June 2006
Before you even consider putting yourself under the knife or spending another $110 on a jar of wrinkle cream, you should know that nature’s own vitamin C can help you look and stay young.
Vitamin C is a key player in the formation of collagen, which softens your skin and fills in wrinkles. Recently, a group of researchers had volunteers apply topical vitamin C to one side of their faces each day and a placebo gel to the other side. After 12 weeks, they found that the skin treated with vitamin C had noticeably fewer wrinkles than the placebo sides. Pretty impressive, considering how many people use fancy, expensive creams for years without a single crow’s foot disappearing.
Look for a product that contains at least 10 percent vitamin C. They may not be the cheapest items out there, but at least you know this method’s been tested and proven itself in clinical studies. Shop around and find one that offers the most vitamin C bang for your buck.
One of the scariest things in the world is to go blind. It used to be that glaucoma and cataracts were the biggest threat to our eyesight. Now there’s a bigger, meaner culprit. It’s harder to treat, and it causes permanent damage. It’s called age-related macular degeneration (ARMD).
Blindness should not have to be a symptom of getting older. And I don’t have one patient over 50 who doesn’t worry about his or her eyesight.
In fact, ARMD is such a big issue that this year the government will launch its second study in 10 years on age related eye diseases. The first study, known as AREDS I, proved that nutritional therapy-in this case high doses of zinc and antioxidants-could help macular degeneration patients slow the disease’s progression. In the new study-AREDS II, which begins this year-researchers will study the nutrients lutein, zeaxanthin, and omega-3 fatty acids, and their benefits to ARMD patients.
What’s so interesting about these studies is that the government-which is usually more prescription-drug friendly-is investing tons of time and money into studying nutritional treatments for eye disease. And you know what that means: Prescription drugs aren’t working.
While I hate to put a damper on the good news that came out of AREDS I, there were a few shortcomings that I think you should know about, not to mention some easy ways to fix them. Plus, there are plenty of other approaches you can take-some that you can even start today-to prevent ARMD.
Breaking it down
Even though I’m not an eye doctor, I still hear from so many patients wanting to know how to protect their vision from macular degeneration and whether it’s too late to start. Well, it’s never too late to live healthy. But first you need to know what you’re protecting yourself from.
ARMD occurs when your macula -the part of the retina responsible for most of your eyesight-deteriorates. There are two different forms of macular degeneration: the dry form, which accounts for 90 percent of ARMD cases, and the wet form, which makes up the other 10 percent.
The list of risk factors for ARMD is long, so long in fact that it’s hard to believe there are people out there who aren’t at risk. Women face a higher risk, as do people who’ve had previous cataract surgery. Also, a fair complexion, smoking, too little exercise, using antacids, and getting too much sun can all put you at risk. So can different illnesses, such as diabetes, high cholesterol, an underactive thyroid, and high blood pressure.
In the dry form of macular degeneration, yellow deposits called drusen build up in the retina, and result in a slow loss of vision. In the wet form, blood vessels in the retina grow rapidly and break over two to three years, destroying the patient’s vision. The wet form is the worst kind of ARMD and causes the most severe vision loss. But just because the wet form is less common doesn’t mean you’re in the clear. Unfortunately, dry ARMD can eventually turn into wet ARMD, so if you already have the dry form, it’s important that you monitor the disease’s progression and do everything you can to slow it down, starting by making an appointment with your ophthalmologist.
The first step in fighting back
Yearly eye examinations are an absolute must for detecting ARMD as early on as possible and giving you the best chance of minimizing vision loss.
Your exam should include having your pupils dilated by your ophthalmologist. As uncomfortable as this can be, it’s really the best way to get a good look at what’s going on inside your eye.
If you have ARMD, your eye doctor will see signs of abnormal blood vessels, such as bleeding, fluid, and scarring in your retina. And if you have any of those problems, your doctor should do a test called a fluorescein angiography immediately.
The term fluorescein angiography sounds pretty technical, but it’s basically just a shot in the arm of a special fluorescent dye that goes straight to the back of your eye. Then your doctor uses a special camera to take pictures of your retina (with the dye in it) to get a better look at the problem.
Another good screening technique is the Amsler grid, and it’s one of the easiest methods you can use to detect vision problems.
The grid is a simple checkerboard pattern with a small dot in the center. Your doctor will ask you to focus on the dot and pay attention to whether you see any distortions, holes, or wavy lines. If you do, there could be a problem.
