Itchy Eyes, Runny Nose, Scratchy Throat.........

Ragweed is Blooming!

Are your eyes itching a little? Is your nose running and your throat a little scratchy? Do you have a tickly cough? If so you may be suffering from Ragweed Allergy. The Ragweed plant is currently in full bloom and its pollen is blowing in the wind. In Elk River the end of July the pollen level was 6.7. August 24 it was 11. Pollen levels between 9.7 and 12.0 tend to effect even people with mild Ragweed allergy. The bad news is that Ragweed can bloom until October. For Ragweed Pollen levels in our area, click on the following link: http://www.pollen.com/allergy-forecast.asp?zip=55330


If you are having allergy symptoms there are several things that you can do:
Reduce your exposure to the pollen: Keep your air conditioning on and windows closed during ragweed season. Take a shower after spending time outside so that you aren’t rubbing your face in a pillow that is covered with pollen that was on your skin and in your hair. Try to stay indoors from 10am to 4pm when pollen levels are the highest. Don’t hang sheets or clothing outside to dry – pollen can settle on them.

Try a daily saline nasal flush. Neti Pots or Squeeze bottles can be used to flush your sinuses with a mild salt water solution to help keep mucous membranes moist and to flush out irritating pollen from your sinuses. The water that you use to mix the saline solution must be sterile (boiled) or distilled so that you aren’t squirting bacteria or other microbes into your nose.

Antihistamines help your body react less to the pollen in the air. They work best when you begin taking them regularly before your allergies start rather than waiting until your eyes are itching and nose is running. We are currently recommending Fexofenadine (Allegra) and Cetirizine (Zyrtec). They are effective in treating seasonal allergies and tend to cause less drowsiness during the day. If your symptoms have already started, antihistamines will still work to decrease future symptoms from occurring but don’t immediately stop the symptoms that you are having. Adding a decongestant, if appropriate for you, for a few days usually helps until the antihistamine starts to work.

Corticosteroid Nasal Spray: If you have significant nasal allergy symptoms, talk to your Doctor and discuss using a Corticosteroid Nasal Spray like Fluticasone. This is used regularly during allergy season. It makes your sinus passages react less to the allergens in the air. It helps to reduce sinus drainage into your lungs and can also help reduce wheezing and coughing during allergy season. And unlike antihistamines, corticosteroids don’t cause drowsiness or irritability.

Our Pharmacists are Medication Specialists and are happy to answer your medication questions. We can help you pick out over the counter medications that best meet your allergy needs or contact your Doctor if a prescription medication is the best option for you.

Should You Be Taking Dietary Supplements?

There are some medications that reduce levels of vitamins, minerals or nutrient in our bodies. Sometimes this change can be significant.

The following list of medications have been shown to reduce the nutrients listed after them in some people. If you are taking one of these medications and are having no side effects or symptoms of a deficiency, I would not race out to buy the nutrient. If however, you have noticed changes in how you feel since you have started a medication it could be related to a deficiency of the nutrient that it affects. Blood levels of many nutrients can be measured by your Doctor. It may be worth taking a supplement to increase that nutrient in your body. If you feel better or the side effect goes away that is a good thing. If you don’t notice a difference after trying the supplement for a month or feel worse, stop taking the supplement and talk to your doctor.

As people get older, they do not absorb vitamins as well. It can be good preventative medicine to take a multiple vitamin/ mineral daily. Women on Birth Control Pills can supplement with a multiple vitamin/mineral daily so that in the event they do decide to become pregnant that they have good levels of folic acid.

It is a good idea to check with your Doctor or Pharmacist before starting a supplement to make sure that it won’t interact with another medication or conditions that you may have.

