Vitamins and Life

Vitamins and Life:

Once again, good food trumps pills

Vitamins have succeeded in tapping into our fear of illness and death.

Just as Ponce de Leon was drawn into the swamps of Florida in pursuit 

of an illusory Fountain of Youth, over half of all Americans buy and eat 

vitamins packaged as pills, gels, and gummy bears, driven by even the 

faintest possibility that we can avert aging, disease, and death.

This is an ancient and deeply held hope of humanity, and we do not 

minimize its power.  The only question we raise is do vitamins work?

At some point or another Ponce de Leon had to decide whether there 

was a Fountain of Youth to discover.  And so we too, will at some point

see if our pursuit of vitamins actually leads to a boost of health, a longer life,

and/or slower aging.

This turns out to be an easy question to answer.  Simply look at a huge number 

of people who take vitamins and a comparable huge number of people who do not.

And then ask, does one group age more slowly, avoid any diseases, or live longer?

Before presenting the answer let's consider an intervention that does indeed

make people age more slowly, avoid disease, and live longer.  

You might ask, is there really such a Fountain of Youth?  If there is, why doesn't 

everyone flock to it?

Well, it turns out that a very simple intervention grants these wonders.

It is simply eating fruits OR vegetables.  Notice that fruits and vegetables are equally helpful.  And we also know how much works, and what happens when you do this.

The magic number is 80 grams or 2 and 2/3 ounces, five times a day.

If you eat at least 2 and 2/3 ounces of fresh fruit OR vegetable five times a day, 

something rather extraordinary happens:

• You have a 20% drop in the chance of developing cancer
• You have a 15% drop in the chance of having heart disease or stroke
• You drop you chance of dying in any year by 50%

This last point was proven in a study of the rate of dying in a group of 11,000 people

over a 17 year period.  Those who ate 2 2/3 ounces of fresh fruits OR vegetables five times a day had a mortality rate (chance of dying) half that of the rest of the group.

A related, and perhaps, as astounding fact, is that after many years of trying to find

out why this happens, we still have no idea.

In addition to wanting to be healthy, not age, and to live longer, another reason vitamin

supplements have become taken so commonly, is the thought that the reason fruits and 

vegetables grant such good health must at least be in part the fact that they are loaded 

with vitamins.

It sounds reasonable. but is it true?

The answer is clear and proven in countless study after study:  NO.

Consider Vitamin C.  It turns out that Vitamin C is a very powerful molecule with a staggering number of critical roles to play in the human body (actually in nearly every life form that uses oxygen, like us).  Vitamin C is intimately connected to the body's use of oxygen.  It helps the body use oxygen to make collagen, a protein used to make bone, muscle, nearly all tissues, and in fact makes up 25% of all our proteins.  Vitamin C is also central to the creation of critically important neurotransmitters, and the formation of growth hormone.

If some Vitamin C is so good and necessary, why wouldn't a lot be even better?

Because for nearly all biological materials, balance is what works best.  Too little is 

bad, but so is too much.

Vitamin C is such a powerful substance that the body goes to great lengths to make sure we never have too little or too much.  Once the body has enough Vitamin C in it, it closes the door to absorbing more.  Eating more will simply lead to passing it out the stool, and if you eat enough the gut will revert to diarrhea to purge the excess.

But what happens if you take large doses of Vitamin C?  Do you have fewer colds, less cancer, less heart disease, age more slowly, live longer?

These questions have been asked by having huge numbers of people eat massive quantities of Vitamin C over many years and comparing their lives to people who take no extra Vitamin C.

In every study, and there have been many, those who take extra Vitamin C experience no advantage.  They have the same risk of cancer, of heart disease, and die at the same pace and rate.

The same has been found in the case of all the B vitamins and Vitamin E, with one dangerous twist.

For groups that take extra B Vitamins or Vitamin E the rate of dying actually increased!

One study of Vitamin E supplementation had to be stopped in the middle because the group taking was noted to be dying faster, even before the study was completed.

