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The Most Effective Over-The-Counter Medication to Treat Your Cold

1/20/2017

There are over 200 different types of viruses that can cause the common cold, and you are much more likely to be infected with a virus than bacteria. Unfortunately, antibiotics do not work on viruses and your cold will just have to run its course. That being said, there are certainly many things you can take to make yourself feel better.

Here is a list of the most common cold symptoms I hear in practice and what to look for at the pharmacy to make you feel better.

1. “My nose won’t stop running”
This is one of the most common symptoms associated with a cold, and can be incredibly annoying to be constantly grabbing for a tissue. Start taking a first generation histamine blocker, the most common is diphenhydramine (aka Benadryl) – yes these are marketed as allergy medication, but a side effect of these drugs is that they dry you out and will dry up that snot coming out of your nose and down your throat. Unfortunately, first generation anti-histamines can make you drowsy so best to take only at night time. Note that second generation anti-histamines ( i.e. Claritin, Allegra) do not have as much of a drying effect, but can take these during the day for possible relief.

2.“I am so stuffed up and congested”
Hands-down, most effective medication for this is pseudoephedrine (aka Sudafed) . Pseudoephedrine restricts blood vessels in your nassal passages, in effect reducing the pressure of your sinuses. Unfortunately, this constriction happens to all vessels in your body and can make your blood pressure go up a couple of points and may make you feel jittery because of this - so do not take if you already have high blood pressure and also do not take right before you want to go to bed. Another effective medication for sinus pressure is a nasal steroid such as Flonase. Note that nasal steroids take about a week to see full effect, so you are unlikely to get as much of a response compared to Sudafed.

Important note: Do not buy a product with phenylephrine (aka Sudafed PE), you will see this ingredient listed in any product that markets itself as a decongestant. This is the “Sudafed” that you see on the shelf that you can just walk out with without showing your ID. Phenylephrine has shown to be no more effective then placebo – and yes it will also raise your blood pressure, so not a good alternative for anyone

3. “My ears feel full”
This is an extension of your inflamed sinuses - your ears feel full because your sinuses are blocked, so how do you clear your ears? Clear your sinuses. As stated above, take pseudoephedrine and/or Flonase to help clear this congestion.

4. “I have a cold and the worst part is the cough”
There are a couple of different remedies for this.The American Academy of Chest Physicians recommends a combination of a first generation anti-histamine (i.e. diphenhydramine or Benadryl) PLUS a decongestant (pseudoephedrine or nasal decongestants such as Flonase).

Another popular ingredient for cough is dextromethorphan which you will as the main component in Robitussin DM or Delsym. Dextromethorphan theoretically works to make you stop coughing by blocking the cough reflex in the brain. Studies have shown this to be marginally effective, and I’ve had mixed results in practice as well. Read more about this here.

5. “My cold is gone, but I still have a cough”
AKA “post-infectious cough” can last up to 8 weeks after your cold goes away – 8 weeks! You can try one of the above remedies for cough, but if the cough is very irritating probably best to see your provider for an inhaler or prednisone which should make it go away quicker. Note that if it has been over 8 weeks your cough is likely due to some other cause and you should make an appointment to see your practitioner for evaluation.

6. “I'm coughing up thick phlegm”
For thick gunky mucus, Guaifenesin (aka Mucinex) is the ingredient you should look for to help with this. Note that this medication needs fluids to be able to work, so you must be hydrating yourself properly. Another potential benefit of taking this medication is that is has been shown to work as an anti-cough agent. Studies have shown this medication to be possibly effective for the above, this is another medication I've had mixed results with in practice.

7. “I have body aches”
Take nothing. Try light exercise, stretching, and avoid taking pain relievers. Body aches are a side effect of interferons, which are released in the presence of an infection, and whose job is to fight off the invader making you sick. In other words, body aches are a good sign because this means your body is trying to fight off the infection, let it be. Avoid taking ibuprofen because ibuprofen will block production of these virus killing cells - meaning longer duration and severity of cold symptoms for you.

