Questions & Answers

Menu Medicine: Oranges May Slash Stroke Risk in Women


You know the old saying, “an apple a day keeps the doctor away…”  New research shows oranges can be powerful too.


Studies have shown that high vitamin C intake and high intake of fruits and vegetables was linked to lower risk of stroke. Now new research shows that flavanones, a sub-type of flavonoid antioxidants found in oranges and other citrus fruits, also plays a role.


Women who consume high amounts of flavanones were 19 percent less likely to suffer ischemic stroke (the type caused by a blood clot) than women who consumed the lowest levels of flavanones, a new study reports.


Lead author Aedin Cassidy, PhD, professor of nutrition at the University of East Anglia’s Norwich Medical School in Norwich (England, in the United Kingdom), explained in a news release that “flavonoids are thought to provide some of that protection through several mechanisms, including improved blood vessel function and an anti-inflammatory effect."


The researchers on Cassidy’s team analyzed data collected from the more than 69,000 nurses in the USA who provided their diet and health information for the Nurse’s Health Study. Oranges accounted for 82 percent of flavanone intake, and grapefruit accounted for 14 percent.


Does that mean women at risk of ischemic stroke should drink more orange juice or eat more oranges?  That’s not clear yet.


As is often the case that note a connection between a certain type of food and a health problem, more studies will have to be done before we know for sure or make recommendations or tell women at risk of ischemic stroke they should make sure their diets include oranges or orange juice, or tell them how much OJ or oranges to consume and how often.


The same applies to those who prefer grapefruit – but be sure to check with your doctor before you increase the amount of grapefruit or grapefruit juice you consume because, despite its other benefits, grapefruit can interact with some medicines. (See our explanation in a previous Q & A column.)


See American Stroke Association website for resources and more information about stroke.


Want to read the study? See: Dietary Flavonoids and Risk of Stroke in Women, published online before print February 23, 2012 in the journal Stroke.



© 2012, all rights reserved

What Makes an Alternative Medicine Source Credible (or Not)?


The wonderful thing about having access to information on the Internet is that everything you want to know or could ever want to know is “out there” somewhere. It may be easy or hard to find, depending on how obscure it is and how well you use search tools, but odds are the answer is there, somewhere.


And the not-so-wonderful thing about it is that everything is out there, whether it’s valid or false, useful or frivolous, sincere or scam. Sometimes it’s easy to brush off the baloney, weed out the wacko, and spot the scams. But not always.


That’s why it’s important to think about what signs to look for before you believe (or buy) what you find online.  Conventional health and medicine websites may display the HON (short for Health On the Net) Code  symbol, which tells you the site has gone through a fairly stringent vetting process and passed. I can’t recall seeing the HON Code on an AltMed site but if I found it on one, I’d consider that site trustworthy.


But even without such a clear cue, other signs can tip the balance toward or away from credibility. Here are a few of my “red flags.”

  • Too much hype. Enthusiasm is fine but when an email or post or website that raves too enthusiastically about how wonderful a supplement or treatment or product, it casts a big shadow of doubt. If the item – whatever it may be – is really THAT fantastic, why do you have to push it so fervently? Can’t it stand on its own merits?  If facts and evidence show it really does what the hype claims, that goes a lot further to convince me than shouting and touting it with slick sales spiels.


  • Selling. It’s disappointing to discover an otherwise promising report about a supplement, product or device, book or treatment is really just fancy packaging for a sales pitch. If the person or group that created that report weren’t selling the item, would they still praise it so highly? 


  • Secrets “they” don’t want you to know. If this really is true, how did this report manage to sneak past the mysterious “They” who don’t want us to know about it?  And how did the author of this article or email or web page get past “them” to discover this “secret” information? To me, that “secret” tag means “be skeptical.”


What are your red flags? What tells you that you can trust what you’re reading? Please share your comments and we’ll revisit this topic in the future.



© 2012, all rights reserved

Omega 3 – Friend or Foe

Today’s plan was to focus on a different topic. But after seeing several email and online chat comments about omega-3 fatty acids, I’m shifting gears.

Too many intelligent, well read, supplement savvy people have misconceptions about omega 3 fatty acids or fish oils and need to know what to do to stay safe.

Overall, fish oils, which contain omega-3 fatty acids, are great. The American Heart Association (AHA) recommends fish oil, preferably from foods — at least two 3.5-ounce servings 6wice a week. Recommended fish include salmon, canned tuna, sardines, and others.

The AHA’s Fish 101 for tips on which fish to choose and how much omega-3 is in each. The site also provides information on how much mercury the listed fish contain so you can weight the balance between mercury (bad) and omega 3 (good) for fish you’re considering.


If you can’t do that – anyone who has priced salmon at the grocery store lately knows it’s a potential budget breaker – or you don’t like any of the fish they recommend, supplements are you next best choice. Check the info on omega-3 fatty acid supplements on the AHA’s Vitamin and Mineral Supplements.

The AHA site recommends omega 3 for high triglycerides (a type of blood fat that should not be high), tachycardia (rapid heart rate – more than 100 beats per minute), and other heart conditions.

As a friend says, “all good, right?”

Maybe. But there’s also a maybe hitch. They AHA doesn’t mention cautions and caveats.

If you recently upped your daily intake of omega 3 and you’re noticing any unusual problems that involve bleeding such as bruising more than normal or more easily than normal or subjunctival hemorrhage (a red blood spot in the white of the eye), check further or ask a qualified medical professional who knows you, knows your medical problems, knows what else you’re taking, and knows the risks and benefits of this supplement.

