Vitamin D: Is It the ‘Cure-All’ Vitamin?

Studies surrounding vitamin D can be conflicting, often leading to confusion on the part of our patients. So our concierge primary care doctors in Jupiter thought we’d take a look at some of the newest findings about this essential vitamin.

Dueling Conclusions

As an example of how different researchers can draw opposite conclusions even from the same study, one doctor recently wrote in The Washington Post that a study she led “found no statistically significant reduction in cardiovascular disease or cancer” in a nationwide randomized trial of 26,000 adults over five years.

Furthermore, she wrote, “My colleagues and I have conducted further studies from VITAL [the study’s title] showing that vitamin D supplements do not decrease the risk of cognitive decline, depression, macular degeneration, atrial fibrillation or several other health conditions. The most recent report showed no reduction in the rate of bone fractures—once the vitamin’s most commonly touted benefit.”

She concluded that the vast majority of Americans are already getting all the vitamin D they need from brief sun exposure and a normal diet.

“Is it necessary for you to spend money on the supplement? For most healthy adults, the answer is no,” JoAnn Manson wrote in The Post.

However, this same researcher told the Harvard Gazette in January of this year that the VITAL study showed subjects who took vitamin D, or vitamin D and omega-3 fatty acids, had a significantly lower rate of autoimmune diseases such as rheumatoid arthritis and psoriasis than those who took a placebo.

“Given the benefits of vitamin D and omega-3s for reducing inflammation, we were particularly in whether they could protect against autoimmune diseases,” she said.

More Confusion

So maybe the vitamin has some value after all, at least for some.

Yet in 2018, another study published in the National Institutes of Health’s (NIH) National Library of Medicine looked at the prevalence of vitamin D deficiency in the U.S. population. In the introduction, the study’s authors wrote that, “Since foods containing natural vitamin D are rare, the primary source of the compound remains . . . exposure to ultraviolet rays in sunlight.”

It went on to assert that “subclinical vitamin D deficiency . . . plays a role in downstream clinical consequences, including cardiovascular disease, cancer, diabetes, osteoporosis, and fractures.”

Why the frequent discrepancy among various studies? One 2020 clinical study published in the journal BMJ sought to answer that question. 

“Our analysis of pooled raw data from each of the 10,933 trial participants allowed us to address the question of why vitamin D ‘worked’ in some trials, but not in others,” Adrian Martineau, a professor at Queen Mary University of London (QMUL) and a lead researcher on the study, wrote in a release.

Those who have the lowest levels of vitamin D in their blood seem to show the largest benefit, he said, along with those who took it daily or weekly, as opposed to intermittently.

The Last Word?

A fact sheet on vitamin D produced by the NIH’s Office of Dietary Supplements (ODS) updated last month summarized numerous studies, including the VITAL study.

For each of the most common health claims connected to vitamin D it reached the following conclusions:

Bone health – All adults should consume recommended amounts of vitamin D and calcium from foods and supplements.

Cancer – Taken together, studies to date do not indicate that vitamin D with or without calcium supplementation reduces the incidence of cancer, but adequate or higher levels might reduce cancer mortality rates.

Cardiovascular disease (CVD) – Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low levels as measured in their blood.

Depression – Overall, clinical trials did not find that vitamin D supplements helped prevent or treat depressive symptoms or mild depression, especially in middle-aged to older adults who were not taking antidepressants.

Type 2 diabetes – Clinical trials provide little support for the benefits of vitamin D supplementation for glucose homeostasis.

Weight loss – Overall, the available research suggests that consuming higher amounts of vitamin D or taking vitamin D supplements does not promote weight loss.

And although the COVID-19 pandemic sparked hope that vitamin D could help prevent or reduce the severity of the illness, two new clinical studies released this month found that it didn’t help with the coronavirus or any other type of respiratory virus.

Vitamin D Overdose?

