Does High Fructose Corn Syrup Make You Socially Unacceptable?

Thirty years ago, few people knew about lactase enzyme deficiency.  Some knew that they developed diarrhea and gastrointestinal complaints if they drank milk or ate dairy products, but few knew that the normal state for humans is to be unable to digest lactose (milk sugar), and that a genetic mutation has allowed some people to drink milk without any lactose-related problems.

Just as some individuals may not be able to digest milk sugar because they lack a specific digestive enzyme, a few may have a rare condition, hereditary fructose intolerance, which leaves them unable to digest fructose, the sugar found in many fruits and in foods containing high fructose corn syrup as a sweetener.  This relatively rare condition is serious and can lead to severe metabolic complications.  A different, less serious,  medical condition is fructose malabsorption   "...in which the cells of the intestine cannot absorb fructose normally, leading to bloating, diarrhea or constipation, flatulence, and stomach pain. Fructose malabsorption is thought to affect approximately 40 percent of individuals in the Western hemisphere."

If you don't feel well when you consume those high-fructose drinks or snacks, it may not be your imagination. You might have a rare condition, hereditary fructose intolerance, or just be one of the 40% of our population who malabsorb fructose. The treatment is straight-forward: avoid high fructose foods.

If you are interested, see the National Institutes of Health publication,   The Genetics Home Reference  on hereditary fructose intolerance.  You might learn that those pains in your belly, that gas that embarasses you, and your other strange abdominal complaints are related to that ubiquitous high fructose corn syrup  sweetener, passed off as nutritionally benign, which might be causing you difficulty.

Read the food label. If you know that the ingredient listed doesn't agree with you, don't buy or eat the product. You will feel better and be more socially acceptable!

More About Cognition and Alzheimer's & Diet

Two articles of interest.

Fran Lowry, writing in Medscape Medical News, reports  Erin McGlade, Ph.D.'s  findings that women (40-60 years old) taking  250 mg. a day of citicoline, a nutritional substance experienced better cognition and possibly mitigation of the decline in thinking that we consider an age-associated finding. Dr. McGlade is associated with the University. of Utah Brain Institute in Salt Lake City.

In another Medscape Medical News report,  writer Megan Brooks reported on findings by Suzanne Craft, Ph.D. of the Veterans Affairs Puget Sound Health Care System, Seattle, WA. These findings point to a possible protective effect of the Mediterranean diet, not only on the cardiovascular system, but also on some biologic markers for Alzheimer's Disease.

There is increasing evidence for the important role of diet in brain and cardiovascular function. My readers might want to Google "Mediterranean Diet" and then use that information to guide their food intake. Preventing disease through a good-tasting healthy diet is more efficient and less expensive than dealing with vials of pills from your pharmacy plan. And, there's no copay or (literally) doughnut hole.

Will This Test For Early Alzheimers Explain Why Americans Have Forgotten?

If you are thinking - what does he mean, "Americans Have Forgotten" -go back a few years, to a previous presidential administration driven by an ideology justifying the exhaustion of America's financial resources so there would be no money left for social programs. That administration wasted America's financial resources (in two ways, [1] through endless budgetary deficits created by reckless spending - i.e. - a several trillion dollar war in Iraq - coupled with reduction of taxes for the wealthy  and [2] through deregulation of their political contribution supporting financial services industry leading to America's economic collapse and today's severe continuing recession). Now, its representatives who control the House of Representatives smugly  claim that the other party is fiscally irresponsible as the party's President struggles out of the swamp we inherited from them.

If business is unhappy with the cost of social services including those mandated by the Affordable Care Act, it should look at what the party which professes to be its best friend did.  Business has collapsed, employment has collapsed, the home building industry has collapsed and America is in a mess. Gee, wasn't that the exact consequence planned by the overseers of the ideology of destruction of our economy to complete their  ideologic triumph? Or did you forget that?

If you want to know why you forgot what that party and its ideology have done to you and your families, to our health care system, and to America, you might go ahead and get the Alzheimer's test described in the article, or even better, you might be more thoughtful about casting your vote in the next election. That party is  counting on you to forget again.

Think Of It This Way ....

When I arrived at the lab, in this large new clinic building decorated with spectacular art work, it was 6:35 AM. Many of the chairs were filled and those that were empty were soon occupied by people waiting to be called for their tests.  Six or seven people lined-up at the intermittently-staffed lab reception desk.

You might not recognize this as cost-shifting, but in my opinion, it is.  Clinic management has decided that it is more efficient, in terms of their needs, to keep 18 people waiting for more than a half-hour each, rather than bring in phlebotomists to draw blood and instruct patients on how tests are to be performed.  Those patients, waiting for their blood to be drawn and specimens to be taken, were not at work, were not earning wages, and had just used expensive cars and expensive gasoline so that they could sit and wait and wait and wait.

