Is there a cure or celiac disease?

There is no cure for celiac disease. However, the disease can be managed by simply avoiding gluten in the diet. All products which contain wheat, rye, or barley must be avoided. For this treatment to work, one must start to become obsessive about reading food labels. Recent laws now make it mandatory for all food labels to clearly state if the food contains any of the top eight food allergens, including wheat. However, wheat free doesn't mean gluten free. Proposals are currently on the way which will require companies to identify other hidden components, such as barley and rye.

One should be aware that Gluten is also found in some candy, some meat products (cold cuts), soy sauce, vitamins, herbal supplements, over the counter and prescription medications. And although often overlooked, gluten is also found in communion wafers, lip balms, and Play Doh.

Today, many gluten free foods and medication are available for children. Still following such a regimental diet is not easy and one must regularly see a dietician to ensure that the child is getting a well balanced diet and yet keeping gluten out of his body.

How is the diagnosis of celiac disease made?

The diagnosis of celiac disease is made by simple blood tests. For those in whom the diagnosis still cannot be confirmed, a small bowel biopsy may be required. In some cases, a trial of gluten free diet may be done and if the symptoms resolve, then no further testing is necessary.

Zeltiq’s Cool Sculpting or is it a Cool Scam?

Thousands of men and women have been rushing to get the new Zeltiq’s Cool sculpting system to get rid of their localized fat pockets. The Zeltiq system is a novel approach to getting rid of love handles. The doctor applies a cup-shaped applicator to the area of fat and turns on the vacuum. The device is cooled for about 60 minuets and once the temperature is reached, your fat is magically gone. Like all things in plastic surgery, you do not see the results right away and most people need several sessions. The optimal results occur after 2-3 months. At least that is what is supposed to happen.
 

There is no anesthesia, no needles, no incision  but you must have a lot of money. So does Zeltiq’s cool sculpting system work? 

Anyone who believes that applying an ice pack to the skin leads to burning of fat must be either very gullible, very stupid or both. Of course, this is a scam. There are hundreds of reports on cyberspace about women who have undergone this treatment and discovered that Zeltiq does jack shit.

To make you more depressed, Zeltiq's cool sculpting costs a cool $700-$1000 per session and if you want to get rid of the fat around your belly and the back of your thighs, add another couple of thousand dollars.

If you have any common sense, avoid this scam. The only thing cool about Zeltiq is that you will have a sign over your forehead saying that you are a Cool Sucker.

Can ephedra be detected in the body?

Ephedra is widely used at all levels of sports. Beside professional athletes, the alkaloid is also used at the college levels and in high schools. However, do remember that many sporting agencies do check for ephedra and it is easily detectable in urine. So for those who take it, it must be understood that the alkaloid can be identified in the urine at least 7-10 days after the last dose.

Ephedra to boost exercise endurance

Do you think ephedra can help improve my exercise endurance?

To be honest, I am not sure. Ephedra is widely used by athletes. While there is no real proof that it does anything, athletes who take ephedra claim that it allows them to perform better and improves exercise endurance. For sporting activities which require sudden bursts of energy, there is evidence that ephedra can provide a boost. Weightlifters report that after taking ephedra, they are able to lift more weights. The other reason why ephedra is taken is because it is said to help one burn of body fat. 

Ephedra is a potent weight loss agent. When combined with caffeine and aspirin, it can cause weight loss of at least 2-3 pounds/month- all fat. Many studies have shown that in short term, this formulation is quite effective for weight loss. The only reason ephedra is not prescribed for weight loss is because of its adverse effects.

Is ephedra available?

Is ephedra is still available in North America?

Ephedra was once the most sold dietary supplement in North America. It was widely available and sold without a prescription. Over the years, it was observed by the FDA that the substance was associated with a fair number of complications including heart attacks and deaths. In 2004, FDA banned the sale of ephedra and ephedra containing products from most health food stores. Today, the sale of ephedra in the USA is illegal. Now that ephedra is gone, it has been replaced with bitter orange.

Diet for diabetes

Where can I get good advice about diet for my diabetes?