According to the NIH, the recommended daily allowances for vitamin D are:

  • 0-12 months: 10 mcg (400 IU)
  • 1-70 years: 15 mcg (600 IU)
  • >70 years: 20 mcg (800 IU)

And while many people who supplement with vitamin D take much higher doses than that, too much can be dangerous. Vitamin D is a fat-soluble vitamin, which means it tends to be stored in the body’s fat and can lead to accidental overdoses. 

The upper limit of safety appears to be 100 mcg (4,000 IU) daily.

Those who take more than that could experience side effects from supplementing with vitamin D, including nausea and vomiting, constipation, weakness, and kidney damage, among others.

Overall, most studies seem to show that supplementing with vitamin D doesn’t have much effect on various conditions. On the other hand, moderate doses from a reputable manufacturer are generally considered safe. So if you think you could benefit from vitamin D supplements, the decision is up to you.

Some Common Questions About Organic Foods

Our concierge primary care doctors in Jupiter of course want our patients to eat healthy foods as much as possible.

This typically means a diet low in processed foods and high in fresh fruits, vegetables, nuts, and seeds, along with lean meats and fish.

Does it also mean eating organic foods as well? Many people hear the word “organic” and automatically think it equals “healthy,” but that may not always be the case. So let’s try to clear up the confusion around this widely available—and usually much more expensive—food.

What does the term “organic” mean?

The word “organic” refers to the way the food is grown and processed. The U.S. Department of Agriculture (USDA) has created a set of standards that describe the specific requirements that must be verified by a USDA-accredited certifying agent before products can be labeled organic.

The National Organic Program (NOP), an advisory committee that includes members of the public, develops these rules and regulations for the USDA.

They include several restrictions on farming practices and raising livestock and poultry, as well as on handling and labeling.

In general, the regulations restrict the types of pesticides, fertilizers, and seeds that can be used, and ensure healthy farming practices to protect the environment.

To receive the USDA Organic seal, a product must:

Improve soil and water quality.
Enable farm animals’ natural behaviors.
Cut pollution.
Promote a self-sustaining cycle of resources on a farm.

Certified organic products cannot use:

artificial fertilizers or sewage sludge as fertilizer
radiation to preserve food or get rid of pests or diseases
genetically modified or engineered materials to improve crop harvests or improve pest or disease resistance
antibiotics or growth hormones for livestock
most synthetic pesticides (except in special, USDA-approved circumstances)

Is organic food healthier?

You can find all kinds of persuasive arguments and testimonials online about how organic food is so much healthier for you to eat.

It’s certainly healthier for the environment, because of the sustainable practices organic farmers use.

It’s also undeniably better to avoid products from animals that have been fed antibiotics throughout their lifecycle to promote unnatural growth and suppress diseases that occur from overcrowded conditions. This is one of the things that contribute to antibiotic resistance in humans.

Other than that, though, science has so far not been able to prove that organic foods contain more substantial nutrients than conventionally grown foods.

As reported by Harvard Health, one meta-study by Stanford researchers, for example, found little difference in nutritional content, except for slightly higher phosphorus levels and a higher omega-3 fatty acid content in organic milk and chicken. And the bacteria that can cause food poisoning were equally present in both organic and non-organic foods.

And according to the Mayo Clinic, studies have shown much lower cadmium levels in organically grown grains, but not fruits and vegetables. Cadmium is a toxic chemical found naturally in the soil and absorbed by plants as they grow.

Is the label ‘organic’ a guarantee?

If the food contains the USDA Certified Organic label, that means it was grown and processed according to federal guidelines.

According to the USDA, “Produce can be called organic if it’s certified to have grown on soil that had no prohibited substances applied for three years prior to harvest. Prohibited substances include most synthetic fertilizers and pesticides.

“As for organic meat, regulations require that animals are raised in living conditions accommodating their natural behavior (like the ability to graze on pasture), fed 100 percent organic feed and forage, and not administered antibiotics or hormones.”

The agency performs more than 45,000 onsite inspections per year to ensure compliance with regulations. If foods are labeled “100 percent organic,” that means all ingredients are certified organic. Foods labeled “organic” contain at least 95 percent certified organic ingredients.

