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Archive for the ‘Alternative therapies’ Category

 

Strike a Pose to Lower Your Blood Pressure

Monday, November 23rd, 2015
Image courtesy of arztsamui at FreeDigitalPhotos.net

Image courtesy of arztsamui at FreeDigitalPhotos.net

By Kathrine Distel, PharmD Student Cedarville University School of Pharmacy

Hypertension or, as it is more commonly known, high blood pressure, is a chronic disorder that is becoming increasingly prevalent. It can be caused by a number of different factors, including a sedentary lifestyle, poor sleep habits, food choice and smoking. The most common treatment for high blood pressure is medication geared toward lowering blood pressure along with a suggestion to make some lifestyle changes. Unfortunately, those changes—namely diet and exercise—are unappealing at best to most people. Few people want to drastically alter their eating habits and rearrange their schedule so they can go to the gym every other day. Fortunately, there are plenty of other options that are emerging as effective ways to lower blood pressure without endlessly circling a track. One such option, yoga, has been in practice for many years.

Many people balk at the idea of doing yoga because it brings to mind impressive flexibility, leggings, and a room full of yoga mats. However, that doesn’t have to be the case. Thanks to the internet, you can pick a yoga instructor who moves at your pace in the privacy of your living room, avoiding all of the unappealing aspects of the exercise. A study1 conducted in India, a country that has been practicing yoga for centuries, found that regular yoga combined with blood pressure medications can produce significant decreases in blood pressure.

Study participants were divided into two groups. The first group, the control, continued to take their blood pressure medications as they had been with no changes besides instructions to avoid smoking, alcohol and any medications that may interfere with the study. The second group, besides the same set of instructions, began practicing yoga with trained yoga therapists three times a week. The sessions were about 45 minutes long and included preparatory practices, static postures, pranayama—exercises that focus on breathing control—and relaxation techniques. Participants were also encouraged to practice what they had learned throughout the rest of the week. 1

The study lasted for 12 weeks and, while the control group had no significant changes from its original measurements, the group practicing yoga showed some interesting results. When compared with both their own original measurements and the end results of the control group, the group practicing yoga had a significant decrease of both components of blood pressure (p < 0.05)—systolic and diastolic pressures— as well as mean arterial pressure (MAP) (p < 0.001). MAP is influenced by several different components, including blood pressure, heart rate, how much blood the heart is pumping every minute, and how much resistance the blood vessels are offering to the heart. When these values are low, the heart doesn’t have to work as hard and risks such as heart attack and stroke are decreased.1

There were two main limitations to this study. The sample size—70 people split evenly between the two groups—was a small one. Additionally, the study only lasted 12 weeks which did not allow it to assess the long-term effects of yoga on high blood pressure. However, other studies2-7 have also found yoga to have positive effects on blood pressure. One systematic review6 of 32 articles found that yoga could lower blood pressure in both healthy and hypertensive patients. Another study5, a year-long study in Hong Kong consisting of 182 participants, found that regular yoga practice could lead to decreased blood pressure, resting heart rate and waist circumference.

When the exercises for these studies were designed, the instructors kept in mind the group they would be teaching. The exercises were geared toward beginners and seniors. One case study, 7 which used resources such as a DVD and a YouTube video, evaluated the effectiveness of a modified chair yoga. This program increased safety for participants with decreased mobility or balance while still effectively lowering blood pressure. Participants also reported decreased anxiety and joint pain.

Results of systematic reviews3,6,8 have been mixed on the effects of yoga. Many, but not all of the trials found positive effects on blood pressure, some of those results were statistically significant while others were not. With so many varying results, there is still more research that needs to be done to determine a true measure of the effect of yoga on blood pressure.It is important to note that, because research into the effects of yoga on blood pressure is still relatively new, this practice has not yet been shown be effective in replacing blood pressure medications. Rather, it works well in conjunction with those medications.

So if your doctor has recommended a lifestyle change to aid in controlling your blood pressure, yoga may be a great place for you to begin. There are many free resources available, ranging from DVDs at the library to videos on YouTube, and it doesn’t require any equipment besides an open floor and perhaps a chair.

What do you think? Will you try yoga to assist in controlling your blood pressure?

 

References:

1. Pushpanathan P, Trakroo M, RP S, Madhavan C. Heart rate variability by poincaré plot analysis in patients of essential hypertension and 12-week yoga therapy. National Journal of Physiology, Pharmacy & Pharmacology. 2015;5(3):174-180.

2. Centre for Reviews aD. Yoga and hypertension: A systematic review (provisional abstract). Altern Ther Health Med. 2014:32-59.

3. Cramer H, Haller H, Lauche R, Steckhan N, Michalsen A, Dobos G. A systematic review and meta-analysis of yoga for hypertension. Am J Hypertens. 2014;27(9):1146-1151.

4. Hagins M, Rundle A, Consedine NS, Khalsa SBS. A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. J Clin Hypertens (Greenwich). 2014;16(1):54-62.

5. Siu PM, Yu AP, Benzie IF, Woo J. Effects of 1-year yoga on cardiovascular risk factors in middle-aged and older adults with metabolic syndrome: A randomized trial. Diabetology & Metabolic Syndrome. 2015;7(1):1-12.

6. Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evidence-based Complementary & Alternative Medicine (eCAM). 2007;4(4):487-491.

7. Awdish R, Small B, Cajigas H. Development of a modified yoga program for pulmonary hypertension: A case series. Altern Ther Health Med. 2015;21(2):48-52.

8. Centre for Reviews aD. Yoga for hypertension: A systematic review of randomized clinical trials (provisional abstract). Complement Ther Med. 2014:511-522.

Sugar and Spice

Wednesday, October 28th, 2015

By: Micah Bernard800px-Ground_cinnamon

Cinnamon. What comes to mind when you hear that word? Cinnamon buns, cinnamon glazed apples, snickerdoodles? It’s no secret that cinnamon and sugar are a great pair! But is there more to the relationship between sugar and cinnamon than just the great taste?

