Identifying a zinc deficiency

Suffer from weak immune system? Trouble maintaining an erection? Feel tired and run down? You may just not be getting enough zinc daily.

Zinc is a mineral that we must eat every day to survive, as our bodies produces zero (zilch! nada!) of it daily. The recommended dietary allowance is 8mg for non-pregnant women and 11mg for pregnant women and men. The daily dose should not exceed 25mg/day.

The reason zinc is so important is that it’s used for so many processes and functions in the human body. It starts by your cells being improved all over – from skin to immune cells. It works to ensure your DNA is produced properly. By doing this, it helps with wound healing and tissue repair. As well, it can help with the sense of taste and smell.

People at higher risk of zinc deficiency are those with poor diets. Those with chronic disease such as ones that affect the liver or kidney, and diabetes. Alcoholism, being a vegetarian, and those that take in large amounts of iron daily are also high risk for zinc deficiency.

In mild cases of not enough zinc you may experience diarrhea, tiredness, growth restrictions, and poor immune function. In more serious cases – impotence, low testosterone production, low sperm counts, loss of hair, skin inflammation, impaired nerve conduction, unhealthy weight loss, eye degeneration, impaired taste and smell, as well slow wound healing.

The difficult part of discovering you are not getting enough zinc is hard. Plasma and serum concentrations found in typical blood work do not give the whole picture. These do not accurately reflect the cellular zinc status where the majority of zinc hangs out to do all the necessary body functions. You may still be experiencing these symptoms even when the lab values seem good.

Luckily, if you have a mixed diet its easy to get additional zinc if needed. It is found in a large variety of foods from seafood to nuts, grains, etc. The daily recommendations, again, are men and pregnant women 11mg, non-pregnant women 8mg. Oysters have the most with roughly 3 oz delivering a whopping 74mg (about 3x the max dose). In the meat family, dark poultry meat has more zinc then the white meats. The zinc from meats and seafoods are more easily absorbed. Dairy products like yogurt, milk, and cheese contain a good amount – just check the containers, as some are fortified with more. Beans and seeds are full of zinc. In 1 cup of pumpkin seeds, you get 6.6mg where 1 cup of sunflower is 1.5mg and flax seeds are a lowly 1.2mg. Baked beans contain roughly 5.8mg per cup, chickpeas 2.5mg, and kidney beans at 1.8mg. Nuts are another excellent source of zinc, cashews in particular. 1 cup of cashews is 7.7mg. They fall off quickly with pecans getting 1.35mg. Almonds, walnuts, and peanuts have about 1mg per cup.

If none of these foods wet your appetite, then there are over the counter supplements to help out. Not all zincs are created equal. Zinc comes in 4 major varieties – 2 of which generally are overkill and 2 that are just right. Zinc oxide and Zinc sulfate are the overkillers. Zinc oxide is 80% elemental which means for every 100mg you get your daily dose would be 80mg a little over 300% of the recommended value. Zinc oxide is about 25% elemental. In 110mg, you get 25mg of zinc and in 220mg you get 50mg. Again, the recommendations state the max being 25mg. With all the foods that contain zinc to some degree, this is certainly likely to make you toxic. The 2 zincs to look for are zinc acetate and zinc gluconate. Our friend zinc acetate 25mg = 7.5mg elemental, a good sweet spot to aim for if diet is not enough. Zinc gluconate 50mg = 7mg of elemental likewise putting you well on your way if your diet lacks anything of substance. Any supplement should be taken with food.

If you take too much zinc you may experience diarrhea, abdominal cramping, nausea/vomiting, and metallic taste. As well, it may start to weaken your immune system. Doses of 100mg-300mg per day can lead to urinary problems and possibly prostate cancer. It can also lead to anemia as zinc will displace copper in the body.

So ensure you get the zinc your body needs, but as well – everything is good in moderation, so don’t overdo it. This is not one of those “if some is good then more is better” things. Again, we recommend zinc gluconate 50mg or zinc acetate 25mg to supplement diet if necessary to increase and improve ones zinc levels.  A bottle goes for about $5-$8 per 100 depending on the manufacturer.

by Eric Borgeson, Pharm.D

posted on February 24, 2015

5 Bonus Benefits of Exercise

01-22-2015

by Eric Borgeson, Pharm.D

For as long as you can remember, you’ve been hearing about the benefits of exercise: weight control, chronic disease management, stronger muscles and bones, to name a few.. but the list of exercise benefits just keeps getting longer. If you could package it in a pill, you might have a multi-million dollar product!