8. “I had a fever of 102 this morning”
Take nothing. Plenty of fluids. A fever is a normal physiologic defense mechanism by your body to kill the pathogen making you sick - the American Academy of Pediatrics stresses that fever has beneficial effects and no evidence that a fever prolongs illness or causes any neurologic effect in the future. How does a fever work to help you? The increased body temperature stimulates production of your white blood cells (ie your immune system which functions to get rid of the bug making you sick), it lowers viral replication rate, (meaning less virus in your system), and high temperatures are toxic for some of the most virulent bacteria - such as those that cause pneumonia. Bottom line, let your body do its job and avoid taking fever reducers like acetaminophen or ibuprofen.

9. “I need to get better ASAP”
If you want to cut back on the length of your cold, start taking zinc gluconate now. Many studies have shown that zinc can decrease the length of your cold by 4-7 days – that’s like a 50% reduction in the length of your symptoms! If you are going to take anything for your cold, take zinc and take zinc gluconate specifically as it has shown to be the most absorbable formulation - the zinc needs to coat the throat where the virus normally lies. Also make sure to take in lozenge form as pills or drinks with zinc are less effective. Read more about this here.

Honorable mention: Vitamin C has also shown to be able to shorten the length of your cold, but there are limited studies on this, and the studies that do show a positive effect show only a ½ day reduction in the length of your cold when you take Vitamin C.

SK

IN With the Fat, OUT With the Carbs for a Healthy Heart

1/8/2017

Obesity, diabetes, and heart disease have skyrocketed and continue to increase since the government’s recommendation for low-fat diet for a healthy heart starting in the 1970s. When we take a closer look at the evidence connecting saturated fat and heart disease, the evidence presented is pretty weak, and more and more evidence is mounting and getting recognition against the long term belief that saturated fat intake leads to cardiovascular disease and death.

The low-fat mantra all started in the 1950s with a scientist named Ancel Keys. He performed a couple of highly flawed studies where he "cherry-picked" data to show that saturuated fat intake caused heart disease. The government and food industry locked onto this idea, despite data and numerous studies that have flooded in to debunk this theory. I highly recommend the books Eat Fat Get Thin by Mark Hyman, MD, and Why We Get Fat by Gary Taubes, for more information and citations of this.

Here are 5 reasons that saturated fats are not going to increase your risk for heart disease or death:

1. Low-fat diets are NOT effective at preventing heart disease
No study has been able to prove that a low fat diet will decrease risk of cardiovascular mortality. Plenty of studies show that saturated fat can increase total cholesterol, and then make the simplified conclusion that saturated fats lead to heart disease. But this is highly misleading because yes, saturated fat will increase total cholesterol because it increases HDL cholesterol (good cholesterol), as well as the good type of LDL cholesterol (more on this below); however, no study can show a direct link between saturated fat intake and cardiovascular related death. Again, there are more studies then I could ever reference, but here are a couple good ones:

In 2010, an analysis of 21 quality studies that looked at roughly 350,000 individuals up to a 21 year period found no risk of saturated fat intake with cardiovascular disease or stroke

And lastly, one of the largest and most expensive and long term clinical trials called the Women’s Health Inititiative (WHI) was meant to show the benefit of a low-fat diet for lowering cholesterol and heart disease. After eight years of this study, the women on low-fat diet had lowered their total and LDL cholesterol, however, there was no beneficial effect on heart disease, stroke, or cancer found from eating a low fat diet.

2. Fat increases your HDL cholesterol (good cholesterol)
Low HDL cholesterol has been found to be a far greater risk factor of having a heart attack than a high LDL cholesterol . When you replace fat in your diet (including saturated fat), with carbohydrate, this lowers your HDL cholesterol. A study by The New England Journal of Medicine explains that a low HDL cholesterol is a “biomarker for dietary carbohydrate.” Saturated fats have been shown to increase your HDL cholesterol (good cholesterol), and to have either no effect on your triglyceride cholesterol or to reduce this (another type of bad cholesterol).