People with pre­diabetes or type 2 diabetes must be very careful to manage blood sugar levels. This can be achieved by following a special diet, losing weight, exercising, and taking medications such as metformin. Now there is a common spice that is being investigated as a supplement to help control blood sugar. In 2013, NPR published an article stating that cinnamon can help lower blood sugar.1 But is this claim backed up by science? Researchers in the last few years have been studying the impact of cinnamon on the management of blood sugar and have had promising results.
In 2003, researchers sought to determine if cinnamon could improve blood glucose levels in people with type 2 diabetes.2 In this study of 60 people with type 2 diabetes ranging in age from 45 to 58, subjects took either a placebo or one of three amounts of cinnamon: 1, 3, or 6 grams each day. After 40 days, the results showed that cinnamon in any of the three doses helps lower blood glucose levels 18­-29%, while no significant changes were reported in the placebo groups.

Another study in 2006 of 79 diabetic patients looked at whether cinnamon extract helps improve glycemic control in patients with type 2 diabetes.3 Each person either received a capsule of 3 grams of cinnamon or a placebo three times a day for 4 months. The results showed that the reduction in fasting blood glucose levels in the patients receiving cinnamon (10.3%), was significantly greater than in the control group, who had a reduction of only 3.4%. However, no significant differences were seen in hemoglobin A1c, which is an indicator of average blood sugar levels over the past three months.

A recent study that ran statistical tests on data from ten randomized controlled trials studying cinnamon’s effect on blood glucose found that cinnamon decreased fasting blood glucose levels by 24.59 mg/dl.4 There was no significant difference in the patients’ hemoglobin A1c. The study was unable to determine what the optimal dose of cinnamon or duration of treatment; this is an area where further research is needed.

How does cinnamon do it? Researchers do not fully know how cinnamon works, but they believe it may increase the body’s levels of and sensitivity to insulin, the hormone that helps your cells take sugar out of the blood stream, thereby lowering blood sugar levels.5 In addition, cinnamon may slow the emptying of the stomach, so there is less of a spike of sugar in the bloodstream.6 There is debate among researchers about what dose of cinnamon should be used to manage blood sugar.

As with any supplement, it is important to check with your doctor before adding cinnamon to your diet. If, after talking to your doctor, you decide to see if cinnamon works for you, it is important to choose the right kind of cinnamon. Cinnamon comes in two varieties, Cassia and Ceylon. Cassia is the more common type found in many supermarkets, however in higher doses, such as those used to control blood sugar, coumarin isolates (not to be confused with the blood thinner Coumadin) found in cinnamon can cause liver damage.1 The Ceylon variety of cinnamon has only trace amounts coumarin isolates, making it safer for the liver.7 So, if you plan to supplement your blood sugar management with cinnamon, ask a pharmacist to help you correctly select the Ceylon variety.

While researchers still do not fully agree on the effectiveness of cinnamon as a supplement for controlling blood sugar in type 2 diabetics and pre­diabetics, many recent studies show promising results. The effects of cinnamon may not be enough to replace a drug intended to control blood sugar, but those with pre­diabetes or diabetes may find it a useful supplement to help manage their condition.

What are your thoughts on using a natural supplement to manage a health condition?

Sources:

1. Aubrey A. Cinnamon Can Help Lower Blood Sugar, But One Variety May Be Best. NPR 2013. Accessed October 15, 2015.
2. Khan A, Safdar M, Ali khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. 2003;26(12):3215­8.
3. Mang B, Wolters M, Schmitt B, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 2006;36(5):340­4.
4. Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta­analysis. Ann Fam Med. 2013;11(5):452­9.
5. Kaiser C. Cinnamon’s Effect in Diabetes Uncertain. Cinnamon’s Ef ect in Diabetes Uncertain 2013. Accessed 2015.
6. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr. 2007;85(6):1552­6.
7. Johannes L. Little Bit of Spice for Health, but Which One? WSJ 2013. Accessed 2015.

Could your phone be used for more than games?

Friday, October 16th, 2015

By: Abigail Savino

Nowadays, it seems as if everyone has a cell phone – from kids to our grandparents, they are commonplace.  So why not design an application for the phone that could help improve our health? There are fitness tracking apps and calorie counting apps that are designed to help develop healthy lifestyles, but some suggest using text messages as forms of encouragement.1 One research study tested out the power of a text message in helping people become healthier over a period of six months.256px-Texting_closeup

Researchers from Sydney, Australia studied the effectiveness of text messaging on health in patients with coronary heart disease, a cardiovascular disease where plaque builds up in the arteries slowing the flow of blood to the heart.2,3 One group of patients received a typical intervention such as modifying diet and exercise at the suggestion of their doctor.3 The other group received four text messages each week providing advice, encouragement, and support for lifestyle changes. Text messages that the participants received were selected from a bank catered to the participant’s chronic condition. Participants who were smokers received a message similar to: “Try identifying triggers that make you want a cigarette and plan to avoid them.” Those who were trying a modified dietary approach received messages such as: “Try avoiding adding salt
to your foods by using other spices or herbs.” Others told to increase physical activity received messages like: “Don’t forget physical activity is good for you! It reduces your risk of diabetes, heart attack, stroke, and their complications.” Investigators also sent texts containing information about the cardiovascular system, for example, “Studies show that stress…can increase the risk of heart disease. Please talk to a health professional if you need help.”

The primary outcome of the study was to determine the text messaging effect on cholesterol levels. After six months, the participants who partook in the text messaging intervention had an average LDL cholesterol level of 79 mg/dL which was lower than the typical intervention group who had an average of 84 mg/dL.3 The study also monitored blood pressure, body mass index (BMI), active smokers, and physical activity levels.4 These were all positively affected by the intervention – average blood pressure for the text message intervention group was 128/81 vs 136/84 for control, BMI was lower at 29 vs 30.3, and more physical activity was completed at 936.1 minutes per week compared to 642.7 minutes per week. The study also started off with 184 smokers in the text message intervention group and ended with only 88 people still smoking. Since cardiovascular disease can be managed by lifestyle changes (diet, smoking, physical activity), it is significant that the text messages focused on those areas and help explain why these results were observed.2 One limitation to the study is the small scale, which may not allow representation of the full effect of clinical outcomes. This study was conducted through a hospital facility so it is not known how generalizable this will be to the overall population. Additionally, the messages were only sent in English excluding non-English speakers, the final results were recorded through self-reporting, cost-effectiveness of the intervention was not studied, and the study was not completely blinded.

