November 2010 Magazine

People First Health Magazine

Vol. 10 No. 10

Tips On How to Energize Your Life Complimentary Therapies For

Menopause Dr. Hister On Managing

Depression The Benefits Of

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People First contents

4

Depression Dr. Hister looks at depression and offers helpful insight into this troubling condition.

15 5

Fight Colds & Flu Great selection of products to help you combat the cold and flu season.

6

Managing Menopause Peoples Pharmacist Ian Lloyd discusses several complimentary therapies that can help manage menopause.

5 7

Vitamins & Supplements Great selection of quality health and wellness products from Peoples Pharmacy.

4 9

Pharmacist Recommended Health news on low Vitamin D and the risk of dementia in seniors.

Read about CoQ10 supplements and how they can be a benefit if you are taking certain cholesterol lowering medications.

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Energize Your Life Darlene Booth offers helpful tips on how to add a bounce to your step and your daily life.

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Depression Although I usually try to make a few jokes in every column (poor jokes, I know, but hey, I’m not a comedian and I’m just trying to make this stuff less scary so I need lots of slack), I must admit that this month I’m pretty stumped because the topic is depression and depression is hard to joke about.

In fact, I’ve found depression to be a very frustrating topic to tackle, and I seriously considered asking the editor for another topic but what kept me going is 1) I knew he wouldn’t agree, and 2) the knowledge that my frustration as a writer about depression is nothing even remotely close to the frustration suffered by so many people who are clinically depressed because it’s often hard to admit – or even to realize that one is depressed. It can be very difficult explaining to “normal” people why being depressed doesn’t allow you to enjoy things or participate in activities the way they do.

Depression can be tough to treat, and depression can be notoriously recurrent despite the best attempts to keep it at bay.

And then there’s the frustration often endured by family members or friends of someone who’s depressed and who don’t know when to intervene or don’t know what to do when they see their loved one not getting diagnosed properly or not responding well to treatment or suffering the side effects of some treatments.

But hey, before you give up on this article for, well, making you depressed, please read on because

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Dr. Hister

there is in fact some hopeful material in here and it might help someone you care about, even yourself.

Even when it’s not defined loosely (are the normal “blues” that everyone suffers from time to time just very mild forms of depression?), depression is still very common, affecting roughly one in 20 people at any time, which means that the next time you’re in a room with 100 people – a meeting, conference, movie – at least 5 of them are depressed, although the extent of their depression will vary considerably, and indeed some of them probably don’t even know they’re depressed.

Doctors tend to rely on a cluster of symptoms to make the diagnosis of depression, which may include (according to the US National Institutes of Health): • difficulty concentraing, remembering details, and making decisions.

• fatigue and low energy • feelings of guilt, worthlessness, helplessness and/or hopelessness.

• sleeping problems, such as insomnia, early morning rising, or excessive sleeping.

• irritability.

• loss of interest in activities or hobbies, including sex.

• overeating or appetite loss.

• persistent aches or pains, or digestive problems.

• persistent sad, anxious, or "empty" feelings.

• thoughts of suicide, suicide attempts.

When you examine that list closely, however, it’s quickly clear that many of these “vague” symptoms Continued On Page 11

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Managing Menopause Menopause is a personal topic which I get asked about in my Pharmacy. Gathering information can sometimes make women feel very uncomfortable, or it can make them feel empowered. Many women ask what complementary therapies are available to treat menopause. Many forms of healing do not consider the 'change of life' to be an abnormal functioning of the female body. It is considered to be the natural progression of the reproductive cycle, similar to puberty only reversed. Yet, for some women the symptoms of hot flashes, mood swings or memory loss can be very disrupting.

Regardless of whether women choose treatment or not, women need to be aware of the new health responsibilities that menopause can bring. Women who have reached the age of menopause are at a higher risk of developing osteoporosis, or low bone density, and heart disease. It was once thought that menopausal women might also be at higher risk for Alzheimer’s disease.

However, recent evidence suggests that this may not be the case. It may be best to talk to your Doctor or Peoples Pharmacist about your risk factors for osteoporosis and heart disease.

