August 2005
Home Up '05 Jan-Jun July 2005 August 2005 August #2 2005 Sept. #1 '05 Sept. #2 '05 Oct. #2 '05 Oct. #1 '05 Dec. '05 Dec. #2 '05


Pramipexole (Mirapex) Helped: In a 14-week DB PC study of 60 patients with fibromyalgia, those on 4.5 mg of pramipexole, a dopamine 3 receptor agonist, orally every evening experienced gradual and more significant improvement in measures of pain, fatigue, function, and global status. At 14 weeks, the VAS pain score decreased 36% vs. 9% for placebo. The percentages of improvement were for function (22% versus 0%), fatigue (29% versus 7%), and global (38% versus 3%) scores. There were also decreases in the MDHAQ psychiatric score (37% versus 28%), the BAI score (39% versus 27%), and the HAM-Depression score (29% versus 9%). The most common side-effects were transient anxiety and weight loss. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Holman AJ, Myers RR. Renton, Washington. Arthritis Rheum. 2005 Jul 28;52(8):2495-2505. Ed: This dosage would cost $214/month at Walgreens on 8/1/05.  At that cost, its not a first line treatment, but worth trying in severe cases. For more, see Fibromyalgia.

rTMS Helped Depression in Chinese Study: In a 2-week DB, sham-controlled study of add-on rTMS for 30 medication-resistant patients with DSM-IV major depressive disorder or bipolar disorder, 10 sessions of active rTMS at either faster (20 Hz) or slower (5 Hz) at 100% motor threshold demonstrated a superior reduction of depression severity compared to sham stimulation (active = 56% vs. sham = 16%). No difference in clinical response was observed between 5 Hz and 20 Hz active rTMS. Add-On rTMS for Medication-Resistant Depression: A Randomized, Double-Blind, Sham-Controlled Trial in Chinese Patients. Su TP, et al. National Yang-Ming University, Taipei, Taiwan. J Clin Psychiatry. 2005 Jul;66(7):930-937. For more, see rTMS.

Simvastatin Helped Reduce Cerebral Vasospasm: Cerebral vasospasm remains a major source of morbidity after aneurysmal subarachnoid hemorrhage (SAH). In a DB PC study of 39 adults with documented aneurysmal SAH, those randomized within 48 hours of symptom onset to receive either simvastatin (80 mg daily) for 14 days had highest mean middle cerebral artery transcranial Doppler velocities were significantly lower (103 versus 149; P<0.01). In addition, vasospasm was significantly reduced (P<0.05) in the simvastatin-treated group (5 of 19) compared with those who received placebo (12 of 20). Simvastatin Reduces Vasospasm After Aneurysmal Subarachnoid Hemorrhage. Results of a Pilot Randomized Clinical Trial. Lynch JR, et al. Duke University. Stroke. 2005 Jul 28. For more, see Subarachnoid Hemorrhage and Stroke.

Three Different Echinacea Preparations All Failed to Prevent or Help Colds: Three preparations of echinacea, with distinct phytochemical profiles, were produced by extraction from E. angustifolia roots with supercritical carbon dioxide, 60 percent ethanol, or 20 percent ethanol. A total of 437 volunteers were randomly assigned to receive either prophylaxis (beginning seven days before the virus challenge) or treatment (beginning at the time of the challenge) either with one of these preparations or with placebo. The results for 399 volunteers who were challenged with rhinovirus type 39 and observed in a sequestered setting for five days were included in the data analysis. There were no statistically significant effects of the three echinacea extracts on rates of infection or severity of symptoms. Similarly, there were no significant effects of treatment on the volume of nasal secretions, on polymorphonuclear leukocyte or interleukin-8 concentrations in nasal-lavage specimens, or on quantitative-virus titer. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. Turner RB, et al. University of Virginia School of Medicine, Charlottesville. N Engl J Med. 2005 Jul 28;353(4):341-8. Ed: Previous research has suggested that echinacea has at most minor benefit with many studies finding no benefit.  For more, see Echinacea.

