Top10MD Blog

SCIENTISTS PREDICT LYME DISEASE TO SURGE THIS YEAR

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With kids heading off to camp this summer and families headed to the mountains or camping outdoors ticks can be a problem if not a life-long problem if infected with Lyme Disease or other tick related diseases. “It’s a good idea to take preventive measures against ticks year-round, be extra vigilant during the months of April-September when ticks are most active,” says Dr. Jeffery West Ticks transmit over ten diseases to humans and pets. Some of these diseases can be debilitating for the rest of you or your child’s life; it’s important to seek immediate care. Early recognition and treatment decrease the risk of serious complications later on.

Approximately 300,000 people in the United States are diagnosed with Lyme disease yearly; while only 30,000 of these are estimated to be reported to the CDC by state health departments. Ninety-six percent of Lyme disease cases come from 13 states.

HOW TO PREVENT LYME DISEASE

  • Avoid direct contact with ticks
  • Avoid wooded and brushy areas with high grass and leaf litter
  • Walk in the center of trails

REPEL TICKS TO PREVENT LYME DISEASE

  • Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.
  • Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings. Pre-treated clothing is available and may be protective longer.

FIND TICKS FROM YOUR BODY

  • Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs.
  • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.
  • If the clothes are damp, additional time may be needed.
  • If the clothes require washing first, use hot water. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.

HOW TO REMOVE A TICK

  • Remove the tick as quickly as possible, do not wait for it to detach.
  • Use a fine-tipped tweezers. Grasp the tick as close to the skin as possible, and pull straight up with steady pressure. Then thoroughly clean the bite (and your hands) with rubbing alcohol and soap and water.
  • Kill the tick without touching it and throw it away. If you develop a rash or fever following exposure, see a doctor immediately.

SYMPTOMS OF LYME DISEASE & TICK ILLNESSES

  • Fever/chills: With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
  • Aches and pains: Tickborne disease symptoms include a headache, fatigue, and muscle aches. With Lyme disease, you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient’s personal tolerance level.
  • Rash: Lyme disease, southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, and tularemia can result in distinctive rashes:
    • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
    • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding “bull’s eye” lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any arthritic or neurologic symptoms.
    • The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of individuals with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted (petechial) rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
  • In the most common form of tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
  • 30% of patients and up to 60% of children, ehrlichiosis can cause a rash. The appearance of the rash ranges from macular to maculopapular to petechial and may appear after the onset of fever.

Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decrease the risk of serious complications. Seek medical advice immediately if you have been bitten by a tick and experience any of the symptoms described here.

PATHOGENS TICKS CARRY THAT CAN CAUSE DISEASES

  • Anaplasmosis is transmitted to humans by tick bites primarily from the blacklegged tick.
  • Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of babesiosis are caused by Babesia microtiBabesia microti is transmitted by the blacklegged tick.
  • Borrelia mayonii infection has recently been described as a cause of illness in the upper Midwestern United States. It has been found in blacklegged ticks. Borrelia mayonii is a new species and is the only species besides B. burgdorferi known to cause Lyme disease in North America.
  • Borrelia miyamotoi infection has recently been described as a cause of illness in the U.S. It is transmitted by the blacklegged tick and has a range like that of Lyme disease.
  • Colorado tick fever is caused by a virus transmitted by the Rocky Mountain wood tick. It occurs in the Rocky Mountain states at elevations of 4,000 to 10,500 feet.
  • Ehrlichiosis is transmitted to humans by the lone star tick, found primarily in the south central and eastern U.S.
  • Heartland virus infection has been identified in eight patients in Missouri and Tennessee as of March 2014. Studies suggest that Lone Star ticks may transmit the virus. It is unknown if the virus may be found in other areas of the U.S.
  • Lyme disease is transmitted by the blacklegged tick in the northeastern U.S. and upper Midwestern U.S. and the western blacklegged tick along the Pacific coast.
  • Powassan disease is transmitted by the blacklegged tick and the groundhog tick. Cases have been reported primarily from northeastern states and the Great Lakes region.
  • Rickettsia parkeri rickettsiosis is transmitted to humans by the Gulf Coast tick.
  • Rocky Mountain spotted fever (RMSF) is transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. The brown dog tick and other tick species are associated with RMSF in Central and South America.
  • STARI (Southern tick-associated rash illness) is transmitted via bites from the lone star tick, found in the southeastern and eastern U.S.
  • Tickborne relapsing fever (TBRF) is transmitted to humans through the bite of infected soft ticks. TBRF has been reported in 15 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming and is associated with sleeping in rustic cabins and vacation homes.
  • Tularemia is transmitted to humans by the dog tick, the wood tick, and the lone star tick. Tularemia occurs throughout the U.S.
  • 364D rickettsiosis is transmitted to humans by the Pacific Coast tick. This is a new disease that has been found in California.

