5 Problems with Over-the-Counter Painkillers

Pills you pop every day could be causing serious damage in the long run.
 
 Aspirin is hailed as a miracle drug, and there's not a person among us who hasn't popped an ibuprofen or acetaminophen to deal with achy joints or a crushing headache.
But if you're doing that every day, you could be causing long-term damage to your health, says Gary Kaplan, DO, medical director of the Kaplan Center for Integrative Medicine and author of a new book called  Total Recovery: Solving the Mystery of Chronic Pain and Depression.

"The biggest misconception people have about over-the-counter painkillers is that they're completely safe and harmless," says Dr. Kaplan. "They are neither of the above." In fact, most over-the-counter painkillers started out as prescription drugs but now are sold at lower doses without your needing to talk to a doctor.
And they're all bad in their own way. While Dr. Kaplan does contend that low doses of aspirin (81 milligrams) do have some benefits for people with risk factors for stroke, heart disease and some forms of cancer, larger doses taken daily to deal with the pains of daily living do not. "People pop these things like it's no big deal," he says. "If you do this every day, in the majority of people, you're doing real damage."
Before getting into what that damage is, it helps to understand how these medications work. Aspirin, ibuprofen (sold as Advil and Motrin), and naproxen sodium (sold as Aleve) all fall into a class of drugs called nonsteroidal anti-inflammatories, or NSAIDs. They work by inhibiting prostaglandin, a hormone that can produce pain and inflammation in response to an infection or injury. Acetaminophen (or Tylenol) falls into a different category and seems to interrupt the pain messages your brain receives.


#1: Gut ulcerations
NSAIDs, particularly ibuprofen and aspirin, are rough on your stomach, and they're just as rough on the lining of your gut. They create ulcerations and inflammation in the gut lining, damage that causes something known as a "leaky gut." When your gut is leaky, it doesn't absorb nutrients, which can lead to deficiencies (which can also contribute to pain problems), and problematic proteins and allergens, such as gluten, soy, or egg proteins, can escape, triggering food sensitivities. "Your gut is a very sophisticated filter," Dr. Kaplan says. "It's a very complex organ that's not one to disrupt, but one that we disrupt all the time."
Furthermore, NSAIDs disrupt the gut bacteria that control your immune system. As a result, you get sick more frequently and you might develop more chronic ailments.
Sixty to 80 percent of people develop gut inflammation within 24 hours of taking an NSAID, Dr. Kaplan says, and 50 to 70 percent of people who take them long term will develop chronic small intestine inflammation. And initially that might present as just feelings of bloating, gas or changes in your bowel movements, but over time, you might start experiencing chronic fatigue or develop food intolerances.

#2: Liver damage
Acetaminophen doesn't cause those gut ulcerations, Dr. Kaplan says. Rather, its problem is that it will damage your liver--sometimes, in unexpected ways. Things like alcohol can interfere with the way your body breaks down acetaminophen, even if you're taking a normal dose. "That leads to the potential to get a toxic level of acetaminophen in your system, which leads to liver damage," Dr. Kaplan says. He's also found that taking too many painkillers that contain caffeine can stress out your liver and interfere with sleep.

#3: Kidney damage
Along with your stomach, your kidneys are a major production site of prostaglandins, the hormones that NSAIDs are designed to silence. In addition to controlling the acid secretions in your stomach, prostaglandins help the kidneys fulfill their function of removing proteins and waste from your blood. Too many prostaglandin-inhibiting NSAIDs can interfere with that process, leading to kidney damage and a buildup of toxic waste by-products in your bloodstream. "As soon as we start seeing damage to kidneys, we tell people to get off all anti-inflammatory medications," Dr. Kaplan says.
Furthermore, prostaglandin produces inflammation in response to damage your body is experiencing. "Inflammation is not always a bad thing," he adds. "It's critical for repair--inflammation cleans up damaged tissue and brings in new cells to repair it. When inflammation gets disrupted, the normal healing process gets disrupted."


