Calculating Your BMI

The Body Mass Index is simply a calculation of your body weight and height.  Here is the exact formula they use (I’ll plug in my own numbers as an example.  I’m 6′1″ and weigh 178 pounds)

So, according to the calculations I’m at high normal.  I also hover around 12% body fat.  Ideally, I would like to get up to 185 to 190 pounds at 10% bod fat.  This just feels like a little better number based on my frame.  Plus, I could stand to gain a few more pounds of muscle.  But, if I did that and got to 190 pounds I’d then fall into the overweight category.

Now, let’s use another example to show you where this formula fails.

I have a friend who, back in his day, was a nationally ranked drug free power lifter.  Over the years he began to put on weight but still worked out.  After ballooning to over 250 pounds he finally came around to my way of eating and watched his weight literally fall off in around two months.  While continuing to work out he settled in at around 214 pounds.  He is 6′ tall.

Now, after working his numbers into the formula above his number would be 29.02.

According to his BMI he is not just overweight, he is borderline obese.

Now, here is something else I can tell you about this guy.  After shedding the weight you can nearly see all his abs.  Just from experience I can assume that he is approaching 10% body fat.  He also has a significantly broader bone frame and is designed to carry more weight.

So, if it was up to a doctor simply basing his decision on a BMI he would have a healthy man who is 88% to 90% muscle start a diet because he is worried about him being obese?

I could give you other examples.  But the point is this:  the BMI has one huge fault and that is it fails to take into account your actual amount of fat and muscle in the calculation.

References are careful to point out these kind of discrepancies but in the same breath paint the BMI as “a reliable indicator of body fatness for people”.  How can it if it doesn’t actually take body fat into account?

If you want to use the BMI as a red flag that is one thing.  Because there certainly are cases of it being a reliable indicator.  But my point is that it is simply too vague of a measurement and that you have to take into account your own individual situation including actual body fat measurements and other measurements of fitness.

My Answer: Ten years ago hair loss – whether man or woman – was shrouded in a lot of mystery and wives tales.  But one thing that appears to be pretty conclusive at this point is that DHT (dihydrotestosterone) appears to play a role in baldness (but a much stronger role in men vs. women).

So, DHT blockers like Shen Min have become very popular and it seems like another product appears every few weeks.

But, like any product that appears to be a godsend, I’m not completely sold on Shen Min or any other DHT blockers for that matter.

If I were you here are a few things I’d consider before making the decision.

DHT’s Role In Your Body

DHT is produced in your body with the help of an enzyme from testosterone.  And when your body produces a substance it is usually for a reason.  DHT is no different.

So yes, DHT has been linked to baldness (some also claim problems with the prostate, but the jury is still out on that I think).  But it also is a very potent androgen (more potent than testosterone in this regard) and helps maintain masculine characteristics.  So, the deepening of your voice, facial hair and body hair are a result of DHT.  This explains why DHT levels in your body skyrocketed during puberty.  It’s one of those things that helps make a man a man.

There is also some evidence that DHT plays a strong role in sex drive and muscle growth.  Again, one of the differences between men and women.

While this last point is debatable, the evidence I have seen to this point seems to support it because I see more and more reports of users of DHT-blockers saying there has been a noticeable drop-off in their sex drive.

Here is my main point:  DHT is a hormone.  When you start messing around with hormones in your body – whether it’s a prescription drug or a ‘natural supplement’ like Shen Min you are likely to have side effects.  Personally, I would not take the risk.  And this is coming from another man that is bald just like you.

Another point to consider is that DHT, unlike testosterone, can help mitigate estrogens effects in your body.  This is something few men know about, or understand.

You see, just because testosterone is a ‘mans’ hormone (again, it isn’t, women have testosterone too) you must understand that it can be converted to estradiol.  Which is an estrogen.  DHT, on the other hand, cannot be converted to estradiol.

Also, Shen Min is systemic.  That means you take it by mouth and it has effects throughout your body.  If I were to look at a DHT blocking product I would rather it be applied topically to the scalp to minimize the whole-body effects of blocking DHT.

But, whether that product would be effective or not is another question for another day.