You can actually learn to use the Amsler grid by yourself to keep tabs on your vision in between your yearly visits to the eye doctor. St. Luke’s Cataract and Laser Institute has an Amsler grid that you can download for free on its Web site. Go to www.stlukeseye.com/eyeq/AmslerPrint.htm and follow the instructions.
The heart test that could save your vision
Once you have your bases covered with an ARMD screening, it’s time to address the two main causes of ARMD-malnourished retinal photoreceptors and oxidative stress.
Oxidative stress occurs when free radicals-molecules full of oxygen-attack and strain your photoreceptors (the cells responsible for converting light into signals that are carried to our brains through the optic nerves). But it’s also provoked by other problems going on in the body, like emotional stress, nutritional deficiencies, obesity, and disease. All of these things can trigger inflammatory reactions that put you at risk for ARMD.
You see, inflammation is your immune system’s reaction to oxidative stress-the two evils go hand-in-hand. When you’re in a constant state of oxidative stress, you’re in a constant state of inflammation, which increases your risk of all kinds of diseases-heart disease, diabetes, cancer, and ARMD. One of the best tests we have for inflammation is the highly sensitive C-reactive protein (hs CRP) blood test. It’s typically used to test for heart attack risk, but it may also be good for evaluating your ARMD risk.
To combat these problems, you need plenty of antioxidants, which neutralize the free radicals causing inflammation. And this is where the recent research-especially the AREDS study-comes into play.
The AREDS formula-which you can purchase in stores now-includes some of the best antioxidants around: 500 mg of vitamin C, 400 IU of vitamin E, 80 mg of zinc, 2 mg of copper, and 15 mg of beta carotene.
But, like I said earlier, there were a couple of flaws in the techniques used by AREDS scientists. For instance, the vitamin E they used was just a synthetic alpha-tocopherol (your body doesn’t absorb synthetic vitamin E as well), and they recommended an 80 mg dose of zinc, which is very, very high.
I don’t think most people need that much zinc. In fact, I usually recommend about 30 mg per day. As for the vitamin E, it’s always better to go with the natural, mixed-tocopherol form.
For a complete list of the nutrients you need to keep your vision going strong, ”Good vitamins for good vision”. In the meantime, let’s talk food.
Comfort foods for your eyes
If your mother was anything like mine, she probably always told you that carrots are good for your eyes. Well, she was right. The best place to start getting the nutrients your eyes need is at the dinner table.
Yellow, red, and orange vegetables, such as carrots, red peppers, and squash, along with leafy green vegetables like broccoli, spinach, and kale are full of the carotenoids lutein and zeaxanthin-antioxidant pigments known to promote good vision.
Foods that contain omega-3 fats (like salmon or grass-fed beef) and sulfur compounds (like garlic and onions) are also good for protecting your vision. These nutrients reduce inflammation and neutralize the free radicals that attack your eyes.
Also, try a handful of blueberries or blackberries for dessert, since both of them are rich in anthocyanin, a dark purple and blue pigment that research has shown to have a protective effect on vision.
Finally, round it all out with a nice glass of red wine. According to one study, the antioxidants you get from a glass or two of red wine daily can reduce your risk of ARMD by up to 34 percent.
If you don’t like wine, then black, green, and red teas contain similar antioxidants. And so does my personal favorite: premium-quality dark chocolate. ACD
HOMETOWN HEALING
The friendly bacteria cocktail that can help you break free of the bathroom
Ethyl is a widow in her late 70s. She can’t hear too well anymore, but otherwise she’s pretty healthy. She likes to spend time with her grandchildren, and she still plays bridge with the same group of friends that she’s been playing with for the last 30 years. So when she called me the other week and told me she’s had to give up playing bridge, I was concerned. Ethyl told me she’s been having diarrhea three or four times a day-along with gas and bloating-for the last two weeks.
By the time she called me, Ethyl was really frustrated. She felt like she couldn’t even leave her house. And the Imodium she bought wasn’t helping a bit.
“Please doctor,” she said. “What’s wrong with me?” I told her I wasn’t sure yet what the problem was, but I was sure that we could fix it together. I had her come into my office that afternoon for a stool test, just to make sure there wasn’t an infection going on that we should know about. It came back normal.
From there, we talked about what she’d been eating lately, and again, there was nothing out of the ordinary.
Ethyl usually has eggs, toast, and an apple for breakfast, a sandwich or soup for lunch, meat or fish with a potato, a vegetable, a salad, and a piece of fruit for dinner. She does have the occasional cookie or piece of chocolate as a snack, but nothing that concerned me too much.
