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### Human:\ni am a 26 year old male ht. 5'5" wt. 42kg. i want to increase my weight in a healthy way. please advise.\n\n### Assistant: because you are underweight and i don't have information about your diet or weight history i recommend you see a registered dietitian. your weight is quite low and it can be helpful for you to get individualized advice. you can find a dietitian in your area by going to eatright. org. in the meantime here are some things you can do to get started: eat regular meals and snacks every day (5-6 times daily). try to plan your meals ahead of time and have items you can put together for quick and healthy meals. include 3-5 food groups at meals including a whole grain protein (meat/beans/nut butter) fruits vegetables full-fat dairy (whole milk/yogurt) 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. lunch might be a big sandwich salad and soup. 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 more tips on how to gain weight in a healthy way see this article.

### Human:\nwhat is a fistula?\n\n### Assistant: a fistula is an abnormal connection that develops between two body parts. fistulas most often form as part of the healing process in an area of inflammation injury or previous surgery. there are many different types of fistulas: enterocutaneous fistula (between the intestine and the skin usually developing after abdominal surgery) rectovaginal fistula (between the rectum and the vagina) tracheoesophageal fistula (between the trachea and the esophagus) umbilical fistula (between the navel and the intestine) arteriovenous fistula (between an artery and a vein). some fistulas may heal and go away on their own. fistulas that do not heal generally require surgical repair.

### Human:\nthe left side of my chest has hurt since childhood but at 17 it has gotten worse. should i have more cardiac tests?\n\n### Assistant: many many things can cause chest pain although we worry about the heart being a cause of it typically first as heart disease can carry some serious consequences. at age 17 the risk of artery blockages leading to chest pain would be very unusual except in some cases of congenital coronary abnormalities. it is important that you have a complete history and phsyical exam by a physician to help look for causes of this persistent pain. they will ask questions about your activity level (for example can you and do you exercise regularly without difficulities? ) and carefully exam your heart lungs and blood vessels. you deserve to get an answer for something like persistent pain and at age 17 it's a good time to be reminded of heart-healthy living with things like eating healthy exercising regularly avoiding tobacco products etc.

### Human:\nim 314lbs and trying to lose weight. i cant excercise 2 min before im gasping for air. how can i get a work out in?\n\n### Assistant: first congratulations on taking this important first step in reducing your weight to a healthy level! i salute you. second be sure you've received the ok from your health care provider to undertake a diet and exercise program. if your doctor has cleared you to exercise then your shortness of breath may be normal simply due to your current size. don't let this discourage you. it may not be realistic for you to expect to perform say 20 minutes of aerobic activity at this point. that time will come. right now 2 minutes might actually be more realistic for you. i'd suggest you start with simply walking. if you can manage to walk for 2 minutes 10 times a day there's your 20 minutes. do that every day and you'll gradually build up stamina. if you've been watching one of those television shows where 300+ pound people engage in vigorous workouts and lose dramatic amounts of weight quickly i'd suggest you stop watching. in my opinion those programs do not depict a realistic vision of exercise for people who weigh over 300 pounds. the workouts shown on those programs are closely monitored by an entire medical team and can be dangerous for the average unsupervised exerciser. again i can't stress how much i admire you for your determination. try checking out webmd's diet community for support and access to experts who can help you on your journey. be patient. it may take you quite some time to lose all the weight you want to lose. remember to set intermediate goals and rewards along the way to stay motivated. best wishes to you! don’t give up! although you may not be able to exercise for long now you should expect to see less shortness of breath and better cardiovascular endurance the longer you stay consistent with your exercise routine. be sure that you’re not trying to do too much with your exercise. it may be best to start out with a low intensity level of exercise and expanding upon it as tolerated. it may not seem like a lot at first but you can slowly and gradually build up the duration and intensity of your exercise the more that you are able to adhere to it. remember your exercise doesn’t have to be done all in one session. divide it up and takes breaks to rest and recover if you need to and then pick it back up later. you may be able to continually shorten the amount of rest that you take in between sessions to eventually spend more time in a single session. also try building in more opportunities to incorporate more physically activity within your daily routine. try taking the stairs instead of the elevator or park further away. making a habit out of incorporating small opportunities like these can ultimately lead to becoming better conditioned for exercise. if exercise remains to be too difficult i’d still encourage you to continue to do what you can but i’d suggest placing more of an emphasis on your nutrition to lose enough weight until you’re at the point that you can exercise more comfortably. keep up the great work! remember to always consult your doctor before beginning an exercise routine or weight loss plan. please keep one thing in mind. you did not gain the weight over a few months so don't expect it to magically fall off in a few months; there are no shortcuts just dedication and the will power you will need to get your butt off the couch and head outside (or treadmill) and walk everyday. at first just do what you can but make a training schedule and follow it - you are accountable to no one but yourself so don't let yourself down! i will not do you any favors by lying to you or telling you loosing weight is easy. as you know it is not. it is a long hard journey to loose the weight but if your mindset is right and your willpower is strong (do it for no one but yourself). then you are on your way to a successful weight loss journey! good luck! btw. before putting something in your mouth ask yourself if you are really hungry if you are not - ask yourself why you are eating. congrats on this big step in life! you can do it! however to safely do it i would go to your local ymca and have a professional check you out( your heart rate ect. ) they will put you on a plan that fits you!

### Human:\nwhat's the difference between the fat-burning mode and the cardio mode on the machines at the gym?\n\n### Assistant: there are problems with the fat burning option on the cardio machines and it really ought to be eliminated. the idea behind the fat-burning option is this: because fat is denser than carbohydrate it requires more oxygen to burn. so to maximize the percentage of fat you burn compared to carbohydrate the fat-burning mode would have you work out at a pace at which your body can deliver lots of oxygen to your muscles. that generally means a slow pace to keep you from getting breathless. the problem is that when you exercise at a slower speed you burn fewer total calories -- from both carbohydrate and fat -- because you simply don't do as much work. further the way to get aerobically fit is to get your heart rate into the training range (usually 60% to 85% of your maximum heart rate) which is hard to do at slower speeds. and fitness is ultimately what you're after whether your goals are better health burning calories or improving heart and lung capacity. the bottom line is that the fat-burning mode probably won't be intense enough to maximize total calorie- or fat-burning or to help you increase or maintain optimum fitness levels. use the cardio mode to maximize your exercise benefits. using the fat burning mode on exercise machines at the gym actually isn’t the best way to burn fat. the key concepts to understand here are the percentage of calories that come from fat and total calories. the fat burning mode is typically set at lower exercise intensity where more calories burned come from fat. not as many calories burned during higher exercise intensity will come from fat. the point to understand though is that while more of the calories that you burn will come from fat at a lower exercise intensity you have the potential to burn more calories per session doing higher exercise intensity. the percentage of calories burned from fat will be lower during the higher exercise intensity but you will be burning more calories overall including the amount of calories from fat. also higher exercise intensity leads to a greater boost in metabolism even after you’re done exercising which burns additional calories. it’s best to do exercise that you’re comfortable with and that meets your level of training/conditioning. in general however increasing the time spent on exercise and increasing exercise intensity will provide a greater potential to burn more calories and lose weight.

### Human:\nwhat workout or workouts are best for people in midlife?\n\n### Assistant: creative cardio. burn 400 to 500 calories a day in cardio. on the elliptical for instance you can burn about 400 calories in about 35 minutes. cross train as much as you can. burn the 400 to 500 calories all at once or accrue it. and don't forget the weight training.

### Human:\nhow soon does the food you eat affect your cholesterol? how long does food you eat affect your cholesterol?\n\n### Assistant: no one knows exactly but the national heart lung and blood institute (nhlbi) national cholesterol education program (ncep) recommends checking cholesterol after 6 weeks after diet changes are initiated. always check in with your health care provider about recommendations for monitoring cholesterol levels. for more help with managing cholesterol visit webmd's cholesterol management health center <link>

### Human:\ncan certain medications cause diabetes?\n\n### Assistant: yes. there are several classes of drugs that may increase blood sugar levels and thus increase the risk for diabetes. some of these are: • statins: these are very effective medicines that reduce cholesterol. they reduce risk of heart attack and stroke. these include atorvastatin (lipitor) simvastatin (zocor) rosuvastatin (crestor) fluvastatin (lescol) lovastatin (mevacor) and pravastatin (pravachol) • thiazide diuretics: these are a type of water pills that are sometimes used to treat high blood pressure or swelling. hydrochlorothiazide or hctz is a common example. • steroids: these are anti-inflammatory medicines such as prednisone and cortisone. they also include anabolic steroids used in muscle building. • beta-blockers: they are used to treat high blood pressure and certain heart problems including heart failure. they are also used after heart attacks to increase survival rate. examples include carvedilol (coreg) propranolol (ideral) metoprolol (toprol and lopressor) nadolol (corgard) and atenolol (tenormin). • atypical antipsychotics: these are used to treat a variety of psychiatric illnesses. these medications may cause weight gain and increase the risk for diabetes. they include: olanzapine (zyprexa) risperidone (risperdal) aripiprazole (abilify) and ziprasidone (geodon) in many cases the benefits of using these medicines outweigh any risks. only your own doctor can help you decide what medicine is right for you. never stop any medicine without first talking to your doctor. statins may be very effective at stopping our body from producing natural endogenous cholesterol but they are not very effective in stopping heart attacks according to the medical research i have read. this may be due to the fact that cholesterol is not the cause of arteriosclerosis; cholesterol buildup in the artery walls is caused by inflammation. forcibly lowering cholesterol causes other problems too numerous to list here. other than this important point the answers to the question seem to be accurate but the standard knee-jerk response that statin drugs are useful as a blanket approach to high cholesterol is outdated and misguided. it should be corrected. a study from brigham and women's hospital in boston published in july 2012 found a link between phthalates commonly called "plasticizers "and diabetes in women. researchers analyzed urinary concentrations of phthalates in 2 350 women aged 20 to 80 participating in the government-sponsored national health and nutrition examination survey and found that those with higher levels of phthalates in their urine were more likely to have diabetes than those with low levels. phthalates are found in medical products including tubing iv bags and some medications diabetic link does exist. can certain medications cause diabetes? maybe

### Human:\nwhat can i do to prevent perimenopause weight gain. i've been working out at the gym for over a year now and i've been watching what i eat (weight watchers at home) and i'm still struggling to loose weight and its been frustrating what am i doing wrong?\n\n### Assistant: there is a difference between preventing weight gain and losing weight. research shows exercise of about an hour a day is protective for weight gain during midlife. also resistance training is key to help maintain muscle mass because gradual muscle loss is part of the reason women gain weight with age. i guess the question is is your weight in a healthy range now? if it is it might not be realistic to expect it to stay the same throughout this time or lose it to be at a weight you used to be. if your numbers are good (cholesterol etc. ) and your blood pressure is normal overly focusing on weight may not be helpful to your health or quality of life. but if you feel the extra weight isn't good for you or you have risk factors than i highly suggest you see a registered dietitian. you can find one in your area at eatright. org also see weight loss menopause and exercise tips

### Human:\ni've heard that adding avocados to my diet could help me lose weight. is this true?\n\n### Assistant: unfortunately there are no magic foods to add to your diet with any unique weight loss properties. but avocados do contain a nice combination of nutrients associated with maintaining a healthy weight. since they are a source of healthy monounsaturated fats they can help to protect your heart. they're also pretty high in fiber and contain a moderate amount of protein. and both fiber and protein can help you feel fuller longer. but keep in mind avocados are pretty high in calories. and any successful weight loss diet must be calorie-controlled. (one avocado contains 322 calories 13. 5 g of fiber 4 g of protein and 29. 5 g of fat mainly monounsaturated. )

### Human:\nwhat medicines can cause your skin to turn blue?\n\n### Assistant: amiodarone a cardiovascular medication does cause some people to turn irreversibly blue. it is important to check with a pharmacist in order to understand this medication prior to taking it. also if you have any apprehensions you should talk to your pharmacist about the risks and benefits of any medication to make sure that you are comfortable and compliant.

### Human:\nhow do nuts work in a heart-healthy diet?\n\n### Assistant: we know that high cholesterol is one of the major risk factors for atherosclerosis. in the may 10th edition of archives of internal medicine researchers found that eating nuts improves blood lipid levels which may help stave off heart disease. in a pooled analysis of 25 intervention trials eating an average of 67 grams of nuts a day (2. 4 ounces) reduced total cholesterol by 5. 9% and ldl cholesterol by 7. 4% (p<0. 001 for both) according to joan sabaté md drph of loma linda university in california and colleagues. in 2003 the fda allowed 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. walnuts and almonds have been most comprehensively studied. epidemiological studies have linked nut consumption with a reduced risk of coronary heart disease and many dietary intervention trials have studied the effects of nut consumption on blood lipid levels. most clinical trials evaluating the impact of nuts on lipid profiles have been small scale (10-49 participants). ldl-c (the bad cholesterol) reduction has been consistently shown in these small-scale studies typically in the range of 12-13%. though less consistent triglyceride reduction was shown. however hdl-c (the good cholesterol) generally remained unchanged. one must always remember that these studies are far too small to establish any guidelines and there certainly is not one ounce of level one outcome data regarding the effect on cardiovascular morbidity and mortality. the american dietetics association evidence library concludes “consumption of 50-113 grams (1/2 cup to 1 cup) of nuts daily with a diet low in saturated fat and cholesterol decreased total cholesterol by 4-21% and ldl-c by 6-29% when weight was not gained. ” although the decrease in ldl cholesterol in the current analysis is modest compared with that seen with statins “the value of regular nut consumption for coronary heart disease prevention is unlikely due to the blood cholesterol-lowering effect alone ” sabaté and his colleagues wrote. the authors of the current study felt that “nut consumption exerts beneficial effects by improving endothelial function lowering oxidative stress and reducing lipoprotein(a) level. ” i have previously written about lipoprotein(a). aside from the fatty acid composition of nuts other components such as arginine plant sterols and phenolic components may play a favorable role in the lowering of lipid levels for those who eat nuts as a regular part of their diet. in the current study the researchers performed a pooled analysis of raw data from 25 intervention trials conducted in seven countries that included 583 men and women with normolipidemia or hypercholesterolemia. none of the participants was taking lipid-lowering medications. sample size ranged from 10 to 49. all of the dietary interventions were exclusively nuts – mostly almonds and walnuts – and ranged in duration from three to eight weeks. quantities ranged from 23 to 132 grams per day with a mean of 67 grams. the interventions resulted in the following mean reductions (with percentage changes) regardless of the type of nut used (p<0. 001 for all): total cholesterol: 10. 9 mg/dl (5. 1%) ldl cholesterol: 10. 2 mg/dl (7. 4%) ratio of ldl to hdl cholesterol: 0. 22 (8. 3%) ratio of total to hdl cholesterol: 0. 24 (5. 6%)

### Human:\nwhat is stage 2 hypertension? . stage 2 hypertension is defined as a systolic blood pressure of 160 mm hg or higher or a diastolic blood pressure of 100 mm hg or higher. blood pressure is expressed as the systolic blood pressure “over” the diastolic blood pressure. for example normal blood pressure is “120 over 80”.\n\n### Assistant: stage 2 hypertension is defined as a systolic blood pressure of 160 mm hg or higher or a diastolic blood pressure of 100 mm hg or higher. blood pressure is expressed as the systolic blood pressure “over” the diastolic blood pressure. for example normal blood pressure is “120 over 80”. assigning “stages” to blood pressure was the idea of a national committee dedicated to raising awareness and treatment of hypertension. in their system stage 1 is blood pressure that’s high (140-to-159 systolic or 90-to-99 diastolic) but not as high as in stage 2. the higher stage expresses the more serious health risks from untreated severe high blood pressure. however some experts argue that the term “stage” is misleading because it suggests that blood pressure steadily gets worse in stages which is not always the case.

