Yet Another Risky Pill for Weight Loss

Written by yvonnethornton on July 23rd, 2012

Are you ready for a miraculous weight loss pill?  Aren’t we all?  As much as we’d all love to believe that they finally came up with a pill that will melt away the pounds, most of us are also worrying about the side effects, and rightly so.  The FDA just approved yet another wonder drug, but it will still be up to the public to find out just how safe it is.

On Tuesday, the US Food and Drug Administration allowed another weight loss pill to be put on the market.  It’s called Qsymia, and though it does have risky side effects, they believe the benefits outweigh the dangers.  Dr. Janet Woodcock, Director of FDA’s research department said that “Obesity threatens the overall wellbeing of patients and is a major public health concern.”  Because obesity impacts two-thirds of Americans, it does indeed seem like a major issue, but taking care of that problem with a pill is quite another matter.  Some past weight loss drugs approved by the FDA were found to have very dangerous side effects that cost people their lives.  You might remember the rise and fall of the popular diet pill Fen-Phen for example.  Even after years of testing in the lab, some drugs can prove to have side effects that either weren’t observed in the controlled tests or were ignored as minor drawbacks.

Qysymia is a combination for stimulants and anti-seizure drugs and is one of the first new diet pills to become FDA approved in 13 years.  Its side effects and risks include a fast heart rate, metabolic acidosis, birth defects, and heart damage.  It is only approved for those considered obese, which is a BMI of 30 or more, and those with a BMI of 27 or more and who have a weight-related medical condition.  The two experts on the FDA panel who voted against the approval of Qsymia worry that it will have “severe, even fatal, consequences.”  Dr. Woodcock, however, believes that if it’s used properly and in combination with a healthy diet and regular exercise, it could be just the thing we need to halt the obesity epidemic.

I don’t know about other physicians, but I plan to stick to the less-miraculous prescription for a health weight- eating right and staying active.  There just can’t be a pill for everything!

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Posted in General health news, Women's health news | No Responses »
Tags: , , ,

Fertility Financing Becomes a Popular Option

Written by yvonnethornton on July 19th, 2012

How much is a baby worth to a couple trying to get pregnant?  It’s likely priceless, but to the lending industry, it’s worth millions.  Apparently, because of the steep cost of fertility treatments, some couples are turning to financing to get enough money to improve their odds of having a child.

One couple in Rockville, Md, Jill and Tom Clinton, tried desperately to get pregnant, but after a heartbreaking miscarriage, they decided to try a fertility clinic.  Unfortunately, the cost of the average in-vitro fertilization cycle is about $12,000 and their insurance wouldn’t cover any of it.  Additionally, it often takes several cycles to get good enough odds for a successful pregnancy.  In order to make it happen, they drained their savings and were happy to receive a baby boy from that investment.  When they wanted a second child though, there was no money left for fertility treatments, so their doctor told them about the possibility of getting financing.  After more research, they found that fertility financing companies are being created around the country and the industry is growing fast.  It’s so popular in fact, that Capex MD, the company the Clintons decided to use, funds a whopping one million dollars in fertility loans each month and that number is rising steadily.

It appears unclear as to why this new industry is growing so fast.  Some speculate that more couples are trying to get pregnant later in life and so are more likely to need fertility treatments, while others believe it’s simply the new option that is giving rise to the results.  Couples who previously couldn’t afford in vitro fertilization now have the option to get financing and so they do.  Either way, it is causing concern among medical ethics committees like the one at Langone Medical Center.  They wonder if lending companies aren’t taking advantage of the desperate nature of couples in this situation, seemingly holding a miracle right in from of them.  Arthur Caplan, head of the Langone Medical Center Ethics Division worries that couples are “not going to hear the failure and success rate, the interest rate, and what the risks are of the treatments.” Instead, couples may only pay attention to the idea that there is one more opportunity to allow them to give pregnancy another try.

– Yvonne S. Thornton, M. D., M. P. H.

 

Posted in Fertility & Infertility, Pregnancy, Women's health issues | No Responses »
Tags: , ,

Osteoporosis and Alcohol

Written by yvonnethornton on July 16th, 2012

Like any reputable physician, I don’t condone heavy drinking, but that doesn’t mean I don’t necessarily partake in a glass of my favorite wine every now and then.  The truth is, a little alcohol once in a while never hurt anyone.  While recent studies suggest that a little bit of drinking may actually help our bones, my personal opinion is that one might be jumping the gun a bit.  Nevertheless, in the “spirit” of being complete and open, I wanted you to know about the recent research that has been covered by the media.