Similar ideas have been popping up in other places in healthcare. Medicaid uses this system to give more individualized attention to their patients.5 They do this by sending appointment reminders, medication reminders, and also educational material that relates to them specifically.5 Also a study has been done with patients that have had a stroke in which the text messages were sent to remind them to take their medications, dietary and lifestyle changes, and to be in contact with a health care provider.6 This study increased appointment and medication adherence by 40%.5

Data from the research study above shows that text messaging could help to improve your health, and almost everyone has a phone so your motivation comes straight to your fingertips. If your doctor recommends you to be a part of a program like this then I suggest you strongly consider becoming a participant. If you don’t think a typical intervention approach is going to benefit your health, using this text message system could help to improve your health on your own time. It is great that they send little reminders to help motivate and remind you why it is important to follow through. Participating in something similar to this would be beneficial to improve your health as a whole. With today’s technology, this will likely become a bigger thing in the near future. Would you be willing to try using text messages as encouragement or as reminders? I know I would, everyone needs a little bit of motivation to get the ball rolling with whatever you are battling.

 

References

  1. Macfarlane S. Can A Simple Text Lower Your Cholesterol?. Diabetes Insider. 2015. Available at: http://diabetesinsider.com/can-a-simple-text-lower-your-cholesterol/39648. Accessed September 29, 2015.
  2. Heart.org. What is Cardiovascular Disease? 2015. Available at: http://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovascularDisease/What-is-Cardiovascular-Disease_UCM_301852_Article.jsp. Accessed October 1, 2015.
  3. Chow CK, Redfern J, Hillis GS, et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: A randomized clinical trial. JAMA. 2015;314(12):1255-1263.
  4. University Herald. Texting Patients Could Lower Cholesterol, Blood Pressure. 2015. Available at: http://www.universityherald.com/articles/23954/20150923/texting-patients-could-lower-cholesterol-blood-pressure.htm. Accessed September 30, 2015.
  5. Comstock J. RCT: Text message-based program boosts adherence to appointments, medication | MobiHealthNews. Mobihealthnewscom. 2014. Available at: http://mobihealthnews.com/34749/rct-text-message-based-program-boosts-adherence-to-appointments-medication/. Accessed September 29, 2015.
  6. 6. Kamal A, Shaikh Q, Pasha O et al. Improving medication adherence in stroke patients through Short Text Messages (SMS4Stroke)-study protocol for a randomized, controlled trial. BMC Neurology. 2015;15(1). doi:10.1186/s12883-015-0413-2.

Flush Out Your Child’s Allergies!

Thursday, November 20th, 2014

By Kelly Huston, Pharm.D. Student.

Got allergies? Is your child sneezing and/or have a stuffy, itchy, or runny nose? Flushing the nose out with a saltwater solution may provide some relief. Allergies are the body’s response to a substance that causes these symptoms.1 Because germs can contribute to allergy symptoms, flushing the nose could help by removing germs and by increasing the nose lining’s ability to stop germs from entering the body.2,3 Parents are looking for a simple solution to relieve their children’s allergic symptoms. Rinsing the nose out with a saltwater solution may be the answer they are hoping for.

Currently, self-treating allergies in children less than twelve years old is only appropriate if they have been seen by the doctor. However, if the child is twelve years or older, self-care is appropriate without first seeing the doctor. The best way to treat allergy symptoms in children is to avoid the cause of the allergic reaction. If the child cannot avoid the cause of the reaction, a second option to try before using medications is to flush the nose out with a saltwater solution. If medication is necessary, remember that choosing the medicine focused on relieving your child’s main symptom(s) can greatly help.1

An article published in June 2014 entitled, The Effectiveness of Nasal Saline (seawater) Irrigation in Treatment of Allergic Rhinitis in Children, looked at how effective flushing out the nose with a saltwater solution is at reducing allergy symptoms. The study consisted of sixty-one children between the ages of two and fifteen who were diagnosed with allergies. The individuals were randomly placed in three groups to look at how well fluticasone propionate (a steroid-medication used in the nose), nasal rinsing, and a combination of both methods relieved the symptoms of allergies. The study looked at the ability of each of the three treatments to reduce the symptoms of itchy nose, runny nose, blocked nose, and sneezing. The researchers found that flushing the nose out twice a day had no side effects among any of the children, improved all of the children’s symptoms after three months, and was effective when combined with the nasal medication. They discovered that both flushing out the nose and using the nasal medication caused the children’s symptoms to improve more at four, eight, and twelve weeks, compared to each method done individually. Using both methods made it possible to reduce the amount of medication used to treat the allergies. Using a larger amount of the nasal medication can be costly, but flushing the nose out in combination with this medication may lead to a decrease in the cost of treating allergies. These findings reinforce the idea that flushing out the nose with saltwater can effectively relieve the symptoms of allergies. However, this study is limited. A good scientific study will include a group (called the control group) that does not receive any type of treatment in order to see if the treatment that the other group is receiving is really as good as the researchers think it will be. This study did not have a control group. Another limit of the study was that it only looked at one nasal medication and did not look at other medications used to treat allergies.3 Previous studies have looked at the effectiveness of flushing out the nose. In fact, two studies conducted in the years 2000 and 2012 concluded that flushing the nose is effective at reducing allergy symptoms.4,5

Currently, there are several different methods of rinsing out the nose such as a Neti Pot, battery powered pulse water device, bulb syringe, and squeeze bottle. The proper technique of flushing out the nose is important because, if done inappropriately an infection may result.6 This procedure can be done one to two times a day or as needed to relieve symptoms.7 Individuals should wash their hands and make sure the device is dry and clean before following the procedure below. Specific directions may vary between methods, but they generally include:

  • Over a sink, learn your head sideways and facedown to avoid getting the solution in your mouth.
  • Keep your mouth open, place the spout of the device that is filled with the saltwater solution in the top nostril, so that the liquid comes out the other nostril
  • Once finished, blow your nose. Lean your head to the other side and facedown. Then repeat this procedure for the other nostril.6

Mild side effects may include slight stinging. Stop using this treatment and see the doctor if a headache, fever or nosebleed occurs.6 Also, if this treatment does not improve allergy symptoms, the use of a medication may be an option.1 If concerns or questions come up, please speak with a pharmacist or doctor.

Given this information, will you flush out your nose, or a loved-one’s nose with saltwater solution to relieve symptoms in the future?