Probiotic (Yogurt Type) Bacteria Reduced Cold Symptoms by Over 20%: In a 3-month DB PC study of 479 healthy adults during winter/spring months, that receiving Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 (5x10(7)cfu/tablet) had a lower total symptom score, the duration of common cold episodes, and days with fever: 79.3 vs. 102.5 points (P=0.056), 7.0 vs. 8.9 days (P=0.045), 0.24 vs. 1.0 days (P=0.017). The intake of probiotic bacteria during at least 3 months significantly shortened common cold episodes by almost 2 days and reduced the severity of symptoms. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: A double blind, randomized, controlled trial. de Vrese M, et al. Federal Research Centre of Nutrition and Food,  Kiel, Germany. Clin Nutr. 2005 Aug;24(4):481-491

Probiotic-Multivitamin-Mineral Supplement Slight Benefit Against Common Cold: In a 3-5 month DB PC study of 477 healthy adults, those assigned to take daily the probiotic multivitamin and mineral supplement had 13.6% fewer viral respiratory tract infections (p = 0.07), a relative reduction of 19% in the total symptom score (p = 0.12), 25% in influenza symptoms (p = 0.09), and 54% in the number of days with fever (p = 0.03). The duration of infections was not affected. Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Winkler P, et al. Federal Research Center for Nutrition and Food, Kiel, Germany. Int J Clin Pharmacol Ther. 2005 Jul;43(7):318-26. For more, see The Common Cold

Probiotic Yogurt Helped Children with H. Pylori Infection: In a DB PC study of 86 children with symptomatic H. pylori infections of the stomach, all received the standard eradication therapy with omeprazole, amoxicillin, and clarithromycin (OAC) for 7 days. The half who also received yogurt with Lactobacillus casei (L. casei) DN-114 001 had Intention-to-treat (ITT) based eradication rates of 85%, and 92% by per-protocol (PP) analysis vs. 57% and 61% without the yogurt (P = 0.0045) and (P = 0.0019). Effects of a Specially Designed Fermented Milk Product Containing Probiotic Lactobacillus casei DN-114 001 and the Eradication of H. pylori in Children: A Prospective Randomized Double-Blind Study. Sykora J, et al. Charles University Hospital, Pilsen, Czech Republic. J Clin Gastroenterol. 2005 Sep;39(8):692-698. Ed: I recommend lite or plain yogurt everyday for everyone.  It's no miracle, but it helps.  Lactobacillus capsules are inexpensive for those who don't like yogurt. For more, see Yogurt.

Topirimate Causes Modest Weight Loss: In a 28-week, DB PC study of 531 obese adults with hypertension, those taking 96 or 192 mg/day of topiramate had weight losses of 5.9%, and 6.5% vs. 1.9% for placebo (p <0.001) and decreases in diastolic BP of 5.5, and 6.3 vs. 2.1 mm Hg (p <0.015 vs placebo). Systolic BP was decreased by 8.6 and 9.7 mm Hg in the 96- and 192-mg groups and 4.9 mm Hg in the placebo group (p = NS). All subjects received a standardized diet, exercise advice, and behavioral modification from run-in through study end. fficacy and safety of topiramate in the treatment of obese subjects with essential hypertension. Tonstad S, et al. University of Oslo, Norway. , Am J Cardiol. 2005 Jul 15;96(2):243-51. Ed: Topirimate is expensive and causes a high rate of side-effects, some serious.  The small benefit of an 8-9 pound weight loss for a 200 pound person means that it is not a first line treatment.  Long-term effects are unknown, but, based on other medication studies, it may lose some of its effectiveness and have to be continued indefinitely to have.

Chitosan Small Benefit: Chitosan is a deacetylated chitin. In a review of the 14 best DB PC trials including a total of 1131 participants, chitosan resulted in a greater weight loss (mean difference 3.8 pounds; P < 0.00001), decrease in total cholesterol (-0.2 mmol/L; P < 0.00001), decrease in systolic (-5.9 mmHg; P < 0.0001) and diastolic (-3.4 mmHg; P < 0.00001) blood pressure compared with placebo. However, the quality of many studies was sub-optimal. Results obtained from high quality trials indicate that the effect of chitosan on body weight is minimal and unlikely to be of clinical significance. Chitosan for overweight or obesity. Ni MC, et al. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003892

Sibutramin (Meridia) Patients Gradually Regain Their Lost Weight: In an 18-month DB PC study of 189 obese adults who had first lost at least 10% of their body weight by means of a 3-month Very Low Calorie Diet, of those who were randomized to sibutramine 10 mg/day (n=94) in addition to a recommended diet and exercise program, 70% at 6 months, 51% at 12 months and 30% at 18 months maintained more than 80% of the weight loss achieved during the VLCD phase. This compared to 48, 31 and 20% of placebo-treated patients. The differences between the treatment groups were significant (P</=0.03) at all time points. Long-term maintenance of weight loss with sibutramine in a GP setting following a specialist guided very-low-calorie diet: a double-blind, placebo-controlled, parallel group study. Mathus-Vliegen EM. University of Amsterdam, The Netherlands. European Journal of Clinical Nutrition (2005) 59, Suppl 1, S31-S39. Ed: While the authors stress the benefits, after 18 months of continuous medication, only 10% of the Meridia patients were maintaining their weight loss better than placebo patients. Meridia has a very poor track record.