Since there was no obvious cause for Ethyl’s diarrhea, I figured that the best and safest route to take was to get her on a probiotic. I explained to her that bad bacteria sometimes get the upper hand in the digestive system, causing gas, bloating, and diarrhea. We call it bacterial overgrowth or gut dysbiosis. I suspected that Ethyl’s digestive system may have been thrown off by exposure to some virus she picked up from one of her grandchildren. By filling the gut with good bacteria from a probiotic supplement I thought we could balance things out. And if it helped with the diarrhea, we’d also pretty much know what caused the problem in the first place.
Bacteria with a vegetable-juice chaser
I prescribed over-the-counter PB8, a freeze-dried probiotic on local shelves that I’ve had good results with. It costs about $15 for 60 capsules, and I gave Ethyl my usual recommendation: two capsules four times a day on an empty stomach with a few sips of water or juice. When your body is dehydrated from a bout of diarrhea, it’s important to drink nutrient-rich fluids–especially those containing lots of potassium and magnesium. I like low-salt V8 juice (or regular V8 if the salt’s not a problem for you). It has much more of the potassium and magnesium we need than Gatorade or orange juice.
A week later, Ethyl came back in for a checkup. She’s usually pretty prim and restrained, but this time she was elated. As soon as she sat down on the exam table, she said “Doctor, the diarrhea cleared up in a day. I could almost feel the pills working as they went through me.”
By the way, Ethyl isn’t especially into natural remedies or alternative medicine, although, like lots of folks, she prefers to avoid drugs if possible. To be honest, I’m not 100 percent sure she understands exactly how the probiotics worked, only that they worked. I told her if she continues to use the PB8 a couple of days a week just to keep things in order, she’ll be a lot less likely to have the problem in the future. I also suggested she not wait two weeks before seeing me in the future. I reminded her that I always see people immediately if they need it.
I’ve lost count of the number of patients with Ethyl’s problem who’ve had good results with probiotics. As a bonus, probiotics confer general health benefits by supporting healthy digestion and immune system functions. How many drugs do that? ACD
Your step-by-step guide for knocking out tough cases of diarrhea
1) First, consider whether you are doing or taking anything out of the ordinary.
2) If not and it continues for more than three days, have your doctor take a stool sample to make sure there’s not a serious problem.
3) Once you’ve ruled out anything serious, consider taking a probiotic supplement. The one I recommend, PB8, is available from health food stores and on the Internet (just do a google.com search for it, and you’ll turn up dozens). Take two capsules four times daily on an empty stomach until you feel better. I also like the products from Jarrow (Jarro-Dophilus) and New Chapter (All Flora). I’ve also just finished working with the folks at Pure Country Naturals to develop a line of products based on my own medical practice, including a probiotic called Healthy Gut. If you’re interested, call 1-800-913-2565. The order code is MGUT, and for a limited time they are offering a special introductory price to my readers–just $19.95 for a 30-day supply.
4) Get plenty of fluids. I especially recommend V8, which has lots of potassium and magnesium, two nutrients your body will need after a few attacks of diarrhea.
5) Once the probiotics balance out your gut bacteria, cut back on your dose to two capsules twice a day a few times a week.
10 most surprising drugstore remedies
Cures that work-and don’t break the bank!
These days, there’s an expensive prescription drug for just about every condition you can think of, even the tiniest ailment. But just because they’re around doesn’t mean you need them. Your local drugstore has dozens of cheap cures for what ails you, and you don’t need a prescription to get them.
A lot of these remedies have been long forgotten and don’t get a lot of attention-if any (mostly because there’s no big money to be made from them). But they’ve been around for years, and I can assure you that they all work just fine.
Black drawing salve
This stuff has all sorts of uses, but it’s especially good for prying pesky splinters, thorns, and insect stingers out of your skin. The active ingredient is ichthammol, which softens your skin cells, allowing the splinter to work itself out in a few hours. Black salve also has antibacterial properties that help prevent infection.
Some people don’t like its strong odor, but those who do use black salve swear by it. If you can’t find it at your local drugstore, try www.wonderlabs.com, which sells it for a just three bucks a tube.
Liquid Benadryl and Maalox for sore throats
Chances are you probably have both of these things in your medicine cabinet. And you probably already know what they’re typically used for. But when you mix them together, these two products can heal something entirely different –a sore throat.
Make a solution of 50 percent Benadryl and 50 percent Maalox and gargle for about half a minute up to four times a day. I know it sounds like a strange concoction, but the liquid Benadryl is great for easing swelling and redness, and the Maalox has a soothing effect, and it smooths out the mixture, making it a little easier to use.