References:

  1. Krinsky DL, Berardi RR, Ferreri SP, et al. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 17th ed. Washington, D.C.: American Pharmacists Association; 2012.American Rhinologic Society. Nasal/Sinus Irrigation. http://care.american-rhinologic.org/irrigation Updated August 2012. Accessed October 29, 2014.
  2. Chen J, Jin L, Li X. The Effectiveness of Nasal Saline Irrigation (seawater) in Treatment of Allergic Rhinitis in Children. International Journal Of Pediatric Otorhinolaryngology [serial online]. July 2014;78(7):1115-1118. Available from: Academic Search Complete, Ipswich, MA. Accessed October 30, 2014.
  3. Tomooka LT, Murphy C, Davidson TM. Clinical Study and Literature Review of Nasal Irrigation. Laryngoscope, 2000, 110, 7, 1189-1193, John Wiley & Sons. http://onlinelibrary.wiley.com/doi/10.1097/00005537-200007000-00023/full
  4. Hermelingmeier K, Weber R, Hellmich M, Heubach C, Mösges R. Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. American Journal Of Rhinology & Allergy [serial online]. September 2012;26(5):e119-e125. Available from:
  5. MEDLINE with Full Text, Ipswich, MA. Accessed October 30, 2014.
  6. U.S. Food and Drug Administration. Is Rinsing Your Sinuses Safe? http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM316649.pdf Published August 2012. Accessed October 27, 2014.
  7. deShazo R and Kemp S. Patient information: Allergic Rhinitis. UpToDate. http://www.uptodate.com/contents/allergic-rhinitis-seasonal-allergies-beyond-the-basics Updated February 2014. Accessed October 30, 2014.

 

Poised Poses for more Z’s

Monday, November 17th, 2014

by Rachel Bull, PharmD student

Poor sleep quality is one of the most common health complaints in older adults today.  It is approximated that more than 80% of older adults experience sleep disturbance to some degree, while 50% note the common recurrence of sleep disturbance.1 Insomnia can be defined as, “having trouble falling or staying asleep, waking up too early and cannot return to sleep, or not feeling refreshed after sleeping”.2 The identification of the presence of insomnia is often quite obvious while the cause of the insomnia can be more difficult to identify.  The cause of insomnia can range greatly and is often not the primary disorder rather a response to an underlying issue.  The most common causes of insomnia are stress and anxiety.  Other causes can include a medical illness, poor sleep habits, or other sleep disorders such as sleep apnea and narcolepsy. The standard of care for insomnia is the practice of reestablishing a normal sleep cycle which can be accomplished with sleep hygiene practices such as exercise, a nonprescription sleep aid, or a prescription sleep aid.2 These treatments still pose barriers such as not being completely effective for all patients, therefore alternative treatments for insomnia are still being pursued.  Also, many over the counter sleep aids come with barriers of their own including the body building tolerance against antihistamines which are commonly found in these sleep aids, feeling groggy or unwell the next day, potential medication interactions, and a list of side effects associated with each sleep aid such as dizziness, dry mouth, and daytime sleepiness being the most common among all sleep aids.3 Recently an up and coming trend for treating insomnia has been focused on using the practice of yoga.  Yoga has been found to naturally strengthen the body by improving physical strength and flexibility, reducing stress, improving breathing patterns, and enhancing mental focus.4

A recent publication in Alternative Therapies by Health & Medicine explored the effects of yoga as a treatment for insomnia.1 Alternative therapies, such as yoga, have been proposed to be a safe alternative from the standard of care such as sleep aids and provide a treatment with little adverse events.  This waiting-list controlled trial study was conducted at Shaare Zedek Medical Center in Jerusalem, Israel and looked at how participating in yoga classes twice weekly as well as recommended home-based practices would affect older adults with complaints about insomnia.  The study included 67 participants who were 60 years and older. Sixteen of the participants were assigned to the waiting list control group while the other 43 participants were assigned to the yoga intervention group and 7 participants dropped out for various reasons.  The results concluded that overall the practice of yoga by older adults was shown to be a safe treatment and led to improved sleep quality and duration.  The study found that just 25 minutes of yoga per day for 12 weeks led to improved sleep status. A limitation presented by the authors was that there was not a single method of measuring the outcomes instead a wide range of measuring methods were used.  Another limitation would be the compliance of the participants throughout the study. This was evident with only 10% of participants maintaining the practice compliance level.1

There has been previous research done on this topic over the years. Another study showed yoga can positively affect insomnia by improving sleep efficiency and sleep duration.4 The study provided the participants with yoga training and instructed all participants to maintain daily yoga practice for eight weeks.  The participants kept sleep diaries for two weeks before the yoga practices began and for the entire eight week study to record the amount time spent asleep, number of times they woke up during the night, and the time spent sleeping between waking periods.  The study also noted that the cause of insomnia has commonly been linked to anxiety and depression.4 Another study published in the Indian Journal of Psychiatry found that 60 minutes of yoga daily for 6 months led to improved sleep quality among the elderly aged 60 years and older.5 This study supports the conclusion that the practice of yoga improves sleep quality while noting that further research should be conducted on this alternative therapy because of its great potential to treat insomnia.5

Yoga still offers barriers such as potential injury and the fact that the elderly population should not first attempt yoga on their own without seeking advice from their primary care provider. On the other hand, yoga can be more financially friendly than some medications offered to treat insomnia.  The benefits of yoga naturally target the most common causes of insomnia, which prove to be another reason why the practice of yoga should be utilized as a treatment for insomnia. Yoga can easily be incorporated into a basic lifestyle change by finding a yoga class at a local gym or fitness center or in the peace of your own home by using instructed yoga videos for just 30 minutes a day.

Are these poised poses worth a try? Do you think specifically yoga treats insomnia or simply exercise in general?  Is yoga the answer to your sleepless nights?

 References

  1. Baharav A, Cahan C, Cohen M, Halpern J, Kennedy G, Reece J. Yoga for improving sleep quality and quality of life for older adults. 2014; 20(3):37-38-46.
  2. Melton, C. K. Insomnia, Drowsiness, and Fatigue. In: R. R. Daniel L. Krinsky, Handbook of Nonprescription Drugs An Interactive Approach to Self-Care. Washington, DC: American Pharmacists Association; 2012: 867-876.
  3. Mayo Clinic Staff. Sleep aids: Understand over-the-counter options. Mayo Clinic Web site. http://www.mayoclinic.org/healthy-living/adult-health/in-depth/sleep-aids/art-20047860. Published 12/10/2011. Updated 2014. Accessed 11/15, 2014.
  4. Khalsa, SBS. Treatment of Chronic Insomnia with Yoga: A Preliminary Study with Sleep-Wake Diaries. 2004; 29(4):269-278.
  5. Basavaraddi IV, Gangadhar BN, Hariprasad VR, et al. Effects of yoga intervention on sleep and quality-of-life in elderly: A randomized controlled trial. 2013; 55:364-365-368.