If you do have a family history of osteoporosis (especially on the male side), smoke, drink more than 2 cups of coffee or alcoholic beverages a day, or are inactive you may be at greater risk of developing osteoporosis. In this case, you should consider the idea of taking some form of hormone replacement therapy (HRT), or bone density building drugs. Low bone density is slow to develop and very difficult to reverse. One of the greatest complications of osteoporosis is the possibility of breaking a hip or vertebrae in the spine. If this does occur, the loss of mobility, independence or pain can be severe and sometimes

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People First

Ian Lloyd

Pharmacist, Peoples Pharmacy

permanent. However drug therapy is not without risk, recent studies have shown that women who take HRT may be at a higher risk of having strokes, blood clots and breast cancer. Talk to your Doctor or Peoples Pharmacist about the benefits and risks of HRT or bone density building drugs.

Regardless of which option for menopause you choose, it is important to take your calcium. Calcium is essential to maintain bone and teeth strength at any age.

The Osteoporosis Association of Canada recommends that women over the age of 50 get at least 1500mg of elemental calcium a day. I often get asked which form of calcium is best.

The best form of calcium is the kind that you remember to take. It is true that calcium citrate is slightly better absorbed by the body than calcium carbonate, but the difference is not very significant.

Magnesium is sometimes added to calcium supplements for a couple of reasons. It can offset the constipating side effects of calcium and your body also uses it to make bone. The minerals zinc, copper and manganese also play a role in bone health. A good multi-vitamin has adequate amounts of all of these minerals, except magnesium. It is also important you get enough vitamin D. Your body needs vitamin D to absorb and use calcium. Some people ask me if they still need to take vitamin D, since the body can make its own supply from sunlight. I recommend take an extra 1000-2000IU of vitamin D a day just to be sure.

There was recent news that mentioned taking extra calcium might increase the risk of having a heart attack. This made a great headline but the reality was a little misleading. Calcium was only associated with but did not cause more heart attacks. The actual increase was quite small. These people were also not taking vitamin D with their calcium. I still recomContinued On Page 8

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Ian Lloyd...Continued From Page 6

mended that my Mother keep taking her calcium as usual.

Some women may experience the troublesome symptoms of menopause: hot flashes, insomnia, mood swings and depression. Can herbs and supplements help? Yes and no. Some of the most promising products are soy, red clover and black cohosh. Soy and other legumes (peas, beans and red clover) contain substances called phytoestrogens. These natural plantbased estrogens act like estrogen in the body, only considerably weaker. In one study, women who took 50mg soy isoflavones/day reported a significant reduction in the number and severity of hot flushes after only six weeks. In another 6 month study, 120mg of soy isoflavones was as effective as 0.625mg of conjugated equine estrogens in reducing menopausal symptoms. Increasing the amount of soy in one’s diet has also been shown to help reduce the risk of heart disease. In one study, women who took soy protein containing 34 mg of phytoestrogens not only reported significant improvements in hot flashes, but they also showed declines in total cholesterol (6%), LDL (7%) and blood pressure (5mm Hg).

The average North American diet provides about 3mg of phytoestrogens daily. Yet the average Asian diet provides about 40 to 80mg of phytoestrogens daily, most likely due to the larger consumption of soy products, such as tofu, tempeh, and soy milk. This is thought to be one of the reasons why Asian women, who eat a traditional soy rich diet, experience fewer menopausal side effects. Try to incorporate more tofu, soymilk, “meat-like” soy products like tofu wieners or deli slices, tofu-almond desserts and dry roasted soy nuts into your diet. I recommend unprocessed soy products over supplements, because soy foods also provide vitamins, minerals and fibre.

Soy products are usually low in unsaturated fat and cholesterol. Regular dietary soy consumption is safe, but those taking high dose supplements should talk to their Doctor or Peoples Pharmacist to see if these products are right for them.

Another herbal product recommended to help with menopausal symptoms is black cohosh. This herb has been shown to reduce the symptoms of menopause such as: hot flashes, sweating, and headaches. It is not clear how black cohosh works. However, it is believed Continued On Page 10

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Health News Low Vitamin D Increases Risk Of Dementia In Elderly Older people with low levels of vitamin D appear more likely to have problems with memory, learning and thinking, suggesting low vitamin D could give an early warning for dementia risk, reports a study published in the Archives of Internal Medicine journal. Researchers from Britain, Italy and the United States studied 850 Italians aged 65 or older and found that those who were severely vitamin D deficient were 60 percent more likely to experience substantial general cognitive decline, and 31 percent more likely to experience problems with mental flexibility.