### Human:\nis it better to apply heat or cold to sore muscles after stenuous exercise?\n\n### Assistant: most helpful answer everything i have read says cold. if there is tissue damage the cold constricts blood flow which reduces spread of cellular components which can cause rupture of nearby cells making the injury worse and longer to heal. heat is not usually applied to an injury until 72 hours have passed. this is to increase circulation and promote healing. more recent research shows movement of skeletal muscles produces hormone-like substances that promote and speed healing of damaged or inflamed tissues throughout the body. so if you can move do. lastly a small meal of four parts carbs and one part protein within 90 minutes of exercise will help speed muscle recovery. the body will use that energy and protein to quickly try to re-construct those damaged tissues. this information is from exercise physiology. ice is typically among the first thing to do in the recovery process after strenuous exercise. icing your muscles helps to reduce pain and decrease swelling and inflammation. ice causes your blood vessels to narrow which will reduce your blood flow to the muscle or injured area. never place ice directly on your skin however. wrap an ice pack around a thin cloth and place on the affected muscle for ten minutes at a time. you can use ice multiple times per day for a few days after exercise but make sure to allow for your skin to return to room temperature before icing after each 10 minute interval. heat is typically applied to uscles or injuries that do not have swelling or inflammation. heat will cause your blood vessels to expand which improves circulation and allows more blood to go to the affected area. heat can be useful for chronic injuries and muscle soreness or it can be used before exercise to stimulate blood flow and help prepare the muscle for exercise. heat should also not be directly applied to skin and should be used for short 10-15 minute intervals. always check with your doctor before starting treatment of an injury especially if the condition worsens or fails to improve. within the first few days of an injury ice can help the process of healing. applying ice to injured tissue can cause blood vessels to shrink and this makes them less capable of releasing chemicals that lead to swelling inflammation and pain. after a few days it probably best to apply heat to sore muscles. this makes muscle spasms less likely and relaxes injured muscles. however because the events behind every injury are different speak with your doctor first. i have just spent the last 6 weeks in physical therapy. they always apply heat or have me get on a bike to heat up my muscles for 15 minutes before i go through any table massage work. next i do all my exercises then they end the session with 10 minutes of ice. somtimes what contributes to soreness is 1) lack of warm-up so insuffcicient oxygen was available to fuel the work. and 2) lack of cooldown which will help the muscles recover by completing any partial combustion of sugars for energy leaving residual metabolites such as one feels with the muscle burn of working beyond anerobic threshold. anerobic threshold can be increased through more careful training. i can exercise well beyond my predicted 100% of age heart rate for periods of 10 20 and 30 minutes or more

### Human:\nare there certain foods that should be avoided after ones gall badder is removed?\n\n### Assistant: because the gallbladder is a storage space for bile that breaks down fat (originally produced in the liver) you'll need to watch your fat intake. while the body eventually adjusts to not having a gallbladder every person is different in how their body reacts. you'll want to keep the following points in mind for your diet moving forward: consume small frequent meals over large infrequent ones. avoid greasy foods high in fat such as fried food and creamy sauces. and when you do choose to eat these foods consume them in small amounts. gradually increase fiber in your diet (fruits vegetables and whole grains) to help move food through your intestines. keep a food dairy to note foods that may not be tolerated. some people who have had their gall bladder removed notice foods like dairy are more difficult to tolerate. if you are noticing many symptoms see a registered dietitian for help. i t have removed my gallbladder 8 months ago and i always feel pain when i consume meals high in fat. and its true that every person reacts in different way to food. so just monitor your food intake and your reaction to it. if you ever felt uncomfortable then you should lower its intake. saturated fats. everyone should avoid these! saturated fats are the fats that at room temperature solidify. such as bacon grease the fat in the pan of ground beef melted margarine that cools down and becomes solid again. these are some of the fats that get into the arteries and eventually clog them causing heart attacks and strokes cut out or at least down on the cholesterol too as well as the triglycerides. as many physicians and nurses recommend consult with a dietitian they will help.

### Human:\ni have a heart murmur and was told that pre-medication is no longer necessary before dental treatment. is this true?\n\n### Assistant: the american heart association guidelines have changed. only the people at the greatest risk for bad outcomes from infective endocarditis -- an infection of the heart valves -- should receive short-term preventive antibiotics before common routine dental and medical procedures. i generally request that patients have a screening by a cardiologist and a specific recommendation to go along with it.

### Human:\nwhat is dyslipidemia?\n\n### Assistant: dyslipidemia means an abnormal amount of lipids or fats in the blood. lipids are essential to life but an excess of certain lipids can increase the risk for cardiovascular disease. the lipids that are commonly measured in blood include various forms of cholesterol as well as triglycerides. high-density lipoprotein (hdl) is the “good cholesterol ” and higher levels reduce the risk of cardiovascular disease. low-density lipoprotein (ldl) is the “bad cholesterol ” linked to increased risk of heart attacks and strokes. high triglycerides are also a risk factor for cardiovascular disease. in dyslipidemia the level of one or more of these lipids is abnormal (either too high or too low). increased activity and a healthy diet should be the first course of treatment for dyslipidemia. if you are at risk for heart attack or stroke and diet and exercise fail to bring high lipid levels into the healthy range your doctor may recommend taking a lipid-lowering medicine.

### Human:\ndespite regular cardio exercise and eating healthy i can't seem to lose weight? . okay maybe i can't lose weight is misleading but i am losing muscle and gaining fat. my exercise includes running for an hour at least four times a week for over a month and eating includes eating salads eggs fruits and white meats like chicken (and none of the junk i won't even allow myself cheat days). in spite of the fact that i have lost 20lbs i don't look any thinner. in fact i've gained fat and it's becoming increasingly harder to continue keep the same running time and pace.\n\n### Assistant: it sounds like you are losing weight and your body is changing. here are some tips that might help: consider working with a certified personal trainer to help you incorporate strength training exercises to help build muscle while monitoring your body fat. try yoga as another way to build muscle mass. eat some protein with small amounts of carbohydrate after working out to help stimulate muscle growth (e. g. protein bar peanut butter on whole wheat toast greek yogurt with almonds). see this article for more on what to eat before and after workouts eat balanced meals which includes all the food groups -- fruit vegetables healthy fats whole grains low fat dairy and lean protein. a registered dietitian can help you develop an eating plan that helps you lose weight in a healthy way. to find one go to eatright. org even though it's hard try to be patient. it takes time to find a healthy lifestyle that works for you. get the support you need! i would suggest you visit this site - how to get ripped. there you can find a customized nutrition and weight training plan based on details you fill in. like age weight height metabolism and body type. you can also read my story it contains information about my struggle. meybe you will find it heplful. good luck the body responds to what is known as the said principle. specific adaptations to imposed demands. when you look at marathon runners they are generally thin but actually have a higher body fat % than sprinters. this is an adaptation when you run for long periods your body needs energy. if your exercise program has no variation your body adapts and begins to hold on to it's fat so that it has energy stores to be used during long runs. running/cardio is fine but mix in resistance training. muscle burns more calories than fat. this doesn't mean you will get bulky if that's a concern but by activating more muscle fibers your body will burn more calories helping to lose weight. circuit training can be a useful tool for this you will burn a lot of calories your heart rate will get up and you will increase muscle. the key is variation most personal trainers or at least good ones progress your workout through different stages to keep your body adapting. using simple tools like exercise selection # of sets # of reps time of rest in between can all help. one final piece of advice most supplements out there are junk. don't waste your money on false promises. a registered dietician can help you with meal planning if you need it. hope this helps if anyone want to loose the weight than exercise is the best way for him/her to losse the weight or to maintain the body. but in this busy life sometimes we wont get the time to do the workout or jogging etc. many people are asking here that without doing exercise we can loose the weight. there are many ways through which you can loose the weight one of the way to loose the weight is eat healthy and fresh food drink the healthy tea like green tea. green tea benefits-it is healthy tea it helps one for lossing weight is also helps to cure from diseases. so i think now you know that without doing the exercise you can also loose your weight by maintaining your diets by taking healthy food. you may be losing inches! not just lowering your number on the scale! <positive_smiley>

### Human:\nwhat kind of medicine would the doctor give you for heart palpations\n\n### Assistant: the choice of medications would totally depend on the cause of the palpitations. there are no universal medications that would treat all causes. your medical provider will select an appropriate treatment based on your evaluation and diagnostic tests.

### Human:\ni need a list of foods that would be helpful with lowering my triglycerides and cholesterol. any suggestions?\n\n### Assistant: a healthy diet that follows the myplate. gov guidelines is a good start. fill half of your plate with fruit and vegetable servings one quarter with a serving of whole grains such as brown rice or whole grain bread and the other quarter with a serving of lean proteins such as chicken breast fish turkey or sirloin steak. choose fat free or 1% fat dairy products. avoid sugary soft drinks and other pre-sweetened beverages. limit your consumption of solid fats such as butter or vegetable shortenings and the foods they're made with.

### Human:\ndoes aerobic exercise interfere with muscle gains from weightlifting?\n\n### Assistant: your body prefers not to use amino acids the building blocks of muscle as an energy source unless it has to because it’s simply not the most efficient way for your body to get the energy it needs. your body will typically use the more efficient means of attaining energy first. weight lifting and aerobic exercise can complement each other well but if you have concerns with not being able to gain muscle mass keep the aerobic exercise at a moderate amount. it might be best to refrain from doing overly excessive endurance aerobic events. try doing high intensity interval training. interval training involves coupling short bursts of high intensity exercise with less intense recovery periods. for example you could run on a treadmill for 1 minute at 8mph and then jog for 30 seconds at 6mph repeating for a total of 10 to 15 minutes. this is just an example to illustrate the point; you can do different intensity levels and different work to rest ratios. consider also doing circuit training which is a workout regimen involving resistance training with very little rest in between exercise sets. this form of exercise is high intensity and helps keep your heart rate elevated so that it can function as aerobic exercise while providing a foundation for muscular strength and endurance. lastly make sure that you are getting enough protein in your diet. the essential amino acids necessary for muscular growth and development can only be obtained through dietary intake. if you’re not getting enough protein you won’t be building muscle regardless of your activity. if you're training for an endurance event like a marathon when you might run 60 miles or more per week you'll almost always see a decrease in your muscle mass. for most of us who do more moderate amounts of physical activity there will be minimal if any loss in muscle mass from aerobic exercise -- so there's nothing to worry about. if you do plan on lots of aerobic exercise and are concerned about losing muscle try starting with 20-30 minutes of moderate aerobic exercise (at 50% to 70% of your maximum heart rate) two to three days per week and see how it goes.

### Human:\ncan you tell me what causes hair loss on lower legs and calves in men?\n\n### Assistant: there are several reasons for hair loss on the legs. poor circulation may be a factor which can be caused or aggravated by diabetes thyroid disorders peripheral artery disease medications poor diet lack of exercise smoking being overweight and other health issues. to properly diagnose your condition and to rule out a serious condition you need to be evaluated and tested by a physician. it might be worth checking on your 5-alpha reductase level. this is an enzyme that regulates the conversion of testosterone into dihydrotestosterone (dht). reduced 5-alpha reductase levels can lead to an overabundance of dht which in turn can adversely affect the health of hair follicles and reduce hair reproduction on your legs. pad can cause hairless legs. lack of proper blood circulation is the root of this phenomenon. crossing your legs and/or ankles. it's rubbing the hair off. crossing your ankles.