Can You Drink Your Way to Good Health?

Friday, November 14th, 2014

by Rachel Wilcox, PharmD student

Red wine is often thought to be a good source of antioxidants and is associated with heart health.1 Resveratrol is an antioxidant found in a variety of sources, including red wine, nuts, berries and dark chocolate.2 Antioxidants are believed to be important in either preventing or reducing heart disease, cancer, the effects of aging and increasing the body’s resistance to stress.3,4 Resveratrol acts to rid the body of harmful toxins and some evidence shows that resveratrol may play a role in slowing progression of cancer.2 One current popular antioxidant is Vitamin C, which is found in orange juice and has a daily-recommended intake of 90mg for adult males and 75mg for adult females.5 Although evidence of resveratrol’s benefits may not be as concrete as Vitamin C, resveratrol is gaining popularity in the public eye. In fact, some consumers in the US are going beyond just drinking wine for the supposed benefits of resveratrol and are spending about $30 million dollars each year on resveratrol supplements.1,6 A major problem concerning resveratrol is that there is no FDA approved recommendation for daily intake and current studies provide conflicting evidence about the benefits of this antioxidant.7

A recent article from CNN cites an observational study that investigated the effects of resveratrol on health outcomes such as heart disease, inflammation, cancer and mortality in 783 patients who were 65 years of age or older. 1,6 This study found that resveratrol in red wine was not associated with anti-cancer properties, reducing inflammation or improving heart disease.6 The researchers did note that a limitation of their study was in their sample size. Increasing the amount of patients studied might allow the researchers to find an association between resveratrol and health outcomes.6

There is conflicting evidence for the benefits of resveratrol. Some scientific studies found that resveratrol improved health outcomes while other studies found no benefit. One study looked at the relationship between resveratrol and its effect on protecting a second heart attack in humans. The study describes that resveratrol did thin the blood, which is important for prevention of secondary heart attacks.3 Resveratrol also possesses anti-cancer properties but this study only looked at resveratrol effects in rats and mice.2 On the other hand, several studies show that resveratrol does not live up to the hype. One study showed that resveratrol was only responsible for about less than 5% of the antioxidant activity in wine.4 In fact, their research shows that there was no significant difference in terms of antioxidant benefit between red wine and wine with 10 times the amount of resveratrol added.4 This information brings up an important question. If wine consumption may not provide enough resveratrol to see benefits, should resveratrol supplements be recommended instead? The bottom line answer is probably not. A recent publication from Harvard Medical School explains some of the concerns with resveratrol supplements. One major concern is that there is no safe and effective dose established for these supplements.7 Long-term safety is also an issue since studies have not evaluated what effects resveratrol has on the human body over time.7

Since there is so much conflicting evidence about the benefits of resveratrol and whether moderate portions of wine will even provide the needed amount of resveratrol, I would not recommend drinking wine solely for antioxidant effects of resveratrol. It is also important to weigh the potential benefits of drinking alcohol against any negative consequences. The U.S. health department guidelines strongly recommend that women do not consume more than 1 alcoholic drink per day, and that men consume no more than 2 alcoholic drinks a day.8 Overconsumption of wine and other alcohol can cause liver damage as lead to other serious health issues. Remembering to consume alcohol responsibly and within the recommended guidelines is important to reduce the chances of negative consequences. While alcohol consumption does have drawbacks, it is important to note wine contains many other antioxidants that may be beneficial. I encourage wine enthusiasts and other curious individuals to do more research on different types of antioxidants wine provides and the associated health benefits. One study did find that the health benefits of wine were attributed to many different antioxidant compounds rather than a single compound.4 I also do not recommend taking resveratrol supplements because there may be more effective products on the market with stronger scientific evidence to support the use, such as Vitamin C. What do you think, would you consider taking a resveratrol supplement? What antioxidant supplements have you tried and why?

References

  1. Hudson W. Antioxidant in red wine has no benefit at low doses. CNN. http://thechart.blogs.cnn.com/2014/05/12/antioxidant-in-red-wine-has-no-benefit-at-low-doses/. Accessed October 1, 2014.
  1. Murtaza G, Latif U, Najam-Ul-Haq M, et al. Resveratrol: An active natural compound in red wines for health. Journal of Food & Drug Analysis. 2013;21(1):1-12. Accessed October 2, 2014
  1. Das DK, Mukherjee S, Ray D. Resveratrol and red wine, healthy heart and longevity. Heart Fail Rev. 2010;15(5):467-477. Accessed October 1, 2014.
  1. Xiang LM, Xiao LY, Wang YH, Li HF, Huang ZB, He XJ. Health benefits of wine: Don’t expect resveratrol too much. Food Chem. 2014;156:258-263. Accessed October 2, 2014
  1. Office of Dietary Supplements. Vitamin C. National Institute of Health. http://ods.od.nih.gov/factsheets/VitaminC-Consumer. Updated June 24, 2011. Accessed October 21, 2014.
  1. Semba R, Ferrucci L, Andres-Lacueva C, et al. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Internal Medicine [serial online]. July 2014;174(7):1077-1084. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed October 1, 2014.
  1. Can drinking wine really promote longevity? recent evidence shows the antioxidant resveratrol in wine does not offer a health boost. Harv Health Lett. 2014;39(11):5-5. Accessed October 2, 2014.
  2. Center for Disease Control and Prevention. Alcohol and Public Health. Center for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm#standDrink. Updated March 14, 2014. Accessed November 9, 2014.

 

Tried everything for your headache?

Wednesday, November 5th, 2014

By Neal Fox, PharmD Student

One problem with treating headaches is that we don’t know exactly how they happen. Therefore, it is hard to know how to keep them from happening or even stop them once they start. When people have to deal with a headache on their own, they go to the pharmacy and buy something. They can take acetaminophen, ibuprofen, naproxen, or aspirin, which can potentially cause side effects if used too much. These drugs can also upset the stomach. For worse headaches prescription drugs are used, many of which have bad side effects and can be expensive. Melatonin can prevent and treat different types of headaches with few side effects and low cost.1,2 People who often get migraine headaches tend to not have enough melatonin inside of them.3 To fix this, melatonin can be taken as a pill.

