Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts

Tuesday, January 3, 2017

4 Supplements to Question After Age 50


Calcium, iron, and more may not be so good for you. What you should know.

Consumer Reports / December 16, 2016 / Lauren Cooper

Vitamins and minerals are marketed to keep you healthy. But some may carry more risks than benefits, especially as we age.

Supplements are most useful when they’re used to replace dietary deficiencies,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser. “Therefore, most of us don’t need them. Such needless use can be harmful, especially if you also take prescription medications.”

In addition, the evidence supporting supplements is often flimsy or mixed, and because of lax regulation, you can’t always be sure what they contain. The following four supplements may be especially harmful to your health if you’re over 50.

Folic Acid Supplements
Research has suggested, but not proved, that folic acid (vitamin B9) may help ward off Alzheimer’s disease, depression, and heart disease.

Still, a recent study published by the American Journal of Clinical Nutrition links excess folate (including folic acid) to burning, tingling, or numbness in the extremities of people with a common gene variant.

“The odds were sevenfold higher for those who consumed more than 800 mcg daily,” says co-author Ligi Paul, Ph.D., of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

In addition, taking as little as 300 mcg daily may mask a B12 deficiency, which is relatively common in older adults, says Orly Avitzur, M.D., Consumer Reports’ medical director. “Undiagnosed, that can lead to nerve damage, cognitive trouble, and even psychiatric problems,” she says.
Folic acid can also reduce the effectiveness of the seizure drug fosphenytoin (Cerebyx and generic) and the cancer drug methotrexate (Rheumatrex and generic).

Who might need it? Women who are pregnant or planning to get pregnant, to prevent birth defects.

Calcium Supplements
You might take calcium supplements to strengthen your bones, which can weaken with age. But regular use may increase the risk of kidney stones and possibly heart disease.

A study in the Journal of the American Heart Association in October found that people who took calcium supplements over a 10-year period were more likely to accumulate the artery plaque that can lead to heart attacks.

Supplemental calcium can also negatively interact with some heart and thyroid medications.

Who might need it? People who eat little or no calcium-rich food, such as dairy products and leafy vegetables.

Iron Supplements
Anemia­, or low blood levels of iron­­, is more common with age. But taking too much iron can mask symptoms of anemia, which can be caused by internal bleeding, and lead to a missed diagnosis.

Iron supplements can also inhibit the absorption of certain antibiotics and blood pressure-lowering drugs such as captopril (Capoten and generic).

And if you have hemochromatosis, a common genetic condition, iron pills can lead to an overload of the nutrient in vital organs, potentially causing diabetes symptoms, heart problems, and liver damage.

Who might need it? People with diagnosed iron-deficiency anemia.

Vitamin E Supplements
These supplements are said by some to help prevent cancer, dementia, and heart disease, but there’s little proof—and plenty of reason to avoid them.

Research has linked regular use to a 13 percent higher risk of heart failure in certain populations. A study published in JAMA in 2011 also found that taking 400 IU daily may boost the likelihood of prostate cancer by 17 percent. Vitamin E supplements may also make some chemotherapy drugs
less effective.
Who might need it? Our experts don’t recommend it for anyone.

3 Supplements to Consider
Vitamin D—It might make sense if you’ve been diagnosed with osteoporosis, get little sunlight, or rarely consume D-rich foods such as fatty fish, eggs, and fortified milk.

AREDS2 (a blend of vitamins C and E, copper, lutein, zeaxanthin, and zinc)—It might make sense if you have age-related macular degeneration, a leading cause of vision loss.

Vitamin B12—It might make sense if you’re a strict vegan, or if you regularly take certain kinds of heartburn drugs or metformin, a diabetes medication.

Friday, February 12, 2016

Cholesterol-Lowering Drugs May Be Linked to Diabetes


Consumer Reports Health / February 2016



You may have concerns about taking a cholesterol-lowering statin drug, such as atorvastatin (Lipitor and generic), rosuvastatin (Crestor), and simvastatin (Zocor and generic), after a recent study linked those drugs to an increased risk of type 2 diabetes. But Consumer Reports Best Buy Drugs experts say the heart-protective benefit of statins usually outweighs the risk of diabetes, so don’t skip a statin if you need one to lower your cholesterol.

Diabetes isn’t a new side effect of statins. The Food and Drug Administration added it to the label of all statins in 2012 based on a review of studies that found a slightly elevated risk. For example, one study that reviewed 13 randomized, controlled clinical trials of statins found that 4.9 percent of people who took one of the drugs for 4 years developed diabetes compared with 4.5 percent of those who didn’t take a statin.

Lower Cholesterol vs. Higher Blood Glucose

The new study, published in the Journal of General Internal Medicine, raises questions about whether the diabetes risk is higher than previously thought. Researchers looked at medical data of nearly 7,000 men and women with an average age of 53. About 31 percent of those who took a statin for an average of 5.5 years developed diabetes compared with 19 percent of those who didn’t.

But since the study was not a randomized, controlled study—the gold standard for determining whether a drug causes a particular side effect—it’s not known for sure that the increase in diabetes was entirely due to statins. The study participants might have had other factors that contributed to the development of diabetes.

"All we can say," says Ishak Mansi, M.D., an internist at the Veteran's Hospital in North Texas and co-author of the study, "[is] that in the healthy population selected ... the risk of diabetes after prolonged followup was higher than expected."

The risk of diabetes with statins is relatively low and is likely outweighed by the potential benefit of the medications to reduce LDL or “bad” cholesterol levels and prevent a heart attack or stroke, says Paul Thompson, M.D., chief of cardiology at Hartford Hospital in Connecticut. Previous research found that for every case of diabetes statins triggered, they prevented at least three heart attacks or other serious heart problems, Thompson adds.

“The bottom line is that the remote risk of developing type 2 diabetes should not deter you or influence your decision to use a statin if one is indicated,” says Marvin M. Lipman, M.D.,Consumer Reports’ chief medical adviser.

To figure out if a statin makes sense for you, our Best Buy Drug report on statins recommends using this calculator. It estimates your overall risk of a heart attack or stroke in the next 10 years based on your total cholesterol level, HDL “good” cholesterol, your age, blood pressure, and whether you smoke, or have diabetes.




Our medical advisers say that for some people with a low risk of heart attack or stroke—less than 10 percent over the next 10 years—diet and lifestyle changes should be the first step to lowering cholesterol. That includes adopting a healthy diet that is low in saturated fats, trans fats, and cholesterol, and making lifestyle changes such as exercising and losing weight if you need to or quitting smoking if you are a smoker.


Those changes could reduce your LDL and your heart attack and stroke risk low enough that you won’t need to take a statin. Or, if you already take a statin, these changes might allow you to discontinue your medication or lower your dose, which can in turn reduce your risk of side effects.

Our medical advisers also recommend that you use the calculator to look at how much taking a statin would reduce your risk. And talk with your doctor. You might find that reducing your cholesterol levels with a statin will not make much difference in your 10-year risk of heart attack or stroke. If that's the case, then skip it.


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