Summary: Aloe vera shampoo has risen in popularity because it is perceived as a very natural product and is also capitalizing on aloe’s long and safe reputation.  Most aloe vera shampoos appear to safe and relatively inexpensive and might be worth a try.  A lot of reviews report satisfaction as well as improved hair appearance after use.  Some product do contain harsh chemicals like parabens.

Dear Curtis: Do you think an aloe vera hair shampoo is really any better then other shampoos?  I’m not really looking for any super-healing properties, but I heard that shampoos that contain aloe vera can make your hair look softer and silkier.  Just wondering …

My Answer: While there have been some reliable studies looking at aloe vera for wound healing and so forth it’s been tough to come up with anything reliable regarding aloe’s effect on your hair.  Also, from a lot of the products I see online and in the stores it’s clear that manufacturers of aloe vera shampoos appear to be doing it mostly to capitalize on the use of the words aloe vera to make the shampoo seem better than what it actually is.

Now, before I get into specifics there are some reliable reports from aloe vera users trying to improve their hair growth who apply raw aloe vera directly onto the scalp – not in an actual shampoo formulation.

Aloe Vera’s Effects on Your Hair

We know that one of the things aloe vera does is act as an antibacterial when it comes into contact with your skin.  Theoretically, this should have some benefit if you think you might have excess sebum which could be clogging your hair pores.  Also, aloe is loaded with a lot of nutrients – including vitamin A, B’s, C and E as well as over a dozen minerals.  Obviously, this is beneficial to anyone’s scalp.  In addition, aloe is loaded with water and moisture which can help moisturize your scalp.

But, like I said above, there isn’t a whole lot of reliable evidence to show that these effects can continue when you mix and dilute aloe into commercial shampoos that contain a lot of other products.  In fact, one of the ‘knocks’ – if you will – against so called ‘organic’ aloe vera shampoos are the fact that they contain parabens as a preservative.

One product that I ran across right away, Jason Aloe Vera Shampoo claims to not contain any parabens.  On a side note, this product also contains other natural ingredients like chamomile, lavender and spirulina (among others).  So, if there is benefit I don’t know if you can totally contribute it to the aloe.

After looking at everything I guess this is what I’d say about using any sort of shampoo with aloe vera:

1. It’s worth a shot and I certainlly don’t think it’s going to hurt you.  Aloe is extremely safe with a long history of use.
2. Keep in mind that a lot of users claim that the aloe shampoos don’t ‘foam’ as well as normal shampoos that you might be use to so some users find that frustrating.
3. A lot of the reviews I did read mention that their hair after use did seem shinier and fuller.  I don’t know how reliable you might consider this but I’ve learned from over 10 years of working with medications and supplements that a lot of time individual reports like these are often seen in many other users.  Of course, some of these people might be experiencing more of a placebo effect.
4. The Aloe Vera Shampoos that I looked at really weren’t all that expensive (at least compared to some of the stuff my wife has bought before) – so I don’t think you’d be out anything by giving it a shot.
5. If you have an actual aloe vera plant you might want to try applying some of the raw aloe vera gel to your scalp and hair first to see if there is any improvement.

Summary: The benefits of garlic include antibiotic and possible antiviral activity, no resistance shown from bacteria like traditional prescription antibiotics and some antioxidant activity.  Using garlic as a way to lower cholesterol appears to be more controversial.

Dear Curtis: People always point out the health benefits of garlic.  But, in your opinion, is it really as great as they claim.  And, are the benefits of garlic supplements the same as eating raw garlic?

My Answer: While supplement manufacturers and pharmaceutical companies are searching for the next breakthrough that they can patent, sometime Mother Nature has something that is better than anything we could ever come up with.  Garlic may just be one of those natural foods that you and I should be eating more of.

Especially after you look at what the scientific evidence shows about garlic:

1.  Natural Antibiotic Activity

In one study at the National University of Health Sciences researchers obtained allicin, the major component of garlic, from garlic tablets.  They then tested microgram quantities (1 milligram is 1000 micrograms; so we are talking extremely small amounts here) and found that even these small amounts were enough to inhibit VRE (vancomycin-resistant enterococci).