### Human:\nwhat is indicated when you have a high systolic number but a normal distolic number?\n\n### Assistant: this is a very good question! your blood pressure reading consists of two numbers. the number on the top is called the systolic number. the number on the bottom is the diastolic. the systolic number is the pressure in your arteries when your heart is beating. the diastolic number is the pressure when your heart is relaxed between beats. blood pressure is considered normal when it is below 120/80 mm/hg. if the systolic number is 140 or higher or the diastolic number is 90 or above this may mean you have high blood pressure or hypertension. but your doctor will not usually diagnose you after just one high reading. he or she may have you come back again or may have you take your blood pressure at home. as we get older several things happen inside our blood vessels. our arteries get more stiff and plaque builds up. this makes the pressure of the blood inside the arteries increase when the heart is pumping. thus the systolic number goes up as we age. other things that can also cause the systolic number to go up include heart disease anemia thyroid disease and heart valve problems. doctors pay very close attention to the systolic number because it is linked more closely with heart attack and stroke risk. the good news is that there are many things you can do to bring down your systolic blood pressure. if you have been diagnosed with high blood pressure your doctor can help you get back on track. he or she will likely suggest lifestyle changes including healthy eating options and regular physical activity. if you smoke you can get help quitting. if stress is a problem for you ask for help in reducing it. you may need to take medication to keep your blood pressure in a healthy range.

### Human:\nwhy does coffee give me such an energy boost?\n\n### Assistant: as you're drinking your morning cup of joe you're probably just waiting for that wonderful rush of energy and alertness you've come to know and enjoy. within 15 minutes of gulping your caffeine your adrenalin rises increasing your heart and breathing rates your stomach starts to produce more acids and your urinary output rises (as anyone with a small bladder knows! ). but i bet you didn't know that caffeine tweeks your adrenal glands to produce more cortisol (stress hormone) which then stimulates the release of the liver's stored sugars. any endurance athlete knows this and uses it to their advantage. you drink your caffeine and then use the newly circulating sugar fuel to power through another workout. but what if you're sitting at your desk sipping your coffee with nowhere to go? then you might have problems because when the sugar levels rise with caffeine so do insulin levels which when they finally plummet after handling the circulating sugar leave a rip roaring appetite for more sugar in their wake. for runners and bikers this makes sense since you've just burned a zillion calories and need to replenish the sugar stores. not so for someone in an office cubicle with nowhere to go. here are some suggestions. to kill carb cravings associated with caffeine ingestion make certain to eat a combo of protein and fiber. how about peanut or almond butter on a multigrain cracker? or have that caffeine with a yogurt and blueberries or eggs and veggies. you get the point. when you're downing lots of coffee with nothing in your stomach you're more likely to reach for sugary foods so watch out. or you can just drink beverages with less caffeine in them: 6 ounces brewed coffee 105 mg caffeine; 6 ounces instant coffee 55 mg; 12 ounces colas 35-45 mg; 6 ounces tea 35 mg. now remember when you go to one of your fancy schmancy coffee houses you'll often be purchasing at least 8 ounces of coffee and closer to 12 ounces so you're really consuming over 200 mg of caffeine. all the more reason to be cautious if you just happen to be one of those people who is affected by the sugar rush.

### Human:\nhow does a doctor choose the kind of stent needed to treat heart blockages?\n\n### Assistant: there are two basic types of stents that cardiologists use to treat blockages in coronary arteries. both are made of metal but one type is coated with a polymer that has drugs embedded in it that can help prevent the re-narrowing of the blockage that occurs in 20-30% of the blockages treated with the "bare metal" stents. these "drug-eluting" stents were a major step forward in the technology used to treat blockages. but they also carry with them a need for longer periods of antiplatelet therapy (aspirin plus clopidogrel) than was required with the bare metal ones. it's these two characteristcs (reducing the risk of re-narrowing balanced against the need for long-term antiplatelet treatment) that influence which stent a cardiologist might use to treat blockages. for example blockages with a greater likelihood for re-narrowing include very long blockages in smaller arteries. cardiologists might more likely use a drug-eluting stent for these while using bare-metal ones for more discrete blockages in large arteries. this is just one example. cardiologists consider many patient factors (for example is someone willing to take clopidogrel for a year) as well as technical factors when making these decisions. if you find out that you need a stent ask your cardiologist how and why he/she will make these decisions.

### Human:\nim on cumdine = so i cant eat any dark leafy veggies -what other foods cant i eat? . i need a guide= to what i can eat and cant eat- on cumidine? '. . can i eat peanuts? . can i eat potatoes? . if i eat veggies? how much each day or do i alternate= with a salad. . i eat a handful since i do not know if a cup a day- is just vegetable or includes green salad- a cupful?\n\n### Assistant: the good news is that most people do not have to drastically change their diet when they start on the blood-thinner warfarin (coumadin). but you do have to pay close attention to what you are eating. the goal is to keep the level of vitamin k about the same from day to day. you can do this by knowing which foods have a lot of vitamin k and not making any big changes in how much of them you are eating each day. foods that have a lot of vitamin k include most of the green leafy vegetables like spinach kale lettuce cabbage swiss chard endive and seaweed. greens such as turnip collard and mustard are all high in vitamin k as well. other vegetables that contain a lot of vitamin k are cauliflower broccoli and asparagus. liver is also high in vitamin k. other things to watch out for include green tea canola oil and soybean oil. peanuts and potatoes do not have a large amount of vitamin k. but watch out for cashews and pine nuts. they have a bit more vitamin k so eat them sparingly. so what does all this mean? if you have always had a salad for lunch then it is probably fine to keep eating one every day as long as it is ok with your doctor. if you want broccoli or asparagus with your dinner for a change then it would be best to skip the salad that day. and remember to keep your portions small. liver has a lot of cholesterol so i would recommend skipping that altogether. if your doctor has recommended a multivitamin make sure you take it every day. they usually have vitamin k in them as well so you want to be consistent. talk to your doctor before making any changes in your diet. do not take any over-the-counter medicines or supplements without checking with your doctor first. some of them may interfere with your medicine. also be sure to get all blood tests done on time. don’t be overwhelmed! it may seem like a lot to do at first but it will become second nature before you know it.

### Human:\nmy wife weighs 242lbs she only eats about 1500 calories a day and excercises. why can't she lose weight? . . my wife is 5ft 4inches tall weighs 242lbs and is a size 14-16 in pants sizes. she only eats about 1500 calories a day and exercises about 90+ minutes a day burning 800-1200 calories. she has been doing this for about 2 months and hasn't lost any weight. she has been diagnosed with ibs. she also has be test for hypothyroids and was negative. . .\n\n### Assistant: it's difficult to say exactly why your wife isn't losing weight without more information but here are some things to consider: how is she tracking her calories? it is possible that she is getting more than she thinks she is. seeing a registered dietitian can help her examine her food intake for hidden calories. high levels of activity mixed with low calorie intake may increase cortisol (levels stress hormone) and cause weight to stay where it is. this is a theory but i have seen it many times. your wife can experiment with cutting back the exercise or increasing her calorie intake. unless she's enjoying the exercise it likely isn't sustainable so i suggest she focused on doing something she enjoys. if your wife did not exercise at all before it is possible she is gaining some muscle mass and losing fat even the scale isn't moving. other factors can cause weight to plateau such as stress and lack of sleep. see this webmd article for more ideas. weight loss -- and especially weight loss maintenance -- can be a challenging task. i suggest your wife get help and support with the process. the key is to address the reasons for the weight gain in addition to tackling food and exercise. i had the same issue. 1-2hours a day in the gym cardio and weights 4-5 days a wk eating 1200 calories only lost 2 lbs in 4 months. turns out there is so much msg in food that it was hindering my progress. i switched to eating only organic food with light exercise and lost 5 lbs. in one week. i also stopped getting head aches and back aches. i even gained energy and improved disposition. (msg is an excitotoxin used to get mice fat and stay that way in order to research diabetes. -there are over 40 types of msg under different names and it is in 95 percent of foods you find in stores. ) <link>

### Human:\ni am unemployed and can’t get insurance. i have social anxiety gad and depression. how can i get help i can't afford?\n\n### Assistant: a lack of insurance and an inability to pay more than a minimal amount should never prevent you from getting the help you need and deserve. licensed professionals including psychologists have an ethical responsibility to take a number of "pro-bono" cases. this means for little or no fee. of course there is a limit to the number of these cases that anyone can take but it's worth asking. you can call your local psychologists association explain your situation and ask for the names of psychologists in your area who would be willing to help you. you can also check social service agencies as well as any major hospital center because these entities generally have access to mental-health providers who require minimal fees. hello -- in the depression community <link> (first and tenth posts) we have a list of resources for finding free/low-cost medical care including counseling. take a look there for some other ideas. i'm so sorry you are suffering such heartache. -- susie margaret

### Human:\nwhat foods or drinks can help my blood pressure?\n\n### Assistant: there is a well researched diet for high blood pressure called the dash diet standing for dietary approaches to stop hypertension. here are the basics of the diet: low in sodium no more than 2300mg sodium (the average sodium intake in the american diet is 3 500). reading labels is key. plenty of fruits and vegetables which contain potassium an important nutrient to help lower blood pressure. try including sources at every meal. some ideas include cutting fruit up ahead of time for quick meals fruit and veggie smoothies in between meals and green salads with lunches and dinners. 2-3 servings of low fat dairy foods such as milk yogurt and low fat cheeses. nuts seeds and legumes most days of the week healthy fat sources such as olive oil instead of butter limited amounts of sweets no more than 5 times per week alcohol in moderation -- no more than 2 per day for men and 1 for women for more details on this diet see this webmd article. there's a lot you can do to lower your blood pressure. good luck!

### Human:\nhow much should i weigh?\n\n### Assistant: doctors nutritionists and public health authorities most often use the body mass index to define a healthy weight. body mass index (bmi) is your weight in kilograms divided by the square of your height in meters (kg/m2). according to the cdc a bmi of less than 18. 5 is considered underweight. a normal bmi falls within the range of 18. 5 to 24. 9. the bmi range of 25. 0 to 29. 9 is considered overweight and a bmi of 30. 0 or higher is considered obese. . obesity increases the risk for diabetes high blood pressure heart attack stroke certain cancers. losing weight reduces your risk. waist size matters too. even in people who are only slightly overweight a waist circumference greater than 40 inches in men and 35 inches in women increases health risks. don’t believe your pant size; it often underestimates waist circumference. measure your waist yourself with a tape measure just below the belly button.

### Human:\nwhat are the symptoms of arrhythmias?\n\n### Assistant: an arrhythmia can be silent and not cause any symptoms. a doctor can detect an irregular heartbeat during a physical exam by taking your pulse or through an electrocardiogram (ecg or ekg). when symptoms of an arrhythmia occur they may include: palpitations (a feeling of skipped heart beats fluttering or "flip-flops"). pounding in your chest. dizziness or feeling light-headed. fainting. shortness of breath. chest discomfort. weakness or fatigue (feeling very tired).

### Human:\nhow should i prepare for the echocardiogram?\n\n### Assistant: on the day of the echocardiogram eat and drink as you normally would. take all of your medications at the usual times as prescribed by your doctor.

### Human:\nwhat should i do to prepare for a stress echo?\n\n### Assistant: if you are scheduled for a dobutamine stress echo and you have a pacemaker please contact your doctor for specific instructions. your device may need to be checked before the test. on the day of the stress echocardiogram do not eat or drink anything except water for four hours before the test. do not drink or eat caffeine products (cola chocolate coffee tea) for 24 hours before the test. caffeine will interfere with the results of your test. do not take any over-the-counter medications that contain caffeine for 24 hours before the test. ask your doctor pharmacist or nurse if you have questions about medications that may contain caffeine. do not take the following heart medications for 24 hours before your test unless your doctor tells you otherwise or unless the medication is needed to treat chest discomfort: beta-blockers (for example tenormin lopressor toprol or inderal) isosorbide dinitrate (for example isordil sorbitrate) isosorbide mononitrate (for example ismo indur monoket) nitroglycerin (for example deponit nitrostat nitropatches) your doctor may also ask you to stop taking other heart medications on the day of your test. if you have any questions about your medications ask your doctor. do not discontinue any medication without first talking with your doctor. if you use an inhaler for your breathing please bring it with you.

### Human:\nwhy do i yawn after 30-40 minutes of exercising?\n\n### Assistant: it doesn’t seem like anyone really knows exactly why some people yawn during or after exercise but there are some theories. one thought is that you may be trying to get more oxygen. think about what a yawn actually is; a long deep breath of air. this deep breath may serve as a means to get more oxygen into your body which makes sense because exercise can make your body oxygen-deprived. yawning can also increase heart rate and blood pressure helping to increase the cardiac output that your heart might need during exercise. some research suggests that yawning could actually provide a cooling effect as a way to regulate your core body temperature after exercise as well. of course you may just be yawning because you’re fatigued or sleep deprived or it could be a side effect of some medications too. there really isn’t one single answer as to why we yawn during or after exercise. excessive yawning may be the sign of an underlying health condition however so please consult your doctor for further guidance. iron deficiency

