2/6/2019 Newsletter—An Ounce of Prevention

To my Patients and Friends,

Here are some of the recent medical news highlights… enjoy!

Measles 2.0

Unfortunately, measles is making a comeback. A public health emergency has recently been declared in response to a measles outbreak in Clark County, Washington—a region considered to be an anti-vaccine (anti-vax) hotspot. This latest outbreak has resulted in the highest incidence of measles infection since 1996. And the east coast has been affected as well—in fact, two cases of measles have already been reported in New Haven County this year. The current anti-vax movement evolved largely as a result of false and discredited claims about a link between the measles vaccine and autism in children, but they have expanded their horizons, now making false claims about other vaccines, such as the influenza vaccine.

Measles is a highly infectious viral disease which can lead to serious complications such as pneumonia and encephalitis (inflammation of the brain), and sometimes death. Measles can also damage our immune systems, which means that those who have been infected with measles are more vulnerable to other infectious diseases—an effect that can linger for up to three years. According to the CDC, measles is so contagious that 90% of unvaccinated people exposed to an infected individual are likely to come down with the disease. We got very close to eradicating measles in this country thanks to our robust vaccination program, but the anti-vax messaging has taken us two steps back. Please disregard the false and dangerous information promulgated by the anti-vaxers…be sure your children are all vaccinated against measles!

And it’s still not too late to get your flu shot. We’re seeing a rise in flu-related deaths in our area. Please don’t believe the false anti-vax claims about the dangers of the flu vaccine. Last year alone, 80,000 Americans died from the flu, and we know that most of the children who succumbed to the disease were unvaccinated. Give us a call…we still have a few left.

George Harrison would probably enjoy this 

We are all aware of the recommendations that we use sunscreen in order to protect ourselves from the potentially harmful rays of the sun. Well, this very interesting article lays out the history of these recommendations, some of the benefits of moderate amounts of sun exposure, some of the potential harms associated with sunscreen, how different skin types may impact the way we respond to sun exposure, and why vitamin D may be a red herring. I’m certainly not suggesting that we disregard the very real link between sun exposure and skin cancer, or slather on the baby oil and bake ourselves. But the article is thought-provoking and worth a few minutes of your time…and it reminded me how much I love the summer!

The e-cigarette epidemice-cig health risks-Larry Leibowitz, MD newsletter

Electronic cigarettes (aka: e-cigs, e-hookahs, hookah pens, vapes, vape pens) are often touted by manufacturers as “safer” because they do not contain tar, the most commonly-cited cancer-causing agent found in traditional tobacco products. However, this message is very deceptive, as these products can contain other carcinogens, have been shown to cause other health problems and deliver significant quantities of nicotine (which is highly addictive)… so they should certainly not be viewed as a risk-free alternative to smoking. Preliminary studies suggest that adults who smoke conventional cigarettes may be more likely to quit with the help of e-cigs (in conjunction with behavioral counseling) versus other nicotine replacement options (i.e., patches, chewing gum, lozenges). However, kids who begin using these products are putting themselves at great risk for nicotine addiction and a tendency to begin smoking cigarettes in the future. And e-cigs have been blamed for other tragic outcomes.

I worry greatly for our teens and young adults (many of whom use these products recreationally and not because they’re trying to quit smoking cigarettes), as usage in these populations has skyrocketed, and nicotine addiction is reaching epidemic proportions as a result (which is undoubtedly the industry’s “holy grail”). Although industry leaders sanctimoniously insist that they do not market to young people, the fruity flavorings with which they lace their products belie that dubious claim. Please communicate with your kids regularly about the dangers of vaping (and of substance abuse in general).

Migraine preventionMigraine prevention-larry leibowitz, MD newsletter

Recurrent migraine sufferers may want to consider a couple of supplements that have been shown to reduce the frequency of migraine headaches.

The first is magnesium. Studies have shown that up to one-third of us are deficient in magnesium, and those migraine sufferers who take magnesium on a daily basis often see a significant reduction in the frequency of headaches—especially in those who suffer from migraine with auraMagnesium supplements come in numerous forms, some of which are more apt to cause side effects than others. I have found some options that work quite well…happy to discuss.