Acid Blockers like Proton pump inhibitors (Prilosec, Prevacid, Protonix) and H2 Blockers (Zantac, Tagamet, Pepcid) : B12, folic acid , Calcium, Vitamin D, Iron, Zinc

Corticosteroids (Prednisone) long term use: Calcium, Magnesium, Potasium

Aspirin, NSAID (Ibuprofen, Naproxen): Vitamin C, Folic Acid, Iron

Diuretics (Thiazide): Magnesium, Sodium, Potassium and Zinc + (Loop Diuretics) Thiamine

Hormones (Birth Control Pills, Hormone Replacement): B Vitamins, Folic Acid, Magnesium, Vitamin C

Metformin: Folic Acid, Vitamin B12

Methotrexate: Folic Acid

Phenytoin, Carbamazepine: Calcium, Vitamin D

Statin Drugs: (Lipitor, Crestor, Simvastatin etc.): Coenzyme Q10

This list continues to grow. There are also medications that aren’t very commonly used that I haven’t included here. Please check with our Pharmacists if you have any questions about your medications and their ability to decrease nutrient absorption.

Links to additional information on medications and supplements:
Birth control pills: http://www.ext.colostate.edu/pubs/foodnut/09323.html
Specific Drug Information: http://www.nlm.nih.gov/medlineplus/druginformation.html
Specific Dietary Supplement Information: http://ods.od.nih.gov/factsheets/list-all

Foie Gras in People

Question:
What do Ducks or Geese overfed with large amounts of corn and not allowed to exercise have in common with people?

Answer:
Fatty Livers - in Ducks we call it Foie Gras and some consider it a delicacy to eat. In people we call it non-alcoholic liver disease and it is frequently found in people with Diabetes, Insulin Resistance and Metabolic Syndrome (Abdominal Obesity, High Blood Pressure, High Cholesterol, & Insulin Resistance). Just like the ducks, our livers get fatty when extra calories not needed for energy are stored there as fat.

Question:
Can children have fatty liver disease?

Answer:
Yes, fatty liver disease has been found in children as young as 2 years old - it becomes more common as their weight increases. In a study in California, 81% of the case of fatty liver disease in children were found in those who were overweight.

The good news is most cases of fatty liver disease can be reversed!
As the liver becomes less fatty, cholesterol levels improve and insulin resistance decreases.

Eating a healthful diet and engaging in regular exercise are essential for reversing fatty liver. Following are several visualizations you can use to help you make positive changes in how you take care of yourself:

· Instead of thinking of white carbohydrates or fatty, fried foods as delicious treats, think of them as disguised pieces of lard. Imagine the gluey mess that lard creates in your blood vessels, contributing to feelings of sluggishness, being bloated and tired.

· Plan on eating a fruit, vegetable or other healthful snack when hungry between meals. Increase the fiber in your diet. Picture your nutritious food melting away the fat in your liver, and the fiber grabbing the fat and escorting it out of your body. Make a mental connection between this dissolution of your liver’s fat with feeling good and having increased levels of energy.

· Choosing to flop on the couch and stare at a television encourages your liver to grow fat. Whenever you know you should move but just don’t feel like it, visualize evil smiling fat globules racing to your liver and growing before your eyes. Walk around during commercials, lift weights while you sit and give those fat blobs the evil eye.

· As you move around, imagine your muscles kicking the extra fat out of your liver. Whether you walk, bike, swim, box, dance or do other forms of exercise, an active body moves the calories to parts of your body that need them so they don’t get stuck in your liver.

Choose to be more healthy now so you can stay more active as you age!

When Should You Treat a Fever?

Fever is a normal and healthy response of our bodies to an illness. The body's immune system releases chemicals that raise the body temperature. This is part of the normal infection-fighting process. Studies that look at the relationship of fever and outcome show an overall decreased time being sick and a better outcome for patients who have a fever when fighting off an illness.

WHAT TEMPERATURE CONSTITUTES A FEVER?
(based on oral temperature – to use chart to compare temperature from under the arm add 1 degree to actual temperature, to compare rectal subtract 1 degree from actual temperature)
Normal temperature – 97 to 99 degrees (36 to 37.2 Celcius).
Low-grade fever – 99 to 100.9 degrees (37.3 to 38.3 Celcius).
Common fever – 101 to 103.5 degrees (38.4 to 39.7 Celcius).
High fever – any fever over 103.6 degrees (39.8 Celcius).

