ever since the black box warning of SSRI increasing depression, prescription of SSRI decreased by 22%, while suicide rate increased 14% between year 2003-2004. In Netherlands, a 49% increase in suicide between 2003-2005 was noted inversely related to prescription of SSRI. Cochrane review deems that more evidence is needed to agree with either side of the coin.
Kevin Wang http://www.ncbi.nlm.nih.gov/pubmed/17728420
Kevin Wang http://www.ncbi.nlm.nih.gov/pubmed/17636776
Saturday 29 December 2012
Thursday 22 November 2012
断开血脂指标和高血脂治疗
高血脂的治疗并不用考虑血脂的指标。2008年的ENHANCE研究又一次证明降低血脂并不直接等于保护心血管。说实在的，药理学还有待提高。人类并不了解降血脂药的工作原理。现阶段的有效治疗：高血脂人群适合用他汀类药物。如果血脂还高，大可不必担心。应为再增加药物来降低血脂对心血管健康并无大帮助。最有效的治疗还要归功于运动，减肥和饮食。
Sunday 11 November 2012
药名限加拿大药。
简介：1960s, 避孕药被研究出来。当年的避孕药有100-150mg estrogen。导致了相当多的副作用。现在的避孕药，仅仅只有20-50mg estrogen. 避孕效果不减，但副作用大大减少了。
避孕药分好多种，estrogen + progesterone 和 progesterone only。也分口服和注射。但并不完善。
成功率：如果按时服药，不忘记，成功率高达99.7%。如果忘记服药了。。。当然，就不太好啦。
避孕药一定要21天吃么？ - 不用。避孕药完全可以无间断的吃。无间断吃避孕药不但没有想象中的坏处，反而有利于记着服药，有利于于女生身体。21天间断的好处就是，如果怀孕了，你会知道。（也是差不多唯一的好处）
避孕药会导致以后不孕么？ - 不会。 大量研究证明。
避孕药的副作用如下：（副作用由药物分类。如果你有以下的副作用，可以调整药剂的含量（就是换一个牌子）来控制副作用）
太多estrogen: 恶心，胀气，色斑，头痛，头晕，乳房肿胀 (ps. 有的避孕药是没有estrogen的。如果你不能接受estrogen，试一试那些避孕药)
太少estrogen: 经常在吃药期间流血。
太多progesterone：累（原因很多，不要盲目认定是药物作用）， 心情不好，抑郁，口味大增（也不算是坏事，哈哈）
太少progesterone：副作用很少。（如果药挺了，但流血来得很晚，也许是应为progesterone太少）
太多androgen：（progesterone其实是很多种不同药物的统称。有些药物带有男性荷尔蒙的功能）青春痘。换个牌子可以帮助，尤其是青春痘的问题
紧急避孕药：
每个国家的药都不一样。在加拿大，成分为Levonorgestrel 0.75mg 2片装（ex. Plan B）。 2片可以相隔12小时吃，或者一起吃。（如果你想分开吃副作用会少，那大可不必。副作用是一样的。分开吃反而容易忘）
紧急避孕药无法堕胎！！只是防止身体排卵而已。如果已经排卵了，紧急避孕药的用处其实不大。紧急避孕药不会对胎儿造成伤害。
不要相信紧急避孕药可以代替普通避孕措施。。。一是，成功率低；二是，副作用大（药剂很大）
每一片相当于普通避孕药4-5颗。如果你无法买到紧急避孕药，你有普通的避孕药，紧急情况可以用多颗来代替。如下 （美国和加拿大牌子）（来自于http://ec.princeton.edu/questions/dose.html#dose - 普林斯顿大学著）
| Brand | Company | First Doseb | Second Doseb (12 hours later) | Ulipristal Acetate per Dose (mg) | Ethinyl Estradiol per Dose (µg) | Levonorgestrel per Dose (mg)c |
| Ulipristal acetate pills | ||||||
| ella | Watson | 1 white pill | Noneb | 30 | - | - |
| Progestin-only pills | ||||||
| Levonorgestrel Tablets | Perrigo | 2 white pills | Noneb | - | - | 1.5 |
| Next Choice | Watson | 2 peach pills | Noneb | - | - | 1.5 |