#4: Heart disease
You may remember a prescription painkiller called Vioxx that was pulled from the market a few years ago. The reason? It caused heart attacks, and it's not the only one. "It's a lower risk than with Vioxx, but all NSAIDs pose a risk," says Dr. Kaplan. NSAIDs block an enzyme called COX-2, which works with prostaglandin to protect your arteries. When both are silenced by chronic use of over-the-counter painkilllers, your risk of heart disease increases.

#5: Hypersensitization
Here's an ironic fact: Painkillers can heighten your susceptibility to pain. While this phenomenon has been seen mostly with prescription opiods (such as Vicodin or Oxycontin), studies have shown that acetaminophen and NSAIDs can have the same effect on headaches. "It's called a rebound headache," Dr. Kaplan says. "They dull your response to pain, so you need more medications to get to the same place. And you end up developing increased sensitivity to pain."
So are we all supposed to just grin and bear it if we have a headache or a sore knee? "The occasional use is fine, less than once a week," Dr. Kaplan advises. "But if you have pain that requires that you take over-the-counter pain medication on a regular basis, you need to seek medical attention."
Ultimately, Dr. Kaplan's beef with painkillers is that they aren't dealing with deeper health issues. "Doctors have to start looking at pain as a symptom and not the disease," he says. "We're better off addressing the problem. We need to understand where the pain is coming from."

Original article at:  
By Emily Main, Rodalenews.com

By Emily Main, Rodalenews.com

By Emily Main, Rodalenews.com

9 Things You Must See Before They Disappear Forever

I don’t want to be the one to tell you this, but the sad truth is that nothing truly lasts forever. The sea levels are rising, glaciers are melting, rain forests are being chopped down, and climate change is no longer just the plot of a disaster movie starring John Cusack. Things move pretty fast these days. If you don’t put these gems on your must-see list, you could miss them altogether. And frankly, we don’t want to be responsible for your FOMO.

Kilimanjaro from above. (Photo: Ben Freeman)

1. Kilimanjaro’s Snow-Capped Peaks: As far as travel brags go, that iconic photo of you atop the snow-capped peak of Uhuru Summit on Mt. Kilimanjaro is a solid. Sadly, that shot is about to get way less awesome now that all of the snow is melting. More than 85 percent of the ice cap has disappeared in the last century and it could be completely gone within the next 20 years.

Fun fact: It takes the average Joe between six and nine days to summit Kilimanjaro, depending on which of the six routes they choose.

The Details: Climbing requires hiring a licensed guide and will typically cost between $1,000 and $5,000, including food and accommodations on the mountain. It helps to plan at least six months, if not a year, in advance. We recommend Thomson Treks for their knowledgeable guides and stellar summiting success rate.

The crystal waters of the Maldives. (Photo: Rom)
2. The Maldives: Perched precariously 1.5 meters above sea level, the Maldives could soon become a real-life Atlantis. President Mohamed Nasheed has already warned world leaders that if greenhouse gases are not reduced soon, this island chain in the Indian Ocean will be swallowed up by the sea, which means you’ll never experience their bone-white beaches, crystal-clear waters, and turquoise reefs.
Fun fact: The Maldives are one of the few places on earth where you can swim with whale sharks year round. They tend to stick to the western side of the archipelago from May to December, then head east for the rest of the year.
The Details: The Maldives Whale Shark Research Programme runs weekly, year-round snorkeling and scuba trips where you can actually swim with the world’s largest fish.
3. The Unspoiled Beaches of Culebra: Known to locals as Ultima Virgen (The Last Virgin), Culebra is the quieter kissing cousin to Vieques. Today this small island of Puerto Rico remains relatively undeveloped. Unfortunately, that probably won’t last much longer. Plenty of large hotel chains are turning their gaze onto the tiny island, with its perfect beaches and magnificent coral reefs. Go now to savor the remaining years of its truly rustic beauty.
Fun fact: Flamenco Beach is widely considered one of the most beautiful beaches in the world, but it is worth a walk to some of the sleepier beaches the island has to offer, like Melones. A local favorite, this coral beach is an easy walk from town.
The Details: Hotels are few and far between, and you will be better off renting out a private home. Reach out to the folks at Culebra Island Realty to try to find something in your price range.
 