Oxyntomodulin Helped Short-Term Weight Loss: Oxyntomodulin is a 37 amino acid peptide containing the 29 amino acid sequence of glucagon. It was discovered in rats in 1981 to stimulate cAMP in the gut. In a DB PC 4 week study of obese adults, those injecting oxyntomodulin three times a day had weight reduced by 5 pounds vs. 1 pound for placebo (P = 0.0106). There was a reduction in leptin and an increase in adiponectin with a loss of body fat. Energy intake by the treatment group was significantly reduced by 250 kcal (P = 0.0023), with no change in subjective food palatability. Subcutaneous oxyntomodulin reduces body weight in overweight and obese subjects: a double-blind, randomized, controlled trial. Wynne K, et al. Imperial College Faculty of Medicine, London, U.K. Diabetes. 2005 Aug;54(8):2390-5. For more, see Obesity.

Osteoporosis: Vitamin D at 800 IU and 2000 IU Didn't Help: In a 3 year DB PC study of 208 African American postmenopausal women, 20 microg/d (800 IU) of vitamin D(3) and 2000 IU for the third year with all women receiving calcium supplements of 1200 to 1500 mg/d led to no significant differences in BMD between the active and control groups throughout the study. There was also no relationship between serum 25-hydroxyvitamin D levels attained and rates of bone loss. There was an increase in BMD of the total body, hip, and radius at 1 year in both groups. Over the 3 years, BMD declined at these sites by 0.26% to 0.55% per year. A randomized controlled trial of vitamin D3 supplementation in African American women. Aloia JF, et al. Winthrop University Hospital, Mineola, NY. Arch Intern Med. 2005 Jul 25;165(14):1618-23. Ed: While vitamin D is a great supplement for prevention of cancer and heart disease, it has only a minor benefit for osteoporosis. Vitamin K plays a more important role. For more, see Osteoporosis.

Testosterone Patch Slight Benefit for Low Sexual Desire After Ovaries Removed: In a 24-week DB PC study of 447 women who had developed distressful low sexual desire after bilateral salpingo-oophorectomy and hysterectomy and who were receiving oral estrogen therapy, placebo (n = 119) or testosterone patches in dosages of 150 microg/d (n = 107), 300 microg/d (n = 110), or 450 microg/d (n = 111) twice weekly were compared. Compared with placebo, women receiving the 300-microg/d testosterone patch had significantly greater increases from baseline in sexual desire (67% vs 48%; P = .05) and in frequency of satisfying sexual activity (79% vs 43%; P = .049). The 150-microg/d group showed no evidence of benefit. The 450-microg/d group also was not statistically different from the 300-microg/d or placebo groups. Marginally significant linear dose-response trends were observed for total satisfying sexual activity and sexual desire at 24 weeks (P = .06 and .06, respectively). Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial. Braunstein GD, et al. Cedars-Sinai Medical Center, Los Angeles. Arch Intern Med. 2005 Jul 25;165(14):1582-9. For more, see Low Female Arousal.

Slow-Release Morphine Did Better than Methadone for Heroin Addicts: In a 14-week DB PC study of 64 adults with opioid dependence, a mean methadone dose of 85 mg was compared to a mean slow-release morphine dose of 680 mg. No significant differences in retention or use of illicit substances (opioids, benzodiazepines, cocaine) were observed. However, patients receiving slow-release morphine had lower depression (P < 0.001) and anxiety scores (P = 0.008) and fewer physical complaints (P < 0.001). Comparative study of the effectiveness of slow-release morphine and methadone for opioid maintenance therapy. Eder H, et al. Medical University, Vienna, Austria. Addiction. 2005 Aug;100(8):1101-9. For more, see Heroin Addiction.