As odd as the connection may seem, a study by the College of Public Health and Human Sciences at Oregon State University found that even small amounts of alcohol have an impact on bone metabolism.  Their study of 40 postmenopausal women who drank moderately did show some benefit.  In fact, according to the principal investigator, “moderate alcohol [use] may slow bone loss by lowering bone turnover.”  That can help to reduce a woman’s risk for osteoporosis later in life.  Urzula Iwaniec, associate professor at OSU, explained that bones are living tissue with old bones constantly being replaced by new bone.  This is why increasing the metabolism of bones helps to stimulate the growth of new bone and keep older, thinning bones at bay.  One of the problems I had with this study is the sample size.  The number of patients studied was way too small to arrive at such a conclusion.  The three main mechanisms by which osteoporosis develops are an inadequate peak bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption, and inadequate formation of new bone during remodeling. An interplay of these three mechanisms underlies the development of fragile bone tissue.  This study only addresses one aspect of osteoporosis and fails to investigate the other possibilities.

Women who are postmenopausal are normally most at risk for bone thinning because of their reduced estrogen.  With that said, researchers did warn against drinking by young adult women, whose bones are still building and that excessive drinking is not a healthy idea for anyone.  However, even the lead author concluded that “the study doesn’t prove that moderate alcohol consumption wards off osteoporosis; it merely shows an association between the two.”  Those who drank one or two alcoholic beverages per day showed increased bone metabolism, and when they stopped drinking for two weeks, the risks for osteoporosis immediately began to show in their blood.  When they resumed drinking again, researchers were amazed to see their bone marker turnover rate return to previous levels.  Unfortunately, the researchers did not test any other hypothesis or mechanism for this change. They believe the reason for this effect is the ability for alcohol to act like estrogen, but it may not be due to this mechanism with respect to bone turnover.

We once thought that calcium and Vitamin D supplementation should be taken to prevent bone fractures.  However, the United States Preventive Services Task Force, an independent panel of experts in prevention and primary care, recently issued a draft statement in June, 2012 recommending that healthy postmenopausal women should not take low doses of calcium or vitamin D supplements to prevent fractures.  Why?  Because the supplements were found not to prevent fractures and only increased the risk of other problems, such as kidney stones.   So the risk outweighed the benefit and taking these supplements may actually be harming you.

While this seminal study about imbibing alcohol doesn’t give us an excuse to throw our healthy calcium- and vitamin D-rich diets out the window, it may be another factor to consider when it comes to our bones.  We already know that red wine may help prevent heart disease, so perhaps, in time, larger studies may support the conclusions of this research and that we may pour ourselves a drink and raise a glass to women’s health.

– Yvonne S. Thornton, M. D., M. P. H.

 

Posted in Women's health issues, Women's health news | No Responses »
Tags: , ,

Reversing the Biological Clock with Someone Else’s

Written by yvonnethornton on July 12th, 2012

Because so many women hold giving birth as one of their ultimate lifetime experiences, they don’t want to miss out on it because of infertility or the aging process.  Unfortunately though, as women get older, their ability to reproduce decreases.  With so many American women waiting until later in life to start their families, these upwardly mobile women are finding problems with fertility issues to be more common than they had expected.  For this reason, doctors have been working on adding to their various fertility treatments to help these older women give birth.  In vitro fertilization is one method that has gained a new strategy that seems to be reversing the biological clock of women over 40 years of age.

For women who are 43 years or older, the likelihood of getting pregnant, even with the help of three cycles of in vitro fertilization, is only 10 percent.  This is because a woman is born with all the eggs she will ever have and over time, the number of eggs of a woman significantly decreases from 1 million at her birth down to 34,000 at 36 years of age.  Not only are there less in numbers but the likelihood of the remaining eggs to function normally in the reproductive process becomes less.  However, researchers have found that when one uses a “donor” egg, i.e.,  when a young woman’s eggs are donated and in vitro fertilization is used in combination with these younger eggs, the chances of pregnancy increase to 60 or even 80%.   Nearly 250,000 women participated in this reproductive study by researchers at the Baylor College of Medicine and what they found was quite promising.  Even infertile, older women using donated eggs and in vitro fertilization had the same chances of getting pregnant as fertile young women using natural means.