The other supplement worth considering is Coenzyme Q10-an anti-inflammatory substance which our bodies produce naturally and which our cells use for growth and maintenance. CoQ10 has been shown in some studies to reduce the frequency of migraine headaches. The recommended dosage is 150 mg once daily.

benefits of hemp oil-Larry Leibowitz, MD newsletter

A number of patients have asked about the anti-migraine properties of cannabidiol (or CBD) oils- the non-psychoactive medicinal compounds found in cannabis plants such as marijuana and industrial hemp.  Although it’s a huge topic riddled with speculation and unknowns, I’ll touch on it here as well. Preliminary studies do suggest potential health benefits and treatment opportunities for a number of conditions, including but not limited to:

While more rigorous research is needed in order to confirm the health benefits for humans and to justify and fine-tune treatment protocols, the industry is already booming—CBD is everywhere. Anecdotally, I’ve heard some good things from my patients who use prescription cannabis products. Although hemp and marijuana plants both produce similar CBDs, there are differences in the plants themselves. For instance, there is some concern that, by virtue of hemp’s tendency to absorb impurities from its surroundings (one of its established industrial roles), hemp-derived CBDs may contain contaminants (including pesticides), even when grown in organic conditions. As with nutritional supplements in general, no meaningful regulatory protocols are in place, so you can never be certain as to what you’re getting when you purchase hemp-derived products.

On the other hand, marijuana is available legally in many states-either by prescription at approved dispensaries (usually staffed by Registered Pharmacists) or at licensed retail outlets depending on individual state laws—and is more tightly monitored by regulatory agencies. However, marijuana-derived CBDs may sometimes contain small, measurable amounts of tetrahydrocannabinol (or THC), which is the primary psychoactive ingredient marijuana-users find so appealing…so those who wish to avoid exposure to THC (and/or who plan to undergo drug screening) should take heed. Hemp may contain trace amounts of THC, although typically not in quantities sufficient to impart psychoactive effects or to result in a positive drug screen. It’s also important to note that marijuana and its derivatives are still considered illegal at the federal level and that marijuana is a psychoactive substance. Hemp-derived products are generally tolerated by drug enforcement agencies and are readily available over-the-counter or online.

I welcome my patients to reach out to discuss all of the above.  And for the record, I believe the physicians should feel comfortable prescribing cannabis products under the proper circumstances.

plant based diets-larry leibowitz, md

And speaking of medicinal plants

Two recent studies have added to the mountain of research confirming the many health benefits of a whole-food plant-based diet, this time as related to blood pressure and heart disease. The plant-based approach may not be for everyone, but in my evidence-based opinion, it beats other dietary patterns including paleo, keto, low-carb, intermittent fasting, OMAD, Whole 30, calorie-counting commercial diets, and certainly the Standard American Diet (or SAD—the worst of them all). For those who wish to prevent chronic diseases such as diabetes, high blood pressure, atherosclerosis, and cancer or to maintain an optimal weight without resorting to a restrictive diet that is difficult (or dangerous) to sustain, gravitating toward a more plant-based dietary pattern is truly the way to go. I realize it would be unrealistic to expect everyone to convert to veganism and that an individualized approach works best, but I do recommend that we all choose whole-food plant-based meals as often as possible. Although there may be a learning curve, I promise you’ll feel great and it can be an immensely satisfying way to eat. Come on in…I’d be happy to coach you!

Medicare's new app-Larry Leibowitz, MD newsletter

Not sure what Medicare covers?  The answer may be right at your fingertips

In closing, here’s a helpful hack for Medicare participants: if you’re not sure if Medicare will cover a procedure or service, check out Medicare’s free What’s Covered app—it’s an easy way to get accurate information about costs and coverage. It’s available for free on both Apple’s App Store and Google Play.

That’s all for this installment…I hope you’re all staying warm!

Larry Leibowitz, MD

 

Matrix Personalized Medicine LLC
45 Grove Street
New Canaan, CT 06840
(203) 920-1772
www.LarryLeibowitzMD.com