Podcasts about benicar

Nadine spent 17 years working as a nurse in the ER. She holds a membership in the Emergency Nurses Association, as well as a Certified Emergency Nurse certification. During the course of her career, Nadine obtained ACLS, PALS, NALS, ENPC and TNCC certifications, honing her skills in advanced cardiac life support, neonatal advanced life support, pediatric advanced life support, and trauma. Despite this impressive background and experience, she had never been educated about celiac disease, and didn’t know what to look for until she was diagnosed herself. Nurses are in a unique position to recognize potential celiac patients and act appropriately. Though most nurses don’t have the authority to diagnose, they do have an obligation to act as patient advocates. Because celiac disease is the most underdiagnosed and misdiagnosed autoimmune disease in the world, it is important that nurses get educated about the fundamentals of celiac disease, the wide array of symptoms an undiagnosed patient may present, and how to keep celiac patients safe in and out of the hospital. Today on the podcast, the Gluten Free RN addresses nurses, explaining how celiac disease damages the GI tract, the consequences of a ravaged immune system, and the neurological nature of the disease. She also reviews the genes that indicate a predisposition to celiac disease, the best available tests for gluten sensitivity, and the need for a worldwide mass screening. This is a must-listen for medical professionals, offering an overview of the most current celiac studies and an explanation of how to approach doing research on your own. Celiac disease is on the rise and it doesn’t discriminate, so it is crucial that the nursing community get educated – STAT. What’s Discussed:  Why nurses need to employ a high index of suspicion regarding celiac disease Most undiagnosed and misdiagnosed autoimmune disease in world  The lack of training around celiac disease in the medical community Nadine was nurse for 17 years Didn’t know symptoms of celiac disease Diagnosed ‘by accident’  The celiac symptoms Nadine thought to be ‘normal’ Canker sores Intermittent constipation, diarrhea Eczema on hands Difficult time gaining weight Whole family had gas  What nurses need to know about celiac disease What it is, what it entails Symptoms may present with How to keep patients safe (in and out of hospital) How to request testing How to interpret lab results  How long it takes to receive celiac diagnosis in US 9-15 years  The restrictions of being a nurse Can’t diagnose (can recognize, treat appropriately) Can’t perform surgery Can’t prescribe meds, take patient off medication  Nadine’s experience leading up to her celiac diagnosis  Nadine’s celiac diagnosis Dermatologist diagnosed Blood test, skin biopsy negative HLA-DQ2.5 gene carrier (super-celiac category)  Why a negative blood test, skin biopsy doesn’t rule out celiac disease  Nadine’s current health  Why Nadine stopped working as an ER nurse Celiac diagnosis was life-changing Started own businesses RN On Call, Inc The Gluten Free RN Celiac Nurse Consulting  The increased prevalence of mortality in undiagnosed celiac patients Undiagnosed celiac disease associated with 4-fold increased risk of death (45 years of follow-up) Prevalence of undiagnosed celiac disease has increased dramatically in US over last 50 years  The grains that contain gluten Wheat Barley Rye Oats (cross-contamination)  The products that may contain gluten Medication Food Personal care products  The search terms to use when doing celiac research Gluten-related disorders Both spellings (celiac, coeliac)  Why celiac disease is primarily a neurological disorder Involves enteric nervous system (in intestines) Vagus nerve (superhighway of information from intestines to brain)  Why celiac disease is not an allergy Allergy is IgE-mediated antibody response Celiac tends to be IgA, IgG-mediated antibody responses  The genes that indicate a predisposition to celiac disease HLA-DQ2 HLA-DQ8  Why Nadine advocates for a world-wide mass celiac screening  The relationship between celiac disease and infertility People with infertility issues, difficulty maintaining pregnancy should be tested  The chronic nature of celiac disease Never goes away Gluten is neurotoxin Must be 100% gluten-free for life  How gluten exposure presents for Nadine Blisters in mouth within 10 minutes  How gluten can cause damage along entire length of GI tract 28 to 32 feet in length Person-to-person variability  How damage to GI tract presents Canker sores Difficulty swallowing, dysphasia GERD Eosinophilic esophagitis Gas, bloating Diarrhea constipation Crohn’s disease Atypical diseases Idiopathic diseases Ulcerative colitis Diverticulitis Diverticulosis Rectal cancer Bowel cancer Hemorrhoids  How constipation can be a neurological issue Gluten as neurotoxin can paralyze nervous system, intestines Stool cannot get pushed through Can result in colon cancer, megacolon  Disorders that may be caused by undiagnosed celiac disease Diabetes Heart problems Sudden cardiac deaths Strokes Bowel, rectal cancer (recent increase in young people)  Why a biopsy is no longer considered the gold standard of celiac testing Positive anti-tissue transglutaminase and positive EMA indicates damage to intestines Endoscopist should take six to 15 samples in duodenum, jejunum (damage can be patchy)  The stages of intestinal damage