For those who can afford it, a consult with a decent nutritionist or a dietician may help. These professionals can help you with develop a well balanced diet and monitor your progress. However, there is a lot of free literature on how diabetics can manage their diet on cyberspace and there is absolutely no need to pay a dietician for some common sense advice.  The best website for good information on diabetes is the American Diabetes Association. Diabetes does not mean that one cannot enjoy food. In moderation, almost all types of food can be eaten by the diabetic.

How can I best manage my diabetes at home?

The best way to control diabetes is being smart and selecting foods which will keep not only the sugar down, but will also help to control weight gain and decrease cholesterol. This can be approached by changing to a diet with fewer calories and less fat- you can accomplish this by eating more fresh fruit, vegetables, sea food and legumes instead of daily steak and hamburgers.
One should try and eat a healthy diet which derives at least 20-20% daily calories from protein, 30% of less from fat and the rest from carbohydrates. 

One should become a label based shopper and check which foods are sugar and fat free. Some labels even mention which foods are good for the diabetic. Stop wasting money on consultation with dieticians because there is ample free information on cyberspace.

Diabetes and alcohol

How much alcohol can I drink? I am a type 2 diabetic

When it comes to alcohol, there is no rule on how much on should drink. Alcohol is known to lower sugar and so drink it with your meals. And do not go overboard. One should not treat the diabetes and at the same time require treatment for alcoholism. Do be aware that brandy and some liqueurs have very high sugar content. 

Because diabetes increases the risk of heart disease, one should make every attempt to control the cholesterol levels. Combination of cholesterol and diabetes is bad news. There are drugs to decrease cholesterol levels, but the first choice of therapy is exercise and this is highly recommended.

Is there any treatment for hair loss?

Do any of the products on the internet have the ability to grow hair?

There are thousands of products for hair cures all over the internet and touted by the pharmaceutical industry- but all of them lack any scientific evidence and are not worth a dime. You may as well drink a cow’s urine or yours- but hair once gone is hard to get back. The hair industry is a billion dollar business because men, it appears can’t live without two things- women and hair.

The majority of products that are recommended for reversing hair loss border mainly on quackery and junk science. Today, we have nothing that can bring back hair, there are no drugs, potions, lotions, spices – even praying fails to help. The best remedy for hair loss is hair transplantation or a wig. While not the first treatment of choice, there remain the only choice –good or bad!

Why does hair loss occur in men?

Why does hair loss occur?

Hair loss has been associated with many myths and folklore tales, all which are based on superstition and ignorance. Everything under the sun has been blamed for hair loss including excess shampooing, daily washing, type of shampoo, use of hair dryer, type of soap, use of towel, the hardness or softness of the water, the geographical area where one lives, ethnicity, eating herbs, pooping once a week, not cleaning the backside after poop and even excessive masturbation. In the majority of cases, the cause of hair loss is not known and is mainly due to bad genes and a lot of bad luck.

Losing hair-please help

I am 27 and am losing my hair. Can this hair ever grow back?
   
Estimates indicate that more than 80% of men will lose their hair at some point in their lives and balding will be an accepted part of daily life. Unfortunately, for the majority of men this is not a good option and the remedy to grow hair goes back to the time of Hippocrates. Hair loss has affected millions throughout the centuries and still today, we have no cure or treatment.

Most men suffer with hair loss, a few learn to live with it, others cry silently, some pray for a miracle, some cover up the head with a hat or a wig and the majority surf the web for the elusive cure for hair loss. Loss of confidence, depression and emotional stress are common features in males who undergo premature hair loss. There is nothing positive about hair loss (except perhaps having a very small penis).

The hair you have lost will never ever come back. Unfortunately, despite all the advances in medicine, no one has been able to figure out a remedy for hair growth

We are a long ways from a drug that will grow hair. We can send men to the moon and have the technology to look at the heavens millions of years away from us (unless NASA is lying about that too), but we still do not have a cure for hair loss. Of course, there are medications, lotions, potions, herbs and nutrients, but none of them work- at least not one will ever get back the hair that is lost. A strand of a new hair growing here and there (usually around the arse) is the best what these medications will do.

Creams to remove tattoos

Can tattoos be removed with creams?