Most fevers in healthy adults are short lived and harmless. Fevers are naturally lower in the morning and higher in the afternoon. It is important to try to determine the cause of the fever before you treat it. Is it a viral infection like the cold or flu which just needs to run its course? Or is it bacterial like strep throat, bladder infections, pneumonia, ear infections, etc. that may require an antibiotic?

It is generally a good idea to avoid the use of acetaminophen or ibuprofen to treat fever until it rises to 102 degrees Fahrenheit unless directed to do so by your doctor. If you are taking care of older children who have a fever this can also be true. Fever in infants, however, should be handled more cautiously. You should get a plan from your physician on when and how to treat fever in a child or infant.

If a fever is present with any of the following symptoms, a physician should be consulted right away: Irritability (more than just crabby), confusion, lethargy (doesn't easily wake up), difficulty breathing, rapid and weak pulse, refusal to eat or drink, ill-appearing even after the fever is brought down , severe headache or other specific complaint (burning with urination, limping, pain, etc). Physicians should also be consulted for all ages if temperature rises to 104 degrees, if fever above 102 lasts more than three days or if low grade fever lasts more than 3 weeks.

If you or your child are uncomfortable or can’t sleep you can still give acetaminophen or ibuprofen when you have a fever. It is just important to know that you don’t have to automatically give fever reducers for fevers under 102 if there are no other reasons to do so.

Our pharmacists at Kemper Drug are happy to answer your questions about medications to treat fever and how to dose them in children. We can also help you choose cold medications that treat only the symptoms you have and don't contain acetaminophen or ibuprofen if you don't need them.

Preventing Colds and Flu

We would all like to find the magic pill that will prevent us from getting sick during cold and flu season. There is a large amount of advice available as to what that magic pill is! While most of the magic pill advice won’t cause you any harm, there isn’t good evidence that it will help prevent or cure a viral infection like a cold or the flu.

The proven best things to do to keep your body healthier are:
• Get enough sleep
• Eat regular meals
• Exercise 30 minutes daily
• Keep your stress level down
• Make sure you are drinking a normal amount of fluids so that you are not dehydrated
• Wash your hands frequently during the day
• Keep your distance from people who have cold or flu like symptoms
• Get a Flu Shot.

Some evidence for the Magic Pills:
• Vitamin D: People with low levels of vitamin D are more prone to infections. It wouldn’t hurt to take up to 1000 units of vitamin D everyday from supplements.
• Probiotics: Good bacteria that normally live in our bodies which help us fight off infection. Taking a probiotic supplement may help
• Multivitamins: Just to make sure that you are covering all your bases.

Less evidence for the Magic Pills:
• Vitamin C
• Echinacea
• Zinc

Check with your pharmacist or other healthcare professional before adding a new medication. Some medications may interfere with ones you are already taking and some medications shouldn’t be used if you have other health conditions.

Do you know what your fasting blood sugar is?

If you are often hungry, are overweight (have a roll around your middle not looking like a six pack), have high triglycerides, low HDL and high blood pressure, there is a good chance that your body is insulin resistant. When your body is insulin resistant, more insulin is released than normal to try to get glucose (sugar) into your cells for energy. The extra insulin causes excess fat storage in both the blood (in the form of cholesterol and triglycerides) and in the body in the form of a fat roll around the stomach area.

Health care providers use blood tests to determine whether a person has pre-diabetes but do not usually test for insulin resistance. If tests indicate pre-diabetes, insulin resistance most likely is present. One way to test for this is to have your blood sugar tested when you haven't eaten anything for 8 hours -preferably in the morning. A normal fasting blood sugar is less than 100, pre-diabetes blood sugar is between 100 and 126 and Diabetes is diagnosed at a fasting blood sugar over 126.

People who have pre-diabetes often benefit from a low carbohydrate diet. Eating less carbohydrates helps them keep their blood sugars down and causes them to release less insulin.

If you have pre-diabetes, I think you could benefit from reading The Metabolism Miracle by Diane Kress who is a Registered Dietitian and a Certified Diabetes Educator. She struggled to eat properly and control her weight using the knowledge that she had learned in school. Even though she was doing what she thought were the right things, she continued to gain weight. She discovered that she was pre-diabetic and insulin resistant and figured out that she had to try to change her diet in a different way.