Giving vitamin D supplements to older people to boost their levels could be a promising therapeutic target for the prevention of dementia,, particularly since supplements are cheap, safe and have already been shown to help prevent to reduce the risk of falls and fractures.

Most vitamin D is made by the body as a natural by-product of the skin's exposure to sunlight. It can also be found in a few foods such as oily fish and is vital for health, as it helps cells absorb calcium and is key for bone strength.

Some recent studies have also suggested vitamin D may protect against cancer, artery disease and tuberculosis.

In this study, the researchers found that older people who were severely deficient in vitamin D -- defined as having blood levels of 25-hydroxyvitamin D of less than 25 nanomoles per liter -- were 60 percent more likely to have substantial cognitive decline over a 6-year period studied.

They were also 31 percent more likely to show decline in a test measuring executive function than those with good vitamin D levels.

Dementia is a brain-wasting condition that affects around 35 million people worldwide. Its most common form is Alzheimer's disease, in which patients gradually lose their memory, their ability to navigate and understand the world around them and to look after themselves. Despite decades of research, doctors still have few effective weapons against it.

The study reported that Vitamin D may help prevent the degeneration of brain tissue by having a role in formation of nervous tissue, maintaining levels of calcium in the body, or clearing of beta-amyloid, the substance that forms the brain plaques that are associated with Alzheimer's disease.

Experts estimated that in the United States and Europe, between 40 percent to 100 percent of older adults are deficient in vitamin D and the problem is aggravated in the elderly as they spend more time indoors and their skin becomes less efficient at producing vitamin D with age.

The Benefits of CoQ10 The Latin word ‘ubique’ means ‘everywhere’; ubiquinone is another name for coenzyme Q10, or CoQ10 for short, because it is found in every live human cell, where it is essential for life and health.

CoQ10 is a fat-soluble, vitamin-like nutrient that helps produce energy at the cellular level, fueling the cells and muscles. CoQ10 is found in high concentrations in the heart, kidneys, and liver. It also enhances immune system function and is a potent antioxidant, scavenging free radicals to protect cells from oxidative damage.

People over the age of 50 should consider taking CoQ10 supplements. Coenzyme Q10 is produced by the body, usually in good supply in our early years, but supplemental CoQ10 can be needed when the body simply does not make enough. Since the heart is the most active muscle in the body, a CoQ10 deficiency affects the heart most and can lead to serious health problems.

Cardiovascular diseases, including high blood cholesterol levels and high blood pressure, can increase the body’s demand for CoQ10. Anyone over the age of 50 needs more CoQ10, as levels tend to decline as we age.

A growing body of evidence suggests that coenzyme Q10 supplements, alone or in combination with other drug therapies and nutritional supplements, may prevent or treat cardiovascular diseases such as elevated cholesterol levels, high blood pressure, congestive heart failure, cardiomyopathy, mitral valve prolapse, and angina.

In addition, certain cholesterol-lowering drugs called statins (such as Lipitor, Mevacor, Pravachol and Crestor) appear to deplete natural levels of CoQ10 in the body. Taking CoQ10 supplements can correct the deficiency caused by statin medications without affecting the medication's positive effects on cholesterol levels.

Talk to your Peoples Pharmacist on how CoQ10 may help with your health and wellness.

People First

9

Ian Lloyd...Continued From Page 8

that it does not act like estrogen in the body. This product may take up to 4 to 6 weeks to fully work.

Side effects are rare, with only the occasional stomach upset reported. Due to a lack of longterm safety studies, therapy is recommended to be no longer than six months at a time.

Yet, black cohosh has had over 60 years of safe clinical use in Germany. The most common dosage for black cohosh is one or two tablets, twice a day, of a standardized extract, made to contain 1 mg of 27-deoxyacteine per tablet. There are many combination menopause formulas on the shelves, look for ones that contain standardized black cohosh as their main ingredient.

Perhaps the most prominent health risk for menopausal women is heart disease. In fact cardiovascular disease (heart attacks and strokes) kills more women yearly than any other disease. So what can be done to help counteract the effects of both osteoporosis and heart disease? Regular weightbearing exercise is the answer. A weight bearing exercise is one where the muscles must work against gravity. These exercises could be walking, stair climbing

and dancing. While bicycling and swimming are excellent exercises to strengthen the cardiovascular system, they are not weight bearing and may not be helpful for preventing osteoporosis.