| Next Choice One Dose | Watson | 1 peach pill | None | - | - | 1.5 |
| Plan B One-Step | Teva | 1 white pill | None | - | - | 1.5 |
| Combined progestin and estrogen pills | ||||||
| Altavera | Sandoz | 4 peach pills | 4 peach pills | - | 120 | 0.60 |
| Amethia | Watson | 4 white pills | 4 white pills | - | 120 | 0.60 |
| Amethia Lo | Watson | 5 white pills | 5 white pills | - | 100 | 0.50 |
| Amethyst | Watson | 6 white pills | 6 white pills | - | 120 | 0.54 |
| Aviane | Teva | 5 orange pills | 5 orange pills | - | 100 | 0.50 |
| Camrese | Teva | 4 light blue-green pills | 4 light blue-green pills | - | 120 | 0.60 |
| CamreseLo | Teva | 5 orange pills | 5 orange pills | - | 100 | 0.50 |
| Cryselle | Teva | 4 white pills | 4 white pills | - | 120 | 0.60 |
| Enpresse | Teva | 4 orange pills | 4 orange pills | - | 120 | 0.50 |
| Introvale | Sandoz | 4 peach pills | 4 peach pills | - | 120 | 0.60 |
| Jolessa | Teva | 4 pink pills | 4 pink pills | - | 120 | 0.60 |
| Lessina | Teva | 5 pink pills | 5 pink pills | - | 100 | 0.50 |
| Levora | Watson | 4 white pills | 4 white pills | - | 120 | 0.60 |
| Lo/Ovral | Akrimax | 4 white pills | 4 white pills | - | 120 | 0.60 |
| LoSeasonique | Teva | 5 orange pills | 5 orange pills | - | 100 | 0.50 |
| Low-Ogestrel | Watson | 4 white pills | 4 white pills | - | 120 | 0.60 |
| Lutera | Watson | 5 white pills | 5 white pills | - | 100 | 0.50 |
| Lybrel | Wyeth | 6 yellow pills | 6 yellow pills | - | 120 | 0.54 |
| Nordette | Teva | 4 light-orange pills | 4 light-orange pills | - | 120 | 0.60 |
| Ogestrel | Watson | 2 white pills | 2 white pills | - | 100 | 0.50 |
| Portia | Teva | 4 pink pills | 4 pink pills | - | 120 | 0.60 |
| Quasense | Watson | 4 white pills | 4 white pills | - | 120 | 0.60 |
| Seasonale | Teva | 4 pink pills | 4 pink pills | - | 120 | 0.60 |
| Seasonique | Teva | 4 light-blue-green pills | 4 light-blue-green pills | - | 120 | 0.60 |
| Sronyx | Watson | 5 white pills | 5 while pills | - | 100 | 0.50 |
| Trivora | Watson | 4 pink pills | 4 pink pills | - | 120 | 0.50 |
Saturday 3 November 2012
有糖尿病的高血压用药