A paper from India in September 2014, titled “Melatonin: functions and ligands”, detailed much about melatonin and all of the possible medical uses for it. Melatonin is created by the pineal gland, a part of the brain. Melatonin is related to sleep and it has been used to help people sleep better. There are many other things that melatonin can help with such as swelling, pain, and free radicals. This means that it could be involved in treating more diseases in the future.2 Right now, there is good evidence to support the use of melatonin for headaches. Using melatonin is very different from what Americas normally do. We use medications with unpleasant side effects that often work only in 50% of people who take them.4 Due to the research on melatonin being performed overseas, its benefits may not be well-known in America.

Around the world, scientists are looking at melatonin and headaches, and there are many studies supporting the use of melatonin in migraines as well.3 In a recent article from Turkey by researchers Karadas and Odabasi, 23 people were given 3 mg of melatonin before bed. This study found that, when taking melatonin, people had migraines less often. Plus, the migraines that they did have, hurt less. Because of this, the people taking melatonin needed to use other drugs less.5 Miano et al. found that melatonin 3 mg at bedtime was effective in reducing headache attacks in 22 children ages 6-16. However, 7 of the children reported no improvement.6 Melatonin has been used in other kinds of headaches, such as cluster headache. Cluster headache is a type of headache with really bad pain on one side of the head for a short time. This type also tends to mess up the body’s internal clock in different ways. Leone et al found that 10 mg of melatonin worked very well for half of people but another study by Pringsheim et al used only 2 mg and did not see any benefit.1,7 Finally, another type of headache called hemicrania continua (HC) is normally treated with a drug called Indomethacin, which has side effects including headache. HC is a type of headache that lasts for a long time and is usually on one-side of the head but not very bad. However, at times this headache can become much worse and the severe pain can last for hours or days.  Melatonin has been used to help people with HC and has been very successful.8,9 Finally, a Dutch group treating sleep patients found that 78.6% of them had a decrease in headaches with melatonin. However, 13.8% of patients who didn’t have headaches before, got them while on melatonin.10

We don’t know exactly how melatonin works for headache. A possibility suggested by some experts is all about the internal sleep clock that we have and melatonin’s effect on that. The research that has been done so far shows good things about melatonin. We know that it is highly safe and inexpensive. The only reported side effects of melatonin are that it can make people really sleepy and might cause headaches in some people with sleep disorders.10 If you think melatonin may be beneficial to you, talk with your doctor and make an informed decision together. Melatonin may not work for everyone, because of the complexity of headaches and the different kinds. But if it could work, is it worth it to try?

Kaitie’s Story

Since I was thirteen, I used to get terrible headaches 3-5 times a week. I started taking melatonin (3 mg before bed) in April of 2013 and have only had about 10 major headaches since then (currently October 2014). The main issue I have had with taking melatonin regularly is that it can be more difficult to get out of bed due to drowsiness; but this usually subsides within 30 minutes of actually getting up. I would definitely recommend trying melatonin for prevention of frequent headaches.

Have you tried everything for your headache? Are you willing to try melatonin?

 

References:

  1. Pringsheim T, Magnoux E, Dobson CF, Hamel E, Aubé M. Melatonin as adjunctive therapy in the prophylaxis of cluster headache: A pilot study. Headache. 2002;42(8):787-792.
  2. Singh M, Jadhav HR. Melatonin: Functions and ligands. Drug Discov Today. 2014;19(9):1410-1418.
  3. Vogler B, Rapoport AM, Tepper SJ, Sheftell F, Bigal ME. Role of melatonin in the pathophysiology of migraine: Implications for treatment. CNS Drugs. 2006;20(5):343.
  4. Peres M, Masruha M, Rapoport A. Melatonin therapy for headache disorders. Drug Development Research (USA). 2007;68:329-334.
  5. KARADAS Ö, ODABASI Z. Migrende melatonin proflaksisinin etkinligine yönelik açik uçlu klinik çalisma: Ön rapor. Archives of Neuropsychiatry / Noropsikiatri Arsivi. 2012;49(1):44-47.
  6. Miano S, Parisi P, Pelliccia A, Luchetti A, Paolino MC, Villa MP. Melatonin to prevent migraine or tension-type headache in children. Neurol Sci. 2008;29(4):285-287.
  7. Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G. Melatonin versus placebo in the prophylaxis of cluster headache: A double-blind pilot study with parallel groups. Cephalalgia. 1996;16(7):494-496.
  8. Hollingworth M, Young T, M. Melatonin responsive hemicrania continua in which indomethacin was associated with contralateral headache. Headache. 2014;54(5):916-919.
  9. Rozen TD. Melatonin responsive hemicrania continua. Headache. 2006;46(7):1203-1204.
  10. Rovers J, Smits M, Duffy JF. Headache and sleep: Also assess circadian rhythm sleep disorders. Headache. 2014;54(1):175-177.

Can Ginger Cure Rheumatoid Arthritis?

Tuesday, November 4th, 2014

by R. Brandon Kime, PharmD Candidate

Rheumatoid arthritis is a disease that causes the breakdown of joints throughout the body due to the body’s immune system attacking these tissues. As the joints degrade, they become less able to support and lubricate the bones that they attach. Eventually, the bones can rub together, causing erosion of the bone and possibly deformity of the joint. This entire process results in a considerable amount pain for those affected, as well as difficulties in day-to-day functioning. Unlike other types of arthritis, rheumatoid arthritis can occur in people of all ages. Rheumatoid arthritis is usually treated by prescription drugs that decrease inflammation or decrease immune system activity. Some of these drugs may have significant side effects, including increased chance for infection for those that suppress the immune system, or increased chance for ulcers and bleeding for anti-inflammatory drugs. Physical therapy may also be used to increase joint flexibility and decrease stress and degradation of the joints. One European study estimated the total cost of rheumatoid arthritis in the US as 42 billion euros,1 or over 53 billion dollars.

Plants have been used since ancient times for medicinal purposes,2 and traditional medicine is growing acceptance in developed countries.3  An article written by Al-Nahain and colleagues evaluated the potential of the ginger plant (Zingiber officinale) in treating rheumatoid arthritis.4 The root of the ginger plant is most often used in food because of its unique taste, but it also has several medicinal properties that have been observed. Ginger has been well-studied for its anti-inflammatory effects (it is similar in action to aspirin or ibuprofen).5,6 The plant contains many drug-like compounds that may be useful in either treating rheumatoid arthritis outright or developing new anti-inflammatory drugs.2 One study tested both ginger extract as well as several chemicals isolated from ginger in an animal model of rheumatoid arthritis and found ginger to have “profound antiarthritic efficacy.”7 This means that ginger is capable of treating arthritis on multiple levels. While ginger may have potential in treating arthritis, it would not be without disadvantages. There is a lack of precise dosing information for this application of ginger. Furthermore, since it is considered a dietary supplement insurance companies would be unlikely to cover it.