On the other hand, labels that say “made with organic” or “organic ingredients” can’t carry a USDA seal, because they contain less than 95 percent organic ingredients.

More confusion in labels

In addition, there is a difference between “organic” and “natural” on a product’s label. The term “natural” may simply refer to products or animals that have been minimally processed and contain no artificial ingredients, but that doesn’t mean they’re organic.

Another confusing term is “grass-fed,” which means animals receive a majority of their nutrients from grass throughout their entire life and have continuous access to pasture during the growing season. It does not mean they have been raised without the use of antibiotics, hormones, or pesticides on their feed.

Likewise, “cage-free” birds are able to freely roam a building, room, or enclosed area with unlimited access to food and fresh water during their production cycle. “Free-range” birds are provided shelter in a building, room, or area with unlimited access to food and fresh water, as well as continuous access to the outdoors during their production cycle. But neither of these terms reveals whether they have been raised without antibiotics or hormones.

So is organic better for you? In some of the ways we’ve listed above, yes. But only you can decide whether the extra expense is worth the small gains in nutritional value, as well as the larger impact on the environment and the animal’s welfare.

New Guidance on COVID-19 Can Be Confusing

Sometimes it seems as though we need a spreadsheet to keep track of all the changing information and recommendations on COVID-19.

  • Masks/no masks?
  • Boosters? Maybe not, maybe now, maybe later.
  • Quarantine? Yes, no, who, and how long?

Our primary care concierge doctors in Jupiter don’t mean to criticize the researchers and public officials who are responsible for keeping us healthy. The SARS-CoV-2 coronavirus is, after all, a disease we’d never seen until early in 2019. No one knew how to deal with it.

And thanks to the combined efforts of scientists around the world, we’ve made tremendous strides in the effort to combat it.

But one thing few counted on was “pandemic fatigue,” which meant many people rapidly grew tired of taking precautions and radically altering their lifestyles to help stem the spread of COVID-19.

Which may be what’s behind the latest guidance from the Centers for Disease Control and Prevention (CDC). (https://www.cdc.gov/media/releases/2022/p0811-covid-guidance.html

A new approach

This month the CDC relaxed many of its coronavirus recommendations, leaving measures to battle to limit viral spread largely up to individuals.

According to The Washington Post:

  • “No longer do schools and other institutions need to screen apparently healthy students and employees as a matter of course.
  • “The agency is putting less emphasis on social distancing—and the new guidance has dropped the ‘six-foot’ standard.
  • “The agency’s focus now is on highly vulnerable populations and how to protect them—not on the vast majority of people who at this point have some immunity against the virus and are unlikely to become severely ill.”

In releasing the new guidance, the CDC cited improved tools like vaccination, boosters, and treatments to better protect ourselves from the virus.

“We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation,” Greta Massetti, a CDC epidemiologist, said in a statement.

“This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” she added.

Isolation changes

In one fairly substantial shift, for example, the CDC no longer recommends quarantine if you’re up to date with your vaccines and have been exposed to COVID-19. Instead, you should mask for 10 days and get tested on Day Five.

Additional CDC guidance on isolation includes the following:

  • If you’ve tested positive and have a healthy immune system, regardless of your vaccination status, you should isolate yourself for five days. On Day Six, you can end isolation if you no longer have symptoms or have not had a fever for 24 hours and your symptoms have improved.
  • Once isolation has ended, you should wear a high-quality mask through Day 10. If you test negative on two rapid antigen tests, however, you can stop wearing your mask sooner.
  • Until Day 11 at least, you should avoid visiting or being around anyone who is more likely to have severe outcomes from COVID-19, including the elderly and people with weakened immune systems.

These changes stem from a new statistic, according to Massetti: 95 percent of the U.S. population has at least some level of immunity against the virus, either from vaccination or previous infection.

What about boosters?

As for booster shots, the U.S. Food and Drug Administration (FDA) finally decided last month against allowing adults younger than 50 to become eligible for a second booster vaccine (for a total of four mRNA shots).

Currently, only those age 50 and older and children at least 12 years old with impaired immune systems can get a second booster.

