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Magda was a new patient who was referred by one of my ENT colleagues for “refractory reflux”. She’d been on the proton pump inhibitor Nexium at a dose of twice daily for over a year, and was still complaining of symptoms. She’d cut out caffeine, alcohol, chocolate and late-night eating when the symptoms first began, and was a pretty healthy eater at baseline: oatmeal or fruit for breakfast; a salad for lunch, and chicken or fish with rice or quinoa plus veggies for dinner. At 5’8” she weighed 126 pounds, and was an avid exerciser. Magda was 29, didn’t take any other medications besides Nexium, and had no other medical problems. Hmmm. Why would a lean, active, healthy 29-year-old woman with good eating habits suddenly start having acid reflux? The symptoms had developed seemingly out of the blue, on the heels of a bad viral upper respiratory tract infection 14…

Antibiotics reduce the effectiveness of hormonal contraceptives in a new study. Anecdotal evidence shows women getting pregnant on hormonal contraceptives (this includes the pill, the patch, the vaginal ring, implants, IUDs, and injections) while taking antibiotics. Yet, past research has shown either no interaction between hormonal contraceptives and antibiotics or the findings have been inconclusive. Based on this previous research, the advice up until now has been that antibiotics do not interfere with the effectiveness of contraceptive drugs and the two medications can be taken together. This latest study retrospectively looked at the incidence of unwanted pregnancies in relation to taking an antibiotic along with hormonal contraceptives using data from the UK Medicines & Healthcare Products Regulatory Agency database from 1963 to 2018. Three different drug types were assessed: non-enzyme inducing antibacterial drugs (amoxicillin, ampicillin, cephalexin, ciprofloxacin, erythromycin, metronidazole, nitrofurantoin, oxytetracycline, trimethoprim)enzyme inducing drugs that were shown in previous research…

Increased antibiotic use is associated with an increased risk for hospitalization. The study looked at primary care medical records linked to hospital admissions in 1.8 million patients from 2000 to 2016, and analyzed those who had received systemic antibiotics. Infections of interest included urinary tract, ear, and respiratory (those with more serious chronic conditions like cystic fibrosis and chronic lung disease were excluded from the study). The results showed that the more antibiotics a patient was prescribed, the more likely they were to be hospitalized for a subsequent infection in 3 or more months. Those with 9 or more antibiotic prescriptions were 2.26 times more likely to be hospitalized, while those with 5 to 8, 3 or 4, and 2 antibiotic prescriptions were 1.77, 1.33, and 1.23 more likely, respectively. BMC Medicine Takeaway: Researchers who conducted the study claim that the overuse of antibiotics for common infections is “unproven –…

In this webinar with Dr. Chutkan, hosted by Our Health Talks, you will learn the following: How Dr. Chutkan’s “Live Dirty, Eat Clean” mantra applies to health todayDr. Chutkan’s produce-cleaning regimeHallmark foods in a “clean eating” dietRisk of antibioticsDoes having a GI issue make someone more susceptible to contracting illness? Explaining IBS vs. IBDCan nature exposure and sunlight help in combating the spread of COVID-19? What are some self-care practices that you using right now? How is the practice of medicine going to change after all this?Do you think it’s a good idea to increase dosage of probiotic supplements right now? Are you recommending prebiotics in conjunction with probiotics?Is sourdough considered a healthful fermented food?What is the role of hand sanitizers in the COVID-19 battle?How are you staying educated on our understanding of the disease right now? How do you think we could better prepare for the next time something…

Certain medications could make you more susceptible to contracting COVID-19 and could worsen infection. NSAIDs: You may have already heard that non-steroidal anti-inflammatory drugs (such as ibuprofen and aspirin used to reduce pain, fever, and inflammation) may aggravate coronavirus infection. Because these drugs may affect the immune response, they can potentially elongate the infection time and increase the possibility of complications. While some studies support this line of thinking, the evidence is minimal and more studies are needed. Experts agree that they know very little about how NSAIDs effect coronavirus infection and are looking further into the association. In the meantime, the recommendation is that patients should use acetaminophen (such as Tylenol) to reduce pain and fever.  Corticosteroids: Because of their immunosuppressive characteristics, the routine use of corticosteroids is discouraged during the COVID-19 pandemic. These recommendations are in place because corticosteroids dampen the immune system, hypothetically increasing the risk of…

Proton pump inhibitors (PPIs – acid blocking medications prescribed for reflux and GERD) are linked to increased rates of acute gastroenteritis in the winter months when enteric viruses are at their peak. In a cohort matched study containing 233,596 patients receiving proton pump therapy and 626,887 not receiving the therapy, researchers found that the PPI group had 1.81 times higher instances of infection. JAMA Takeaway: Previous studies have linked long-term PPI use to a host of health complications, including dysbiosis, kidney damage, cardiovascular disease, declining bone health, and even an increased risk of death. If you are taking a PPI and are considering tapering off the drug, check out our article on this subject and work with your healthcare professional for support to be sure this is the right decision for you and your condition.

If you’ve read our newsletter in the past, you’re familiar with our motto of lifestyle interventions first and foremost, and medications as a last resort for treating physical ailments. But even we were shocked to find out that older individuals, on average, are on 15 prescription medications each year. A recent New York Times article highlighted these findings from the American Society of Consultant Pharmacists – “People aged 65 to 69 take an average of 15 prescription medications a year, and those aged 80 to 84 take 18 prescriptions a year. And that’s in addition to the myriad of over-the-counter drugs, herbal remedies, vitamins and minerals they may take, any of which — alone or in combination — could cause more problems than they cure.” An overwhelming majority of prescription drugs and over-the-counter remedies have harmful side-effects, especially when taken improperly. Legacy prescribing – when a drug is prescribed and…