Sugar, Pressure, and Lipids…Oh My! Metabolic Syndrome

Posted on by Michelle Fritsch, Pharm.D.

Slide1Do you have diabetes, or have you been told you have pre-diabetes? Are you overweight, especially around your midsection? Do you have high blood pressure? Do you have high cholesterol? Did you know they often go hand-in-hand? As a group they are called ‘metabolic syndrome’.

Metabolic Syndrome

This term describes a collection of medical conditions that each impacts the other. These conditions have many negative effects on your body. The primary risks have to do with your possibility of heart disease and stroke.

Risk factors

The biggest risk factor seems to be weight. Our population as a whole has been gaining weight over the last several years. As that has occurred, the number of people with diabetes has rapidly climbed. The number of people with metabolic syndrome has also climbed. Family history of high blood pressure, diabetes, heart disease, and/or high cholesterol also increases your risk of developing these conditions.

Treatment

No matter what medications are used, DIET and EXERCISE are key components of treatment. In particular, less fat, salt, sugar, carbohydrates, and overall calories can help you control this syndrome. Simple carbohydrates are foods like white bread, white pasta, sweets, honey, and fruits.

There have been many new types of medications to treat diabetes in recent years. This is great news if you have type 2 diabetes! The different types of medication help control your blood sugar in different ways. So, you might find that more than one medication is used.

The situation is similar with high blood pressure. There are several different types of medications to lower blood pressure.  These impact the blood pressure from different mechanisms. Using more than one can better lower blood pressure in some patients.

The best type of cholesterol medication depends on which parts of the lipid profile are to be treated. Which are selected is also impacted by liver function.

In addition to those medicines, often a low-dose aspirin is added to further lower risk for heart attack or stroke.

So, if you have metabolic syndrome, you are probably taking several different medications. You also hopefully monitor parts of the syndrome at home – blood pressure and/or blood sugars.

If you would like to better understand your medication regimen, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

There are multiple different types of medications that approach the control of some medical conditions from different angles. Similarly, there are multiple ways to worship. In what ways do you worship the Lord?

Colossians 3:14-17 ESV

And above all these put on love, which binds everything together in perfect harmony. And let the peace of Christ rule in your hearts, to which indeed you were called in one body. And be thankful. Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God. And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

John 4:24 ESV

God is spirit, and those who worship him must worship in spirit and truth.”

Psalm 95:6 ESV

Oh come, let us worship and bow down; let us kneel before the Lord, our Maker!

Isaiah 12:5 ESV

“Sing praises to the Lord, for he has done gloriously; let this be made known in all the earth.

Worship is so much more than going to church on Sunday. God wants you to get to know Him and to worship in multiple ways. Fully experience the glory and joy of God!

Blessings,

Michelle

Too hot, too cold? Do you have hypothyroidism?

Posted on by Michelle Fritsch, Pharm.D.

Thyroid glandThere can be several reasons you are cold or hot more than the people around you. One of those reasons can be your thyroid.  If your thyroid is underactive, you could have hypothyroidism.

Normally, your body has this ingenious feedback loop that keeps your thyroid hormone levels just right. The two key hormones produced in your thyroid are triiodothyronine (T3) and thyroxine (T4). When these are at the correct levels, your thyroid stimulating hormone (TSH) controls their production. When more is needed, it stimulates more. When no more is needed, it does not stimulate more.

Hypothyroidism

The most common thyroid medical condition is hypothyroidism, or an underactive thyroid. In this case, the TSH keeps going up and up but the needed amounts of extra T3 and T4 are not produced.

Some of the common symptoms of hypothyroidism are:

  • feeling cold all the time
  • feeling sluggish or tired
  • brittle nails and hair
  • weight gain

The most common and very effective treatment for hypothyroidism is levothyroxine. A common brand name is Synthroid. It is T4 that is given to replace the T4 your thyroid is no longer producing. Giving T4 in this form is enough to bring your TSH back to normal levels. It is not necessary to take both T4 and T3; several studies have now demonstrated this. Each dose has a different color. This helps you and your prescriber keep track of exactly what dose you are taking.

When you are first started on levothyroxine, your prescriber will probably have you get blood drawn to check your TSH about 2 months after you start therapy, every 3-6 months until your dose has your TSH right in the goal range, then it will be checked at least yearly. It is common for your dose to change several times, in the first year especially, until the correct dose is identified to keep your TSH at the target level.

When you take levothyroxine, you should take it either first thing in the morning about an hour before breakfast or at the last part of your day at least 3 hours after your last meal. There are several foods and other medications that can interact with levothyroxine. Keeping it separated from your other medicines and meals helps to avoid these interactions.

