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### Human:\ncan anyone tell me why we use both abbreviations ekg and ecg for electrocardiogram?\n\n### Assistant: interesting question and one that i have wondered about at times myself. the ecg is short for electrocardiogram while ekg is short for the original german (kardiogram) word describing this test that is commonly used by doctors to examine the electrical system of the heart. wikipedia has some nice background and medical history on this if you are interested in the topic. <link>

### Human:\ncan janumet and zantac be taken together?\n\n### Assistant: there is a moderate interaction with one of the components found in janumet (metformin/sitagliptin) and zantac (ranitidine). ranitidine is a cationic drug and theoretically could decrease the excretion of metformin. this drug interaction has been observed when using another cationic medication cimetidine. because of this we use caution with similar medications. these interactions can increase the risk of lactic acidosis which included symptoms of malaise myalgia respiratory distress hyperventilation slow or irregular heartbeat somnolence abdominal upset or other unusual symptoms. lactic acidosis is a possible side effect from the metformin. consult your health-care professional if both of these medications are being prescribed together. monitor your reactions for side effects of lactic acidosis and stop medication right away if the symptoms occur.

### Human:\nis it normal to constantly become hungry yet become full from eating very little? what does this sound like? . ever since i started strength training my appetite is out of control. i have to eat something almost every hour to avoid that feeling of starvation in my stomach. and yet when i choose to eat it takes very little to satisfy my appetite. i've never felt so confused about hunger in my life. what can i do so that i can feel full for more than an hour at a time and not have to worry about eating over a half dozen times a day? in the same vein how can i still feel hungry after a few bites?\n\n### Assistant: i'm not sure how you ate or exercised before strength training but now that you have made a change and are more hungry it's time to put more thought into your meals. you want to eat 3 balanced meals every day that contain 3-5 food groups at each meal (whole grain lean protein fruit vegetable dairy and healthy fat). if you are hungry in between meals have a snack with 2-3 food groups (e. g. apple with peanut butter yogurt with nuts cheese stick with whole grain crackers). so if you are used to having some cereal in the morning that may no longer be enough to keep you going. adding a lean protein source and more filling carbs like oatmeal along with chopped fruit and nuts will stick with you longer. protein (eggs lean meat nuts/seeds soy fish cheese) and fiber-rich foods (frutis veggies whole grains and beans) are the most filling and will keep hunger away longer. for more on what to eat before during and after exercise see this article. if you find that after taking a couple of bites of food you feel really full see your healthcare provider to make sure there is nothing else going on.

### Human:\nwhat can i do to increase my potassium? . i already take a potassium supplement. so i am taking two a day now. i also was already eating several bananas a week. i am eating at least one a day now. i already eat pretty much all of the foods that contain potassium so i don't know what to do. i am doing this by doctors orders but am now more tired than ever and having soft stools and frequent urination too. i go back for more tests in a few days but don't feel better at all (worse actually). what else can i do? !\n\n### Assistant: having low potassium is not always due to diet but fluid balance. that's because potassium along with sodium helps regulate body fluids (they are called electrolytes) so when fluid changes occur with certain disease states or medications like diuretics it can go too low or high. diet cannot always correct changes in potassium so working with your doctor on the appropriate medical management will be key. if you are getting worse call your doctor to see if you need to go in earlier. it is important to know which foods have potassium and how to balance your intake which this webmd article discusses in detail. also eating well moderate exercise and good sleep will only help you feel better. hope you feel better soon! finding the cause for your low potassium needs to be the first objective. here is a list of some possible reasons for low potassium: 1. ) sometimes low potassium is a symptom of some other problem. for example having low magnesium l evels can be a contributing cause for low potassium. it may be difficult in these cases to stabilize potassium levels until magnesium levels are increased. routine serum blood studies do not always uncover low magnesium. 2. ) consuming foods that are insufficient or lacking in nutrients necessary to maintain potassium at an optimal level can be a real challenge. yes consuming foods that are rich in required nutrients is a worthy objective. but due to hectic life styles and the frequent fast eating of fast foods your diet may come-up lacking in potassium. 3. ) some medications can cause low potassium levels. be especially careful in taking laxatives and diuretics which can deplete potassium levels. 4. ) electrolyte imbalances as seen with vomiting and diarrhea can also cause potassium levels to plummet. 5. ) some digestive irregularities as seen in conditions like crohns disease gluten sensitivity issues and irritable bowel syndrome can cause fluid loss and ultimately to cause low potassium levels. 6. ) drinking alcoholic beverages to excess drinking large amounts of tea coffee and soda can cause excessive urination and result in potassium depletion. here are my recommendations as a lay person who has had family members suffering the negative effects of having low potassium levels : - start a food diary listing as best you can (with only a few days until your follow-up appointment) all foods and beverages that are being ingested. also annotate any physical or emotional symptoms like excessive sweating feeling anxious muscle cramps lightheadedness thirst and overall body weakness. - for the immediate time follow your doctor's plan of action. keep that appointment with your doctor to follow -up with the results achieved. - show your diary to the doctor along with an updated list of all prescription medications and over the counterdrugs. that person has been highly trained in nutrition pharmacology and medical conditions. digestive problems absorption defects low magnesium levels and many other problems may be uncovered by your physician who is also a diagnostic detective. - once the cause of your low potassium level is determined then an effective treatment plan may be started. hi this first bit is from the uk paper the daily mail. this is an interesting question because although potassium is rarely in the limelight we actually need it in higher amounts than any other mineral - around 3 500mg a day by adult men and women. potassium plays a fundamental role in maintaining the fluid and acid/alkaline balance of the body. it is vital for the transmission of nerve impulses and helps the heart to beat regularly. it also counterbalances sodium in the body and is known to help lower blood pressure. to get enough you need to eat plenty of fruit and vegetables which are especially good sources because they also provide a low level of sodium. (health-wise it's a high potassium to sodium ratio that really counts). however several other foods also provide potassium including whole bread and pasta brown rice milk fish and meat. the dietary and nutritional survey of british adults (hmso 1990) showed that the average intake of potassium is 3 187mg in males and 2 434mg in females. compared with the daily recommendation of 3500mg intakes they are therefore low. to make up the difference eat an extra banana or two daily - each banana contains around 400mg. people most at risk of marginal potassium include the elderly athletes and manual workers who sweat out a lot of potassium and people taking certain diuretic drugs. heavy coffee and alcohol drinkers may lack the mineral and should try to increase their dietary intake i think from this and other stuff around with your supplements you should be getting there but keep of any fast foods junk foods and sodas just keep eating healthy. do hope this helps good luck ps the extra urination is from all the fruit your eating same as the soft stools.

### Human:\nhow much do nuts help lower cholesterol?\n\n### Assistant: if you're looking to decrease your cholesterol or just prevent it from increasing in the first place i've got a simple tip for you -- eat nuts. nuts are a wonderful source of high quality fats and protein. and now we know they'll help keep your cholesterol under control as well. researchers at loma linda university found that folks who consumed about 2. 5 ounces of nuts throughout the day decreased their total cholesterol by an average of 5. 1% and reduced their bad cholesterol ldl by 7. 4% and a whopping 10. 4% decrease in trigylerides only if they were elevated to start with. the scientists found that you got your biggest bang for your nut-buck if your bad cholesterol ldl was high to start with and if you were consuming a typical high fat western diet. in other words if your diet is great and your cholesterol is normal you'll be preventing problems but you won't see big changes in your numbers since they're normal to start with. the folks with higher numbers and junky diets see the biggest changes. and those folks need to clean up their diet to start with as well as get physically active to get the most for their new nut consumption. walk around with a 2 ounce plastic bag in your purse or briefcase or car and fill it with 12 nuts -- a combo of almonds and walnut halves or pecans is great. this makes for a wonderful snack anytime you want it. or put the nuts on a yogurt for extra crunch. at the start of every week i load up the bags and keep them everywhere so that i'm always prepared and never caught without a healthy snack.

### Human:\nwhat is cardiomegaly?\n\n### Assistant: cardiomegaly is an enlarged heart. in most cases enlargement of the heart occurs over an extended period of time (weeks or more often years) due to an injury to the heart. the heart responds to the injury by remodeling itself in a way that lets it continue to do its job of pumping blood. this sometimes results in a stretching of the heart muscle. the condition may also be called dilated cardiomyopathy. the most common causes of cardiomegaly are: high blood pressure that’s inadequately treated for a long time coronary artery disease or heart attacks alcohol abuse viral myocarditis (heart infection by a virus) postpartum cardiomyopathy (unexplained heart enlargement after delivering a baby) in many cases no cause can be identified which is called idiopathic dilated cardiomyopathy. the heart may also only appear enlarged on a chest x-ray (the traditional way doctors have diagnosed cardiomegaly). an abnormal amount of fluid around a normal-sized heart (pericardial effusion) will deceptively enlarge the heart’s shadow on a chest x-ray film. an echocardiogram (heart ultrasound) is usually recommended for people with an enlarged heart. an echocardiogram can tell the difference between a pericardial effusion and true cardiomegaly and can provide additional information about the heart’s shape and function.

### Human:\nhow does naturaly produce cholesterol of the body differ from cholesterol in dietary foods?\n\n### Assistant: cholesterol in the body is a waxy like substance that travels through blood and provides many important functions like making hormones. no one needs to ingest cholesterol because the body makes it especially the liver. the process of making "bad cholesterol" (ldl) increases when someone eats too much saturated and trans fat and not enough fruits vegetables and soluble fiber. the good cholesterol (hdl) is beneficial for health because it helps clear the bad cholesterol out and is related to exercise and the consumption of healthy fats (nuts vegetable oils etc) intake. there is also a genetic link to cholesterol levels meaning people with a family history of high cholesterol may be at higher risk. cholesterol is also found in foods of animal origin such as meat poultry and full fat dairy but isn't linked to high cholesterol as much as saturated and trans fats are. that being said the american heart association says too much cholesterol in the diet can lead to increased plaque in the arteries. for more info see the basics of cholesterol

### Human:\nhow many grams of sugar per day. how may grams of sugar should you take in a day\n\n### Assistant: recommendations vary based on organization. for example the world health organization recommends keeping added sugar intake to 10% of total calories. for the average 2000 calorie-diet that's a maximum of 50 grams. the american heart association recommends 6 teaspoons of sugar for women and 9 for men (1 teaspoon of sugar has about 4g of sugar). the primary source of added sugars are soft drinks and other sugar-sweetened beverages. for more on added sugars in the diet see this webmd article "sugar fix. " how many g of sugar per day for women is allowed <link> "most american women should eat or drink no more than 100 calories per day from added sugars and most american men should eat or drink no more than 150 calories per day from added sugars " states the aha. 8 books on body and sugar

### Human:\nwhy is my total cholesterol number less important than my ldl (bad) cholesterol number?\n\n### Assistant: traditionally physicians looked at the total cholesterol and have told patients that if it is greater than 200mg/dl it is bad and less than 200mg/dl it is good. they have mistakenly believed that the total cholesterol number is the goal of therapy. thus it has become pretty much dogma that patients memorize their total cholesterol number so they can compare it with friends or tell their doctor. surprisingly lowering one’s total cholesterol is not even mentioned by the national cholesterol education panel (ncep) atp iii as a goal of cholesterol management. the national heart lung and blood institute (nhlbi) launched the national cholesterol education program (ncep) in november 1985. the goal of the ncep is to reduce illness and death from coronary heart disease (chd) in the united states by reducing the percent of americans with high blood cholesterol. in 1988 the first guidelines from the first adult treatment panel of ncep which was called ncep atp i were published. since that time many studies were published and guidelines have been updated. atp ii was published in 1993 and atp iii issued an evidence-based set of guidelines on cholesterol management in 2001. since this publication five major clinical trials of statin therapy were published and addressed issues that were not examined in previous clinical trials of cholesterol-lowering therapy. thus in 2004 an atp iii addendum was published with revised guidelines. these guidelines are currently used by physicians to treat high cholesterol levels. the next set of guidelines called atp iv are scheduled to be published in the fall of 2011. although physicians still talk about total cholesterol levels all the atps have lowering ldl cholesterol (the bad cholesterol) as the primary target of therapy and have never once mentioned total cholesterol! the truth is that prior to atp i based on the data from the famous mrfit trial it was shown that those patients with a total cholesterol greater than 200mg/dl were at increased risk of a cardiovascular event and those with a level less than 200mg/dl at a lower risk. apparently in the evolution of understanding lipid management and therapy it was incorrectly stated that a magic cholesterol level of 200mg/dl or less was the goal of therapy.

### Human:\ncan antidepressants cause weight gain?\n\n### Assistant: most of the antidepressants and probably all of the mood stabilizer[s] can and do cause weight gain. bupropion -- commonly known as aplenzin wellbutrin or zyban -- usually does suppress appetite and can result in less weight gain than other antidepressants. within each family or class of meds there are some that are more weight-gain prone and others that are a bit more friendly. ask your doctor specifically about the more weight-friendly ones. also be careful in that weight gain may lead to diabetes and cholesterol problems. if you have gained ask your doctor to check on these and blood pressure too.

### Human:\nwhat is the percentage for a heart attack with poor dental health? . i am a female and my age 59 years old. i have a severe stabbing pain in the upper center of my back. my two lower front teeth are separating and the roots expose. i have been coughing and bringing up mucus with a dark green texture. my pulse is 103 and my blood pressure 105/61 as of 12-11-2012.\n\n### Assistant: you should seek immediate emergency help with any symptoms of upper back or chest pain. call 911 now. poor dental health bleeding gums or not maintaining oral hygiene have known to cause strokes. the bacteria from the mouth gets into the blood stream and also reaches the heart leading to strokes. a number of researches have proved this fact.

### Human:\ni had open heart surgery five bypasses i need to lose weight and start a diet and excise program where can i fine one? . i'm over weight and been fighting this for awhile i\n\n### Assistant: i would start by looking for a program where you got your surgery. most hospitals offer cardiac rehab classes for new patients where they have dietitians and physical therapists counsel and provide advice. it's important to get this specialized help because of your cardiac history. i would start there or with your doctor as they might have a program they recommend for their patients. be sure not to try any fad diets. see this article for more about cardiac rehab.