Dr. Jeffery West is a Rockwall Otolaryngologist specializing in allergies and ENT surgery. Board Certified by the American Board of Otolaryngologists, Dr. West is Medical Director of Lakeside Allergy ENT with offices in Rockwall, Forney, and Wylie Texas. Named Top10MD in 2016 – an honor only 1-in-3 doctors succeeds within the United States. To schedule a consultation with Dr. Jeff West, click on his profile or call his office at 972-398-1131.

SOURCE: https://www.cdc.gov/ticks/avoid/on_people.html

IMAGE: Shutterstock


DIABETES | THE SUGAR STRUGGLE

 1 year ago    Leave a comments (0)



Although diabetes is an extremely common disease, nearly 28% of the population does not know they have it. This is a very high percentage and a sad statistic. Sometimes people are not diagnosed until they fall into a diabetic coma. When it comes to diabetes, it is important to know the symptoms and risks. There is not one type of diabetes but many. Even understanding the different types can help you understand the treatment as well as the possible cures.

We hear the term sugar diabetes, but that is redundant. Diabetes is a disease that leads to too much sugar in the blood. Whenever you eat, your body processes the food by breaking it down into its different components. Most foods have sugar in them. The more sugar you eat, the more that will end up in your bloodstream. Sugar levels that are too high can be very dangerous and lead not only to negative symptoms but also other serious diseases. Two main mechanisms can cause diabetes. The first mechanism is the body’s inability to produce insulin. Insulin is the hormone that takes the sugar out of the blood and restores it to normal levels. When the body is not making enough insulin, your sugar levels are too high. The second mechanism is the body’s inability to process the sugar properly. There is no insulin problem, but the body just does not handle sugar.

Whenever there is a malfunction in insulin, you are considered to have Type 1 Diabetes. If there is a malfunction in sugar processing, you are regarded as having Type 2 Diabetes. Gestational diabetes is also common but among pregnant women. With gestational diabetes, you may only have diabetes while pregnant. This occurs when the body cannot make enough insulin support the increase sugar levels due to the baby. Normally after giving birth, the sugar levels return to normal.

If you know the symptoms of diabetes, you can prevent it before it starts. When you are experiencing symptoms, you may already be in the prediabetes stage. It is important to get control now before you are diagnosed with Type 1 or Type 2 Diabetes.

Early Symptoms Include

  • Blurred Vision
  • Dry mouth
  • Fatigue
  • Increased Hunger
  • Increased Thirst
  • Increased Urination
  • Numbness

A lot of times we do not pay attention to these symptoms. We just think it is temporary. If you notice these symptoms are ongoing, you should see a physician and have a blood test as soon as possible. If you ignore these symptoms, diabetes can get out of control leading to neuropathy, slower healing processes and a greater risk of yeast infections.

Diabetes is nothing to joke about. It is very serious, and when left uncontrolled, it can be deadly. So many people ignore the signs and end up in the hospital. Getting an early diabetes diagnosis can help you manage the disease better. Just changing your diet can cure Type 2 diabetes. Eating a healthy diet and exercising can help prevent diabetes. If you notice you are having symptoms, make an appointment with your doctor as soon as possible. Get control of your diabetes and you can get control of your life.

Dallas Vascular Surgeon Dr. Gregory Pearl is board certified by the American Board of Surgery in General Vascular Surgery and a Fellow of Peripheral Vascular Surgery. Dr. Pearl is named Top10MD – 1-in- 3 doctors succeeds with this recognition in the United States. To schedule a consultation with Dr. Pearl link to his profile or call his office today 214-821- 9600.