Tattoo removal has become a billion dollar business and topical creams have been postulated to remove tattoos. Tattoo removal creams have been around for decades with all sorts of claims of success. Some creams have names like TatBgone and Tattoo off are widely available. Just like weight loss products, the claims are typically made by the manufacturer that these wonder creams can remove not only tattoos but also acne and skin wrinkles. Everyday on the Internet there is a new tattoo removal cream.
  
There is absolutely no scientific evidence that any such cream works. The FDA and numerous other scientific organizations have made repeated assertions that tattoo removal creams have no credible benefit. One has to be aware that many of these chemicals have unknown ingredients and numerous individuals have complained of severe skin rashes, blisters and pain upon applying these creams.



How much do these creams cost

These creams are not cheap. They vary in price and may cost anywhere from $50-100 for a small jar. It is recommended that these creams be bought every month and be applied for 3-12 months. The manufacturer usually advertise silly sales schemes, buy two and get one for free for the price of one. Many people have tons of these jars at home.

What can these creams do?

At best, these creams function as skin bleaching or camouflage agents. They may fade the tattoo and surrounding skin for a few weeks, but the tattoo never disappears—just the money in your pocket. In fact recent investigations have revealed that the more expensive the cream the less likely was it going to do anything except function as a skin moisturizer.

Creams to remove tattoos

Are there any creams to remove tattoos?

Tattoos have never been more popular than today. Millions of individuals are getting tattoos placed on spontaneous whims, only to regret it later. Tattoo insertion is relatively easy but having it removal is a lot harder. Over the years, tattoo removal parlors have flourished all over America. Numerous cosmetic surgeons claim that tattoo removal is big business. Many tattoo removal methods are available today and include excision of the tattoo, chemical peels, lasers, dermabrasion, intense pulsed light and topical creams.

Incisional hernia

I have been told I have an incisional hernia. Do I need surgery to fix it?

Unfortunately, yes. These hernias can turn serious anytime. Bowel can get trapped and make life hell. So best advice is seek a good surgeon and see if he/she can fix it via a laparoscope. The procedure will require time off. In the mean time, lose weight, avoid straining  and remain active.

Blisters that itch

Recently I developed small blisters on my hand that are extremely itchy. Is this an infection?

Most likely, you have developed a condition called pompholyx or dyshidrotic eczema. It is a rare disorder that presents with itchy blisters on the hand and feet. The treatment is easy- just use any  topical corticosteroid and that will take care of the itching. You may apply a  cool compress to relieve the itch also. There are some other fancy treatments if the steroids do not work like immunosuppressants. However, try an over the counter topical steroid for a few days and if that does not work, see a skin doctor. The average GP will not have a clue what you have.

Antidepressants and loss of libido

I am on sertraline and have lost my ability to have an erection. Is this related to the drug?

Yes, all antidepressants will decrease your libido and ability to have an erection. The only way to avoid the loss of libido is to take the lowest dose of the drug, but in many cases, even this does not work. Some doctors prescribe Viagra to help depressed people regain their libido. I am sorry to tell you that change to a different antidepressant will not help restore your libido-it is a universal adverse effect of many drugs acting on the brain.

Sclerotherapy for Spider veins

Is sclerotherapy for spider veins painful?

Yes, it involves use of a small needle. Each time the needle is inserted it hurts. A chemical is used to destroy the spider veins. Most women can only take 10-15 injections at a time because of the pain. If you want to know how it feels, take a needle and prick yourself and that is the same feeling you get during the procedure.  In addition, if the procedure is being done by a GP who knows nothing about spider veins, the injected material can leak out of the vein and cause permanent scarring of your leg. I do not recommend this procedure because not only is it expensive and painful, the results are not great. Your leg will be bruised for many weeks. 

Try laser- the results are better and it is less painful. It is expensive though. There is no cure for spider veins, so I suggest you wear compressions stockings if you do not want them to recur.

Treatment for dystonia

Can you tell me what is dystonia? I have been diagnosed with this disorder and am 33 years old.

Dystonia is a very rare disorder where you have muscle contractions or repetitive or twisting movements. This often occurs in the neck, eyes lids, hands but can affect any part of the body. The condition can be disabling and affect the quality of life. Unfortunately, dystonia can be difficult to treat. There are several medication used to relieve the muscle movement, but often they do not work. In addition, the meds have numerous unpleasant side effects. Botox has been tried and does work. However, the benefits of Botox are short lived (3-6 weeks) and you need repeat injections, which adds to the cost.

