Sunday, January 18, 2009

Statins role in CAD

The chiropractor for whom my mom works tried to dissuade my dad from continuing to take statins based off an article: "Dr. Julian Whitaker's Health & Healing-Your Definitive Guide to Wellness Medicine".
Dr. Whitaker's claim is that MI's are caused from inflammation and have nothing to do with cholesterol. Recent research is finding that the role of inflammation is much more involved than originally thought. So Dr. Whitaker has some validity in his claims.
http://content.nejm.org/cgi/content/abstract/336/14/973
http://circ.ahajournals.org/cgi/content/full/105/9/1135

However extensive research still shows that cholesterol plays a role in CAD.

http://jama.ama-assn.org/cgi/content/abstract/285/4/430
http://content.nejm.org/cgi/content/abstract/344/26/1959
http://jama.ama-assn.org/cgi/content/abstract/282/24/2340

The last link is a meta-analysis of Medline articles from 1966 to 1998 on CAD and statins.

Furthermore, Dr. Whitaker's references are a bit concerning: Business Week, 2 science articles-1 from Biofactors and 1 from Circulation (seemingly valid), and a book.

Finally, statins not only help reduce cholesterol, but also help reduce inflammation, which could be another factor in which they are helping to reduce MI's. So be it cholesterol or inflammation, research has shown that statins continue to lower MI's.


"Dr. Julian Whitaker's Health & Healing-Your Definitive Guide to Wellness Medicine". June 2008. Vol. 18; no. 6; pp. 1-3

Monday, January 5, 2009

Soy Beans

So remember studying for Step 1 and having to know that vegetarians are at an increased risk for B12 deficiency? Well, I came across an article talking about the benefits of soy beans. If fortified w/cobalamin as some soy products are, it looks like being a vegetarian isn't so "risky" and actually beneficial.
To make this article peds related...I found it interesting that babies on soy formula can have decreased absorption of iron or thyroid hormone supplementation. Furthermore, soy contains tyramine so could cross react with MAOI's.
Key points from article:

Advantages:
-reduce cholesterol, LDL, and TG levels.
-reduce menopausal hot flashes
-reduce bone turnover-->improve bone mineral density
Disadvantages:
-diarrhea (common)
-Rare:menorrhagia, amenorrhea, HA, dizziness, MSK complaints


Article from American Family Physician, Vol 79, No. 1, Jan. 1, 2009
Michelfelder, Aaron J., MD. "Soy: A complete Source of Protein", pp. 43-47