Note, you especially to do not want to take it near milk or other dairy products, vitamins, or some cholesterol medicines. Taking levothyroxine too close to some of these foods and medicines can make the levothyroxine less effective.

A common question is about brand versus generic when taking levothyroxine. Either is truly fine. What you don’t want to do is switch back and forth. There can be a very tiny variance (2.5%) between medicine made by different manufacturers. For most medicines that makes no difference. Levothyroxine is a ‘narrow therapeutic index’ medication. This means the range from too little to too much is very small. So, the tiny variation between products can make a difference. I recommend generic, but ask your pharmacist to always give you the generic from the same manufacturer.

If you suspect you might be hypothyroid, please talk with your doctor. The most common age to be diagnosed with hypothyroidism is in your 40’s and 50’s, but it can be identified at younger or older ages.

For more information about your thyroid and medications to treat thyroid conditions, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We just read about the amazing feedback loop of the thyroid gland. It is a perfectly designed system that keeps itself in constant check. (Unless it is harmed by disease or other outside influences).

This makes me think of a feedback loop described by Paul. It is not necessarily a comfortable feedback loop, but I know I have seen the truth of it in my own life. And, when I look at those people that have been big spiritual mentors to me, I can definitely see the realities of this feedback loop in their lives. I have yet to find a spiritually mature person who hasn’t experienced this feedback loop more than once.

So, what is the loop?

Romans 5:3-5 ESV

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.

Slide1

The part that we sometimes miss is that this is a continuous loop. It’s just each time you go through it, the better you are able to ‘REJOICE’ in the suffering knowing that the love is continuous. The loop always involves suffering – something bad is happening to you. But, the more you embrace the love that is yours no matter what, the braver and more joyful you can be with each time around the loop.

So buckle up. The next round is coming! Experience it with the joy that God’s love never fails.

Blessings,

Michelle

Image Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

Snowed – Are you missing out on life needlessly?

Posted on by Michelle Fritsch, Pharm.D.

 

Winter
Avoid that ‘snowed’ feeling from medication

 

How often do you feel “snowed”? Do you feel a lack of motivation? Is your thinking sharp? Is it hard to get the energy to get off the couch? Do you nod off when you sit down? Does your thinking seem fuzzy? Do you have trouble keeping up with conversations?

Medications can make you feel ‘snowed’

Now I ask you, do you take medicine for:

Your ‘snowed’ feeling could be a result of your medication. Many of the medicines used to treat these problems have this side effect. This is especially true if you take more than one or if the dose is too high.

Sometimes there are other medicine or non-medication options that will avoid these side effects. At least a trial of a lower dose might help.

Be sure to discuss your concerns with your doctor before making any changes.

Do you wonder if you might be taking one of these medicines or experiencing this type of side effect? Contact us at www.medsmash.com.

As you might imagine, where I live we had about 30 inches of snow recently. Everywhere we look we see snow.   It is beautiful for a while. It is fresh and clean and bright. The ability to take a break is refreshing. When you know you can’t go anywhere, it is easier to give yourself permission to read a book or relax in front of a favorite movie.

There are times, especially with certain injuries or emotional traumas, when medication-induced relaxation is warranted. In these cases, extra care for safety from falls and avoidance of driving are important.

But, this is not a long-term desirable state. So, again, if you are experiencing this ‘snowed’ feeling on your regular daily medication regimen, let’s see what can be done to wake you back up.

BIBLICAL APPLICATION

Do you feel like you’re lacking focus and clarity?

Are you distracted by negative thoughts and/or worries?

Do you find you are working from one to-do to another with no time to think or plan?

Do distractions and daily activities override prayer? This is a common excuse for not spending time with God and in the Bible. I have certainly made this excuse and continue to do so.

Yet, there is more than enough evidence day after day that walking closely with God, daily prayer, surrendering worries is how we are designed to live. Life is more joyful. There is much more peace. Worries don’t slow you down.

There are many Bible verses that reassure us that this is exactly what we are called to do.

Philippians 4:6 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

John 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

1 Thessalonians 5:17 ESV

Pray without ceasing,

Romans 8:26 ESV

Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words.

I challenge you to dedicate time each day to God. I challenge myself as well.

God knows you, everything about you, and loves you no matter what. So, hand it all over, accept the peace that is yours, and take a break from the worries.

Blessings,

Michelle

 

Weight – Less of you might mean less in your medicine cabinet

Posted on by Michelle Fritsch, Pharm.D.

…or at

Medicine doses should be adjusted with weight loss
Medicine doses should be adjusted with weight loss

least lower doses.