高血压可以用很多种不同的药物来控制。但是，如果病人同时又糖尿病和高血压，血管紧张素转换酶抑制剂 （ACE inhibitor. 英文药名有相同词尾：xxxxxpril） 是必须的（单独吃或者和其他降血压药物组合在一起都可以）！血管紧张素转换酶抑制剂可以保护肾功能。肾功能下降是糖尿病和高血压患者中常见的并发症。就算病人血压控制的很好，如果病人的降血压药并不是血管紧张素转换酶抑制剂，请考虑更换药物。（为什么血压控制住了还要换药？降血压的目的就是为了保护内脏健康。如果你的药品仅仅把血压的数字降下来，这个药品是毫无意义的。血管紧张素转换酶抑制剂可以最大化对肾脏的保护。）
顺带 - 有糖尿病的高血压患者，血压应该控制在130/80 mmHg以内。（比普通患者更低，普通患者应控制在140/90以内。）血压，血糖，血脂，是精密相连的，控制住任何一个都可以帮助控制其他的2个。
Tuesday 30 October 2012
回国大众化补品 - 鱼油 和 银杏，好与不好
在加拿大，购买任何药物补品前，请注意NPN, DIN或者EN编号。拥有这些编号的产品，不论是产品还是厂家都是被health canada检查过的。但是，这并不代表这些产品有益，或者无害。（任何产品运用不对都有可能造成伤害）
鱼油：
每种鱼油成分各不相同。购买之前，需细读成分列表。
常见成分：
vitamin A: 在饮食正常的情况下，缺少vitamin A是很少见的。少量补充维他命A并无害处，但是大量摄取维他命A会导致头痛，厌食，晕眩，皮肤干燥起皮。每日vitamin A摄取量应该控制在10000IU以内。
Vitamin D: 现阶段的研究证明vitamin D对骨骼，以及对其他身体机能有好处。适量补充vitamin D并无害处。摄取量应该控制在每日4000IU以内（虽然有专家认为一日4000-5000IU并无害处）
DHA and EPA: 是鱼油中富含的2中omega-3 fatty acid. 也是很多消费者购买鱼油的主要原因。要注意的是，在研究中，为了降血脂和保护心血管，DHA+EPA应该达到每天2g（2克）。很多鱼油产品含有非常少的DHA/EPA. 为了达到每日2g，仅仅靠饮食是很难达到的。除非每日饮食大部分都是肥的鱼（100g Atlantic 三文鱼=2gDHA+EPA; 100g鲱鱼=1.4g; 100g sockeye三文鱼=1.2g; 100g虾=0.5g, 100g 金枪鱼=0.3g）
但是。。。。鱼油虽好，也不是没有副作用！2g以上的鱼油可以导致出血。如果病人再服用aspirin（阿司匹林），warfarin (华法林) 或者其他的稀血药品，鱼油可以与这些药品产生同样的作用，导致出血。手术前2个星期，病人不应该吃鱼油。
银杏：
银杏对老年痴呆的预防和对智力的保护并没有实在的研究资料。大部分研究资料证明银杏并没有绝对的好处。现代西医对这方面也是作为不大。少量服用银杏并无害处。但是。。银杏可以导致流血。如果病人再服用aspirin（阿司匹林），warfarin (华法林) 或者其他的稀血药品，应该注意。如果可以，不要服用银杏产品。手术前更不要服用。质量不过关的产品可能参杂银杏本身的毒素（ginkgotoxin），可能导致癫痫发作。购买产品前，请确认产品质量。
鱼油：
每种鱼油成分各不相同。购买之前，需细读成分列表。
常见成分：
vitamin A: 在饮食正常的情况下，缺少vitamin A是很少见的。少量补充维他命A并无害处，但是大量摄取维他命A会导致头痛，厌食，晕眩，皮肤干燥起皮。每日vitamin A摄取量应该控制在10000IU以内。
Vitamin D: 现阶段的研究证明vitamin D对骨骼，以及对其他身体机能有好处。适量补充vitamin D并无害处。摄取量应该控制在每日4000IU以内（虽然有专家认为一日4000-5000IU并无害处）
DHA and EPA: 是鱼油中富含的2中omega-3 fatty acid. 也是很多消费者购买鱼油的主要原因。要注意的是，在研究中，为了降血脂和保护心血管，DHA+EPA应该达到每天2g（2克）。很多鱼油产品含有非常少的DHA/EPA. 为了达到每日2g，仅仅靠饮食是很难达到的。除非每日饮食大部分都是肥的鱼（100g Atlantic 三文鱼=2gDHA+EPA; 100g鲱鱼=1.4g; 100g sockeye三文鱼=1.2g; 100g虾=0.5g, 100g 金枪鱼=0.3g）
但是。。。。鱼油虽好，也不是没有副作用！2g以上的鱼油可以导致出血。如果病人再服用aspirin（阿司匹林），warfarin (华法林) 或者其他的稀血药品，鱼油可以与这些药品产生同样的作用，导致出血。手术前2个星期，病人不应该吃鱼油。
银杏：
银杏对老年痴呆的预防和对智力的保护并没有实在的研究资料。大部分研究资料证明银杏并没有绝对的好处。现代西医对这方面也是作为不大。少量服用银杏并无害处。但是。。银杏可以导致流血。如果病人再服用aspirin（阿司匹林），warfarin (华法林) 或者其他的稀血药品，应该注意。如果可以，不要服用银杏产品。手术前更不要服用。质量不过关的产品可能参杂银杏本身的毒素（ginkgotoxin），可能导致癫痫发作。购买产品前，请确认产品质量。
Monday 29 October 2012
B12, B6, Folic acid combo for heart?