In practice, when I get a patient's labs back and I see a low HDL cholesterol level with high triglycerides, this is an indicator to me that this individual is eating a high carb, low fat diet.

3. Fat increases large LDL particles (good type) and decrease small LDL particles (bad type)
Yes, to make things more confusing there are different types of LDL, large "fluffy" type (think cotton balls), small dense type (think rocks), and many other sizes in between. We want more of the large LDL particles to small dense LDL particles because the small dense LDL particles are much easier to lodge themselves into the walls of your arteries causing your arteries to narrow which leads to decreased blood flow (ie oxygen to your heart). These small dense LDL particles also are known to oxidize which leads to rancidity and inflammation in the blood vessels. Saturated fats will increase large LDL and decrease small LDL which in effect will cut your risk of heart disease.

4. Replacing saturated fats with carbohydrates increases bad cholesterol
This is more of a summary of the above, but I want to reiterate that replacing saturated fats for carbohydrates makes your cholesterol profile much worse. Carbohydrates have been shown to decrease your good HDL cholesterol while increasing small particle LDL bad cholesterol, as well as inceasing your triglyceride cholesterol. As mentioned above, heart disease is most associated with a low HDL cholesterol and high triglyceride cholesterol. LDL is a little harder to predict with heart disease because of the varying sizes and conflicting evidence.

5. Prevents "Diabesity"
Cutting back on fat almost enevitably means you are going to add carbohydrates to your diet, and high carbohydrate intake is what leads to diabetes as well as obesity - this is something that is not disputed. Obesity is a risk factor in itself for heart disease, as is diabetes, put these two major risk factos together and you are talking about a massive increase in your chance of cardiovascular disease (think heart attack).

Just as guidelines have changed in terms of cholesterol containing foods (in case you didn’t know, cholesterol containing foods do not raise bad cholesterol and this has finally been recognized by the American Heart Association (AHA) and the United States Department of Agriculture (USDA)) I have a hunch that there will be new guidelines for saturated fats in the near future.

Be sure to increase your intake of good saturated fats such as organic eggs, organic grass-fed beef, coconut oil, and dark chocolate.

SK

8 Good Reasons to Limit your Wheat Consumption

1/2/2017

One of the most frequent questions I have in practice is about wheat/gluten-free and my take on how it effects the body and mind. I started doing more research on the topic and I found more than enough reasons to cut out wheat completely from my own diet. Here are the top 8 to get you started:

1. Not the original wheat
First of all, wheat is not what it was thousands of years ago, or even fifty years ago. Wheat today is produced by countless hybridiazations making for thousands of different potentially harmfull proteins and other compounds We now have “wheat” that was grown in synthetic soil, saturated in chemicals, made to survive the worst environmental conditions and cultivated so that no pest would eat it – and we’re wondering if this could make us sick? Currently there is no requirement for crops that have undergone hybridization to be tested on animals or humans. Read more about this here and here.

2. Increases blood sugar higher than table sugar
Wheat’s main carbohydrate is Amylopectin A and raises your blood sugar higher and faster than any other carbohydrate including table sugar! When there is a large amount of sugar in your blood all at once, this signals a large amount of insulin to remove this sugar as quickly as possible and deliver this preferentially to your fat cells (why we call insulin the fat storage hormone). This is why you feel hungry an hour or two after eating a wheat product – all the sugar has been removed from your bloodstream by then and your cells are still hungry because your fat cells are hogging all of the energy.