### Human:\nmy weight has hit a plateau. what do i do?\n\n### Assistant: there are several reasons why your weight can hit a plateau including: losing weight too quickly. when this happens your metabolism (the rate at which your body burns calories) can slow down because your body senses it is starving. rapid or large amounts of weight loss can slow your metabolism by as much as 40% in six months. losing muscle. when you lose weight up to 25% can come from muscle tissue. and since muscle is the engine in your body that burns calories and helps maintain your metabolism losing it can hinder weight loss. weightlifting can help preserve and build muscle. reaching your body's particular set point -- the weight and metabolic rate your body is genetically programmed to be. once you reach that point it's much harder to lose weight and even if you do you're likely to regain it. if you're at a weight at which you've hit a plateau in the past if your body generally seems to gravitate toward that weight and you're within a bmi (body-mass index) range of 20 to 25 then you may be at your set point. decreasing your physical activity and/or increasing your caloric intake. people lose weight all the time by reducing their caloric intake without doing any exercise but it's almost impossible to keep weight off without exercising. many scientists agree that physical activity is the single best predictor of whether a person will maintain a weight loss. other health factors including thyroid or adrenal gland problems; medications like antidepressants; quitting smoking; menopause; and pregnancy. even with any of the above factors the bottom line to losing weight is eating fewer calories than you burn. studies show that people almost always underestimate how many calories they're eating. so if you're struggling with weight loss you're still exercising and you've ruled out any of the above reasons for weight plateaus look at your calorie intake. as for exercise and weight plateaus sometimes a change in routine can help. instead of the treadmill try the bike or the stepper. instead of a dance class try a stretch and tone class. if you're not weight lifting this would be a good time to start. if you already do aerobic exercise try adding intervals (short bursts of higher-intensity exercise) to your aerobic workouts. and keep reminding yourself that if you maintain an active lifestyle and continue with healthy eating you will reach your goals. it can be frustrating when you’re putting so much hard work into losing weight only to hit a plateau. don’t be discouraged; a few simple changes may be all that you need. for exercise consider the f. i. t. t. principle: f – frequency – how often or how many days you exercise i – intensity – how hard you work during your exercise t – time – how long or how many minutes you spend per session. t – type – the type of activity that you are doing making adjustments in one of these areas could help you break through your plateau. of course the more that you do with your exercise the greater the benefits you should see from it. for example let’s say that your current exercise routine is walking three times per week for thirty minutes at a moderate intensity. you could add more days per week or spend more time per session to expend more calories and hopefully further boost your metabolism to promote weight loss. try increasing the intensity by walking at a quicker pace or incorporating intermittent bouts of jogging. you could also try carrying arm weights having a weighted backpack or incorporating more hills or inclines to challenge yourself further. your body may have just become accustomed to your exercise routine so sometimes it can also be helpful to change the type of activity as well. try different forms of cardiovascular exercise or try doing strength-building exercise if you’re not already. with nutrition try reassessing your dietary intake. in what ways can you eat healthier? can you eat out less often or drink less soda? what about having less chips pastries or candy? can you increase your fruit or vegetable intake? try food journaling to track and monitor your dietary intake so that you can better recognize areas for improvement. don’t forget to reevaluate your calorie needs as you continue to lose weight. keep working at it! often times the best way to break through a plateau is simply persistence! stay calm and don't worry about it the more you worry the worst its going to get how low do my carbs need to be to lose weight

### Human:\ntype your question here. my husband is dizzy - ears have water in them and is blue in the face. sleeping a good bit.\n\n### Assistant: dizziness can be caused by a number of serious conditions. these can include a stroke a heart attack breathing problems or trouble with blood sugar. a bluish tint to the skin is also a worry. it can mean that a person is not getting enough oxygen. someone with these symptoms should call 911 right away.

### Human:\naccording to the cdc 16 new antibiotics came to market between 1983-1987 but only 2 between 2003-2007. why so few?\n\n### Assistant: the number of new antibiotics in development is alarmingly low and it's a matter of resources. antibiotics are taken for a shorter period of time and it's more economical for drug companies to make drugs that are taken for a long time. we're also promoting the concept of using these antibiotics judiciously so companies and researchers don't see the economic benefit. antibiotics are not used in volume like a cholesterol or diabetes medication. the fda is currently considering options to facilitate new antibiotic development.

### Human:\nare there certain foods i should eat -- or avoid -- to lose belly fat?\n\n### Assistant: this is a very popular question. but belly fat builds when we eat too much food in general. rather than focusing on certain types of foods i recommend revving up your exercise routine with more cardio such as walking or jogging. and add strength training to your regimen by using weights and resistance. pilates and yoga classes can also be helpful in the effort to strengthen your core.

### Human:\ncan soy help lower cholesterol?\n\n### Assistant: in the last 12 years soy has been believed to lower ldl-c [bad cholesterol]. however recent data has not shown soy to be a practical means to lower ldl-c. in order to achieve any meaningful ldl-c reduction large amounts of soy are required. even when individuals consume half their daily protein with soy protein only a very small reduction (3%) in ldl-c is achieved. soy seems to be a more efficacious lipid-lowering agent in persons with marked hyperlipidemia. it should be noted that reduction in lipids may be due to replacing high-fat animal protein with soy rich foods that may indirectly result in lipid reduction via a reduction in saturated fat intake.

### Human:\nshould people with serious heart problems avoid fast food all together?\n\n### Assistant: just because a food is "fast" doesn’t mean it's automatically unhealthy. many quick-service restaurants today offer whole wheat buns grilled chicken cuts salads and reduced-fat dressings on their menus. when eating out avoid fried items and sugary soft drinks. ask for more lettuce tomatoes onions or whatever kinds of veggies the restaurant has. at sub and sandwich places go for lean proteins such as turkey or roast beef. ask for mustard instead of mayo. avoid adding cheese to sandwiches which can contain about 100 calories per slice as well as saturated fats which should be limited for a more heart-healthy diet.

### Human:\ncan my 9-year-old take over-the-counter prevacid?\n\n### Assistant: prevacid or lansoprazole has recently moved from prescription strength to over-the-counter. the over-the-counter dose is labeled for adults 18 and older. this medication is intended to treat stomach ulcers or heartburn that occurs 2 or more times per week. it is not a quick fix to elevate symptoms for heartburn. it slows the production of acid within the stomach over a period of time and is taken daily for 14 days. we recommend seeking medical advice if the product needs to be taken for more than 14 days. i would not give prevacid to your 9-year-old child. while this product is found over the counter it still must be used according to its labeled directions in order to be safe and effective. if your child is having constant heartburn or stomach issues seek medical advice from your pediatrician. consider looking at the cause of the symptoms to help educate your child. for instance eating slower avoiding certain foods that trigger symptoms or eating smaller portions may help his/her symptoms. while medications are readily available and sometimes seem to be the quick fix look at preventing the symptoms by changing behaviors.

### Human:\nwhat is myopathy?\n\n### Assistant: myopathy simply means “something wrong with a muscle” (or more often multiple muscles). myopathy is a very general term that can be applied to almost any condition affecting muscles. some examples of myopathies include: muscle inflammation caused by cholesterol-lowering drugs called statins cardiomyopathy or poor function of the heart muscle genetic conditions resulting in severe birth defects affecting muscles autoimmune conditions affecting muscles like dermatomyositis there are many more conditions in the category of myopathy which vary widely in their causes treatments and prognosis. all forms of myopathy can cause muscle weakness.

### Human:\ndoes resveratrol really work?\n\n### Assistant: resveratrol which is a compound found largely in the skins of red grapes has gained a lot of media attention and has been touted as having many beneficial health effects. resveratrol is a component of ko-jo-kon an oriental medicine used to treat diseases of the blood vessels heart and liver. it came to scientific attention during the mid-90s as a possible explanation for the “french paradox” — the low incidence of heart disease among the french people who eat a relatively high-fat diet. since then it has been touted by manufacturers and examined by scientific researchers as an antioxidant anti-cancer agent and phytoestrogen. it has also been advertised online as “the french paradox in a bottle. ” if you do a literature search and look at well-accepted peer review journals there is very little published to support any of these effects of resveratrol. new work produced by both amgen and pfizer has cast doubt on the manner in which the health supplement is said to work. prominent researchers supposed that it worked by activating a certain gene sirt1. this activation is thought to produce the benefits of a caloric restriction diet even among those with high fat and high caloric intake. in 2009 in chemical biology and drug design amgen scientists published experimental results that indicate resveratrol does not in fact activate sirt1. pfizer scientists in the journal of biological chemistry in 2010 offered similar results showing that resveratrol (and related substances such as srt1720) do not active sirt1 and did not reduce blood sugar in mice fed a high-fat diet. thus it suggests that resveratrol doesn’t work at all (though it’s not possible to translate mice studies into human studies). despite what is promoted on many national television shows on health none of the claims has been demonstrated in any valid human study. while present in other plants such as eucalyptus spruce and lily and in other foods such as mulberries and peanuts resveratrol’s most abundant natural sources are vitis vinifera labrusca and muscadine grapes which are used to make wines. it occurs in the vines roots seeds and stalks but its highest concentration is in the skin. the resveratrol content of wine is related to the length of time the grape skins are present during the fermentation process. thus the concentration is significantly higher in red wine than in white wine because the skins are removed earlier during white-wine production lessening the amount that is extracted. grape juice which is not a fermented beverage is not a significant source of resveratrol. since wine is the most notable dietary source it is the object of much speculation and research. resveratrol is also available from supplement pills and liquids in which it is sometimes combined with vitamins and/or other ingredients. it is also an ingredient in topical skin creams. the supplements are generally labeled as containing from 20 to 500 mg per tablet or capsule. however the purity of these products is unknown. and because dietary supplements are loosely regulated it should not be assumed that the labeled dosage is accurate.

### Human:\nwhat lifestyle changes should be made if i have an arrhythmia?\n\n### Assistant: if you notice that your arrhythmia occurs more often with certain activities you should avoid them. if you smoke stop. limit your intake of alcohol. limit or stop using caffeine. some people are sensitive to caffeine and may notice more symptoms when using caffeine products (such as tea coffee soft drinks and some over-the-counter medications). stay away from stimulants used in cough and cold medications. some such medications contain ingredients that promote irregular heart rhythms. read the label and ask your doctor or pharmacist what medication would be best for you.

### Human:\nwhat should i do to prepare for a transesophageal echo?\n\n### Assistant: before a transesophageal echocardiogram tell your doctor if you have any problems with your esophagus such as hiatal hernia swallowing problems or cancer. on the day of a transesophageal echocardiogram do not eat or drink anything for six hours before the test. take all of your medications at the usual times as prescribed by your doctor. if you must take medication before the test take it with a small sip of water. if you have diabetes and take medication or insulin to manage your blood sugar please ask your doctor or the testing center for specific guidelines about taking your diabetes medications before the test. someone should come with you to your appointment to take you home as you should not drive until the day after the test. the sedation given during the test causes drowsiness dizziness and impairs your judgment making it unsafe for you to drive or operate machinery.

### Human:\nwhat's best of day to check your blood pressure. my pressure changes all the time when i check it at different times. i'm 74 and a active person. thomas\n\n### Assistant: keep in mind that your blood pressure can vary naturally throughout the course of a day. exercise or physical activity has a tendency to raise blood pressure so refrain from taking a reading afterwards. stress can influence blood pressure too. in fact white coat hypertension is a phenomenon where the anxiety of visiting with a doctor can raise blood pressure where it wouldn’t be elevated otherwise. make sure that you are measuring your blood pressure on a regular basis and at the same time of day controlling for as many confounding variables as possible. for these reasons measuring your blood pressure first thing in the morning works well for some people. also because your blood pressure can vary it’s important to obtain many readings to observe a trend or pattern. the best way to check your blood pressure is manually through trained medical personnel. the accuracy of automated electronic blood pressure machines can vary depending on the quality of the device. some machines may need occasional calibration or maintenance too. to determine the accuracy of your home device take it with you the next time you go to the doctor and have a trained medical person measure your blood pressure manually and then compare it with your device. it is normal for blood pressure to change nearly every time you take it regardless of the time of day. the most important reading would then be the average reading so just take your bp a few times a day and write it down. as long as your average blood pressures are in the normal range minor daily fluctuations are usually not that important. my moms blood pressure is 56 over 40 what

### Human:\nwhat if i don’t have time to exercise 60 minutes a day?\n\n### Assistant: the 60-minute suggestion is based on the national academy of science's recommendation for people who are trying to prevent weight gain or keep themselves from regaining after weight loss -- not for people who are trying to increase or maintain their cardio-respiratory fitness or health. there's plenty of research to show that 30 minutes of physical activity a day will help you gain lots of health and fitness benefits. remember that you don't have to do all your exercise in one session. if you already exercise vigorously at the gym several times a week there's no reason to quit. but if 60 minutes seems like too much for you try 30 minutes a day as a starting goal. the most important thing is that you do something. do what you can! it’s still beneficial for you to do as much exercise as you can even if you’re not meeting the recommended amount. keep in mind that you can break up your physical activity into as little as 10 minute sessions throughout the day which may be more mindful of your time constraints. build more physical activity into your daily routine naturally by parking further away taking the stairs instead of the elevator or using a break room or restroom on an opposite side of the building or on a different floor at work. consider finding a different mode of transportation to work or while running errands. you may live close enough to be able to walk or bike to some of the places that you need to go. if you take the bus try getting off at an earlier stop and walking a bit more. find ways to be active with your family like going for a walk or bike ride and set up a regular routine with it. fit in exercise while you’re watching tv by doing body weight exercises during commercials or use exercise equipment like a treadmill elliptical or stationary bike that you may have at home to do activity while you watch your shows. lastly write down your entire weekly schedule. this can help you to better visualize your schedule so that you can better see opportunities where you can incorporate more physical activity or perhaps you can move things around to create an opening for exercise. you may not be able to meet a recommended amount but do what you can!

### Human:\nhow much salt does a person need?\n\n### Assistant: about 1 teaspoon a day (or 2300 mg) for people ages two and up. how much salt do we ingest on a daily basis? on average about 50% more than that. ouch! and that extra salt raises blood pressure making the heart work harder and thus leading to heart disease.

### Human:\nis there anything you can really do to increase your metabolism?\n\n### Assistant: the best way to increase your metabolism is to increase two types of physical activity in your weekly regimen. strength training with weights helps build muscle mass and increases your ratio of lean muscle tissue to fat tissue. and muscle burns more calories than fat. also cardiovascular exercises such as walking running biking and dancing get the heart pumping and the body moving to burn calories while you work out.

### Human:\nlow carb diet cause high pottasium?\n\n### Assistant: i cannot find any research to show that low carbohydrate diets increase potassium levels. in fact low carbohydrate diets tend to be low in potassium since it is found in plant foods including potatoes fruits and vegetables. for more on source of potassium see this article. but potassium is also an electrolyte that can increase or decrease due to medical problems such as kidney and heart failure that aren't necessarily related to dietary intake. for the person with kidney damage (called renal failure) not yet on dialysis high protein is not recommended. if you are concerned about your potassium levels see your healthcare provider to see if something else is going on.