### Human:\ni have a very high metabolism and i can't gain weight. how can i lower my metabolism while exercising more? . i'm 20 years old 6' tall and weigh only about 150-155. i'm also not very active. i want to start running and lifting weights but it's tough for me to gain muscle because i have a very hard time putting on weight. what can i do to lower my metabolism enough to start putting on weight and getting bigger? i also don't eat very well but tend to eat a descent amount of protein every day.\n\n### Assistant: the goal should not be to lower your metabolism but to start feeding yourself better and reap the benefits of activity which can result in muscle gain. it doesn't matter if you get adequate protein if you are missing out on other important nonprotein calories and nutrients. that's because inadequate carbohydrate and fat intake (total calories) means protein is used for energy instead of for muscle formation. exercising more can increase your appetite and weight training can gradually help you put on muscle. it may take time to see results but because muscle weighs more than fat you are likely to gain weight. here are some tips: eat regular meals and snacks every day. try to plan your meals ahead of time and have items you can put together for quick and healthy meals. gradually build a list of balanced meals you can make for yourself. include 3-5 food groups at meals including a whole grain lean protein fruits vegetables dairy and healthy fats. for example in the morning you might have a big bowl of oatmeal topped with fruit and nuts and a side boiled egg. include 2-3 food groups at snack time which may consist of cheese and whole grain crackers or an apple with peanut butter or half a meat sandwich with veggie sticks. gradually increase exercise to include cardiovascular exercise and resistance training. for tips on how to exercise to build muscle see this article. what you may discover during this process is how much better you feel by moving more and eating better. you won't regret starting on a healthier road! i here this a great deal at the school i teach at. if you really want to gain some weight you need to develop a comprehensive nutrition and exercise plan. first keep a food diary for three days. are you really eating as much as you think? when counseling athletes at school i generally recommend they consume 1. 8-2. 0 grams of protein a day per kilogram of body weight. so for you at 150 lbs = 68 kilograms that would put your protein needs in the range of 122 -136 grams a day. now that you know what your eating and how much protein you need. develop an eating plan. here's an example: breakfast 1 large egg scrambled 1 cup old fashioned oat with one tablespoon honey 1 banana 1 cup skim milk protein in meal = 20 grams lunch 2 grilled chicken breasts (8 ounces) 2 cups of veggies (broccoli green beans califlower) 1 apple 1 serving greek yogurt protein in meal = 69 grams dinner 1 servings baked pork tenderloin (3 ounces) remove all fat 2 cups of veggies 1 banana 1/2 cup fat free cottage cheese protein in meal = 38 grams snacks 1 apple with 2 tablespoons of peanut butter (protein: 7 grams) 1/4 cup sunflower seed string cheese fruit (protein: 12 grams) total protein for the day = 147 grams notice there's no junk food (chips soft drinks etc) or any expensive supplements just good solid nutritional foods. regarding exercise the best way to add weight is by adding muscle. to do this you need a well thought out strength training plan. follow the link pasted below to find a great beginners workout on webmd <link> as you advance you can find some additional info here <link> <link> like i said earlier the key to healthy weight gain is with a comprehensive nutrition and exercise plan both of which you can find here at webmd. to be on the safe side be sure to check with your physician before starting. i had an extremely high metabolic rate and was an athlete competing in martial arts. i had to gain weight to compete with stronger opponents in a heavier weight class. let's keep it simple 3 key elements will allow you to gain muscle mass/weight. 1. rest - get two days/week of rest to recover from training. you grow when you're resting. you can split up the 2 days or have it simultaneously. take it easy on those days and don't do anything too physical. 2. train - lift heavy weights with low reps for 1 1/2 hour and then do another 30 min of plyometrics. next day do it in reverse. repeat this cycle throughout the week. if you're an athlete you'll need to extend training time up to 3 hrs in one day. when running do sprints. do high impact high intensity exericises. do not perform long-distance endurance training. if you have to run don't go over 3 miles. 3. eat - consume a lot of carbs from veggies and fruits. 3/4 of your meal should be carbs to give you energy and pack on necessary fat. 1/4 of your meal should be protein to build muscle. contrary to popular beliefs you need plenty of fat storage in order for the body to be healthy and build muscle. consuming protein volume based on your body weight is not accurate for everyone some bodies will not utilize extra protein. you want that carb for energy to push harder and grow bigger/stronger. eat pasta rice and potatos with every meal. you will bulk up in size/strength adding 10 lbs of muscle like me within a month. if you get too bulky and need to trim down to make weight for athletic competition then reverse the diet eat more protein and less carbs. always drink a ton of water! find people with similar goals to train with! it's not just about building your body it's also about building a community. good luck!

### Human:\nwhat happens if you crush or chew a prilosec otc pill?\n\n### Assistant: this medication is not intended to be crushed or chewed which may interfere with the absorption of the medication and decrease the effectiveness. if you are experiencing symptoms of heartburn or an ulcer seek advice from your health-care professional. there are liquid products available also.

### Human:\nmy wife is in her fifties and hasn't had a period in over three years. could she still get pregnant?\n\n### Assistant: when a women has had a natural menopause. we suggest that birth control be used for 12 months after the last natural period. the reason is that some women will have a temporary interruption of ovulations/periods creating months of no periods. then periods and possible fertility can resume. this is especially common during the four years preceding menopause and the year following probable last natural period. bottom line after three years in a woman over 53 years old pregnancy is unlikely. . get off the pills! i was taking ortho-tricycline for years 50 yrs old ended up in hospital with "cardiac event" got to choose a cardiologist chewed me out royally for taking birth control pills @ my age (and my gyno had recommended them to help me sail through menopause). little did i know they could have killed me. cause high blood pressure blood clots--i was a heart attack waiting to happen and dr. said i definitely was headed for a stroke! get the blood test to show if you are in menopause to know for sure. use condoms get a hysterectomy whatever but don't kill yourself! when young the pill is great; no place for the over 50 crowd.

### Human:\ni want to take nyquil but can i take it if i am taking buproprion?\n\n### Assistant: never take paxil or prozac and nyquil as these two drugs triple the dose of nyquil in your system and can hurt your heart and you. bupropion only has a mild interaction in a very very small percentage of people and is safe to mix. if you are really worried take the nyquil but use one-third less than the dose suggested on the nyquil bottle.

### Human:\nwhat could the purple area on my labia be?\n\n### Assistant: if there is a single isolated area which appears to be bruised it might be a varicose vein of the labia. alternatively one can get a bruise in the labia from a small broken blood vessel. a bike seat or fall onto bike bar can create bruising. if you have easy bleeding (e. g. from shaving cuts bleeding gums etc. ) even minor trauma can leave bruising. . certainly if the involved area appears to be enlarging you should get seen.

### Human:\nis it safe to take otc energy pills/supplements if you drink a lot of coffee?\n\n### Assistant: otc energy pills and supplements contain a large amount of caffeine sometimes 2-3 times the amount of a cup of coffee depending on the brand. by increasing your daily caffeine dosage you may be increasing your risk of caffeine addiction. and too much of any stimulant has consequences for the body such as elevated blood pressure and an increased heart rate. this could be dangerous. i would use these products with caution or not at all. the risk can be greater than the value of the short energy boosts they provide.

### Human:\nam i getting too much vitamin a? . for the last couple of months i have been on a unusual diet of mostly ceasar salad and yams. now i eat around a full heart of romaine lettuce a day and a large yam a day. the diet works great but i didn't look at the vitamin count. i recently noticed that i have been consuming a large amount of vitamin a. i don't take any supplements but i am now worried that i might have vitamin a toxicity. i looked up some of the symptoms and i don't think i have any but should i stop this diet?\n\n### Assistant: while it may turn your skin yellow/orange vitamin a from fruits and vegetables is not toxic. but you do need to worry about missing out on other key nutrients. if all you are eating are yams and romaine lettuce you may not be getting enough fat protein and are at risk for other vitamin/mineral inadequacies like vitamin d. i suggest seeing a registered dietitian to develop a balanced eating plan to help you be healthy and lose weight if needed. good luck!

### Human:\nis aerobics a good exercise to loose fat in belly?\n\n### Assistant: absolutely. cardio exercise including aerobics is one of the best things you can do to lose belly fat and fat anywhere. strive for 30 minutes of moderate cardio exercise (aerobics fast walking/jogging elliptical biking etc) at least 5 days per week. on a 10-point scale moderate means you're working at about a level 5 or 6. if you don't have this much time you can pump up the intensity to vigorous exercise and slim down the time to 20 minutes and get the same benefit. vigorous exercise would be a 7 to 8 on a 10-point scale. in fact if you do vigorous exercise 3 days a week should do the trick. of course the more you do the more fat and calories you'll burn. interval training is a great way to get your body used to vigorous exercise. to start do 2 minutes of moderate alternating with 30 seconds of vigorous for 20 minutes. as you get in better shape you can increase the vigorous exercise time. good luck! aerobic exercise is great to help expend calories and boost metabolism to promote weight loss. keep in mind however that you can’t “spot reduce” weight loss meaning that you can’t do a certain exercise to target weight loss from a particular part of your body. the surgeon general recommends 30 minutes of moderate intensity exercise 5 days per week 60 minutes is even better if your goal is to lose weight. these recommendations are cut in half however if you do vigorous intensity exercise instead of moderate intensity. also be sure to also include strength training into your routine as well. visit this cdc website for more information on exercise recommendations. yes i've been told that plain old mind-numbing cardio plugging away on a treadmill elliptical recumbent bike etc. is by far the worst way to lost fat belly or otherwise. yes interval training is better but even better is to lift weights (less weight more reps) with the cardio occurring in between sets because you rest 30 secs and move on to the next set. google fat loss and weight lifting and you'll see the preponderance of the evidence on the side of weights with inherent cardio is the best method. works for me! fordjohna you can't spot reduce fat you need to lose it all over with diet and heavy lifting

### Human:\nwhat if i have diabetes and need an echocardiogram?\n\n### Assistant: for people with diabetes who need an echocardiogram follow these guidelines unless your doctor tells you otherwise: if you take insulin to control your blood sugar ask your doctor what amount you should take the day of the test. often your doctor will tell you to take only half of your usual morning dose and to eat a light meal four hours before the test. if you take pills to control your blood sugar do not take your medication until after the test is complete. do not take your diabetes drug and skip a meal before the test. if you own a glucose monitor bring it with you to check your blood sugar levels before and after your test. if you think your blood sugar is low tell the lab personnel immediately. plan to eat and take your blood sugar medication following your test. i do not need echocardiogram!

### Human:\nhow much of an impact does vitamin d have on cardiovascular disease?\n\n### Assistant: in finland a 25- to 30-year study of over 6 000 persons found an increased risk of fatal vascular disease in those who had the lowest blood levels of 25(oh)d. interestingly this relationship was apparent for the incidence of strokes but not heart attacks. proposed mechanisms for improved blood vessel health include vitamin d's beneficial impact on high blood pressure via kidney hormones decreased inflammation inside the arteries and improved insulin resistance via changes in parathyroid hormone (lee 200<positive_smiley>.

### Human:\nwhat is dyspnea?\n\n### Assistant: dyspnea is difficulty breathing. dyspnea can have a wide range of causes including: being out of shape (deconditioning) problems in the lungs (infections emphysema asthma) problems with the heart (congestive heart failure pulmonary embolism) anemia (a low red blood cell count) problems with the chest wall or breathing muscles (muscular dystrophy). everyone has dyspnea with exercise—even olympic athletes breathe faster after running up a flight of stairs. with increasing regular exercise it takes higher levels of exertion to bring on dyspnea. shortness of breath that occurs with a level of activity that used to be easy or dyspnea that’s getting worse might be due to a medical condition. generally speaking worsening or unexplained dyspnea should prompt a call to your doctor. dyspnea is

### Human:\nbmi of 35. i am 29 a woman who is 4'11 weigh 178 lbs. my breasts are over dd. i am not fat. how can my range be obese? . i have large hips but they are mostly muscle. my breasts are the only other large fat content place on my body. are there better ways of determining a healthy weight?\n\n### Assistant: bmi is just a classification of weight and not a determinant of health. that being said carrying extra weight can increase health risk. first i would consider your size over time. have you always been this size or have their been increases lately? if this seems to be your normal weight than it may just be where your body wants to be. if it has increased lately you may want to take note of what has changed to see if it has affected your weight. next would be to look at your other health-related numbers. if you cholesterol blood pressure and blood glucose are all normal than those are positive indicators of health. regular exercise and a health diet matter too! lastly where you carry excess weight makes a difference. those who carry fat in the abdomen tend to be at higher risk for chronic disease like diabetes and heart disease. in particular figuring out your waist-hip ratio can help you determine if this is a concern for you (see this article for more information). weight is just one piece of the health puzzle. finding out about all the other pieces can help a great deal!

### Human:\nwhich nuts are most likely heart-healthy?\n\n### Assistant: the fda allow[s] a qualified health claim that evidence suggests – but does not prove - that eating 1. 5 ounces (43 grams) of nuts per day as part of a diet low in saturated fat and cholesterol reduces coronary heart disease risk. the government allows the claim on dietary labeling for specific nuts including almonds hazelnuts pecans pistachios walnuts peanuts and some pine nuts.

### Human:\nwhat is an iron infusion? . an iron infusion is simply a liquid dose of iron given in the veins.\n\n### Assistant: an iron infusion is simply a liquid dose of iron given in the veins. iron is an essential mineral that we get from eating foods such as meat eggs and leafy greens. iron is needed to make hemoglobin the oxygen-carrying substance in red blood cells. many people especially women having regular menstrual periods have low iron levels (iron deficiency). if iron remains low for weeks or months the body makes fewer red blood cells and a low blood count (iron-deficiency anemia) can result. for the overwhelming majority of people with iron deficiency taking iron pills every day replaces the missing iron and low blood counts return to normal. in a few people iron pills aren’t sufficient to keep up with iron losses. this can occur when there is ongoing bleeding or the intestines can’t absorb the swallowed iron. in other people oral iron may cause a bad reaction. people in these special situations may need to receive an iron infusion to replace the missing iron. an iron infusion is most often given at a doctor’s office or hospital. a nurse places an iv and a bag of fluid containing dissolved iron drains into the person’s veins. some conditions or situations that may require an iron infusion include: • people with inflammatory bowel disease with severe iron deficiency • people with end-stage renal disease on dialysis • people with cancer and anemia • people taking erythropoietin or similar drugs to stimulate red blood cell production iron infusions are generally safe but severe reactions to the drug preparation do occasionally occur. these can cause shortness of breath itching spasms or (rarely) a life-threatening allergic reaction called anaphylaxis. how many times do you have to iron infusion to not feel tired?

