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*** Low Blood Sugar Problems *** by Dr. Lendon Smith

* What Kinds Of Problems Are The Result of Low Blood Sugar? **

Low blood sugar levels may produce violent Jekyll and Hyde behavior. They are at least ill behaved. One of my patients robbed a bank on an empty stomach. After eleven years in prison he figured it out. * Editor's note: As a former victim of low blood sugar I can tell you this problems masks as almost any physical bodily symptom as well. Mine included weakness, fatigue to exhaustion, imbalance and a feeling of falling down, waking up in the middle of the night, cravings for sugar, difficulty thinking clearly, and the shakes.

* How Do People With Low Blood Sugar Control These Symptoms? **

The treatment plan is to eat small amounts of protein every 2 to 4 hours to maintain that all-important blood sugar. * A low carbohydrate diet works best for these people. * Eating pasta, white bread, potatoes, and other rapidly digested starchy or sugary foods often leads to overeating by triggering an insulin release. The blood sugar falls and hunger sets in. * Dr. Seale Harris (JAMA, in 1924) noted some patients had sudden panic attacks in the middle of the night or if a meal had been postponed.

What Are The After-effects of Hypoglycemia?

Low blood sugar is related to heavy consumption of alcohol, sugar, and white flour products. * Therefore hypoglycemia can lead to obesity, rage, and a tendency to drink alcohol. * Eighty percent of alcoholics have hypoglycemia.

* What Additional Things Might One Do? **

If there is much sickness in the family, extra immune-building nutrients should be consumed daily. Vitamin C, Echinacea, and colostrum are worth using to slow down the infection rate. *If these are not adequate, an investigation of the immune system is the next step. It seems quite obvious that frequent infections in the family means the lifestyle and diet are not adequate.

After almost two years. I can report that my low blood sugar symptoms are now a thing of the past.

Dr. Lendon Smith
International Healh Foundation and

Robert Annand - 04:25am Aug 20, 2000 EST

Fact Sheet on Prescription Drug Abuse

Medicine is prescribed to combat illness, relieve pain, help with injuries, to make us feel better. Prescriptions, though, are often more powerful than we realize, and the side effects can sometimes be dangerous. When used incorrectly, some medicines can be as lethal and addictive as street drugs. And because medicine is prescribed by a doctor, some people don't recognize the potential danger involved in misusing or abusing prescriptions.

Quick facts

More deaths and injuries are caused by the abuse of prescription drugs than from the use of all illegal drugs combined.

A recent study revealed that 9 percent of high school seniors reported using prescription-type stimulants without medical supervision. Fifty percent of older adults regularly use over-the-counter medicine. One out of every four adults over the age of 60 takes four or more prescribed medications at once. One-third of older adults take medications prescribed by more than one doctor, and 77 percent of this group do not discuss with one doctor the medications prescribed by another.

Aspirin is one of the top five drugs involved in emergency room visits due to poisoning.

Take only as prescribed

More than half of all prescription drugs are taken incorrectly-using someone else's prescription, taking medicine in larger doses or more frequently than prescribed, mixing them with other drugs.

Sometimes a medication may be safe when used alone but is potentially lethal when used in combination with another drug, like alcohol.

Drinking and drugs

One of the most common-and serious-mistakes people make is drinking alcoholic beverages when taking medicine. Alcohol is a depressant. It increases the effects of some drugs to a degree much greater than if either drug were taken alone. It can also lead to fatal overdoses when used with other depressants such as tranquilizers and barbiturates.

Frequently abused drugs

Any drug can be misused, but there are certain "drugs of choice" for individuals prone to drug abuse:


Ritalin, amphetamines, amyl nitrate


Xanax, Valium, Librium, Halcion, Miltown


Dilaudid, Codeine, Methadone

Some of these drugs are sold illegally, and sometimes a mixture of over-the-counter medicines (like the decongestant pseudoephedrine, caffeine tablets, cough syrup, antihistamines) imitate the effects of prescription drugs.