This is because the agency expects to have reformulated mRNA boosters available by next month that will contain components from both the original virus and its variants, as well as from the currently circulating (and highly contagious) omicron subvariants BA.4 and BA.5.

Meanwhile, the FDA still recommends that anyone under age 50 receive a single booster shot, and people older than 50 or those with weakened immune systems receive a second mRNA booster.

The mask question

No one likes wearing masks, especially in the heat. However, our primary care concierge doctors believe it’s better to err on the side of caution, especially if you’re immunocompromised or older than 65.

Especially given the new CDC guidance revisions, there’s no harm in wearing a mask in crowded indoor situations with poor ventilation.

It’s true that we now have effective treatments for COVID-19, but given the risk of long COVID—one recent study found that as many as one in every eight people who contracted it had lingering symptoms—what’s the point in taking unnecessary chances?

It’s up to you, of course, but in a recent interview with The Post, Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis, compared the current state of the country to “the Wild West.”

“There are no public health measures at all,” he told the paper.

“We’re in a very peculiar spot, where the risk is vivid and it’s out there, but we’ve let our guard down and we’ve chosen, deliberately, to expose ourselves and make ourselves vulnerable.”

pfas

How to Combat the Lingering Danger of ‘Forever Chemicals’

They’re called “forever chemicals” because they don’t break down fully in the environment, and this summer the Environmental Protection Agency (EPA) warned that they are more dangerous to human health than regulators knew.

Within weeks, the National Academies of Sciences, Engineering, and Medicine (NAS) weighed in with its own 300-page report on these chemicals, known as perfluoroalkyl and poly-fluoroalkyl (PFAS) substances, urging doctors to test high-risk patients for PFAS contamination.

Because of the heightened attention on these chemicals, our primary care concierge doctors in Jupiter want to summarize for you what we’ve learned about them, and offer tips on how to reduce your exposure.

The Problems with PFAS

In 1946, DuPont introduced its revolutionary non-stick product, Teflon. By 1950, studies by DuPont and 3M showed that PFAS could build up in the blood, but chose to keep these results secret, according to the non-profit Environmental Working Group (EWG).

Since 1998, when a class-action lawsuit against a West Virginia DuPont factory revealed the extent of the pollution from the factory, researchers have found probable links to such diseases as:

  • thyroid disease
  • high blood pressure
  • kidney cancer
  • testicular cancer
  • breast cancer
  • higher cholesterol levels
  • ulcerative colitis
  • weakened immune system 
  • vaccine interference
  • weight gain
  • changes in liver enzymes
  • decreased fertility
  • growth and learning delays in infants and children

The NAS report encourages doctors to conduct blood tests for these chemicals on patients who are worried about exposure or who are at high risk for exposure or who are in “vulnerable life stages”: during pregnancy, early childhood, and old age. 

They’re Everywhere

As we’ve seen with microplastics, PFAS can begin innocently enough and end up in unexpected places, including our water.

Recently, for example, Consumer Reports (CR) tested more than 100 food-packaging products from U.S. restaurants and supermarkets. They found dangerous PFAS chemicals in many of the products, including paper bags for french fries, hamburger wrappers, pizza boxes, molded fiber salad bowls, and single-use paper plates.

These chemicals are used in a wide variety of products, including waterproof and sweatproof makeup, nonstick cookware, cellphones, waterproof clothing, carpets, and—especially—fast-food containers, where their ability to make products grease-proof has led to their widespread use.

They are also used to make products water-repellent and resistant to high temperatures, as well as in fire-fighting foams used at military installations, floor wax, upholstery, and clothing. The qualities that make items containing PFAS so desirable, however, also make them long-lasting in the environment.

Lingering Threat

“These chemicals are ubiquitous in the American environment,” Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the NAS committee that wrote the report, told CNN.

“More than 2,800 communities in the U.S., including all 50 states and two territories, have documented PFAS contamination,” he said.

Researchers have even detected them in the snows of Mt. Everest, apparently shed from climbers’ waterproof tents and parkas. 