### Human:\nif i have my undiagnosed hypertension diagnosed it will become a preexisting condition. why should i have it diagnosed? . in late 20s always around 160-170 lbs at 5'11. semi-active. havent had a checkup in over 10 years. hypertension has lessened some of what i could do but otherwise i've lived with it just fine. plus i have other medical issues that are more intrusive to my quality of life which will never go away. if i have hypertension diagnosed then it will become a preexisting condition and will cost me 10s if not 100s of thousands of dollars in added medical costs during my life.\n\n### Assistant: i think this represents a very dangerous way of thinking. some of hypertension’s negative effects on the body if left untreated include stroke aneurysm heart attack congestive heart failure coronary artery disease nerve damage eye problems kidney damage or damage to your arteries (just to name a few). is it really worth gambling your health to potentially save money? consider this how much will your health insurance costs go up if you end up having a stroke or any one of those conditions from untreated hypertension? for some people hypertension can be managed through modifiable lifestyle behaviors (such as diet exercise stress management or weight management) while others simply have a genetic predisposition towards having high blood pressure. the bottom line is that although things like diet and exercise are always encouraged they alone may not be enough for you to properly manage your high blood pressure. meet with your doctor to discuss treatment and management options. i'm not sure what you mean by hypertension or what method you are using to determine you have it. however untreated high blood pressure is a dangerous disease with consequences that can reduce your quality of life cause serious chronic disease or kill you. it has been implicated in altzheimer's disease as well. if you are not diagnosed you will not be able to receive treatment. you are very young and deserve to have a beautiful life--don't risk it by not taking care of yourself.

### Human:\ncan gas cause chest pain?\n\n### Assistant: yes. chest pain has many possible causes; some are harmless but some (like a heart attack) can be life-threatening. part of the problem is that the heart and other internal organs have a type of sensory nerve conduction where it is sometimes difficult to precisely pinpoint the exact origin of a painful sensation. pain due to something wrong in the heart lungs or belly can be vague or feel like something else. this is why chest pain can be such a difficult problem for those who have it as well as for their doctors. gas causes swelling in the intestines and a bloated feeling. when gas causes pain it’s usually in the abdomen (belly). however the pain may also be felt in the chest. if pain is due to gas it should go away within a short time. other causes of chest pain not due to the heart include problems with the esophagus gastroesophageal reflux disease (gerd) musculoskeletal (chest wall) pain problems in the lungs and many others. studies have shown that even doctors have a hard time identifying the cause of chest pain just through conversation or physical examination. laboratory tests a chest x-ray and an electrocardiogram are generally needed to know for sure that chest pain is nothing serious. no one wants to call 911 or sit in an emergency room to be treated for what turns out to be gas pain. however playing a waiting game when you are having chest pain can be a gamble with your health or maybe your life. if you’re having chest pain in almost all cases a doctor’s recommendation will be to seek medical attention. yes thanks i have been having a chest pain and thru my underarm since early this morning i am scared it could be a heart attack then again i have experienced this pain before but does not last as long as it has today. it gets worse when i lay down. could it be gas or should i go to the emergency room yes yes

### Human:\ni have high triglycerides and high ldl's and i'm in excellent physical shape. how do i lower these levels without meds? . high cholesterol htn etc. all run in my family. i cut out red meats and non-whole wheat breads and pastas for about 6 weeks without any change. i would like to find a way to drop my cholesterol w/o going on meds. my entire family is on various cholesterol and bp meds but they're all overweight and refuse to diet/exercise. is this something i can beat w/o meds? if i continue on with high levels throughout my life would i be able to mitigate the risks of heart disease diabetes and so on?\n\n### Assistant: you mention that you have a family history of high cholesterol so you may just have a genetic predisposition to having high triglycerides and high ldl cholesterol. that doesn’t mean however that you shouldn’t try to do everything that you can through modifiable lifestyle behaviors such as diet and exercise to manage your levels. some suggestions to lower your triglycerides and ldl cholesterol levels would be to: • do cardiovascular exercise five times per week for thirty minutes or greater • lose weight if you are overweight or obese according to bmi • change dietary habits like reducing saturated and trans fat from your diet cutting out sugar getting more fiber getting more omega-3 fatty acids and drinking less alcohol if you drink • quit smoking if you smoke i really applaud your efforts to avoid getting on cholesterol lowering medication. continue to do what you can with diet and exercise and continue to follow up with your doctor on a regular basis. it might sound strange but i had triglycerides over 1000 and got them to normal range with lots of black tea and 5000 mg of epa dha (omega-3) fish oil supplements daily. the fish oil was at my mds advice but didn't seem to work until i started drinking plain black tea in place of water - 5 tea bags in 64+ oz water daily.

### Human:\nhow do i stay motivated with my diet when i see no change at all in my waistline? . i've been trying to lose weight for about two years now. i thought i'd see a noticable difference when i went from drinking 4-5 cans of soda a day to one (and sometimes none) but no difference at all. i started doing pilates. no difference. two days of strength trainging. no change. added a cardio day. no difference. cut portion sizes in half (except for my fruits and veggies) no difference. i don't look better i certainly don't feel better and now i'm hungry all the time.\n\n### Assistant: you don't say whether or not you are overweight which can be a factor but i understand how hard it can be to make changes and not see the results you want. i think the biggest myth about eating healthy and exericse is that weight is a long-term motivator. when we focus solely on weight we make more extreme changes for results and feel deprived and frustrated when we don't see results. i recommend you go see a registered dietitian for strategies on how to eat a balanced diet that is also satisfying (go to eatright. org to find one in your area). she/he can also help you troubleshoot your weight and help with appetite control (you shouldn't be hungry! ). when you eat a healthy diet that matches your lifestyle and preferences you'll continue to eat that way even when weight loss slows. a recent study showed that women who exercised because it made them feel good (quality of life) exercised more often than those who did it for weight and health. you are more likely to exercise and keep at it if you truly enjoy it and see the daily benefits including improved mood better sleep and productivity. for more on this study and my interview with the researcher see this webmd post <link> weight is one part of a healthy lifestyle. don't let it stop you from being healthy and enjoying your life! i would suggest that you meet with your doctor or a dietitian for more guidance. they may be able to help you determine if there’s something that you could still improve upon or perhaps to do differently to promote better results. your doctor may also be able to do tests to see if you have any other diseases or conditions that could be interfering with your progress. also i’d recommend that you don’t just judge your progress by weight loss alone. look for changes in body composition such as a loss of inches a more “toned” appearance or even whether clothes fit differently. schedule a wellness visit with your doctor that includes blood work and try to understand what’s happening with other areas of your health such as cholesterol blood sugar or blood pressure. these can also be used as indicators of progress or improvement with the changes that you’ve made. it can definitely be very discouraging to put so much hard work and effort into something and to not see the results. it might be best to get professional assistance and to look for other indicators of progress besides weight loss. stay positive and keep up the great work! keep it up! you may start noticing the weight loss in other places before you see it in your "trouble spots". unfortunately we can't control where the weight drops first but you will eventually see the changes. make sure to monitor your food intake too - to make sure your calorie intake is not higher than the amount of calories burned. at the end of the day as long as you are burning more calories than the amount of calories consumed you will see the weight drop. most importantly don't lose your momentum. stay active and you'll reap the benefits in time - just give yourself time to see it pay off! even a 10% loss in body weight makes a huge difference in your health. hopefully while you wait to see the pounds drop you will at least feel more energy and feel good about yourself! you're at least on the right track in searching for answers. from what you've shared it sounds as though you're basing your results on generalities more than measurable specifics. i recommend having very specific parameters for measuring progress from hereon. i mean: weight body fat percentage (a good trainer will know how to measure best with calipers and there are less invasive methods like bio-impendance scales) then girth measures on specific locations across your chest torso abdomen and hips. at the very least having these will show you where you have improved given your efforts. as a formerly obese kid i can tell you that my subjective view of looking better or feeling better did not correlate to my actual progress. keep that in mind. lastly since you're keeping measurements in check you might as well keep track of the exact changes you're making in your food/drink intake and exercise. there's a website and app that's most frequently used right now called myfitnesspal. i use it to see what my clients have been up to. you'll be surprised how a food/weight/exercise log makes a big difference. good luck. delf www. delfenriquez. com sometimes there are emotional issues/reasons why we don't lose weight. at our office we use mind-body techniques such as eft (emotional freedom technique meditation etc. ) to help resolve core beliefs that keep us stuck. if you are interested and think it might help feel free to contact me at excelweightloss@gmail. com. best to you!

### Human:\nwhat is electrical cardioversion?\n\n### Assistant: if drugs are not able to control a persistent irregular heart rhythm (such as atrial fibrillation) cardioversion may be required. after administration of a short-acting anesthesia an electrical shock is delivered to your chest wall that synchronizes the heart and allows the normal rhythm to restart.

### Human:\ndo you have to eat oat meal every day to get the benefits?\n\n### Assistant: i think you are referring to the heart health benefits of consuming. the fda recommends 3g of soluble fiber (beta glucan) daily to help reduce the risk of heart disease because it helps lower cholesterol. one serving of oatmeal contains. 75g and can help you get to three grams. other foods that contain soluble fiber are cold cereals made from oats (e. g. cheerios) oat bran and barley. you can also add oats to muffins and other baked goods. so you don't have to eat oatmeal every day to get the benefits but it is a good way to get heart healthy soluble fiber in your diet. for more on oats see this article <link> oatmeal has some very beneficial health benefits but the idea of eating oatmeal every day could get very old and boring. i think the oatmeal companies would like you to do this but there are many many other ways to live a healthy lifestyle eat a healthy diet and lower your cholesterol than eating oatmeal every day. 365 days a year. for a healthy intervention to be sustainable it must be something you can tolerated. if you love oatmeal. and want to eat it every day go for it but in my opinion life is too short not to have variety and pleasure in our diets. no

### Human:\nis dizziness a sign or symptom of parkinson's disease?\n\n### Assistant: dizziness is extremely common in pd and is a result of the condition itself pd medications and other medications. what typically happens is a patient has a long history of hypertension - or high blood pressure (bp) - and has been treated appropriately for many years before developing pd. the pd lowers bp a little. then he is started on levodopa or a dopamine agonist or other pd drugs and his bp drops further. in addition many men have difficulty with bladder control and begin to restrict their water intake. this creates a "perfect storm" for. faint[ing]. . treatment requires reducing the long-time hypertensive drugs increasing. fluid intake by at least 2 glasses of water per day and if not enough adding salt and medications to raise. bp. . dizziness primarily in the morning hours is present.

### Human:\nhow do i lose the last 10 pounds? i eat relatively health vegetarian and stay active. am not overweight but not ideal. i've been a vegetarian since i was 10 and love vegetables and naturally low-fat foods. i exercise 3-4 times a week and enjoy hiking and walking as well and have since childhood. i've never been overweight but i've never been able to get to my "ideal" weight either. i'm 5'5' and 147lbs. my goal is 135. the closest i've ever managed was 140 (and i was practically starving myself). i do have mild hypothyroidism but it's under control. . any advice or notes on something i could change?\n\n### Assistant: we all have a genetic blueprint to how our big or small are body is supposed to be. when we eat healthy eat mindfully (meaning we don't eat past fullness often) and are active weight tends to take care of itself. if you are healthy (good blood pressure cholesterol etc. ) and not overweight there is no reason to get to an ideal weight. if you need to starve to get there then that tells me that is not the right weight for you. we are not all meant to be small and there is nothing magical about the ideal weight numbers. so my advice is that you focus on your healthy lifestyle and accepting your body as it is. you could focus more on different exercises and ways to increase fitness such as feeling stronger but i see no reason why you need to lose weight. i know our society says otherwise but spending all that energy on a weight that seems right for you may not be the best use of your time. best of health to you! i am not a fitness expert although i work for them but i wanted to offer an answer from my own personal experience. i had this same question not to long ago. i exercise 3-4 times a week eat healthy have 4 kids and 3 dogs who i run after or with all day long! but i was stuck at my target weight. i'm 5'6 i wanted to be 145. made it down to 165 from almost 190 about 6 months ago. my trainer also a good friend of mine said i needed to stop looking at the scale and focus on what was most important. being healthy and enjoying life. just as the last expert answer states. everyone is different. i stopped looking at the scale and put my efforts into enjoying the activities i love best and eating healthy but not limiting myself from foods i love or starving myself. i also change up my exercise routine regularly. i started doing hiit (you can google it) high intensity training classes. wow definitely felt the difference. about a week ago i went to my annual physical and weighed in for the 1st time in months. i was 155. i must be doing something right but what's different now is my outlook on my body and lifestyle. weight is just a number what's important to me is how i feel and having the energy to keep up with my very active family. it sounds like you are on the right path to a healthy fit life style. i wish you all the best and don't sweat the small stuff. enjoy life and save the sweat for the gym! <positive_smiley> -angel

### Human:\nwhat is an aneurysm?\n\n### Assistant: an aneurysm is a balloon-like bulging of a portion of a blood vessel most commonly occurring in arteries. aneurysms occur in places where the muscular wall of the artery is weak. when the heart contracts and pushes blood pressure to its maximal point the weak part of the artery bulges and swells. the main areas where aneurysms can cause problems in adults are the arteries in the brain and the aorta (the main artery in the center of the body). the cause of aneurysms is unknown but high blood pressure and smoking are risk factors. aneurysms are dangerous because they can burst (rupture) causing rapid life-threatening bleeding. doctors often recommend observation for small aneurysms. larger aneurysms are more likely to rupture and doctors may recommend surgery or another procedure to reduce the risk.