There is no curative surgery for dystonia but recently some surgeons have been implanting electrodes in the brain to stop the nerve signals and inhibit dystonia. The surgery is experimental, expensive and has many complications. Try Botox and if it works, you will have temporary relief.

Stopping my statin

I am a 55 year old and am taking a statin for my cholesterol. Can I stop taking this pill?

Well, it depends on many facts. Statins, I believe are heavily prescribed for many patients who do not need them. If you are not obese, do not have high blood pressure and your cholesterol is well controlled, you do not need to take a statin.  Statins are expensive and you have to take them for life. I usually tell my patients to  change their diet, exercise and control  their weight. If this works, there is no need for statins. 

In your case, stop the pill, change your diet, exercise regularly and get your cholesterol measured in 4-6 weeks- if it is on the low side, dump the pill.

Cervical spondylosis treatment

Can you tell me what is the best treatment for neck stiffness? I have been told I have cervical spondylosis

Cervical spondylosis is essentially a disorder that results from the general wear and tear of the neck joints. It is very common. The initial treatment is always non-surgery. That includes use of pain pills, steroid injections and physical therapy. I should warn you that even though surgery is done very often for this disorder, the results are horrendous. While these orthopods can fix the neck joint, they almost always damage the important nerves which run from your neck into the arms. I do not recommend surgery, as the results are horrible. Some of these surgeons who operate on the neck do not know the mouth from the anus. They have poor surgical skills, lack the anatomical knowledge and will mess you up. The complications from neck surgery are usually permanent. 

Please speak to another patient who has had neck surgery before you undertake this hazardous procedure. Best advice- try neck exercises and you will live a life without hassles. However, remember if you have severe nerve compression, physical therapy can make the condition worse. So only do exercises that make you feel better. 

As far as surgery is concerned, I do not recommend it, unless you have severe stenosis of the spine with nerve impingement. The biggest problem is finding a good surgeon as most are hopeless (I know this as I often get to review malpractice cases).

Treatment for achalasia

I am a 33-year-old female who has been diagnosed with achalasia. My doctor says I should go for surgery. What do you recommend?
 

Achalasia is a rare disorder that presents with difficulty swallowing solids and liquids. The condition is progressive and can be debilitating. There are some medications to relax the esophagus, but they often do not work. You have two good choices. Try out Botox- If it works, you will have relief for a few weeks but will need many more repeat treatments (can get to be expensive). The other option is endoscopic balloon dilation. This can be done as an outpatient and the relief is immediate. Surgery is a great option but is a last option. Go with balloon dilation and I think you will be impressed with the results. 

Even if you decide on surgery, seek a good thoracic surgeon. Ask for their experience with myotomy (muscle splitting surgery). Most North American surgeons have never ever seen this disorder.

Blood thinners

I am on warfarin and need to get my INR measured every month. Is there any other medication I can take that does not require all this blood work? This is getting to be expensive.

Yes, there are some newer blood thinning medications which do not require frequent blood work. Please ask your doctor for dabigatran (Pradaxa). However, I should warn you that almost all the newer blood thinners are prohibitively expensive. While you may not need frequent blood tests, the cost of these pills is significant. My advice is stick to warfarin as it has been around for more than 70 years, works well, and is cheap. The monthly blood test is not fun, but it is still cheaper then the newer blood thinners. 

You have to understand that the pharmaceutical industry and some doctors are in the business to make money.

Wrist replacement

I hurt my left wrist some years ago, and received several steroid injections. The surgeon now recommends a wrist replacement. Does this surgery work?

In general, pinning of single bone fracture does work, but major wrist replacement surgery is a complete failure. I think you should give it a serious thought are extremely poor. If you have a fractured wrist bone or a bone that has not healed, that is fine but anything other than that has yielded bad results. Wrist replacements have never worked well and most people are in severe pain with a stiff wrist. Please do not go for this surgery until you have spoken to another patient who has had wrist replacement surgery. Do not speak to another surgeon, as he/she is most likely to brag about their results.

Diabetic with heart disease

I am a diabetic and have been told I have 2-vessel disease in my coronary arteries. The surgeon wants to operate on me. Any suggestions?