### Human:\nwhen to stop losing weight. question is. 4-5 months ago i weighed 231lbs. i'm 41 5'11. i started. excersising 5-6 days a week bout an hour a day. started eating more fruits and nuts. mainly for breakfast and normal dinners just lower portions. i now weigh 188lbs. people tell me to quit losing weight? when. do i know to stop losing weight?\n\n### Assistant: i think it's important for you to get a physical and lab work done. you want to see what your blood lipids are (cholesterol etc) blood pressure and other health indicators. this will help you figure out the state of your health. you can also track your bmi here based on your age and gender to see where you fall. together with your healthcare provider you can decide when it's time to focus on weight maintenance instead of weight loss. there is no magic number and it's important to keep up your healthy habits to maintain good health and the weight loss you've achieved to date. you just need to make an informed decision. congrats on your weight loss!

### Human:\nnumbness of the tongue causes. my husband has type 2 diabetes and has been expierencing numbness of the tongue. he also has peripheral aertial disease. could either one of these cause the numbness of the tongue?\n\n### Assistant: there are many things that can cause numbness or tingling of the tongue. some of these include: • problems within the brain—such as multiple sclerosis stroke or brain tumor • problems with a nerve in the mouth or the face—most commonly the result of dental procedures such as tooth extractions. • vitamin or mineral deficiencies—such as low vitamin b 12 folate iron • infections—such as yeast infections or the tingling that comes before a cold sore • burning mouth syndrome • certain medications • toxic exposures diabetes can cause nerve damage but that usually affects the feet and the hands. peripheral artery disease also affects the arms and legs. your husband should see his doctor to see what is causing his discomfort. he may be referred to an ear nose and throat specialist to help find the cause. i hope he gets some relief soon.

### Human:\ncan a nursing mother safely take any otc nasal allergy medication?\n\n### Assistant: there are three different types of nasal sprays used for allergy relief: corticosteroids antihistamines and decongestants. if you need relief you would work with your ob-gyn to make sure one of these medications is right for you especially the decongestants (the only group found over the counter). examples of corticosteroid nasal sprays include fluticasone (flonase) mometasone (nasonex) budesonide (rhinocort aqua) flunisolide (nasarel) triamcinolone (nasacort aq) and beclomethasone (beconase aq). side effects can include unpleasant smell or taste nasal irritation and nosebleeds. these medications are much less likely to cause any side effects than are oral corticosteroids. prescription antihistamine nasal sprays include azelastine (astelin astepro) and olopatadine (patanase). side effects of antihistamine nasal spray may include bitter taste dizziness drowsiness or fatigue dry mouth headache nasal burning nosebleed nausea runny nose sore throat and sneezing. examples of nasal decongestant sprays include phenylephrine (neo-synephrine others) and oxymetazoline (afrin others). nasal decongestants can cause dryness burning or stinging inside the nose runny nose and sneezing. taking too much of a nasal decongestant can cause irritability fast or irregular heartbeat dizziness insomnia headaches anxiety tremors and increased blood pressure. don't use a decongestant nasal spray for more than a week or so or you may develop severe congestion as soon as you stop taking it (rebound congestion).

### Human:\nis there absolute minimal daily intake of unsaturated fat in grams or grams per body weight? grams not percents. im young adult male on strict balanced low calorie diet and i wonder whats the minimal daily intake of unsaturated fat in grams or grams per body weight and not percents. the only info i found was that with vlcd some researchers speculated that 15 to 25g of fat will decrease the chance to develop gallstones but on the other hand famous vlcds sold on the market contain less then 10g of total fat a day (one contains 6. 9g another 4. 7g and another 8. 4g) and theyre popular and considered safe.\n\n### Assistant: there is not a minimal recommended amount of unsaturated fatty acids based on body weight. the institute of medicine (iom) does provide adequate intakes for the two essential polyunsaturated fatty acids for males 19-70 year old: linoleic acid (la) -- 17g per day for males alpha-linolenic acid (ala) -- 1. 6g per day. these fats are essential because they cannot be made by the body. lower levels would still prevent essential fatty acid deficiency but it is difficult to say how low you could go. the question is why would you want to lower your fat intake to such a low level? the iom recommends a range of total fat between 20-35% of calories. some very low calorie diets (vlcd) may go below that but that should not occur without a doctor's supervision. for more on vlcd see this article. it's important to remember that you need fat to absorb fat soluble vitamins for satiety and satisfaction and to obtain other important fats such as dha and epa (from marine sources) which are vital for heart and brain health. good luck!

### Human:\ni notice that sugars are supposed to be under 25 grams per day. how is that possible when milk has 7 grams per glass? . isn't it best to get your calcium from foods rather than supplements? how can you eat any sugar at all and still meet the guidelines when you have 3 cups of milk per day for your health?\n\n### Assistant: the types of sugar people should limit in the diet are added sugars. sugars that are naturally occurring in milk yogurt and fruit would not count. added sugars would be the sugar that is added to a meal or drink (sugar to coffee or syrup on pancakes) or the addition of sweeteners during processing (granola/energy bars and soda). you can check the ingredient line for sources of added sugars such as brown rice syrup high fructose corn syrup malt syrup molasses corn sweetener honey syrup evaporated cane juice and fruit juice concentrate. for more on added sugars see this webmd article detailing the american heart association recommendations.

### Human:\ncan cinnamon help lower cholesterol?\n\n### Assistant: in 2003 an in-vivo study was concluded on 60 diabetic candidates in pakistan. the results of this study were released to the western media and a frenzy of cinnamon capsules were sold in the u. s. and other countries promoting cinnamon's lipid-lowering effects. since that time numerous studies in germany and in the netherlands have been published. the result of these studies differs significantly from the original pakistani study. based on the data from these studies it would appear that the early enthusiasm for cinnamon supplementation might have been premature.

### Human:\nshould my child's cholesterol be checked?\n\n### Assistant: should every child be screened for high cholesterol? that’s an issue currently up for debate. the current recommendations from the american academy of pediatrics say no. as it stands right now there are only certain children who are screened. those include: * children who have a parent or grandparent diagnosed with heart disease at or under 55 years of age. * children who have a parent or grandparent who have had a heart attack heart-related chest pain vascular disease or sudden cardiac death at or under 55 years of age. * children who have a parent with an elevated blood cholesterol level of 240 mg/dl or higher. * children who are diagnosed with obesity. but a recent study questions if practitioners are missing a significant number of children who might be identified with elevated cholesterol levels. having that awareness might encourage families to be stricter about enforcing a healthy diet and exercise routine. and some kids might actually need to be treated with cholesterol-lowering medications. the study found that almost 10 percent of kids who would not be tested under the current guidelines have elevated levels of ldl cholesterol. bottom line: just relying on a family’s history of high cholesterol may be an insufficient screening tool to determine who needs a blood cholesterol level drawn. but even if your child has not been diagnosed with high cholesterol it’s a good idea for everyone to follow the advice of the american heart association — maintain a low-fat diet for all kids ages two and up. and encourage your whole family to take time for exercise every day.

### Human:\nshould i continue exercise if i have a cold or bronchitis? . i developed sinus pressure and chest congestion. i continued my running. when my symptoms didn't improve after 3 weeks i went to a doctor who gave me a steroid and an antibiotic but said it was okay to keep running. i recovered mostly though i still felt the symptoms a little. last night i developed a dry cough which feels again to be in my chest and i have a little sinus pressure again. my exercise helps me mentally but is it the cause of my prolonged problem?\n\n### Assistant: deciding to exercise while you’re sick can depend a lot on your illness and your symptoms. to be honest the answer to your question often depends on who you’re asking since there really doesn’t seem to be a clear consensus or agreement. i personally feel more often than not that it’s best to take time to rest and recover from your illness before continuing with exercise. my rationale comes from a physiological standpoint. basically exercise can put a lot of stress on your body and your immune system is the only way that your body fights infections and pathogens that make you sick. when you exercise you’re devoting some of your body’s resources towards recovery from exercise instead of recovery from illness. in some instances exercise may even make you sicker or even prolong your illness. you also have to consider how comfortable you would feel while exercising with some of your various symptoms. medication may help alleviate some symptoms but otherwise how would you feel trying to go for a run if you’re congested or have a persistent cough? if you choose to exercise while sick you should consider decreasing your exercise intensity frequency or duration until you fully recover. please be considerate by following proper gym etiquette if you choose to work out in a gym. check out this webmd article for more input and guidance: <link>. i have the same symptoms. i feel its closer to the bronchitis side of things because of the clear mucus i cough when i am not riding. i am able to comfortably take my heart rate over 160 but i still have a cough which lasts for weeks after an upper respiratory tract infection (generally also involving the sinuses. i also get the odd drainage from my sinuses after/during a hot shower for example which seems to clear them. my explanation is as follows: when i am riding outdoors in the summer i breath a lot of pollens (i am not in the city) a little exhaust and this will tend to exacerbate an existing irritation. corticosteroids have limited effect to reduce the irritation but can reduce an acute irritation to the point where it is no longer chronic and my body's defenses can make a difference. thus its a combination of factors which typically plays out in the following order 1. bad cold/urt infection (5 days) 2. chronic cough (1 week to 8 weeks) but lungs good enough to exercise. 3. clear 2-8 months managing the level 2 is what this is all about. on occasions where i have been at the coast swimming in the sea often clears things up much faster. (which supports the sinus/allergen/irritant theory).

### Human:\nwhat is the minimum number of calories a woman can safely eat long term (up to two years or more)? . i’ve seen numbers ranging from 800 to 1200 (even here on webmd) where 800 might be the break between low calorie and very low calorie and 1050 is where your body enters starvation mode. . 1200 is the conventional number but is this in keeping with modern understanding? if a person opted for 800 without supervision would this be safe and sustainable long-term provided it was followed with proper transition and maintenance?\n\n### Assistant: the actual minimal number of calories that you can safely eat long term depends on your basal metabolic rate (bmr) which is the energy necessary for your body and its organs to maintain normal function while simply at rest. although there are equations to calculate bmr such as the harris-benedict equation these are all theoretical estimations and your actual number could vary. there are other more accurate methods to calculate your bmr through either direct or indirect calorimetry techniques that usually measure gas exchange between oxygen consumption and co2 production. you could do an internet search to find test facilities near you for these methods if you’re genuinely curious otherwise the bmr equations might give you a good enough estimate. you’re correct in stating that 1 200 calories is typically the conventional lower threshold value given and i think that it’s fair to use as an estimate for most of the general population (again your actual number will vary). by far however 800 calories per day would be considered a very low calorie diet (vlcd) because it would be very hard to meet your nutritional needs with so few calories. this type of diet would generally not be recommended for individuals who are not obese and who don’t have proper medical supervision. your doctor will take your specific circumstances into consideration before helping you decide if you should go on a vlcd and you may need to work with a dietitian to develop a specific eating plan to help ensure that you meet your nutrient needs while following the diet. it’s important to note that although vlcds have been shown to lower weight and help with obesity-related conditions like hypertension diabetes or high cholesterol in obese individuals; they don’t seem to be any more effective than a more modest dietary eating plan long term. you will likely regain any weight loss after going off the vlcd unless you transition into a healthy eating plan while incorporating regular exercise which is another aspect of why medical supervision from your doctor or a dietitian would be essential.

### Human:\nnot loosing weight exercise brutally and consistently! due to a recent stressful situation i became partially bald! . i am a 27 year old male with no prior medical illnesses other than allergies and colds. i exercise frequently and more than many people i know who are fit. i have been tracking my workouts for the past 2 years and have followed a million diets. i always try to make the healthier choice when i go out to eat (not often) and drink on occasion. from august 2014 - december 2014 i ran boxed lifted weights in combination and lost little to no weight. bp is 9<negative_smiley>72 and after exercise 115/90ish\n\n### Assistant: you don't mention how much weight you have to lose. if you don't carry that much weight you might be at the place your body wants to be. your blood pressure is good but how about other health indicators like cholesterol? if you weight is too high you need to closely look at how much and what you are eating. do you eat mindfully by sitting down to meals and stopping when comfortably full? do you skip meals? how is your diet quality? research shows that exercise doesn't aid weight loss as much as diet. another factor is stress as you mention which can affect appetite. getting a handle on stress management can go a long way. here is more reading that can help: do you really need to lose weight? why can't i lose weight? hi for me if you was doing everything you say then you would be losing weight. but your not so your cheating its the only answer you need to as strict with what your doing as you say above do that and you will lose weight. but get on to some of these new ways of losing weight like the caveman. get out walking but brisk walking take a weighted back pack and when doing that find some hills to climb get up early go swimming these last two are some of the best ways to lose weight you just keep away from fast foods and junk foods and no sodas drink lots of water. all ways think of these self discipline. self control. breaking bad habits. in grain these in your mind. good luck

### Human:\nhow do i treat a pulled calf muscle? . if it’s mild you should treat a pulled calf muscle by resting it and protecting it from re-injury.\n\n### Assistant: if it’s mild you should treat a pulled calf muscle by resting it and protecting it from re-injury. painful calf muscle strains deserve “price” therapy (see below) and complete calf muscle tears (which are rare) may need surgical repair. the vast majority of pulled calf muscles will heal completely within a few weeks without any treatment. pulled muscles are also called muscle strains. they occur when muscle fibers are stretched beyond their normal length. the injury creates tears in the muscle that are usually tiny (microtears). in the most severe calf muscle strains the entire muscle is torn causing significant swelling and pain. the calf muscle (also called the gastrocnemius) is a commonly injured muscle. a pulled calf muscle most often occurs after vigorous activity (running jumping climbing stairs) but can happen with normal activity in middle-aged and elderly people. pain possibly with some swelling or bruising is the main symptom of a calf muscle strain. immediately after a pulled calf muscle using “price” therapy may help speed healing: p for protect from re-injury r for rest i for immobilize with tape or an athletic bandage wrap c for compression (make that wrap tight but not so tight your leg goes numb) e for elevate (keeping your calf muscle above your heart may reduce swelling) price actually stands for prevention rest ice compression evaluate elevate*** i had the same thing happen to me. you need to go to a sports medicine doctor and get an x-ray of you ankle. it might sound crazy but there is a possibility that you broke your tibia in your ankle. when you break your tibia your calf hurts then your ankle starts to hurt. i had this happen and i went to my physician and they said it was a mild sprang so i walked around for a month with a broken ankle and i just found out three weeks ago and i am still in a cast.