In case you didn’t know vancomycin is one of those antibiotics that is considered a big-gun and a last resort.  Now, with the overuse of typical antibiotics the medical community is starting to see a lot more resistance to even our last resort drugs.

Another dangerous strain of bacteria is known as MRSA (methicillin-resistant Staphylococcus aureus).  Allicin is also showing signs in the lab of being able to eradicate this dangerous strain.  At the University of East London researchers used liquid and cream formulations of allicin and found it was a potent inhibitor of MRSA.  Including those strains of MRSA resistant to mupirocin – a common antibiotic used to treat MRSA in hospitals.

SIDENOTE: These studies were performed in vitro (in the lab) not in vivo (in humans).

2.  Low, or no, resistance

With current antibiotics we are always worried about the bacteria eventually mutating and becoming resistant.  But with garlic it doesn’t look like the body ever develops any sort of resistance to the anti-bacterial effects of garlic.

Of course, more testing needs to be performed.  But right now that is a huge advantage over other antibiotics.

3.  Cold and flu prevention

Garlic isn’t just an antibiotic.  It appears as though it has some antiviral properties as well.  As in, preventing, and maybe even treating, the common cold and flu.  While the studies out there aren’t definitive there have been some positive news.

For example, one double-blind, placebo-controlled survey (this is the gold standard of clinical studies) showed that there was a statistical difference between the incidence and duration of a cold or flu in volunteers who took a garlic supplement versus those who didn’t.

In short, the volunteers who took a garlic supplement saw significantly fewer colds during cold season.  If they did get a cold, the number of days it lasted was significantly shorter.

Right now we don’t know if it is true antiviral acitivity, or if garlic ‘revs up’ your own immune system to protect you better.  Either way, it’s apparent that garlic can improve your cold and flu defense.

SIDENOTE: The main study supporting garlic’s use to prevent colds and flu was performed at a pro-garlic facility.  However, I thought the design of the study was solid and trust the results.

4.  Garlic is an antioxidant

In 1995 scientists from The College of Medicine at the University of Saskatchewan found that Garlicin (a commercially available garlic supplement) showed a concentration-dependent lowering of hydroxyl radicals.  In short, the more Garlicin they gave, the more antioxidant activity they saw.

The question is, are free radicals as big of a deal as we once thought?  I tend to think they are and anything you can do to keep your free radical load down is a positive thing.  It was clear from this study that a garlic supplement can do that.

The study did not look at raw garlic, but I would think the results would hold true in that case.

Controversy About Garlic

Some readers have asked my why I didn’t include cholesterol lowering as one of garlic’s benefits.  Frankly, I don’t think the evidence supports the use of garlic for lowering cholesterol.

However, I have reviewed some of the studies and I will say that the study design, in my opinion, was faulty.  For example, they gave raw garlic in a sandwich.

First of all, if you are designing a study the participants diets should not have changed during the study.  Secondly, there is some evidence to show that adding grains to a persons diet can raise cholesterol.

Despite my problems with the study I still think the cholesterol-lowering effects of garlic have been overstated.

If you have any information that you think would change my mind please pass it along.

Summary: Green tea tablets appear to be a safe alternative to drinking brewed green tea for weight loss and contain all the beneficial compounds found in the brewed tea.  I wouldn’t recommend taking the green tea extract tablets every day – instead alternate every other day.  You may want to use caution if you have any liver conditions or take any blood thinning medications like warfarin or aspirin.

Dear Curtis: Do you think it’s better to take green tea extract tablets for weight loss or to try and drink the tea itself?

My Answer: From what the available studies have shown – here’s what we know about green tea’s use as a weight loss supplement.

First, green tea contains a number of pretty beneficial compounds.  Namely green tea catechins and epigallocatechin gallate (EGCG).  which have shown to reduce fat cell growth, fat mass, body weight, triglycerides, cholesterol, glucose and, maybe most importantly for fat loss, insulin.  It’s important to note though, that these positive effects were seen only in cell culture’s and lab animals.