PARKINSON’S DISEASE & MUHAMMAD ALI

 1 year ago    Leave a comments (0)



With great sadness, a legend of his own Muhammad Ali passed away at the age of 74 fighting a battle he could not win Parkinson’s disease. Ali had suffered from the disease since the early 80’s. As a three-time World Heavyweight Champion boxer, he retired and committed his life to philanthropy and social activism. Did boxing contribute to Ali acquiring Parkinson’s disease? Medical professionals and researchers still do not know, as the cause is unknown and there is no cure.

Parkinson’s disease is a chronic and progressive movement disorder with over one million people in the United States suffering from it, and approximately 60,000 people are newly diagnosed each year. The onset of this disease usually begins around the age of 60.

The disease affects neurons in an area of the brain called substantia nigra; this area of the brain controls a person’s movement and coordination. For an unknown reason, the malfunction and death of neurons lower a person’s dopamine levels; thereby, reducing their ability for correct movement and coordination.

Symptoms of Parkinson’sParkinson's Disease and Neurons

  • A slowness of movement
  • Tremor of the hands, arms, legs, jaw and face
  • Stiffness of the limbs and trunk
  • Impaired balance and coordination

Treatment Options for Parkinson’s

  • Medication
  • Surgery to manage symptoms

New Treatment Options for Parkinson’s

A breakthrough procedure where cutting edge stem cells is being utilized and  administered either intravenously or subcutaneously- under the skin in patients with Parkinson’s Disease.

 

If you are showing symptoms of early Parkinson’s disease contact a Top10MD Internist today and schedule an initial evaluation.

 

For more information visit the American Parkinson’s Disease Association.


GOUT AND THE BIG TOE

 1 year ago    Leave a comments (0)



Gout is a common and treatable form of Arthritis affecting more than 2 million Americans caused by deposits of uric acid — a white, odorless crystal that accumulates in the body and causes redness and swelling of the joints. Attacks come on suddenly and are painful, lasting 3 to 10 days. Most people believe Gout only affects the big toe. Though Gout is common in the big toe, it often affects other areas. 

Gout Can Affect

  • Ankles
  • Big Toe
  • Elbows
  • Fingers
  • Heels
  • Insteps
  • Knees
  • Wrists

Symptoms Include

  • Heat
  • Pain
  • Redness
  • Stiffness in joints.
  • Swelling

While occurring in men and women of all ages, it rarely occurs in women before menopause. One way to obtain a diagnosis of is to remove fluid from an affected joint and examine it for the presence of uric acid. The diagnosis can also be confirmed by clinical criteria and imaging studies. Finding an elevated uric acid does not mean you have gout. First, the uric acid level in the blood may be normal even when gout is present. Second, a high level of uric acid in the blood by itself does not necessarily signify the presence of gout.

Medications and diet may trigger gout attacks. Certain substances in drugs and food can increase levels of uric acid in the blood. Diuretics such as Lasix® and hydrochlorothiazide, which are used to treat high blood pressure and edema (fluid retention), can increase the risk of gout attacks. Aspirin also increases uric acid levels and can worsen attacks.

Foods with high purine levels also increase uric acid levels in the blood. So changing your diet may help to prevent attacks. Avoiding sweetbreads, herring, mussels and sardines can be helpful. So, too, can avoiding alcoholic beverages, especially beer, dark wines and champagne. Results of a study published in the New England Journal of Medicine indicate that a diet that includes dairy products and vegetables may help to prevent gout. Obesity and overeating or “bingeing” have been associated with gout, so maintaining a reasonable weight may also be a preventative measure.

If frequent gout attacks persist despite icing the area and elevating the joint, changes in medications or diet it may be time to visit a Rheumatologist to diagnose you accurately and prescribe medication to prevent flare-ups. These medications may include colchicine, Benemid® (probenecid) or Zyloprim® (allopurinol) or Uloric.

Dr. Scott Zashin is a respected and published Dallas Rheumatologist. He is dual board-certified by the American Board of Rheumatology and the American Board of Internal Medicine. Dr. Zashin is the Medical Director of Dallas Rheumatology. For more information on getting back to feeling great visit his website or call today to schedule your initial consultation 214-363- 2812.