### Human:\nare there lifestyle and dietary factors that can decrease the risk of breast cancer?\n\n### Assistant: weight is a really important factor to the postmenopausal woman. higher body mass index and postmenopausal weight gain increase a woman’s risk for breast cancer. a woman who has a bmi of more than 33 is 27% more likely to get breast cancer than a woman with a bmi of less than 21. losing about 22 pounds will lower your risk regular physical activity can help women protect themselves from breast cancer. engaging in say fast walking for 10 hours or more per week can benefit women immensely. drinking alcohol has definitely been shown to be a risk factor and the more one drinks the higher the risk. i always say “one drink is good for the heart but two drinks are bad for your breasts”. other factors that seem to help decrease the risk: eating olive oil sticking to a low-fat diet that includes monounsaturated and polyunsaturated fats complex carbohydrates and minimal red meat. taking vitamin d and coq10 may also help lower your risk. soy is still controversial so i advise eating no more than what is in a standard asian diet — 20 grams per day. breastfeeding for a least six months may decrease breast cancer risk. with every 12 months of breastfeeding a reduction of 4. 3% was seen for breast cancer risk. finally if a woman can control for this she should try to have a baby at a younger age. having a first baby before age 25 will decrease a woman’s risk by 10% and having a baby before 35 decreases her risk by 5%. unfortunately having a first baby later in life puts a woman at greater risk for breast cancer because of perimenopausal breast changes from hormones of pregnancy. yes

### Human:\nshould i hold off on weight training until i lose weight?\n\n### Assistant: absolutely not. lifting weights will not only help you lose weight but maintain the loss. here's why: muscle keeps your metabolism revved up burning calories fat and glucose (sugar). when you lose weight up to 25% of the loss may come from muscle resulting in a slower metabolism. weight lifting will help preserve or rebuild any muscle you lose by dieting. muscle helps you with aerobic exercise. the stronger you are the better you will be at any aerobic activity. weight training improves your body's muscle-to-fat ratio (you end up with less body fat and more muscle) which improves both your health and your fitness level. gaining muscle will help you look better as you define and tone your physique. building strength helps you feel good about yourself. although the scale may show a slight weight gain when you start lifting weights (usually five pounds or less) you probably won't look heavier because the gain is in muscle and your clothes may even fit more loosely. strength training along with cardiovascular exercise can boost your metabolism and can help you expend calories to lose weight. strength training however also has the added benefit of helping you to preserve muscle as well. if you lose weight while only doing cardiovascular exercise some of the weight loss may come from body fat as well as muscle. you want to preserve muscle because it can help to keep your metabolism elevated since muscle burns calories at a higher rate than fat. strength training can also help to promote a more “toned” appearance which would be another added benefit to you as well. the surgeon general recommends that you strength train all major muscle groups two or more days per week. consult your doctor before starting an exercise routine. no you should remaind that it's a continuous process. if you stop it your weight will start increasing.

### Human:\nis coffee good for your heart and how much coffee? . i heard it was good for the heart one cup a day is it true?\n\n### Assistant: there is emerging evidence that moderate coffee consumption is linked to decreased risk in type 2 diabetes parkinson's and liver cancer. a recent study published in circulation heart failure discussed in detail here on webmd showed moderate coffee intake was associated with lower risk of heart failure. the researchers recommended 2 average american cups of coffee as moderate which was actually 4 smaller cups in europe. it's important to remember that these studies only show associations and do not prove cause and effect. but if you love coffee you can feel good about making it a part of your healthy diet. i know i do!

### Human:\nwhat is a heart murmur?\n\n### Assistant: a heart murmur is a sound created by the flow of blood in the heart heard when listening to the heart with a stethoscope. some heart murmurs called innocent murmurs occur in completely healthy people. heart murmurs also can result when the valves of the heart are diseased creating abnormal blood flow through the valve. people with congenital heart problems (birth defects) or congestive heart failure frequently have heart murmurs. a heart murmur can be a clue to the presence of heart disease. innocent murmurs don’t need further testing but unexplained heart murmurs often prompt other tests like electrocardiogram (ecg) or a heart ultrasound (echocardiogram).

### Human:\nwhat are the health benefits of green tea?\n\n### Assistant: while the curative power of green tea has been touted for centuries science is finally starting to catch up! the benefits of green tea come from antioxidants (polyphenols) that protect cells from free radicals and also may help prevent plaque buildup in the arteries. studies indicate an association between green tea consumption and reduced risk of heart disease and cancer. it's important to remember that green tea also contains caffeine.

### Human:\nhow can you tell a child has strep?\n\n### Assistant: when your child has a sore throat it’s important to find out if it’s strep throat or not. ever wonder why? strep (officially called group a streptococcus) is a bacterial infection that needs to be treated with antibiotics. and all the other sore throats caused by the virus of the week just need time and tlc to resolve. why does strep need to be treated? while many people clear the throat infection on their own untreated strep can do some pretty serious damage in other body parts. untreated strep can infect the heart brain and joints. that’s called rheumatic fever. and it’s why we need to know if that sore throat is due to strep bacteria. doctors have always known that strep prefers to infect school-aged kids instead of babies toddlers or preschoolers. but a recent study in the journal pediatrics confirmed this. about 37% of school-aged children who see their docs for a sore throat will have a strep infection. but only 24% of children under five years of age have strep when they have a throat infection. bottom line: little kids usually get viral sore throats big kids are more likely to have strep. so how do docs know when it’s strep throat (besides doing a strep test of course). here are 10 things that make me think of strep: 1. 5 years of age or older? 2. sore throat without runny nose or cough? 3. sore throat with headache and/or stomachache? 4. sore throat and fine pinpoint sandpapery/rough feeling rash (called “scarlet fever”)? 5. sore throat and raised dots on the tongue (called “strawberry tongue”)? 6. sore throat and a persistent fever for more than a couple of days? 7. (for girls) sore throat and a really red vaginal area? 8. sore throat and really red skin around his/her anus? 9. strep going around your child’s school childcare or your house (late fall winter spring)? 10. a history of getting strep throat before? if you think your child has strep don’t panic. even if your child has had the illness for a few days antibiotics will do the trick to clear the infection and prevent rheumatic fever. just make an appointment to see your child’s doctor!

### Human:\nis sepsis contagious?\n\n### Assistant: no sepsis itself is not contagious. sepsis is an out-of-control infection due to bacteria viruses or other invading organisms. when an infection becomes uncontrolled localized symptoms (like diarrhea from e. coli food poisoning or coughing and sneezing from influenza) become serious whole-body symptoms like a rapid heart rate low blood pressure and confusion. although a person’s infection itself may be contagious (you’d have to know the specific organism to say) sepsis is a complicated response to infection that varies widely between individuals and is poorly understood in general. however it’s clear that most people with sepsis don’t transmit their infection to anyone else and most people with infections (from any cause) don’t get sepsis.

### Human:\nwhat is the difference between healthy and unhealthy fat?\n\n### Assistant: most food contains several kinds of fat and some are better for you than others. some fat is needed in your diet so it’s not a good idea to completely eliminate all fat. instead choose foods with healthier fats and enjoy them in moderation. unhealthy fats include saturated and trans fats (also called partially hydrogenated fats). sources of unhealthy fats come from eggs meat dairy and tropical oils (coconut palm and palm kernel oils). good fats include monounsaturated fats and polyunsaturated fats. healthy fat sources include nuts seeds avocados olives and other plants. healthy oils aid in having healthy skin hair and a strong immune system. saturated fats and trans fats grams should be less than 10% of your total calories for the day. to determine the healthfulness of fat consider where it comes from -- animal vs. plant origin. healthy fats coming from plants (and fish) are beneficial for health especially when replacing saturated fat (animal fats) in the diet. at too high levels saturated fats can adversely affect heart health. saturated fats are found in high-fat meats full-fat dairy baked goods and fried foods. trans fat the worse fat of all is mostly found in products (i. e margarine) that contain vegetable oils that have been "partially hydrogenated" to become solid at room temperature. since 2006 fda requires companies to label trans fat in food products. if an item contains <. 5g it can be labeled "trans-fat free. "&nbsp; because the american heart association recommends 2g or less per day for the average 2000 calorie diet check the ingredient line for partially hydrogenated fats. &nbsp;for example &nbsp;natural peanut butter only has peanuts (and salt in some cases) in the ingredient line but other peanut butter products often contain partially hydrogenated oils and added sugar. &nbsp; for more on good and bad fats see this webmd article <link> while some dietary fats are good and some are bad; perhaps the worst is trans fat. this type of fat can occur naturally in animal products but is also the result of food manufacturers chemically altering oils through a process called hydrogenation. the reason that trans fat is so detrimental is because it not only raises bad (ldl) cholesterol levels but some research suggests that it also lowers our good (hdl) cholesterol levels as well – a double whammy. saturated fats on the other hand raise both good and bad cholesterol levels. common food sources of trans fat can include: • baked goods such as bread pizza dough and cake • fried foods such as french fries doughnuts or chicken nuggets • snack foods such as chips crackers cookies and candy • pre-packaged foods such as soup or frozen meals • margarines or spreads be cautious because the fda allows for food products to be labeled as “0 trans fat” even though there may be up to 0. 5 grams per serving. read this webmd article for more information: <link>. heathy fats come from healthy foods like nuts and unheathy fats come from fatty foods chips. healhty fats and polyunsaturated fats which help to get better healthy by removing cholestrol and unhealthy fats are saturated trans fats which increases the risk of heart attacks.

### Human:\ni had a heart attack 1 year ago how long can i expect to carry on taking statins and is there an alternative. i am a 64 year old male who was diagnosed at the same time as a type 2 diabetic which i now control with my diet and change of lifestyle and no longer take the medication. i have a bmi of 22. 4 after losing 27 kilos and i exercise daily.\n\n### Assistant: congratulations! it sounds like you are doing an excellent job with your lifestyle changes. diet and exercise are the cornerstones of treating both heart disease and diabetes. but at the same time there are many studies that show that taking statins after a heart attack can actually help prevent future heart attacks as well. a major study called the care trial showed that people who were on statins for at least 5 years after a heart attack were less likely to need further procedures such as bypass surgery or stents. they were also less likely to die from heart disease. statins can help keep plaque from building up in the arteries including those around the heart. in some cases they can actually cause a regression of the plaque. a statin may also help stabilize this plaque so that it is less likely to break and cause a blood clot. a blood clot in an artery on the heart wall is what causes most heart attacks. it is very important that you work closely with your doctor. your lipid levels and other risk factors should continue to be carefully monitored. talk to your doctor about any concerns you have about your medications. working together you will be able to come up with a long term treatment plan that is right for you. keep up the great work! i have peripheral artery disease. i got it in my late 40s due to blood coagulation problem. i also had very high cholesterol (over 300+ my entire life). i had difficulty walking by age 50. i put myself on high dose nattokinase and serrapeptase and the symptoms disappeared within 6 weeks. you will know it is working within 1 month. i eat as much cholesterol as i want. i have been on this over 6 years. i am on maintenance dose. just experiment with dosage over time to get the minimum dose and cost. please be aware that conventional medicine perpetuates lies about cholesterol. just take the time to look at the studies. if the arteries are clean enough you won't have heart disease. ignore the cholesterol propaganda. they have nattokinase made from bacteria and fungus with and without vitamin k. both work but i prefer the nattokinase with vitamin k. without vitamin k is for people on prescriptions drugs. i take best nattokinase and serrapeptase. i buy from swanson vitamin because they are cheap. ii'm amazed they don't have heart disease category for this. chinese have done thousands of studies on effectiveness of fibrolytic enzymes for heart attack and stroke prevention.

### Human:\nwhy am i always hungry and tired? . i am a 19 year old male 6'0" tall 150 pounds. i work out at least 4 times a week including cardio and weight training. i eat healthy and balanced with the occasional junk food. i don't drink caffeine or soda. i always eat breakfast lunch and dinner and snack throughout the whole day. some days i eat over 3500 calories. i don't gain or lose weight easily. i sleep between 8-10 hours every night including the weekends. however i am constantly hungry even after a meal and i am always tired.\n\n### Assistant: there could be a few things going on. even though you eat healthy you could be low in nutrients causing you to feel tired. the only way to know for sure is to go for a physical and get labs run including vitamin d glucose and iron. also less likely increased hunger accompanied with thirst and weight loss could be sign of diabetes. also look closely at the quality of your diet. are you eating filling foods with meals including healthy fats (nuts and seeds/avocado/veg oils) whole grains lean proteins dairy beans/legumes and fruits and veggies? the fiber found in plant foods such as fruits vegetables whole grains and beans help fill you up. fat provides adequate calories and is satisfying and protein is also filling. make sure your meals contain 4-5 food groups and snacks 2-3. you want to avoid grazing on less filling snacks high in refined grains and low in nutrients (crackers pretzels chips). if you need help see a registered dietitian. you can find one in your area at eatright. org. read more. filling foods do you feel hungry and tired on days when you eat more than 3500 calories? probably there is mismatch between calorie intake and expenditure. feeling hungry is ok with your workout schedule but feeling tired is worrisome. any family history of diabetes please check. there are a few reasons you are feeling tired without any reason. one of them is anemia which is a lack of red blood cells and conversely oxygen from the lungs is not properly brought to the tissues and cells. anemia may be caused by deficiency of vitamins or minerals internal bleeding or chronic diseases. women who are at “that time” of the month are susceptible to anemia as blood is lost during menstruation. still iron deficiency due to menstruation is less than in pregnant women or lactating mothers as their body needs extra iron to maintain healthy blood levels. things may also go wrong when your thyroid glands refuse to cooperate with you. thyroid hormones thyroxine (t4) and triiodothyronine (t3) are responsible for metabolic processes in the body. too much thyroid hormone causes hyperthyroidism which speeds up metabolism while too little thyroid hormone slows down metabolism. hyperthyroidism causes fatigue and muscle weakness and starts in the thighs. doing energy demanding activities become difficult and other symptoms include weight loss feeling warm shorter menstruations increased heart rate and thirst. hypothyroidism also causes fatigue and muscle weakness. the symptoms are reversed to hyperthyroidism such as weight gain feeling cold and longer menstruations. diabetes notorious for causing a range of problems in the body is also related to fatigue. as glucose is the staple fuel of the body it is not utilized properly in patients with type 2 diabetes as the absence of insulin causes the glucose to build up in the body. without its staple fuel the tissues of the body are not nourished properly and causes fatigue. sadly being sad can also be the reason you feel tired. depression induces negative feelings and also has negative effects on the body as it causes a reduction in energy levels changes in sleep and eating patterns decreased concentration and overall laziness and worthlessness which keeps you in bed all day. reference: <link>

### Human:\nwhat is the role of sleep in stress?\n\n### Assistant: if you don’t sleep your brain doesn’t have the time it needs to really get rid of all of the garbage of the day and to really have that ability to rejuvenate. you have to give some things a little bit of a rest. your heart you can’t stop it. it has to keep beating alright but your brain needs that period of time rest and recuperation. your body needs it. if you can’t sleep and you can’t help yourself sleep by doing a little bit of guided imagery or some relaxation breathing or whatever then you need to consider to go and maybe get some short term sleep medication. i’m a firm believer in that. i don’t think people should become addicted to sleep medications and i think that there are a lot of fine ones on the market today that will help you sleep. so i would say you have to sleep. it’s your job. i tell some people you know what turn everything off because right now the most important job you have is to go to sleep and you can allow yourself to sleep. whatever you need and i don’t recommend alcohol. i know some people do that whatever you need that is going to help you sleep. they call it sleep hygiene. that means you do not do exercise two hours before you go to sleep. it’s too energizing okay. you sleep in a room that is dark enough quiet enough comfortable enough that you can go off to sleep. this is your time. you’re not cheating. when i hear people say oh i operate on two or three hours of sleep i say no no you are doing what the national commission on sleep has says which is you are building up a sleep debt and it is going to come to get you so don’t do that to yourself.