### Human:\ni have little tumors around my eyes. i was told that they could be removed but they would come back. what should i do?\n\n### Assistant: there are deposits around the eyes that can be associated with high cholesterol. if that is indeed the case it's most important to address your cholesterol. heart disease is serious. after you correct your cholesterol you can have the lesions removed without them returning.

### Human:\ni want to know if adding olive oil to my diet could help lower my cholesterol.\n\n### Assistant: olive oil is a fat and like any fat contains about 100 calories per tablespoon. so keep in mind: olive oil is just as caloric as other fats and can contribute to weight gain if consumed in high amounts. olive oil does contain heart-healthy fats which are associated with lower blood cholesterol levels. but you can't just pour olive oil all over an otherwise unhealthy diet and expect your cholesterol levels to suddenly go down. making dietary changes to control your cholesterol levels is a twofold process. first increase the amount of fiber in your diet such as the fiber found in oatmeal fruits and vegetables. second decrease the amount of animal fats and saturated fats you consume such as the fats found in butter whole milk cream sausage bacon and heavily marbled cuts of beef. exercise is also good for your heart health and cardiovascular function. but you have to address any issues with your diet. i suggest using olive oil-based cooking sprays to sauté your vegetables as well as using olive oil as a salad dressing base. canola oil is a good choice as well.

### Human:\nwhat are the symptoms of stomach cancer?\n\n### Assistant: in its early stages stomach cancer typically causes vague often mild symptoms that a person may describe as indigestion nausea loss of appetite heartburn or pain. the problem is millions of people without stomach cancer experience these symptoms every day. when should a person with vague stomach or abdominal symptoms seek medical attention? that’s a hard question to answer because stomach cancer is still uncommon in the u. s. and screening for it (with invasive testing called endoscopy) carries small but real risks; screening everyone with indigestion might cause more harm than good. as stomach cancer becomes more advanced weight loss bleeding more severe nausea and vomiting and blockage of the exit of food from the stomach can occur. if you’re concerned about stomach cancer the best thing is to see your doctor and discuss your symptoms. my father died half a yr ago from stomach cancer and i have an uncle and a cousin died from stomach cancer. now my symptoms are nauseated all day i want to eat all the time which is not like me to do so even when i eat i still nauseated. one point i have a chronic ulcer. can that convert to cancer my chronic ulcer? .

### Human:\ni am a 73 year old female. my primary insurance is medicare; secondary insurance is usaa. will i be forced to change secondary insurance and if so when? and at what cost? will my coverage change? i have a primary care physician a cardiologist a pulmonary physician and a gyn physician. will i lose my doctors?\n\n### Assistant: a lot of seniors who have medicare coverage have questions about the impact of the affordable care act. the new law does not make major changes to the traditional medicare program. it does add some new coverage for preventive benefits and make some other changes - but nothing that should affect your medicare coverage. in addition nothing in the law will require you to change your secondary insurance from usaa. so you should not have to change coverage or change doctors.

### Human:\nconsuming large amounts of baking soda. is drinking alot of baking soda bad for me.\n\n### Assistant: consuming excessive sodium bicarbonate (baking soda) can lead to metabolic alkalosis a condition in which ph balances are elevated outside of the normal range. some symptoms of alkalosis include: • confusion • light-headedness • nausea vomiting • numbness or tingling in the face hands or feet • prolonged muscle spasms • muscle twitching • hand tremor if you are currently taking excessive amounts of baking soda your doctor can conduct tests to diagnose alkalosis. it’s important to visit with your doctor if you notice any of these symptoms. i would also consider asking yourself about what benefits you hope to gain from consuming large amounts of baking soda. it might be beneficial to explore other ways to achieve the same results that you’re hoping for in a different manner. if you’re having problems with acid reflux or heart burn dietary changes or prescription medication may be helpful.

### Human:\nwhat are the types of echocardiograms?\n\n### Assistant: there are several types of echocardiograms and your doctor will help determine which is best for you. transthoracic echocardiogram: this is the standard echocardiogram. it is a painless test similar to x-ray but without the radiation. the procedure uses the same technology used to evaluate a baby's health before birth. a hand-held device called a transducer is placed on the chest and transmits high frequency sound waves (ultrasound). these sound waves bounce off the heart structures producing images and sounds that can be used by the doctor to detect heart damage and disease. transesophageal echocardiogram (tee): this test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach). because the esophagus is located close to the heart clear images of the heart structures can be obtained without the interference of the lungs and chest. stress echocardiogram: this is an echocardiogram that is performed while the person exercises on a treadmill or stationary bicycle. this test can be used to visualize the motion of the heart's walls and pumping action when the heart is stressed. it may reveal a lack of blood flow that isn't always apparent on other heart tests. the echocardiogram is performed just prior and just after the exercise. dobutamine stress echocardiogram: this is another form of stress echocardiogram. however instead of exercising to stress the heart the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. the test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. it is also used to determine how well your heart tolerates activity and your likelihood of having coronary artery disease (blocked arteries) as well as evaluating the effectiveness of your cardiac treatment plan. intravascular ultrasound: this is a form of echocardiography performed during cardiac catheterization. during this procedure the transducer is threaded into the heart blood vessels via a catheter in the groin. it is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

### Human:\nwhat are platelets?\n\n### Assistant: platelets are cell fragments derived from bone marrow cells called megakaryocytes. platelets circulate in blood but are much smaller than red or white blood cells. platelets are coated with substances that normally glide smoothly along the surface of blood vessels and other blood cells. however when platelets encounter a damaged blood vessel they collect together in a plug to stop the bleeding. a blood clot then forms sealing the platelet plug. aspirin and other medicines like clopidogrel (plavix) interfere with platelets’ ability to clump together. this helps protect against the sudden formation of blood clots inside blood vessels (the cause of heart attacks and strokes). antiplatelet drugs also increase the likelihood of abnormal or excessive bleeding.

### Human:\ncan what you eat the day before a cholesterol blood test skew the results? . i went out to eat the day before my blood test and had an irish blt and french fries and didn't eat a very healthy dinner either. my cholesterol 2 years ago was under 200 my diet habits have not changed much other than the occasional slide like mentioned above. so my total cholesterol was 232 - my hdl is 83 and my ldl is 118. my doctor did not give me the number for triglicerides. just curious if what was eaten could skew the numbers. . . . . thank you.\n\n### Assistant: the good news is your hdl is nice and high and that is protective against heart disease. it could be possible that what you ate the day before affected your ldl levels but by how much is hard to say. it is generally recommended to consume your usual diet for 2 weeks before testing. if it is bothering you get re-tested after eating your normal diet. for more on cholesterol levels see this webmd article.

### Human:\ncould you provide a few links to the major studies showing excessive saturated fat is unhealthy? . this website and the american heart association continue to recommend a diet low in saturated fat. but the current buzz on the internet is that there is really little evidence for that position. in fact france eats a diet high in saturated fat yet has a low rate of deaths from heart disease (<link> <link> ). can i see links to the original studies showing sf is harmful?\n\n### Assistant: most helpful answer there has been a backlash against low fat diets leading people to go in the opposite direction embracing diets high in saturated fat diets. the truth is diets low in saturated fat won't reduce heart disease risk if the saturated fat is being replaced with refined carbs. this decreases hdl (good cholesterol) and can increase triglycerides and the blood sugar response. but as both of the review studies below demonstrate when saturated fat in the diet is replaced with plant and fish sources of fat (omega-3 fatty acids and monounsaturated and polyunsaturated fats) it decreases heart disease risk -- hdl increases and ldl (bad cholesterol) decreases. <link> <link> this is basically the mediterranean diet -- low in saturated fat high in fruits and vegetables and healthy fat sources like olive oil and nuts. while the french may have diets higher in saturated fats they also tend to be leaner walk more and eat other heart healthy foods like fruits and vegetables. while the evidence continues to evolve there isn't enough to recommend a diet high in saturated fat to reduce heart disease. yes some propit change to lipid and make your belt bigger. see more here hi for those who have interest in saturated fat have a good read through this one site there is lots on it. <link> just copy link into google to the www. to open and read. should help some of you. good luck our old belief was that saturated fat have the ability to raise cholesterol levels and give us heart attacks but s everal recent review studies that combined data from multiple other studies found that there really is no link between saturated fat consumption and heart disease h owever it's a fact that replacing saturated fats with unsaturated fats reduced the risk of cardiac events by 14%. so it's always better to stay away from a fatty body. i had a very fatty body from my childhood it self but by doing a plastic surgery procedure at montreal omar fouda neel clinic i reduced overall body fat and there by weight. i think the links you have are pretty awesome. sf's are great just really need to have them in moderation i would think.

### Human:\nshould i be concerned about hardening of the arteries at the age of 41?\n\n### Assistant: it's never too early to consider heart health especially in terms of prevention. there are key factors that put you at higher risk for hardening of the arteries (the medical term is atherosclerosis). risk factors include a family history of heart disease abnormal blood lipid levels (high cholesterol/low hdl/high ldl/ high triglycerides) poor eating habits smoking high blood pressure and having diabetes. the american heart association recommends cardiovascular screening starting at age 20 so if you haven't already visit your doctor. for more on risk factors for atherosclerosis see this webmd post.

### Human:\nhow can proteinuria be treated? . i have been suffering from ckd-3 since 2004. by maintaining my blood pressure at normal level (110+/70+) adhering to a strict low-protein and low-sodium diet i have managed to delay the progression of the disease to a more severe stage. since early october i started a treatment plan for my ckd using herbal nutrients and medicines prescribed by a naturopath. for eight years i had never had protein in my urine. but since about two weeks ago my urine became foamy an indication of proteinuria\n\n### Assistant: it sounds like you've been doing the right thing by keeping your sodium and protein intake low as recommended by the national kidney foundation. several health organizations recommend regular checks of proteinuria so don't rely on symptoms and get yourself checked. i also recommend checking in with your nephrologist about the herbal treatments you are trying to see if they are contraindicated. if you have diabetes blood sugar control is very important as well as keeping your blood pressure down. there are other factors that can increase the progression of renal disease including anemia abnormal blood lipids such as cholesterol and problems with mineral metabolism. a registered dietitian can help you troubleshoot your diet as a whole. you can find a dietitian at eatright. org.

### Human:\nhi i'm 15 years old take nature-made b complex omega369 100mg ubiquinol daily is this okay? . i'm using nature-made super b-complex omega 3-6-9 and qunol 100mg ubuiquinol as alternative adhd medicine. i'm just concerned that these pills maybe detrimental. i've read the label on the nature-made super b-comples and it contains 6 667% daily value of thiamin 1 176% riboflavin and 250% b12. also the qunol has 100mg of pure coq10 (i've heard the reccomended amount was around 50mg) is this too much for my body to handle? should i cut the pills into smaller portions? please help! . thanks!\n\n### Assistant: i'm not sure why you are taking all those supplements but let's go down the list. i don't know of any evidence that shows that taking large amounts of b vitamins is beneficial or particularly harmful. if you don't eat fish twice a week taking fish oil high in omega 3 fatty acids dha and epa can help but americans get more than enough omega 6 fatty acids so i'm not sure why this would be needed in a supplement. there seems to be some research that qunol (coenzyme10) can help people who take cholesterol lowering medications who have lower levels in the body but not sure how it helps the general population. i'm not familiar with ubuiquinol but like any supplement check to see if there is any research to show its safety and effectiveness. supplements are not regulated by the fda so safety has to be demonstrated by the company. according to a recent study in pediatrics teenagers fall short on various nutrients including magnesium phosphorus and vitamins a c and e. so if you feel your diet is lacking include a multivitamin that provides 100% daily value for the majority of vitamins and minerals. many people (of all ages) need to supplement with vitamin d because they get little sunshine and foods are generally low in this vitamin. recommendations for calcium at your age are 1300mg because this is a peak time for bone growth. one cup of milk 1. 5 ounce cheese and 6-8 ounce yogurt contains about 300mg calcium so if you are falling short you may want to consider supplementation. no supplement can make up for a diet poor in nutrition. i always recommend a food first strategy but sometimes supplementation is needed to fill nutrition gaps. and most importantly make sure supplements have the research behind them to show they are safe and effective. always check with your healthcare provider about supplements you take.

### Human:\nwhat causes an arrhythmia?\n\n### Assistant: arrhythmias may be caused by many different factors including: coronary artery disease. electrolyte imbalances in your blood (such as sodium or potassium). changes in your heart muscle. injury from a heart attack. healing process after heart surgery. irregular heart rhythms can also occur in otherwise normal healthy hearts. what is the difference between atrial tachycardia and svt?

### Human:\ncan fiber help lower cholesterol?\n\n### Assistant: there are two kinds of fiber or nondigestible carbohydrates. the first which is insoluble aids in bowel function. an example is wheat bran. the second is soluble fiber now referred to as viscous fiber which has an additional cholesterol-lowering effect. examples include dried beans grains and certain fruits and vegetables. psyllium is a source of soluble fiber and has been shown to augment the lipid-lowering response when combined with other lipid lowering medications. oat products have the most soluble fiber of any grain. several recent studies have looked specifically at the effects of oats or oat bran on ldl-c [bad cholesterol]. both oats and oat bran demonstrated favorable results in the lowering of ldl-c. . the atp iii (adult treatment panel) recommends a minimum of 5-10 grams a day of total dietary fiber for people with even mildly elevated ldl-c levels but higher intakes of 10-12 grams of fiber per day can be more beneficial in those with more severe hyperlipidemia.