(Photo: National Ocean Service)
4. Arctic Polar Bears in the Wild: When I told our editor-in-chief that I was going to plan a trip to northern Canada see the polar bears in the wild ASAP, she grew concerned for me. “I can just see the headline of the New York Post now: ‘Travel Editor Mauled to Death Trying to Hug a Polar Bear’.” She isn’t wrong. But these magnificent carnivores are becoming so few and far between that spotting a polar bear in the Arctic Circle is already akin to seeing a unicorn. Just ask Al Gore.
Fun fact: Churchill is only accessible by plane or train, making it incredibly remote—and incredibly awesome.
The Details: Absolutely everything is charming about the handcrafted log building that is the Lazy Bear Lodge. This hotel will happily arrange all of your bear-peeping activities. Summer is the best time to go, since the polar bears are all leaving the pan ice and the temperatures are less frigid.
Fun fact: With two-thirds of the world’s polar bears possibly going extinct by 2050, it is high time you booked a trip to Churchill, Canada, the self-proclaimed Polar Bear Capital of the world.
5. Glacier National Park: A century ago, there were more than 150 glaciers in Northern Montana. Today only 27 remain and even those could disappear within the next 15 years. When the naturalist John Muir visited the park at the turn of the 20th century, he wrote: “Get off the tracks at Belton Station [now West Glacier] and in a few minutes you will find yourself in the midst of what you are sure to say is the best care-killing scenery on the continent.” He is right. Even without the glaciers, the views would be nothing short of spectacular, but they add frosting to an already amazing cake.
Fun fact: One of the best ways to see the park is by horseback.
The Details: Swan Mountain Outfitters offers a variety of riding options, which you be paired with rafting and fly fishing for an overnight saddle-paddle adventure.
6. Maria von Trapp’s Austrian Mountain Range: The snow line in the Alps is receding faster than Sting’s hairline. It has moved 200 feet in the past 50 years alone. Where the hills were once alive with the sound of music, climate change and reduced snowfall is destroying Austria’s gorgeous high-altitude flowers, among them Edelweiss.
Fun fact: Edelweiss actually originated in the Asian Steppe, but it is now most often found at an altitude of 1,700 meters in German, Italy and Austria.
The Details: Visit the picturesque village of Zell Am See in the heart of the Leogranger Steinberge Alps to take in the views from the top of Kitzsteinhorn and over the glacier. For the classic old-school Alp experience, check into the Grand Hotel Zell Am See on its own private peninsula on the shore of Lake Zell.


(Photo: Meg and Rahul)

7. The Taj Mahal: More than three million visitors a year currently visit the iconic mausoleum built in the 17th century in memory of the emperor Shal Jahan’s favorite wife. See it while you still can. In recent years, cars were banned from driving close to the Taj because of pollution (tip: take a donkey ride the remaining distance). And some preservation groups are pushing to close the landmark since all that foot traffic is seriously eroding the structure.

Fun fact: Dawn is the best time to see the Taj. Or ask a taxi driver to bring you across the river, where you can view the back of the temple at dusk.
The Details: If you want a room with amazing views of the Taj, book with Oberoi Amarvillas, just 600 meters from the monument.
8. The Tigers of Rajasthan: It is a distinct and incredibly unsettling possibility that the tiger could become extinct in our lifetime. Their natural habitats have been reduced by 93%. In 1900, some 100,000 tigers lived in India. Today, as few as 3,200 remain.
Fun fact: In 2012, the Indian Supreme Court ruled that no new tourist attractions can be created in the tiger areas and that only 20% of the tiger habitats can be open to visitors.

The Details: Ranthambore National Park is the best place to spot tigers in the wild and there’s no shortage of tour operators eager to take you on a safari. That said, the scarcity of tigers, even in the sanctuary, means that a sighting isn’t guaranteed. Make sure to book two to three days in the area. Ask for the smaller six-seater jeep (less intrusive in the tiger habitat) directly through the national park. 

 

(Photo: Paul Vladuchick / Flickr)

9. The Yangtze River Basin: The ongoing construction of China’s $24 billion Three Gorges Dam is posing a serious threat to the wildlife of the Yangtze River basin, including the giant pandas, Yangtze finless porpoises (known in Chinese by the very excellent name the “river pig”), and dwarf blue sheep—so rare I’m not even sure what they are, but I definitely want to see them before they disappear.