Herbal Remedy Helped Colicky Infants: In a 1-week DB PC study of 93 breastfed colicky infants, the daily average crying time for the herbal treatment was 201 min/day at the baseline and 77 min/day at the end of the study; for the placebo it was 199 min/day and 170 min/day (p < 0.005). No side effects were reported. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil((R))) in the treatment of breastfed colicky infants. Savino F, et al. Universita di Torino, Italy. Phytother Res. 2005 Apr;19(4):335-40. Ed: A little yogurt each day also helps. For more, see Lemon Balm.

Black Cohosh and Soy Isoflavones No Benefit for Menopausal Symptoms: In a 12-week DB PC study of 124 postmenopausal women with climacteric symptoms, a combination of soy isoflavones and black cohosh (Actaea racemosa Linnaeus: formerly called Cimicifuga racemosa L.) had no statistically significant benefit over placebo with both groups showing improvement. Effect of a combination of isoflavones and Actaea racemosa Linnaeus on climacteric symptoms in healthy symptomatic perimenopausal women: a 12-week randomized, placebo-controlled, double-blind study. Verhoeven MO, et al. University Medical Center, Amsterdam. Menopause. 2005 Jul-Aug;12(4):412-20

Black Cohosh Mild Help Only for More Severe Menopausal Symptoms: In a 12-week DB PC study of 122 menopausal women with >/=3 hot flashes a day, the primary efficacy analysis showed no superiority of the tested black cohosh extract compared to placebo. However, in the subgroup of patients with a Kupperman Index>/=20 a significant superiority regarding this index could be demonstrated (P<0.018). A decrease of 47% and 21% was observed in the black cohosh and placebo group, respectively. The weekly weighted scores of hot flashes (P<0.052) and the Menopause Rating Scale (P<0.009) showed similar results. Prevalence and intensity of the adverse events did not differ in the two treatment groups. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Frei-Kleiner S, et al. University of Basel, Switzerland. Maturitas. 2005 Aug 16;51(4):397-404. For more, see Menopause.

Famine Causes Doubling of Schizophrenia: The famine study focused on the Wuhu region of Anhui province in eastern China, one of the hardest-hit areas. The researchers examined data on births and deaths before, during and after the famine of 1959-61 and on psychiatric records from 1971 to 2001. In 1960, in the midst of the famine, there were 13,748 children born in the region; 192 of them developed schizophrenia. That compared with 483 schizophrenics out of 59,088 births in 1956 and 695 out of 83,536 births in 1965. Compared with children born before or after the 1959-61 famine, those born during the disaster faced double the risk of becoming schizophrenic later on. The results are nearly identical to a previous study of a famine in Holland resulting from a Nazi food blockade toward the end of World War II. David St. Clair, et al. University of Aberdeen, Scotland. JAMA 8/3/05. Ed: There are many causes of schizophrenia in addition to genetics. For more see Schizophrenia Risk Factors.

Tretinoin (Retin-A): No Detectable Harm After 2 Years for Photodamaged Skin: In a DB PC 2-year study of 204 adults with photodamaged skin, those on tretinoin emollient cream 0.05% had a significantly greater improvement relative to placebo in clinical signs of photodamage (fine and coarse wrinkling, mottled hyperpigmentation, lentigines, and sallowness), overall photodamage severity, and investigator's global assessment of clinical response (p < 0.05). There was no increase in keratinocytic or melanocytic atypia, dermal elastosis, or untoward effects on stratum corneum following treatment with tretinoin compared with placebo. There was a significant increase relative to placebo in facial procollagen 1C terminal, a marker for procollagen synthesis, at month 12 (p = 0.0074). Long-term efficacy and safety of tretinoin emollient cream 0.05% in the treatment of photodamaged facial skin : a two-year, randomized, placebo-controlled trial. Kang S, et al. University of Michigan. Am J Clin Dermatol. 2005;6(4):245-53. v

Eplerenone, an Aldosterone Blocker, Reduced Death After Heart Attack: In the 16-month DB PC Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS), eplerenone 25 mg/day started 3-14 days after a heart attack reduced all-cause mortality by 15% (p = 0.008) over a mean follow-up of 16 months when used with standard therapy in patients after AMI with an LVEF < or =40% and clinical signs of heart failure. At 30 days after randomization, eplerenone reduced the risk of all-cause mortality by 31% (3.2% vs. 4.6% in eplerenone and placebo-treated patients, respectively; p = 0.004) and reduced the risk of CV mortality/CV hospitalization by 13% (8.6% vs. 9.9% in eplerenone and placebo-treated patients, respectively; p = 0.074). Eplerenone also reduced the risk of CV mortality by 32% (p = 0.003) and the risk of sudden cardiac death by 37% (p = 0.051). Eplerenone reduces mortality 30 days after randomization following acute myocardial infarction in patients with left ventricular systolic dysfunction and heart failure. Pitt B. et al. University of Michigan. J Am Coll Cardiol. 2005 Aug 2;46(3):425-31. For more, see Heart Disease.