### Human:\nhelp! . i am having difficulty locating recipes and ideas for my type of diet; i need a gluten free low cholesterol vegetarian diet. i love to cook and experiement so fear of trying new things is not an issue.\n\n### Assistant: it sounds like you have your work cut out for you! but the good news is that there are many good-tasting healthy foods that will fit the bill. you should start with some good basic gluten free recipes-like the ones found in our gluten-free recipes directory. look them over and pick the ones that do not contain meat. and start cooking! there are many types of vegetarian diets—ones that include eggs and dairy –or vegan options that do not include any animal products at all. if you choose ovo-lacto (eggs and dairy) vegetarianism just be sure to use only low-fat dairy in your cooking. eggs can be part of a healthy low fat diet—just don’t go overboard. it is the yolk that has the cholesterol. so switch to the egg whites whenever you can. and you can use olive oil as a healthier alternative to the animal fats. if you are changing your diet because of health issues such as heart disease diabetes celiac disease or high cholesterol talk to a dietitian. they are a wealth of information. many insurance companies will even help cover the visit. detailed information about a gluten-free diet is also available at the celiac disease foundation website <link> also make sure you talk to your doctor before starting any new diet. there are several recipes that can be found on the webmd website. i have included links to gluten free recipes and vegetarian recipes. when looking at the ingredients of a recipe feel free to alter to fit within your diet regimen. i have also included a link about the tlc diet (therapeutic lifestyle changes) to help you choose foods that are lower in cholesterol.

### Human:\nwhat are the symtoms and complications of vitamin d deficiency in adults age 30-35?\n\n### Assistant: i think a lot of it depends on how long you've been deficient and to what degree. it is well accepted that a lack of vitamin d increases the risk of osteomalcia (bone/muscle pain) osteopenia (lower than normal bone density) osteoporosis and bone fractures in adults. so in addition to working with your healthcare provider about getting your levels back up you may want to check your bone density to see if there's more you can do. most the symptoms of vitamin d deficiency are subtle or absent in the initial stages. low vitamin d levels have also been linked to the development of immune disorders heart disease and certain cancers but more research is needed to draw conclusions. the good news is you can correct your levels now to help keep you healthy for the years to come. for more on vitamin d read this article on webmd.

### Human:\ni am five and a half months pregnant and take xanax. can this drug harm the fetus and how do i taper off my dosage?\n\n### Assistant: the u. s. food and drug administration (fda) assigns a category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. xanax and its generic (alprazolam) have been assigned pregnancy category d meaning this class of medication have shown clear evidence of risk to the fetus in studies. pregnancy category d is a stronger warning class than pregnancy categories c or b classifications. a pregnancy category d medicine may still be given to a pregnant woman if the health care provider believes that the benefits to the woman outweigh the possible risks to the unborn child. i would not just stop taking the medication if you are concerned that you may be causing harm to your baby. work with your health care provider to decide whether you should be taking the medication. if you reach a decision to not take the medication any longer work with your provider or pharmacist to taper (decrease gradually) the dose to take and to prevent withdrawal symptoms. common withdrawal symptoms consist of but are not limited to nausea vomiting diarrhea increased heart rate palpitations hallucinations memory loss confusion panic attacks seizures dizziness headaches depression and insomnia. it is important to work with your health care provider to make sure you are getting the best care possible. one side effect is clef lip to your unborn child

### Human:\nhow do you break a fever in a toddler?\n\n### Assistant: remember that any fever in a newborn infant (under 3 months of age) needs prompt medical attention because at that age it’s hard to tell when a serious infection might be present. a fever is the body’s natural response to infection or other illness and will subside when the underlying process gets better. other than treating the infection (or other condition) causing it no home treatments can shorten the duration of a fever. also remember that fever doesn’t always need to be treated. if a toddler is acting normally and unbothered by her fever and her temperature is less than 104 degrees (40 degrees celsius) there’s no need to treat the fever. for a fever that’s high or is bothering your toddler either acetaminophen (mapap tylenol) or ibuprofen (advil motrin) are good treatments. you’ll need to know your toddler’s weight (don’t guess) and use the dosing guidelines on the package. it’s best to stick with one medicine if you can. if you feel you need to use multiple drugs call your pediatrician’s office. don’t ever use aspirin to treat a child’s fever as it increases the risk for reye’s syndrome. if sponging with water helps your child with a fever feel better use a warm bath (not cool) with water around 85 degrees. i know it sounds weird but my great granny used to cut an onion in half and put one half on the bottom of each foot then cover with socks and leave them on me all night. (in addition to tylenol or advil) when i would wake up in the morning my fever would be gone (or at least drasticly reduced) and the onions in my socks would be black. she said the onions drew the fever away from the brain and other vital organs. i don't unserstand how it works but i used this on my children and now on my grands and it works every time. it helps to understand what a fever is. some of the answers on here are very misleading and aren't factual at all. a fever occurs when the body increases in temperature. most common cause of this is an infection of some kind. the white blood cells that eat the infection release chemicals that go to the brain and tell it to raise the temperature of the body. the brain has a set point for our temperature 98. 6f. it is like a central heating/cooling system with a thermostat in a house. if the temp gets hot the a/c turns on. if it gets to cold the heater kicks on. and the temperature stays at 98. 6f. what these chemicals from the white blood cells do is they increase the thermostat. so the brain now has a set point of 101 f. but the body is still 98. 6 f. so the heater kicks on. you get shivers moving of muscles fast makes heat. you feel cold and you get under covers to get warm. this is why people say they are so cold when their temp is 100 because the thermostat is set to 101 or higher. the body does this because some of the bodies defenses are activated at higher temperatures and some bacteria don't function well at higher temperatures. so they die or we kill them better with a higher temperature. so what is it when a fever "breaks"? well eventually your white blood cells kill everything and they stop releasing those chemicals that changes the thermostat. so the thermostat changes back to 98. 6f. now you have a temperature of 101f and your body is set to 98. 6f. it is too hot. turn on the a/c. so you start sweating to cool yourself off. this is a fever "breaking". so when the person with the fever is sweating like there is no tomorrow it is a good thing and you can probably expect the fever to start going back down. fever is a natural defense mechanism against foreign invaders of your body. it is very normal. as long as my fever isn't over 102f it makes sense to me to not interfere with the natural process. even help it. if i'm running a little fever i'll get in the hot tub or a nice hot bath. fevers can be very dangerous and you should ask your doctor when those dangerous temperatures are. they are different for kids and adults. to answer the question the fastest easiest way to break a fever is with anti-inflammatory medications like tylenol and motrin. but that doesn't mean everything is all better. and by the way: water is zero calories! (in case you read the other post) don't believe any of that stuff. what i do is rub my baby down with green rubbing alcohol. it works every time. a fever is not your body fighting an infection. anything that heats up your body including heat and induces sweating causes a fever. fevers cause heat exhaustion and heat stroke as heat heats up the body inducing sweating wich causes water to be ejected from the body. you may induce a fever and prove this by simply visiting a steam room and when your sweating check your temp youll have a fever. you may also go out jogging and see when your hot and sweating you have a fever with a fever thermometer. if you do either for long periods youll eventualy drop from exhaustion enjoying before that mild to severe dehydration symptoms heat exhaustion and heat stroke and possible mild heart attacks. cardio excersize and steam rooms have been around for centuries inducing fever and not cured any disease other than treat obesity. your heartrate can generate heat and cause a fever by pumping friction wich happens during jogging just like shaking a pop can or rubbing your hands generates warmth. make sure you maintain bodyweight during a fever. if food poisioning is suspect having a person stomach pumped and an enema given may be needed if fatigue sets in. fluid calories are better during a fever its important to maintain heartrate as lowering your heartrate also induces fatigue. if a fever is starting with no fatigue water may be ok. its important to keep dry and keep cool (keeping dry to avoid chills). humans thrive in cool temp climates of 55-65 degrees thier is little life in deserts do to heat heat starves an area of water. for children its important that children playing maintain thier bodyweight during excersize/play and eat and drink and take rest breaks and normalize thier heartrate reducing sweating. if people have to loose weight then i recommend simply getting out and walking bringing food fluids before or during thier walk to avoid dehydration with rest breaks. obesity causes fever and dehydration by carrying around 50-100 lb weights. you may simulate obesity by carrying a backpack of 50-100+ lb barebell weights and grow it daily and see what affects that has on your health. weather and activie levels can affect weight loss. people eat drink and rest to maintain thier heartrate and energy levels. in a virus or poision a fever is a response to excess blood volume wich causes your heart to pump harder and faster generating heat. you may simulate this by giving an unnecessary blood transfusion wich will likely cause a fever and may cause a mild heart attack so i wouldnt advise it. water causes weight gain at 1/2 lb a cup its a myth its zero caloric. overdrinking from dehydrationcan cause excessive urination in addition to lowering your heartrate further so cold water if a fever has started with no fatigue otherwise fluid calories.

### Human:\nwhat colic remedies work?\n\n### Assistant: of course every baby is different but there are several things parents can try to soothe a colicky baby: for younger infants a good tight swaddle often helps. being swaddled makes them feel secure and can calm them. babies also tend to like loud repetitive sounds like radio static or the sound of washing machines so if you go shhhh-shhhh in your baby’s ear that can work as well. but you do have to do the "shhhing" loud enough to be heard over the baby’s crying. the reason they like sounds like this is that they remind the baby of the sound of their mother’s heartbeat. another thing i like to try is singing; some babies really respond well to their parents’ voice. you can also try turning babies on their the sides when you’re holding them and giving them something to suck on like a pacifier or your finger. or try taking the baby out in a stroller.

### Human:\nhow much should a healthy active athletic 22 year old male weigh?\n\n### Assistant: that all depends on your height muscle mass and individual body type (genetics). this calculator from webmd can give you an idea of a weight that is right for you: <link>. remember that all tools including body mass index (bmi) are not perfect. bmi for instance 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. what is more important than weight is your health. getting a physical and checking cholesterol blood pressure and other labs can help you determine the current state of your health. good luck!

### Human:\nwhat is moderate right distal carotid artery stenosis?\n\n### Assistant: the carotid arteries are a pair of arteries that serve as the main pipelines bringing oxygen-rich blood to the brain. the carotid arteries travel through the neck next to the windpipe. stenosis means an abnormal narrowing of a body part -- in this case an artery. distal means the far end of a body part. (the closer end is referred to as proximal. ) so this condition could more plainly be described as moderate narrowing of the far end of the right main artery in the neck. carotid artery stenosis often is caused by atherosclerosis a slow process of hardening and narrowing of the arteries throughout life. cholesterol-rich plaques develop in the walls of arteries in the neck heart and elsewhere and slowly grow. if cholesterol plaques grow and protrude into the center of the artery they can interfere with blood flow. this usually occurs very gradually and the body adapts so there are often no symptoms. the biggest risk is from the sudden rupture of a cholesterol plaque. this can result in rapid formation of a blood clot causing a heart attack or stroke. moderate carotid artery stenosis means the artery is narrowed but blood flow is not severely reduced. treatment depends on whether symptoms are present. for people who have had a stroke or mini-stroke (transient ischemic attack or tia) surgery to open the blockage (endarterectomy) is often recommended. however even without symptoms carotid artery stenosis is a yellow caution flag signaling you’re at risk for heart attack and stroke. a healthy diet regular exercise not smoking and taking the right medications can reduce your risk significantly. can diet change carotid artery disease if so what diet changes are recommended

### Human:\nwhat does it mean if a food product is labeled “light ” “low ” “reduced ” or “fat-free? ”\n\n### Assistant: the fda sets rules for what food manufacturers can call "light " "low " "reduced " "free " and other food terms. here's the low-down on these terms: "healthy" food must be low in fat with limited cholesterol and sodium. anything labeled "free" must only contain tiny amounts of the ingredient in each serving. for example "trans-fat free" or "fat-free" products can have only 0. 5 mg of trans fats or fat; "cholesterol-free" foods can only have two milligrams of cholesterol and two grams of saturated fat. a serving of food labeled "low sodium" can have a maximum of 140 milligrams of sodium. a serving of "low cholesterol" food can have a maximum of 20 milligrams of cholesterol and two grams of saturated fat. one serving of a "low-fat" food can have a maximum of three grams of fat. a serving of a "low-calorie" food can have a maximum of 40 calories. a serving of a food labeled "reduced" must have 25% less of the ingredient than a serving of the regular version. one serving of a "light" food must have 50% less fat or 1/3 fewer calories than the regular version. the food and drug administration (fda) regulates what claims a product can make. the following are a few examples to answer your question: - free. this term means that a product contains no amount of or only trivial or "physiologically inconsequential" amounts of one or more of these components: fat saturated fat cholesterol sodium sugars and calories. - low. this term can be used on foods that can be eaten frequently without exceeding dietary guidelines for one or more of these components: fat saturated fat cholesterol sodium and calories. - low-fat : 3 g or less per serving - low-saturated fat : 1 g or less per serving - low-sodium : 140 mg or less per serving - very low sodium : 35 mg or less per serving - low-calorie : 40 calories or less per serving. - low-cholesterol : 20 mg or less and 2 g or less of saturated fat per serving - reduced. this term means that a nutritionally altered product contains at least 25 percent less of a nutrient or of calories than the regular or reference product. however a reduced claim can't be made on a product if its reference food already meets the requirement for a "low" claim. - light. this descriptor can mean two things: - that a nutritionally altered product contains one-third fewer calories or half the fat of the reference food. - that the sodium content of a low-calorie low-fat food has been reduced by 50 percent.

### Human:\nwhy do i need an echocardiogram?\n\n### Assistant: your doctor may perform an echocardiogram to: assess the overall function of your heart. determine the presence of many types of heart disease. follow the progress of heart valve disease over time. evaluate the effectiveness of medical or surgical treatments.