There was one small study in Japan that looked at Oolong Tea containing catechins that showed positive reductions in body weight, fat mass and other body fat measurements.  And, since green tea also contains catechins it’s plausible that you could extend the benefits to green tea.

So, as far as helping with weight loss green tea may be of benefit.

Now, the meat of your question focuses on whether you should take the green tea diet tablets or just brew the tea.  Honestly, from what I can tell in the literature, it’s going to be based on how well you enjoy green tea itself.  Many people find green tea only mildly palatable and would rather take it in tablet form.

The main point is that pretty much all the compounds that are in green tea itself, are transferred to green tea tablets.  Including the caffeine.  There are green tea tablets that have been decaffeinated but you’ll have to look for that on the label.

The advantage of taking a green tea supplement is that the beneficial components I named above are actually concentrated in the tablets compared to the brewed tea.  So, if you do decide to take green tea in supplement form to help with weight loss I wouldn’t take the tablet every single day.  Maybe go two days on, one day off, or take a capsule every other day.  Besides, it’s generally a good idea to not take any supplement religiously every day (despite what a lot of manufacturers would lead you to believe).

Concerns About Green Tea

Now, another point I need to tackle that you didn’t ask about but that you might be warned on: liver damage.

Recently, green tea supplement manufacturers were forced to put warnings on their supplements about possible liver damage.  The one thing I have to say about the study that found the liver damage was that it used extremely high amounts of polyphenols injected into small animals.  In short, these are supraphysiological doses – doses that no human should be consuming.  So, personally, I wouldn’t lose any sleep over that.

The one area you should be concerned about is if you have any preexisting liver conditions like cirrhosis (scarring of the liver) or hepatitis.  If so, you’ll want to talk to your doctor first about starting any green tea extracts.  The same goes if you are taking any blood thinning medications like warfarin or aspirin as green tea can interact with these medications.

Summary: A true codeine allergy is actually rare.  Most patients have what could be called a intolerance to codeine – meaning they get an upset stomach.  If you have a true allergy to codeine than your chance for having allergy to other pain killers rises.  The actual rate at which your risk will increase isn’t easy to determine.

Dear Curtis: In the past my doctor prescribed Tylenol #3.  It made me sick including hives, nausea and it closed up my nose and throat.  Now, my doctor has prescribed Lortab and I’m wondering if I’m going to run into the same problems?

My Answer: I get patient’s all the time who claim a codeine allergy but who really don’t have a true allergy.  Right off the bat, it sounds like you have a true allergy to codeine.  In other words, the hives and ‘closing up’ of the nose and throat are hallmark signs.  That’s opposed to a codeine intolerance which basically means that you don’t tolerate codeine well and it upsets your stomach.  If codeine truly causes an allergy like this it’s classified as an anaphylactoid reaction and can be very serious.

I’m assuming that your doctor knows well what happened last time when you took codeine.  That’s very important because if he or she doesn’t know it may very well change the fact that he prescribed Lortab.

As you may already know Lortab is the brand name for a combination of hydrocodone and acetaminophen.  Tyelonol #3 is the brand name for codeine with acetaminophen.  If you are truly allergic to codeine it’s important for you and your doctor to know that codeine is closely related to hydrocodone.  In fact, codeine is the starting point, chemically, for a number of different pain killers on the market – hydrocodone being one of them.  So, consider hydrocodone and codeine ‘cousins’ if you will.  In practical terms, this raises the chance of what is called cross-reactivity.  Meaning you can be allergic to a drug that closely resembles another drug.  In this case hydrocodone and codeine.

I can’t give you numbers or what your absolute risk is – but a risk exists and I would caution you and your doctor to tread lightly.  At the very least it might be wise to try your first dose in the doctor’s office and wait for at least 1/2 hour just to see how you react.

Summary: Opiate withdrawal is a very real possibility when you have been taking opiates long term, especially one year or longer.  While, the drug itself may no longer be in your system the receptors in your body will still be responding to the changes that the drug caused in them.

Dear Curtis: Could you please tell me how long Vicodin® stays in your system if you have been taking it for several years?