The program that she designed has helped her lose weight and become less insulin resistant. The program has three steps. In the first step you retrain your body to become insulin sensitive again. The first step is an 8 week low carbohydrate diet that lets your pancreas rest and puts your body in fat burning mode rather than carbohydrate burning mode since you are only eating 5gm of carbohydrate per meal and snack. For the second 8 weeks you can increase carbohydrates to 11-20 Gm per meal - no more than 5 hours apart. Her third and final step is a diet in which 30 to 35% of daily calories come from carbohydrates. If you exceed your carbohydrate intake for more than 3 days in a week in step 3, she tells you to go back and repeat step 1 for ten days and then step 2 for ten days.

The Metabolism Miracle gives meal plans and recipes for each step of the way. She also answers questions which her patients had as they progressed through the steps.

I had always wondered why people who successfully lost weight felt it was important to eat breakfast every day. The book explains that glycogen is sugar that is stored in your liver and muscles for energy. If your pancreas detects that your blood sugar is getting too low, it releases a hormone called glucagon which tells your liver to release glycogen. The Glycogen releases its sugar and makes your blood sugars go up even if you haven't eaten anything! This is one reason why you should eat breakfast within 30 minutes of getting up in the morning and why you should have a small amount of carbohydrates at every meal and snack (no more than 5 hours apart)- if you don't, your body will release glycogen which will make your blood sugars spike. You will spend the day having your insulin chase your blood sugars up and down.

Links: The Metabolism Miracle
Insulin Resistance and Pre-diabetes National Diabetes Information Clearinghouse (NDIC)

Please Stand Up!

According to James A Levine MD., PhD, in his new book Move a Little, Lose a Lot our bodies weren't made to spend long periods of time sitting down. We are meant to be moving. We have gotten too clever and efficient at using machines to do things we used to use energy to do before. His goal is to get us to increase the NEAT in our lives. NEAT stands for nonexercise activity thermogenesis. It sounds complicated, but it couldn't be more simple. NEAT is the calories you burn living your life. It is the calores you burn walking to lunch, running errands, folding laundry, tapping your toes, standing up, even chewing gum. It is not going to the gym. It is the energy we use simply living.

When we sit at a desk we are burning 5 calories/hr. When we are standing we burn 15 calories/hr. If we throw in a little gum chewing for 20 calories/hr, walking at 100 calories/hr and stair climbing at 200 calories/hr it becomes obvious that we can increase the number of calories we burn a day without having to go to the gym! His research shows that the loss of NEAT from work and play, when we are spending our day sitting down, can decrease our daily calorie use by up to 2000 calories a day.

Dr. Levine has set up his office so that he can walk on a treadmill while he works at his computer or talks on the phone. He is only moving at 1 to 2 miles an hour so he doesn't even break a sweat. Don't have a treadmill in your office - stand up while you talk on the phone, or better use a cordless phone or headset that allows you to pace as you talk. You can put a simple stair stepper by your desk or sit on an exercise ball rather on a desk chair. Doing these things while you work helps your body work better without having to find time during the day to go to the gym.

Don't forget to think about NEAT movement when you are at home. Multitask while watching tv or surfing the internet - stand up, ride an exercise bike or pace. While sitting you can use a peddler or knit or use stretch bands or weights. Stand up and stretch during commercials or while waiting for a website to load. It's the little movements that add up for great benefits!

Sitting all day can be a brain drain! NEAT movement can also help in brain cell growth. Moving about improves the blood flow to your brain! This increased muscle movement and blood flow to your brain triggers changes that increase the production of new brain cells. This growth of new brain cells appears to be in the parts of the brain that affect memory, multitasking and decision making. Try to remember when your best ideas come to you - are they while you are sitting at your desk or while you are moving around?

Try to add more NEAT movement into your day. By the very act of standing and moving you can boost your metabolism, lower your bood pressure and increase your mental clarity. You probably will find that you are also less tired at the end of the day.

Links:
Mayo Clinic NEAT laboratory
Muveinc: we believe desk-sentenced workers should stand up.