caused by celiac disease Marsh 1 – microvilli destroyed Marsh 2, 3 – villi themselves fall over, blunt or atrophy Marsh 4 – looks like hot, inflamed sponge and immune system compromised  The consequences of a damaged immune system Hypo-responsive (doesn’t respond) Hyper-responsive (reacts to everything)  The importance of including a total IgA and IgG in the celiac antibody panel Ensure patient is not IgA deficient  How the US has gone backwards in the last 70 years Times article from 1950 declares ‘cures certain in 90% of cases’ and ‘deaths rare’ Celiac disease has gone unrecognized since then  The testing for celiac disease Celiac antibody test (baseline) Small intestinal biopsy Nutritional panel (D3, B6, B12, magnesium RBC, zinc, ferritin) Follow-up to track healing, ability to absorb nutrients  The difficulty with the celiac antibody test 70% false negative  The best available celiac testing EnteroLab Gluten Sensitivity Stool Test Cyrex Laboratories Array 3  Factors that might interfere with accurate celiac testing IgA deficiency Benicar (blood pressure med) known to cause villous atrophy in absence of celiac disease Lab-to-lab variability Only tests for anti-tissue transglutaminase 2  How to carry out a clinical trial for celiac disease or gluten sensitivity Adopt gluten-, dairy-free diet for at least three months It takes six months to a year for intestines to heal Recommended for patients with genetic predisposition, regardless of negative blood test  The Paleo diet Nadine suggests for celiac and gluten-sensitive patients Whole food Meat, fish and eggs Nuts and seeds Fruits and vegetables  The findings of a celiac study published in the Journal of Insurance Medicine Atypical, non-diarrheal presentations now most frequent Celiac disease is grossly underdiagnosed in US Average delay in diagnosis for adult patients ranges from four to 11 years Diagnosis and treatment with gluten-free diet leads to improved quality of life Medical costs in celiac cohort were 31% lower over three-year period  Why celiac disease should be on every primary care physician’s differential diagnosis  The rise of celiac disease 1:501 in 1974 1:219 in 1989 1:100 is current estimate Doubles every 15 years (according to Mayo Clinic)  Why Celiac disease is a worldwide issue Affects every ethnicity Frequency of tTGA in Mexico City study was 1:37 Increasing diagnoses in North Africa, Middle East and Northern India  How celiac disease can lead to obesity Patient cannot absorb nutrients (malnourished) Body responds by storing fat for cheap energy  How the risk of cancer increases exponentially in undiagnosed celiac patients  Why nurses must be patient advocates  Nadine’s advice around research and celiac disease for nurses Not taught in nursing programs Do your own research to keep up with current info Resources: Snarky Nurses  on Instagram National Nurses in Business Association “Increased Prevalence and Mortality in Undiagnosed Celiac Disease” in Gastroenterology PubMed Cyrex Laboratories EnteroLab New York Times Article, May 1950 “Economic Benefits of Increased Diagnosis of Celiac Disease in a National Managed Care Population in the United States” in the Journal of Insurance Medicine “Celiac Disease Could be a Frequent Disease in Mexico: Prevalence of Tissue Transglutaminase Antibody in Healthy Blood Donors” in the Journal of Clinical Gastroenterology “Celiac Disease in African-Americans” in Digestive Diseases and Sciences “Coeliac Disease” in The Lancet Connect with Nadine:  Instagram Facebook Contact via Email ‘Your Skin on Gluten’ on YouTube Melodies of the Danube Gluten-Free Cruise with Nadine Books by Nadine: Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism

You'll see more top-selling drugs go generic in 2016. But don't expect drastic price drops initially...the first generic usually has 180-day exclusivity before other generics come out. Prepare patients for these switches. Explain these are best-guess release dates...they can change due to legal maneuverings, etc. OxyContin (oxycodone ER)...available now. But advise patients generics are only out for the 10, 20, 40, and 80 mg tabs so far. Gleevec (imatinib)...February. This could be a game changer for certain leukemias...since the brand costs about $10,000/month. Crestor (rosuvastatin)...May. This is big...it's the only high-intensity statin besides atorvastatin. Consider rosuvastatin if interactions or muscle problems are an issue with atorvastatin. Nuvigil (armodafinil)...June. Explain armodafinil may last longer than modafinil...but there's no proof it's better or safer. Suggest either option for shift workers if nondrug treatments (sleep hygiene, etc) and caffeine aren't enough. Benicar (olmesartan)...October. It will join a handful of other generic ARBs. Pick one based on payer preference. ProAir HFA (albuterol)...December. Explain this generic will NOT be equivalent to Ventolin HFA, Proventil HFA, or ProAir RespiClick. Encourage prescribers to write "albuterol HFA" to give you flexibility. Zetia (ezetimibe)...December or early 2017. Suggest saving ezetimibe as an add-on for high-risk patients who can't tolerate a high-intensity statin. For patients on Vytorin, consider suggesting generic ezetimibe plus a generic statin instead...at least until Vytorin goes generic. Also look for Basaglar in late 2016. It's a new BRAND of insulin glargine that will be similar to Lantus...NOT a generic or biosimilar.