Healthy weight loss can lead to decreased doses

Unhealthy weight loss can, too. Actually, sudden, unexpected, or drastic weight loss can be even more hazardous. If it is unplanned please talk with your doctor right away.

Fat loving (lipophilic) medicines distribute throughout all of the extra weight in our bodies. The medication finds places to travel and stay stored in all of these fatty areas. Once we lose fat, it takes a lower dose to get the same effect. If the dose is not changed with weight loss, the same dose you have taken for years can actually be toxic. Rather than being stored in the fat, the amount of medicine stays in your blood where it has more effect. I have seen several cases where someone was getting more confused, more sleepy, having more difficulty thinking with no change in their medicine regimen. Upon further analysis, we found they had lost several pounds over the past several months with no reduction in medicine dose. So talk with your doctor as you lose weight to double check doses of meds.

Medical conditions related to weight

There are also several medical conditions that are related to your weight, especially excess weight. For many people diabetes, high blood pressure, and high cholesterol are found when the person is overweight. They get worse with increased weight. If that person then loses weight, those medical conditions can get better. The need for medicines to control these conditions can go down as the body is better able to manage the blood sugar, blood pressure, and cholesterol on its own. This means the number and doses of medicines might also need to be decreased. Blood pressure medicine doses that are too high can lead to dizziness, especially with standing, and falls. Diabetes medicine doses that are too high can lead to low blood sugar, confusion, dizziness, sweating, or even passing out. Cholesterol medicine doses that are too high might increase risk of side effects like liver damage or muscle pain.

If you have diabetes, high blood pressure, or high cholesterol and have lost at least five pounds, ask your doctor if you could take fewer medicines or lower doses.

What are other benefits of weight loss?

Data has shown that a 5% weight loss can help prevent high blood pressure. It can also help control your blood pressure, your diabetes, and your cholesterol. So, if you weigh 200 pounds, this would be a 10 pound weight loss. This can be accomplished through diet and exercise. Fast weight loss fad diets are NOT the diets of choice. Eating healthy foods, vegetables, fruits, and low-fat options are the safest diet changes. Also, exercise does not mean running a marathon tomorrow. Increased movement several times each day can have a huge positive benefit.

I had one patient once who took this message to heart. He gradually changed his diet and started walking. None of his changes were extreme. Over time, he lost weight. We were able to remove EIGHT medicines from his regimen as his own body resumed control of his conditions. Not everyone will have results this dramatic, but small changes can have big positive impacts.

For more information about healthy weight loss and associated medicine reductions, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

In line with these thoughts about the positive benefits of weight loss, consider the benefits of guilt loss! How much of your daily activity is influenced by guilt? Do ayou feel worthy, accepted, loved, precious, and good enough? Or, do doubts cast a shadow over you? Do feelings of guilt or shame impact your confidence and your attitude? Are you as positive and hopeful s you could be?

If you could shed guilt and shame, can you even imagine how much lighter your load would be? Think how much freer you would be to rejoice and praise and live the life you were meant to live!

Here are some of the thoughts in the Bible about guilt.

Romans 8:1 ESV

There is therefore now no condemnation for those who are in Christ Jesus.

Romans 3:23 ESV

For all have sinned and fall short of the glory of God,

Romans 5:1 ESV

Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ.

Rather than being burdened and weighed down by guilt, consider this offer from Jesus.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

The past is gone. You are forgiven! You do not need to carry around this guilt and shame. Shed it and see how good you can feel!

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Ephesians 4:22-24 ESV

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Blessings,

Michelle

Image Source:  National Center for Complementary and Integrative Health; National Institutes of Health; U.S. Department of Health and Human Services

Flu or Cold – What do you take with high blood pressure?

Posted on by Michelle Fritsch, Pharm.D.

‘Tis the season of flu, cough, and colds. I’ll be surprised if you don’t know someone with one of these right now. There are many products lining the shelves of the pharmacies and grocery stores ready to treat your symptoms.

If you have high blood pressure or a heart condition

Does it matter which product you choose to treat your symptoms if you have high blood pressure, heart failure, have had a heart attack, or you have some other heart condition? Actually, it does. Most of the products used to treat your cold or flu contain two main ingredients: decongestant and antihistamine.

Decongestants decrease the swelling of the lining of your nose. When these swell, you feel stuffy and have trouble breathing through your nose. Taking one while you have a cold or flu can help you breath better and relieve that stuffed-up feeling. Decongestants can be found in tablets, capsules, nasal sprays, nose drops, and liquids. They are often found in combination with other medicines for fever, headache, cough, sore throat, and mucous.