Only two vitamins have emerged as offering any benefit if taken as a supplement:

1. Folate.  400 mg of folate once a day taken by women from their first to last period drops the chance of having a baby with a spinal defect by over 80%.  This is the only actually proven benefit of any vitamin as a pill or supplement.
2. Vitamin D.  The data here are not yet proven, but preliminary studies suggest that getting your Vitamin D (D3) level up to 80 (U/dl) in your blood may reduce the chance of developing a range of illnesses including diabetes, colon cancer, and multiple sclerosis.

BOTTOM LINE

• Eating five servings of fruits OR vegetables, each at least 2 2/3 ounces, every day, can have a profound on living longer, dropping the chance of cancer, heart disease, and stroke
• Taking a supplemental vitamin is not the same thing.  It is a waste of time and money, and may actually prove to be harmful.
• Exceptions are limited to only 2 vitamins:  Folate for women of child-bearing age, and Vitamin D
• Therefore Advanced Pediatrics recommends that you:
• Eat 2 2/3 ounces of fresh fruits OR vegetables daily
• Do not take multivitamins- they may be harmful
• If you have had your first period, take 400 mg of folate daily until your last period
• Children of all ages should be given 400 IU of Vitamin D daily, but not as a multivitamin.

Dr. Arthur Lavin   

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Come join us at the Conference

May 23 and May 24 Siegal College in Beachwood is 

offering a major conference on 

Health Care in America:  What is it and What Could it be?

Details are at this link:

http://www.siegalcollege.edu/component/content/article/25-single-offerings/212-mt-sinai-health-care-symposium

Featured speakers include:

• Congresswoman Marcia Fudge
• Fred Rothstein, President of University Hospitals
• Professor Joseph White, nationally recognized political science scholar, at Case

At 10AM on Monday, May 24th,  Dr. Arthur Lavin will be presenting his perspective on 

health care in America.

So if you are interested, feel free to join us:

http://www.siegalcollege.edu/component/content/article/25-single-offerings/212-mt-sinai-health-care-symposium

 Dr. Arthur Lavin

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Tylenol, Motrin, Zyrtec, and the McNeil Labs Recall

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Tylenol,  one brand of Acetaminophen
Motrin, one brand of Ibuprofen
Zyrtec, one brand of Cetirizine
Benadryl, one brand of diphenhydramine
and the McNeil Labs Recall


What to Do?


In the spring of 2010, McNeil Labs took all its pediatric formats
of the drugs tylenol, motrin, benadryl, and zyrtec off the market.

Why did they do this, what is the risk to your children, and what should
you do?

Why did they do this?
The manufacturer, McNeil, found that the number of milligrams
in their tablets, syrups, and capsules was not exactly as it should be.
The manufacturer did not find anything toxic or harmful
in these products.
And so McNeil recalled these products to be safe, not because any
harm was imminent.
Here is their link:
http://www.mcneilproductrecall.com/page.jhtml?id=/include/new_recall.inc

What is your risk?
The risk in giving the recalled lots of benadryl, tylenol, motrin, or
zyrtec is limited to a dosage error.  We do not know the size of the
dosing error, but clearly one pill or teaspoon of any of these products
cannot cause harm.
Be aware that the problem is limited entirely to these brand names.
So there is no problem beyond the side effects of the drugs themselves
in taking diphenhydramine, acetaminophen, ibuprofen, or cetirizine made by
someone else than McNeil Labs.

What should you do?

1. Throw away any Benadryl, Tylenol, Motrin, and Zyrtec you have.
2. Do not buy any Benadryl, Tylenol, Motrin, and Zyrtec until your pharmacist says it is OK to do so.
3. Not to worry if your child has taken Benadryl, Tylenol, Motrin, and Zyrtec recently.  The problem is actually a minor dosage discrepancy that should cause no harm.  So if your child took these drugs, they will be fine, but no reason continue giving these brands at this time.
4. Rite-Aide, CVS, Walgreen's, Walmart, Target, etc. do not make any drugs.  So their generic brands may also be made by McNeil Labs.  Do not buy diphenhydramine, acetaminophen, ibuprofen, or cetirizine, unless you know that the private label did not buy it from McNeil Labs.
5. Diphenhydramine, acetaminophen, ibuprofen, or cetirizine are perfectly safe to use if not made by McNeil Labs.  For example, Advil is a type of ibuprofen not made by McNeil Labs.  All these medications are available from other manufacturers, you just have to be sure it is not made by McNeil Labs, until your pharmacist can verify that the McNeil Lab products of these drugs are once again OK.