My Answer: There are actually two parts to your question.  First, how long the Vicodin will stay in your system (i.e., how long you’ll show up with measurable blood levels).  Secondly, and more importantly for someone in your position whose been taking a pain killer (called an opiate) for years like you have, is your risk of running across opiate withdrawal symptoms.

So, let’s tackle the blood level question.

When we are looking at any drugs we can calculate about how long the drug will be able to be measured in your blood.  Pharmacists do this by using a property called half life.  Essentially what this means is each and every substance has a half life.  Now, Vicodin actually contains two drugs: hydrocodone (the pain killing opiate) and acetaminophen (or plain old Tylenol).  For your question I’m only going to focus on the opiate part of Vicodin.

Hydrocodone has a half life of roughly four hours.  So, in 4 hours roughly half of the drug has been eliminated from your system.  As a general rule pharmacist and doctors consider the drug to be gone, or reach unmeasurable levels, within 5 half lives.  So, if the half life is four hours the hydrocodone portion of Vicodin will be eliminated from your body within 20 hours.  So, within a day, it should be out of your system.  This is one of the reasons why you must dose Vicodin every 4 to 6 hours – because it’s half life is relatively short and if you didn’t you wouldn’t maintain high and level enough amounts of the drug in your blood to do it’s job.

Serious Concerns of Opiate Withdrawals

Withdrawal from opiates is a very real concern especially for someone who has been on them for years.  Of course, the lower the dose the easier time you’ll have getting off them.  But you do want to proceed slowly.  Recently, I had a patient who was on extremely high doses of narcotics for years who was sick and tired of being on them.  In a fit, she decided to go cold turkey.  She basically went through two weeks of pure hell until she started feeling human again.  Skin crawling, nausea, uncontrollable vomiting, sweating.  You name it – she had it.

She’s thankful now and said that she will never go on another narcotic but doing what she did is something you should NEVER do – people have died from trying that.  She’s fortunate she didn’t.

But, back to getting off your Vicodin.  When you start taking a drug like Vicodin there is a phenomenon called neuroadaptation.  This bascially means that your neurons and receptors get ‘numb’ to the effects of the drug.  So, to get the same effect you may find you have to start increasing the dose.

Now, will you have withdrawal symptoms?  It’s hard to tell because each person is different.  But, from the fact that you’ve been taking it for years I would venture to guess that, Yes, you will.  Obvisouly, this is something you have to talk to your doctor about but he/she will likely recommend a slow step down therapy.  So, for example, if you have been taking 1-2 tablets every 4 to 6 hours he will likely have you cut that down to 1 tablet every 4 to 6 hours for a week or so then drop down to 1 tab every 8 hours or something similar.

This is much less of a shock to your system and is a lot more maneagable.  Also, you should talk to your doctor about magnesium and zinc supplementation which will help as will avoiding alcohol and caffeine during this time which can make your symptoms worse.

Summary: Amitriptyline can be used as a peripheral neuropathy treatment and has about a 50% success rate.  Amitriptyline is actually an old antidepressant. It’s very seldom used for that purpose anymore. But it is used frequently for ‘off-label’ uses. This is partially due to it’s side effect of causing drowsiness so you can get sleep during the night and not be kept up due to leg pain.

Dear Curtis: How successful is amitriptyline (Elavil) as a treatment for peripheral neuropathy? Is fast pulse rate a side affect?

My Answer: Amitriptyline HCl (for hydrochloride) is an old antidepressant. It’s in a class called tri-cyclic antidepressants (TCA’s) because of it’s unique chemical structure.

When it came out in the early 60’s it was a great choice for patients with depression because there wasn’t much out there.  But, as newer anti-depressants began showing up – particularly drugs like Prozac (fluoxetine) – they didn’t have the sedation (causing you to become groggy and fall asleep) that Elavil (amitriptyline) did.  Which leads to why it can be used as a treatment of peripheral neuopathy.

Peripheral Neuropathy is an Off Label Use

Doctors will often use drugs for reasons other than why they were designed.  This is called an “off-label” use.  For instance, amitriptyline was originally an anti-depressant but is used for a number of different diseases now – like as one of the many treatments for peripheral neuropathy.  The same is true for Neurontin® (gabapentin), Depakote® (divalproic acid) and other drugs.