Decongestants work by increasing your sympathetic system. This is the part of your system that kicks in to gear when you are angry or afraid. It is called the ‘fight or flight’ response. It also causes your heart to beat harder and faster.   Your veins and arteries get tighter. Your blood pressure goes up.

If you have high blood pressure or heart disease, this is not helpful. It puts you at risk of worse heart disease or even heart attack or stroke.

Antihistamines block histamine. This helps to dry up a runny nose, tearing of your eyes, sneezing, and itching in your nose and eyes. They are helpful with these symptoms for allergies or for colds/flu. They come in tablets, capsules, liquid, eye drops, and nasal spray. Some of the antihistamines (first generation) cause you to be sleepy and slow your thinking. The newer, second generation versions have fewer of these side effects, but they can still make you sleepy. Be very careful if you must drive while taking these.

Antihistamines should also be taken with caution with people in high blood pressure or heart disease.

The cold and flu medicines on the market for people with high blood pressure leave out the decongestant. They have the antihistamine and usually acetaminophen for fever. So, still be careful using these if you have high blood pressure. Check your blood pressure while you are taking them. Let your doctor know what you are taking for your cold and flu.

So, if most of the cough and cold and flu medicines on the market are not good for your heart or blood pressure, what should you do?

What can you do without taking cold and flu medicines?

For your fever, take acetaminophen. Medicines like ibuprofen (brand names Motrin, Advil) or naproxen (brand name Aleve) can raise your blood pressure and increase your risk of heart disease.

For your congestion, try a humidifier. Moist, warm or cool air can help break up the mucous and ease your swollen nasal passages.

Get plenty of rest so your body’s immune system can fight the virus. Drink plenty of fluid.

With or without a decongestant or antihistamine your cold or flu is likely to last about 5-7days.

Wash your hands, especially after being out in public. When you are in public or haven’t washed your hands recently, avoid touching your face (mouth, nose, eyes). And finally, please get your flu shot each year!

For more information about managing a cold or the flu with high blood pressure, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

When you have high blood pressure or a heart condition, your treatment options for a cold or the flu are limited. To avoid letting your blood pressure get even higher, you need to carefully select a treatment that is best for you and your specific medical conditions.

Similarly, in your faith walk, what is best for you might not be best for someone else.

Paul mentioned this in at least two of his letters. After Christ came to reconcile us with God, the rules of the past changed. But, this was easier to accept for some people than for others. In particular, new believers found this transition to be confusing sometimes.

So Paul encouraged all believers to consider their friends and neighbors when making decisions. If something would cause confusion for someone else, then Paul encourages us to not do that thing.

Romans 14:13 ESV

Therefore let us not pass judgment on one another any longer, but rather decide never to put a stumbling block or hindrance in the way of a brother.

1 Corinthians 8:13 ESV

Therefore, if food makes my brother stumble, I will never eat meat, lest I make my brother stumble.

1 Corinthians 8:9 ESV

But take care that this right of yours does not somehow become a stumbling block to the weak.

These verses make even more sense in context, so I encourage you to read them within their chapter.

Remember those around you when making decisions. It is easy to get caught up in your own life and not even think about how your actions impact others. Even when you are making ‘good’ decisions, realize other people younger in their faith might not understand your freedoms and reasons for exercising those freedoms.

Blessings,

Michelle

Approach Your Doctor Visit Differently in 2016 – Win-Win

Posted on by Michelle Fritsch, Pharm.D.
Slide1
Prepare for your doctor visit

 

How do you prepare for a doctor visit? Have you ever experienced, or can you picture, the following scenario?

You have a health-related issue and want to see your doctor. You call to make the appointment. You wait and monitor the issue until the day of the appointment. You think about the appointment as you get ready and drive to the office. You think about the visit while in the waiting room. You briefly tell the assistant about the issue while you are being checked in with your weight, blood pressure, etc. You think more about the issue while waiting for your provider to enter the room. Then, your provider comes in and your mind goes blank.

Has this ever happened to you? Even if you remembered most of what you wanted to discuss, did you leave and realize you forgot to mention something important?

Doctor Visit Preparation

This happens all too often! Sometimes people feel rushed. Sometimes they get caught up in conversation with their doctor and don’t realize the time available for the appointment has slipped way. I have had patients bring up important information at the very end of appointments many times. It is so late that we can’t fully address the issue with the time remaining.

So, what can you do to avoid this situation?

Important steps

Here are some important steps to help you get the most from your healthcare visits.