ZIKA VIRUS AND SAFE SEX GUIDELINES

 1 year ago    Leave a comments (0)



The World Health Organization has released safe sex guidelines for those who are returning from Zika-affected areas. The report recommends doubling the abstinence time from having sex; the initially suggested four weeks to eight weeks. Scientists have come to this conclusion from finding that the Zika Virus lingers longer in blood and other bodily fluids than previously thought. To ensure your partner’s safety and the safety of a potential pregnancy, seriously consider the following recommendations.

What You Should Know About Zika

  • If you and your partner are trying to get pregnant, it’s crucial that you consider delaying pregnancy until the recommended abstinence time has passed.
  • If the male partner in a couple is planning pregnancy has symptoms of the Zika Virus, the period of abstinence is increased to six months.
  • Evidence points to male semen as the source of transmission between partners. It is important to practice safe sex by using a condom if your partner is currently pregnant or abstain from sex altogether for the remainder of the pregnancy.
  • Tests are still inconclusive as to how long the Zika Virus stays in the saliva.
  • For those living in Zika zones, it is important to continue your use of insect repellents such as DEET, covering up, and stay inside as much as possible.

Healthcare professionals are more concerned than ever about Zika Virus link to an epidemic of brain defects known as microcephaly. The Zika virus has now hit 52 countries to date according to the World Health Organization.

To learn more about Zika and how it can affect your unborn child, visit ZIKA or our blog.


FROM TOP10MD TO YOU…

 1 year ago    Leave a comments (0)

doctor


DIGESTIVE HEALTH: FACT VS. FICTION

 1 year ago    Leave a comments (0)



Myth 1: The More Fiber, the Better.

Tired of having bran cereal for breakfast, lunch, and dinner? Maybe it’s time to ease up. Most experts agree that you need to get 25-30 grams of fiber per day for good digestive health. It is difficult for many to reach 25. However, some aim to go above and beyond the recommended amount. Should we? No! Not only is reaching 25 grams an accomplishment in itself but going above and beyond can be troublesome for your gut. For people with conditions such as irritable bowel syndrome (IBS), the increase in fiber isn’t as important as the type of fiber. Research shows that insoluble fiber, like bran, may aggravate IBS symptoms. What is more important is an intake of soluble fiber such as psyllium that can offer a reduction in IBS severity. Either way, it is very important to increase fiber intake gradually (2-5 grams per day) to avoid discomforts such as gas, bloating, constipation, or diarrhea.

Myth 2: Nuts Lead to Diverticulitis

This is a common myth among people with diverticulitis. Diverticulitis is a condition in which pockets in the intestine become inflamed and irritated. If you have diverticulitis, you may have been told to avoid nuts, corn, popcorn, and food with small seeds. You may also have been told that these foods might worsen or even cause diverticulitis by lodging in pouches along your intestine. However, researchers have looked at the health records of more than 47,000 men and found no connection between these foods and diverticulitis. New studies suggest that people who eat a high-fiber diet have a lower risk of the disease, and the main culprit of diverticulitis is a low fiber diet.

Myth 3: You Will Know if You Have Cancer

There are usually no symptoms of colon cancer until its later stages. This makes early detection important with routine colorectal checks. Those at risk of colon cancer should start getting tested at age 50 through a CT scan of the colon, a colonoscopy, or a colonoscopy. Talk to your board-certified practitioner about which one is right for you.

Myth 4: Bowel regularity means a bowel movement every day.

The frequency of bowel movements varies from person to person. For some, three a day is regular and for some it is three a week. Perfectly healthy people can fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. If you have had a change in your frequency, it is best to speak to your practitioner to make sure there are no underlying issues.

Myth 5: Spicy Foods Cause Ulcers

Bring on the tabasco sauce and Texas chili! Hot sauce lovers you may now rejoice! People used to believe that too much spicy food would give you an ulcer. But now we know the majority of stomach ulcers are caused either by infection with a bacteria called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen. Spicy food (and stress) may exacerbate ulcer symptoms in some people, but they do not cause ulcers.


FIVE MYTHS ABOUT YOUR GUT

 2 years ago    Leave a comments (0)



Myth 1: The More Fiber, the Better.