Both ACE Inhibitors and ARBs Help Prevent Diabetes: In two meta-analyses of clinical trials investigating the effect of the inhibition of the renin-angiotensin system either with an angiotensin converting enzyme inhibitor (ACEI) or with a selective angiotensin receptor blocker (ARB) on the incidence of new cases of type 2 diabetes mellitus in adults with arterial hypertension or with congestive heart failure, the protection appears similar with ACEIs in six trials in a total of 24.623 patients (hazard ratio: 0.77; p < 0.00001) and with ARBs in five trials in a total of 14.344 patients (hazard ratio: 0.79; p < 0.00001). It is consistent whatever the comparator, a thiazide diuretic agent, a beta-blocker, a dihydropyridine calcium channel blocker or a placebo. Similar reduction in new cases of type 2 diabetes with angiotensin receptor blocker and ACE inhibitor: comparison of meta-analyses of prospective randomised trials. Scheen AJ. Universite de Liege. Rev Med Liege. 2005 May-Jun;60(5-6):424-8. For more, see Diabetes.

Niacinamide (Vitamin B3) Cream Helped Facial Aging: In multiple chronic clinical studies, topical niacinamide (vitamin B3) has been well tolerated by skin and improved the appearance of aging facial skin (eg, reduced hyperpigmentated spots and red blotchiness). In a study of 50 European-American women with clinical signs of facial photoaging, the women applied 5% niacinamide cream to half of the face and its vehicle control to the other half twice daily for 12 weeks (double blind, left-right randomized). Niacinamide reduced fine lines and wrinkles, hyperpigmented spots, red blotchiness, and skin sallowness (yellowing). In addition, elasticity (as measured via cutometry) was improved. Niacinamide: A B vitamin that improves aging facial skin appearance. Bissett DL, et al. The Procter & Gamble Company, Cincinnati, Ohio. Dermatol Surg. 2005 Jul;31(7 Pt 2):860-5

Green Tea Extract Caused No Visible Help to Facial Aging: Green tea extracts have gained popularity as ingredients in topical skin care preparations to treat aging skin. In an 8-week DB PC study of 40 women with moderate photoaging, those using 10% green tea cream and 300 mg twice-daily green tea oral supplementation did no different from the placebo group other than higher subjective scores of irritation in the green tea-treated group. Histologic grading of skin biopsies did show significant improvement in the elastic tissue content of treated specimens (p<.05). Whether longer treatment would have caused visible improvement is unknown. Double-blinded, placebo-controlled trial of green tea extracts in the clinical and histologic appearance of photoaging skin. Chiu AE, et al. Emory University. Dermatol Surg. 2005 Jul;31(7 Pt 2):855-60. For more, see Acne and Sun-Damaged, Aging Skin.

Cholesterol: LDL Decreased by Probiotic (Yogurt-Like) with Selenium: In a 56-week DB PC study of 43 elderly adults, those taking a daily capsule of probiotic strain Enterococcus faecium (EF) M-74 enriched with selenium 50 mcg had a 12% decrease in total cholesterol  from 5.94 to 5.22 mmol/l (p<0.001), mainly due to a fall in LDL cholesterol (3.85 to 3.09 mmol/l, p<0.001) with significant change in HDL and triglycerides. There were no significant changes in the placebo group. One-year application of probiotic strain Enterococcus faecium M-74 decreases serum cholesterol levels. Hlivak P, et al. Comenius University, Bratislava, Slovakia. . Bratisl Lek Listy. 2005;106(2):67-72. Ed: Lite yogurt, i.e., artificially sweetened or plain, daily has many health benefits. For more, see Yogurt.