So how do you keep medicines from becoming a problem? Should you stop taking medicines altogether?

Of course not. Careful use and knowledge of the medicines prescribed to you should prevent mishaps. Here are some suggestions you might follow for safer use of prescription drugs:

Prevention tips

Take exactly the amount of drug prescribed by your doctor and follow the dosage schedule as closely as possible. If you have trouble or questions, call your doctor or pharmacist.

Never take drugs prescribed for a friend or relative, even though your symptoms may be the same. Medicines do not produce the same effects in all people.

Always tell your doctor about problems you have had with drugs such as rashes, indigestion, dizziness or lack of appetite. When your doctor prescribes a new drug, be sure to mention all the other medicines you are currently taking, including those prescribed by another doctor and those you buy without a prescription.

Keep a daily record of the drugs you take, especially if your treatment schedule is complicated or you are taking more than one drug at a time.

Discard old medicines. Many drugs lose their effectiveness over time.

Always call your doctor promptly if you notice unusual reactions.

When you start taking a new drug, ask your doctor or pharmacist about side effects that may occur, about special rules for storage and about foods or beverages, if any, to avoid.

Information is constantly updated about prescription drugs and their effects. You should occasionally review with your doctor the need for each medicine you take.

In addition, the National Council on Patient Information recommends that you ask these questions every time you are prescribed a medication:

What is the name of the medication?

What is it supposed to do?

Are there any potential side effects? What should I do if they occur?

Are there any foods or beverages I should avoid while taking the medication?

Is there any literature available?


Fibromyalgia & Sleep



For many people with fibromyalgia, sleep offers no escape from the painful symptoms they experience during the day. Fibromyalgia is a chronic condition characterized by fatigue, musculoskeletal aches and disordered sleep. Many people with fibromyalgia experience a type of sleep disturbance called alpha delta sleep disorder.

When a person is awake and resting, "alpha" brain waves are emitted at a frequency of 8 to 13 per second. When a person is in deep sleep, "delta" brain waves are emitted at a rate of less than 3.5 per second. People with alpha delta sleep disorder experience a disruption in these patterns. When they reach deep sleep, the phase in which muscles are repaired, alpha waves intrude and jolt them back to lighter sleep. They don't obtain enough deep sleep, and their body is not adequately refreshed. This condition aggravates fibromyalgia symptoms.

People with fibromyalgia can take steps to improve their sleeping patterns. Here are answers to frequently asked questions about fibromyalgia and sleep:

Q: How does insufficient sleep affect fibromyalgia symptoms?

A: Lack of sleep accentuates the fatigue that most people with fibromyalgia experience. Musculoskeletal pain is also worsened by poor sleep. Most people who don't sleep well have muscle aches, regardless of the cause of their sleep disturbance.

Because people with fibromyalgia achieve only light, non-restorative sleep, their body never fully relaxes. In addition, they often toss and turn all night, which keeps the muscles tensed and active. People with normal sleep patterns typically awaken feeling refreshed. But people with fibromyalgia may be in significant pain when they get out of bed in the morning.

Q: What behavioural changes can be made to improve sleep quality?

A: There are a number of behaviour modifications that can help people attain more normal sleep patterns. It's helpful to go to bed and wake up at the same time each day to set the body's sleep clock, so your body 'expects' to sleep during those hours. Your bed should be used only as a place to sleep, so your body learns to sleep when it's there. Don't use your bed for other activities like eating, reading, paying bills or watching television.

When you can't sleep, get up and go into another room to read or do something else relaxing. When you begin to feel sleepy, go back to bed and try again. You may need to repeat this pattern several times during the night.

Getting regular exercise during the day or early evening promotes better sleep. Be sure to complete exercise several hours before bedtime. It's also best to avoid caffeine and alcohol within 6 hours of bedtime.


Napping during the day may not be helpful and can even worsen nighttime sleep. If you do take naps, keep them to 30 minutes or less. Try skipping a nap one day to see whether that improves your nighttime sleep.