Maybe these less touted benefits will offer the motivation you need to make exercise a regular part of your daily routine.

1. Improve your immune system. Seem like you catch every bug in the book? Maybe exercise can help. Researchers are finding that as little as 30- to 45-minute brisk walks five times a week can greatly boost your immune system. It does this by increasing the levels of natural killer cells that fight off infections such as colds or the flu.

2. Influence aging. Early research indicates that exercise may partly reverse the aging process caused by stress. How do we know this? Shorter telomeres are a sign of aging, and researchers have found that exercise lengthens them. Telomere is a fancy name for the strands of DNA at the tips of chromosomes.

3. Enhance your mood. You may already know that exercise can improve self-confidence, distract you from negative thoughts, and help you feel fitter. Increasing body temperature may have a calming effect. Exercise also releases brain chemicals that may relieve tension and ease depression and anxiety. Some studies have even shown that exercise may be as effective as an antidepressant.

4. Boost your brain. Exercise increases growth factors in the brain, which help the brain make new brain cells and new connections between them. This may enhance memory, attention, and concentration, helping with learning.Some studies have even begun to show a link between exercise and grades on math and reading tests. The benefits aren’t limited to kids in school – exercise may also greatly reduce the risk of developing Alzheimer’s disease, a form of dementia.

5. Sleep better. A recent poll conducted by the National Sleep Foundation uncovered some interesting connections to exercise. Those who exercised—no matter what time of day—reported better sleep than those who didn’t, even when they slept the same length of time. Sedentary people were also about twice as likely to be sleepy during the day and were more likely to have sleep apnea, a disorder that interrupts breathing while you’re asleep.

So how much do you need to reap benefits like these? Experts recommend getting at least two hours and 30 minutes each week of moderately intense aerobic activity or one hour and 15 minutes weekly of vigorous aerobic exercise. It’s best to combine this with muscle strengthening two times a week. However, be sure to remember: short stretches of physical activity throughout the day can bring many of the same advantages as a structured gym workout.

If you’re not sure where to begin, I may be able to help in directing you. So far this year I have joined Retro Fitness. I do 30 minutes with their machine and sit ups and then 30 minutes of cardio to help burn excess calories. It hurts and burns in the beginning but after about 2 weeks you get use to it and it isn’t so bad. Then you can continually challenge yourself with weights, distances, times, or # of calories burned to help it be more enjoyable.

The New Hope for Hepatitis C Patients

January 13, 2015

Before we delve on into the new treatments, we will start with some background information about hepatitis C such as – what is it, how it is transferred, how we can prevent the spread of the disease, and finally the treatments available for it.

Hepatitis is any time the liver has inflammation whether it be from over-consumption of alcohol, liver injury caused by medications, virus, etc. The most concerning forms of hepatitis are B and C. Hepatitis A is also common throughout the world but it is treated by the body without the need of additional medications. There are also hepatitis D,E,F,and G however these are rare and are not currently believed to cause serious damage.

Hepatitis B and C are transmitted via blood to blood contact. People can be infected many ways but with some basic prevention steps, most transmissions can be avoided –  such as healthcare workers, sewage and water treatment works, mother to newborn and hemophiliacs. The people most at risk are: IV drug users (as they pass blood in the syringes they use) and people with multiple unprotected sex partners, as there is exchange of bodily fluids.

Hepatitis B and C are both conditions that can become chronic. Chronic hepatitis lasts over 6 months. The virus multiplies unable to be stopped by the hosts immune system. This leads to the liver being in a constant state of inflammation which makes it become less efficient at clearing the body of toxins and other waste products. Overtime this inflammation can lead to scarring of the liver which is called cirrhosis. This extended period of inflammation can also cause liver cancer and liver failure.

