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| Melatonin: Miracle or Mistake? |
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I get a lot of questions about melatonin in particular, since many supplement companies and health food stores will tout that melatonin is a "natural" sleeping aid. Given the availability of this supplement today, you'd presume it's safe and effective. But is it really? What's better, taking a melatonin supplement to help you go to sleep on a crazed Monday night or going for a "PM" version of a pain reliever? Melatonin is a hormone your body produces to help it regulate your sleep-wake cycles, but taking additional melatonin in the form of a supplement isn't as good of an idea as you might think.
So here is how natural melatonin, the kind produced by your body, works. When the sun sets and darkness sweeps over, a pea-sized structure located deep between the hemispheres of your brain called the pineal gland begins to secrete this hormone, preparing you for bed. As melatonin levels in the blood rise, you begin to feel less alert and sleep becomes more inviting. Melatonin levels stay elevated for about 12 hours, falling back to low daytime levels by about 9 a.m. Daytime levels of melatonin are barely detectable. The precise mechanism of melatonin secretion is not well-known. We do know, however, that melatonin isn't just about sleep-wake cycles. It's been shown to:
A hormone with all of these possible effects - even though it's "natural" - isn't something you should be taking without the specific recommendation of your doctor. Most commercial products are offered at dosages that cause melatonin levels in the blood to rise to much higher levels than are naturally produced in the body. So taking a typical dose (1 to 3 mg) may elevate your blood melatonin levels to 1 to 20 times its normal state. If you take it at the wrong time of day, you may reset your biological clock in an undesirable direction. How much to take, when to take it, and melatonin's effectiveness, if any, for particular sleep disorders is only beginning to be understood. Remember melatonin is a sleep regulator not a sleep inducer, so it really should not be used as a sleeping pill. In the future, we may find several useful applications of melatonin. You're better off regulating your own sleep-wake cycles in a genuinely natural way by:
Remember: Your body will reset its own internal clock with the proper exposure to light at the right time. (And you shouldn't need a PM formula, either, unless you truly do need an occasional fix for quelling muscle aches or other pains that can prevent you from going to sleep easily. Just don't make this a habit every night.) Bottom line: better sleep hygiene, better time going to sleep. And better moods the next day. Melatonin, on its own, is not a sleeping pill.
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| Associations Between Pet Ownership and CFS |
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This study explored the association between pet ownership and self-reported health in people suffering from chronic fatigue syndrome (CFS). Methods: One hundred and ninety-three (193) people with medically diagnosed CFS completed a postal survey designed to collect information on illness severity, physical and psychologic health, and pet ownership practices. Results: Most of the participants were female (72.0%), over 45 years of age (57.1%) and married (41.1%) with no children (63.1%). Pets were owned by 58.3% of the sample, with dogs and cats being the most commonly kept types of companion animal. The general health of the participants was discovered to be poor, as assessed by scores on the Chalder Fatigue Questionnaire (CFQ), General Health Questionnaire-12 (GHQ-12), and Short-Form-36 (SF-36) health survey. Pet ownership was not significantly associated with scores on the CFQ, GHQ-12, or SF-36 scales, although pet owners considered their animals to offer them a range of health benefits, notably those associated with mental well-being. Conclusions: Overall, findings suggest no statistically significant association between pet ownership and self-reported health in people with CFS. Nonetheless, people suffering from this condition believe that their pets have the potential to enhance quality of life. Although animals should not be regarded as a panacea for people with long-term conditions such as CFS, they may, nonetheless, serve a valuable, and currently underutilized, role in promoting well-being, whether in their own right, or in conjunction with more traditional forms of therapy.