“You are not just exposed in one place or one source,” toxicologist Linda Birnbaum, former director of the National Institute of Environmental Health Sciences and the National Toxicology Program, told The Washington Post. “They are everywhere.”

The problem is that these chemicals build up (or “bioaccumulate”) in the body over time. 

And according to the Centers for Disease Control and Prevention (CDC), which has been conducting studies of the U.S. population, PFAS has been found in the blood of nearly all people they’ve tested. Since the risk appears to rise with the amount of exposure, it’s important to try to limit the amount we come in contact with.

What You Can Do

Because PFAS chemicals are found in so many consumer products, they’re next to impossible to avoid. But there are ways to reduce the amount you’re exposed to.

“The most dangerous way that people are exposed to PFAS is through drinking water,” says Don Huber, director of product safety at CR.

That’s why the NAS report recommended filtering tap water as a major step consumers could take to protect themselves.

“The water filters that are most effective for PFAS are reverse osmosis filters,” David Andrews, a senior scientist for the EWG, told CNN, adding that some carbon-based filters can also reduce some levels.

“The important part is that you have to keep changing those filters,” he said. “If you don’t change that filter, and it becomes saturated, the levels of PFAS in the filtered water can actually be above levels in the tap water.”

The NAS committee also offered these tips:

  • Stay away from stain-resistant carpets and upholstery, and don’t use waterproofing sprays.
  • Look for the ingredient PTFE or other “floro” ingredients on product labels.
  • Avoid nonstick cookware. Instead, use cast-iron, stainless steel, glass, or enamel products.
  • Boycott takeout containers and other food packaging. Instead, cook at home and eat more fresh foods.
  • Don’t eat microwave popcorn or greasy foods wrapped in paper.
  • Choose uncoated nylon or silk dental floss or one that is coated in natural wax.
health benefits of coffee

Coffee Scores Another Win for Improving Health

Besides water, our primary care concierge doctors in Jupiter are hard-pressed to think of another beverage that offers such a wide range of health benefits as coffee.

For example, research has found that regular coffee consumption has been linked to a lower risk of: 

  • heart disease and strokes
  • heart failure
  • melanoma
  • diabetes
  • liver and prostate cancer
  • Parkinson’s disease

Evidence piles up

Studies have also found that the caffeine in two cups of coffee a day provides significant protection against Alzheimer’s disease, as well as other types of dementia. A study released last year, for example, found that individuals who drank four to six cups of coffee or tea a day reduced their risk of stroke and dementia by 28 percent compared to those who did not drink either beverage.

Another study, published last year in the journal BMC Public Health, found that those who drink three to four cups of coffee a day (whether ground, instant, caffeinated or decaf) reduced their risk of chronic liver disease by 21 percent, compared with those who didn’t drink coffee at all.

A third study, also published last year in the American Heart Association (AHA) journal Circulation, found that drinking one or more cups of plain, caffeinated coffee a day was associated with a long-term reduced risk of heart failure.

The AHA researchers found that the risk of heart failure dropped between five percent and 12 percent for each cup of black coffee the subjects drank. The risk declined even more, to 30 percent, when subjects drank two or more cups daily in one of the studies. The study found, however, that decaffeinated coffee did not offer the same benefit. 

“The association between caffeine and heart failure risk reduction was surprising,” senior author Dr. David Kao, medical director of the Colorado Center for personalized Medicine at the University of Colorado School of Medicine in Aurora, said in a statement.

“Coffee and caffeine are often considered by the general population to be ‘bad’ for the heart because people associate them with palpitations, high blood pressure, etc. The consistent relationship between increasing caffeine consumption and decreasing heart failure risk turns that assumption on its head,” he said.

Latest findings

The most recent research, published last month in the Annals of Internal Medicine, found that people who drink a moderate amount of coffee, defined as up to 3 1/2 cups a day, were up to 36 percent less likely to die from any cause over the seven-year period of the study than those who did not drink coffee.

