Welcome to Straight Talk on Health, I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the world of health. Whether it’s research that makes the news, another miracle diet, or a new food fad, I look at the science behind them, and let you know whether it’s real or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
The question of the day is do we really need to take medications or use medical devices to be healthy for the rest of our lives? Before I go any further, every decision that you make about whether or not you should continue a medication or whether or not you should continue to use a medical device is up for a discussion with you and your healthcare team of physicians. They are the ones who know your personal situation and they are the ones who should guide you in any decision. My objective in this podcast is to raise some questions as it relates to treatment with medications and medical devices.
There are some things that just don't make a whole lot of sense to me relating to the treatment plans that never change. My attitude towards personal health is it is my body and it is my choice as to what I'm willing to do and not do to get healthy and stay healthy. If I work on changing my lifestyle, are the treatments still necessary or can they be modified? Am I willing to eat a better diet, eating fruits and vegetables, eating less refined foods? Absolutely. Am I willing to exercise? Absolutely. Am I willing to take medications, undergo surgery, or do other things that allow my body to function properly. Absolutely.
But that doesn't mean that I'm not going to question what healthcare professionals would like me to do. Question everything. Just understand that you shouldn’t be foolish either. Get all the facts, as best as they can be determined. Look at the probabilities of the outcomes. And then make a decision based on that information.
I got a question from a client about using her CPAP device. For those of you who don't know what it means, CPAP stands for Continuous Positive Airway Pressure. You've probably seen photos or videos of people with devices attached to their face or to their nose with airway tubes attached to it. It is typically used by people who have been diagnosed with sleep apnea. Sleep apnea is a potentially dangerous condition where people stop breathing for extended periods of time instead of a normal rhythmic breathing. We're not talking minutes without breathing here; it's just longer than typical. That seems to wreak havoc on blood pressure. So the objective of the CPAP device is to maintain continuous air into the lungs
This client had been using such a device for close to 30 years. She first got the device when she was young, had to work as well as get three kids to three different schools at three different times in the morning. She was sleep deprived and took planned naps in her car at pre-specified times during the day. She had told the woman who worked in a cubicle next to her that if she ever thought that she heard her fall, that she should get her medical attention. She did, and she did, and the end result was a blood oxygen of 68%. Typically, blood oxygen is 90 to 95% in resting individuals. But her kids are all grown up, and while she is still classified as obese, she's lost over 100 pounds. Her question was do I still think she needed the CPAP machine?
She has to do that in consultation with her physicians. That may involve a sleep study test to check on whether she has sleep apnea or not. Also, a recording of her blood O2 levels with and without the CPAP device. She is mostly sedentary due to some physical challenges she has had but she questions whether she really needs this device. I understand it’s cumbersome but if you need it, you need it. Time for that discussion with her team.
I also got a question from someone who was told that curcumin would interfere with their statin medication and therefore they should not take it. That one sent me to the research on turmeric, curcumin, and curcuminoids, and their potential impact on statin medications. That one was fairly simple because turmeric and curcumin are being examined for benefits to people who have to take statins to regulate their blood cholesterol. One of the benefits seems to be a reduction in the occurrence of muscle pain, the result of rhabdomyolysis, which a small percentage of people get when they take statins.
One of the areas of research that popped up as I was examining the studies on curcumin and statins was the research on statins and grapefruit juice. When statins became popular, maybe 30 or so years ago, a research group began examining the impact of grapefruit juice on the absorption of statin medications. They used something called double-strength grapefruit juice in their studies. What they found was that there was an increase in the absorption of the statin medications. Therefore, the standard of care was to make sure nobody took citrus products if they were on statin medications and that standard of care continues today.
Recently, people are asking about whether the blends of fruits that are becoming so prevalent in powders today would have any impact on statin medications. Why? Because they often contain a citrus blend which would include grapefruit, oranges, lemons, and limes. I'm sorry to say that there is no research on such extracts and statin medications that I could find. My feeling is that it would have minimal effect if at all. But in reality, it may not matter at all.
One of the questions that is never answered is whether the increase in absorption of a statin when taking grapefruit juice would have any impact on the effectiveness of the drug to lower cholesterol and whether there was an increased risk of heart disease or cardiac events if someone regularly used grapefruit juice with a statin medication. In a study published in 2016, researchers in London examined that very question. What they found out was that there was an increase in the absorption of three different types of statin medication when taken with grapefruit juice. In all cases, however, the result was a reduction in LDL cholesterol and a decrease risk of ischemic heart disease. They concluded that it was time to stop the recommendation of avoiding grapefruit juice when taking a statin.
Has that been adopted? Absolutely not. The recommendation remains. Healthcare providers are slow to change. Every decision that you make about whether or not you should continue a medication or whether or not you should continue to use a medical device is up for a discussion with you and your healthcare team of physicians. You should never do it without finding the upside or downside of what you're considering. Every condition would involve some updated testing with and without treatment. It may not be possible to change the treatment plan. But once you have had the conversation, the ultimate choice should be yours, the patient. It's your responsibility to get the best information possible in order to make an informed decision and to do it with the support of your treatment team. It may not work out but the only way you'll know that is with constant testing to monitor your progress. Health is a choice. Choose wisely today and every day. I'm Dr. Chet Zelasko