Diagnosis can be done quickly and easily. Testing is done after determining the symptoms qualify a person. The most common symptoms include severe nausea, fatigue, and abdominal pain. More severe symptoms are darker yellowing of urine, jaundice, and taking longer for blood to clot. There are 3 different blood tests needed to make a diagnosis. They are liver enzymes, antibodies to the viruses, and the presence of viral proteins. To see how advanced a patient’s disease is, the doctor may have to do a liver biopsy where they insert a long needle into the liver and take a sample to examine.

The patient’s genotype will determine the therapy options available to them. There are 4 genotypes with genotype 1 being the most common in the US. The FDA recently has allowed 2 breakthrough drugs come to market. They are Harvoni and Viekira Pak. These medications can cure up to 100% however each patient does represent a unique challenge. They are for genotypes 1. The price tag for the 3 month treatments is $84,000-$100,000. The manufacturer’s of the medications say it is a lot cheaper than a liver transplant running at a minimum of $300,000 not to mention the anti-rejection medications required after the procedure.

With these 2 therapies, no injections are necessary of interferon therapy. The leading cause of people stopping treatments is that the side effects are very difficult to deal with. Other therapies are available for patients with type 2-4. In type genotype 2-3 patients Sovaldi and Ribavirin must be used. This can lead up to a 100% cure in type 2 (again individual patient experience may vary) and up to 91% in genotype 3. For genotype 4 patients a 3 drug combination is required and the success rate is up to 92%.

The triple combination is Sovaldi, Pegasys, and Ribivirin. Compared to the old therapies of the pre 2000’s where success rates were at most in the 60% so these newer medications represent greater than a 50% better cure rate with potentially a lot less debilitating side effects.

At Jersey Shore Pharmacy, we pride ourselves in being able to get these breakthrough treatments to our patients so that they can cure themselves of this horrendous disease.  We have access to all medications to treat the condition and working with your doctor, insurance company, and medication manufacturers get the medications into your hands.  Don’t hesitate to call and speak with our hepatitis specialists.

Flu Shot Season

That time of the year again…

 

Should You Get a Flu Shot?

The flu is a respiratory infection that’s caused by many different viruses. Up to one in five people get the flu in the U.S. each year. It comes on suddenly, causes worse symptoms than the cold, and can be serious for some people. As you know, last year, a new strain of flu was thrown into the mix. Called swine flu at first, then H1N1, it caused symptoms similar to regular flu, such as fever, cough, aches, chills, and fatigue.

Did you get a flu shot last year? If you’re someone who’s always thought flu shots are just for your grandparents, think again. For the flu season, the Centers for Disease Control and Prevention (CDC) now recommends that almost everyone get a flu shot. That is, everyone six months and older. These changes will simplify guidelines that have been confusing to many people. You should know that the new flu vaccine will include the H1N1 strain.

Any shortage in vaccine supplies this season may slightly alter a plan to vaccinate everyone at once, however. In that case, the CDC may prioritize vaccines as it has in the past. It would first target people who are at higher risk of developing complications from the flu. This includes people who are 65 and older and pregnant women. Also, people with certain chronic medical conditions, such as asthma or heart disease, would take priority. In addition, it is also important for those coming into close contact with these people to get vaccinated early.

Now, if you’re pregnant, you may wonder if it is safe to get a flu shot. The short answer is, yes. However, this is not true if you have a severe allergy to eggs. That’s because the ingredients for flu shots are grown inside eggs. Also, you should not get a vaccine if you have had a severe reaction to a flu shot in the past. If you’re pregnant, request the flu shot, not the nasal spray vaccine. It is made from an inactivated virus. This makes it safe for you and your baby during pregnancy. Avoid trying to get pregnant for four weeks after a vaccination with a nasal spray vaccine.

So, when should you get a flu vaccine? Now is a good time to start thinking about it. Flu season runs from November to April. Most cases hit between the end of December and early March. You can usually get the vaccine starting in September. It’s best to do it as early as possible so you can head off any infections “at the pass.” Getting the flu shot early gives your body time to build up immunity. This means it will protect you better against the flu.

If you haven’t gotten the vaccine by February or so, or if it hasn’t been available for some reason, still go ahead and get it when you can.

