By Gary Pepper, M.D.
A survey by metabolism.com reveals that a vast majority of the public believe doctors in the US are overly influenced in their decisions by the pharmaceutical industry. 500 visitors to the website participated in the survey. 419 (84%) answered yes to the question, “Do you feel that US doctors’ decisions are overly influenced by pharmaceutical industry money?” 56 (11%) were not sure, and only 20 (4%) voted no to this question. Continue reading
by Gary Pepper, M.D.
Chances are, if you have diabetes you have heard about a new class of drugs to treat high blood sugar (glucose). The first of these new medications to gain FDA approval in the U.S., in 2013, is Invokana manufactured and promoted by Janssen Pharmaceuticals and Johnson & Johnson. In the last year and a half the number of these drugs known as SGLT2 inhibitors, has multiplied faster than tribbles to include Farxiga, Xigduo, Jardiance and Invokamet. Prescriptions for these medications are also showing explosive growth, increasing 300% since January 2014. A recent forecast by Express Scripts calls for this one class of drugs to be responsible for about a 20% increase in the yearly cost of prescriptions per all members per year for the next 3 years . The explanation behind the eager adoption and dissemination of this brand new class of medications may eventually serve as a tragic lesson for diabetic patients and for the medical community in general.
by Gary Pepper, M.D.
“New is not always better.” This caution seems reasonable when considering the value of the recently approved medications for treatment of Type 2 (adult type) diabetes. These drugs include three new classes of medication referred to as GLP-1 analogs, DPP-4 inhibitors and most recently SGLT-2 inhibitors. The focus of this discussion will be the most widely prescribed of the newcomers, the DPP-4 inhibitors.
The first thing consumers will notice about the new diabetes medications are their TV commercial friendly names, Januvia, Onglyza, Tradjenta, and Nesina. Mix these newcomer drugs together into a single pill with the venerable low cost generic metformin and the names becomes Janumet, Kombiglyze, Jentadueto, and Kazano.
The next thing a consumer will notice is the price tag. At the local pharmacy in Jupiter, Florida the retail prices of a 3 month supply of Januvia, Onglyza or Tradjenta are all about $1100. A three month supply of the established generic drug, glipizide, is $9.99 and metformin is between zero and $41. Continue reading
by Dr. S. Brown
As a physician in private practice familiar with highly skilled pharmaceutical representatives pitching the latest (and most expensive) medications, I am fairly good at separating truth from salesmanship. These clear cut interactions with the drug reps visiting my office are relatively harmless. Drug maker’s are now changing up the game however, with a new, more subversive tactic to influence doctors’ prescribing habits.
I have been compiling a “medical propaganda” file, consisting of emails directed to my work and personal address offering cash for my time. In less than a year, I count over 500 of these emails. Here are twenty from the past week. Some details are blacked out for legal reasons. Continue reading
It seems as if “bioflavonoid” is a popular buzzword for the health conscious. But what are bioflavonoids and why are they helpful?
In the past “Bioflavonoids” were often referred collectively as vitamin P. Bioflavonoids are a group of naturally occurring plant compounds, which act primarily in nature as plant pigments, metabolic enhancers, chemical messengers within the plant and also fight various plant infections. In humans, they exhibit a host of biological activities, most notably powerful antioxidant properties. More than 5,000 bioflavonoids have been identified as of now. Continue reading
Obesity Related Type 2 Diabetes is More Severe in Teens than Adults
by Gary Pepper, M.D. and Andrew Levine, Pre-Med, Univ of Central Florida
The recently published TODAY study found obesity related type-2 diabetes mellitus (T2DM) is more severe as a teen than as an adult, and high risk of developing diabetes could be tied to weight gain at an early age.
Between 2004 and 2009 the “Treatment Options for Type 2 Diabetes in Youth Study Group” (TODAY) gathered 700 participants who met the American Diabetes Association’s criteria for this disease. The participants were monitored for between two to six years. TODAY’s goal was to assess treatment options and the clinical progression of obesity related T2DM in youth. The mean age of the 700 participants in the TODAY study was thirteen, the majority being female. Sixty percent of the 700 participants were African American or Hispanic, with the remainder being Caucasian. The mean duration of diabetes for the study’s’ participants was less than seven months. A major worrisome finding from the study is a majority of participants were also discovered to have dyslipidemia, an abnormally high amount of fats (cholesterol, triglycerides) in the blood, as well as high blood pressure (hypertension). Continue reading
I am often asked by patients with hypothyroidism (low thyroid hormone levels), “What is the right thyroid hormone dose for me”. Of course, a physician wants to find the appropriate dose of medication to treat each condition a patient has. When it comes to thyroid disease however, this can be a complex question. Not only is there an issue of whether T4 alone or combination T3 and T4 will be required to treat a particular individual but the therapeutic window of these hormones must also be considered. Continue reading
Several months ago I posted my thoughts on possible hormonal complications of using HCG for diet purposes . Since HCG is the “pregnancy hormone” it has a profound effect on the ovaries, causing them to work harder with the potential to over produce various sex hormones. Based on this theory I proposed that HCG could make you hairy by raising levels of the hormone testosterone. Today I had confirmation of my suspicions about ovarian side effects of HCG injections for weight loss. I learned that a woman who was being treated for a thyroid condition and polycystic ovarian disease (PCO) developed a dangerous ovarian condition while using HCG for weight loss. She was happy because she lost 14 lbs. but was stopped by her GYN doctor from continuing her HCG injections. Continue reading
Much as has been said recently about the health benefits of coconut milk and coconut oil. Coconut milk is a white liquid mixture of water and the white “flesh” of the coconut and is considered a more diluted form of coconut oil a thick clear liquid. Coconut extracts have been used in commercial food products, non-dairy creamers and cooking for many years but lately there has been a burst of publicity for coconut oil and milk as a new form of health-food with beneficial properties including increasing energy, preventing cancer and speeding weight loss. I have seen it being added to ice cream and even bottled water. I want to sound a note of warning here.
Most physicians and nutritionists will advise against having too much fat in the diet for a number of reasons. First, and most obvious, fats have lots of calories. In addition dietary fat can increase the bad cholesterol (LDL) content of the blood leading to increased risk of heart attack and stroke. Among the different kinds of fat that raise LDL the worst are the saturated fats. One tablespoon of coconut oil contains about 120 calories with about 90% of the coconut oil being saturated fat. In fact the saturated fat, palmitic acid, takes its name from the plant that produces coconuts, the palm tree. Compare this to the fat in dark chocolate which is 30% oleic acid, the healthy monounsaturated fat found in olive oil.
Oils which are far more beneficial for preparing foods are unsaturated fats including the monounsaturated and polyunsaturated fats. I like canola, safflower and olive oil due to their high content of these healthier fats.
Coconut oil has many other applications which are useful outside the body. It can be used as a diesel fuel, deodorant, insect repellent, to make soap, and as a moisturizer for hair and skin. My advice is to think twice however, before supplementing your diet with it.