Fun fact: Thirteen years ago, the Panda Breeding Research Base in the river basin was home to only 20 pandas. Advancements in insemination technology have since grown that population to more than 100.

The Details: A trip to "panda kindergarten" is one of the greatest gifts you could ever give yourself. Trust me. I gave it to myself in 2009 when I travelled to the city of Chengdu with the sole intent and purpose of cuddling a baby panda. I accomplished this goal (and you can too) at the Panda Breeding Research Base, where it costs about $100 for 90 seconds of blissed-out panda snuggling.

Original article at: 9 Things You Must See Before They Disappear Forever

By:  Jo Piazza Editor Apr 26, 2014

9 Lessons You Won't Learn in Business School

 

 Image credit: Celestine Chua via Flickr

More and more in Silicon Valley, we’re seeing less and less of an interest in pursuing MBA programs. It seems every week a new story highlights the opportunity costs of these programs, the unemployment rates for its graduates (though less than 5 percent of Harvard's class of 2012 was unemployed three months after graduating) and the celebrated entrepreneurs who didn’t finish college let alone a graduate program (Steve Jobs, Bill Gates, Richard Branson, Mark Zuckerberg).

Combine that with the fact that startups -- where everyone seems to want to work -- don’t care at all about graduate business degrees. They want to see real-life experience and that you have the grit to make it in the startup trenches where it’s much more visceral when your job, not your grade, is on the line.

Yet applications still deluge many elite schools and some admission consultants are predicting a greater number of applicants at the top schools.  

So what's the right call? First of all, if you are accepted or enrolled in an MBA program, understand that your degree will never hurt you. There is much to be gained from the coursework as well as a lot you can do to make the most out of your time in school. The right attitude and the right degree provide a formula for long-term sustainable success.

         

While a business school will give you a pedigree, the real world is about results. As soon as the job interview process ends, no one cares which degree you received from Harvard, Stanford or Florida Atlantic (my alma mater). All they care about is that you get the job done. So here are some lessons from the real world of work:

1. The way to keep a job is to understand what success looks like. Commit to aggressive and achievable goals. Then deliver more than others.

2. Get voted onto the team every day. In football and the real world, when you try to solve today’s problems no one gives you credit for past accomplishments. People care about how well you get today’s hard stuff done.  

3. Operate with a mind-set that reflects a meritocracy. That's opposed to displaying a sense of entitlement -- no matter how proud you are of your education. Having a pedigree doesn't mean you can look down on others. People sense that -- and won't like it. And while Harvard or Stanford may open the door to opportunities, capitalizing on those opportunities is all about how well you do the job.

4.  Be ready to demonstrate how you handle adversity. When I hire, I often look at educational achievements as a basis for assessing someone's raw intellectual prowess. But I spend way more time looking at the challenges they've tackled, what they've achieved and how sought after they are.   

5. Be open to seeing excellence wherever it is. You’ll find it often comes in the most unlikely of places.

6. Leverage your network. That’s one of the most valuable assets of any degree. Work it. 

7. Understand that it’s not all about you. MBA programs spur a lot of competition; there’s an intense race to be the top of the class. But that individualistic focus isn’t always welcome at the workplace, where a “company first” not a “me first” attitude is desired.

8. Learn a new culture. Don't adhere to what you learned in school. Do extra-credit projects that provide exposure to executive management and hopefully the board. Watch how people handle themselves at these meetings and modify your behavior accordingly.

9.  Give back and continue to enhance and help others on their path. If you have an MBA, use it for good.

Original Article at:    9 Lessons You Won't Learn in Business School
By Maynard Webb | April 4, 2014

Vitamin D – Why You are Probably NOT Getting Enough

WHAT VITAMIN DO WE need in amounts up to 25 times higher than the government recommends for us to be healthy?

What vitamin deficiency affects over half of the population, is almost never diagnosed, and has been linked to many cancers, high blood pressure, heart disease, diabetes, depression, fibromyalgia, chronic muscle pain, bone loss, and autoimmune diseases like multiple sclerosis?

