Sanford T, et al. JAMA. 2015;doi:10.1001/jama.2015.8295

Lakewood Ranch is a very active community whose citizens are very health conscious. More and more people are remaining active well past retirement age. Biking is one activity that is healthy and easy on the body but studies have shown that there has been a substantial increase in injuries (even requiring hospitalization)over the past 15 years. An astounding 81% increase in injuries were seen in people older than 45.

Try to keep your bike tuned up and check your tires and brakes regularly. We are also lucky in that we have wide sidewalks so we don’t have to ride in the streets. When riding, it is always a good idea to wear a helmet. And finally, never assume that a motorist will yield the right of way to you, or even see you. The car will always win the battle!




Hopefully this year’s flu vaccine will be more successful than last year’s. Some people may have questions concerning the regular dose versus the high dose vaccine. In our office we only use the regular dose. We are aware that the immune system weakens as we age but studies show that only 1 case of the flu will be prevented out of 217 people over 65 given the higher dose.

If you want to get the vaccine we can give it to you during your office visit or if you just call the office, we will be happy to administer it to you without seeing the doctors.

While in the office, we may discuss other vaccines like the pneumonia, vaccine, shingles vaccine or DTaP (tetanus booster) which can be given at the same time, if indicated..

Most vaccines are covered by insurance and costs the same or LESS than your local pharmacy.

Call us 941-747-2090 for further information




The FDA has taken action against over 1,000 websites that sell unapproved medications and medical devices to US consumers.

Operation Pangea VIII is aimed to identify and eliminate these products with the help of regulatory authorities from 115 countries. As part of the operation, warning letters were sent to almost 400 website operators, whose sites sell unapproved or misbranded prescription medications, along with nine firms offering unapproved or uncleared medical devices to U.S. consumers. The FDA warned that in addition to the health consequences these sites and products pose, accessing the sites could also lead to computer viruses, credit card fraud and identity thefts.

Please buy your medications from approved pharmacies. If the price is too good to be true……..




Indoor and outdoor pollutants can lead to acute respiratory infections, heart disease and skin problems. It is thought that pollutants compromise the immune system, which is further compromised if you have deficiencies of certain micronutrients.

From a scientific point of view, this is what occurs: Airborne pollution leads to increased pulmonary intake of reactive oxygen species (ROS). When we inhale, particulate matter (PM) enters the respiratory (lung) system, causing coughing and sneezing. The finest particulate matter, PM2.5, travels all the way to the alveoli and causes local and systematic harm, including increased oxidative stress and increased inflammation. In addition, there is evidence of specific mechanisms whereby PM2.5, traffic-related or combustion-related air pollution exposure can affect the cardiovascular system.

Micronutrient intake is important with regard to the sensitivity of an individual to air pollution ; it affects the composition and quantity of antioxidants in the respiratory tract lining fluid (RTLF) of the lungs. The older you are, the more likely it is that you could have a micronutrient deficiency, which is probably the reason elderly people are 2-10 times more likely to die of an infection than younger people.



Vitamin A is important for innate, cell-mediated immunity and antibody response. Retinoic acid in particular imprints protective T-cells and B-cells into intestinal tissues.

Vitamin D, in the active form of 1,25(OH)2D3, is a potent immunomodulator. In addition, it enhances innate immunity by increasing the differentiation of monocytes into macrophages.

Vitamin E is a key, fat-soluble antioxidant capable of protecting cell membranes from oxidative damage. It also enhances T-cell-mediated functions. Vitamin E is an integral component of the alveolar surface of the lung and directly affects lung function.

Vitamin C is a key, water-soluble antioxidant which helps maintain the redox balance inside cells. It also helps regenerate vitamin E as well as stimulating the transit of neutrophils and monocytes. Vitamin C is particularly important inside the lungs to help counter the presence of inhaled oxidative substances.

Vitamins B6, B12, and folic acid modulate immune function by means of nucleic acid and protein biosynthesis.

Selenium has an important role in redox regulation via glutathione peroxidases by removing excess ROS. Zinc, iron, and copper are critical components of enzymes which are required for the correct functioning of immune cells.


Intracellular micronutrients can be tested by a simple blood test that we draw in the office. If you would like to be checked, call our office. 941-747-2090




All restaurants in Florida are subject to periodic health inspections. There is a free app for your phone called “WHAT THE HEALTH” that will let you view the health inspection score for any restaurant in Florida. In some other states, like California, their inspection grades must be posted on the front door of the restaurant( not a bad idea for Florida!).

The app is very easy to use and actually shows you what the infractions are.

The only problem that I have found is that it only populates restaurants in your current area. There is a search engine but it does not work. So, if you live in Lakewood Ranch and want to search a restaurant on Main Street-Sarasota, it will only show up if you are near that location.