### Human:\nre:nutrition what are safe levels of saturated fat polyusaturated fat monousaturated fat sodium & carbohydrate. looking for a guide to safe levels of saturated fat polyunsaturated fat monounsaturated fat sodium and carbohydrates found in almost all foods for an average person 62 years old. they are on every label but nothing to say what is too high of safe levels for the average person.\n\n### Assistant: first off you want to get an idea of how many calories you need as some of the recommendations are based on a percentage of calories. according to the dietary guidelines someone your age would need: female sedentary: 1600 calories/male sedentary: 2000 female moderately active: 1800/male moderately active: 2400 female active: 2000/male active: 2600 as for fats the 2010 dietary guidelines recommend 7-10% of calories (or less) come from saturated fat. if you get about 2000 calories 10% is about 20grams. generally it is recommended that people replace saturated fats with unsaturated fats (found mostly in plants and fish) such as polyunsaturated and monounsaturated to benefit heart health. you do not need to check grams for unsaturated fats but it is recommended people consume fish twice a week for beneficial omega-3 fats. for more details on fat see this article. there is a wide range of carbohydrate intake that is acceptable and recommended -- 45-65% of calories. carbohydrates are in many foods such as fruit milk bread and starchy vegetables. the institute of medicine recommends 130 grams to ensure adequate blood glucose for the brain. you want to minimize added sugars found in processed foods and drinks and instead get carbohydrates from whole foods such as whole grains fruits vegetables and dairy products. for more on the different types of carbohydrates see this article. limits on sodium range from 2300g - 1500mg. the dietary guidelines recommend 1500mg or less for those with certain health conditions and over 51 years of age. for more on how to lower sodium see this article. dietary recommendations now focus more on food patterns over specific nutrients. so focus more on getting healthy whole foods such as fruits vegetables whole grains lean proteins low fat dairy and healthy fats. good luck!

### Human:\nis it normal for my dad who had a triple bypass three months ago to be constantly short of breath and blacking out?\n\n### Assistant: these are worrisome symptoms: shortness of breath and passing out. after a bypass operation these symptoms could reflect some damage to the heart leading to heart failure symptoms (the shortness of breath) continued abnormal blood flow to critical areas of the heart (also the shortness of breath) and/or a heart rhythm problem that led to the syncope (passing out). these symptoms warrant a very careful evaluation by your dad's doctor and an explanation. this sounds like more than the "normal" healing process. i suggest that you (or another family member) accompany your dad to his doctor's appointment and make sure that the doctor fully hears the story. this really needs follow-up.

### Human:\nwhere can i find quinine pills for my husband’s leg cramps?\n\n### Assistant: don’t use quinine for your husband’s leg cramps. quinine is a malaria drug that can cause serious side effects such as severe bleeding abnormal heart rhythms and even death. the fda issued a drug safety warning on july 8 2010 and will soon require the drugmaker to warn doctors of its potentially life-threatening side effects. talk to the doctor about other safe ways to ease leg cramps.

### Human:\nwhat is catheter ablation for the heart?\n\n### Assistant: during an ablation high-frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart that causes the abnormal heart rhythm. this energy "disconnects" the pathway of the abnormal rhythm. ablation is used to treat most psvts atrial flutter atrial fibrillation and some atrial and ventricular tachycardias. ablation may be combined with other procedures to achieve optimal treatment.

### Human:\nwhat vitamins are present in fish oil? carrots are carrots but they contain vitamins as well. what's in fish oil?\n\n### Assistant: the reason people take fish oil is for the type of fat it provides: omega-3 fatty acids (dha and epa). most people do not get enough of these fats through diet unless they consume 2 servings of fatty fish such as salmon or tuna per week. these type of fats are important for brain development in babies cardiovascular health and they play a role in brain related conditions such as adhd and dementia. see this article for more information on fish oil.

### Human:\ni have type ii diabetes. what is the best form of exercise for my condition? . i take metformin twice a day and insulin in the evening. i would like a recommendation on a good exercise program especially since i have a busy and sometimes inconsistant schedule.\n\n### Assistant: most helpful answer the easy answer would be any exercise. find an activity that you like. it can be as simple as walking (aerobic) or even taking up a sport like tennis. the best exercise program is really one that you will do on a regular consistent basis at least three or more times per week. find a partner - it is easier to exercise with a friend. having type 2 diabetes means you need to make the time. having a busy schedule is the norm for everyone. the insulin you take daily makes up for the little insulin that you produce. metformin helps sensitizes your body and muscles to insulin. in people with diabetes the only way to break and improve insulin resistance and reduce your risk of heart disease and other complications is by using muscles. most any type of regularly performed physical activity will do. find something you like it helps increase the chance that you will stick to it. a buddy system for exercise also helps make you more accountable and less likely to miss out on the social mental and physical benefits of exercise. a combination of aerobic type exercise and weights targeting core muscles is something to aim for. find an endocrinologist that is passionate about working with people that have type 2 diabetes. the surgeon general recommends 30 minutes of moderate intensity physical activity most days per week. for individuals with diabetes it’s recommended that there should not be more than two consecutive days without aerobic physical activity because the benefit of increased insulin sensitivity gained from exercise generally doesn’t last longer than 48-72 hours. moreover high-intensity physical activity will tend to enhance insulin sensitivity more than low-intensity physical activity. also a greater duration spent on exercise appears to more effective than a lesser duration. with both intensity and duration however the benefits appear to be a result of more energy being expended. exercise can significantly lower a1c levels and can even help glycemic control during times when not exercising. both resistance training and aerobic exercise have helpful effects on insulin and can help with diabetes management. do not exercise if your blood sugar is too low and stop exercise if you feel faint have chest tightness or are extremely short of breath. i generally recommend a combination of both aerobic exercise and some resistance exercise in most of my patients. and the good news is that most people can do low-impact exercise (like walking) and still see a benefit. you should talk to your doctor about your own specific exercise prescription. and while you're asking see if your doctor is exercising too! walking is the best exercise for everything! if you don't seem to have time to go and walk park as far from the door at work grocery store drug store anywhere you go as possible. then walk briskly while going in and out and if possible while you are shopping. this will help some and hopefully make you want to walk more and get into a routine! you can always find 30 min 3 times a week to walk!

### Human:\nwhy is vitamin d important?\n\n### Assistant: there a variety of reasons vitamin d is important. first it helps your body absorb calcium for healthy bones. . it is well accepted that a lack of vitamin d increases the risk of osteomalcia (bone/muscle pain) osteopenia (lower than normal bone density) osteoporosis and bone fractures in adults. severe vitamin d deficiency is also responsible for rickets and growth retardation in children which has made a comeback in recent years. because vitamin d helps to with cell growth the immune system and reduces inflammation it has been linked to the development of immune disorders heart disease and cancers. more research is needed to draw conclusions on these links. modern lifestyles put people at risk for lack of vitamin d due to excessive time indoors the use of sunscreen and excess weight.

### Human:\nwhat medications are used to treat arrhythmias?\n\n### Assistant: a variety of drugs are available to treat arrhythmias. these include: antiarrhythmic drugs. these drugs control heart rate and include beta-blockers. anticoagulant or antiplatelet therapy. these drugs reduce the risk of blood clots and stroke. these include warfarin (a "blood thinner") or aspirin. because everyone is different it may take trials of several medications and doses to find the one that works best for you.

### Human:\ni'm taking vicodin for pain and clindamycin for infection after a tooth extraction. can i add zantac 150 or tums?\n\n### Assistant: both vicodin and clindamycin have side effects like upset stomach nausea and vomiting but not heartburn. these medications currently do not have any known drug interactions with zantac 150 (ranitidine) or tums. he should be fine taking all these products together. however watch his symptoms. if symptoms worsen you may want to seek medical advice to make sure he doesn’t have another condition.

### Human:\nwhat should i eat in order to have a normal lipid profile?\n\n### Assistant: visit your health care provider to get your numbers for the good cholesterol (hdl) and the bad (ldl). keeping track of these numbers is important for managing risk factors for heart disease. if your physician tells you that your ldl is too high there are several dietary changes you can make to lower that number. you may have heard that eating oatmeal is healthy for good cholesterol. this is because the soluble fiber found in oatmeal can grab onto dietary cholesterol in your body and remove it through waste elimination. other foods that contain soluble fibers include apples okra and just about all other fruits and vegetables. eating more fish can help too. the usda's myplate. gov dietary recommendations advise us all to eat at least two servings of fish per week. fatty fish such as salmon sardines and tuna are especially good sources of the fish oils that are associated with a decreased risk of cardiovascular disease. and not only can they help lower ldl levels but they actually help increase hdl levels. lastly be sure to avoid foods that are high in saturated fats which can raise ldl levels. these include cream butter fatty meats and whole milk. fish and fiber

### Human:\nwhat kinds of vegetables are good for heart health?\n\n### Assistant: just about all vegetables help support a healthy cardiovascular system. veggies which contain deep dark pigments -- winter squash dark leafy greens broccoli kale tomatoes red peppers and carrots -- are good sources for antioxidant nutrients such as vitamin a and vitamin c and folate. these nutrients help protect the body's cells including cells in our heart and arteries. even white-colored vegetables such as onions and garlic contain important nutrients for heart health including a flavonoid called quercetin. most vegetables are also a good source of dietary fiber which is important for digestive health. one word of caution: dark green leafy vegetables such as collards kale and spinach are an excellent source of vitamin k which is important for the blood clotting mechanism. but if you're taking drugs such as coumadin or warfarin to prevent blood clots your doctor may advise you to avoid these kinds of vegetables. there are many vegetable which are good for heart such as carrot for vitamin a and a powerful antioxidants bell peppers which reduce homocysteine onions a rich source of sulphur-containing phytochemicals leafy greens are an better source of magnesium and many more.

### Human:\nis cheap red wine just as heart healthy as a fine red wine or does the aging process boost the wine's healthy values?\n\n### Assistant: as someone who loves and collects wine i was particularly interested in this question. first how did people come to the notion that red wine might have some heart healthiness to it? there's an observation called "the french paradox". that emerged when scientists noted a relatively low incidence of coronary heart disease among the french despite a high incidence of smoking and a diet heavy in fats (cheese creams etc). this notion gained widespread attention in the 1990s after it was covered in a story on "60 minutes. " it has spurred a great deal of scientific intrigue into whether or not a moderate amount of red wine consumption might balance some other dietary indiscretions. bottom line we don't know the answer definitively. most believe that a modest amount of daily alcohol has some health benefits. some believe that this benefit is pronounced with red wine due to some particular chemicals that are part of the grape skin. in fact companies have been formed to explore whether some of these compounds might be extracted and developed as drugs to treat/prevent heart disease. now back to your question. while drinking fine aged red wine is truly a delight there's no evidence (yet) to suggest that this might be better for your health than more simple less expensive wines. the key is moderation! so enjoy your glass after work or with dinner tonight and stay tuned for more evidence as the story evolves.

### Human:\ncan a low ferritin level cause hair loss and heart palpitations in women? my ferritin level is at 12. every time i shower or blow dry my hair i am losing tons of hair! i can barely cover my scalp at crown of my head. after researching i found that ferritin levels in women should be around 70. i have also been experiencing an increased heart rate since august. i went to cardiologist and he said my heart was healthy. my thyroid is fine. started taking iron supplements (45 mg) 3000 mbg biotin pills and using shampoo that removes dht from hair within the last week but have seen no difference.\n\n### Assistant: there is some research to show that anemia is associated with hair loss but not all studies agree. in fact a 2010 study in the journal of the american academy of dermatology showed no difference. it's best to work with your healthcare provider on optimal ferritin levels and supplementation. you also want to rule out other potential issues related to hormonal or skin changes. changes such as pregnancy childbirth and menopause can increase hair loss. when it comes to nutrition protein and adequate calories play an important role in hair growth so including good protein sources at most meals may help (lean meats eggs fish beans and dairy) as does eating balanced meals throughout the day. this webmd article provides more information on eating right to keep hair healthy.

### Human:\nis it safe to take fish oil capsules if you have shellfish allergies?\n\n### Assistant: when it comes to medication products it is important to read all product labels carefully before purchasing and consuming any item. consult the local pharmacist to help make sure no shellfish materials are found in the product. remember also that ingredients change from time to time. so check labels every time you shop. fish oil products usually come from oily fish such as salmon trout swordfish and mackerel. particular products that are epa and dha derived come from the “omega-3” sources tend to be more bio-available making the product more effective to provide the cardiovascular effects desired. shellfish are typically not used to make the fish oil products. however it is important to read all ingredients on the bottle. call the manufacturer to make sure there are no shellfish ingredients. once you find a particular brand that works for you stick with it. but continue to check the label to make sure nothing has changed with the product.

### Human:\nwhy does caffeine make thirsty?\n\n### Assistant: one of the reasons why caffeine may be making your thirsty is because caffeine is a diuretic meaning that it can make you urinate more frequently. as a result dehydration and increased thirst may occur if your body is getting rid of too much fluid. caffeine isn’t a strong diuretic so there is typically a net gain in water retention if you only consume a moderate amount of caffeine but large enough doses could dehydrate you though your individual response and caffeine-sensitivity may vary. diuretics can also be used as a medication for heart-related conditions like high blood pressure so your symptom of feeling thirsty may be worse if you’re on this medication or one with similar side effects. also depending on what you’re consuming say coffee or tea you could also be experiencing astringency from the naturally occurring bitter plant compound called tannin. astringency can be described as the dry puckering sensation in your mouth that you get by consuming tannin which might be making you feel thirsty. coffee is typically low in tannin content but tea especially black tea is high in tannins.

### Human:\ncan the paleo diet raise my cholesterol. my wife is on the paleo diet and i have joined her (to some degree). i eat two eggs every morning along with 2 pieces of bacon. i use coconut oil along with real butter to cook with. could these factors be raising my cholesterol?\n\n### Assistant: research shows that over the short-term low carbohydrate/high protein diets have beneficial effects on blood lipids especially raising the good kind of cholesterol hdl. it's important to note that some of the benefits seen in cardiovascular risk factors may be due to the weight loss that accompanies such diets. there isn't much data regarding the long-term effects on cholesterol especially ldl. some of the foods avoided on paleo help keep cholesterol (ldl) down such as oats and beans. so it is possible that your cholesterol could go up especially once you are done losing weight. i recommend getting lab work done so you can track your blood lipid levels. best paleo recipes books for good health<link>