Although these findings are exciting for those desperate to have a baby later in life, the process is not as easy as it sounds.  It is an expensive, unpleasant process, and not without its drawbacks.  It’s important to remember that the baby is not genetically related to the mother.  Some women find that less appealing (to be carrying a child that does not have her DNA).  Moreover, sometimes infertility is a sign of other reproductive problems that can cause issues during a pregnancy and long-term concerns for a child born in this manner.  For this reason, it is extremely important to consult with your OB/GYN before proceeding with such a program.  Many “older” celebrities have become mothers in this fashion.  But, keep in mind, healthy babies come from healthy mothers, so one should consider all other options before traveling down this path to motherhood.

You can read more about infertility in the chapter, “I’m not pregnant—and I want to be” in my health book, “INSIDE INFORMATION FOR WOMEN”.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

Posted in Fertility & Infertility, Parenting, Pregnancy | No Responses »
Tags: , , ,

Lung Cancer in Women is on the Rise in the South

Written by yvonnethornton on July 9th, 2012

Have you seen an anti-smoking ad recently?  Odds are, you probably have not, and if you have seen them, there most likely haven’t been many.  About twenty years ago, anti-smoking campaigns were extremely prevalent due to the high numbers of lung cancer deaths related to the habit.  As a result, both smoking and lung cancer have declined significantly.  At least, they’ve declined in most places around the US.  Unfortunately, statistics are now showing that in the south and some parts of the Midwest, lung cancer among women is once again on the rise.

According to the Journal of Clinical Oncology, the risk of dying from lung cancer was highest in women born in the 1930s, but that rate dropped in the following decades.  Among the baby boomer generation, that rate has dropped further or remained low, except for in southern and Midwestern states.  For example, in Alabama, lung cancer deaths increased from 6.9% to 10.7% as opposed to rates in California which fell from 6.1% to 2.8%.  These statistics came about after a 23 state comparison meant to find out the current rates of lung cancer in connection to smoking.  There is much speculation as to the causes of these differences which appear to be regional issues.  Some experts believe it is due to a letting up of anti-smoking campaigns and strategies like cigarette taxation.  Others though, feel that a study on the availability and cost of health care for lung cancer treatment in those areas is needed to determine if that may be the actual cause.

No matter the reason for these regional differences, there is obviously still a significant amount of the population who are smokers and who ignore the warnings about the harmful effects of such a habit.  It’s likely to take both an improvement in the medical care available in those areas as well as an anti-smoking campaign as aggressive as California’s to make any kind of difference.  In the meantime, it’s up to parents like us to continue to warn our children to stay away from tobacco products.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Posted in General health news, Women's health issues, Women's health news | No Responses »
Tags: , ,

Stressing Out Trumps Family Nutrition

Written by yvonnethornton on July 5th, 2012

Let’s face it.  Whether you’ve been at work all day dealing with stress, or are like many who are stressed because of their daily unsuccessful job hunts, the last thing you want to do is come home and cook a big, balanced meal for your family.  Researchers have found that this is becoming more of a problem as more Americans are either out of work or feeling increased pressure from their jobs.  This means that the stress of parents is now affecting the nutrition and health of their children.

According to a study published in the Journal of Science and Medicine, parents with high stress levels were more likely to serve fast food, unbalanced meals, and less fruits and vegetables each day.  Although their study included people who were unemployed and had more time to cook for their families, stress still played a bigger role.  Whether parents were stressed out because of work or lack of it, their teens received less nutritional meals.  The study compared the meals of 3700 parents with teens in the Midwest, about half of which, were unemployed.  Professor of Nutrition Science and Policy at Tufts University in Boston, Dr. Alice Lichtenstein, says that “work stress can affect many areas of daily life, including meal times and quality.”  In most families, it was the mother who did most of the meal prep, despite employment.   Lichtenstein suggests helping each other to lighten the load by sharing kitchen and cooking duties with any able family member.  Perhaps this would help stressed out parents increase the amount of balanced family meals they provide each week from the average of 4 to 7.

