Archive for January, 2013

Patrick J. Skerrett

Vitamin B12 deficiency can be sneaky, harmful

What harm can having too little of a vitamin do? Consider this: Over the course of two months, a 62-year-old man developed numbness and a “pins and needles” sensation in his hands, had trouble walking, experienced severe joint pain, began turning yellow, and became progressively short of breath. The cause was lack of vitamin B12 in his bloodstream, according to a case report from Harvard-affiliated Massachusetts General Hospital published in The New England Journal of Medicine. It could have been worse—a severe vitamin B12 deficiency can lead to deep depression, paranoia and delusions, memory loss, incontinence, loss of taste and smell, and more, according to another article in tomorrow’s New England Journal. Some people, like strict vegetarians, don’t take in enough vitamin B12 every days. Others, like many older people and those who have had weight-loss surgery or live with celiac disease or other digestive condition don’t absorb enough of the vitamin. Daily supplements can help.

Patrick J. Skerrett

Generic drugs: don’t ask, just tell

Greater use of generic drugs could save the healthcare system—and American consumers—billions of dollars that would be better spent elsewhere. What’s holding us back? Some consumers are reluctant to use generic medications, thinking they are inferior to “the real thing.” Doctors are also a big part of the problem. Up to half of physicians hold negative perceptions about generic drugs. And a new study to be published in tomorrow’s JAMA Internal Medicine shows that about 4 in 10 doctors sometimes or often prescribe a brand-name drug just because their patients ask for it. Prescribing a brand-name drug when a generic is available is a huge source of wasteful spending that could easily be prevented. People ask for brand-name drugs because they have heard of them through advertising or word of mouth, while their generic alternatives generally aren’t advertised. Doctors could help save billions of dollars by just saying “no.”

Patrick J. Skerrett

Many drivers asleep at the wheel

If you’ve ever nodded off while driving, you aren’t alone. In a new report from the Centers for Disease Control and Prevention, 4.2% of Americans admitted to falling asleep while driving at least once in the previous month. The just-published survey, conducted in 19 states and the District of Columbia, found the sleepiest drivers in Texas (6.1%) and Hawaii (5.7%), and the most alert ones in Oregon (2.5%) and the District of Columbia (2.6%). Individuals most likely to have fallen asleep while driving were those who said they unintentionally fell asleep during the daytime at least once during the preceding month, those who said they snore at night, and those who reported sleeping less than six hours a night. Keep in mind that these numbers reflect only the percentage of people who were aware they had fallen asleep. They don’t include those who fell asleep while driving without recognizing that had happened.