AIR DATE: February 16, 2012 at 7PM ETFEATURED EXPERT: FEATURED TOPIC: “All Things Lipids (Cholesterol 101)” Episode 6 of “Ask The Low-Carb Experts” features the topic “All Things Lipids (Cholesterol 101)” with blogger and doctoral candidate in Nutritional Sciences at the University of Connecticut  where he will be graduating this Spring. He is the creator and maintainer of Cholesterol-and-Health.Com and is the author of two blogs, The Daily Lipid at Cholesterol-and-Health.Com and Mother Nature Obeyed at WestonAPrice.org. He is also a frequent contributor to Wise Traditions, the quarterly journal of the Weston A. Price Foundation. Chris is the author of five publications in peer-reviewed journals, including a letter to the editor of the Journal of the American College of Cardiology criticizing the conclusions of a widely publicized study about the effect of saturated fat on blood vessel function, and letter to the editor of the American Heart Journal arguing that the effect of cholesterol ester transfer protein inhibitors on vitamin E metabolism should be studied before these drugs are deemed safe for preventing heart disease, a hypothesis published in Medical Hypotheses about the molecular mechanism of vitamin D toxicity and the involvement of vitamins A and K in this mechanism, a pilot study in humans suggesting that vitamin E protects against some of the negative effects of sugar consumption published in the Journal of Nutritional Biochemistry, and a review published in Nutrition Reviews about the potential for green tea to prevent or treat nonalcoholic fatty liver diseases. Chris Masterjohn has thoroughly studied the impact of cholesterol on your health and the answers he has discovered might just surprise you. If you have questions about cholesterol, HDL, LDL, triglycerides and more then this is the podcast for you. Here are some of the questions Chris addressed in this podcast: DARREL ASKS:My cholesterol has been high for quite a while. I was previously on Lipitor which made me feel pretty bad (old and feeble even though I’m neither) so I quit. This week my doctor got back my blood work and noticed my number was high (295) and insisted I go back on Lipitor. He said I was a ‘heart attack brewing’. I don’t want to and need some ammunition. Point me in the right direction. MARK ASKS:I have a senior lady that her doctor has recommended her to take statins for a while. She doesn’t want to go on them, and her doctor just ran an Lp(a) test and hers was at 80. I seem to recall that statins don’t really affect Lp(a) and it’s mostly genetic. I’m not sure of her triglyceride/HDL ratio at this time, but should she be worried? Seems that Lp(a) is only an issue if you have heart disease or a lot of inflammation. JOHN ASKS: http://diabetes.diabetesjournals.org/content/early/2011/05/18/db11-0085 Question: Is MGmin LDL the silver bullet of atherosclerosis? I’ve read suggestions that small, dense LDL is the killer, but I see studies suggesting that large, fluffy LDL can also be atherogenic. JAMIE ASKS:In some countries (like Australia) you cannot get your cholesterol measured down to “small dense” and “large fluffy”. They only measure the basics, Triglycerides, HDL, LDL and Total cholesterol. From these numbers, is there a good ratio to indicate good health versus poor health? SHARON ASKS:My husband has high cholesterol which is made worse by another necessary medication he takes. Triglycerides were over 700; he is taking very high doses of statins, bring it to 600; We started Paleo (no sugars; no grains; full-fat dairy and meats) and blood results after two weeks showed them at 199. Is this possible to have such a dramatic change so quickly from this diet? If followup blood work shows continued improvement, what is the number that would get his doctor to take him off of the statins? SAM ASKS:I’m a 42-year-old male with little to no family history of heart disease. My latest VAP results include: Tot LDL-Chol Direct 167 H mg/dLTot. HDL-Cholesterol Dir. 52 mg/dLTot. VLDL-Cholesterol Dir. 23 mg/dLSum Total Cholesterol 241 H mg/dLTriglycerides-Direct 75 mg/dLTot. NonHDL Chol(LDL+VLDL) 189 H mg/dLTotal apoB100 – calc. 118 H mg/dLLP(a) Cholesterol 4.0 mg/dLIDL Cholesterol 23 H mg/dLReal LDL-Cholesterol 140 H mg/dLSum Total LDL-C 167 H mg/dLREAL-LDL Size Pattern A ARemnant Lipoprot(IDL+VLDL3) 37 H mg/dL My doctor insists I take a statin such as Lipitor. I say I may not need it. Which one of us is right? Also, is it possible that statins inhibit the formation of arterial plaque over time? PAUL