Work out so you can sack out! - New study documents a relationship

Q: What prescription medications are used to help people with fibromyalgia sleep better?

A: Prescription medications may be tried if behaviour modifications don't improve sleep patterns. Tricyclic antidepressants are the most commonly prescribed drugs to improve sleep in people with fibromyalgia. When these drugs prove helpful, they are frequently recommended for long-term use.

For details from the drug database, see:

Tricyclic antidepressants

Prescription sleeping pills may provide short-term benefits for some people with fibromyalgia, but long-term use of these drugs is usually not advised. These medications tend to work for only a short time, after which the body becomes resistant to their effects. They are also very addictive. Ultimately, the use of sleeping pills tends to create even more sleeping problems in people with fibromyalgia.

Q: Can over-the-counter drugs and herbal medications improve sleep in people with fibromyalgia?

A: Some people with fibromyalgia experience moderate benefits from over-the-counter (OTC) sleep-promoting drugs, many of which can be found combined with acetaminophen for pain relief. It is very important to follow the directions on the label. These drugs should never be used in combination with alcohol or with other sedatives. Older people generally have slower metabolisms, so OTC drugs may stay in their systems longer and cause daytime sleepiness.

Approach herbal sleep agents, like valerian root and melatonin, with caution. The U.S. Food and Drug Administration doesn't regulate these herbal substances, so there is little reliable research available about their safety, side effects and interaction with drugs.

Always tell your doctor if you use any OTC drugs or herbal agents.




2000 Mayo Foundation for Medical Education and Research. All rights reserved.

Joint & Soft Tissue Corticosteroid Injections

Joint and Soft Tissue Corticosteroid Injections

Sometimes a doctor may recommend a steroid injection for the arthritis or soft tissue problem. This is a way of settling local inflammation while minimising the side effects to your who system.

When Is An Injection Useful?

Steroid injections are used when one or more joints are badly inflamed. Sometimes your doctor will ask you to wait to see if it will settle with rest and / or medication, so that the injection can be avoided where possible. In the case of inflamed joints, there is often lasting relief of pain, stiffness and swelling for up to 6 months. When there is not a precise diagnosis, a sample of fluid may be taken. Unfortunately, it is not usually helpful for osteoarthritis or when the joint is too badly damage.

It is also useful for many other conditions where the tissues around joints and tendons are inflamed. These conditions include frozen shoulder, tendinitis,bursitis, tennis elbow, and plantar fascitis. In many of these cases the effect is less dramatic, but you should usually get some pain relief to help you exercise the affected area.

How Will It Be Given?

Many patients are worried about the injections being painful. The thought of pain is usually worse than it really is, and to minimize the pain a local anaesthetic (‘freezing agent’)is used.

What Are The Side Effects?

The usual side effects of steroids such as weight gain are not usually a problem, as most of the steroid remains in the small area into which it is injected. Steroid injections just under the skin can cause a thinning of the tissue with a loss of pigment-rather like a tiny scar. If you are particularly worried about the cosmetic effect of this please discuss your concern before the procedure. A rare complication is "allergy" to the steroid preparation-the appearance of a rash or a dramatic change of mood after the injection may be a clue to this. Some people get a ‘crystal arthritis’ after the injection, where the joint becomes quite sore and warm over the first 24-48 hours after the injection. This is rare, and settles with simple painkillers and rest. Finally, very rarely (one in 20,000) the joint may get infected. To prevent this from happening we take sterile precautions and may put off the injection if there is evidence of infection elsewhere. The number of times a joint may be injected is controversial, but there is no evidence that up to 8 injections in large joints are harmful to the joint. We usually restrict the number of injections into a joint within a year to three.

What Should I Do After The Injection?