Bottom Line 

• McNeil Labs has found an error in the dosage of 4 pediatric drugs:  Benadryl (a brand of diphenhydramine), Tylenol (a brand of acetaminophen), Motrin  (a brand of ibuprofen), and Zyrtec  (a brand of cetirizine).
• The error is a minor one of dose size.
• Even so, you should toss all your Benadryl, Tylenol, Motrin, and Zyrtec
• You should not buy Benadryl, Tylenol, Motrin, and Zyrtec until your pharmacist can be sure the lots on the shelf are reliable.
• Until then, you can purchase diphenhydramine, acetaminophen, ibuprofen, or cetirizine, as long as they are made by someone other than McNeil Labs.

Dr. Lavin

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Does Fluoride in Water cause Cancer? No

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Does Fluoride in Water cause Cancer?  No


Over the last several years, a study in animals raised a question:

Does exposing teeth to fluoride in water increase the chance of a person
developing a cancer?

This question has been bouncing around US communities ever since, prompting
a large number of important, and highly reliable studies to be completed to answer
the question.

Often, such questions are hard to be sure about answering.  But this time, the answer
is sure and certain:  fluoride in the municipal water supply, and as a supplement if your
water is not fluoridated has not impact on the chance of developing any cancer.


Perhaps the best source of the data on this whole story is available from the
United States National Cancer Institute at
http://www.cancer.gov/cancertopics/factsheet/Risk/fluoridated-water

If you have any doubts about the safety of fluoride in water, please take a
moment to go this link.  


The data take concerns about fluoride quite seriously.  But the evidence is solid, and
deeply reassuring.

BOTTOM LINE
Taking fluoride supplements in tap water, or if that is not available, by the right dosage, is
safe and bears no relation to the risk of cancer.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The Health Care Reform Law

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The Health Care Reform Law


On March 30, 2010, President Barak Obama signed into law what many have described
as the most important legislation passed by Congress in many generations.

The importance of these new laws has generated much discussion, debate, and political
passion.

Whatever one's political views, however, a very important set of laws is now in effect, commanding the attention of all who provide or use health care.

As a provider of health care, we thought we should share with you what we know about these laws.

The health care reform laws were crafted to solve three problems:

1. Needless death and disability- A rapidly increasing number of American citizens are actually dying from not being insured.
2. Unnecessary financial ruin- Over half of all personal bankruptcies in the US are from uncovered medical costs.
3. Not knowing what works-  A proliferation of drugs and medical devices has exploded with little or no ability for people to know what works best.

Many may disagree about whether these new laws will work, but a striking consensus emerged during 

the debate that these three problems had to be addressed.

As to what the new laws do, a very simple summary would state:

• Insure nearly all American citizens for health care
• Outlaw being excluded or kicked off a plan for getting sick
• Reduce the ability to increase premiums if you get sick
• Give small businesses tax credits if they insure their employees
• Close the Medicare Part D "donut hole"
• Cover preventive health services
• Force Congresspersons to get their health insurance policies through the same health insurance exchanges as everyone else
• Create the ability for the US to test and know which medical interventions work best at the least cost

To achieve these ends, the laws set up a gradual timetable of implementation of a number of provisions.

A good guide to the specific provisions of the health care reform law is offered by the following three 

resources, that describe to provisions in a simple to more comprehensive approach, as follows:

A two-page summary and timetable of the 

legislation (put together by the National Physicians Alliance [NPA])

http://npalliance.org/images/uploads/Whats_in_Health_Reform_for_All_of_Us.pdf

A comprehensive review of our current health care 

system and the new laws (presented by the president of the 

NPA, Dr. Valerie Arkoosh at the Cleveland City Club) 

http://www.cityclub.org/MediaCenter/CityClubPodcast/PodcastListing/tabid/194/Default.aspx

A detailed printed review of the new health care legislation
(From the Kaiser Family Foundation)

http://www.kff.org/healthreform/upload/8061.pdf

Health care is our business, but clearly is everyone's business.  Whatever our political flavor, it 

makes sense to know what the law of the land is, we at Advanced Pediatrics hope 

that these resources help you understand the new health care reform laws.