Decoding over-the-counter (OTC) cough & cold medication

It’s that time of year again! The sniffles and sneezing, stuffy head, and congestion are all back. No one is safe in any age group – from infants and toddlers to 100 year old centurions. As you look through the aisles of your local pharmacy, you will see a wall somewhere about 30 feet long full of all different color boxes full of tablets, liquids, sprays, teas, and other products claiming to be able to get you better. The interesting fact is that some of these medications have the exact same ingredients in them or are made up of different combinations that do the same thing just the price is different.

If coughing is your issue there is really just 1 over the counter to slow it down. Its called dextromethorphan. It can be found in Delsym and anything that ends in “DM” such as Mucinex DM, Robitussin DM, etc. It does take 30-45 minutes to start working but will last 12 hours or so. In different products, there is different amount so be careful win the dosing.

Do you have mucus that needs to be broken up in the head, sinus, or chest? There is only 1 product that will help: guaifenesin. It can be found in combination products as well as all by itself in the familiar blue box of Mucinex. It helps to drink water with this medication 4-8 ounces as it will help produce the benefits of breaking up the mucus.

 In all the cold and flu medications, you will find something to relieve aches, fever, or pain. One of the following 4 ingredients will be used; however, acetaminophen is the most common. Acetaminophen, Aspirin, Ibuprofen, or naproxen can be used to reduce aches, fevers, or pain. Just be careful if already on a blood thinner such as coumadin as you should avoid all the other ingredients except acetaminophen.

If you have congestion and need to reduce pressure in your sinuses or stop a post nasal drip, but don’t have high blood pressure then you can use phenylephrine. If you prefer a nasal spray you can use oxymetazoline (Afrin). Sudafed (pseudoephedrine) is still available over the counter; you just have to get it at the pharmacy counter and will require a government issued ID since the Patriot Act in 2001 in an effort to decrease methamphetamine production.

So, you’re experiencing congestion but have high blood pressure? This is the solution for you – as well, it can be used if experiencing excess drainage from your nose. A post nasal drip can also run down your throat and cause it to become dry, itchy, and inflamed. A way to reduce this is to use an antihistamine. There are 2 generations or types, the ones that make you drowsy and the ones that don’t. Loratadine (Claritin), Cetirizine (Zyrtec), Fexofenadine (Allegra), Chlorpheniramine (Chlor-Trimiton) all will not make you drowsy due to their chemistry and the inability of them to get into the brain. Diphenhydramine (Benadryl) and Doxylamine are in the other category and will cause some level of sedation/ drowsiness to occur. Although, sometimes this is the preferred side effect in night time formulations.

We hope this helps you decode the cough and cold aisle a little bit to help you get better and relieve those pesky symptoms. As always if you have questions ask your pharmacist about drug interactions with your prescriptions or what would work best to help clear up the symptoms that you are experiencing.

Getting Sick While Traveling

December 2, 2014

By Eric Borgeson, Pharm.D

Considering traveling abroad? You may want to read this first..

After a recent trip to the Dominican Republic with my wife and 2 kids, I realized how unprepared we really would be if a medical problem was to occur to one of us. My kids are 9 months old and 23 months old. We hope you take our advice – even though it may seem excessive at times, you could be lauded as a hero in the event anyone needs anything.

Fever:

Thermometer – we always have an ear thermometer for the kids (it can be used on adults as well). They are small, compact and only take about 5 seconds to get a reading as compared to the oral ones which take longer. It can be difficult to get a reading with finicky kids, as well. It is good to have – as even though a person does feel hot, they may not actually be running a fever. We recommend the Braun Thermoscan which retails for about $49.

Non-prescription therapies include cold compresses to the forehead and neck, lukewarm to cold showers/baths.

Tylenol (Acetaminophen) – If someone has a fever, Tylenol is usually the first thing that comes to mind to help reduce it. Dosing can be every 4 hours to bring the fever below 100 degrees. It can also be used for aches and pains.

Motrin, Advil (Ibuprofen) – The best other fever reducer and reduces inflammation. This can be dosed every 4 hours along with Tylenol to help break a fever. For example: dose Tylenol at noon, Advil at 2pm, Tylenol 4pm, Advil 6pm, Tylenol 8pm, Advil 10pm if necessary.

