If you have a medical problem, or something is bothering you or a member of your family, The Jackson County Times now has a local physician, Dr. John Spence, of the Panhandle Family Care Associates available to respond to your questions via e-mail.
Anyone who knows me intimately, and many of those who don’t, are aware that I am a basketball junkie. I have followed college hoops for longer than I can remember and have been a fan of the Duke Blue Devils for longer than that. March Madness marks the one time of year in my life where everything else takes a back-seat. Akin to a religious zealot, I watch games with a frenzied passion rivaled only by the face-painted lunacy of the Cameron Crazies. As the first round of the NCAA Men’s Basketball has come to a close, one thing is certain. Uncertainty. Witness the ascension of teams like St.Mary’s, Cornell, and Northern Iowa to the Sweet 16. There is predictability in the unpredictability of the tournament. An astute reader at this point (perhaps bored to tears) may ask, what does this have to with medicine. You are a physician, not a sports journalist!
The comparisons between March Madness and medicine are blatantly obvious and unnerving. Regardless of what we think it going on with a patient, regardless of what a lab may tell us – there is always a degree of inherent uncertainty that exists in medicine. The ever changing medical landscape never ceases to amaze me. For example, a recent journal article suggested that vitamin D supplementation may actually be DETRIMENTAL as it may cause increased calcium deposits in blood vessels. The same journal reported that lowering blood sugars in diabetics to less than 165 on average resulted in increased mortality. This was a reputable journal, by the way, not just some wayward information I pulled off wikipedia. This is counterintuitive to everything we recognize to be true! Is there any validity to these studies? Only time will tell.
A professor and mentor of mine once stated that 50% of what he had learned in medical school and residency was obsolete only 15 years later. Now, I hold him in high regard as a scholar, and it has nothing to do with the fact he graduated from Duke University School of Medicine. His jump shot may be horrific, but he knows medicine. This is a scary proposition – perhaps a large part of what we are doing academically is flawed. I can relate the stories of dozens and dozens of patients who either defied the odds, beat the statistics, or had remarkable, miraculous recoveries where none were expected. What does this tell me? There is always uncertainty. This is certain. Sound familiar?
There is predictability in the unpredictability of life, medicine and the NCAA basketball tourney. In medicine, we use trends, clinical experience, education, and clinical research to dictate our treatment plans. Sometimes we “go with our gut”. We generally do a good job, but there is always that potential margin of error that must be accounted for. The same is true in hoops. I don’t care how many games you watch, how many statistics you analyze or how much of an inside scoop you think you may have.
No one in their right mind could have predicted that Northern Iowa would beat Kansas. If you did, there are only one of two explanations. You know nothing about college hoops or you live in Northern Iowa. Which is why I picked Kansas!
Do you have any medical questions or concerns that you would like addresses? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
Imma Akin
Dear Dr. Spence,
I have been unable to tolerate any of the statin medications like lipitor or zocor due to muscle pain. Is there any alternative? My bad cholesterol is through the roof.
Signed,
Imma Akin
Dear Imma,
A recent study performed at the University of Pennsylvania has shown that red yeast rice therapy performs similarly to pravastatin (pravachol) in head to head trials. They randomized 43 patients who had previously been unable to take statins due to muscle pain, to either red yeast rice or pravastatin. The lowering of LDL (bad cholesterol) was 27% in the statin group and 30% in the red yeast rice group proving that the alternative therapy was just as effective. Though muscle pain was still a possibility, it was half of what was seen with the pravastatin.
Red yeast rice is made by fermenting polished rice with strains of a particular yeast. It has been a staple of Asian culture and medicine for centuries. Its actions are similar to prescription drugs in that they lower cholesterol by inhibiting a key step in cholesterol production in the liver. Not all practitioners have adopted the use of red yeast rice due to lack of knowledge about the product and the general lack of FDA regulation of the various preparations.
A Chinese analysis from 2006 examined 93 separate trials that involved nearly 10,000 patients. It showed that not only can red yeast rice lower LDL cholesterol as effectively as some statins, it also appeared to increase HDL (good cholesterol) and improve triglycerides. Most importantly, red yeast rice seemed to be extremely well tolerated.
Given that so many people suffer muscle pain as a result of being given statin medication, it seems only natural to look for alternative sources of cholesterol lowering. Red yeast rice is a low cost option for those in need of additional help. The remaining question is – does it provide any true protection against heart attack, stroke, or death? This, unfortunately, is less clear. Medications like zetia have fallen out of favor despite their ability to lower LDL, as they have not proven to decrease death rates. Future studies may elucidate the positive effect that red yeast rice has. Until that time, we have to simply rely on the data at hand.
In your case, I think that red yeast rice would be a great option. Other options include fish oil, flaxseed oil, red wine, and garlic (among others). They all work to a lesser degree but they may be more tolerable. Remember! According to statistics, a decrease of 2 mg/dl in LDL represents a 1% risk reduction in heart disease, so every little bit counts.
Do you have any medical questions or concerns that you would like addresses? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
I have been unable to tolerate any of the statin medications like lipitor or zocor due to muscle pain. Is there any alternative? My bad cholesterol is through the roof.
Signed,
Imma Akin
Dear Imma,
A recent study performed at the University of Pennsylvania has shown that red yeast rice therapy performs similarly to pravastatin (pravachol) in head to head trials. They randomized 43 patients who had previously been unable to take statins due to muscle pain, to either red yeast rice or pravastatin. The lowering of LDL (bad cholesterol) was 27% in the statin group and 30% in the red yeast rice group proving that the alternative therapy was just as effective. Though muscle pain was still a possibility, it was half of what was seen with the pravastatin.
Red yeast rice is made by fermenting polished rice with strains of a particular yeast. It has been a staple of Asian culture and medicine for centuries. Its actions are similar to prescription drugs in that they lower cholesterol by inhibiting a key step in cholesterol production in the liver. Not all practitioners have adopted the use of red yeast rice due to lack of knowledge about the product and the general lack of FDA regulation of the various preparations.
A Chinese analysis from 2006 examined 93 separate trials that involved nearly 10,000 patients. It showed that not only can red yeast rice lower LDL cholesterol as effectively as some statins, it also appeared to increase HDL (good cholesterol) and improve triglycerides. Most importantly, red yeast rice seemed to be extremely well tolerated.
Given that so many people suffer muscle pain as a result of being given statin medication, it seems only natural to look for alternative sources of cholesterol lowering. Red yeast rice is a low cost option for those in need of additional help. The remaining question is – does it provide any true protection against heart attack, stroke, or death? This, unfortunately, is less clear. Medications like zetia have fallen out of favor despite their ability to lower LDL, as they have not proven to decrease death rates. Future studies may elucidate the positive effect that red yeast rice has. Until that time, we have to simply rely on the data at hand.
In your case, I think that red yeast rice would be a great option. Other options include fish oil, flaxseed oil, red wine, and garlic (among others). They all work to a lesser degree but they may be more tolerable. Remember! According to statistics, a decrease of 2 mg/dl in LDL represents a 1% risk reduction in heart disease, so every little bit counts.
Do you have any medical questions or concerns that you would like addresses? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
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