The area injected may become more painful over the first 24 hours after the local anaesthetic wears off. Applying a cold compress or taking simple painkillers may help if the pain is troublesome. If the pain becomes more severe after this, or is accompanied by fever or shivering, you should contact your doctor without delay. The effect of the steroid usually begins to work within 48 hours, but it may take 2 weeks for the full benefit to be realized. It is usually helpful to rest the joint for 24-48 hours after the injection. This is especially important for weight bearing joints such as the knee. If the injection was for a soft tissue injury you should avoid activities that aggravated the pain in the past. Contact your GP or where you had the injection immediately if you find that the joint has become red, warm and painful in the days following the injection.

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease

(Hiatal Hernia and Heartburn)


Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES) - the muscle connecting the esophagus with the stomach. Many people, including pregnant women, suffer from heartburn oracid indigestion caused by GERD. Doctors believe that some people suffer from GERD due to a condition called hiatal hernia. In most cases, heartburn can be relieved through diet and lifestyle changes; however, some people may require medication or surgery.

What Is Gastroesophageal Reflux?

Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.

In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the lower esophageal sphincter (LES) is weak or relaxes inappropriately allowing the stomach's contents to flow up into the esophagus.

The severity of GERD depends on lower esophageal sphincter (LES) dysfunction as well as the type and amount of fluid brought up from the stomach and the neutralizing effect of saliva.

What Is the Role of Hiatal Hernia?

Some doctors believe a hiatal hernia may weaken the lower esophageal sphincter (LES) and cause reflux. Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (diaphragmatic hiatus). The diaphragm is the muscle separating the stomach from the chest.

Recent studies show that the opening in the diaphragm acts as an additional sphincter around the lower end of the esophagus. Studies also show that hiatal hernia results in retention of acid and other contents above this opening. These substances can reflux easily into the esophagus.

Coughing, vomiting, straining, or sudden physical exertion can cause increased pressure in the abdomen resulting in hiatal hernia. Obesity and pregnancy also contribute to this condition. Many otherwise healthy people age 50 and over have a small hiatal hernia. Although considered a condition of middle age, hiatal hernias affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated (twisted in a way that cuts off blood supply, i.e., paraesophageal hernia) or is complicated by severe GERD or esophagitis (inflammation of the esophagus). The doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.

What Other Factors Contribute to GERD? Dietary and lifestyle choices may contribute to GERD. Certain foods and beverages, including chocolate,peppermint, fried or fatty foods, coffee, or alcoholic beverages, may weaken the lower esophageal sphincter (LES) causing reflux and heartburn. Studies show that cigarette smoking relaxes the lower esophageal sphincter (LES). Obesity and pregnancy can also cause GERD.

What Does Heartburn Feel Like?

Heartburn, also called acid indigestion, is the most common symptom of GERD and usually feels like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Many people say it feels like food is coming back into the mouth leaving an acid or bitter taste.

The burning, pressure, or pain of heartburn can last as long as 2 hours and is often worse after eating. Lying down or bending over can also result in heartburn. Many people obtain relief by standing upright or by taking an antacid that clears acid out of the esophagus.

Heartburn pain can be mistaken for the pain associated with heart disease or a heart attack, but there are differences. Exercise may aggravate pain resulting from heart disease, and rest may relieve the pain. Heartburn pain is less likely to be associated with physical activity.

How Common Is Heartburn?

More than 60 million American adults experience GERD and heartburn at least once a month, and about 25 million adults suffer daily from heartburn.Twenty-five percent of pregnant women experience daily heartburn, and more than 50 percent have occasional distress. Recent studies show that GERD in infants and children is more common than previously recognized and may produce recurrent vomiting, coughing and other respiratory problems, or failure to thrive.

What Is The Treatment for GERD?

Doctors recommend lifestyle and dietary changes for most people with GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials.

Avoiding foods and beverages that can weaken the lower esophageal sphincter (LES) is recommended. These foods include chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products, and pepper, should also be avoided.

Decreasing the size of portions at mealtime may also help control symptoms.Eating meals at least 2 to 3 hours before bedtime may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially. In addition, being overweight often worsens symptoms. Many overweight people find relief when they lose weight.