Cola syrup
This is an old-fashioned remedy that works for mild nausea (and it’s one of the few old-time cures that tastes good too). Cola syrup is basically just a non carbonated version of the soft drink, but used in smaller amounts of course. If you can’t find it in your pharmacy or grocery store, try www.vermontcountrystore.com. They have a caffeine-free version –which I use myself–for $9.95.
Bag Balm
This mixture is great for fixing dry cracked hands, elbows, and feet. I use it myself every night in the winter for chapped lips. For more serious cases, apply a thick layer before you go to bed and cover the affected area with a thin T-shirt, cotton gloves, or socks-wherever you need it.
You should be able to find Bag Balm at your local drugstore, feed store, pet store, and some hardware stores. But if you can’t find it, try www.bagbalm.com. The company’s Web site has a phone number and address you can use to order it.
Alkalol
A pharmacist in Massachusetts developed this product back in 1897, and it works as good now as it did back then. In fact, all of my patients with sinus problems use it regularly for relieving congestion and sinus infections. You can also use it as a nasal wash or throat gargle.
Alkalol contains a bunch of soothing herbs-eucalyptus, thymol, menthol, camphor, wintergreen, spearmint, pine, and cinnamon, plus a tiny, non-irritating amount of alcohol that works as a disinfectant. You can find it at your nearest drugstore, and it usually costs less than four bucks.
Vicks VapoRub
That jar of Vick’s VapoRub that you haven’t thought about since your last cold also has two other handy uses.
Try it as an insect repellent. It can also work for clearing away toenail fungus when applied twice daily. But be patient-nail fungus can take a few months to clear up.
Second Skin
Spenco’s Second Skin is a clever spongy material that absorbs pressure and reduces friction around blisters. For maximum benefit, apply some petroleum jelly or Bag Balm first, then cover it with Second Skin and tape it in place. You should be able to find Second Skin at any drugstore and some athletic stores.
Witch hazel
This natural cleansing agent is good for hemorrhoids, but it’s even more useful for treating a condition that’s often mistaken for hemorrhoids, called-for lack of a better term-”itchy bottom syndrome.”
A large bottle costs just a little, and this stuff really works. Apply it liberally to your toilet tissue, wipe gently, and you’re all fixed up.
Packer’s Pine Tar Soap
This soap has been sold since the 1860s, and it’s still available on most drugstore shelves.
When I was a kid, I gave a bar to my dad every year for Christmas. It wasn’t until I started my medical studies that I learned about its healing qualities from a dermatologist I studied under. This man was a strict, by-the-book doctor who wasn’t afraid to prescribe an old-fashioned remedy if it worked. He taught me how pine tar soap can relieve eczema and milder forms of psoriasis. It can work for dandruff, too.
Fels Naptha
Here’s another soap with healing qualities. Fels Naptha has been used for more than a century to clear away poison ivy. It costs about $2 a bar and is still on most grocery and drugstore shelves.
Rinse the affected area with water as hot as you can stand, and then wash with Fels Naptha to remove any remaining poison ivy resin.
That’s all for my top 10. If you have any of your own homegrown remedies that you swear by, feel free to drop me a line and I’ll share them with other readers in a later issue. You can write to me at America’s Country Doctor, 819 N. Charles St., Baltimore, MD, 21201. ACD
Good vitamins for good vision
1) Lutein, zeaxanthin, and beta-carotene
These powerful antioxidant carotenoids absorb dangerous light rays that harm your retina.They’re found in many red, orange, green, and yellow fruits and vegetables like spinach, collard greens, red peppers, and carrots. One study showed that people who consume lutein and zeaxanthin-rich foods just five times a week are eight times less likely to develop ARMD than those who consume them once a week. Research also shows that beta-carotene-also found in many red, yellow, orange, and green vegetables-helps fight vision problems.
If you’d rather take supplements, try getting at least 10 mg of lutein, 2 mg of zeaxanthin, and 6 to 15 mg of beta-carotene each day.
2) Glutathione
Glutathione is an antioxidant found in onions, garlic, avocados, asparagus, watermelon, and cruciferous vegetables like broccoli, cabbage, and brussels sprouts. It promotes healthy tissues in your eyes and is essential for maintaining overall eye health. Our bodies don’t absorb glutathione very well in supplement form though, so it’s best to get this nutrient by eating fruits and vegetables.