  1. From the time the issue arises until your appointment, write down important details your doctor will want to know.
    1. When did it start?
    2. How did it start?
    3. What makes it worse?
    4. What makes it better?
    5. Use good descriptive words to describe your symptoms.
    6. How often does it occur?
    7. Have you had something like this happen before?
    8. What has changed that might be related to this issue?
    9. Keep a journal of how the issue impacts you daily.
    10. What outcome are you hoping to have from your visit?
  2. Prioritize the issues you want to discuss at the appointment.
  3. Limit your list to the top 3. You can bring others to mention if there is time, but most visits have time for only 1 major or up to 3 more minor issues.
  4. Bring two copies of your list to your appointment.
  5. Give the list to the assistant who checks you in. He/she can then give it to your provider to review before coming in to the room with you. This will save a lot of time in the first part of your appointment.
  6. When your provider comes in the room, you will each have a copy. This will take the pressure off of you to remember the details. It will also help guide your provider to quickly understand the issue(s) you want to talk about.
  7. You can now have a more relaxed conversation with your provider in the time that is available for your visit.

Your provider will truly appreciate this approach. Keep in mind, for some symptoms your provider only knows what you tell him/her. So, the more thorough you can be, the better your provider can make the correct diagnosis.

Consider your healthcare to be a partnership rather than a one-way interaction. You and your providers will feel better about your relationship.

For more information about preparing for doctor visits, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as there are more successful ways to approach medical visits, there are some best practices for communicating with God.

Jeremiah 29:12-13 ESV

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart.

In all parts of the Bible there are tips, insights, and instructions for maintaining our awareness and dependence on our Lord and Savior to walk with us through any circumstance.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

Philippians 4:6-7 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

James 5:16 ESV

Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.

John 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

1 John 5:14-15 ESV

And this is the confidence that we have toward him, that if we ask anything according to his will he hears us. And if we know that he hears us in whatever we ask, we know that we have the requests that we have asked of him.

God is there with you, loving you, holding you at all times. He never leaves to take a break. He never gets distracted.

If you are feeling alone and not aware of His presence, you have your ‘shields’ up. Take them down. Go to Him in prayer and take down those defenses that are making you feel separated. God will love being able to communicate with you again. You will love that flood of security, grace, and unconditional love.

Blessings,

Michelle

P.S. Have you noticed that all of our instruction in prayer puts praise first? Then, bring your requests, hurts, and desires to God.

Are you meds making your memory better or worse?

Your Medications and Your Memory – making things better or worse?

Posted on by Michelle Fritsch, Pharm.D.
Are you meds making your memory better or worse?
Memory

Do you ever feel like your memory is slipping? Are you getting forgetful?

Prescription Medications and Memory

Which of your medicines is helping preserve your memory? There are several medical conditions that can make your memory worse. The medicines that treat those conditions then help preserve your memory. Some examples include medicines for heart disease, seizures, blood thinners, asthma inhalers, or emphysema and bronchitis inhalers. Oxygen is a common theme with many of these medications. If you have a medical condition that could decrease the oxygen getting to your brain, this could worsen your memory.

Which of your medicines is actually making your memory worse? Unfortunately, there are many medications that can do this. Any medication that can make you sleepy or slow your thinking can make it harder to remember things. Any medicine that impacts how your brain functions can alter clear thinking. This does not mean all of these medications should be avoided. It does mean to not assume you have dementia when you have foggy thinking while on these medications. There are many examples; some common ones are medications for pain, anxiety, and depression. Anticholinergic, or very drying, medicines cloud your thinking. Recently, statin medications for cholesterol have also been associated with memory impairment.

There are currently two classes of medicines approved for use in Alzheimer’s Disease. For many medical conditions, once diagnosed, you are prescribed a medication(s) to treat that condition. This is not as simple with the dementia medications. They do NOT cure or prevent dementia. They do NOT help all people with dementia. The best impact they have is to slow the progression of dementia, and again, not everyone who takes them will have this result. They have cholinergic side effects that include nausea and diarrhea. If they are stopped after they have been taken, there can be a rapid decline in the dementia. It is not known if the decline is to the point the person would have been if they had not taken the medicine, or if it is an even sharper decline. So there is much to discuss with your physician and healthcare team before deciding to take these medicines.

How about vitamins?

Vitamins are perfectly safe, right? The more the better, right? For many vitamins, taking more than you need is just a waste; your body gets rid of what it doesn’t need. But some other vitamins are not easily cleared, and too much can cause problems. Vitamin E is a vitamin that has been studied to see if it can help with memory. Although some studies have had mixed results, there is no evidence that vitamin E can prevent dementia. There is some data that suggests it might help slow the progression of Alzheimer’s disease. But, there have also been reports of increased risk of death with vitamin E. This is because it can interact with several medications, especially those that can cause bleeding such as medicines that prevent clots. It is also one of the vitamins that the body can’t easily expel, so it is possible to get too much.