Tired of having bran cereal for breakfast, lunch, and dinner? Maybe it’s time to ease up. Most experts agree that you need to get 25-30 grams of fiber per day. It is difficult for many to reach 25. However, some aim to go above and beyond the recommended amount. Should we? No! Not only is reaching 25 grams an accomplishment in itself but going above and beyond can be troublesome for your gut. For people with conditions such as irritable bowel syndrome (IBS), the increase in fiber isn’t as important as the type of fiber. Research shows that insoluble fiber, like bran, may aggravate IBS symptoms. What is more important is an intake of soluble fiber such as psyllium which can offer a reduction in IBS severity. Either way, it is critical to increase fiber intake gradually (2-5 grams per day) to avoid discomforts such as gas, bloating, constipation, or diarrhea.

Myth 2: Nuts Lead to Diverticulitis

Diverticulitis is a condition in which pockets in the intestine become inflamed and irritated. If you have diverticulitis, you may have been told to avoid nuts, corn, popcorn, and food with small seeds, which is a common myth. You may also have been told that these foods might worsen or even cause diverticulitis by lodging in pouches along your intestine. However, researchers have looked at the health records of more than 47,000 men and found no connection between these foods and diverticulitis. New studies suggest that people who eat a high-fiber diet have a lower risk of the disease, and the main culprit of diverticulitis is a low fiber diet.

Myth 3: You Will Know if You Have Cancer

There are usually no symptoms of colon cancer until its later stages, so early detection is important with routine colorectal checks. Those at risk of colon cancer should start getting tested at age 50 through a CT scan of the colon, a colonoscopy, or a colonoscopy. Talk to your board-certified practitioner about which one is right for you.

Myth 4: Bowel regularity means a bowel movement every day

The frequency of bowel movements varies from person to person. For some, three a day is regular and for some, it is three a week. Perfectly healthy people can fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. If you have had a change in your frequency, it is best to speak to a practitioner to make sure there are no underlying issues.

Myth 5: Spicy Foods Cause Ulcers

Bring on the tabasco sauce and Texas chili! Hot sauce lovers you may now rejoice! People used to believe that too much spicy food would give you an ulcer. But now we know the majority of stomach ulcers are caused either by infection with a bacteria called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen. Spicy food (and stress) may exacerbate ulcer symptoms in some people, but they do not cause ulcers.

 

FIND A TOP10MD GASTROENTEROLOGIST NEAR YOU

There are hundreds of Gastroenterologists to choose from; however, not all doctors are created equal. Gastroenterology takes the skill and finesse of an experienced Gastroenterologist. That’s why we’ve selected your city’s finest Gastroenterologists – to make your decision process easier.

For your peace of mind Top10MD Gastroenterologists’ credentials are validated yearly to verify medical licenses have no serious patient care sanctions, current Board Certifications in their given Medical Specialty, current DEA & DPS licenses and malpractice insurance. Top10MD’s have at least 5+ years experience and/or performed 300+ procedures in their given specialty and current Patient Satisfaction Score of 8.5 or higher.


AVOIDING SORE THROAT IN DRY WEATHER

 2 years ago    Leave a comments (0)



Though we may not experience very cold weather here in North Texas, if you travel for the holidays, here are some tips for maintaining throat health during colder, drier weather.

  1. Add Moisture to the Air – Running a humidifier at night helps keep congestion in the sinuses from drying out. This helps with your breathing and keeps the sore throat from showing up in the morning.
  2. Blow Your Nose – Blowing your nose can keep the congestion out of your sinuses, which also stops any drainage from dripping down to your throat.
  3. Drink A Lot Of Water – It’s just as important to keep your body hydrated in the winter as it is in the summer. Drinking water can break up the drainage, stopping a sore throat from occurring.
  4. Drink Tea With Honey & Lemon – Tea, honey and lemon numb and soothe throats.
  5. Take Vitamin C – While Vitamin C may not help soothe a sore throat, it will help fight off a potential cold if you notice symptoms coming.
  6. Rest Your Voice – If you woke up with a sore throat, avoid cheering, yelling or singing for a couple days or until you feel your throat isn’t sore.