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| In-Depth Look at FM Medications - Elavil® |
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Elavil is used to treat symptoms of depression. Elavil is also used in the treatment of Fibromyalgia. Elavil is in a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain. How To Use This Medicine Elavil comes as a tablet to take by mouth. It is usually taken one to four times a day. To help you remember to take Elavil, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Elavil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of Elavil and gradually increase your dose. It may take a few weeks or longer before you feel the full benefit of Elavil. Continue to take Elavil even if you feel well. Do not stop taking Elavil without talking to your doctor. Stopping Elavil suddenly may cause withdrawal symptoms such as:
Special Precautions Tell your doctor and pharmacist if you are allergic to Elavil or any other medications. Tell your doctor if you have any of the following:
Elavil may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. Remember that alcohol can add to the drowsiness caused by this medication. You should know that your mental health may change in unexpected ways, especially at the beginning of your treatment and any time that your dose is increased or decreased. These changes may occur at any time if you have depression or another mental illness, whether or not you are taking Elavil or any other medication. Call your doctor right away if you experience any of the following symptoms:
Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Elavil. Elavil will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants. Alcoholic beverages, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness or weakness. Involuntary and uncontrollable movements may develop in patients taking Elavil. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if you experience involuntary movements of the:
Elavil may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined. Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Elavil. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own. Drug Interactions Do not take Elavil if you are taking monoamine oxidase (MAO) inhibitors, including:
or you have stopped taking them within the past 2 weeks. Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following:
Your doctor may need to change the doses of your medications or monitor you carefully for side effects. There may be other drugs not listed that can affect Elavil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Side Effects Elavil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. The following symptoms are UNCOMMON, but if you experience any of them call your doctor IMMEDIATELY:
Elavil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (at http://www.fda.gov/MedWatch/report.htm) or by phone (1-800-332-1088). I hope this article has been helpful. Next month the focus will be on Flexeril®.
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| Assessment of Personality in Chronic Fatigue Syndrome |
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OBJECTIVE: The study examined whether CFS is associated with specific dimensions of Cloninger's psychobiological model of personality. METHOD: Personality profiles were compared between 38 CFS patients and 42 control subjects by means of the Temperament and Character Inventory (TCI). RESULTS: The CFS group showed significantly higher scores on Harm-Avoidance and Persistence. CONCLUSION: The current study shows a significant association between specific personality characteristics and CFS. These personality traits may be implicated in the onset and/or perpetuation of CFS and may be a productive focus for psychotherapy.
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| Stopping Stroke With Medications |
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Understanding t-PA Tissue plasminogen activator, or t-PA, is one of the best weapons when it comes to stroke treatment. Given by injection, t-PA breaks up a clot that is causing an ischemic stroke and allows blood flow to the brain to resume. It can only be given to a person having an ischemic stroke - never a hemorrhagic stroke because t-PA can only worsen bleeding for those patients. Unfortunately, the use of t-PA is restricted. Current recommendations state that t-PA should only be given within three hours of the onset of the stroke, a short window of opportunity that shows the importance of early recognition of symptoms and quick stroke treatment. Ongoing research is providing information that may eventually extend that window, but it will still be only a matter of hours. Other Drug Treatments A number of other medications are prescribed to help stroke patients recover and to prevent another stroke:
Treat and Prevent The immediate goal of stroke medication is to restore blood flow to the brain to prevent any further damage. Because patients who have already had one stroke are likely to have another, doctors may prescribe a number of medications to help prevent that from happening. Taking stroke treatment medication is an important part of getting back to good health - and staying there.
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| Cardiovascular and Clinical Pain Responses in Fibromyalgia & Temporomandibular Disorder |
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This study examined cardiovascular, epinephrine (EPI), norepinephrine (NE), cortisol and clinical pain responses in 54 female patients with these disorders and 34 controls. In a subsample of 10 FMS, 10 TMD patients and 16 controls, using a counterbalanced, double-blind, crossover design, the same responses were assessed after intravenous administration of low dose propranolol vs placebo. Testing included baseline, postural, speech and ischemic pain stressors. FMS patients showed lesser heart rate (HR) increases to posture challenge but greater blood pressure (BP) increases to postural and speech tasks than controls, as well as higher overall BP and greater total vascular resistance (TVR) than TMDs or controls. TMDs showed higher overall cardiac output and lower TVR than controls. Both FMS and TMD groups showed lower baseline NE than controls, and TMDs showed lower overall EPI and NE levels. Group differences in HR, EPI and NE were abolished after propranolol although BP, CO and TVR differences persisted. In both FMS and TMD, the number of painful body sites and ratings of total clinical pain obtained 4 times during each session were significantly lower after beta-blockade vs placebo. These findings support the hypothesis that both FMS and TMD may frequently involve dysregulation of beta-adrenergic activity that contributes to altered cardiovascular and catecholamine responses and to severity of clinical pain. Acute treatment with low-dose propranolol led to short-term improvement in all these domains.