For short... doesn't do you much good.
Let's take a look at the real science behind why not...
Long ago... people observed that in patients with high homocysteine level, they have increased risk of heart diseases, depression and death. One effective way to decrease homocysteine is to take B12-B6-Folate combination.
in 2002 - a research called "Swiss Heart Study" showed great benefit in taking B12-B6-Folate. They showed this combination actually helped heart health. HOWEVER...
in 2006, NORVIT showed increased heart diseases by taking B12-B6-Folate (however, not statistically significant... meaning this increase can be due to chances).
in 2006 again, HOPE 2 study showed absolutely no differences between taking B12-B6-Folate and the placebo (sugar pill).
In 2008, WENBIT study.... there is again... no difference between taking B12-B6-Folate and placebo.
also in 2008, WAFACS study..... absolutely no difference
in 2009, Cochrane review summarized all the data and agreed that B12-B6-Folate provides no significant benefit.
Funny thing this year... in 2009, NOVIT and WENBIT came together and took a look at the data again... they found out... Folic acid actually INCREASED CANCER, cancer death and death-in-general.
However... DON'T worry yet.... in 2010, SEARCH study didn't find that increase in cancer. They found no difference between taking B12-B6-Folate with placebo... (no benefit, no harm)
In 2010 again... VITATOPS study found no difference either...
So.... Overall.... B12-B6-Folate for heart health is not recommended at this stage. There are evidence suggesting no benefit for this combination in heart health.
Let's take a look at the real science behind why not...
Long ago... people observed that in patients with high homocysteine level, they have increased risk of heart diseases, depression and death. One effective way to decrease homocysteine is to take B12-B6-Folate combination.
in 2002 - a research called "Swiss Heart Study" showed great benefit in taking B12-B6-Folate. They showed this combination actually helped heart health. HOWEVER...
in 2006, NORVIT showed increased heart diseases by taking B12-B6-Folate (however, not statistically significant... meaning this increase can be due to chances).
in 2006 again, HOPE 2 study showed absolutely no differences between taking B12-B6-Folate and the placebo (sugar pill).
In 2008, WENBIT study.... there is again... no difference between taking B12-B6-Folate and placebo.
also in 2008, WAFACS study..... absolutely no difference
in 2009, Cochrane review summarized all the data and agreed that B12-B6-Folate provides no significant benefit.
Funny thing this year... in 2009, NOVIT and WENBIT came together and took a look at the data again... they found out... Folic acid actually INCREASED CANCER, cancer death and death-in-general.
However... DON'T worry yet.... in 2010, SEARCH study didn't find that increase in cancer. They found no difference between taking B12-B6-Folate with placebo... (no benefit, no harm)
In 2010 again... VITATOPS study found no difference either...
So.... Overall.... B12-B6-Folate for heart health is not recommended at this stage. There are evidence suggesting no benefit for this combination in heart health.
Saturday 27 October 2012
Thursday 25 October 2012
lower cholesterol, triglycerides, blood pressure
Some of the ingredients here for your information:
before heading into natural health products, keep in mind, statins (conventional medicine) lowers LDL by 55%. They are effective and safe for many patients.
Can be recommended:
1. Plant Sterol - aka phytosterols, beta-sitosterol.
It doesn't let cholesterol get absorbed! However, plant sterol itself is very hard to absorb. Taking plant sterol by itself won't help you much. It has to be inside fat (ex. margarines) to work. These margarines are widely available from many supermarkets.
If you see a capsule product containing plant sterol, think again...
Overall pretty safe. If you are taking a medication called "ezetimide", this medication will block plant sterol absorption, making the plant sterol useless.
It lowers LDL mildly (6-15%) and does not change HDL.
2. Fish Oil
2-4g of EPA-DHA a day have been shown to lower triglycerides (25-30%) (but increase LDL and HDL cholesterol a bit). However, for patients with high triglycerides, they are a good choice of medicine. They have been shown to mildly decrease cardiovascular death and all-cause death in high risk patients.