A really famous example is Rogaine®.  It was originally tested as a drug to combat high blood pressure. But, during it’s early use researchers discovered that while it could help with blood pressure it also had the strange side effect of causing hair growth in it’s users.  Obviously, the market for men looking to grow more hair on their head is astronomical – so Rogaine® was formulated as a cream and turned into a big “off-label” hit.

But, back to why they may be using amitriptyline to treat your leg pain.

Peripheral neuropathies are caused by nerve damage.  What caused the nerve damage can vary from trauma from some kind of injury, an infection, toxins or even diabetes or other metabolic conditions.

Some patients can see their symptoms improve over time.  However, in the case of diabetic peripheral neuropathy treatment with some sort of medication is usually the only option because the underlying damage is usually only progressing or staying the same.

As I mentioned above, amitriptyline was originally developed as an antidepressant.  And all antidepressants work because they inhibit or promote certain chemical processes in the brain.  These same chemical processes can also be altered in the brain and spinal cord to affect how much pain you feel from your peripheral neuropathy.

It’s estimated that if you take amitriptyline for treatment of peripheral neuropathy you’ll experience about a 50% chance of having the pain lessened or go away.  The good news is amitriptyline is NOT expensive.  So a trial of it may be perfect for you.

Bare in mind that amitriptyline may take a while to work.  So, give it at least two weeks and preferably 30 days before you decide whether to stop it or not.  And, yes, amitriptyline can cause a fast pulse rate (tachycardia).  However, this seems to be a more rare side effect.

Summary: The evidence surrounding caffeine side effects can be confusing.  In my opinion, many studies as well as case studies and anecdotal evidence show moderate caffeine consumption is OK, maybe even beneficial.  You should focus more on where your getting your caffeine.

Dear Curtis: I drink a cup or two of coffee a day and don’t notice any side effects of caffeine.  But, I’m starting to get concerned because I’ve read that caffeine can harm my health.  Do you think this is a problem?

My Answer: A couple of points:  first of all, caffeine – by definition – is a drug.  It and it’s derivatives have been used for a long time to treat certain diseases states like asthma.  Secondly, and this is on a personal note, the side effects of too much caffeine to me have been put too much in the spotlight.  I’m more concerned about ‘how’ people are getting their caffeine and how much of it they are getting.

What do I mean?  Simple…caffeine itself can be good or bad depending on how much you take.  When caffeine gets into your body one of it’s first actions is to dilate blood vessels.  Well, this can be good as it can increase blood flow to your brain and allow the ‘fog’ to lift so you can think clearer.  But, at higher doses it can cause the jitters.  Also, it can lead to changes in blood pressure and heart rate.  Obviously, in folks with preexisting heart conditions this is concerning and they should follow their doctors orders regarding caffeine intake.

So, you can think of the effects of caffeine like a good versus evil sort of thing.  In moderation caffeine can be beneficial in many populations.  But, get carried away and the side effects begin to show up.

Caffeine Sources

The second, and often overlooked point, is where are you getting your caffeine from?

My main source is my morning cup (yes, 1 cup) of fresh ground, black coffee.  However, if your source is soda than I would stop immediately.  Soda may be one of the most harmful substances on this planet.  And no, diet soda isn’t any better.  Normally, most folks mistakenly think that the ‘diet’ in front makes it better.  It doesn’t.  It’s loaded with substances that mess with your metabolism, insulin secretion and may even increase your risk of osteoporosis (from phosphoric acid, which is also contained in milk).

In my opinion, coffee and tea in moderation are just fine.  I’ve tried tea, but it’s doesn’t agree with me in the morning.  And, for many years I went without both.  But, I’ve found that I really enjoy a nice cup of dark coffee to start my morning.  Also, as a writer, I find it makes my work more productive first thing in the morning – particularly since I’m up at 4:45AM every day.

Yes, there are studies showing detrimental effects from caffeine.  But nearly any scientist could go in and find fault with these studies.  For me, most people in most studies have terrible eating habits.  But the studies still make a link to disease states without looking at (or controlling) the most likely link: nutrition.