It didn’t matter what type of coffee the subjects drank—ground, instant, caffeinated, or decaf—or even if they added a modest amount of sugar: The results were the same.

According to Johns Hopkins, there are also many other benefits from daily coffee consumption. For example:

  • Coffee may help your body process glucose better, meaning you may be less likely to develop type 2 diabetes.
  • Coffee may lower the risk of developing Parkinson’s disease, and help those who have it control their movements better.
  • Coffee can help lower your risk of colon cancer.
  • Drinking dark-roast coffee has even been shown to decrease breakage in DNA strands, which helps protect against various cancers.

Some coffee caveats

It’s typical with humans, however, to think that if something is good for you, more of it is better. That’s rarely the case, including with coffee.

The U.S. Department of Agriculture’s (U.S.D.A.) Dietary Guidelines for Americans recommend no more than 400 milligrams of caffeine a day. An average eight-ounce cup contains 95 milligrams of caffeine.

Several studies—including those outlined above—have found that five cups of coffee a day appears to be the upper limit of safety. In fact, a 2009 study found a 17-21 percent increased risk of death among those who drank four or more cups a day.

Other possible negative effects of too much coffee include:

  • increased blood pressure
  • headache
  • heartburn
  • dehydration
  • increased heart rate
  • abnormal heart rhythm
  • anxiety
  • dizziness
  • insomnia

In addition, a 2017 study found that pregnant women who drink more than four cups of coffee a day were more likely to experience low birth rate babies, preterm births, and stillbirths.

Another study linked coffee consumption with the possibility of increased bone loss in postmenopausal women if their diets lack sufficient calcium intake.

Finally, those who are sensitive to caffeine may experience many of these side effects with even small amounts of coffee. Older adults also may not be able to metabolize caffeine as well they did when they were younger.

And anyone who is taking certain drugs (like ephedrine, used in decongestants) can experience increased blood pressure, along with a higher stroke risk, when they consume coffee as well. 

But if you’re not caffeine-sensitive, and you don’t overdo it, our primary care doctors urge you to feel free to enjoy that third or fourth cup of the day without guilt.

The Risk of Salmonella in Backyard Chickens

If you’ve been buying cage-free eggs, or eggs from your local farmer, or even raising your own chickens to lower your risk of salmonella, our concierge doctors in Jupiter have some unhappy news for you: Most chickens, ducks, and turkeys carry some form of the more than 2,000 types of salmonella, according to Craig Coufal, Texas A&M AgriLife Extension Service poultry specialist.

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is kratom safe

Use Caution with Kratom

Our concierge primary care doctors in Jupiter know that many of our patients are interested in over-the-counter (OTC) alternative treatments for their ailments.

One of the more popular of these is kratom, an herb that has been used for centuries in Asian countries as a way to reduce fatigue and ease various aches and pains. In this country, it is sold in drinks or as supplements and is said to treat such common conditions as anxiety, depression, and opioid withdrawal.

One report estimated that as many as 16 million Americans also use kratom for pain relief in such chronic diseases as lupus, multiple sclerosis, fibromyalgia, rheumatoid arthritis, and other similar conditions.

Testimonials from users include such claims as, “Kratom gave me my life back after being addicted to pain pills;” “It has helped me enormously with chronic back pain;” and, “It got me off a 20-plus-year addiction to narcotics and opioids.”

On the other side are statements like these from a former user who told The Washington Post that “kratom was fun—it was like having morphine and cocaine at the same time”—until he got addicted. Withdrawal, he reported, was like “getting ripped apart by fishhooks.”

Agencies fighting it

Various agencies including the U.S. Food and Drug Administration (FDA), the World Health Organization (WHO), and even the U.S. Drug Enforcement Agency (DEA) have spent the last several years trying to ban it. Six states have already done so, with several others considering it. It is still legal in Florida, but may be banned or controlled in some localities here.

In April, the FDA released a statement warning consumers not to use the herb, Mitragyna speciosa, commonly known as kratom:

“FDA is concerned that kratom, which affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.”

FDA

Opponents have been buoyed in their arguments by several studies linking kratom to serious side effects.