Resistance exercises, including weight lifting or using elastic exercise bands, can also be helpful in preventing bone loss. Remember, it is best to talk to your Physician before starting any new exercise program.

Menopause can be a very troubling and confusing time of life, especially considering all the treatment options that are available. There are both natural and pharmaceutical treatments available and sometimes no treatment is required. Talk to your Doctor or Peoples Pharmacist about which option is best for you. Your Peoples Pharmacist may also hold in-store clinics that can provide information about menopause, heart disease and osteoporosis. You might be able to have a bone density scan performed in the Pharmacy. As always they best advice is to get regular exercise, eat well and take a multivitamin.

Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

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Dr. Hister...Continued From Page 4

have occurred – and indeed, often continue to recur – in all of us occasionally.

I mean, who hasn’t complained – either occasionally or, if you’re a Jewish male like me, frequently that we’re too tired to do something our partner suggested (yup, even sex, or perhaps especially sex, which, when you think about it, and most of us do, do, do, takes lots of energy, or at least it should)?

And who among us hasn’t suffered insomnia for a few nights in a row or hasn’t woken up in the middle of the night for several nights without being able to go back to sleep?

So the best way to make a diagnosis of depression, I think, is to use symptoms as a guide but to also rely heavily on asking a person with symptoms just how well they are coping.

After all, if you have several of those symptoms – for example, low energy, sleep problems, and some aches - but you’re still managing well, I think it’s hard to say that you’re actually depressed.

On the other hand, of course, if you get recurrent suicidal thoughts, no matter what else you may have on that list, then you’re depressed and need some kind of treatment.

As well, it’s essential, especially in some higher-suicide risk folks - teenagers, for example, but also the elderly – to look for more subtle signs – sometimes very subtle - of some of those symptoms and to take them all seriously, and to never dismiss someone who’s become say, suddenly very irritable or who’s personality has changed recently with an off-handed remark like, “Well, that’s just a phase all teenagers go through, and he’ll get over it.” Maybe, but you really never want to be wrong about that.

And then there’s the thorny issue of treatment.

Most people immediately think of drugs when they think of treating depression, even for people who are just temporarily “low”, and we do in fact use a lot of anti-depressant drugs, so although we are no longer, as Elizabeth Wurzel put it years ago in a very over-wrought book, a “Prozac Nation”, that’s only because there are now so many other antidepressant choices out there to compete with Prozac..

But the point I want to drive home here is that although anti-depressant drugs are probably somewhat effective in some depressed people, especially those with more severe cases (you’d be amazed. I

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Dr. Hister...Continued on Page 13

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Don’t Play A Guessing Game With Your Daily Medications Many people today are on more than one medication and when you combine this with a busy and active life, it can lead to the confusion of properly taking your medications. Medication non-compliance is a major concern and accounts for; approximately 25% of all hospital admissions among seniors.

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Dr. Hister...Continued From Page 11

think, at how much debate there still is in the medical biz about whether anti-depressants work at all, or if they do work, in whom they should be used and when), it’s wise to remember that since all antidepressants produce side effects (some of which can be quite nasty), itsnever a bad idea to consider some other form of therapy either before using drugs or as an adjunct to drug therarpy.

For example, although the data is sparse, common sense tells me that lots of mildly depressed people (and perhaps many moderately depressed people, too) get better without any intervention, either by just waiting it out or by making their own adjustments to ease their situation (quitting a rotten job, for example) or even by self-treating.

For example, the herb, St John’s wort, is often used as a self-medication for depression, although it’s always wise to remember that even “natural” products have side effects and can interact with other drugs you may be taking, which is why it’s also wise, if this is your choice, to discuss it with your Peoples Pharmacist first.

Also, for minimal to moderate depression, there is pretty good evidence that lifestyle adjustments can be quite helpful, especially regular moderate exercise and perhaps even diet (a diet high in fish oils has been linked to improvement in depression scores).

Then, there’s the often-overlooked but often quite effective “talk therapy”, which in this era of easy access to medication (see below), has become the “neglected child’ of treatment, yet studies tell us that for many depressed people, the best approach is often to talk to a good therapist.

After all, the only side effect with this approach is that your pocketbook will get lighter.