Note: fish liver oil may contain little EPA/DHA and lots of Vitamin A and D. Make sure you check the vitamin A dose and not to over dose on vitamin A. It can be dangerous to take too much vitamins.
Safety concern! Fish Oil will increase LDL by a little bit. High dose (ex. 3g/day) can cause bleeding! If you are taking aspirin, warfarin or other blood thinning medication, be cautious and consult a licensed health care professional. BUY trust-worthy products (ones with NPN number). Bad products can have quality problems.
3. Coenzyme Q (CoQ)
Have been shown to decrease blood pressure. But there are not that much evidence. More evidence is needed to say for sure whether CoQ works or not.
CoQ has been used widely in Japan for heart failure. Health Canada allows the claim "helps to maintain and support cardiovascular health".
Safety concern! CoQ is safe. If you are taking warfarin, be cautious. CoQ may reduce warfarin's affect.
THINK again before you try: (not recommended)
Red Yeast Rice: the active ingredient of this product is lovastatin! Lovastatin, a conventional statin drug is a purified version of red yeast rice!
Red yeast rice can contain toxins due to improper manufacturing, ex. citrinin that can cause kidney damage. Purification process of lovastatin as a drug removes impurities.
Basically, if you want to try red yeast rice... why don't you try a normal statin. If you are on a statin already, this is CERTAINLY not a good product for you.
Flaxseed Oil:
Whole flaxseed contains flaxseed oil, lots of fiber and a class of chemical called lignans. Flaxseed oil only has the oil part (mostly ALA). Flaxseed OIL has NOT been shown to reduce LDL cholesterol! Health Canada does NOT allow claims for LDL cholesterol either!
Whole flaxseeds however, have been shown to reduce LDL mildly and Health Canada allows the claim that it "reduce blood lipid levels".
So... if you want to use flaxseed to lower LDL cholesterol, eat whole flaxseeds from bread, etc and NOT flaxseed oil.
before heading into natural health products, keep in mind, statins (conventional medicine) lowers LDL by 55%. They are effective and safe for many patients.
Can be recommended:
1. Plant Sterol - aka phytosterols, beta-sitosterol.
It doesn't let cholesterol get absorbed! However, plant sterol itself is very hard to absorb. Taking plant sterol by itself won't help you much. It has to be inside fat (ex. margarines) to work. These margarines are widely available from many supermarkets.
If you see a capsule product containing plant sterol, think again...
Overall pretty safe. If you are taking a medication called "ezetimide", this medication will block plant sterol absorption, making the plant sterol useless.
It lowers LDL mildly (6-15%) and does not change HDL.
2. Fish Oil
2-4g of EPA-DHA a day have been shown to lower triglycerides (25-30%) (but increase LDL and HDL cholesterol a bit). However, for patients with high triglycerides, they are a good choice of medicine. They have been shown to mildly decrease cardiovascular death and all-cause death in high risk patients.
Note: fish liver oil may contain little EPA/DHA and lots of Vitamin A and D. Make sure you check the vitamin A dose and not to over dose on vitamin A. It can be dangerous to take too much vitamins.
Safety concern! Fish Oil will increase LDL by a little bit. High dose (ex. 3g/day) can cause bleeding! If you are taking aspirin, warfarin or other blood thinning medication, be cautious and consult a licensed health care professional. BUY trust-worthy products (ones with NPN number). Bad products can have quality problems.
3. Coenzyme Q (CoQ)
Have been shown to decrease blood pressure. But there are not that much evidence. More evidence is needed to say for sure whether CoQ works or not.
CoQ has been used widely in Japan for heart failure. Health Canada allows the claim "helps to maintain and support cardiovascular health".
Safety concern! CoQ is safe. If you are taking warfarin, be cautious. CoQ may reduce warfarin's affect.
THINK again before you try: (not recommended)
Red Yeast Rice: the active ingredient of this product is lovastatin! Lovastatin, a conventional statin drug is a purified version of red yeast rice!
Red yeast rice can contain toxins due to improper manufacturing, ex. citrinin that can cause kidney damage. Purification process of lovastatin as a drug removes impurities.