One such study in 2019 reported that the number of phone calls to U.S. poison control centers regarding adverse effects from kratom have soared, from 13 calls in 2011 to 682 in 2017. Reported effects of kratom overdose included rapid heartbeat, agitation, high blood pressure, seizures, coma, kidney failure, and 11 deaths during the study period. Two of those deaths were attributed to kratom alone, while the other nine occurred in people who combined kratom with other drugs.

Another study on kratom use disorder (KUD) by the National Institute on Drug Abuse (NIDA), published in the Journal of Addiction Medicine in March, found that over half of 129 past and current kratom users showed no signs of addiction. But 29.5 percent met the diagnostic criteria for KUD, which includes increased use, tolerance, withdrawal, unsuccessful attempts to quit, and cravings.

Counter-arguments

Proponents attribute these adverse reports to a profit motive on the part of drug companies, overly restrictive U.S. drug policies, and poor research. They say it has been used successfully for thousands of years in Southeast Asia without a problem.

Advocates also maintain that, in these times of widespread and deadly opioid addiction, kratom is an acceptable alternative and that its dangers have been wildly overblown.

In a recent editorial published in the Scientific American, Maia Szalavitz, an author and journalist who focuses on science, public policy, and addiction treatment, writes that kratom “does appear to be far safer than all illegal and most prescription opioids.” She referred to a Centers for Disease Control and Prevention (CDC) study in 2016 and 2017 of some 27,000 kratom-related overdoses. Of those, kratom was implicated in less than one percent of overdose deaths.

“Moreover, in nearly all overdose deaths associated with kratom, it was accompanied by stronger drugs that kill more often, so it is not clear that it actually played a major role or even any at all,” she wrote.

“For example, around two-thirds of the 152 deaths the CDC studied also involved illicit fentanyl and its analogues, which are thousands of times more potent. In only seven cases was kratom the only only substance identified—and even here, researchers cannot rule out the possibility of undetected drugs,” she added.

Caution warranted

Nevertheless, most medical experts warn that kratom use can have adverse consequences. According to the Cleveland Clinic, “kratom’s potential for serious side effects outweigh its potential benefits.”

It lists the following most common side effects of kratom:

  • aggression
  • altered mental status
  • anxiety and irritability
  • constipation
  • delusion and hallucination
  • drowsiness and sedation
  • dry mouth
  • frequent urination
  • itching
  • nausea and vomiting
  • tongue numbness

More serious side effects can include:

  • cardiac issues, such as heart attack, abnormal heart rhythms, and high blood pressure
  • encephalopathy (brain disease)
  • hypothyroidism (underactive thyroid)
  • insomnia
  • liver damage and liver failure
  • loss of appetite
  • psychosis
  • respiratory depression (difficulty breathing)
  • seizure
  • tremor
  • weight loss

In addition, people going through kratom withdrawal may experience:

  • muscle spasms
  • pain
  • rhabdomyolysis (a condition leading to kidney damage when muscles disintegrate and release a protein into the blood)
  • rigidity
  • seizures
  • tremors

Think twice about kratom

While proponents hope more research will eventually vindicate kratom as a useful supplement, the medical community generally holds that its side effects more than outweigh any potential benefits. It can be especially dangerous when combined with other legal and illegal drugs.

While it’s up to you, we would suggest that our patients not take the risk of using this substance. If you’re thinking of using kratom for any reason, please discuss it with us first. We may be able to help you find other safer treatment options.

Skin Cancer Awareness

What to Know About Sunscreens

Because May is Skin Cancer Awareness Month, our primary care doctors in Jupiter want to remind you of the dangers of sun exposure and remind you of the best way to avoid it.

It’s important to know the facts about skin cancer and the sun, along with exposure to tanning beds, because the National Cancer Institute (NCI) estimates that this year 99,780 people in the U.S. will be diagnosed with melanomas of the skin, and that 7,650 people will die from this most deadly form of cancer.

But a proper use of an effective sunscreen can prevent most skin cancers.

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