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Diabetes puts a patient at greater risk for heart disease and stroke. Medications which keep you healthy and keep you alive longer and slow the progression of the disease are most important to utilize. I always tell husbands that I can not let you die before their wives. A longer life can also be a less complicated medical illness time of life.
In the last five years a large number of new medications have come out for the benefit of migraine sufferers. Patients new to the office frequently do not complain of headaches as they may not have been previously listened to in the past. We have knowledge and samples.
Dr. Richman admits to knowing what anxiety and depression feel like. He does not live like that anymore. Helping you live a healthier emotional life is a great reward for him. He’ll be very excited to see you smile.
In 2005 a new class of medications were introduced named GLP-1 receptor agents. In 2006 a class of medications called Gliptins were introduced. Then in 2013 SGLT 2 agents were introduced. These were vastly different than any other medications we had used for diabetes in the past. They were glucose dependent, meaning they were unlikely to cause low glucose called hypoglycemia. They even decrease the burden of diabetes disease as well as death from the disease.
Everyone is talking about the new weight loss injections.
There are medications which patients inject for diabetes. They are little pen systems. They have a little tiny needles that don’t hurt. The most recent is named Mounjaro. Before Mounjaro there was Ozempic and Trulicity. These medications are quite wonderful and have helped me get p
Everyone is talking about the new weight loss injections.
There are medications which patients inject for diabetes. They are little pen systems. They have a little tiny needles that don’t hurt. The most recent is named Mounjaro. Before Mounjaro there was Ozempic and Trulicity. These medications are quite wonderful and have helped me get people off insulin, decrease their risk of heart disease and decrease the risk of stroke. They also have a side effect of helping patients to lose weight.
How do these work? Actually they are copies of hormones that our body makes. When we eat, our “gut” makes two hormones named GIP and GLP, “Glip”. These hormones go through the blood and trigger the pancreas to make insulin to help put glucose into cells to feed them. They also block glucagon which causes your liver to produce emergency glucose. Glucagon causes people to make glucose, even when it’s not an emergency and this is the hallmark of Type 2 or adult diabetes. They also work in the brain to make you feel full and they slow down the stomach to also make you feel full. If you don’t have diabetes and take it, it will not make your glucose go down. It will just make you not hungry.
Mounjaro, which is the latest drug, has both GLP and GIP. The other two including Trulicity and Ozempic only have GLP. All three of these are taken once weekly. Before them there was Byetta (Exenatide), which was the first. Then came Victoza (Liraglutide) All of these medications are approved for the treatment of type 2 diabetes.
Mounjaro (Tirzepatide) and Ozempic (Semaglutide) both have identical copies under different names, which are approved for weight loss. Tirzepatide for weight loss is called Zepbound. They have that “zep” in the name. Semaglutide for weight loss is called Wegovy. They are extremely hard to obtain due to their popularity. Recently, the Wegovy representative visited the office saying that Wegovy is very available, except for CVS.
We caution patients about thyroid cancer, which was only seen in certain lab animals. We have patients obtain an ultrasound of the neck to evaluate the thyroid and this is not difficult and it is for your safety.
In 2013 medications in a class called SGLT 2 inhibitors were introduced. These block the reuptake of glucose at a site that generally grabs any glucose that sneaks into the urine. This glucose also pulls out water into the urine. This is similar to sodium pulling out water with the diuretic or “water pill.”
This loss of glucose leads to a
In 2013 medications in a class called SGLT 2 inhibitors were introduced. These block the reuptake of glucose at a site that generally grabs any glucose that sneaks into the urine. This glucose also pulls out water into the urine. This is similar to sodium pulling out water with the diuretic or “water pill.”
This loss of glucose leads to a loss of calories and therefore a loss of weight. It also pulls out extra fluid. This should be used cautiously with any other water pill. We have used them to rescue failing kidneys, and decrease the risk of heart problems.
These medications are very good for diabetes, but patients must be chosen carefully. Patients with difficulty controlling their bladder, including incontinence or any other difficulties could be present a problem. Hydration is also extremely important because if you get too dehydrated, your sodium level can rise.
The acid in our stomachs is produced for digestion. It also protects us from bacterial invaders. The acid does not cause esophageal or laryngeal (throat) cancer. Pepsin is a digestive enzyme that likes to live in an acid environment and helps digest proteins. This is actually the cause and promoter of cancer of the larynx and esophagus.
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The acid in our stomachs is produced for digestion. It also protects us from bacterial invaders. The acid does not cause esophageal or laryngeal (throat) cancer. Pepsin is a digestive enzyme that likes to live in an acid environment and helps digest proteins. This is actually the cause and promoter of cancer of the larynx and esophagus.
There are many researchers and I agree with them that the best way to deal with us is drinking alkaline water after digestion is complete. Alkaline water is like “smart water“ and it can balance the acid in the stomach and make the stomach a neutral happy pH. It may make our stomach smile. However, pepsin cannot live in a non-acid environment and the alkaline water causes it to disintegrate.
We frequently treat reflux and acid symptoms with Proton Pump Inhibitors (PPIs) The problem is that PPIs can cause constant lowering of stomach acid. Chronically lowering the acidity of the stomach can lead to an increase and bacterial invasion to the G.I. tract. I had a patient with well water that had Giardia lamblia. He took Omeprazole for heartburn which decreased stomach acid and helped him feel better. Unfortunately, this made his stomach acid too weak and he was unable to protect himself from the Giardia. The Giardia infected him and caused a nasty diarrhea illness. He was treated with antibiotics and had done well. Of interest is that his wife did not take acid lowering medication and she was not infected with the Giardia.
Other concerns include significant vitamin (B12 and C) and mineral (iron, calcium and magnesium) deficiencies as it needs gastric acid for their absorption. . The use of PPIs with antiplatelet drugs like clopidogrel can cause risk to cardiac patients . The clopidogrel can NOT be acitvated to help the paitient.
Risk of low magnesium, renal function disorders, vitamin B12 and iron deficiency, dementia, osteoporosis and fractures.
And please don’t aspirate while taking PPIs. The stomach contents will be filled with more bacteria and will lead to pneumonia.
Taking Tums is like throwing an ice cube on a fire. Drinking alkaline water with pH 8.5 like a fire extinguisher.
I like to tell patients to take alkaline water at bedtime at least to dissolve any pepsin laying around and rest your stomach for bedtime.
DO NOT change the standard of care which your physician started. Continue the acid lowering agents and discuss how to integrate alkaline water and ultimately heal and not need acid lowering.