ASKS:What are your thoughts on all the alarmism surrounding glycation and fructation? KAREN ASKS:I’m about to have blood work done to be underwritten for term life insurance. I’m concerned that my cholesterol levels may have elevated because I’ve only been LC’ing for about 9 months. If it comes back bad, do you have any advice for how to explain what’s going on to help mitigate the consequences? LEO ASKS:It’s been almost 2 years since going low carb. Before that time I was taking fenofibrate for almost 8 years because of very high trig (700 -380) and low HDL (37) because of eating SAD. Now my trig is 100 – 75, HDL is 57 and still improving without taking meds. I read that eating saturated fat and red wine will help increase HDL. At my last doctor visit he suggested in begin statins because my total cholesterol was 250 and my LDL was 148 and to see a cardiologist. I asked that he do the test for determining large and small LDL particles to which he replayed he was not qualified to request that test! I also mentioned to him that the LDL level is really a fictitious number gathered by the Friedewald equation. Would you suggest I see a cardiologist and check further? Would it be a good idea to request a CAC score, Lp(a) and test for density particles of LDL? WILLY ASKS:How are you? My question is what is Lp(a)’s role in heart disease and should we really even track it. As I recall Dr. Kurt Harris from the panu blog has what is considered a high level yet has a very low calcium score. While some on Dr. Davis heart scan blog have levels lower than his and suffer from high calcium scores or other cardiovascular issues. If we should be concerned with this lipid what is the best way to lower it? Niacin? Saturated Fats? Low Carb? I wonder if Lp(a) is just the new kid on the block for Big Pharma trying to keep the lipid hypothesis alive. VALERIE ASKS:Chris, In your most recent interview with Chris Kresser you indicate that a TC:HDL ratio of 4 might be cause for concern and should be evaluated. My husband and I just got our results back, our ratios are 4.3 and 4.6. We can rule out recovering from obesity and fatty liver disease. What do you advise we do if anything? Get retested to establish our averages? Without going into too much detail, we have been following a WAPF/Paleo diet for 4 years, we are healthy and fit, I am 47, my husband is 40. Next, I have in my notes a TC range of 180-250 as found in traditional cultures. Can you also provide a range for HDL and LDL? And last, what foods, herbs, supplements, and food preparation techniques would you advise to support a healthy LDL receptor uptake process? KYLE ASKS:There seems to be a growing interest in the blogosphere with the work of Dr. Ray Peat. A major tenet of Peat’s philosophy revolves around the toxicity of virtually any dose of polyunsaturated fats (PUFA)–both n3 and n6. Given your past work on EFAs and PUFAs in general, I’d love to hear your thoughts on Dr. Peat’s stance. LUKE ASKS:What is the relation of lipid volume in the blood and speed of blood flow in the arteries and the body in general? (e.g, the documentary “Supersize Me” made a big deal about animal fat causing slower measured blood flow) ELLEN ASKS:I believe higher cholesterol levels are healthier and protective against many illnesses. If my normal total cholesterol is around 205, and I make a diet change that has the effect of dropping my total cholesterol to 165, am I compromising the protective aspect of cholesterol? LDL is also lower at 92 and HDL has stayed about the same (55). Trigs are at 92. CRP is .75 and HbA1c is 5.5. MACKAY ASKS:Patient just came back with very high cholesterol, but sub markers were phenomenal. HDL 99Triglycerides 66HSCRP .4 Positive for celiac, although eats very little wheat. Total cholesterol 450. What could cause this? EDWARD ASKS:Regarding lab measurements…lipid panels: Cholesterol measurement – what is actually being measured in standard lipid profiles, and what is being estimated? Is LDL calculated based on your TG measurement? DEANNA ASKS:My stepdad has high cholesterol (mostly high Triglycerides) and has for many years—I have attached his lab report from last May—his numbers were better. Total cholesterol 252Triglycerides 534HDL 33Testosterone 235Free testosterone 8.9 He takes: 160mg Fenofibrate, Benicar, Lovaza, DHEA, Niacin, and just started taking Red Yeast Rice. My mother thought he was on a statin—but Fenofibrate and Lovaza aren’t statins are they? Are they just as bad? Haven’t heard much discussion on these meds. Filed Under: , ,