Basically, if you want to try red yeast rice... why don't you try a normal statin. If you are on a statin already, this is CERTAINLY not a good product for you.
Flaxseed Oil:
Whole flaxseed contains flaxseed oil, lots of fiber and a class of chemical called lignans. Flaxseed oil only has the oil part (mostly ALA). Flaxseed OIL has NOT been shown to reduce LDL cholesterol! Health Canada does NOT allow claims for LDL cholesterol either!
Whole flaxseeds however, have been shown to reduce LDL mildly and Health Canada allows the claim that it "reduce blood lipid levels".
So... if you want to use flaxseed to lower LDL cholesterol, eat whole flaxseeds from bread, etc and NOT flaxseed oil.
Monday 22 October 2012
Losing weight?
Try not to use weight loss products. 1. they may not be safe; 2. they likely won't work. (will work for some people, I won't argue with that)
Caution: if you have diabetes or other conditions, talk to a licensed health care professional before buying anything. May be dangerous.
A few kinds that are out on the market are discussed here.
OK to try:
1. Bean Pod: blocks starch digestion theoretically. Pretty safe overall, not for diabetic patients.
2. Glucomannan: soluble fiber that can form a glue-like gel in water. Taken with lots of water can stuff you up! Getting you that sense of fullness. Should take with lots and lots of water, else it may bulk up and cause some obstruction in the gut.
PGX has a similar property, but a different molecule. (you really need that 500mL of water with PGX dose, because PGX's own research study did it this way to get the result. And 500mL is a lot...)
3. CLA (conjugated Linoleic Acid): an omega-6 fatty acid. Can decrease body fat. Have shown to work mildly (~2% drop in body weight in 1 year). Pretty safe, but avoid in diabetic patients.
Maybe think again: (not recommended)
4. 5-HTP: aka 5-hydroxytryptophan. Body uses it to make serotonin and serotonin can reduce appetite (besides other things it can do). Interacts with many drugs, always check with your pharmacist! (ex. some anti-depressants, migraine drugs).
5. Caffeine (aka on label: coffee, tea, cacao, kola nuts, guarana, yerba mate, etc): said to burn the fat... but high doses can cause problems (just like coffee). Very little evidence suggest that they work. Just try coffee. Coffee tends to be cheaper as well~
6. Bitter Orange: aka Seville orange, citrus aurantium. Active chemical is synephrine. It's a stimulant, can cause increased heart rate and blood pressure. Not that safe at higher doses >54mg. Research has shown no efficacy. Highly discouraged.
7. Laxatives and Diuretics: You really shouldn't try. Body can get dependent on long term laxative use and you lose nutrients using them. Diuretics really doesn't help you lose fat, they only help you lose water and important electrolytes. Too much of either can cause big problems. Ask your pharmacist if you are not sure what the ingredients do. Many products do contain these ingredients!
Caution: if you have diabetes or other conditions, talk to a licensed health care professional before buying anything. May be dangerous.
A few kinds that are out on the market are discussed here.
OK to try:
1. Bean Pod: blocks starch digestion theoretically. Pretty safe overall, not for diabetic patients.
2. Glucomannan: soluble fiber that can form a glue-like gel in water. Taken with lots of water can stuff you up! Getting you that sense of fullness. Should take with lots and lots of water, else it may bulk up and cause some obstruction in the gut.
PGX has a similar property, but a different molecule. (you really need that 500mL of water with PGX dose, because PGX's own research study did it this way to get the result. And 500mL is a lot...)
3. CLA (conjugated Linoleic Acid): an omega-6 fatty acid. Can decrease body fat. Have shown to work mildly (~2% drop in body weight in 1 year). Pretty safe, but avoid in diabetic patients.
Maybe think again: (not recommended)
4. 5-HTP: aka 5-hydroxytryptophan. Body uses it to make serotonin and serotonin can reduce appetite (besides other things it can do). Interacts with many drugs, always check with your pharmacist! (ex. some anti-depressants, migraine drugs).
5. Caffeine (aka on label: coffee, tea, cacao, kola nuts, guarana, yerba mate, etc): said to burn the fat... but high doses can cause problems (just like coffee). Very little evidence suggest that they work. Just try coffee. Coffee tends to be cheaper as well~
6. Bitter Orange: aka Seville orange, citrus aurantium. Active chemical is synephrine. It's a stimulant, can cause increased heart rate and blood pressure. Not that safe at higher doses >54mg. Research has shown no efficacy. Highly discouraged.