Cigarette smoking weakens the lower esophageal sphincter (LES). Therefore, stopping smoking is important to reduce GERD symptoms.

Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus.

Antacids taken regularly can neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief. An antacid combined with a foaming agent such as alginic acid helps some people. These compounds are believed to form a foam barrier on top of the stomach that prevents acid reflux from reocurring.

Long-term use of antacids, however, can result in side effects, including diarrhea, altered calcium metabolism (a change in the way the body breaks down and uses calcium), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than 3 weeks, a doctor should be consulted.

For chronic reflux and heartburn, the doctor may prescribe medications to reduce acid in the stomach. These medicines include H2 blockers, which inhibit acid secretion in the stomach. Currently, four H2 blockers are available: cimetidine, famotidine, nizatidine, and ranitidine. Another type of drug, the proton pump (or acid pump) inhibitor omeprazole inhibits an enzyme (a protein in the acid-producing cells of the stomach) necessary for acid secretion. The acid pump inhibitor lansoprazole is a newer treatment for GERD.

Other approaches to therapy will increase the strength of the lower esophageal sphincter (LES) and quicken emptying of stomach contents with motility drugs that act on the upper gastrointestinal (GI) tract. These drugs include cisapride, bethanechol, and metoclopramide.


Tips To Control Heartburn

Avoid foods and beverages that affect lower esophageal sphincter (LES) pressure or irritate the esophagus lining, including fried and fatty foods, peppermint, chocolate, alcohol, coffee, citrus fruit and juices, and tomato products.

Lose weight if overweight.

Stop smoking.

Elevate the head of the bed 6 inches.

Avoid lying down 2 to 3 hours after eating.

Take an antacid.

What If Symptoms Persist?

People with severe, chronic esophageal reflux or with symptoms not relieved by the treatment described above may need more complete diagnostic evaluation. Doctors use a variety of tests and procedures to examine a patient with chronic heartburn.

An upper GI series may be performed during the early phase of testing. This test is a special x-ray that shows the esophagus, stomach, and duodenum (the upper part of the small intestine). While an upper GI series provides limited information about possible reflux, it is used to rule out other diagnoses, such as peptic ulcers.

Endoscopy is an important procedure for individuals with chronic GERD. By placing a small lighted tube with a tiny video camera on the end (endoscope) into the esophagus, the doctor may see inflammation or irritation of the tissue lining the esophagus (esophagitis). If the findings of the endoscopy are abnormal or questionable, biopsy (removing a small sample of tissue) from the lining of the esophagus may be helpful.

The Bernstein test (dripping a mild acid through a tube placed in the mid-esophagus) is often performed as part of a complete evaluation. This test attempts to confirm that the symptoms result from acid in the esophagus.

Esophageal manometric studies-pressure measurements of the esophagus-occasionally help identify critically low pressure in the lower esophageal sphincter (LES) or abnormalities in esophageal muscle contraction.

For patients in whom diagnosis is difficult, doctors may measure the acid levels inside the esophagus through pH testing. Testing pH monitors the acidity level of the esophagus and symptoms during meals, activity, and sleep. Newer techniques of long-term pH monitoring are improving diagnostic capability in this area.

Does GERD Require Surgery?

A small number of people with GERD may need surgery because of severe reflux and poor response to medical treatment. Fundoplication is a surgical procedure that increases pressure in the lower esophagus. However, surgery should not be considered until all other measures have been tried.


What Are the Complications of Long-Term GERD?

Sometimes GERD results in serious complications. Esophagitis can occur as a result of too much stomach acid in the esophagus. Esophagitis may cause esophageal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur from chronic scarring. Some people develop a condition known as Barrett's esophagus, which is severe damage to the skin-like lining of the esophagus. Doctors believe this condition may be a precursor to esophageal cancer.

Conclusion: Although GERD can limit daily activities and productivity, it is rarely life-threatening. With an understanding of the causes and proper treatment most people will find relief.