3) Vitamin E
The alpha and gamma-tocopherol forms of natural vitamin E also protect your eyes. A French study of 2,500 subjects showed that those with the highest blood levels of vitamin E had an 82 percent lower risk of developing ARMD. Shoot for 400 IU of natural, mixed-tocopherol vitamin E per day.
4) Vitamin A
Vitamin A is another inflammation-fighting, vision-protecting antioxidant. It’s found mainly in animal products, especially lamb, beef, and chicken liver. But if you want to go the supplement route, you need to take about 5,000 IU daily.
5) Zinc
Healthy retinas contain a lot of zinc, so it’s important to keep your levels up. But about 50 percent of us don’t get enough. Some good food sources of zinc are oysters, beef, lamb, egg yolks, pecans, and Brazil nuts.
As far as supplements are concerned, a two-year study showed that 100 mg a day of zinc could slow the progression of ARMD. But for prevention, the 15 to 30 mg of zinc found in multivitamins is enough. Just make sure to take some copper along with it, since excess zinc can deplete your body’s stores of copper. You don’t need much-2 mg per day is plenty.
6) B vitamins
Homocysteine is best known as one of the culprits behind heart disease. Levels above 9.0 are associated with an increased risk for all sorts of diseases, including ARMD. But folate (800 mcg daily), vitamin B6 (50 mg), and vitamin B12 (at least 100 mcg) all help normalize homocysteine, protecting your vision in the process.
There are other nutrients that help make the vitamins and minerals I’ve just mentioned more effective. Selenium helps vitamin E and glutathione do their jobs. Vitamin C helps repair light damage to the eyes and keeps vitamin E in its active form. And magnesium helps maintain good blood flow to the eyes.
Also, one study linked ginkgo to a 23 percent improvement in retinal blood flow. Another study, using 240 mg a day, showed significant vision improvement in patients with dry ARMD.
YOUR QUESTIONS ANSWERED
Put the spring back in your step
Q: When I went to see my doctor about the severe pain in my right heel, he told me that I have plantar fasciitis. He prescribed ibuprofen and a heel insert, but it still hurts. What else can I do to relieve this excruciating pain? It’s spring and I have gardening to do!
–Miranda H., Culpeper, VA
A: I see this a lot in my office. Plantar fasciitis means that the connective tissue between your heel and the base of your toes is inflamed, probably from overuse. Sometimes all it takes to ease the pain is what your doctor recommended: common anti-inflammatories and maybe an over-the-counter heel insert.
But if your pain continues and you want to be more proactive, you may also want to consider a few other treatments that actually address the cause of the injury, instead of just relieving the pain.
1) Get some rest: Whatever you’ve been doing to stress your heel, cut back. If you’re walking five miles a day, cut it down to a couple of miles. If you’re digging in the garden, get someone else to do it for you for a couple of weeks. Just lay off of your most strenuous exercises until you feel better. This is relative rest, not absolute rest, so don’t worry, you’re not bedridden.
2) Do heel stretches: Exercising your heels increases their flexibility, making you less vulnerable to another overuse injury later on. Try this one: Hold both ends of a towel in your hands, place the ball of your foot on the middle of the towel, and then slowly extend your leg outward.
Another exercise you can try is what I call “the soup can move.” Roll your foot back and forth over a soup can for a minute at least twice a day.
3) Use orthotic inserts: Customized shoe inserts can work wonders. They’re pricey (usually $200 to $300), but in many cases they’re well worth it. Your primary doctor, foot doctor, or orthopedist will usually know someone who makes these.
4) Consider wearing a night splint: These range in price from $40 to $100, and you can find them online at www.footsmart.com. Night splints work by holding your foot in a slightly flexed position, relieving the affected area and giving it a chance to heal. Some people swear by them. Other people balk at the idea of wearing this somewhat cumbersome device in bed. But if you’re in serious pain, it’s worth it.
Some doctors suggest injecting a shot of steroids into the affected area. I won’t say this can’t relieve the pain, but it should be used as a last resort, if at all. Steroid injections deposit crystals in your connective tissue, which can weaken it and increase your risk of a similar injury later on. Most people don’t like the idea of having a needle stuck in their foot anyway, so they pass on the injections, and I recommend that you do the same, unless you and your doctor decide there is no other way.
Be patient, because it can take weeks or even months for plantar fasciitis to clear up entirely, whether you use all of these cures or just one. But you’ll be surprised by how quickly things can improve to a tolerable level if you use the right combination of therapies.
The text contained herein does not constitute medical advice. America’s Country Doctor advises that you consult your own physician before acting on any recommendations contained within this publication.
Posted in Newsletter.