Let us hope our national community finds its way to prevent needless suffering, financial ruin, and 

the use of ineffective interventions.

We look forward to working together with your family to make sure the health care 

delivered at Advanced Pediatrics is the best care we can provide.

Dr. Arthur Lavin  

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

FDA Asks that One of Two Rotavirus Vaccines Not be Used

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One of Two Rotavirus Vaccines 
Now Off the Market


Advanced Pediatrics has just been alerted that the FDA has advised all doctors
to stop use of the Rotarix vaccine, one of two on the market for use in preventing
stomach flu caused by the rotavirus.


Here is the official notice:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm205625.htm

This notice brings several points to mind:

• Your child is not at risk at Advanced Pediatrics from this vaccine, we have never given this brand to anyone at this office
• Rotavirus is the main type of stomach flu in February.
• All stomach flus tend to be quite mild illnesses in nearly everyone who has them
• By mild, we mean that you recover and you recover with no lasting harm
• By that definition, nearly everyone who gets the stomach flu has a mild illness
• This being the case, any vaccine that would propose to prevent rotavirus infection had better be incredibly safe.  Otherwise, getting the vaccine would prove more dangerous than having the mild illness.

These points leave us confirmed in our recommendation at Advanced Pediatrics

that rotavirus immunization is not yet established as the safe enough to prevent 

this very mild illness, and so we do not recommend immunization with it.

This most recent advisory from the FDA confirms the reasonableness

of our policy to hold on the rotavirus vaccine program at Advanced Pediatrics

until we can be sure this vaccine is far safer than having a bout of mild stomach flu.

In extremely sharp contrast to the typically mild nature of rotavirus, the 
deadly illnesses of tetanus, meningitis, polio, and diphtheria make the urgency of 
being protected against these diseases a very convincing argument for immunization

against these illnesses.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The Second Chickenpox Vaccine- A New Recommendation

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The Two Dose Program of the 
Chickenpox (Varicella) Vaccine:
Advanced Pediatrics Now Supports
This Recommendation


Recently, the state of Ohio has changed its recommendations for 
chickenpox (varicella) vaccine from a one dose to a two dose requirement.


This means, by Ohio law, that a child must have two doses of 
varicella vaccine before they can go to school, unless an exemption
is signed be a clergy, doctor, or parent.


Specifically, at this time, one must have two doses of varicella vaccine
before you can enter an Ohio kindergarten, one dose to enter Grades 1-4, 
but no requirement for any chickenpox vaccine to enter Grade 5 or up.
Again, no varicella vaccine is necessary if you are exempted by a signed
statement from clergy, doctor, or parent.


We have studied the varicella vaccine for many years, and some 
issues do remain, even after careful consideration.  What follows 
is a report of our findings to date, and our current recommendations.


Let us emphasize at the beginning of this discussion that our findings 
and recommendations represent a careful due diligence that has attempted
to be free of influence- either from the marketing of pharmaceutical 
companies, or the lobbying of anti-immunization groups.  Rather, we
have tried to simply stick to the facts as good studies of the facts reveal.


Here are the salient points regarding chickenpox and its vaccine:


Chickenpox in childhood tends to be a mild illness.
This is a rather obvious point, but an important one.  What this 
fact means, however, is that any vaccine used to prevent childhood
chickenpox had better be awfully safe if it can claim to improve our health.
Even relatively unusual or uncommon serious side effects could make the 
vaccine a worse proposition than the disease.


Chickenpox is not always a mild disease
Prior to universal immunization for chickenpox, some healthy children
did die from chickenpox.  It is of course a very dangerous disease
for children with weak or compromised immune systems.  And, as mother's 
antibody weans over the years, adults face quite serious risks from 
more serious chickenpox disease than children, particularly from 
chickenpox pneumonia.