What vitamin is almost totally absent from our food supply?

What vitamin is the hidden cause of so much suffering that is so easy to treat?

The answer to all of these questions is vitamin D.

Over the last 10 years of my practice, my focus has been to discover what the body needs to function optimally. And I have become more interested in the role of specific nutrients as the years have passed.

Two recent studies in The Journal of Pediatrics found that 70 percent of American kids aren’t getting enough vitamin D, and this puts them at higher risk of obesity, diabetes, high blood pressure, and lower levels of good cholesterol. Low vitamin D levels also may increase a child’s risk of developing heart disease later in life.

Overall, 7.6 million, or 9 percent, of American children were vitamin D deficient, and another 50.8 million, or 61 percent, had insufficient levels of this important vitamin in their blood.

Over the last 5 years, I have tested almost every patient in my practice for vitamin D deficiency, and I have been shocked by the results. What’s even more amazing is what happens when my patients’ vitamin D status reaches optimal levels. Having witnessed these changes, there’s no doubt in my mind: vitamin D is an incredible asset to your health.

That is why in today’s blog I want to explain the importance of this essential vitamin and give you 6 tips on how to optimize your vitamin D levels.

Let’s start by looking at the massive impact vitamin D has on the health and function of every cell and gene in your body.

How Vitamin D Regulates Your Cells and Genes

Vitamin D has a huge impact on the health and function of your cells. It reduces cellular growth (which promotes cancer) and improves cell differentiation (which puts cells into an anti-cancer state). That makes vitamin D one of the most potent cancer inhibitors — and explains why vitamin D deficiency has been linked to colon, prostate, breast, and ovarian cancer.

But what’s even more fascinating is how vitamin D regulates and controls genes.

It acts on a cellular docking station ,called a receptor, that then sends messages to our genes. That’s how vitamin D controls so many different functions – from preventing cancer, reducing inflammation, boosting mood, easing muscle aches and fibromyalgia, and building bones.

These are just a few examples of the power of vitamin D. When we don’t get enough it impacts every area of our biology, because it affects the way our cells and genes function. And many of us are deficient for one simple reason …

For example, one study found that vitamin D supplementation could reduce the risk of getting type 1 diabetes by 80 percent.

Your body makes vitamin D when it’s exposed to sunlight. In fact, 80 to 100 percent of the vitamin D we need comes from the sun. The sun exposure that makes our skin a bit red (called 1 minimum erythemal dose) produces the equivalent of 10,000 to 25,000 international units (IU) of vitamin D in our bodies.

The problem is that most of us aren’t exposed to enough sunlight.

Overuse of sunscreen is one reason. While these product help protect against skin cancer – they also block a whopping 97 percent of your body’s vitamin D production.

If you live in a northern climate, you’re not getting enough sun (and therefore vitamin D), especially during winter. And you’re probably not eating enough of the few natural dietary sources of vitamin D: fatty wild fish like mackerel, herring, and cod liver oil.

Plus, aging skin produces less vitamin D — the average 70 year-old person creates only 25 percent of the vitamin D that a 20 year-old does. Skin color makes a difference, too. People with dark skin also produce less vitamin D. And I’ve seen very severe deficiencies in Orthodox Jews and Muslims who keep themselves covered all the time.

With all these causes of vitamin D deficiency, you can see why supplementing with enough of this vitamin is so important. Unfortunately, you aren’t really being told the right amount of vitamin D to take.

The government recommends 200 to 600 IU of vitamin D a day. This is the amount you need to prevent rickets, a disease caused by vitamin D deficiency. But the real question is: How much vitamin D do we need for OPTIMAL health? How much do we need to prevent autoimmune diseases, high blood pressure, fibromyalgia, depression, osteoporosis, and even cancer?

The answer is: Much more than you think.

Recent research by vitamin D pioneer Dr. Michael Holick, Professor of Medicine, Physiology, and Dermatology at Boston University School of Medicine, recommends intakes of up to 2,000 IU a day — or enough to keep blood levels of 25 hydroxy vitamin D at between 75 to 125 nmol/L (nanomoles per liter). That may sound high, but it’s still safe: Lifeguards have levels of 250 nmol/L without toxicity.