While “cure” is far too strong of a word at this time, what does all this mean for those struggling with rheumatoid arthritis? First, it gives them a potential option when standard therapies do not work well enough to treat their symptoms. Individuals suffering from the disease can talk to their doctors and discuss whether using or adding a ginger supplement to their regimen could be beneficial in treating their symptoms. Second, it gives them hope for future research to find more effective treatments for rheumatoid arthritis. The Al-Nahain article is optimistic that further research into the chemical functions of ginger components, “may make it possible to stop further progress or even reverse the damage caused by [rheumatoid arthritis].”2 Finally, if new research into ginger prompts further research into the benefits of other substances marketed as dietary supplements, I think that is good for the world of healthcare as a whole. Selecting healthcare products should be based on evidence rather than advertising. I would recommend that consumers become proactive in discovering the benefits of both mainstream and alternative treatments. In this way, consumers can make more informed decisions and progress can be made in treating various diseases.

Has anyone you have known taken a ginger supplement for their rheumatoid arthritis? How well did his or her treatment work?

References

  1. Lundkvist J, Kastäng F, Kobelt G. The burden of rheumatoid arthritis and access to treatment: Health burden and costs. The European Journal of Health Economics. 2008;8(, Supplement 2: The Burden of Rheumatoid Arthritis and Patient Access to Treatment):S49-S60.
  2. Phillipson JD. Phytochemistry and medicinal plants. Phytochemistry. 2001;56(3):237-243.
  3. World Health Organization. WHO traditional medicine strategy 2002-2005. 2002.
  4. Al-Nahain A, Jahan R, Rahmatullah M. Zingiber officinale: A potential plant against rheumatoid arthritis. Arthritis. 2014;2014:8.
  5. Grzanna R, Lindmark L, Frondoza CG. Ginger-an herbal medicinal product with broad anti-inflammatory actions. Journal of medicinal food. 2005;8(2):125-132.
  6. Mascolo N, Jain R, Jain SC, Capasso F. Ethnopharmacologic investigation of ginger (zingiber officinale). J Ethnopharmacol. 1989;27(1–2):129-140.
  7. Funk JL, Frye JB, Oyarzo JN, Timmermann BN. Comparative effects of two gingerol-containing zingiber officinale extracts on experimental rheumatoid arthritis⊥. J Nat Prod. 2009;72(3):403-407.

Can Aspirin Eventually Replace Warfarin?

Friday, October 31st, 2014

by Kristin Lessig, PharmD Candidate

For patients that have experienced serious trauma, surgical procedures, long periods of bed rest, or have taken certain oral forms of birth control, there is an increased risk for a condition known as deep vein thrombosis (DVT).  Deep vein thrombosis (DVT) is a blood clot that most commonly forms within the deep veins of the legs. This clot can become dislodged from the vein and eventually make its way into the lung where it can become stuck in a pulmonary artery and result in serious complications. 1

One of the primary treatments for DVT is to prescribe a medication that acts as a blood thinner so that the blood cannot form clots that block the blood vessels. These types of medications are known as anticoagulants, with one of the most commonly used anticoagulants being a medication known as warfarin. This medication works by blocking the mechanism that initiates blood clotting. 1 However, warfarin tends to interact with many different medications, and warfarin also tends to make the blood so thin that it is difficult to stop any internal or external bleeding. 1, 2

U.S. News recently published a report discussing the possibility of using over-the-counter aspirin to help treat DVT.3 The news report stated that many patients who take warfarin generally take the medication long enough for the blood clot to be destroyed and then as a preventative measure to keep another clot from forming. 3 Most patients only take warfarin for approximately 6 months because while taking warfarin, it is necessary to have frequent doctor appointments and blood tests to determine if a change in dose is needed. Since many patients do not wish to continue taking warfarin for extended periods of time, physicians need to utilize some other form of treatment that will bring about better results and be easier for the patient to follow.

Recent studies have revealed that aspirin may actually be an efficient treatment for DVT since aspirin also works to thin the blood like warfarin does. Aspirin acts as a blood thinner by blocking the production of certain enzymes that cause blood platelets to clot together. 4 Prospective studies and randomized control trials have been performed in order to determine if aspirin was able to prevent the formation of another blood clot in patients who had previously suffered from DVT. In addition, these studies observed the effects of 100mg aspirin versus a placebo on myocardial infarction (heart attack), stroke, major bleeding, and cardiovascular death. 3, 5 As a result of these studies, it was shown that aspirin was more effective than the placebo at decreasing the risk of DVT by approximately 42%. 4,5 It is very important to realize, however, that these studies showed a serious limitation because they did not show the effects of treatment of DVT with aspirin alone. Instead, the studies focused on the effects of aspirin on DVT after the patient had already taken a much stronger anticoagulant medication. Therefore, it is necessary for a patient who has been diagnosed with DVT to seek a doctor’s approval before beginning self-treatment with aspirin. While these studies have shown that aspirin is capable of blood-thinning properties and can significantly decrease the risk of DVT recurrence, aspirin is not as strong as warfarin or other anticoagulant medications. 5

Based on the evidence from the studies, it is easy to see that a new and potentially more patient-friendly treatment for DVT is evolving. Using over-the-counter aspirin as a blood-thinner to prevent another blood clot from forming is potentially a safer option since the patient won’t experience as many drug interactions as they would if they were on warfarin. Also, taking aspirin instead of warfarin can be easier and more cost effective for the patient. The patient would not have to go to the physician as often for testing and dose changes, therefore giving the patient a more consistent treatment as well as cutting down on medical costs. If an individual has previously suffered from a DVT, I would highly recommend meeting with the physician to discuss the option of possibly using aspirin as a precaution against a second DVT.

Do you think it is wise for people to self-treat a fairly serious condition with over-the-counter aspirin instead of seeing their physician frequently?