Vitamin B12 is another that has been studied.  If your vitamin level is low, then vitamin B12 can help.  However, if your B12 level is normal  supplements will not help.

The best way to get vitamins is through your diet.

And what about herbal remedies, natural remedies, or supplements?

There have been some studies looking at gingko biloba. It does not appear to prevent Alzheimer’s or other forms of dementia. There is some data that suggests it might help stabilize dementia. In particular, some studies show that it can help stabilize mood. Healthy people who take gingko report feeling more alert. However, there are several medication interactions to consider before you take this. It can increase risk of bleeding and can impact blood sugar control if you have diabetes.

Other substances that will change your ability to think clearly are alcohol, marijuana, and illicit substances. They may not be prescribed (yet), but they can definitely impact how sharply you think. Include these when you talk with your physician and your pharmacist about your medicines.

Some medications can help preserve your memory, and some medications can make your memory worse. Vitamins, over-the-counter medicines, supplements, and herbal remedies all should be considered medications. Share all that you take with your primary care provider and your pharmacist. That will allow them to make sure there are no medicines or interactions that are negatively changing your memory.

For more information about your medications and your memory, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as medication can cloud our thinking and memory, what can cloud our spiritual life? Do you ever feel that you are just not fully connected with God? Does it ever feel like something is clouding the connection? Or do you find it’s easier to just ignore the connection?

In my life the most common culprits are:

  • To-do lists
  • Crazy schedules
  • Worries

Martha got caught up in similar tasks. She was fretting so much about hosting Jesus that she failed to experience Jesus.

Luke 10:38-42 ESV

Now as they went on their way, Jesus entered a village. And a woman named Martha welcomed him into her house. And she had a sister called Mary, who sat at the Lord’s feet and listened to his teaching. But Martha was distracted with much serving. And she went up to him and said, “Lord, do you not care that my sister has left me to serve alone? Tell her then to help me.” But the Lord answered her, “Martha, Martha, you are anxious and troubled about many things, but one thing is necessary. Mary has chosen the good portion, which will not be taken away from her.”

There are several verses that help us realign our thoughts and hearts.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.

1 John 2:17 ESV

And the world is passing away along with its desires, but whoever does the will of God abides forever.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

To use a sports analogy, keep your eyes up and focused on the long game. Daily struggles become easier to navigate when your focus is on God. He will lead you step by step according to His plan for you.

For it is impossible to be in the presence of Jesus and not be changed.  

– Joanne Weaver

This might sound contrite, but truly give your day to Him, keep your focus on Him, and see what happens.

Blessings,

Michelle

New Year’s Resolution, Take Only In-Date Medications

Posted on by Michelle Fritsch, Pharm.D.
Old medicine bottles
Take in-date medications

The new year is upon us. I hope your 2015 has been full of happy memories and joyous occasions. Now, as we move on to 2016, I have a New Year’s challenge for you. I challenge you to take only in-date medications.

WHY In-Date Medications?

Sometimes we think expiration dates are just there to make us keep buying new medicine. But, in reality, there are TWO big reasons expiration dates are important. Extensive research is done when medications are created to determine for how long they are effective and safe. This date, when either changes, is the expiration date.

Past this date the medicine will not work as well. If you take a medicine to control your blood sugar that is expired, it might not lower your blood sugar as much. If you take an expired medicine for pain, your pain might not go away.

The other risk is a safety risk. Chemicals change over time. Have you ever opened an outdated bottle of aspirin? It smells like vinegar. That is because it changes into new chemicals over time, one of which is vinegar. Other medicines change into chemicals that can be extremely dangerous.

It is not worth the risk.

HOW

Go through ALL of the medications in your house, cars, purse, etc. Check the expiration date on each one. If it is expired, put it in your discard pile. (But don’t throw it in the trash just yet, there are two more steps).

Next remove all labels that contain information about you or your family. Shred or cut up the label. If you can’t get the label off, scratch out your name and prescription number at least. This is one of many forms of possible identity theft.

Now comes the tricky part. What do you do with all of these medications? There is not an easy answer. In order of ‘best options’, dispose of them in one of these ways:

  1. Take them to a ‘Medication Take-Back’ event sponsored by the Drug Enforcement Agency. Or call the DEA’s Registration Call Center at 1-800-882-9539
  2. Talk with your local pharmacist to see if you pharmacy can dispose of medication. Or, your pharmacist should know who in your community does dispose of medication, if there is a source.
  3. Dump them out of their bottles and put with kitty litter, coffee grounds, or something else that you can’t eat. Then, seal the container and put it UNMARKED in a garbage bag and out with the garbage.
    1. DO NOT flush the medication or put it down the drain. This leads to it reaching the water supply. This used to be encouraged, and now many medicines/hormones/chemicals have been found in the water supply.
    2. Ultimately, putting them in the trash can lead to them being in the water supply as the trash breaks down and leaches into the ground.
    3. This is why an official ‘take-back’ event is the safest option.