Aleve (Naproxen) – This can help adults reduce fevers and reduce and inflammation in their joints if after long hikes. It can also be used for headaches. There is no child strength Aleve.

Nausea and vomiting:

Treating nausea with non-prescription therapies include ginger root – drinking ginger ale can help as well as a bland diet (saltine crackers, dry toast, eggs, peanut butter, and vegetables).

Antivert, Bonine (Meclizine) – This medication helps with dizziness as well as nausea and vomiting. In addition, it can help with motion sickness caused by planes, boats, and cars. It is available over the counter without a prescription

If you have a propensity for getting nauseous the doctor may prescribe a few other medications to help you out such as promethazine or Zofran.

Diarrhea:

Diarrhea is a self-limiting condition meaning it will go away on its own – however, usually it is inconvenient. Be sure to keep hydrated, as loss of fluids and electrolytes is the biggest problem. If it persists for more than 3 days, you should see a doctor as it may be something else such as traveler’s diarrhea which would require an antibiotic for 3 days to treat. For most cases you can try the BRAT diet in hopes of adding binding ingredients to stop the loose stools. BRAT stands for Bananas, Rice, Applesauce, and Toast. It is excellent at restoring electrolytes lost. Other considerations are Lomotil which is over the counter. It can be taken to stop diarrhea for a few hours at a time – sometimes longer. It is taken 2 tablets after the first loose stool then 1 a time after each loose stool up to 4 tablets per 24 hours. Pepto Bismol may also be used in adults over 18. It can help alleviate many symptoms of intestinal upset. It comes in both tablet and liquid form.

We hope this helps you prepare for your adventures abroad and helps give you piece of mind in case of any medical issues arise.

Numbness, Tingling, Loss of Appetite

November 10, 2014

Do you suffer from numbness, tingling, loss of appetite, headaches, fatigue, weakness, nausea and vomiting, muscle cramping, seizures, coronary spasms, abnormal heart rhythms, or restless legs? These may be signs of magnesium deficiency. You could be 1 of the 80% of Americans who are lacking this important mineral. The reason magnesium is important is because it is found in over 3500 processes in the body – from making your heart beat, to energy creation, to proper formation of bones and teeth.

Correcting one’s magnesium levels could possibly help a number of medical conditions. So far, over 100 health benefits have been found by correcting it. Some of the ailments it may help are: fibromyalgia, atrial fibrillation, Type 2 diabetes, migraines, and restless leg syndrome.

So where can you get magnesium, you may be wondering? Some of the usual sources include: green leafy vegetables (such as swiss chard and spinach), and seeds such as pumpkin, flax, almond, sunflower, & sesame.

If none of these dietary options appeal to you, then there are supplements available over the counter in your local pharmacy or nutrition shop. There are many different forms of magnesium – not all of which are created equal. Each form has its own function in the body. Some will work as supplements, while others work as laxatives and stool softeners.

Magnesium citrate is available, however it is used more as a laxative for pre-colonoscopy procedures then as a supplement. Magnesium sulfate and magnesium hydroxide are found in milk of magnesia and are used as a laxative as well for overnight relief of constipation. Magnesium carbonate contains 45% magnesium and has antacid properties similar to Rolaids. It will not help supplement your magnesium level.

Enough of what won’t work as a supplement – here’s what will!

The most common form is magnesium oxide. The downside is that only 1% of magnesium oxide is able to be used by the body. That’s right: of the 400mg dose you are taking, only 4mg is actually getting in your body to work its magic. Magnesium chloride and lactate are a suitable alternative to magnesium oxide. They contain only 12% magnesium but with better absorption than the oxide variety, they are good to have. Not usually sold in most stores, magnesium chelate is highly absorbable and has high availability for your body to use to improve your magnesium levels. The best form of magnesium to take is glycinated. Glycinated magnesium has some of the highest levels of absorption and availability for your body to use. It is the ideal form of magnesium to bring your body’s level back into balance from its deficit.

If you have any questions about this or any other supplements feel free to call us at Jersey Shore Pharmacy Monday through Friday from 9am – 7pm or Saturday 9am-4pm
@ 609-660-1111.