Antidepressants

I’m not surprised when a patient tells me she doesn’t want to take antidepressants.They make some people gain weight, and some lose their interest in sex or find it more difficult to have an orgasm. Others just don’t want to take a drug that mucks with their brains. So my interest was piqued by a recent article in The Wall Street Journal that discussed a “backlash against antidepressants sparked by concerns about their safety, efficacy, and side effects [that] is helping drive patients to alternative methods.”

Given what I do for a living (check the byline), my own bias is in the direction of therapies that have been rigorously tested for safety and effectiveness. However, for patients who can’t, won’t, or simply prefer not to go with conventional medicine, a prudent trial of an alternative therapy, like acupuncture or valerian, might be worth considering. But are these alternative approaches truly effective? That’s a tough question, and it depends on what you mean by “effective.”

For a drug to be effective it should work better than a placebo, but in most drug studies the placebo itself often has a measurable success rate—often around 20 percent. Thus, even if an alternative therapy is no more effective than a placebo, you’re still left with a one in five chance of feeling better at the end of the day. For some people, even this 20 percent chance of feeling better is worth it.

Toned Bodies

How much calcium should I take, and do I need to take Vitamin D to get the calcium benefits?

Calcium requirements vary, so check with your health-care provider before you begin taking any supplements. As a general rule, the recommended daily allowance of calcium for most American men and women, from adolescence through adulthood, is 1,000 to 1,200 milligrams per day. Pregnant women and women who are breast-feeding should take a bit more: 1,200 to 1,500 mg per day. Postmenopausal women who are not taking estrogen should take closer to 1,500 mg per day.



Vitamin D helps with the absorption of calcium, and most people should take between 400 and 800 international units per day—400 of this can come from a multivitamin, while the other 400 can come from milk or other sources.

What about constipation?

 
Calcium supplements can back things up a bit, so try getting your calcium from food sources. Low-fat dairy products are probably best. But if dairy doesn’t agree with you, try calcium-enriched juice, cereal, or bread. Calcium carbonate is often the bad actor in the constipation issue, so you might consider taking calcium citrate. This switch may involve a few more pills and a bit more cash, but let’s face it: There are few things in life more underrated than a good bowel movement.

Menopause And Bone Loss And Aging

Menopause seems to be one of those It topics these days. If I’m not talking about it at work, I’m reading about it on the newsstands. The fact that many of my friends are getting their AARP cards in the mail doesn’t help, either. There’s so much written about menopause, and a lot of what’s written isn’t necessarily science-based. All this tends to create confusion about what menopause really means.
One of the concerns I hear about most is bone loss and osteoporosis. I tell my patients that osteoporosis is largely preventable for most patients, and there’s plenty that can be done before menopause to improve your chances of keeping your bone density. Prevention is the key when it comes to bone loss, because while there are good treatments for osteoporosis, there aren’t really any cures.
A combination of steps is the best approach to holding onto your bone density. I make it a point to remind my patients to be sure they get the recommended daily amounts of calcium and vitamin D. National surveys indicate many American women and girls consume less than half of the recommended calcium and vitamin D. Depending on your age, you should have between 1,000 and 1,300 mg of calcium per day. If you’re not getting enough calcium, discuss calcium supplements with your doctor.

Weight-bearing exercise is another great step toward osteoporosis prevention. This includes walking, elliptical exercise, stair climbing, and weightlifting. Doing this type of exercise a minimum of three times each week will reduce your chances of bone loss later in life, and improve your health today.
Of course, you should avoid smoking and excessive amounts of alcohol. This will not only preserve bone, but is also good advice for an overall healthy lifestyle. Enough said on this one.
For some women, a bone mineral density (BMD) test is a great way to detect osteoporosis and estimate your fracture risk. Talk to your doctor about if and when you need one. For women at risk of bone loss, the BMD test is painless, accurate, and another good way to take charge of your health

Successful Dieting Secrets

As an endocrinologist, I spend a lot of time talking about carbohydrates with patients who are trying to manage their diet—it goes with the territory.
But let me tell you, fat seems to get equal talk time during my office hours.
And even when I’m not talking about fat with patients, I’m thinking about it myself.

I’m a guy who works out six times a week, has a family history of heart disease, eats veggies and fish, and yet I still build holidays and birthday celebrations around sour cream–based dips.
So when the Dietary Modification Trial—a recent study by the Women’s Health Initiative (WHI)—suggested that the link between dieting and fat intake may not be as strong as we think, I was prepared to run, not walk, to the closest Whole Foods for some full-fat onion dip.

Hey, a guy can dream... but simple science still stands to reason that if you consume more calories than you burn, you’re going to gain weight. I agree with the WHI study on several fat-related issues, and a big one is that it's tough reducing fat in your diet, and no fun at all to self-report fat intake accurately. 
The WHI women assigned to the low-fat group had a goal to reduce their fat intake from 38 percent to 20 percent, but the group only made it to 29 percent.