Yes, do not go to the surgeon. It does not matter what the data show, the first thing to determine is if the blocked vessels can be opened by angioplasty. There are some excellent cardiologists around and they can probably stent your blood vessels. So, avoid surgery until you get a second opinion. If stenting fails, you can always go for surgery.

Angioplasty is not only cheaper, but also far safer than open-heart surgery. If you see some of the heart surgeons operate, you will quickly realize that angioplasty is always the first choice of treatment. I should mention that most data now show that angioplasty works well in most diabetics. So, screw your surgeon and do what is right for you. good luck

Sexpo

What exactly is Sexpo?

Sexpo is an erotic Australian exhibition, which focuses on displaying all aspects of health, adult lifestyle and sexuality. The show is only open to adults over the age of 18 and is run by club X. Sexpo is run in many cities across the globe including Toronto, Perth, Hong Kong, Melbourne, etc.

The Sexpo exhibition first started in Australia and the sexy theme quickly brought fame to the company. Initially Sexpo exhibitions were limited to a few Australian cities but soon there was demand from an international market. The 2008 event was held in Durban and almost immediately, Sexpo was a worldwide phenomenon. The exhibition is different from pornography and tries to embrace sexuality in its natural state. Of course, the young men and women who pose at Sexpo are extremely good looking, sexy, appear erotic and wear seductive skimpy clothing. Sexpo organizers claim that they would like to promote sexual behaviors in its natural state through education, workshop and shows like theirs.

Sexpo shows offer sexual entertainment of the highest caliber. Besides sexy lingerie and sexual toys (which can be bought); one can even experience wine tasting and get to mingle with the sexy women and men. There are also “naughty workshops” for those who want to spice up their sex life.
There are Sexpo websites from where one get more details on upcoming exhibitions.

Treatment for panic attacks

Sometimes I develop severe panic attacks when I am in a new environment. Is there is treatment for this disorder?

Yes, you may have a condition called agoraphobia. This condition does respond to a number of SSRIs (newer antidepressants). Some patients may benefit from a combination of an SSRI and a benzodiazepine. The problem with benzodiazepines is that you may develop tolerance and physical dependence after prolonged use. You may need to take these medications for 3-4 months and then slowly taper them to the lowest dose. In most cases, treatment is required for long periods.

Diet for panic attacks

Is there  a diet to prevent panic attacks?

There is no formal diet to prevent panic attacks but I would recommend that you not drink too much caffeine containing beverages. In addition, you need to know that many herbal products  contain ephedrine and have other unknown stimulants. So best advice- avoid unknown dietary and herbal supplements and cola beverages.

Borderline personality

What exactly is borderline personality disorder?

This is a very difficult question to explain but once you have come across a person with this disorder, you will not forget it. There are many people with this diagnosis. 

In BPD, patients have marked volatility in their daily functioning. They have fluctuating mood and affect, volatile interpersonal relationships, and sometimes are not even aware of reality. The disorder is often associated with depression, drug abuse, impulsive behavior, psychosis and self-harm. 

The majority of patients with BPD are known to commits acts of self-harm and have a very high rate of suicide. They bring misery not only to themselves but also to everyone around them. There is no cure and these people are not compliant with medications. They are often arrested for committing acts of violence and are almost always in trouble with the law.

Birth control pills for Hot flashes

Can oral contraceptives be prescribed for postmenopausal symptoms?

Officially, these drugs have not been approved by the FDA for postmenopausal symptoms. Doctors do prescribe them, but only for short periods. You should know that there is a real risk of cancer if these hormones are taken for prolonged periods after menopause. In addition, the oral contraceptives can also cause blood clots. Therefore, use caution. if your doctor gives these pills to you for long periods and you develop complications, you should sue.

Calorie consumption in a female

How many calories should a 140 pound female aged 28 ingest daily?

There are many formulas to calculate calorie intake. In general, females need anywhere from 1,200-1,600  calories/day and males need 1,800-2,200 calories/day. To maintain good nutrition, you should consume about 60% carbohydrate, 20% protein and 20% fat. These numbers can vary by 5% either way. Try and eat fruits, vegetables, low fat dairy products and whole grains. The diet should be flexible so that you enjoy what you eat. Do not make silly rules on what you should eat and when- the most important thing to know is that you need to incorporate exercise as part of your routine-otherwise you will become fat.

