every few minutes of our lives. What? Or Die? You would think so. Ridiculous. Water-bottle "product placement" on TV shows is pervasive. Every speaker at a public forum, every comedian on a special, and half the characters on TV shows are sucking from a bottle of water like their life depended on it. If you feel the need to drink 6-8 glasses of water a day, as is often advised, do it. Drink glasses of water. But sucking on a water bottle all day long is simply neurotic. I did a Google search for "6-8 glasses water." I was laughing so hard, I could not stop. The first "article" cited was "Top 10 Reasons to Drink 6-8 Glasses of Water a Day," by Andrea O'Neill - Corporate Brand Strategist and Executive Marketing Coach. The second cited article was by the Australian Glenn Cardwell, whom I note later takes on the 6-8 glasses-a-day-of-water myth.
Often, of course, the product label is plainly visible on TV, even on C-SPAN - which has no sponsors. Only Gatorade has ever mounted such an equally massive PR onslaught. I often wonder if those guys on the bench on an NFL football team are all actually drinking Gatorade from the cups with the blazing Gatorade logo. If I were playing in the NFL, I might want something like Red Bull, in addition to Gatorade, to get me through a game. And of course, there is the Gatorade drenching of the winning coach. What a stroke of genius. Gatorade is good for showering, too? My layman's opinion is that the bottled water industry has inflated the "requirement for water intake" to sell more bottled water. One bottled water Web site, which caters to offices and homes who use a 5-gallon water cooler, has a chart about the "Daily Water Requirement for Good Health." For a 200-pound person, they say that if you are moderately active, you need 11 8-ounce glasses of water a day. Eleven glasses a day! Oh, my goodness. I starkly remember fasting for 26 days, under medical supervision, and taking in only a few sips of distilled water each day. We walked. We took sunbaths. Nobody got "sick" from drinking too little water. As Glenn Cardwell, an Australian who specializes in sports dietetics, points out in an article, the 6-8 glasses-of-water-a-day myth does not hold water. We get water from a variety of sources, tea and coffee the most obvious. How about beer? Or orange juice? Cranberry juice? Juice bottles typically say that they contain 20% juice. What is the other 80%? Sugar (not good) and water. And on and on. Vegetables and fruits are about 90% water. Have you ever noticed how thirst-quenching Iceberg lettuce is? That is because it is mostly water. It has no nutritive content! Salad-bar owners hope you will load up on Iceberg lettuce, which will make you full, just as if you had drunk a glass of water. And if you are dieting, a full head of Iceberg lettuce has only 70 calories! There are other, more subtle sources of water in the average diet. Other than during periods of exercise, or working under hot conditions, the thirst response is a good indicator of when you need to drink water. The Aussie author, Glenn Cardwell, suggests that if you pee 5-6 times a day, you are probably drinking enough water. As to the myth that your urine should be clear - as an indication that you are "properly hydrated," this gentleman points out that vitamin supplements (and various foods) can change the color or your urine. The New York Times has run several good articles about bottled water versus tap water and one older reference (Oct. 20, 2005) about the dangers of drinking too much water. Dr. Lewis G. Maharam, the medical director of the New York City Marathon, among others, notes: "There are no reported cases of dehydration causing death in the history of world running ... but there are plenty of cases of people dying of hyponatremia (drinking too much water)." A study of runners in the 2005 Boston Marathon found that 13 percent who finished the race had hyponatremia! Drinking too much water rushes into the cells, including brain cells. The swollen brain cells press against the skull, and the result can be fatal. Even marathon runners are cautioned to not drink more than 8 ounces of fluid every 20 minutes. So, if you are sitting in your cubicle in an air-conditioned office and are sucking on a water bottle all day - I repeat - it is simply neurotic behavior. Most everybody is bitching about the price of gasoline. Bottled water in those handy containers costs several times as much per gallon as a gallon of gas. If you cut out bottled water and Starbucks - and brought your lunch from home - you could all be driving a Lexus. Update: June 14, 2008 A doctor friend introduced me to the Berkey Water Filters (www.berkeyfilters.com). The stainless steel model I bought has an upper and lower chamber. The upper chamber has openings to fit from two to four filters (stock model has two filters). You pour about 2 gallons of tap water into the top section and gravity forces the water through the filters into the lower section, which has a spigot. No hoses, no electric cords, just two tanks which fit together to form the tower. The filters are so efficient that you can pour food coloring into the water in the top chamber and the waters comes out clear after filtration. The list of "bad" things that these filters will trap is quite amazing and you can find the list on the Berkey Web page. The Big Berkey, which makes about 2 gallons of filtered water an hour, costs around $250, but there are no moving parts and the shell is heavy stainless steel. They estimate that the cost of filtering water is about 2-cents per gallon. So, while you suck on your $1 + bottle of water, the one I carry in the truck costs less than 1-cent. You can clean the filters, but in time, they must be replaced. The estimated useful life of a single filter is 2,000 gallons. The smaller model would be ideal for a remote cabin or for a camping trip (filtering lake or stream water). They also make a transparent Lexan model that is less expensive. To my palate, the filtered water (from our rural supply) is tasteless. The essential minerals are maintained, but the list of materials that are filtered to a high degree, such as greater than 95% reduction for Lead, Mercury, Aluminum, Cadmium, Chromium, Copper is impressive. The list covers several columns.
Richard C. Rhodes, Sr. Revised June 30, 2007 |