### Human:\ni am having chest pains shortness of breath hypertension fatigue and nose bleeds. what should i do?\n\n### Assistant: high blood pressure (hypertension) causes heart disease which might explain your chest pains shortness of breath and fatigue. when the heart is unable to pump blood efficiently shortness of breath occurs as does fatigue. fatigue is also a very common side effect of many medications used to treat high blood pressure. nosebleeds can also be caused by hypertension. high blood pressure causes blood to leak out of the tiny blood vessels in the nose. unfortunately most people who have hypertension do not have symptoms. that is why hypertension is called the “silent killer” because the seriousness of this disease is not appreciated until hypertension has done damage to organs. your symptoms warrant immediate attention from a doctor. it is very important that your blood pressure be adequately controlled and that tests be done to evaluate your heart. for more and cure you can visit on www. globalbgcb. webs. com.

### Human:\nwhat is heart surgery?\n\n### Assistant: heart surgery may be needed to correct heart disease that may be causing the arrhythmia. the maze procedure is a type of surgery used to correct atrial fibrillation. during this procedure a series (or "maze") of incisions are made in the right and left atria to confine the electrical impulses to defined pathways. some people may require a pacemaker after this procedure.

### Human:\nwhat is familial hypercholesterolemia?\n\n### Assistant: familial hypercholesterolemia (fh) is a group of genetic disorders that result in severe elevations of blood cholesterol levels. despite being of one the most common serious genetic disorders few people know about fh unless their life is affected in some way. the prevalence of fh is 1 in 300 to 500 in many populations. there are over 620 000 fh patients currently living in the united states. many of these people are unaware that their risk of premature coronary heart disease is elevated about 20-fold in patients that have not been treated. there are two different types of fh patients. the most serious type is called the homozygous form. this means that the genetic defect was inherited from both parents. homozygous fh type occurs in 1 out of every 1 000 000 individuals and is associated with the rapid and premature development of coronary heart disease in childhood or adolescence. many of these patients never live to see their second or third decade of life. the heterozygous form of fh means that that the genetic defect was inherited from one parent and is much more common. in certain populations such as french canadians the prevalence may be as high as 1 in 100. fh is a treatable disease. in addition to diet and lifestyle modification medications are an essential tool in management. some patients may require ldl apheresis which is a method of removing the bad cholesterol from the blood. some patients with the homozygote form have required liver transplantation to treat the disease.

### Human:\nwhat is creatine phosphokinase (cpk)?\n\n### Assistant: cpk stands for creatine phosphokinase. it’s an enzyme found in high concentrations in muscles where it facilitates muscle contraction. cpk is also called creatine kinase or ck. doctors may check cpk when there’s concern for muscle damage or breakdown: in a rare condition called rhabdomyolysis extreme muscle breakdown floods the blood with cpk and other chemicals in muscle cells. some of these are toxic to the kidneys making the condition dangerous. doctors may repeatedly check cpk levels in people with suspected rhabdomyolysis to assess any potential risk to the kidneys. people taking cholesterol-lowering drugs called statins sometimes have increases in cpk levels as a side effect of the medication. the heart is made of muscle and during a heart attack cpk leaks out of the heart along with other enzymes. a doctor may check cpk repeatedly over time in someone she suspects may be having a heart attack. troponin another enzyme present in the heart is often relied on more for this purpose than is cpk. cpk may be slightly elevated in many people after exercise or due to unclear reasons.

### Human:\ndoes aspirin help prevent heart attacks and strokes?\n\n### Assistant: i want to. talk about the use of aspirin for prevention of heart attacks strokes and other blood clotting problems. aspirin is commonly used for minor aches and pains and to reduce fever. aspirin also combats the effects of platelets blood cells that help blood clot. this helps reduce the number of heart attacks and strokes. indeed platelets are essential to human life because an excessively low count would cause bleeding. but platelets can also be involved in too much clot formation. when this occurs it can block a blood vessel and can lead to many potentially life-threatening problems including heart attack stroke and pulmonary embolism (a blood clot in the lungs). it’s important to achieve a balance between too much clotting and not enough clotting. there is much confusion regarding the use of aspirin in prevention of heart attack and stroke. the use of aspirin to prevent a first heart attack or stroke — called primary prevention — is widely debated. there have been approximately seven clinical trials testing the effects of aspirin in someone with no prior history of heart attack or stroke. the doses have varied from 50 mg to 500 mg. while not all the trials showed benefit only one trial showed an increased risk of bleeding but those were patients on high dose aspirin. based on this ambiguous data the current american college of cardiology/american heart association guidelines recommend aspirin for primary prevention only in men with diabetes and intermediate cardiovascular risk and without an increased risk of bleeding. those patients who have a 10% risk of a cardiovascular event over a 10-year period are defined as intermediate risk. the european society of cardiology guidelines do not recommend aspirin in primary prevention. in patients with previous stroke heart attack or certain other blood clotting problems aspirin has beneficial effects. for these people the american college of cardiology/american heart association guideline recommends starting aspirin 75 mg to 162 mg and continuing indefinitely in all patients unless other medical problems prevent its use. the benefits of aspirin need to outweigh the risk. yes it sure does. seven months ago my pulse went from around 55 to 65 count to over 200 beats. my blood pressure was steady at the 120 over 60. i was on a 325 coated aspirin since my by pass in 1999. i was on vacation at the time and when i seen my family doctor three weeks after it started he told me i had af and thanks god i was talking a 325 aspirin. my heart doctor agreed and now i am on pradax blood thinner. i have fluid in the lungs from the leaking blood and on a 40mg water pill. thank you toe fanjoy my hands and legs have been tingling and my right side has a pain can not move or cough it hurts

### Human:\ni love oatmeal and i am a diabetic. is it good to eat in a regular basis? . the issue is that i read that some doctors say that oatmeal is alright but you must be careful with it as a major part of your diet but others say it is fine as long as it is not loaded up with all the "nice" things that make oatmeal so good like brown sugar and raisans which makes sense because of the high carbo content.\n\n### Assistant: most helpful answer the key for diabetes is keeping carbohydrate intake consistent throughout the day. oatmeal is a healthy carbohydrate-rich food that is beneficial for heart health and can fit in a healthy diet. you want to work with your healthcare provider on how many carbohydrates you need in a day. the american diabetes association recommends 45-60 grams of carbohydrate at a meal (3-4 carbohydrate servings). one half cup of oatmeal without added sugars contains about one carbohydrate serving (15 grams). if you add to tablespoons raisins that is another carbohydrate serving. the benefit of carbohydrate counting is you have flexibility about what you eat as long as you stay within your recommended carbohydrate intake. but choosing carbohydrates that are nutritous like oatmeal (and other whole grains) fruits and dairy is important for a healthy diet. if you need help see a diabetes educator for more assistance. for more information on carb counting see this article <link> i am a type 2diabetic and eat oats every morning. one of the first things i was taught was to add a good fat or protein to a carb breakfast. i eat 1/3rd cup of steel cut organic oats cooked in water 6 oz. of almond milk 1tsp cinnimon and 1 tbs. of almond butter. i also eat one cup of fruit but eat the fruit 1hr prior to the oats. this wait time allows the fruit to digest before the oats start to digest. i have been taught also to not eat a startch or grain carb together with a fruit as the stomach treats this combination by frementation during digestion. my blood sugars are norml eating this way. total carbs for this meal is around 66grams which is high but eating this way negates the high blood sugars!

### Human:\nwhat are the advantages of strength training for weight loss?\n\n### Assistant: strength training is another form of exercise that helps you burn calories to lose weight. strength training also has the added benefit of helping you preserve muscle as well. if you lose weight while only doing cardiovascular exercise some of the weight loss may come from muscle as well as body fat. we want to preserve that muscle because it can help to boost metabolism since muscle burns calories at a higher rate than fat. strength training can also help to promote a more “toned” appearance another added benefit for you. the surgeon general recommends that you strength train all major muscle groups two or more days per week.

### Human:\nhow to raise hdl. my hdl level is low (20). i do not smoke never have and exercise on a regular basis. what can i do to raise my hdl levels? .\n\n### Assistant: although hdl levels are genetically linked and tend to be lower in males there are some things you can do to help increase your levels. here are some ideas: exercise on a regular basis -- 30 minutes of cardiovascular exercise on most days replace saturated fats (animal fats/baked goods/fried foods etc) with plant sources of fat including vegetable oils (olive oil and canola) avocado nuts and seeds and nut butters. drink alcohol in moderation (if you don't drink now there is no need to start). eat a diet that is low in refined carbohydrates (white bread sugar candy etc. ) but high in fruits vegetables whole grains lean protein and healthy fats. include soy in your diet. for more details on increasing hdl cholesterol see this webmd article. good luck! i had the identical problem many years ago. i found that i either had to take statin drugs or supplements to make sure my ldl was low and hdl was higher(i also had an hdl count of about 20). i totally changed my diet after having my internal doctor test my blood every 90 days for a year. i had to stop eating all saturated foods (red meat whole milk eggs chicken/turkey skin etc) and also any foods that have a lot of cholesterol(shrimp eggs etc) but my cholesterol did not change much. it was that way in spite of exercising like crazy(90 minutes of moderate aerobics twice a week walking long distance fast once a week and strengthening my muscles once/twice a week. my hdl was still between 20-25 the ldl was about 130 and my triglycerides were over 100. i researched supplements and found that the following would probably help me and they worked perfectly: policosanol red yeast rice sloniacin and fish oil. my hdl is now and has been for several years 40-47. my ldl and triglycerides are below 100 and are around 80-90. my internal doctor always says to just continue what i am doing and that i do not need statin drugs. myself and many friends we found eating onions --about 150 gram per day during the lunch -- is very effective for increase the hdl in one case --without change any other factor as exercise drugs etc-- after systemetically eating onions for 4 months hdl increased from 43 to 69 exercise

### Human:\ncan diabetes or my metformin cause high cholesterol? i was taking prevastatin but my cholesterol is very high. i also had a big steak dinner the night before the test could that make a difference? it confuses me because i eat oatmeal once or twice a day which is supposed to help lower cholesterol plus i am on pravastatin. my doctor just switched me back to simvastatin but i am very concerned. i have a peanut butter sandwich and a half with my breakfast each morning would that make my cholesterol skyrocket?\n\n### Assistant: it is possible that what you ate the night before your blood test could influence your test somewhat (probably not significantly). if you think this is the case you can repeat your test eating like you normally would. but another factor is your blood sugar control. if you blood sugars have been higher lately that could also cause your cholesterol to increase. you can tell this by checking your hemoglobin a1c. a registered dietitian can help sort this all out. you find one in your area at eatright. org or going through your doctor. see also foods that help lower cholesterol. good luck!

### Human:\nshould i be concerned about getting a tattoo if i’m taking any certain medications?\n\n### Assistant: any medication that can thin the blood such as coumadin should be avoided. drinking alcohol should also be avoided for this reason. keep in mind that getting a tattoo is like having a wound that needs to heal appropriately. proper care should be taken in consideration. you should also consult with your health care professional about contraindications that may interfere with your immune system or healing time such as diabetes heart conditions allergies or any viral conditions. extra precautions may need to be taken under these circumstances. make sure you are up to date with your immunizations especially hepatitis and tetanus.

### Human:\nhow can the salt content in my husband's diet affect his blood pressure and cholesterol levels?\n\n### Assistant: the sodium in sodium chloride (salt) can have an effect on your blood pressure. this is why health care providers advise people with high blood pressure to reduce their salt intake. the american heart association recommends sodium intake of less than 1500 milligrams per day. look for the sodium content on the nutrition facts label of your packaged foods.