But if it works, hey, it’s absolutely worth it.

Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.

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Energize Your Life The alarm goes off and you sleepwalk your way over to the coffee maker so you can rev up enough to get yourself organized and out the door. Who has time for breakfast these days? You’ll grab another coffee and a donut on the way to work and count yourself lucky to score a quick sandwich at lunchtime. Before you know it, the clock says three and you have little left to give. If it were possible, you would curl up under your desk and take a nap but you still have at least 2 more hours of work before you pick up the kids at the sitter, make dinner and then muster up the energy to host your weekly book club meeting. Okay, well maybe it is a poker game with the boys but you are now rummaging through your desk for a chocolate bar to go with that double Americano you just ordered. You sit back and wait for the buzz to kick in and all is right with the world for another hour at least. This is not sustainable energy.

While the above scenario is a slight exaggeration, it is not too far from the truth for many people. You only have to look at the coffee culture that has sprung up over the past few decades to realize that people have formed quite a dependency on quick energy fixes. We max out our schedules and don’t take the time to nourish ourselves properly so we can actually keep up. The trouble with this practice is that quick fixes like sugar and caffeine are always followed by a blood sugar crash. When this cycle becomes a way of life, it stresses the very systems that are in place to keep us healthy and alert.

Here are some tips for maximizing your energy the healthy way: 1. Always start the day with a nutritious breakfast. Slow cooked oatmeal or whole grains are complex carbohydrates that are rich in fibre and release energy slowly into the bloodstream. Add some fruit, nuts, and eggs or yogurt for a balanced meal. If you really aren’t a breakfast person throw some protein powder, fruit, flaxseed and yogurt or juice into the blender and you have a breakfast you can run with.

2. Eat smaller meals more often and don’t skip meals.

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People First

Darlene Booth R.N.H

Carry healthy snacks with you for a mid morning and mid afternoon snack. Make sure to include protein and healthy fats with your snacks and meals. [A few almonds, a piece of low fat cheese and some grapes can be an ideal snack.]

While complex carbs are the preferred main energy source, protein and fat also provide sustainable energy that burns at a slower rate.

3. Don’t depend on caffeine! Be very careful when reaching for a product that is promoted as an energy drink. If you read the labels you will see that caffeine and sugar are often the main ingredients. The exceptions to this rule are the many wonderful greens drink powders on the market. These drinks are full of super foods and micronutrients that promote health, alkalize and energise the body.

4. Drink water. Even minor dehydration is a major energy sap. Know that caffeine is a diuretic and can contribute to dehydration.

5. Energise with exercise. Nothing better than a bloodstream full of fresh oxygen! Get outdoors as often as you can, walk the dog, dance, swim or ride your bike.

6. While optimal sleep hours vary from person to person getting a good night’s sleep is an obvious recommendation here.

On average we need about 8 hours, some people need more, others can function well on slightly less.

Consistency is helpful in establishing a sleep schedule.

7. Sit for a few minutes and breathe consciously. Take in a full deep breath; expand the belly, the ribcage and chest.

Exhale and repeat a number of times and feel your energy stores increase.

We all have lifestyle habits that drain our energy.

Remember that whenever possible, stay away from junk food and high sugar foods. Use alcohol, coffee and stimulants in moderation. Choose whole foods that are fresh and full of vitality over canned or processed foods; eat more living foods over dead foods. And don’t forget to make some time each and every day for those people in your life that you love and activities that bring you joy!

Good Health to You!

Recipes For tcakes e ShorHealth olatGood

Triple-Choc

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Recipes For Good Health

Triple-ChocolateShortcakes 30-Minute Diabetic Cooking Cookbooks are available at participating

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www.peoplesdrugmart.com The articles published in People First are for the general information of the reader. While effort is made to reflect accepted medical practice and knowledge, articles should not be relied upon for the treatment or management of any specific medical concern or problem and People First accepts no liability for reliance on the articles. For proper diagnosis and medical care, you should always consult your family physician promptly.

Opinions expressed in sponsored articles by, Dr. Art Hister, Ian Lloyd, and Darlene Booth are paid advertisements and are not necessarily shared by Peoples Drug Mart stores or Peoples Drug Mart (B.C.) Ltd. Some advertised products are not available in all stores. We reserve the right to substitute products or limit quantities. Prices effective while quantities last.

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