Menopause: Later is Better: In a study of 12,134 postmenopausal women followed for 17 years, there were 2607 deaths, of which 963 were due to cardiovascular diseases and 812 due to cancer. Ischemic heart disease risk decreased with a later menopause (hazard ratio [HR] = 0.98 per year), but the risk of fatal uterine or ovarian cancer increased (1.07 per year). A later menopause was associated with longer overall survival; HR for total mortality was 0.98 per year. Life expectancy in women with menopause after age 55 was 2.0 years longer than those with menopause before age 40. Age-adjusted mortality is reduced 2% with each increasing year of age at menopause. In particular, ischemic heart disease mortality is 2% lower. Although the risk of death from uterine or ovarian cancer is increased by 5%, the net effect of a later menopause is an increased lifespan. Age at menopause, cause-specific mortality and total life expectancy. Ossewaarde ME, et al. University Medical Center Utrecht, The Netherlands. Epidemiology. 2005 Jul;16(4):556-62. For more, see Longevity.

Osteoporosis: Almost All Elderly with Hip Fractures Had Very Low Vitamin D Levels: Of 82 adults (ages 52-97 with 63% age 80+) hospitalized with hip fractures, 50% reported using at least 400 IU per day of vitamin D through supplements and 13% of all patients were taking osteoporosis medication (3 estrogen, 5 alendronate, 1 etidronate, 1 raloxifene). The mean 25(OH)D concentration was 14.2. All but two of the 78 patients (97.4%) had 25(OH)D concentrations < 30 ng/mL and the majority (81%) of the patients had 25(OH)D concentrations < 20 ng/mL, including 21% < 9 ng/mL. Therefore, nearly all patients in this study hospitalized for fracture had vitamin D inadequacy, i.e., <80 ng/ml.  Prevalence of vitamin D inadequacy in a minimal trauma fracture population. Simonelli C, et al. HealthEast Osteoporosis Care, Woodbury, MN. Curr Med Res Opin. 2005 Jul;21(7):1069-74. Ed: It appears that adequate supplementation for the elderly is at least 2000 IU vitamin D. Vitamin K supplementation of 1 mg or more/day is also important. Sun exposure also helps.

Osteoporosis: Almost All Elderly with Hip Fractures Had Very Low Vitamin D Levels: Of 82 adults (ages 52-97 with 63% age 80+) hospitalized with hip fractures, 50% reported using at least 400 IU per day of vitamin D through supplements and 13% of all patients were taking osteoporosis medication (3 estrogen, 5 alendronate, 1 etidronate, 1 raloxifene). The mean 25(OH)D concentration was 14.2. All but two of the 78 patients (97.4%) had 25(OH)D concentrations < 30 ng/mL and the majority (81%) of the patients had 25(OH)D concentrations < 20 ng/mL, including 21% < 9 ng/mL. Therefore, nearly all patients in this study hospitalized for fracture had vitamin D inadequacy, i.e., <80 ng/ml.  Prevalence of vitamin D inadequacy in a minimal trauma fracture population. Simonelli C, et al. HealthEast Osteoporosis Care, Woodbury, MN. Curr Med Res Opin. 2005 Jul;21(7):1069-74. Ed: It appears that adequate supplementation for the elderly is at least 2000 IU vitamin D. Vitamin K supplementation of 1 mg or more/day is also important. Sun exposure also helps.  

Osteoporosis: Sun Exposure Reduced Fractures in Elderly:  In a randomized study, Alzheimer's disease (AD) patients were assigned to regular sunlight exposure (n = 132) or sunlight deprivation (n = 132) and followed for 1 year. Serum 25-OHD level increased by 2.2-fold in the sunlight-exposed group. Eleven patients sustained fractures in the sunlight-deprived group, and three fractures occurred among the sunlight-exposed group (p = 0.0362; odds ratio = 3.7). BMD increased by 2.7% in the sunlight-exposed group and decreased by 5.6% in the sunlight-deprived group (p < 0.0001). Serum 25-OHD level increased from 24.0 to 52.2 nM in the sunlight-exposed group. Amelioration of osteoporosis and hypovitaminosis d by sunlight exposure in hospitalized, elderly women with Alzheimer's disease: a randomized controlled trial. Sato Y, et al. Tagawa, Japan. J Bone Miner Res. 2005 Aug;20(8):1327-33. For more, see Vitamin D and Osteoporosis.