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| Ten Symptoms Not to Ignore |
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Here's a list of warning symptoms worth reading. You may find some of the symptoms surprising. But, be aware of the significance of these symptoms and when it's important to seek timely medical care. It could make a difference in your quality of life and may even save your life. Don't ignore the following 10 signs and symptoms - some of which are not obviously alarming. But, trust that your body informs you of its needs. While some messages are more urgent than others, milder but persistent symptoms may also signal trouble. Unexplained Weight Loss If you find you're losing excessive weight without intending to do so, see your doctor. Unintentional excessive weight loss is considered to be a loss of more than:
An unexplained drop in weight could be caused by a number of conditions, such as an overactive thyroid (hyperthyroidism), depression, liver disease, cancer or other noncancerous disorders, or disorders that interfere with how well your body absorbs nutrients (malabsorption disorders). Persistent Fever If you have a normal immune system and you're not undergoing treatment, such as chemotherapy for cancer, a persistent low-grade fever - over 100.4 F - should be checked if it lasts for a week or more. If you have a fever with shaking chills, or a high fever — greater than 103 F — or if you're otherwise severely ill, see your doctor as soon as possible. If you have an immune system problem or take immune-suppressing drugs, fever may not be a reliable warning sign and your primary doctor or oncologist can tell you what would signal a need for an evaluation. Persistent fever can signal hidden infections, which could be anything from a urinary tract infection to tuberculosis. At other times, malignant conditions - such as lymphomas - cause prolonged or persistent fevers, as can some medications and conditions, and reactions to certain drugs. Fever is common with treatable infections, such as urinary tract infections. But if a low-grade fever persists for more than two weeks, check with your doctor. Some underlying cancers can cause prolonged, persistent fever, as can tuberculosis and other disorders. Shortness of Breath Feeling short of breath - beyond the typical stuffy nose or shortness of breath from exercise - could signal an underlying health problem. If you ever find that you're unable to get your breath or that you're gasping for air or wheezing, seek emergency medical care. Feeling breathless with or without exertion or when reclining also is a symptom that needs to be medically evaluated without delay. Causes for breathlessness may include chronic obstructive pulmonary disease (COPD), chronic bronchitis, asthma, heart problems, anxiety, panic attacks, pneumonia, a blood clot in the lung (pulmonary embolism), pulmonary fibrosis and pulmonary hypertension. Unexplained Changes in Bowel Habits See your doctor if you have any of the following:
Changes in bowel habits may signal a bacterial infection - such as campylobacter or salmonella - or a viral or parasitic infection. Among other possible causes are inflammatory bowel disease and colon cancer. Mental Status Changes Immediate medical evaluation is warranted if any of the following occur:
Changes in behavior or thinking may be due to infection, head injury, stroke, low blood sugar or even medications, especially ones you've recently started taking. New or More Severe Headaches (especially if you're over age 50) Seek prompt medical attention if you experience:
These headache symptoms may be caused by stroke, blood vessel inflammation (arteritis), meningitis, brain tumor, aneurysm or bleeding on the brain after head trauma. Short-term Loss of Vision, Speaking or Movement Control If you have these signs and symptoms, minutes count. These are signs and symptoms of a possible stroke or transient ischemic attack (TIA). Seek immediate emergency medical care if you have any of the following:
Flashes of Light The sudden sensation of flashing lights may signal the beginning of retinal detachment. Immediate medical care may be needed to save vision in the affected eye. Feeling Full After Eating Very Little Feeling full sooner than normal after eating and having persistent nausea and vomiting that last more than a week are warning signs that should be checked by your doctor. There are many possible causes, including pancreatic cancer, stomach cancer and ovarian cancer. Hot, Red or Swollen Joint These warning signs may occur with a joint infection, which requires emergency care to save the joint and keep bacteria from spreading elsewhere. Other causes may include gout or certain types of arthritis such as rheumatoid arthritis.
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| Depression, Anxiety, Pain in Patients with Chronic Fibromyalgia & Neuropathic Pain |
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Chronic pain is often associated with comorbidities such as anxiety and depression, resulting in a low health-related quality of life. The mechanisms underlying this association are not clear, but a disturbance in the pain control systems from the brain stem has been suggested. Thirty neuropathic pain (NP) patients, 28 patients with fibromyalgia (FM), and 26 pain-free age and gender matched controls were included and examined with respect to mental distress (self-rated Symptom Checklist-92), depression (doctor-rated Hamilton Depression Scale and self-rated Major Depression Inventory), and anxiety (doctor-rated Hamilton Anxiety Scale and self-rated Anxiety Inventory). In addition, patients assessed their health-related quality of life (SF-36). Chronic pain patients with FM and NP had significantly more mental distress including depression and anxiety than healthy controls both by self-rating and by a professional rating. However, these scores are low compared to other studies on mental distress in chronic pain patients. Only few chronic pain patients meet the diagnostic criteria for depression (NP 3.3%, FM 7.1%), and associations between pain and mental symptoms were only found in the FM group despite similar pain intensities. The findings suggest that different mechanisms are responsible for the development of mood disorders in the two patient groups.