Fort Worth Otolaryngologist Dr. Marc Dean is a Board Certified by the American Board of Otolaryngology and practicing full time in private practice. Dr. Dean specializes Otolaryngology/Head and Neck Surgery and conditions and diseases of the ear, sinus and disorders of the eustachian tube. Dr. Dean completed an Internship in General Surgery and his Residency at Louisiana State University Health Science Center, where he now serves as Assistant Professor in Otolaryngology/HNS. Dr. Dean is current President and CEO of the Otorhinologic Research Institute. Contact Dr. Dean today on his profile or call 817-332-4060. Dr. Marc Dean was named Top10MD 2015 / 2016. Only 1 in 3 doctors succeed with this recognition in the United States. 


I HURT ALL OVER – FIBROMYALGIA

 2 years ago    Leave a comments (0)



Low Dose Naltrexone or LDN is a new treatment for fibromyalgia and pain from other autoimmune/inflammatory conditions and its inexpensive! Dallas Rheumatologist Dr. Scott Zashin shares his thoughts.

Pain Free

Naltrexone HCL is an FDA approved medication that has been used for a long time to treat patients addicted to pain medications. In 2009, a small study was published by doctors at Stanford University (Younger and Mackey) showing that using very low doses of naltrexone helped relieve pain in patients with Fibromyalgia.

In this study, patients took 4.5 mg of naltrexone daily (50 mg is the standard dose used to treat narcotic addiction) and after 8 weeks they had reduced pain and fatigue. Other symptoms that often accompany fibromyalgia such as sleep problems, gastrointestinal complaints and headaches also improved. The authors followed up this study with a slightly larger randomized double blind placebo controlled trial published in Arthritis and Rheumatism 2013 and found that LDN had a beneficial effect on fibromyalgia pain and concluded that the medication is “inexpensive, safe and well tolerated. Additional studies were recommended to fully determine the efficacy of the medication.”

In a review published in the Clinical Rheumatology 2014 doctors Younger, Parkitny and McClain concluded that LDN is a promising treatment for not only fibromyalgia but chronic pain conditions that have inflammation. These include Chrohns disease, multiple sclerosis and CRPS (complex regional pain syndrome).They postulate that its benefit is due to its anti-inflammatory effect on the central nervous system via action on microglial cells.

Currently no pharmaceutical company manufactures naltrexone in the low doses used to help pain. As a result, your doctor will need to write you a prescription that you must take to a pharmacy that has expertise in compounding medications. Many of the larger pharmacies such as CVS and Walgreens will not offer this service. While the recommended dose is 4.5 mg, the starting dose may range anywhere from 0.5 mg to 1.5 mg and is slowly increased over a period of 3 to 8 weeks. The medicine is often taken in the evening one hour before bedtime. Initially, symptoms may get worse before they get better. Sometimes sleep disturbances such as vivid dreams can occur when taken at night possibly due to an increase in endorphin release. If this is the case, taking the medication in the morning may help. Standard dose naltrexone has been reported to elevate liver function tests. While LDN may be less likely to elevate liver tests, it makes sense to monitor liver function tests periodically especially if one is taking other medications that may elevate liver function tests. In this regard, patients with preexisting liver or kidney issues may require additional evaluation before treatment with LDN. In addition, because it is a narcotic inhibitor, it can negate the effect of opiate based pain relievers.

In summary, the use of LDN for chronic disorders is considered experimental and the long term safety of LDN is unknown. That being said, the doctors who published the review of LDN in the Clinical Rheumatology Journal concluded that LDN is a “promising treatment approach for chronic pain conditions thought to involve inflammatory processes. The clinical data supporting its use are very preliminary and more research is needed before the treatment approach can be widely recommended.”

If you or a family member is suffering from pain and/or has been diagnosed with fibromyalgia, perhaps its time to schedule an appointment with a board certified Dallas Texas Rheumatologist today.

Dr. Scott Zashin is a respected Texas fibromyalgia Doctor/Specialist in Dallas. He is duel board certified by the American Board of Rheumatology and the American Board of Internal Medicine. Dr. Zashin is the Medical Director of Dallas Rheumatology conveniently located in Dallas, TX. The above information about fibromyalgia is from his arthritis book: Arthritis Without Pain, a comprehensive guide for patients considering or undergoing treatment with the TNF blockers Enbrel®, Remicade®, or Humira®. All rights reserved. For more information on fibromyalgia, pain relief and getting back to feeling great visit his website: http://www.scottzashinmd.com/ or call today to schedule a time to meet with Dr. Zashin 214-363-2812.


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