When you are raising a family, there is certainly a lot of stress to deal with, and nobody should have to bare that burden alone.  Whether that means being open and honest about the family’s financial situation and day-to-day stresses or simply sharing chores around the home, the purpose of family is to share life, not to be the burden of it.  So if you know your partner could use some support, be sure to give it freely, and if you are the one taking on the majority of the work and stress load, don’t be afraid to ask for help.  Both your and your family’s nutrition and overall health could depend on it.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Posted in General health news, Women's health issues | No Responses »
Tags: , ,

Congress Upholds the Health of Americans

Written by yvonnethornton on July 2nd, 2012

When Obama was elected president, most of America was anticipating his universal healthcare plan.  When the actual implementation of that plan looked as though it would be blocked though, many worried that he would be unable to deliver on his promise.  Luckily, Congress decided to uphold most of what has become known as “Obamacare,” and Americans in desperate need of affordable healthcare are celebrating.

According to the US Census of 2010, 49.9 million Americans were without healthcare and that number was on the rise.  Experts say this is in part due to the rise in unemployment and poverty, but also the weak economy causing businesses to cut back on expenses.  By 2014 though, all that will change.  Because the Supreme Court decided that Obamacare is indeed constitutional, more than 300,000 children who have pre-existing conditions will now find health insurance coverage.  That means that being sick will no longer prevent them or anyone else from getting the care they need to treat their sickness.  Additionally, kids will be able to remain on their parent’s health insurance plan until they turn 26, saving families a lot more money in the long run since they won’t have to pay for separate care.  Preventative healthcare benefits like mammograms will also be covered without copays, hopefully encouraging more people to take these precautions to catch issues before they became bigger and more expensive health concerns.

Although some find these new requirements to be a problem for small and growing businesses, businesses with wages less than 50,000 a year will actually receive tax credits for providing coverage.  Otherwise, these benefits will be paid for by increased taxes on Medicare Payroll for couples making more than $250,000 a year, unearned income like capital gains, and added fees for insurance companies, pharmaceutical companies and medical device manufacturers to name a few.  And to prevent those companies from simply upping their premiums, they will need to be more transparent about their costs and justify any “unreasonably” large healthcare premium increases.

Obviously not everyone is happy about the recent ruling, but as healthcare improves, I think all Americans will appreciate the improved health of our nation in the coming years.  Personally, both as a mother and a physician, I am thankful that the Supreme Court has finally ruled on behalf of the people.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

Posted in Health care policy, Women's health issues, Women's health news | No Responses »
Tags: , , , , , ,

Breast Cancer Works the Night Shift

Written by yvonnethornton on June 28th, 2012

Cancer of all kinds have plagued humanity for some time, which is why researchers are working so hard to determine risk factors, treatments, and possible cures.  Breast cancer in particular has received a lot of attention because of its devastating effects on women.  Now, it seems that working the night shift may add one more risk factor for women when it comes to developing breast cancer.

Currently, breast cancer kills more women than any other cause and more than 1.3 million women are diagnosed with it each year.  Researchers have discovered possible risk factors like genetic mutations, late first pregnancies, and hormone therapy.  Environmental and lifestyle causes are also being explored, but have not yet been specifically identified.  In France though, a study by the Center for Research in Epidemiology and Population Health looked at the careers of 3000 women and compared their breast cancer rates.  Shockingly, they found that women who worked the night shift were 30% more likely to develop breast cancer.  They believe this may be due to the disruption of the sleep cycle and circadian rhythms.  These processes, when disturbed, can negatively affect the nocturnal melatonin surge and its anti-carcinogenic effects, functioning of the biological clock genes that control cell proliferation, and/or the immune system.  Women who worked swing shift, switching on and off of at least three days of night shifts at a time, were even more likely to develop breast cancer than those who worked all night hours for each work night.

At a time when so many women suffer from breast cancer and when night work is on the rise, this study shows us yet again how important quality sleep is on a regular basis.  If you do have to work the night shift, make sure you have at least eight hours of time in a dark room to rest, where light does not disrupt your melatonin release.  It is imperative that we all take the time to recharge our bodies and minds, even if we feel we should be up and interacting with our families while they are awake.  When you work at night, both you and your family need to understand the health risks of not allowing yourself that sleep.  If you can sleep, you will enjoy many more healthy years with your family in the future than if you deny yourself that rest now.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Posted in Women's health issues, Women's health news | No Responses »
Tags: , ,

Fertility Institute Plays God

Written by yvonnethornton on June 25th, 2012

For many, having children is an important goal, and when they find that for some reason they cannot, it can be heart wrenching.  Couples can go through years of suffering attempting to conceive, only to find that they are infertile.  When this is discovered, some couples resort to expensive fertility procedures in an attempt to have a child.  One fertility clinic though, decided to capitalize on the desperation of would-be parents by holding a contest offering free in vitro fertilization to the winners.