7. Laxatives and Diuretics: You really shouldn't try. Body can get dependent on long term laxative use and you lose nutrients using them. Diuretics really doesn't help you lose fat, they only help you lose water and important electrolytes. Too much of either can cause big problems. Ask your pharmacist if you are not sure what the ingredients do. Many products do contain these ingredients!
Sunday 21 October 2012
Calcium and Vitamin D?
So... is calcium +/- vitamin D supplement good for you? Try asking that. Likely you will hear, Yes!
Is it really?
1. Fractures aren't overly common. And if you have a hard fall (off the stairs, etc), a fracture doesn't mean you have weak bones.
2. Research have shown small benefit of calcium supplementation. (ex. Tang) Benefit is certainly not large for everyone to blindly supplement calcium +/- vitamin D. Out of 63 patients taking supplement for 3.5 years, we will be able to prevent 1 fracture...
In the News! Calcium causes MI, stroke and cardiovascular problems.
Calcium supplements alone seen with increased MI risk. Risk is small. A review by Bolland et al showed significant MI risk increased looking at 7 different RCT 1999-2007. Interestingly, none of the analyzed RCTs (all 7 of them) showed a significant increase in risk. Although mechanisms are still under speculation, this risk can't be ignored as insignificant. Quoting from Bolland, treating 1000 people for 5 years with calcium supplement, there might be an additional 14 MI seen, but save 26 fractures.
Some study have shown that by taking calcium with vitamin D, we can avoid this risk. Others disagree.
More investigation is underway and we have to work with what we have.
Is it really?
1. Fractures aren't overly common. And if you have a hard fall (off the stairs, etc), a fracture doesn't mean you have weak bones.
2. Research have shown small benefit of calcium supplementation. (ex. Tang) Benefit is certainly not large for everyone to blindly supplement calcium +/- vitamin D. Out of 63 patients taking supplement for 3.5 years, we will be able to prevent 1 fracture...
In the News! Calcium causes MI, stroke and cardiovascular problems.
Calcium supplements alone seen with increased MI risk. Risk is small. A review by Bolland et al showed significant MI risk increased looking at 7 different RCT 1999-2007. Interestingly, none of the analyzed RCTs (all 7 of them) showed a significant increase in risk. Although mechanisms are still under speculation, this risk can't be ignored as insignificant. Quoting from Bolland, treating 1000 people for 5 years with calcium supplement, there might be an additional 14 MI seen, but save 26 fractures.
Some study have shown that by taking calcium with vitamin D, we can avoid this risk. Others disagree.
More investigation is underway and we have to work with what we have.
________________________________
Am I to stop taking supplement then?
1st question to ask:
Do you have osteoporosis? or at risk?
Don't know?
Easy trick - Age - body mass (kg) = ____; <0=less than 5% risk; 0-20=15-20% risk.
If you are just not at risk... then it's totally your call. You can stop, continue or switch to Vitamin D only.
Current scientific data can't make that decision for you. NOTE: don't confused Calcium +/- vitamin D with vitamin D supplement alone. Vitamin D supplements is an entirely different topic. All these risk and benefit talk is for calcium.
Studies found here:
Bolland http://www.bmj.com/content/341/bmj.c3691
Tang BM. http://www.ncbi.nlm.nih.gov/pubmed/17720017
1st question to ask:
Do you have osteoporosis? or at risk?
Don't know?
Easy trick - Age - body mass (kg) = ____; <0=less than 5% risk; 0-20=15-20% risk.
If you are just not at risk... then it's totally your call. You can stop, continue or switch to Vitamin D only.
Current scientific data can't make that decision for you. NOTE: don't confused Calcium +/- vitamin D with vitamin D supplement alone. Vitamin D supplements is an entirely different topic. All these risk and benefit talk is for calcium.
Studies found here:
Bolland http://www.bmj.com/content/341/bmj.c3691
Tang BM. http://www.ncbi.nlm.nih.gov/pubmed/17720017
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