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| Summer Bank Holiday in United Kingdom |
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The summer bank holiday was introduced in the Bank Holidays Act 1871 and first observed in that year. It was originally intended to give bank employees the opportunity to participate and attend cricket matches. Exactly one hundred years later, the Banking and Financial Dealings Act 1971 moved this bank holiday to the last Monday in August for England, Wales and Northern Ireland. This followed a trial period from 1965 to 1970 of the new date. In Scotland, it remained on the first Monday in August. On the summer bank holiday, many organizations, businesses and schools are closed. Stores may be open or closed, according to local custom. There is more local variation in Scotland, where local conditions, rather than national laws, dictate whether organizations and businesses close for the day. Public transport systems often run to a holiday timetable. As this three-day weekend marks the end of the summer holiday period, there can be a lot of congestion on roads and public transport systems. For many people, the summer bank holiday marks the end of the summer. Some people take trips or short vacations during the three day weekend. For others, it is another opportunity to work in their gardens or carry out home improvements. In London the Notting Hill Carnival is held. This street festival is best known for its exuberant costumes, dancing and music played by steel drum bands. The festival has been held every year since 1965 and was originally organized by immigrants from the Caribbean, particularly Trinidad, to the United Kingdom. It started as a protest against the racism, poor working and housing conditions that they suffered. Today, the Notting Hill Carnival, shown above, is a multicultural celebration, attracting over two million people. It is thought to be the second largest street carnival in the world. In the past, a considerable amount of public disorder occurred round the event, but it has been calmer in recent years.
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| On The Lighter Side |
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What did she think I had, an elephant? So since I'm retired and have little to do, on impulse I told her that no, I didn't have a dog, I was starting the Purina Diet again. I added that I probably shouldn't, because I ended up in the hospital last time, but that I'd lost 50 pounds before I awakened in an intensive care ward with tubes coming out of most of my orifices and IVs in both arms. I told her that it was essentially a perfect diet and that the way that it works is to load your pants pockets with Purina nuggets and simply eat one or two every time you feel hungry. The food is nutritionally complete so it works well and I was going to try it again. (I have to mention here that practically everyone in line was now enthralled with my story.) Horrified, she asked if I ended up in intensive care because the dog food poisoned me. I told her no, I stepped off a curb to sniff an Irish Setter's butt and a car hit us both. I thought the guy behind her was going to have a heart attack he was laughing so hard. Costco won't let me shop there anymore. Better watch what you ask retired people. They have all the time in the world to think of crazy things to say!
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| Parting Thoughts |
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In this day and age, when sleep rhythms can go haywire at the drop of bad news,
questions about sleep aids are a hot topic. They are no longer confined to those who
are presumed to have oddball sleep cycles, such as jet setters and shift workers.
In April we did an article on 
Chronic fatigue syndrome (CFS) is characterized by severe and prolonged fatigue,
along with a set of nonspecific symptoms and signs, such as sore throat, muscle
pain, headaches, and difficulties with concentration or memory.
During a stroke, normal blood flow to the brain is disrupted and brain cells can't
get enough oxygen. Medication is often a first step in stroke treatment, given to break
up a blood clot in the case of an ischemic stroke or to stop the bleeding in the brain
in the case of a hemorrhagic stroke. Many stroke medications may also be prescribed
to help reduce the risk of another stroke.
In patients with fibromyalgia syndrome (FMS) and temporomandibular disorder (TMD),
stress and pain may chronically enhance sympathetic activity, altering
cardiovascular responses and worsening pain.
You already know that the obvious signs and symptoms - chest pain, abdominal pain
or unexplained bleeding - are generally good reason to seek immediate medical care.
But, the not-so-obvious symptoms may leave you questioning whether you need to see
a doctor.
In England, Wales and Northern Ireland, the summer bank holiday is on the last Monday
of August. In Scotland it is on the first Monday of August. This day marks the end of
the summer holidays for many people who return to work or school in the autumn.
Yesterday I was at my local COSTCO buying a large bag of Purina dog chow for my loyal
pet, Biscuit the Wonder Dog. While I was standing in the checkout line, the woman behind
me asked if I had a dog.