 

References:

  1. Obalum DC, Giwa SO, Adekoya-Cole T, Ogo CN, Enweluzo GO. Deep vein thrombosis: Risk factors and prevention in surgical patients. West Afr J Med. 2009; 28(2):77-82.
  1. Aspirin’s role in preventing recurring deep vein blood clots. Mayo Clin Health Lett. 2013; 31(5):4-4.
  1. Reinberg, S. Study: Aspirin Might Work Instead of Warfarin for Deep Vein Clots. U.S. News Website. http://health.usnews.com/health-news/articles/2014/08/26/study-aspirin-might-work-instead-of-warfarin-for-deep-vein-clots. Published August 26, 2014. Accessed October 4, 2014.
  1. Cossetto DJ, Goudar A, Parkinson K. Safety of peri-operative low-dose aspirin as a part of multimodal venous thromboembolic prophylaxis for total knee and hip arthroplasty. J Orthop Surg (Hong Kong). 2012; 20(3):341-343.
  1. Simes J, Becattini C, Agnelli G, et al. Aspirin for the prevention of recurrent venous thromboembolism: The INSPIRE collaboration. Circulation. 2014; 130(13):1062-1071.

 

Fighting that Itch!

Tuesday, October 28th, 2014

by Lindsay Mailloux, PharmD Candidate

We have all experienced it before. Whether it be a bug bite, a case of poison ivy, or the annoying t-shirt tag rubbing against your neck, you know what it feels like to have an itch. These cases usually have an easy solution—scratch your arm, cut off that tag, or maybe even apply some hydrocortisone cream. However, if you or your child is one of the many individuals who suffer from atopic dermatitis, more commonly known as eczema, you know the solution is not so simple.

Atopic dermatitis is the most common skin disease among children, affecting 20% of children in the United States and other developed countries.1 This skin condition usually starts affecting individuals during infancy and lasts into adulthood.2 Because atopic dermatitis acts like an allergic reaction, it cannot be cured—only managed. For less severe cases, the symptoms of itchy, dry, and irritated skin are usually treated with regular use of hypoallergenic moisturizers and maybe the occasional use of hydrocortisone cream for the bad flare-ups.2 Other non-medical practices can be used, such as applying lotion immediately after taking short baths to trap the moisture on the skin. Another handy tip is to keep nails clean and short to avoid damage to the skin from scratching.2 However, these measures are not always sufficient for the more severe cases of eczema, and individuals may have to resort to more intensive drug measures like taking prescription oral corticosteroids.1 Because these drugs have more serious side effects, especially for children, researchers are looking for better alternatives.

One study published this year suggests a new type of treatment called “wet-wrap” therapy. In this technique, a child with eczema takes a 10 to 20 minute warm bath and then rubs a moisturizer and medicated cream into his or her skin. The child is then wrapped in wet clothing to “trap” the medication and dressed in additional dry clothing over top. After a minimum of two hours, the wet clothing is removed.1 The goal of this therapy is to reduce irritation and help restore overall health and hydration of the skin. In this prospective cohort study, seventy-two children with moderate-to-severe cases of eczema were treated with wet wraps to test if the therapy improved their condition. However this study was limited by the fact that it did not have a control group for comparison, and its results cannot be generalized to adults.1

The study showed two major benefits of wet wrap therapy not seen with typical treatment. The first is that wet wraps were found to increase the effectiveness of a weaker medication, thus avoiding the need for a stronger drug with more worrisome side effects. Secondly, this technique was actually shown to help heal the skin and provide relief for a month after treatment.1

Since wet wrap therapy was first introduced about twenty years ago, various studies have shown its significant potential in treating eczema. One study showed that wet wrap therapy improved children’s eczema by an average of 74% when compared to their original condition. 3 In addition, a review of multiple studies determined that using wet wrap dressings with a medicated cream was both a safe and effective treatment.4

However, it is important to recognize that this treatment is currently only used for more severe cases of atopic dermatitis under the direct supervision of health care providers. One opinion from medical experts explains that wet wraps are currently used as a “safe crisis intervention.”5 This means that the technique should only be used in severe cases of eczema when the patient is too young to safely use prescription oral drugs. Another important point this expert makes is that use of wet wraps can result in side effects including lowering the activity of your adrenal glands or increased risk of bacterial infection. 5,6

One reason that this new practice is not used outside of the instruction and supervision of a health care provider is because of the complication of the process and the various methods of accomplishing it. One article pointed out that an official wet wrap method has never been established. For instance, various types of medicated creams and bandages have been used as well as different lengths of time for keeping the wraps on the skin. This lack of standardization makes it difficult even for health care providers to recommend wet wrap therapy.6

Current evidence strongly suggests that wet wrap therapy has definite potential as a safe and effective treatment for eczema. However, the major downside of this therapy is how complicated it is to use. At this point, it is not a good idea to try it out without supervision of a health care provider. But keep an eye out for guidelines on wet wrap therapy— this may be a huge area of treatment just around the corner. Also, consider asking your doctor about wet wraps if you or your child is losing the fight against that itch!

What are your thoughts? Do you think the benefits outweigh the risks? What other similar techniques would you recommend in the fight against the eczema itch?

References

  1. Nicol NH, Boguniewicz M, Strand M, Klinnert MD. Wet wrap therapy in children with moderate to severe atopic dermatitis in a multidisciplinary treatment program. The Journal of Allergy and Clinical Immunology: In Practice. 2014;2(4):400-406.
  2. Krinsky DL, Berardi RR, Ferreri SP, et al. Handbook of nonprescription drugs: An interactive approach to self-care. 17th ed. Washington, D.C.: American Pharmacists Association; 2012.
  3. Wolkerstorfer A, Visser RL, De Waard FB, Van DS, Mulder PGH, Oranje AP. Efficacy and safety of wet-wrap dressings in children with severe atopic dermatitis: Influence of corticosteroid dilution. Br J Dermatol. 2000;143(5):999-1004.
  4. Devillers A, Oranje A. Efficacy and safety of ‘wet‐wrap’ dressings as an intervention treatment in children with severe and/or refractory atopic dermatitis: A critical review of the literature. Br J Dermatol. 2006;154(4):579-585.
  5. Oranje AP. Evidence – based pharmacological treatment of atopic dermatitis: An expert opinion and new expectations. Indian J Dermatol. 2014;59(2):140-142.
  6. Devillers ACA, Oranje AP. Wet-wrap treatment in children with atopic dermatitis: A practical guideline. Pediatr Dermatol. 2012;29(1):24-27.