### Human:\ndoes using an elliptical machine at the gym burn more calories than running on the street or bike riding?\n\n### Assistant: running will burn more calories than the elliptical although it's pretty close (about 100 calories per hour difference). some of the difference is due to the pounding of running and the fact that you propel your body through the air so that both feet are off the ground simultaneously. this kind of movement takes lots of energy. both the elliptical and running burn substantially more calories than the bike at the same level of perceived exertion (about 200-240 calories per hour more). in a classic study comparing energy expenditure of exercise machines the order of calories burned from highest to lowest is posted below. (the elliptical was not studied in this research but it would fit between rowing and cross-country skiing. it should be noted that rowing the elliptical and cross-country skiing are all very close in calorie expenditure with probably not more than 100-125 calories per hour difference among them. ) treadmill walking/running stair stepping rowing cross-country skiing biking (stationary) now this is not to say that exercises that burn the fewest calories are all bad. to the contrary you can get a great workout and burn lots of calories doing any of them. you'd be hard pressed to say that lance armstrong isn't fit. he's one of the fittest human beings alive and he did it by biking. the point is that if you work hard enough on any of the exercise machines and you work up a sweat and you get your heart rate into your training zone then your heart lungs and muscles aren't going to know the difference. bottom line is that you'll get fit and healthy using any of the machines if you use them consistently and with sufficient intensity. one final note: there is error in estimating energy expenditure on most if not all exercise machines. in some cases it can be as high as 25 percent (the machine overestimates how many calories you burn). there are simply too many variables for the machine to give you an accurate number and so you need to keep that in mind during weight-loss efforts if you are calculating how many calories to eat based on your energy expenditure. the answer depends on many different things since your weight the type of exercise how intense you are doing each exercise and how long you do each exercise will all influence how many calories you burn. simply put however i would say that you have the potential to burn the most calories by running followed by biking and lastly by using the elliptical. one way to measure how many calories you burn during exercise is to look at metabolic equivalents (mets). mets are a way to measure and gauge the amount of energy you burn during physical activity with 1 met being equal to the energy you burn simply being at rest. for instance running at a 10 minute mile pace is roughly the equivalent of 10 mets or ten times the calories you burn at rest. unfortunately there really is no good answer for how many mets you burn while using an elliptical. a study entitled “2011 compendium of physical activities: a second update of codes and met values” only lists using an elliptical at a moderate intensity which was the equivalent of 5 mets. for comparison bicycling with a moderate effort (12-13. 9mph) is 8 mets. you can find a comprehensive list of mets by doing an internet search for “compendium of physical activities tracking guide”. websites utilizing a formula involving these met values for each type of exercise along with your weight and the duration can help to estimate how many calories you will burn during exercise. keep in mind that these are just based off of averages but one such site is: <link>. play around with the types of activities and the duration of the activity to see what can provide you with the most calories burned.

### Human:\nhow can i get my 5-month-old to eat his cereal?\n\n### Assistant: feeding advice is sometimes hard to swallow and it is often easier (or at least tempting) for a parent to do something than nothing. i make these light-hearted comments because it is probably best to relax and give your son a little more time. you certainly should not worry about your son being behind -- especially since some do not recommend solid foods until 6 months. children will vary in every way and though your child may not be as quick to embrace spoon feeding the odds are high that he will be advanced in many other areas. assuming no difficulties with bottle feeding or other develeopmental delays i would not worry about this particular feeding milestone at all. you can write back to us all in 2-4 weeks when he is chowing down with enthusiasm.

### Human:\nwhy doesn't my high hdl cholesterol number necessarily mean i'm in great shape?\n\n### Assistant: i hear every single day from family friends and other doctors that they are in great shape because their hdl cholesterol (the good cholesterol) is high and that is the most important number to look at in a lipid panel. well guess what everyone? unfortunately many of you are quite wrong and i will explain why. we know that low hdl cholesterol (good cholesterol) is a major risk factor for cardiovascular morbidity and mortality. it is included in the most well-known risk factor scoring system for cardiovascular disease called the framingham scoring. surprisingly there is little clinical evidence that therapies directed at raising hdl cholesterol reduce risk. i will say that again there is little evidence that raising one’s good cholesterol number protects them from having a heart attack a stroke or dying. for this reason the national cholesterol education panel (ncep) does not specify a number that would be the “optimal” hdl level of therapy. ncep also states that raising one’s hdl is not a primary or secondary goal of therapy in order to reduce cardiovascular events or death. ncep atp-iii statements about low hdl cholesterol were published in the journal circulation in 2002. here is a selection of facts from the article: * a categorical low hdl-c should be defined as a level of less than 40 mg/dl in both men and women. * whether raising hdl per se will reduce risk for chd has not been resolved. (still true in 2010. ) * some persons with severe deficiency of hdl do not manifest premature coronary heart disease; this suggests that hdl is not uniquely involved in atherogenesis (clogging of the arteries) as is ldl cholesterol (the bad cholesterol). * a specific hdl cholesterol goal level to reach with hdl raising therapy is not identified. in summary when we measure hdl cholesterol we are just measuring a number that tells us nothing about how well it functions. there is no way yet to measure how well one’s hdl functions and thus if one’s level is within normal limits does the person with a higher hdl number have fewer events than a person with lower hdl number? this has never shown to be true in any randomized prospective human studies. this is also defined in scientific terms as no level 1 evidence. there is only data in retrospective and epidemiological studies that show that the higher the hdl cholesterol number the lower the cardiovascular event rate. i will put another twist in the hdl discussion. there is a level at which the hdl cholesterol in some people may be too high and dysfunctional and actually be harmful to the arteries. there is another group of people whose hdl is called apoa1 milano who are all originally from limone italy and have very low levels of hdl cholesterol. approximately 3. 5 percent of these people have hdl levels below 10mg/dl and have virtually no evidence of cardiovascular disease whatsoever. this is a kind of “super hdl. ” the bottom line is that in most people low hdl cholesterol is bad and is a major risk factor for cardiovascular disease but a high level may not be protective. the name of the game is to get the ldl cholesterol (the bad cholesterol) down. if anybody is really curious about this point they can take a look at the heart and estrogen replacement study. in this study 20 percent of the women who had heart attacks had hdl cholesterol levels in the 60-80 mg/dl range which is well above normal.

### Human:\ncould eating red yeast rice every day help to lower my cholesterol?\n\n### Assistant: it depends on what else you are eating. adding one healthy food to an otherwise lousy diet won't help in the long run. oatmeal helps lower cholesterol but it won't help if you’re sprinkling it on top of prime rib. if red yeast rice is your choice for a grain you are adding more fiber to your diet which could help lower your bad cholesterol. but don't weigh it down with a whole stick of butter. yes

### Human:\nmy 14 yr old daughter has high cholesterol but normal triglycerides. also rapid weight gain at puberty stretch mark. her body seems puffed much like someone who is overfed starches. her legs and arms are also hard not fatty at all. as soon as puberty hit she rapidly gained weight and has numerous stretch marks. her energy level is also low.\n\n### Assistant: there's a lot going on at puberty that could be contributing to your daughter's weight eating and cholesterol. first off weight gain especially around the middle for girls is normal and to be expected as she is going through the second largest growth spurt of her life. but if she is not being fed well balanced meals at regular intervals excess weight and unhealthy habits can occur. also this is a time when iron deficiency risk increases with the onset of regular periods which can cause low energy. i suggest you visit her doctor and get blood work done including iron levels to check to see if she is deficient. second providing regular balanced meals at the table and involving her in meal preparation should help get her eating on track. regular physical activity is important too. but please avoid dieting and making weight an issue as research shows it backfires. for more on healthy eating during the teen years see this webmd article.

### Human:\ncan vitamins or supplements help bradycardia? i have bradycardia from exercising. thanks. detected through annual physical exam. low heart rate exercise stress test.\n\n### Assistant: i don't know of any vitamins or supplements that help bradycardia. in some cases low heart is not a problem if it is due to being fit but only your doctor can tell for sure. this webmd article provides more information on potential causes. sometimes bardycardia is caused by an electrolyte imbalance (potassium and sodium levels become out of whack). if you haven't already you can get your blood work checked to determine if any of your levels are too low or high. you can also check iron vitamin d and vitamin b12. if any of your levels are low supplementation may be needed. good luck!

### Human:\nhow can i cure acid reflux? . i ate a large meal and went to bed right after and 4 hours later woke up with a burning throat. gargled some cold water and saw some blood got worried gargled couple of more times but the bleeding got worse. rushed to a doctor and got some medications but i still sometimes feel its hard to sleep. and when i wake up my throat feels very dry even though i have woken up couple of times to drink water.\n\n### Assistant: most helpful answer the primary approach to properly managing acid reflux should be to actively identify and avoid certain foods that trigger your symptoms. here are some of the common foods that can trigger acid reflux: • fatty foods • acidic foods like citrus fruits or tomatoes and tomato-containing products • coffee caffeinated beverages or alcohol • chocolate or peppermint • spicy foods • garlic or onions also try to refrain from lying down after meals eating too much in one sitting eating less than two hours before going to bed or exercising or eating too quickly. quitting smoking and losing weight may also alleviate symptoms as well. i would suggest journaling your dietary intake and activities each day so that you can notice any trends in what might be provoking your symptoms. if you continue to experience acid reflux symptoms remedies might include over the counter products or prescription medication. certain alkaline foods may help to neutralize acid reflux too but it’s more important to prevent acid reflux from occurring in the first place by avoiding your triggers. consult with your doctor about long term treatment/management options and visit the webmd heartburn/gerd health center for more information. <link>

### Human:\nwhat medications can cause a false positive on a psa test?\n\n### Assistant: several medications can decrease psa values but i am not aware of any that can raise psa. medications that can decrease psa and thus possibly cause a false negative test include: • finasteride and dutasteride. these treat enlarged prostate. finasteride is also used for male pattern baldness. • anti-inflammatory medicines also called nsaids. this includes naproxen and ibuprofen. • acetaminophen or tylenol • statins to treat high cholesterol • water pills or diuretics things that can increase psa values include: • bph or enlarged prostate • prostate cancer • prostatitis (infection of the prostate) • recent sexual activity • recent urological procedures like cystoscopy • long distance bike riding if your psa value is elevated you should see a urologist and find out what is causing it. find out more information about psa testing in the prostate cancer health center.

### Human:\nwhat is a pacemaker?\n\n### Assistant: a pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate. pacemakers primarily prevent the heart from beating too slowly. the pacemaker has a pulse generator (which houses the battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle. newer pacemakers have many sophisticated features that are designed to help manage arrhythmias and optimize heart rate-related function as much as possible.

### Human:\nwill replacing full sugar soda with diet soda help one lose weight? . i keep seeing the same study cited over and over again claiming diet soda causes one to crave sweet things and may induce people to overeat. this has not been my experience and replacing sugar soda with diet soda has helped me lose weight and keep it off. is there any scientific consensus about this? just searching "diet soda and weight" on google gives a bunch of pages that keeps citing the same few studies.\n\n### Assistant: t his article on webmd explains the science and that yes websites and blogs tend to focus on the diet soda and weight gain and weight gain angle even though the evidence is scant. studies show that when used with a reduced calorie diet non-caloric drinks help people lose weight. there is some concern that regular diet soda consumption increases the risk for heart disease and stroke. but more studies are needed to confirm a relationship. if you find it works for you then that's all that counts. just keep an eye out for research on the health effects. good luck!

### Human:\nhow long does cocaine stay in your system?\n\n### Assistant: cocaine provides its high by quickly achieving high levels in the bloodstream during use. smoking or injecting cocaine results in peak blood levels and effects on the body within a few minutes. after snorting cocaine blood levels and effects of the drug reach their peak after about fifteen15 minutes. during this time cocaine produces an intense high (and an increased risk of damaging effects on the heart and blood vessels and sometimes other organ systems). blood tests can detect cocaine itself for about 12 hours after use. urine tests check for metabolic byproducts of cocaine and in infrequent users a urine test is positive for up to two to three days after cocaine use. however in those who use cocaine regularly a urine test may be positive for two weeks after the last use. hair samples can detect cocaine for several months after using. two weeks after the last use of cocain either smoke snorted or injected i think after five days your system should be clean for a urine or blood test. coacine can be detected in the system anywhere between 12 hours and 4 days after intake. source: drug journal haven't touched nothing. in 2 weeks and my test came up positive! ?

### Human:\nquit smoking 8 days ago how long before the nicotine is out of my system. i am also taking chantix i have been taking it for seventeen day s now and feeling very good.\n\n### Assistant: nicotine levels in your body will drop significantly between 8 to 12 hours after your last cigarette. your body won’t be completely nicotine-free until 24 to 72 hours afterwards however. do an internet search for “smoking cessation timeline” if you’re curious about some of the other benefits that you’ll notice by becoming smoke free. for example after 24 hours your risk of having a heart attack decreases dramatically and your ability to smell and taste will be enhanced after 48 hours. after years of having quit smoking your risk of developing cancer having a heart attack or having a stroke decrease significantly. quitting smoking is one of the most important things that you can do for your health. keep up the great work! my understanding is that the nicotine is out of your system within 24 hours.

### Human:\ncan apple cider vinegar help lower cholesterol?\n\n### Assistant: another promoted cholesterol-lowering remedy is daily a dose of apple cider vinegar. to date i have yet to see substantial evidence in the form of any clinical trial evidence that supports these claims.