Nevertheless, this is an app well worth looking into.



A recent study on healthy eating in women showed a 75% decrease in the risk of getting breast cancer. Consuming deep fried foods actually increased the risk by a factor of 8!  Other cancers associated with deep fried foods include: pancreatic cancer, lung cancer, oral and throat cancers, esophageal cancer, and cancer of the larynx. Diets characterized by higher consumption or foods like legumes, cooked greens, cabbage, sweet potatoes and cornbread may reduce the severity of breast cancer. Men who ate deep fried foods showed a greater risk of getting prostate cancer, including more aggressive forms.

So why is deep frying bad for us? First of all it increases oxidative stress and damage to the cells in the body. The more the oil is reused, the more oxidative damage to the body. (Hint: If you are going to order fries, do so earlier in the day as most fast food restaurants reuse the oil over and over. Carcinogens like heterocyclic amines and polycyclic aromatic hydrocarbons form when the meat of chicken and fish are deep fried. Acrylamide is a carcinogen formed from frying vegetables and has been associated with endometrial cancer, ovarian cancer, lung cancer, kidney cancer, and esophageal cancer.

(Another problem with deep fried foods is that flour and batter are very fattening and are associated with both diabetes and obesity.)

Researchers urge that if you do fry, the cooking temperature should be as low as possible and the cooking time should be as short as possible.




It has been known for years that both OTC and prescription non-steroidal anti-inflammatory drugs can increase the risk of heart disease and strokes. (Are any of my readers old enough to remember VIOXX?) The FDA has had warnings on the medication boxes since 2005 but has recently strengthened the wording.

The updated warnings are as follows:

1.       A heart attack or stroke can occur as early as the first few weeks of use

2.       Not enough information is available at this time whether the risk is the same for all medications in this class. Aleve has always been thought of as the least offensive to the heart

3.       Even those people without risk factors for heart disease have an increased risk of a heart attack or stroke

4.       If you have already had a heart attack or stroke, your risk is even greater.

5.       Heart patients who take NSAIDs are more likely to die within one year when compare to those not taking these medications.

6.       There is also an increased risk of congestive heart failure.

Please remember that NSAIDs may also cause kidney failure and internal bleeding stomach ulcers.

When possible, try to use Tylenol (even though the safety of Tylenol is currently being questioned)




A recent study looked at eye pressure in glaucoma patients using glucosamine supplements. They discovered that eye pressure went up when taking glucosamine and dropped back down when it was stopped.

There are also many medications that should be avoided in glaucoma patients. If you are taking glucosamine for arthritis and have glaucoma, you might want to discuss this with your eye doctor.



There are many reasons to check your vitamin D level and supplement if necessary. Low vitamin D has been associated with many diseases including osteoporosis, cancer, neurological and heart diseases.

There is now evidence that vitamin D protects the cardiovascular system and can lessen the damage from strokes. The lower the vitamin D, the larger the stroke.

Researchers recently looked at 96 stroke patients and found that vitamin D levels independent of other risk factors, were directly related to stroke size.

“They found that higher serum 25(OH)D status was significantly associated with smaller infarct volumes (p < .05). There was also an association with low serum status and 90 day outcome. The risk of a poor outcome doubled with each 10 ng/ml decrease in vitamin D status. The study demonstrates that low vitamin D status can help identify stroke patients at risk of a poor outcome.”


University of Minnesota Medical School


Alzheimer’s disease was first discovered in 1907. The disease is caused by a build-up of beta-amyloid and intercellular hyperphosphorylated tau strands in the brain. This then leads to progressive cognitive impairment and ultimately, death. Currently there are no effective ways to prevent or effectively treat this type of dementia. (Mild cognitive impairment (MCI) is common in people aged over 60 years, but only 12-15% of the sufferers of this condition will progress to full blown Alzheimer’s disease.)

There is now some evidence that nutrients could play a role in delaying the onset of cognitive decline. Higher intakes of vitamins and minerals, consumed as foods or supplements, are associated with lower risk of developing cognitive deficits, while blood serum levels for folic acid, vitamin A, B6, vitamin B12, C, E, D, K, thiamine, β-carotene & DHA tend to be lower in Alzheimer’s patients. Anti-oxidant activity of these nutrients is likely to play a role and it has been shown that vitamin E levels are 75% below the recommended levels in the USA and UK. There have been several studies looking at Vitamin E over the years, and it looks like it might be able to delay the onset of Alzheimer’s by 7 months.

What’s interesting is that the benefit was only seen in patients taking Vitamin E in the absence of existing prescription drug therapies.

It should be noted that high doses of vitamin E may be associated with an increased risk of heart disease and prostate cancer.

More studies are obviously needed.

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