Also, many folks who live quite long and healthy lives (yes, I realize these aren’t ‘clinical studies’ but that is only because this population of people is so small) have a cup of coffee in the morning, a glass of wine after lunch and a cigar after dinner.  Than there are others who shun alcohol or any sort of caffeine.

So, what then, was the difference?  Most likely it wasn’t the effects of caffeine, or alcohol or an occasional cigar.  It was how they lived their lives.

National Geographic did a very interesting story on the three longest-lived populations on the earth.  If memory serves me correctly, one group was near Italy, one was from the island of Okinawa near Japan and another was a group of Seventh Day Adventists near Loma Linda, CA.

Here was the things they had in common:  they remained active in something that fed them emotionally, they ate naturally, they had strong family and/or friendship groups and they, as a whole, were grateful and optimistic about life in general.

The Italians drank wine with meals (also some breads which I shunned a bit and was evident in their faces and figures – but no one is perfect which is kind of the point of my answer).  But, first thing in the morning the patriarch of the family (who was in his 80’s or 90’s) went out and chopped wood by hand.  Their meals were 10 or 20 family members sitting down and laughing, enjoying life and the natural food they were eating.

Even more interesting was this: in Okinawa they were starting to see the effects of ‘westernization’ on their longevity.  For example, the youth in that country were becoming heavier and abandoning their ‘old’ ways.  McDonald’s was becoming more and more common.

My advice: don’t stress so much about the effects of caffeine.  I don’t.  From what I’ve read moderate caffeine intake (if you don’t have any preexisting medical conditions) is just fine.

Instead, focus on eating natural and base your food choices on color and texture.  Live happy.  Do work you enjoy.  Learn to control what you can.  Stay active in something you enjoy and cherish your family and friends.  And yes, if you want a cup of coffee, have one.  Just don’t get carried away.

Summary: Darvocet N100 is generally one of the less popular drugs for pain relief.  It is historically ineffective as well as having concerns over dangerous metabolites that may lead to heart problems or severe confusion.  However, some doctors debate this evidence and are comfortable with it’s use.

Dear Curtis: My doctor has me on Darvocet N100 and it doesn’t seem to be helping that much.  Plus, it upsets my stomach when I take it.  Is there anything else that you’d suggest that I could talk to my doctor about?

My Answer: Surprisingly, in the USA Darvocet (particularly the N100 formulation) is pretty popular – usually falling within the top 20 prescribed generic drugs.  But, if you look across the pond in Europe it is seldom if ever used.  Part of the reason may be for it’s low effectiveness rate coupled with the fact that it can be habit forming (as can any of the pain killers in it’s class or higher).  There is also concern about it causing heart abnormalities but this is still very debatable.

So, in short, I’m not really that surprised that Darvocet isn’t working for you.  I still see a lot of doctors writing for it despite poor data on it’s effectiveness.  And, you can’t blame them because that information isn’t that well known.  But, if you want something to take to your doctor here is a good article on the subject:

http://www.emedmag.com/html/pre/fea/features/121501.asp

If they scroll down to myth #3 he will see the discussion on Darvocet N100.

Now, in regards to your other options.  Since you are taking Darvocet N100 that means you are already taking Tylenol (Darvocet N100 has Tylenol in it) with no relief.  You didn’t mention what your particular problem is but I would guess that it is likely inflammatory in some fashion as Tylenol has no anti inflammatory properties.  So, ibuprofen would be a good choice if you don’t have any allergies or stomach issues.

There are literally a dozen other prescription options your doctor could opt for.  Many in the same class or step as Darvocet but with better effectiveness.  Of course, it depends on your allergies and so forth.  I won’t list them all here as your doctor will be very familiar with his or her options.  But some of the more popular ones would be hydrocodone, hydrocodone with tylenol, hydrocodone with ibuprofen, tramadol and even off label drugs like gabapentin or amitriptyline.

Of course, your doctor is going to know a whole bunch more about your particular situation so these options may or may not work for you.  But, frankly, I think they are better than taking Darvocet N100 which, the more the medical community learns about it, the more it is falling out of favor.