REPLACE

As you are sorting out your expired medicines, keep a list of those you use so you can replace them. If it is a prescription medicine, your can see on the label if there are refills remaining. Note, for non-controlled medicines, there are usually available for up to a year. For controlled medicines, the time might be shorter. If you are beyond that time, and you still need the medicine, call your physician to inquire about another prescription.

As you are replacing medicine, over-the-counter medicine, vitamins, and supplements, know that generic versions are just as good as brand. I purchase generic for my family. They have been carefully tested and regulated by the Food and Drug Administration to assure they contain the same key ingredients and work the same.

Here at the end of the year, if you have a health-savings account, check the rules to see if you can use that to replace your expired medicines.

This is an important step in your New-Year’s fresh start. It is important for your safety and the safety of your family.

Happy New Year!

For more information about expired medication and proper disposal, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We are entering a new year. It can be a time to think of fresh starts and hope for the future. It is a great time to reflect on how your life has been changed through your faith.

At the moment we give our life to Christ, we know that our old self is gone. We now live a NEW life in Christ.

Ephesians 4:22-24

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

Galatians 2:20 ESV

I have been crucified with Christ. It is no longer I who live, but Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me.

What a refreshing reminder! Bask in the glow of your new life in Christ as you enter this new year.

I challenge you to take a challenge I FINALLY took in 2015. Read the Bible from cover to cover. I have read my Bible, participated in Bible studies, had several Bible-based lessons, but I had never actually read it start to finish. It has been so enlightening! So many things make more sense. And I hear from those who have done this several times, the insights are new and different each time.

I am praying you will be richly blessed in 2016,

Michelle

 

Image Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

The Season of Giving and Receiving – To Your Health

Posted on by Michelle Fritsch, Pharm.D.

GiftsAs you work through your to-do lists, travel to your holiday destination, and settle in for the holiday season, here are some additional ways to give and receive.

RECEIVE

Following is a list of things that can help you feel your best.

  • Plenty of fluid
    • Avoid dehydration in the busy-ness of your holidays.  This can help avoid headaches, constipation, and feeling lethargic.
  • Fiber in your diet
    • This can help you avoid constipation and and issues with diverticulosis (little pockets in your colon which are more common over age 50).
  • Veggies and fruits for vitamins
    • These are colorful, packed with vitamins, help you feel alert and energetic, and are another source of fluids.
  • Rest
    • Getting plenty of sleep will help reduce your feelings of stress and being overwhelmed.
  • The love and support of family and friends
    • This helps with perspective, reduces stress, allows you to relax, helps to focus beyond your own needs and wants.

GIVE

  • Helping other people can reduce your stress levels
  • Volunteering and caring about other people improves your health
  • Altruism, giving to others, is linked to improved health and longevity (living longer)
  • Time with friends and family. Feeling the love and time with others raises our spirits.

GIVE (UP)

  • Excess alcohol
    • It might relax you for a bit, but then will interrupt your sleep, increase your risk of dehydration, and actually make you feel more tired
  • Tobacco
    • The health risks are just too great. You’ll enjoy many more happy new years if you give up the tobacco.
  • Too much fatty party food
    • A balanced diet, plenty of fruits and vegetables, and exercise will keep you feeling better.
  • Isolation and brooding.
    • Everyone has experienced or will experience hard times, disappointments, betrayal, and/or loss.
    • Your attitude, your source of hope, the support of others will determine whether these events stop you.
    • You can grieve and experience these negative events and also pick yourself back up and continuing living a hopeful, happy life.

Wishing you joy, peace, and love from Meds MASH, LLC. www.medsmash.com

BIBLICAL APPLICATION

Acts 20:35 (NIV)

In everything I did, I showed you that by this kind of hard work we must help the weak, remembering the words the Lord Jesus himself said: ‘It is more blessed to give than to receive.’ 

Throughout the Bible we learn about the importance of giving. The message is consistent. The more we GLADLY give, the more we are blessed, and the more we receive.

Note, giving is not meant to be divisive. Wanting more for yourself is not a reason to give so that you’ll get more in return.

Rather, our giving is a sign of gratitude and love and honor to our Father in Heaven.

Luke 6:38 ESV

Give, and it will be given to you. Good measure, pressed down, shaken together, running over, will be put into your lap. For with the measure you use it will be measured back to you.