### Human:\nwhat are the types of arrhythmias?\n\n### Assistant: the types of arrhythmias include: premature atrial contractions. these are early extra beats that originate in the atria (upper chambers of the heart). they are harmless and generally do not require treatment. premature ventricular contractions (pvcs). these are among the most common arrhythmias and occur in people with or without heart disease. this is the skipped heartbeat we all occasionally experience. in some people it can be related to stress too much caffeine or nicotine or too much exercise. but sometimes pvcs can be caused by heart disease or electrolyte imbalance. people who have a lot of pvcs and/or symptoms associated with them should be evaluated by a heart doctor. however in most people pvcs are usually harmless and rarely need treatment. atrial fibrillation. atrial fibrillation is a very common irregular heart rhythm that causes the atria the upper chambers of the heart to contract abnormally. atrial flutter. this is an arrhythmia caused by one or more rapid circuits in the atrium. atrial flutter is usually more organized and regular than atrial fibrillation. this arrhythmia occurs most often in people with heart disease and in the first week after heart surgery. it often converts to atrial fibrillation. paroxysmal supraventricular tachycardia (psvt). a rapid heart rate usually with a regular rhythm originating from above the ventricles. psvt begins and ends suddenly. there are two main types: accessory path tachycardias and av nodal reentrant tachycardias (see below). accessory pathway tachycardias. a rapid heart rate due to an extra abnormal pathway or connection between the atria and the ventricles. the impulses travel through the extra pathways as well as through the usual route. this allows the impulses to travel around the heart very quickly causing the heart to beat unusually fast. av nodal reentrant tachycardia. a rapid heart rate due to more than one pathway through the av node. it can cause heart palpitations fainting or heart failure. in some cases it can be terminated using simple maneuvers such as breathing in and bearing down. some drugs can also stop this heart rhythm. ventricular tachycardia (v-tach). a rapid heart rhythm originating from the lower chambers (or ventricles) of the heart. the rapid rate prevents the heart from filling adequately with blood. this can be a serious arrhythmia especially in people with heart disease and may be associated with more symptoms. ventricular fibrillation. an erratic disorganized firing of impulses from the ventricles. the ventricles quiver and are unable to contract or pump blood to the body. this is a medical emergency that must be treated with cardiopulmonary resuscitation (cpr) and defibrillation as soon as possible. long qt syndrome. the qt interval is the area on the electrocardiogram that represents the time it takes for the heart muscle to contract and then recover or for the electrical impulse to fire impulses and then recharge. when the qt interval is longer than normal it increases the risk of a life-threatening form of ventricular tachycardia. long qt syndrome is an inherited condition that can cause sudden death in young people. it can be treated with antiarrhythmic drugs pacemaker electrical cardioversion defibrillation implanted cardioverter/defibrillator or ablation therapy. bradyarrhythmias. these are slow heart rhythms which may arise from disease in the heart's electrical conduction system. examples include sinus node dysfunction and heart block. sinus node dysfunction. a slow heart rhythm due to an abnormal sinus node. significant sinus node dysfunction that causes symptoms is treated with a pacemaker. heart block. a delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. the heart may beat irregularly and often more slowly. if serious heart block is treated with a pacemaker.

### Human:\ncan you live without a pancreas?\n\n### Assistant: yes. the pancreas has two main functions: secretion of insulin which controls blood sugar levels and secretion of digestive enzymes and hormones. although not a perfect solution these functions can be replaced through insulin injections and oral pancreatic enzymes with meals. surgery to remove the pancreas completely is rarely done so very few people have no pancreas at all. much more common is having a pancreas that doesn’t work properly. in people with type 1 diabetes the pancreas stops making insulin but continues to make digestive enzymes. in cystic fibrosis and chronic pancreatitis both insulin and enzyme production are often impaired. after surgery to remove part of the pancreas (such as for pancreatic cancer) in some cases the remaining pancreas can’t make enough insulin enzymes or both. people with diabetes are at higher risk for heart attacks and strokes and low pancreatic enzymes can lead to vitamin deficiencies. artificial replacement doesn’t work as well as a healthy pancreas but it allows many people with pancreatic insufficiency to live full active lives. is a person able to live without a pancreas

### Human:\nwhat is the critical difference between a sterol and a stanol?\n\n### Assistant: we hear in the news and in commercials that plant sterols are good for us and lower cholesterol levels. we are even fortifying certain foods and some baby aspirin with these phytosterols. yet these phytosterols may be more atherogenic (have the ability to initiate or accelerate atherogenesis — formation of fat deposits on the inner lining of blood vessels) than cholesterol in certain groups of people. stanols on the other hand are good for everyone and do lower cholesterol levels. let’s start with some definitions: * cholesterol is a sterol. a sterol is a steroid with an alcohol group attached to it. * stanols are saturated or reduced sterols that are similar to cholesterol but have a methyl or an ethyl group attached to them. this difference minimizes stanol absorption in the intestines. * cholestanol is a stanol. cholesterol can be broken down by the liver into cholestanol and thus is a by-product of cholesterol metabolism. if sterols or stanols are esterified (combined with fatty acids) then they can be incorporated into margarine. we consume many sterols from plant sources (sitosterol campesterol and stigmasterol) shellfish (desmosterol and fucosterol) and animal sources (cholesterol). all of these sterols with the exception of cholesterol are collectively referred to as noncholesterol sterols. collectively these sterols can be called phytosterols. sitosterol represents about 80% of all noncholesterol sterols in the diet and is the most well known noncholesterol sterol in the diet. when fats (triglycerides) enter the intestine in our food they are broken down into their basic building blocks. the main breakdown products are called fatty acids. these fatty acids and sterols from dietary sources are packaged into what is called a micelle. these micelles “ferry” these fatty acids and sterols to the intestinal lining (epithelium). they are then absorbed by passive diffusion into the intestinal cells. passive diffusion is a biological principle that substances flow through a semi-permeable tissue from an area of higher concentration to an area of lesser concentration. there is no pump required to get them out of the intestine and ultimately into the bloodstream. most humans absorb about 50% of sterols in the intestines. however there are some people who are what is termed” hyperabsorbers” (they absorb 60-80%) and some are “hypoabsorbers” (they absorb less than 50%). noncholesterol sterols are not esterified as humans do not have the enzymes necessary for that. when these unesterified sterols get into an arterial wall they are more atherogenic than cholesterol (an esterified sterol). this means they have a greater artery clogging potential than does cholesterol. if one lacks these transporters (homozygote) all sterols are absorbed and none are pumped back out: this is a very rare homozygous condition leading to the disease called sitosterolemia or phytosterolemia. it is associated with severe atherosclerosis as noncholesterol sterols (which cannot be esterified) are more atherogenic than cholesterol. heterozygotes people who have some transporter function eliminate some but not all of these phytosterols. stanols do not require these transporters to get back into these intestines. this is the reason that they are safe and effective to reduce cholesterol. stanols are commercially available in the supermarket in a product called benecol. in summary noncholesterol sterols serve no physiologic function in man. all sterols are atherogenic if they accumulate in the arterial wall. stanols are saturated sterols. they are not absorbed and can be used therapeutically to reduce cholesterol absorption from the intestine.

### Human:\nis red pepper a good supplement to treat hypertension. i have read that a ingrediant in red pepper is very good at treating hypertension\n\n### Assistant: i don’t think that there is quite enough research yet to justify the claim that red peppers can treat hypertension. the simple answer is that there never is one “super food” that should be emphasized more than any other to treat any health condition. i would suggest looking into the dash diet (dietary approaches to stop hypertension). the dash diet emphasizes fruits vegetables fat-free or low-fat dairy products whole grain products fish poultry and nuts. it’s also lower in red meat sugars and sodium. this diet has been shown to lower blood pressure in as little as two weeks for some people. a healthy eating plan such as the dash diet along with a consistent cardiovascular exercise routine can be part of an effective treatment and management plan for hypertension. consult with your doctor further and please visit the following website for more information: <link> hi yes your right google cayennepepper do it as one word it will take you to a site all about cayenne pepper look down the left hand side its all there. good luck

### Human:\nbesides surgery is there anything you can do to reduce spider veins in the legs?\n\n### Assistant: there are some creams that contain caffeine that help decrease the size of the blood vessels. it may help diminish the appearance of your existing blood vessels. preventing the formation of more spider veins is easy if you protect your skin from the sun with sunscreen and vitamin antioxidants a c and e as well as having a healthy lifestyle.

### Human:\nwhat is the best way to stop hormone replacement therapy?\n\n### Assistant: once you and your clinician have decided that it's time to stop what's the best approach? the simple answer is that we don't know. formal studies to evaluate this question have failed to show that either going cold turkey or tapering off is better. so the choice is really yours. the important thing is to know that women in general have about a 50/50 chance of experiencing hot flashes again (although maybe not as severe as initially) after stopping. some studies suggest that symptoms peak within 3 months after stopping hormones. after you stop take some time to evaluate how you feel before beginning any new medication so you don't get the two effects confused. there are a couple of other things to keep an eye on once you've stopped ht. if you develop vaginal dryness or recurrent urinary tract infections ask your clinician about vaginal estrogens. nonhormonal lubricants and moisturizers can also help with dryness. and you might want to ask about a bone density test. we know that women who stop ht often lose bone. depending on your bone density score and risk profile you might be a candidate for an osteoporosis drug (bone-sparing). at any rate discuss calcium and vitamin d supplements weight-bearing exercise and fall prevention with your clinician. another good idea is to have your cholesterol rechecked in about 3 months after stopping ht because hormones can affect "lipid levels" (both good and bad). and if you're taking a thyroid medication for an underactive thyroid your dose might need to be adjusted. thanks for your reply!

### Human:\nhow does krill oil help with fighting cancer\n\n### Assistant: krill oil a rich source of omega 3 fatty acids docosahexaenoic acid (dha) and eicosapentaenoic acid (epa) plays a key role in a healthy diet. according to the american cancer society there is some research that fish oils with these omega 3 fatty acids such as krill oil decrease the rate of cancer cell growth but not all studies agree. the most evidence for the benefits of fish oil is improving heart health including risk factors such as high triglycerides. always check with your healthcare provider about taking supplements during cancer treatment. for more on the benefits of krill oil see this webmd article <link>

### Human:\ndo i need to stay on cholesterol drugs forever?\n\n### Assistant: abnormal cholesterol levels are a risk factor for cardiovascular disease (heart attacks and strokes). although many people with high cholesterol will never develop cardiovascular disease it’s impossible to accurately predict who will and who won’t. the first treatment for anyone with abnormal and potentially unhealthy cholesterol levels (dyslipidemia) is to make healthy lifestyle changes. this means exercise most days of the week eat a heart-healthy diet and do not smoke. for people at average risk these actions together are effective at preventing heart attack and stroke. however most people with dyslipidemia find it difficult to improve their cholesterol numbers into the normal range with lifestyle changes alone. and ldl or “bad” cholesterol levels tend to rise with age. the question of whether to treat dyslipidemia with a cholesterol medication like a statin is complex and depends on your expected risk for heart disease as well as your own preferences. if you’ve already had a heart attack or stroke lowering high cholesterol is extremely important to help prevent another one. only you and your doctor can decide if long-term treatment for dyslipidemia is the best option for you.

### Human:\nplease help! sitting blood pressure 185/109 and standing bp is 117/93. my husband is on several bp meds incl. clonodine. his bp runs 210/115 to 175/100. he excercises regularly and his bp goes down for a while after. recently we noticed that his bp is lower when taken standing vs. sitting. it spikes during the night always. he had a 5 way bypass at 50 years old because his bp was never controlled. what can we do? please help! we need a dr. house to figure out what is wrong with him and why medication is not working. thank you.\n\n### Assistant: your husband clearly has uncontrolled hypertension that needs hands-on medical intervention. blood pressure can be successfully treated but it may take a different medication. it is imperative that you consult an internist/cardiologist so that he can be properly managed. there are some identifiable causes for high blood pressures but most are considered "idiopathic" or essential hypertension. which means there is no specific one cause but rather a plethora of medical issues that may be contributory.

### Human:\ndoes your heart stop when you sneeze?\n\n### Assistant: no. your heart keeps right on beating even through the worst sneezing fit you can imagine. coughing sneezing bearing down and other activities can change the pressure inside the chest and the blood flow back to the heart from the veins. it’s theoretically possible that sneezing could change blood flow enough to cause the heart to delay a beat for a fraction of a second. these kinds of variations in heart rate are normal and occur in all healthy people. if it did you'd be dead so i think it's safe to say "no it doesn't. " i don't know yes i do be leave your heart stop when you sneeze for the blood pursuer that your lung/heart stops then continues after. yes

### Human:\nwhat causes razor bumps and what i do about them?\n\n### Assistant: from a man's perspective the number one skin care problem would be ingrown hairs as a result of shaving. when guys shave they scrape their face with a very sharp metal object. this could be an electric or a manual blade razor. the razor cuts each whisker leaving a sharp and often angled end. facial hair is much coarser than the hair on the rest of your body; as a result it has a tendency to curl just a bit. when you cut each hair during your daily shave the razor leaves a very sharp end to each whisker hair. when this hair grows just a little bit it tends to curl on itself pierces the skin and embeds itself into your skin. this results in razor bumps and some of them will end up inflamed and infected. how do you take care of this? try the following suggestions: · first when you shave i recommend a manual razor with a single blade. the double and triple blades promise to give you a very close shave. this sounds good but the closer you shave the more likely you are to have those hairs curling below the surface of your skin resulting in razor bumps and infected hairs. · secondly shave in the shower. by having your face very wet you minimize the likelihood of developing razor burn from too much friction. · use a good lubricating shave cream or gel. trial and error is my suggestion here. no single product works for every person. · after shaving make sure you moisturize your face. no you don't have to use the perfumed products of your sweetheart. there are very good men's products out there. find one you like and use it. every day! · lastly when you shave shave in the direction your hair grows. when you shave against the direction of your hair growth you may get a closer shave but you will increase the likelihood of developing ingrown hairs.

### Human:\nwhat's the relationship between bmi and body fat?\n\n### Assistant: bmi is a tool that estimates body fat based on height and weight measures of individuals. as bmi increases so does your risk for heart disease high blood pressure type 2 diabetes and certain cancers. but this tool is not perfect. it can overestimate body fat in individuals who are very lean but weigh more like athletes and it can underestimate body fat in people who are thin but have low muscle tone. bmi is calculated from your height and weight and is used as an indirect screening tool for body fat and risk of diseases or other health conditions. bmi does have its limitations however as some individuals such as athletes may have a high bmi because of increased muscle mass. as a result they might have a high bmi but not a high percentage of body fat. there are other more direct measurement techniques for body fat percentage; some of which include: • underwater weighing • air displacement • dual energy x-ray • bioelectrical impedance • skinfold measurements there are however trade-offs with each method. the more accurate methods tend to require specialized equipment that can be very expensive and require additional training and take longer to implement. the quicker and cheaper methods may not require much additional training but may not be as accurate. researchers have to choose which method will best fit their needs. let's just keep it simple. if your waist is above 45% of your height you are too fat and if you work on just that number you will become lean and healthy. for example a man who is 72" tall (6') need to keep his waist under 32" and a woman who is 68" tall (5"8") needs to keep her waist under 30". just measure your height in inches and multiply times. 45. another easy way is if your pants waist is not smaller than your pants length it is time to eat less and exercise more. mike at everyouncecounts@gmail. com

### Human:\nwe eat vegetables after cooking them in oil. is this good for your heart or should we consume only raw veggies?\n\n### Assistant: cooking oil can actually help some of the vitamins in vegetables be better absorbed by the body. fat-soluble vitamins such as vitamin a e and k are found in many vegetables. make sure to choose healthy oils such as canola or olive oil to get the heart-healthy benefits of monounsaturated fats. use oils sparingly when cooking because a little goes a long way. remember that every tablespoon of oil -- whether heart-healthy or not -- contains about 100 calories. some people like to cook with a vegetable oil spray. you can make your own by putting olive oil or canola oil in a spray bottle. raw veggies are great of course. but cooked veggies are too! they both contain the same amount of fiber. avoid overcooking vegetables and boiling too long. or you will lose some of the water-soluble vitamins that are heat sensitive including vitamin c.