PMS: Lower in Women with Higher Vitamin D Intake: In a case-control study within the prospective Nurses' Health Study II cohort of women aged 27 to 44 years and free from PMS at baseline, 1057 women developed PMS over 10 years of follow-up and 1968 women reporting no diagnosis of PMS and no or minimal menstrual symptoms. After adjustment for age, parity, smoking status, and other risk factors, women in the highest quintile of total vitamin D intake (median, 706 IU/d) had a relative risk of 0.59 compared with those in the lowest quintile (median, 112 IU/d) (P = .01). The intake of calcium from food sources was also inversely related to PMS; compared with women with a low intake (median, 529 mg/d), participants with the highest intake (median, 1283 mg/d) had a relative risk of 0.70 (P = .02 for trend). The intake of skim or low-fat milk was also associated with a lower risk (P<.001). Calcium and vitamin D intake and risk of incident premenstrual syndrome. Bertone-Johnson FR, et al. University of Massachusetts, Amherst. Arch Intern Med. 2005 Jun 13;165(11):1246-52. For more, see PMS.

Stroke: Vitamin D Lower in Stroke Victims; Iron Lower in Heart Attacks and Strokes: In a population-based health survey of 755 adults ages 65-99 with 10 years follow-up, 130 had heart attacks and 70 had strokes. Low intake of vitamin D (p=0.011) and low serum levels of 1,25-dihydroxy-vitamin D (p=0.0053) were predictive of stroke when adjusted for age, gender, smoking and functional capacity. High dietary intakes of two flavonoids, luteolin (p=0.0096) and kaempferol (p=0.002) were associated with lowered risk of heart attack. Low serum levels of iron predicted both heart attack (p=0.013) and stroke (p=0.019). Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects. Marniemi J, et al. National Public Health Institute, Turku, Finland. Nutr Metab Cardiovasc Dis. 2005 Jun;15(3):188-97. For more, see Stroke.

Magnesium Defiency Said Linked to Mitral Valve Prolapse: Idiopathic mitral valve prolapse (IMVP) refers to the systolic displacement of one or both mitral leaflets into the left atrium, with or without mitral regurgitation. It is one of the most common forms of cardiac abnormalities among young people, especially in women. IMVP usually appears to be a benign condition and even capable of recovery. Some studies suggest a link of IMVP to causing Panic Disorder. Magnesium deficiency (MD) may cause abnormal fibrosis, abnormalities in collagen synthesis as well as in the myocardium, capable of inducing mitral apparatus dyskinesia. It is a part of a picture of metabolic abnormalities, alteration of immune and autonomic nervous systems, cardiac arrhythmias and thromboembolic phenomena in IMVP. Mg therapy is essential and specific for IMVP. In the majority of cases MD is due to Mg depletion and the oral Mg supplementation must be combined with Mg-sparing diuretics or physiological doses of vitamin D. Magnes Res. 2005 Mar;18(1):35-52. The importance of magnesium status in the pathophysiology of mitral valve prolapse. Bobkowski W, et al. Poznan University, Poland. Ed: I haven't seen the studies. v

Infections: Inadequate Multivit-Mineral Supplement No Benefit to Elderly: In a 1-year DB PC study of 910 adults over age 64, no decrease in infections, contacts with primary care, and improved well being was linked to a multi-vitamin and mineral supplement. Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial. Alison Avenell, et al. University of Aberdeen. BMJ  8/6/2005;331:324-329. Ed: The supplement contained vitamin A, which is unhealthy as a supplement, but it contained no magnesium, selenium or vitamin K, and grossly inadequate amounts of vitamin D (200 IU), folate (200 mcg), and B-12 (1 mcg) with only 60 mg. of vitamin C. Selenium 200 mcg has reduced infections. I do not recommend commercial multivitamins. For my recommendations, see my Recommendations for Healthy Living.

Urinary Infections: Give Antibiotic Even If Symptoms Present, But Tests Are Negative: In a DB PC study of 59 women with urinary discomfort and frequency but negative dipstick tests for nitrites and leucocytes, those given trimethoprin 300 mg/d for 3 days had a much more rapid resolution of symptoms including dysuria, fewer, and shivers. Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results: double blind randomised controlled trial. Dee Richards, et al. Christchurch School of Medicine. New Zealand. BMJ  7/16/2005;331:143. Authors state that the results support empirical treatment. For more, see UTIs.


Thomas E. Radecki, M.D., J.D.