Vitamins, minerals & supplements Archive

It's no secret that alcohol affects our brains. Although excessive drinking is linked to an increased risk of dementia, decades of observational studies have indicated that moderate drinking has few ill effects. However, a recent British study seems to have bad news for moderate drinkers.

Some of these prescription medications are linked to daytime sleepiness, a risk of falls, and more.

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Millions of Americans rely on prescription sleep medications, called sedative hypnotics, to fall asleep. While the drugs can help people get a decent night's rest, they are not designed for long-term use. "Each of the pills has its own risks," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School.

Types of sleep aids

Sedative hypnotics fall into three categories.

Melatonin-receptor agonists such as ramelteon (Rozerem) leave the body quickly. They target melatonin receptors in the brain and are not thought to be habit-forming.

Ask the doctor

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Q. I have a mechanical heart valve, so I'm taking warfarin. But the frequent blood tests and occasional dose changes are bothersome. When, if ever, will I be able to take one of the new blood thinners instead of warfarin? Off-label use of other drugs is not uncommon. Why isn't that an option in this case?

A. Your question is a good one, and it requires a two-part answer. When doctors prescribe drugs "off-label," that means they believe the drug will help you, even if it has not been FDA-approved specifically for your condition. Sometimes, subsequent research provides strong evidence to support a specific off-label use, which may lead to the drug's FDA approval for that condition. But sometimes, research shows the exact opposite: a medication that doctors assumed would be beneficial is, in fact, not helpful — and sometimes even harmful.

A high HDL cholesterol level may not be as beneficial as once believed.

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If you're hoping to avoid heart disease, you probably keep tabs on your blood cholesterol values — especially your low-density lipoprotein (LDL), or "bad" cholesterol. Too much LDL in the bloodstream helps to create the plaque that accumulates inside arteries, raising the risk of a heart attack. The lower your LDL, the lower your risk of having a heart attack.

In contrast, high-density lipoprotein (HDL) has long been known as the "good" cholesterol. These particles are known to patrol blood vessels, grabbing cholesterol from both the bloodstream and artery walls and ferrying it to the liver for recycling and disposal. In population-based studies, people with high HDL levels tend to have fewer heart attacks, while those with lower HDL values have more.

Research we're watching

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Do you swallow a daily multivitamin, hoping to make up for a less-than-ideal diet? Sorry, but this strategy won't stave off heart disease, according to a study published online April 5, 2017, by JAMA Cardiology.

Previous research has also failed to find convincing evidence that a daily multivitamin lowers the risk of heart disease or cancer. But these studies didn't always account for the participant's dietary habits, which could potentially skew the results. In theory, people with poor diets might reap greater benefits from vitamins than those who eat healthier diets.

Research we're watching

People in drug studies sometimes experience positive effects even when they take inactive, fake pills (the so-called placebo effect). But sometimes, they experience negative effects from the fake drug — a phenomenon known as the nocebo effect. A new study suggests that the nocebo effect may explain some of the muscle pain and weakness reported by people who take cholesterol-lowering statins.

The study, in the May 2, 2017, Lancet, involved more than 10,000 people randomly assigned to take a statin or a placebo. The study was "double blind," meaning neither the participants nor the researchers knew who was taking statins. After about three years, the statin proved effective, and all the participants were offered the choice of taking the drug. Most of them continued in this "unblinded" study for an additional two years, and 65% opted to take the statin.

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New research may help explain why diets rich in animal-based foods are linked to a higher risk of heart attack.

The average American diet contains about 300 milligrams per day of choline, a nutrient found in meat, eggs, and milk. Earlier research found that when gut bacteria feed on choline, they make a compound called TMA. In the liver, TMA is converted to TMAO — a compound closely tied to heart disease risk.

On call

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Q. I've noticed recently that I sweat excessively, regardless of the temperature. Should I be concerned?

A. Your genes can determine whether you sweat a lot, but a sudden change in your regular sweating may suggest an underlying condition. Sweating is regulated by your nervous system and can be triggered by a number of causes. The primary signal for perspiration originates in the brain in response to a temperature-related or emotional cue, and then is carried by the autonomic nervous system to the sweat glands in the skin.

On call

Q. I have heard that exercising on an empty stomach burns more fat and at a faster rate. Is this true?

A. When the body is in a fasting state, several backup mechanisms ensure your muscles and brain get the necessary sugar for fuel. During exercise, after your body's sugar stores are exhausted, the body then taps into stored fat and turns that into sugar or turns protein from muscle into sugar. This has led to the hypothesis that exercising when the body is already "sugar starved" will lead to more rapid fat burning.