The first dose of chickenpox vaccine works very well
It turns out that if someone gets one dose of chickenpox or varicella
vaccine, it works very well.  About 90% of these children will be 
completely immune for many, many years, perhaps life.  That means
if an immunized child is even heavily exposed to a chickenpox outbreak, they
have a 90% chance of not getting infected.
Further, if they do get infected, essentially all the cases will be quite mild.
For nearly all chickenpox cases in those with one shot, the disease will
be limited to just a handful, sometimes 1-4 chickenpox red dots, with little
discomfort, fever, or distress.


Given that 10% of those with one shot, who are exposed, will
come down with chickenpox a second dose has been 
advised by the public health authorities
Clearly, if you get a second dose, the chance of getting even a mild case
of chickenpox nearly disappears, and that is why this new Ohio statute
requiring two doses to enter Kindergaren was recently enacted by the 
Ohio General Assembly.


Why worry about the chickenpox vaccine?
It turns out the safety record of this vaccine is very good.
Very few serious events have been reported in children that can be
ascribed to this vaccine.  


Before we can recommend the use of this vaccine at all, 
we do feel obligated to make sure you know all the risks.


One issue, more than others, presents an interesting, if theoretical, concern.


It turns out that chickenpox is one of those viruses whose DNA stays in you
the rest of your life.


Any of you who have had chickenpox still have that virus' DNA in you today.
What happens is that as you heal from your chickenpox illness, the virus retreats into 
the insides of the nerve cells that line your spinal cord.  There, the viral DNA forms a 
cozy ring, right next to your cells' DNA.  Every now and then the viral DNA is
woken from its dormancy, and explodes down the nerve cell, causing an itchy 
painful rash in the skin at that nerve's end fibers. That's how anyone gets shingles.
Now it turns out the same thing happens when you get the varicella vaccine, only this
time the viral DNA that lands in your cells is not exactly the same as the chickenpox
DNA that has been circulating across humanity for many thousands of years.
I have personally spoken to Dr. Anne Gerson of Columbia, a leader in the 
development of varicella vaccine, and she confirms that the DNA of the 
chickenpox virus in the vaccine is indeed different from the naturally occurring 
chickenpox viral DNA, and that it does settle for life next to your DNA after immunization.


Has anyone come to any harm having novel DNA lodged in their cells
after varicella vaccination?
No.  Not even after 40 years.


So why worry?
The reason we even bring this concern to your attention, is that no one has ever 
done this on a large scale before.  We have never introduced novel DNA inside millions
of people's cells, and so no one knows for sure what will happen over the course of 80-100 
years.  Further, remember we started the discussion by observing that chickenpox tends 
to be a mild disease?  Now that fact comes into play, for if the illness tends to be mild,
then even unusual, but serious, side effects from a preventive measure like the 
chickenpox vaccine can tip the argument against vaccination.


So what to do?
1.  The First Dose of Chickenpox Vaccine
Advanced Pediatrics urges everyone to have their child immunized against varicella
or chickenpox, at least once.  This is because enough children have been 
immunized that the option of getting immunity by getting chickenpox has nearly
vanished, making those unimmunized likely to be susceptible to potentially fatal
adult chickenpox.  So get the one dose.


2.  The Second Dose of Chickenpox Vaccine
The theoretical risk of introducing a novel DNA is already taken with the first dose
of chickenpox vaccine.  Even though the second dose of chickenpox vaccine likely 
presents little benefit, it also likely presents little risk.


What will we do?
At Advanced Pediatrics, we always honor the family's decisions.  Varicella or 
chickenpox vaccine is clearly one of the least urgently required protections, and 
so we are happy to follow the family's decisions.
Our recommendation at this time is to get the first chickenpox vaccine sometime 
before adulthood, since adult chickenpox is a truly dangerous illness, and that the
second vaccine is fine to get since most of the risk come with the first dose.


Of course, our goal remains clear and simple- to provide the 
very best health care we can to the infants, children, and youth
of your family.  We at Advanced Pediatrics remain greatly honored
by your trust, and will continue to work hard to earn it.


Of course, feel free to call us with any questions.


Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.