Our government currently recommends 2,000 IU as the upper limit for vitamin D — but even that may not be high enough for our sun-deprived population! In countries where sun exposure provides the equivalent of 10,000 IU a day and people have vitamin D blood levels of 105 to 163 nmol/L, autoimmune diseases (like multiple sclerosis, type 1 diabetes, inflammatory bowel disease, rheumatoid arthritis, and lupus) are uncommon.

Don’t be scared that amounts that high are toxic: One study of healthy young men receiving 10,000 IU of vitamin D for 20 weeks showed no toxicity.

The question that remains is: How can you get the right amounts of vitamin D?

6 Tips for Getting the Right Amount of Vitamin D

Unless you’re spending all your time at the beach, eating 30 ounces of wild salmon a day, or downing 10 tablespoons of cod liver oil a day, supplementing with vitamin D is essential. The exact amount needed to get your blood levels to the optimal range (100 to160 nmol/L) will vary depending on your age, how far north you live, how much time you spend in the sun, and even the time of the year. But once you reach optimal levels, you’ll be amazed at the results.
For example, one study found that vitamin D supplementation could reduce the risk of getting type 1 diabetes by 80 percent. In the Nurses’ Health Study (a study of more than 130,000 nurses over 3 decades), vitamin D supplementation reduced the risk of multiple sclerosis by 40 percent.

I’ve seen many patients with chronic muscle aches and pains and fibromyalgia who are vitamin D deficient – a phenomenon that’s been documented in studies. Their symptoms improve when they are treated with vitamin D.

Finally, vitamin D has been shown to help prevent and treat osteoporosis. In fact, it’s even more important than calcium. That’s because your body needs vitamin D to be able to properly absorb calcium. Without adequate levels of vitamin D, the intestine absorbs only 10 to 15 percent of dietary calcium. Research shows that the bone-protective benefits of vitamin D keep increasing with the dose.

So here is my advice for getting optimal levels of vitamin D:

1. Get tested for 25 OH vitamin D. The current ranges for “normal” are 25 to 137 nmol/L or 10 to 55 ng/ml. These are fine if you want to prevent rickets – but NOT for optimal health. In that case, the range should be 100 to 160 nmol/L or 40 to 65 ng/ml. In the future, we may raise this “optimal” level even higher.

2. Take the right type of vitamin D. The only active form of vitamin D is vitamin D3 (cholecalciferol). Look for this type. Many vitamins and prescriptions of vitamin D have vitamin D2 – which is not biologically active.

3. Take the right amount of vitamin D. If you have a deficiency, you should correct it with 5,000 to 10,000 IU of vitamin D3 a day for 3 months — but only under a doctor’s supervision. For maintenance, take 2,000 to 4,000 IU a day of vitamin D3. Some people may need higher doses over the long run to maintain optimal levels because of differences in vitamin D receptors, living in northern latitudes, indoor living, or skin color.

4. Monitor your vitamin D status until you are in the optimal range. If you are taking high doses (10,000 IU a day) your doctor must also check your calcium, phosphorous, and parathyroid hormone levels every 3 months.

5. Remember that it takes up to 6 to 10 months to “fill up the tank” for vitamin D if you’re deficient. Once this occurs, you can lower the dose to the maintenance dose of 2,000 to 4,000 units a day.

6. Try to eat dietary sources of vitamin D. These include:

• Fish liver oils, such as cod liver oil. One tablespoon (15 ml) = 1,360 IU of vitamin D

• Cooked wild salmon. (3.5) ounces = 360 IU of vitamin D

• Cooked mackerel. (3.5) ounces = 345 IU of vitamin D

• Sardines, canned in oil, drained. (1.75) ounces = 250 IU of vitamin D

• One whole egg = (20) IU of vitamin D

You can now see why I feel so passionately about vitamin D. This vitamin is critical for good health. So start aiming for optimal levels – and watch how your health improves.


Original Article at:   Vitamin D – Why You are Probably NOT Getting Enough

 by Mark Hyman, MD    January 19, 2013