Low Carb Diet

What exactly is a low carb diet?

In simple a low carb diet is just eating starchy vegetables, grains and fruit. There are many low carb diets and each has its own restrictions and peculiarities. There is a belief that if you eat a low carb diet, you can lose weight. 

Low carb diets are recommended for patients with heart disease, diabetes and metabolic syndrome. The problem with low carb diets is that you quickly feel hungry and the diet is difficult to sustain. Low carb diets can also deprive you of strength, cause headaches, weakness and dizziness (usually due to low sugar). My advice is eat any diet you want as long as you incorporate exercise. 

Even if you eat a low carb diet but do not exercise, you will gain weight.

Stapling ears for weight loss

I have heard that stapling of ears can help people lose weight. Is this true?

Are you f..ing crazy or what? That is a bunch of crap. You can only lose weight if you staple your mouth shut. Stop reading BS on the internet. If you want to lose weight, eat less and walk more.

Fecal occult blood test

Should I buy the fecal occult blood test kit for home use?

No, it is a bunch of crap. The test has been around for 50 years and it measures trace amount of blood in your poop. It is very insensitive for detection of colon cancer. There is a belief that colon cancer slowly bleeds and this blood can be identified in feces. However, there are other disorders which are more common than cancers that can cause bleeding in the stools-peptic ulcer disease is the most common. The fecal stool test is a complete waste of money. In addition, applying poop to a piece of paper with your finger and instilling a solution on it, is not exactly thrilling.

The test does not tell you where the bleeding is coming from and it can also be affected by certain foods (e.g. horse radish, broccoli, turnips, vitamin C and medications like aspirin). 

My best advice is if you are worried about a polyp, go and see a doctor. You only need one colonoscopy at the age of 50. If that is clear, I doubt you will need another one. Unfortunately, doctors have made colonoscopy a lucrative business by doing the procedure on anyone who walks into their office. So if your first colonoscopy is negative, change your diet and avoid the doctor. Any doctor who urges repeat colonoscopy every several years, is a con artist.

Glucose tolerance test

My doctor says I need a glucose challenge test to see if I  have diabetes. Do you think I need the test? I am a 54-year-old male with no medical problems

Change your doctor, he/she is a first rate fool. Glucose challenge test is rarely done today. The only reason I can think of is financial gain. It is sometimes done during pregnancy. If the doctor thinks you have diabetes, the better test is to measure the hemoglobin A1c. It is not only cheaper, but faster and the results are available in less than an hour. Stop going to see this bum. He is only interested in your money and not your health.

A1c test for diabetes

What is the A1c test for diabetes?

When you have high levels of blood sugars in the body for long periods, the sugar will attach its self to the hemoglobin. Now doctors can measure the amount of sugar bound to the hemoglobin. It gives an idea how long you have had high levels of glucose. When you have high levels of A1c, it means your blood sugars have not been well controlled and you are at risk for developing complications of diabetes. Levels of A1c are usually measured twice a year to monitor how your blood sugars are responding to treatment. 

There  is no workup prior to the test- just give some blood and within an hour you will have the result. In general, the A1c should be less than 6% in healthy people and in well-controlled diabetics, it may be between 6-7%. Higher than 7.5% is not good.

Married man and steamy e-mails

I am a married man and recently a single female at my work has been sending me steamy sexy e-mails. I am thrilled and very excited but am also nervous.  Any thoughts?

The evolution of the internet has led to relationships via e mails. First being married and getting involved with a single female is bad news. Nothing good ever comes out a relationship which deals with a single person and a married person. This relationship will ruin your marriage and you will also disappoint this female. If your marriage is not working great, then I can understand. But you should separate first before starting another relationship. Remember, steamy sexy e-mails bring false hopes and excitement- but this is only a transient phase.

I suggest you work on your marriage first before trying to get involved with a single female. Please do not respond to her e-mails-otherwise it will lead to heartbreak for both of you. I am baffled why married people love to cheat!. If you wanted a liberal lifestyle, you should not have gotten married in the first place.