Proverbs 3:9 ESV

Honor the Lord with your wealth and with the firstfruits of all your produce;

2 Corinthians 9:11 ESV

You will be enriched in every way to be generous in every way, which through us will produce thanksgiving to God.

As the Bible is coming to a close, John takes this concept of grateful giving to a new depth:

1 John 3:16-18 ESV

By this we know love, that he laid down his life for us, and we ought to lay down our lives for the brothers. But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him? Little children, let us not love in word or talk but in deed and in truth.

Giving is a beautiful expression of our gratitude and the love that is spilling over in us.

I’m praying you know God’s ever-sufficient, extravagant, glorious peace and love this Christmas!

Blessings,

Michelle

Holiday Stress and Anxiety – Your Healthiest Treatment Options

Posted on by Michelle Fritsch, Pharm.D.

fireworks_black_150_thmThis is such a joyous exciting season! Many faiths have reason to celebrate this time of year. Many people have long-held precious traditions. Family and friends make special effort to be together. Receptions, parties, brunches, gatherings, and meals are planned.

Do find that this season gives you energy and good, warm feelings?

Or, do elements of this season make you anxious?

Do the preparations, busy calendar, and financial outflow give you stress?

I hope not. But if they do, you are definitely not alone. About 44% of women and 31% of men report an increased level of stress at holiday time. Some rate the hype, finances and issues as mentioned above, as the source of their stress. Others point to discomfort with social situations.

I want to share something helpful I recently read. It is interesting that we each feel like others are looking at and judging us in such situations. In reality, all of those people are having the same self-conscious feelings about themselves.

So, if you are feeling additional stress, what are your best alternatives to manage it?

Alcohol may seem like a good option, but it actually puts you at risk for a fall or a driving accident. Then, it makes you feel even more tired the next day. And, alcohol and drugs can make your stress worse rather than better.

A class of medication used for stress for decades is benzodiazepines. These medications include alprazolam, lorazepam, diazepam, and brand names like Valium and Xanax. They have made the lists of medications that are not safe for most people over the age of 65. They aren’t good options for people under age 65 either with very few exceptions. They make it hard to think clearly, increase risk of falling or other injury, and increase risk of driving accidents. When these are taken regularly, dependence develops. Then it becomes hard to get back off of them. So, I recommend you DO NOT use benzodiazepines to manage holiday stress.

A good night of sleep can be very helpful in dealing with stress. But, using medicine to get to sleep can put you at risk. These medicines include zolpidem/Ambien, zaleplan/Sonata, and eszopiclone/Lunesta. This list also includes over-the-counter sleep aids like diphenhydramine found in Benadryl, Tylenol PM, and Aleve PM. Doxylamine is another ingredient found in sleep aids and cold/flu combinations that has strong anticholinergic side effects. This means it can cause constipation, dry eyes, falls, and can cause slowed thinking.

So what are some safer ways to manage holiday stress?

Take care of yourself :-).

Healthy tips

  • Eat healthy foods, including plenty of fruits and vegetables. Limit fattening party foods.
  • Drink plenty of water/fluids to avoid dehydration while running around busy. Limit the caffeine to avoid the ‘crash’ later and to protect your heart.
  • Get some exercise to clear your head and improve your mood.
  • Get a good night’s sleep. Note, the exercise and avoiding alcohol will help with your sleep.
  • Take a break. Taking some time to relax, pray, meditate, or get a massage can help you recalibrate.

For more information about manageing holiday stress, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Does the Bible give any guidance about managing stress? Oh yes, from the dawn of time people have had fears, doubts, stress, and anxiety. Repeatedly, God has called us back to him. He repeatedly tells us that HIS peace is sufficient and beyond our understanding. Let some of these verses bring you a new perspective.

Philippians 4:6 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

John 14:27 ESV

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid.

Psalm 55:22 ESV

Cast your burden on the Lord, and he will sustain you; he will never permit the righteous to be moved.

Psalm 118:5-6 ESV

Out of my distress I called on the Lord; the Lord answered me and set me free. The Lord is on my side; I will not fear. What can man do to me?

Romans 8:31 ESV

What then shall we say to these things? If God is for us, who can be against us?

In addition, an interesting ‘tip’ is given to help us find more peace. Reaching out to other people benefits both them and us.

Galatians 6:10 ESV

So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith.

John 13:35 ESV

By this all people will know that you are my disciples, if you have love for one another.

Proverbs 12:25 ESV

Anxiety in a man’s heart weighs him down, but a good word makes him glad.

The list of related Bible verses goes on and on. We were not created to live in anxiety and stress. May the peace of our Lord and Savior be yours this Christmas!

Blessings,

Michelle