Vitamins, minerals & supplements Archive

Research we're watching

Serious heart complications are common in people hospitalized with influenza, according to a study published online Aug. 25, 2020, by Annals of Internal Medicine.

Researchers from the CDC looked at the rates of cardiovascular problems in more than 80,000 adults hospitalized with a confirmed case of influenza (commonly called the flu) from 2010 to 2018. Almost 12% had a serious cardiovascular problem, most commonly heart failure or a lack of adequate blood flow to the heart, known as acute coronary syndrome. The body's immune response against the infection can trigger inflammation and other changes that harm the cardiovascular system.

Broccoli, brussels sprouts, and other cruciferous vegetables are associated with fewer calcified fatty plaques in the aorta.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

On call

Q. What would cause my tongue to suddenly swell? Could this be a possible side effect of medication, or something else?

A. There are many reasons for a swollen tongue. Indeed, a reaction to a medication is one of the more common causes. For example, a well-known side effect of ACE inhibitors (a class of drugs used to control blood pressure) is a condition called angioneurotic edema. Swelling of the face, lips, and tongue can happen quickly in people who take an ACE inhibitor. The reaction may occur soon after it's first taken or at any time thereafter. Sometimes people get this reaction even though they have used the drug for several years. ACE inhibitors are more likely to cause angioneurotic edema in African Americans.

New guidelines suggest doing more of the same. The problem is that many people don't.

You never forget your first gout attack. The severe pain, swelling, and redness hits hard and fast. The initial attack often strikes your big toe's large joint, but later ones might affect the foot or ankle. Other hot spots include the knees, hands, and wrists.

First-line treatment is quite effective and includes anti-inflammatory medications, ice therapy, and rest. A combination of diet and lifestyle changes and prescription drugs — an approach called urate-lowering therapy, or ULT — is typically recommended if attacks recur or become more severe.

Peer into your pillbox: It may be time to streamline your drug regimen.

Medication regimens often start simply, perhaps with a multivitamin and a single prescription drug to treat a chronic condition. But with age and more health problems, a regimen may grow to include additional prescription drugs and dietary supplements (such as vitamin D and calcium), plus over-the-counter medicines to reduce symptoms such as pain or heartburn. In time, you can find yourself facing a crowded pillbox and a complicated regimen.

"Among people age 62 to about 85, a third will take five medications per person. In the higher-risk population that I take care of, those people average 15 medications per person. And some of the dialysis patients take about 20 prescriptions," says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

News briefs

If you'd like to try a vegan diet but can't imagine nixing all animal products, consider two recent findings. One, published online July 22, 2020, by The BMJ, comes from researchers at Harvard and Tehran University. They analyzed 32 studies about protein intake that included more than 715,000 people, with follow-up periods ranging from three-and-a-half years to over three decades. Combining data from multiple studies, the researchers calculated that getting 3% more of total calories in the form of plant protein (like beans, nuts, and whole grains) lowered people's risk for premature death by 5%. Another study, published online July 13, 2020, by JAMA Internal Medicine, looked at the survival rates of more than 416,000 people who'd reported their diet and lifestyle information 16 years earlier (when they were 50 to 71 years old). In this study, shifting just 3% of calorie intake from animal protein (meat, poultry, fish, or dairy products) to plant protein corresponded with a 10% decrease in death from any cause over that period, for both men and women. In particular, replacing eggs and red meat with plant proteins appeared to reduce death risk by as much as 24% in men and 21% in women — especially in people with high intake of eggs and red meat. The new findings don't prove that favoring plant-based proteins will add years to your life, but many other studies have associated high intakes of red and processed meats with shorter life span.

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In the journals

Hold off on taking pain pills to treat a sprained ankle, strained neck, or bruised knee. A new guideline from the American College of Physicians and the American Academy of Family Physicians recommends certain topical (gels, liquids or patches placed on the skin) painkillers as the first line of defense for musculoskeletal injuries in areas other than the lower back. The new guideline, published online Aug. 17, 2020, by Annals of Internal Medicine, was based on a review of more than 200 studies including a total of 33,000 patients with short-term injuries (pain lasting less than four weeks). It recommends using a topical nonsteroidal anti-inflammatory drug (NSAID) with or without menthol (which creates a cooling sensation). Topical NSAIDs come in gel, liquid, or patch forms; diclofenac gel (Voltaren Arthritis Pain) and aspirin cream are available without a prescription. Topical NSAIDs may have fewer risks than oral NSAIDs, which raise risk for stomach ulcers and bleeding, high blood pressure, kidney damage, and heart attacks. However, if topicals don't work, the guideline says you can move to oral NSAIDs such as ibuprofen (Advil, Motrin) or the non-NSAID painkiller acetaminophen (Tylenol); acupressure; or transcutaneous electrical nerve stimulation. The guideline recommends against using opioids such as tramadol (Ultram) except in severe cases.

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Growing evidence shows that intermittent fasting leads to significant weight loss. A recent study contradicted these findings, but the way this study was designed and implemented raises some questions about its conclusions.