3. Addictive
Wheat contains a unique protein called gliadin which, when broken down in the body into polypeptides, crosses the blood-brain barrier and binds the morphine receptor in the brain (i.e. euphoric center). These particular polypeptides are termed “exorphins” (exogenous morphine like compounds) because of how like other opiates, you feel a mini-high after ingesting and a slump short while after. In short, these exorphins stimulate the addictive, pleasure seeking part of your brain, stimulating your appetite making you want more and more. Just as other drugs that bind the morphin receptor (think heroin, morphin), this repeated exposure distorts the brain causing mental fog, sluggishness, fatigue and makes one more susceptible to depression and other psychological disorders down the road.

Interesting note - there are now drugs that contain naloxone to treat obesity. Naloxone is formerly known as a drug used to treat narcotic overdose, most notably heroin. It works for weight loss because it blocks the morphine receptor, exorphins are unable to bind, and thus prevents appetite from being stimulated.

4. Blocks your brain from understanding you are full
Digested wheat proteins have been found to block the leptin receptor. This is bad because leptin functions to tell our brain that we are full - if this is being blocked, you are more likely to be hungrier regardless of how much you may have just eaten.

5. Increased risk for diabetes and obesity
This goes along with it’s addictive like quality, stimulating your appetite, increasing blood sugar rapidly, and blocking the mechanism that tells you that you are full. This is a recipe for you to overeat (overeat carbohydrates in particular because of their addictive quality), which leads to obesity and diabetes from too much carbohydrate ingestion aka chronic high blood sugar. I hear all the time from slender patients not understanding how they can be at risk for diabetes with a normal weight and eating healthy “whole grains.” It doesn’t matter if you are thin or overweight, if you are consuming a high carbohydrate diet (which is easiest to do with consuming too many wheat products) your blood sugar will be chronically elevated unless you start making changes.

6. Worsening ADHD
This is still a controversial topic and more studies need to be done to look at this, but there have been many studies showing the improvement of ADHD in children and adults when cutting out the wheat products. You can read more about this here.

7. Inflammation to your gut
Gluten is the main protein of wheat, and it is made up of two proteins gliadin and glutenins. Gliadin is the primary group that triggers the immune response (i.e. infallmation) in celiac diease. But even beyond gluten and celiac diease, there are a wide range of other proteins present in wheat, more than could ever be accounted for due to the countless transformations via countless cross-breeding of strains as discussed above. These modified proteins as well as gluten have been shown to be associated with irritable bowel syndrome in non-celiac disease individuals, and accounts for digestive issues in individuals without full-blown celiac diease. This is why individuals who cut out wheat tend to have less stomach issues.

8. Joint inflammation
As discussed above, wheat products raise your blood sugar more than nearly all foods. The more your blood sugar rises, the more glycation occurs. Glycation is when a sugar binds to protein causing irrversible changes, and thereby modifies proteins in the blood stream, body tissues, and joints. Glycation is particularly damaging to cartilage, and when cartilage proteins become glycated they become stiff. Overtime, glycation makes the cartilage brittle, stiff, and crumbling resulting in more pain and destruction in your joints.

I know it sounds hard to cut back on wheat (because wheat is in virtually all processed foods), but replace with filling full fat foods – avocado, eggs, olive oil, cheese, etc. Healthy non-processed fats should be the bulk of your diet, as the low-fat craze has brought upon the increased obesity, diabetes, and heart diease rate since it was instituted in the 1970s - more on this for another post. If you want to read more about the effects of wheat I highly recommend the book Wheat Belly by cardiologist William Davis, MD.

SK

Health + Fitness + Mindfulness

The Most Effective Over-The-Counter Medication to Treat Your Cold

IN With the Fat, OUT With the Carbs for a Healthy Heart

8 Good Reasons to Limit your Wheat Consumption

Author

Archives

Categories

Health + Fitness + Mindfulness

The Most Effective Over-The-Counter Medication to Treat Your Cold

﻿IN With the Fat, OUT With the Carbs for a Healthy Heart

﻿8 Good Reasons to Limit your Wheat Consumption

Author

Archives

Categories

IN With the Fat, OUT With the Carbs for a Healthy Heart

8 Good Reasons to Limit your Wheat Consumption