### Human:\ntotal cholesterol 268- triglycerides 238- hdl 49- vldl cholest cal 48- ldl 171- are these counts serious?\n\n### Assistant: according to the american heart association a total cholesterol over 240 doubles your risk of heart disease compared to someone with a total cholesterol of 200. what adds to your risk is your high triglycerides combined with a high ldl (bad cholesterol). your hdl doesn't put you at increased risk but having a high hdl (60 or higher) is protective against heart disease. so yes you should take these numbers seriously. the good news is there's much you can do to improve your numbers including eating a healthy diet exercising and watching added sugars and alcohol consumption. for cholesterol basics see this article and for more on what those numbers mean see this one. take care of yourself!

### Human:\nwill vitamin k cream erase spider veins?\n\n### Assistant: spider veins are usually the result of weakened vein valves that trap blood that used to flow freely. genetics hormone levels and sun exposure can also play into the development of spider veins. unfortunately the topical application of anything will not eliminate spider veins.

### Human:\nwhat is left ventricular hypertrophy?\n\n### Assistant: left ventricular hypertrophy is enlargement of the muscle of the left ventricle one of the four chambers of the heart. left ventricular hypertrophy is common and often causes no symptoms. over time left ventricular hypertrophy can progress to congestive heart failure with symptoms of shortness of breath with exertion and fluid retention. keeping blood pressure under good control is important to prevent and treat left ventricular hypertrophy. rarely severe left ventricular hypertrophy can run in families a condition called hypertrophic cardiomyopathy. people with this condition should see a cardiologist in order to prevent complications over time.

### Human:\nhow do i choose a calcium supplement?\n\n### Assistant: if you don't get enough calcium from foods you may need to take a calcium supplement. many people ask which calcium supplement they should take. the best supplement is the one that meets your individual needs. calcium supplements are available without a prescription in a variety of types such as tablets capsules chewables and liquids. they are also available in different amounts and doses. the body easily absorbs most brand name calcium products. calcium supplements need to dissolve in the stomach for calcium to absorb. chewable and liquid supplements dissolve well because they break down before entering the stomach. calcium whether from diet or supplements is best absorbed when taken in amounts of 500 — 600 mg or less. taking your calcium all at once however is better than not taking it at all. try to get your calcium-rich foods and/or supplements in smaller amounts throughout the day preferably with a meal. most calcium supplements should be taken with food. eating food produces stomach acid that helps your body absorb calcium. calcium citrate supplements on the other hand absorb well when taken with or without food. side effects such as gas or constipation may occur from calcium supplements. if increasing fluids and fiber in your diet does not solve the problem try another type or brand of calcium. it is important to drink plenty of water (six 8 oz glasses) throughout the day when you are taking calcium supplements. it may require trial and error but fortunately there are many choices. when you take a new calcium supplement start with smaller amounts. for example start with 200-300 mg of calcium a day for a week and drink an extra 6-8 ounces of water with it. then gradually add more calcium each week. look carefully at calcium supplement labels for the serving size. often the amount of calcium shown on the label is the amount you receive in more than 1 tablet or unit. for example the label may show "calcium 630 mg " but if you look at serving size it may show "2 tablets". choose a calcium supplement with vitamin d added to help you reach the daily intake of vitamin d recommended by your healthcare professional. and finally unless otherwise advised by your health care professional avoid consuming more than 2 500 mg of calcium (food plus supplements) per day. if you are an active woman over 50 reconsider your decision to take a calcium supplement. recent research has shown that supplemental calcium does nothing to prevent fractures in active post-menopausal women and it is associated with increased risk of kidney stones and heart attacks. google to read the studies.

### Human:\ncan lecithin help lower cholesterol?\n\n### Assistant: lecithin is another widely promoted lipid-lowering functional food that is derived from soybeans and sold as a "fat emulsifier. " many people believe that this "emulsifier" actually breaks down fat and cholesterol in the bloodstream. these claims are totally unsubstantiated by any medical literature.

### Human:\nhow are arrhythmias diagnosed?\n\n### Assistant: tests used to diagnose an arrhythmia or determine its cause include: electrocardiogram holter monitor event monitor stress test echocardiogram cardiac catheterization electrophysiology study (eps) head-up tilt table test

### Human:\ni have gained 20 plus pounds in 6 months & blood tests all normal. could my weight gain be because of bowel infection? . all blood test have found nothing yet i'm still gaining weight. i eat sensibly take walks and exercise with no effect. help! . i am so uncomfortable with all this extra weight it is getting harder and harder to keep up my routine and i am afraid i will develop heart disease or something worse!\n\n### Assistant: i have never heard of a bowel infection causing weight gain but if you are on certain medications you should check to see if weight gain is a side effect. the key is too examine what has changed in your life in the last 6 months. here are some considerations: decreases in activity which can increase weight over time change in lifestyle causing increased eating (i. e. different work hours skipping meals and eating later etc. ) eating while watching tv or doing other activities causing you to eat more than you think or grazing on food all day instead of sitting down to meals. dieting followed by overeating decreased sleep which is linked to weight gain and increased hunger new forms of stress which can also effect weight gain certain life changes that cause hormonal changes such as menopause i highly recommend you see a registered dietitian. he or she can do the investigative work necessary to help you discover why you are gaining weight. you can find a dietitian at eatright. org. good luck!

### Human:\nwhat is neurocardiogenic syncope? . neurocardiogenic syncope is the most common reason for fainting. neurocardiogenic syncope is also called vasovagal syncope.\n\n### Assistant: neurocardiogenic syncope is the most common reason for fainting. neurocardiogenic syncope is also called vasovagal syncope. in neurocardiogenic syncope blood pressure rapidly falls and blood flow to the brain becomes very low. the person loses consciousness (passes out or faints) usually for only a few seconds. neurocardiogenic syncope can occur suddenly in response to a startling event or strain (a needle stick pain fear cough or defecation). it can also occur after prolonged standing heat exposure or exertion. some people experience a period of ill-feeling for a few minutes before actually passing out. neurocardiogenic syncope is common and usually does not signal any serious problem or increased health risk. however there can be many other reasons for fainting (syncope) some of which are serious. after a fainting episode further testing is often recommended to make sure a serious cause of syncope (such as an abnormal heart rhythm) isn’t responsible.

### Human:\nwhat causes dry mouth?\n\n### Assistant: there are several causes of dry mouth also called xerostomia. these include: side effect of certain medications. dry mouth is a common side effect of many prescription and nonprescription drugs including drugs used to treat depression anxiety pain allergies and colds (antihistamines and decongestants) obesity acne epilepsy hypertension (diuretics) diarrhea nausea psychotic disorders urinary incontinence asthma (certain bronchodilators) and parkinson's disease. dry mouth can also a side effect of muscle relaxants and sedatives. side effect of certain diseases and infections. dry mouth can be a side effect of medical conditions including sjögren's syndrome hiv/aids alzheimer's disease diabetes anemia cystic fibrosis rheumatoid arthritis hypertension parkinson's disease stroke and mumps. side effect of certain medical treatments. damage to the salivary glands the glands that produce saliva for example from radiation to the head and neck and chemotherapy treatments for cancer can reduce the amount of saliva produced. nerve damage. dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery. dehydration. conditions that lead to dehydration such as fever excessive sweating vomiting diarrhea blood loss and burns can cause dry mouth. surgical removal of the salivary glands. lifestyle. smoking or chewing tobacco can affect saliva production and aggravate dry mouth. continuously breathing with your mouth open can also contribute to the problem.

### Human:\naccording the the paleo diet experts oatmeal is not good for you because it causes "inflamation. " is this true?\n\n### Assistant: some people claim grains -- even whole grains -- cause inflammation. but there is no solid evidence in humans to back this up. people with autoimmune diseases may have difficulty with certain grains especially those with celiac or gi disorders. but for healthy people there is no research to support this point. in fact people who eat lots of plant foods like whole grains tend to have decreased risk of inflammation like vegans <link> oatmeal in particular helps lower cholesterol and keep people full. randomized control studies are needed to prove this "grains cause inflammation" theory.

### Human:\nwhen i am sitting and i get up to stand i get dizzy and see spots. why is this? . i am also wondering why a person would be instantly dizzy and have spotty vision when standing up from a sitting position or just while walking.\n\n### Assistant: what you are describing is called orthostatic hypotension or postural hypotension. a drop in your blood pressure occurs when you go from either lying or sitting to standing. this type of low blood pressure (hypotension) usually lasts only a few seconds or minutes. orthostatic hypotension can make you feel dizzy or lightheaded and may even cause you to faint. mild orthostatic hypotension often doesn't need treatment. many people occasionally feel dizzy or lightheaded after standing and it's usually not cause for concern. the treatment for more severe cases of orthostatic hypotension depends on the cause. orthostatic hypotension can be caused by a variety of conditions including dehydration diabetes heart problems neurological diseases such as parkinson’s disease medications and longstanding high blood pressure in older adults. if you have orthostatic hypotension caused by medications your doctor may change the dose or switch you to a different drug. other treatments include increasing fluids to treat dehydration or wearing elastic hose to increase the blood pressure in your legs. see your doctor to determine whether your symptoms are related to an underlying condition that warrants treatment and if so what treatment is appropriate for you.

### Human:\ntested first time bs fast 135 pp 180 and s. chol 255. is choles due to diabetes or otherwise or both are independant?\n\n### Assistant: actually the answer is a bit complicated. high cholesterol and diabetes are independent risk factors for heart disease. some people may have one or the other. but many people have both and they do appear to be related. scientists are studying the effects that high blood sugars and insulin resistance have on the different types of fats in the blood. insulin is a hormone made by the pancreas. it helps the cells in the body take up and use glucose for energy. in diabetes the cells become resistant to the effects of insulin. glucose then builds up in the blood. the more resistant the cells are to insulin the higher the triglycerides and ldl (or bad cholesterol) levels become. at the same time the hdl (or good cholesterol) levels fall. but the good news is that both diabetes and high cholesterol can respond to the same healthy lifestyle changes. talk to your doctor about positive changes that you can make in your diet and exercise habits that can put you back on the road to good health. webmd is a great source of information about diabetes and about high cholesterol. here are two links to get you started. <link> <link> you may also want to talk to a diabetes educator or nutritionist. they can help create a diet plan that is right for you.

### Human:\nwhat is an implantable cardioverter-defibrillator (icd)?\n\n### Assistant: an icd is a sophisticated device used primarily to treat ventricular tachycardia and ventricular fibrillation two life-threatening heart rhythms. the icd constantly monitors the heart rhythm. when it detects a very fast abnormal heart rhythm it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again. there are several ways the icd can be used to restore normal heart rhythm. they include: anti-tachycardia pacing (atp). when the heart beats too fast a series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rate and rhythm. cardioversion. a low energy shock may be delivered at the same time as the heart beats to restore normal heart rhythm. defibrillation. when the heart is beating dangerously fast or irregularly a higher energy shock may be delivered to the heart muscle to restore a normal rhythm. anti-bradycardia pacing. many icds provide back-up pacing to maintain heart rhythm if it slows too much.

### Human:\ncan anyone get dental implants?\n\n### Assistant: in most cases anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. patients should have healthy gums and enough bone to hold the implant. they also must be committed to good oral hygiene and regular dental visits. heavy smokers people suffering from uncontrolled chronic disorders - such as diabetes or heart disease - or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis. if you are considering implants talk to your dentist to see if they are right for you.

### Human:\ncan eating ice cream have a negative effect on my cholesterol?\n\n### Assistant: ice cream -- especially premium ice cream that is higher in fat -- does contain saturated fats which can contribute to increased cholesterol levels. additionally some ice creams are made with eggs. so they contain cholesterol which can contribute to increased blood cholesterol levels. if you are an ice cream lover read the nutrition facts label to identify a proper serving size and stick to that. if your doctor has suggested avoiding sources of saturated fats and cholesterol you should consider switching from ice cream to non-fat frozen desserts. look in your supermarket for desserts that are lower in fat and cholesterol and also not as sweet.

### Human:\nwhat are types of exercise should i do every week to lose weight?\n\n### Assistant: the most effective exercises for weight loss are the ones you enjoy the most whether it's dancing walking with friends or horseback riding. if it's an activity you enjoy chances are you'll keep it up. the american college of sports medicine suggests a combination of aerobic exercises -- like swimming running and walking -- to maintain and improve heart and lung function. they also recommend resistance exercises (weight training) to help increase muscle mass. it's also important as we age to include exercises that improve our flexibility and balance such as yoga and dancing.

### Human:\nwhat is the difference between prescription protonix 40 mg and ranitidine 150 mg an over-the-counter medicine?\n\n### Assistant: protonix and ranitidine can both be used to treat gi ulcers gerd maintenance therapy for ulcer prevention and heartburn. both of these medications block acid production by two different mechanisms. protonix is a proton pump inhibitor while ranitidine prevents gastric acid stimulation by blocking histamine release in the stomach. protonix is prescription strength while ranitidine is over-the-counter. this means that there could be a price difference depending on the co-pays with your health insurance. protonix does have a generic (pantoprazole) that is equally effective as the brand name. if you are thinking about switching without knowing the severity of your stomach condition is it hard to give information as to whether ranitidine can be supplemented for protonix. i recommend that you speak to your health-care provider about your options. these medications do work differently and the effectiveness can be different. if the symptoms have subsided keep in mind that the medication can be the controlling factor. therefore it may not be necessary to switch if your current treatment is working for you.