According to the CDC, 11.8% of women are infertile and 7.3 million of them have used infertility services.  These services are extremely expensive though, and many couples cannot afford them.  Because the services are elective, competition for clients is fierce in the fertility market.  The Sher Fertility Institute decided to embark on a marketing campaign in which couples would compete for their services through a video contest.  Forty-five hopeful couples submitted heart-breaking videos about their struggle to conceive, hoping to woo the judges and win one free cycle of in vitro fertilization.  Only three couples could win, but the amount of attention the institute received more than accomplished their goal of marketing exposure.  Critics of the contest believe that the institute is making light of a very serious situation though, and that they are taking advantage of the desperation of infertile couples in order to boost sales.  With contestants who have suffered five or six miscarriages and even a stillbirth, it seems cruel to get their hopes up with a contest that appears to be the miracle they’ve been waiting for.  Additionally, it doesn’t cause other couples, watching the contest, to consider all aspects of making such a decision.

For the most part, experts seem to agree that in vitro fertilization is safe.  However, they also warn against complications and want would-be parents to be aware of the risks they’re taking.  Professor Nygren, a speaker at the World Congress of Fertility and Sterility in Munich, concluded that there are low levels of increased problems which can come with in vitro fertilization, but these “may be due to the fact that all patients undergoing IVF procedures are patients who already have reproductive problems.”  He also pointed out that there seem to be more complications associated with those who opt for Multiple Embryo Transfer instead of Single Embryo Transfer.

Although the winners of the Sher contest are likely ecstatic at their free IVF cycle, many others are disgusted by the institute’s advertising practices.  If you and your partner are struggling to have a child, be sure to speak with your OB/GYN about all of your options before jumping into a contest where doctors are playing god for a bigger paycheck.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Posted in Childbirth & delivery, Fertility & Infertility, Pregnancy, Women's health issues | No Responses »
Tags: , ,

Have We Stopped the AIDS Virus in Its Tracks?

Written by yvonnethornton on June 21st, 2012

Although we haven’t heard as much about the AIDS virus lately, that doesn’t mean it has stopped its deadly spread.  Researchers have been working feverishly for years now to come up with a cure or a treatment that could stop the virus and save lives.  For some, expensive treatments seemed to work, keeping the virus at bay for years, but for those living in poverty, treatments like that were only a dream.  Now though, new antiretroviral treatment has been developed at a price that will make it available to even low income people with HIV.

Currently, there are 56,000 Americans infected with AIDS every year and more than 30 million living with it worldwide.  In Africa, where poverty and AIDS are prevalent, a study of 500 HIV-infected women found that Nevapirine, a new and much cheaper treatment, was just as effective at slowing the virus as more expensive medicines like  Lopinavir and Ritonavir.  However, the newer, less expensive drug had 14% of its users stop treatment because of adverse side effects and toxicity.  Also, there was more drug resistance with Nevapirine compared to the more expensive medications.  With that said, nevaprine is an effective, affordable first-line alternative for the treatment of HIV. There are now even more drugs reaching the final testing stages and getting FDA approval that are effective enough to decrease the levels of the AIDS virus to undetectable levels in about 80% of their trial participants.  Recent discoveries of the delta-32 mutation to the gene that encodes CCR5 were found to block HIV receptors, rendering it incapable of multiplying.  Researchers have now found a way to mimic this mutation and, in a sense, cure patients with the use of their small molecule drug called Maraviroc.  Maraviroc (brand name, Selzentry) was approved in 2007 as an antiretroviral drug in the CCR5 receptor antagonist class used in the treatment of HIV infection and is now being tested for its safety and efficacy. More and more drugs are being developed with this break-through in mind.  Once each one has been approved for public consumption, many others will be able to create even less expensive options and get the drugs to the areas where they are needed most.

This flurry of discovery, innovation, and resourcefulness has made the AIDS epidemic suddenly much more manageable.  Although we haven’t quite taken the last step to stop all 2 million AIDS deaths each year, it seems we are on the cusp of putting this virus behind us.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

Posted in General health news, Women's health issues, Women's health news | No Responses »
Tags: , ,

« Older Entries
Newer Entries »