More to come…


© 2012, all rights reserved. 

Restocking Supplements

No news today – just a question and a thought or two to share…


The question:  

When it’s time to restock your supplement shelves, where do you shop?


And the thought or two:

I used to go to the health store, partly because it was such a charming place filled with knowledgeable people, but as other stores broadened their selection of quality supplements, it became easier and easier to buy from other places, at least for some items.


Now I order some things from online retailers (only from those who were recommended by trusted sources have outstanding reputations for honest and fair business practices) mainly for the price and convenience. Delivery is either free or cheap, and there’s no hassle about going out in bad weather, finding a parking space, or carrying things home. Even sells many popular supplements.


In fact, I find the only time I go to the health store these days is when I need something that I can’t get anywhere else.


But now, looking at the bigger picture, I have to wonder what will become of the brick-and-mortar stores if everybody did that.


And what about loyalty to the store that was there for me when I needed them?  


It would be interesting to see other views. Where you shop for supplements? What’s good and what’s not so good about it?  Do you feel any obligation to the “home” store?


Time for a poll? 


© 2012, all rights reserved

Q & A: Grapefruit vs. Medicine?



I’d like to know what the deal is with grapefruit. I’ve always heard you’re not supposed to eat grapefruit with this or that meds, so now it’s pretty much banned in our household. But I like grapefruit! Any light you can shed on this is much appreciated.

— Jane



Although grapefruit is a great fruit from a nutrition point of view, it can cause a problem with medicines because substances in grapefruit interfere with an enzyme that helps your body break down drugs.

Researchers suspect one part of grapefruit that’s causing this interference is naringin, a flavonoid that gives grapefruit its characteristic bitter or tart flavor. (There may be other enzyme-blockers in grapefruit, too.)

Normally, when you swallow a drug, enzymes in the small intestine metabolize, or break down, the drug. If that process is blocked by something like naringin, you could wind up with too much of that medicine in your body.

In Grapefruit and Drug Interactions: What you need to know (2009), Nate Krall from the University of Wisconsin explains there are three main pathways by which grapefruit can interact with medicines:

1.  It can interfere with the tools your body uses to break down medicine and cause metabolism of the drug to slow down which lets too much of the medicine accumulate in your body.

2. It can disrupt  the way your body controls how much of the medicine is eliminated in your intestines and let too much of the medicine get into your bloodstream.

3. Or it can do the opposite – instead of causing too much medicine to build up in your body, it can interfere with a protein in your intestines that your body needs to be able to use the drug effectively. That means you wind up with too little of the medicine in your bloodstream, as if you’d taken a lower dose or not taken it at all.

The tricky part, according to the UC Berkeley Wellness Letter (May 2009, page 3), is this:  “The interaction happens fast and can last 24 hours or longer. But it’s highly unpredictable, varying from person to person and even from grapefruit to grapefruit.” Other citrus fruits that may have similar effects include Seville oranges (that are tart like grapefruit), pomelos and tangelos, UCBWL says.


Drugs known to be affected by this enzyme-blocking action include statins (used to treat high cholesterol), calcium channel blockers (used to treat high blood pressure), some antidepressants, anti-seizure medicines, an immunosuppressant, a drug used to treat HIV, and a medicine to treat abnormal heart rhythm. (For a detailed list and medical recommendations, see Grapefruit juice: Can it cause drug interactions? from the

Best bet:  If in doubt, check with your doctor or pharmacist and be sure they understand you’re asking about the interaction of grapefruit and medicines you take.  And ask if other fruits may also interfere with the specific medicines you’re taking — some research suggests other fruit juices may have a similar effect.

Want to know more?

Here’s where to find additional information:

* New reasons to avoid grapefruit and other juices when taking certain drugs, 19 Aug 2008, American Chemical Society (news release),

* Grapefruit juice boosts drug’s anti-cancer effects, 20 Apr 2009, University of Chicago Medical Center (news release),

* Management of Grapefruit-Drug Interactions, August 15, 2006, American Family Physician

* Nutrition Journal, 2007 Oct. 30;6:33. Medicinal importance of grapefruit juice and its interactions with various drugs.  J. Kiani and S.Z. Imam.

© 2009, all rights reserved


Q & A: Ask Your AltMed Questions Here


Do you have questions about Alternative Medicine? 

What would you like to know? 

Here are 10 questions to start the ball rolling.  Please add your question and if you have a comment to add to someone else’s question, feel free to jump in (use the COMMENTS feature at the bottom of the screen).

1.  What can I take instead of the statin drugs my doctor prescribed to lower my cholesterol?

2.  What natural remedies work to relieve sore throat and runny nose?

3.  Is it safe to take herbs if I’m also taking prescription medicines? What about over-the-counter medications?

4.  Why shouldn’t I take my calcium supplement at the same time as my thyroid medicine or my multivitamin-mineral tablet?

5.  How soon can I expect to see improvement after I start taking a new alternative medicine treatment?

6.  What questions should I ask my doctor or other primary health care provider?

7.  Why do I have to tell my doctor about the supplements and other alternative medicine remedies I’m using?

8.  Do I need to keep a log or record of what I’m taking? If  I do, what should that log include? 

9.  Ugh, needles!  Does acupuncture hurt? 

10.  What’s a Neti pot?

Now, what would YOU like to know?


© 2009, all rights reserved