by James Hubbard, M.D., M.P.H.

The conclusion from the Women’s Initiative Study that multivitamins don’t prevent cancer, heart disease or overall mortality troubles me for some reason.

Don’t get me wrong, I love the Women’s Initiative Study. It involves a large group of women (161, 808) followed over a long period (eight years in this instance.)  Statisticians analyze the tons of data known about this group and report the findings.  The data doesn’t care what I or anyone else thinks.  It is what it is.

In the comment section of this report the author cites two other good, long-term women’s studies that showed an association between multivitamins and decreased colon cancer. It took 10 years in one group and 15 years in the other to start seeing a decrease.

But that’s not what bothers me.  It’s not the study itself, but that people might get the idea no one needs vitamins. I mean, the New York Times has an article entitled “Vitamins; A False Hope?” This was a study on multivitamins, in set doses.  It concluded nothing about set groups of individuals needing specific vitamins at other dosages.

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by James Hubbard, M.D., M.P.H.

A while back, I blogged about a study that suggested over-the-counter lidocaine gel decreases the discomfort of a mammogram. (The gel numbs the skin after you rub it on.)

Recently, the FDA issued an alert reminding us that, although there were no serious side effects in the study, this same lidocaine gel and similar numbing agents can cause life-threatening side effects if you absorb too much through the skin.  Rarely, it has caused heart irregularities, seizures, breathing problems, coma and death.

A lot to risk for the minimal benefit found in the study, don’t you think?  In small amounts it appears to be safe, but the FDA recommends:

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by James Hubbard, M.D., M.P.H.

I’m sure you know by now the FDA is getting rid of foods containing peanut butter faster than I can say Jif. (No, it’s not one of them.)  First tomatoes, now peanut butter.  Is there no end to the misery?

James Hubbard’s My Family Doctor has been following the case closely.  Our dedicated managing editor has made it her mission to specifically find out if Girl Scout cookies are safe to eat, or will that industry go down in flames like Lehman Brothers, Fannie Mae and the Republican party before them.

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Will this be Dr. H by year's end?

Let’s go over my reasoning.

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by James Hubbard, M.D., M.P.H.

I am still trying to decide what my New Year’s health resolution will be.  Something I can keep, but have to work and focus on.  A long-term goal with short-term steps and rewards.  I have a few in mind, and thanks for your suggestions Sagan and Judy.

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by  James Hubbard, M.D., M.P.H.

I used to make New Year’s resolutions when I was very, very young.  They were bold and visionary.  I never kept them and forgot what they were by January 2.  Since my late teens, when people would ask me if had made a resolution, I would tell them something like sweat less, age a year or some other nonsense.

Maybe I should compromise and make one good resolution that I try my best to keep.  Something specific and doable.   Any ideas for me? (keep it civil now)  What is your resolution?

If you smoke, may I suggest to stop by the end of 2009?  Many patients I advise to stop smoking give me a frustrated look that implies easier said than done.  I know.  But what if you make it the one thing you resolve to do, your number one priority for 2009?

Here is one incentive.  Dr. Norman Edleman of the American Lung Association says half of smokers die of lung disease.  Have you ever seen anyone with chronic lung disease?  Most of you can imagine cancer, but there are other more long term diseases that slowly destroy your lungs to the point you become constantly short of breath and nothing (including oxygen) relieves you.  Fully half.  I know most of you think you will not be in that half.  Maybe, if you are lucky (sarcasm goes here), you may die of one of the many other associated cancers, or heart disease.

Here are some tips to help you stop.

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James Hubbard, M.D., M.P.H.

Irritable Bowel Syndrome (IBS) affects 20 percent of U.S. adults.  Although it doesn’t actually harm the intestines, it can wreak havoc on the sufferer with any combination of abdominal bloating, cramping, diarrhea and constipation.  In a recent post I reported a study showing that the old standby treatments of fiber, peppermint oil and antispasmotics still work for most people.

The American College of Gastroenterologists has released updated treatment recommendations, as reported by the University of Michigan. New recommendations of note are:

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James Hubbard, M.D., M.P.H.

News flash.  Medicine is not perfect.  A few years ago, I finished my advice to a patient by saying, I might be wrong.  She sarcastically said she was going to go straight home and call her doctor son-in-law to give him the news. “A doctor said he might be wrong. Who knew?”

Reading the recent news about colonoscopies made me think of this.  Why do we need scientific studies to document that therapies work?  Because we can’t rely on our intuitions and preconceived notions.  Every diagnostic test and treatment needs to be scrutinized objectively.  Even the ones we’re sure of.

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by James Hubbard, M.D., M.P.H.

We thought colonoscopy could prevent 90 percent of colon cancers.  We were wrong.  If the results in the new Annals of Internal Medicine hold up, it’s more like 60 percent.  A colonoscopy is still excellent for a screening test, but far from perfect, we discover.

The investigators did a case-control study.  That’s when you find people with a diagnosis and work your way backwards. In this case, the researchers found people with colorectal cancer and looked back to see whether they’d had a normal colonoscopy six months to seven years before their diagnosis. They compared them to similar people who didn’t have colorectal cancer.

What the investigators found surprised them so much, they asked that the data be looked at a second time.

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by James Hubbard, M.D., M.P.H.

Consumers Union is upset with the FDA, calling for an overhaul of the agency.

Consumers Union, which publishes the popular Consumer Reports magazine, describes itself as “an expert, independent, nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves.” I have always found them to be just that.

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