Howard LeWine, M.D.

Chief Medical Editor
Internet Publishing, Harvard Health Publications

Howard LeWine, M.D., is a practicing internist at Brigham and Women’s Hospital in Boston and Chief Medical Editor of Internet Publishing at Harvard Health Publications.

Posts by Howard LeWine, M.D.

Howard LeWine, M.D.

Probiotics may help prevent diarrhea due to antibiotic use

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Probiotic yogurt2

Eating yogurt or taking a so-called probiotic when you have to take antibiotics may help prevent the diarrhea that often accompanies antibiotic treatment. That’s the conclusion of a study just published in the Journal of the American Medical Association. A team of California-based researchers combined the results of 63 randomized trials pitting probiotics versus placebo among almost 12,000 men and women taking antibiotics. Those who took antibiotics plus probiotics were 42% less likely to develop diarrhea as those who got the placebo. About one in three people who take antibiotics develop diarrhea. Antibiotics kill these “good” microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.

Read more »
Howard LeWine, M.D.

New guidelines offer drug, herbal options for preventing migraine

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Migraine pain

Migraine was once a largely unpreventable and untreatable condition. Today there are dozens of prescription and over-the-counter medications, and even a few herbal preparations, proven to prevent migraine. Unfortunately, only about one-third of people who could benefit from a preventive therapy take one. New guidelines from the American Academy of Neurology and the American Headache Society highlight effective treatments, which should make choosing a preventive agent simpler and safer for migraine sufferers. The guidelines were published in the April 24, 2012 issue of the journal Neurology. The guidelines endorse the use of butterbur extract, an herbal preparation, for preventing migraine, along with several over-the-counter medications, such as ibuprofen and naproxen, and a bevy of prescription medications, including divalproex sodium (Depakote), sodium valproate, topiramate (Topamax), and beta blockers such as propranolol (Inderal, generic versions), metoprolol (Lopressor, generic versions), and timolol.

Read more »
Howard LeWine, M.D.

Experts recommend a more personal approach to type 2 diabetes

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Diabetes-sign

The hemoglobin A1c reading is an important number for people with diabetes. It’s a measure of the average blood sugar level over the preceding three months. For years, the American Diabetes Association recommended that almost everyone with type 2 diabetes should aim for an HbA1c level less than 7%. Keeping blood sugar as low as possible, called “tight control,” was thought to limit the havoc caused by diabetes. New guidelines from the American Diabetes Association (ADA) and European Association for the Study of Diabetes recommend taking a more “patient-centered approach.” For people who are newly diagnosed with type 2 diabetes but who are otherwise in good health, the ADA still suggests aiming for an HbA1C of 6.0% to 6.5%. For people who have had diabetes for a while, an HbA1c goal of 7.5% to 8.0%, or even higher, may be more appropriate.

Read more »
Howard LeWine, M.D.

Late to bed, early to rise: a recipe for diabetes

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Woman with insomnia

Sleeping poorly night after night—because you are trying to burn the candle at both ends or you work night or rotating shifts—has long-term health consequences. People who don’t average at least six hours of sleep a night are more likely to be overweight or develop various medical problems. New research from Harvard-affiliated Brigham and Women’s Hospital shows that lack of sleep plays a complex and powerful role in the development of type 2 diabetes. Among volunteers who lived in a sleep lab for several weeks, their bodies made less insulin after meals when they got under 5.5 hours of sleep a night for three weeks. As a result, their blood sugar levels went haywire. Some of the people had blood sugar levels high enough to have been diagnosed as prediabetic.

Read more »
Howard LeWine, M.D.

$2 drug treatment helps prevent exam-caused pancreas problem

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Pancreas

A test used to give doctors a close-up view of the pancreas, called endoscopic retrograde cholangiopancreatography (ERCP), often cause a painful inflammation of the pancreas (pancreatitis). According to report in the New England Journal of Medicine, a single dose of indomethacin, a powerful nonsteroidal anti-inflammatory drug, can help prevent this post-procedure problem. About half a million Americans have ERCP each year. As many as one in six develop pancreatitis afterward. In a randomized controlled trial that included men and women who had just undergone ERCP, administration of an indomethacin suppository right after the procedure cut the rate of post-ERCP pancreatitis almost in half. Once a person has pancreatitis, the chances he or she will have it again go up. That’s why the New England Journal report is good news for anyone who needs to undergo ERCP.

Read more »
Howard LeWine, M.D.

Aspirin for cancer prevention: promising, but not proven

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Aspirin-tablet

A trio of new studies from the University of Oxford suggests that aspirin is worth testing as a simple way to help prevent cancer. But these are preliminary findings, and you shouldn’t start taking an aspirin a day without having a conversion with your doctor. That’s because aspirin has side effects that could offset any possible cancer-fighting benefit, including stomach upset, gastrointestinal bleeding and hemorrhagic stroke (bleeding in the brain). The Oxford studies couldn’t determine cause and effect. The only way to tally up the true balance of benefits and risks of aspirin for cancer prevention is with trials specifically designed to do that. Several are underway or in the planning stages. But you can work to prevent cancer right now by avoiding tobacco in all its forms, exercising, and making other healthy changes.

Read more »
Howard LeWine, M.D.

FDA changes safety information on statin drugs

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

A new ruling from the FDA offers good news and some warnings for people who take a cholesterol-lowering statin. The good news—no more periodic blood tests for liver function. The warnings—taking a statin may increase the odds of developing type 2 diabetes or suffering reversible memory loss or problems thinking. The FDA warned that one statin, lovastatin, shouldn’t be taken with some antibiotics, anti-fungal agents, or medications used to treat AIDS.

Read more »
Howard LeWine, M.D.

Quick injection helps stop epileptic seizures

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

An epileptic seizure is a frightening thing to experience, and almost as frightening to watch. Fortunately, most seizures stop on their own after a couple minutes. Any that last longer than five to 10 minutes (doctors call a long-lasting seizure status epilepticus) are a medical emergency and must be halted with medication. A new study shows that delivering anti-seizure medication with a hand-held auto-injector—much like the epi pens used by people with life-threatening allergies—is better than delivering them intravenously. This study could pave the way for home treatment of epileptic seizures.

Read more »
Howard LeWine, M.D.

Pregnancy-related high blood pressure, diabetes linked to later heart disease

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Pregnancy

Most of the changes that come with pregnancy—growing a belly “bump,” being tired, mood swings, cravings for particular foods, and the like—are normal, temporary, and harmless. Two other changes, pregnancy-related high blood pressure and diabetes, may have long-lasting implications for heart health. The development of high blood pressure during pregnancy is known as preeclampsia; pregnancy-related diabetes is called gestational diabetes. They are different from “regular” high blood pressure and diabetes because both are “cured” by delivery. A new study published this week in the journal Circulation suggests that these complications boost a woman’s risk of cardiovascular disease during middle age.

Read more »
Howard LeWine, M.D.

Addiction: It retrains the brain, is tougher on women

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

It’s hard for someone who has never battled an addiction to understand how or why a person can’t break free of one. An exchange on the radio about pop star Whitney Houston’s addictions underscores the misconceptions many people have about addiction. Addictions retrain the brain in a way that couples liking something with wanting it. There are important gender differences in addiction. Although men are more likely than women to become addicted to drugs or harmful behaviors, women who have an addiction face tougher challenges.

Read more »