When government and insurance companies calculate the costs of care, rarely are patient transportation costs and lost opportunity costs (not being at work earning a living) added to the equation. Those dollars come out of the patients' pockets, not the government or insurers pockets.  The cost has been shifted and no-one seems to notice or care.

So think of this as a cost shift and as an uncounted tax that each of us pays.

Cancer Anyone?

I remember Frank, quite well.  He was the cadaver that I and three other medical students dissected in our first year anatomy class.  Frank reeked of formaldehyde, and I remember my allergic reaction to his fumes which required me to take an antihistamine so I could finish  my daily assignments and take my tests.  In those days, the most effective antihistamines were sedating, and it was a wonder that I ever passed any of the anatomy exams.

It turns out that my allergic reaction to Frank's preservative was the least of the problems.  Formaldehyde is now listed as a potent carcinogen.  To read more about formaldehyde and other carcinogens - which may have been or may be in your environment, read the 12th Report on Carcinogens.  It will provide plenty for you to think about.

More About Diabetic Meter Control Solution

I sent the postcard back to my heavily advertised diabetes supply vendor, but before receiving it they called me to ask if I was ready to reorder. As my telephone contact went down the list, I said I did not want her company's brand of glucose meter control solution because I had problems with it (accuracy) and had spoken with the company's quality control department.  I asked for the meter manufacturer's brand of control solution but was told that the vendor only supplied its own brand and if I didn't want their (?defective?) brand, they wouldn't supply me with the control solution at all.

If you are diabetic, you know that frequent accurate testing and control of blood glucose prevents heart attacks, strokes, kidney damage, hypoglycemic coma and other serious injuries.  The control solution is an important element in informing you when your meter or testing strips are producing errors which may result in serious, expensive and preventable patient injury. 

Contrary to the company's promise, no one from their quality assurance department had given me additional information about their investigation of my complaint.  I guess that no one from the FDA reads my blog since I haven't heard from them, either.  Nor from the Inspector General's Office of Legal Counsel.

So, who is minding the store on quality and value for price of the products which the federal government is paying the vendor to supply to Medicare beneficiaries who are diabetic? 

If you have had similar problems with  vendors of Medicare-funded diabetic supplies, I strongly urge you to contact Medicare directly (see the link above).   Maybe if enough people call, someone will pay attention to be sure that the federal government, and its Medicare population, get the quality of diabetic test supplies they deserve and pay for.

Do You Get What You Pay For?

When I first practiced medicine, a visit with my internal medicine partners, was scheduled to last 20 minutes.  During that $9 visit, our standard of care called for taking the patient's history, performing a significant physical examination - including looking at the skin, checking for enlarged lymph nodes, examining the heart, lungs, abdomen and breasts, performing a brief neurologic examination, and preparing a chart note which listed significant items and findings. Because there was continuity of care, with patients not changing insurers and doctors every year, we knew our patients well and recognized important changes in their histories or physical examinations. We noticed unusual moles and lumps and masses and though we did not have electronic records, computers, or the extraordinary array of lab tests now available, we had the standards, skill, time and interest to establish early life-saving diagnoses leading to curative treatment for many.

When patients visit their "primary care providers" now, there is neither time nor interest nor a standard of care supporting the performance of anything other than a "focused" examination. The patient is asked what the major reason for the visit is, and anything else is likely to receive not even cursory attention. Ask yourself -  when did your doctor (or non-physician health care provider) last ask you whether you had noted any changes in a mole and actually had you remove sufficient clothing so that a skin examination could be done?

The June 6, 2011 New York Times front page features an article titled "Two New Drugs Show Promise In Slowing Advanced Melanoma" which describes two new drugs [also reported in the June 2, 2011 New England Journal of Medicine (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00019682)) which offer a short window of response to advanced melanoma skin cancer. The article is well written. But  my readers, need to understand that if the melanoma had been found at an early stage in a routine office visit by a health care provider with sufficient professional standards, skill, time and interest to actually look at the patient sitting there on the examining table, that melanoma might have been diagnosed at an early curable stage when it would never require drastic new treatments with significant side effects which offer only short-term respite at enormous patient and societal cost.


So the next time you go to your doctor for a "focused" visit, ask that the doctor (or other provider) to spend enough time to actually look at your skin.  Maybe this simple request will save your life.

The adherence to professional standards, professional skill,  interest and willingness of my doctor during a recent visit, to look for, find and recommend treatment for my melanoma - hopefully - will save mine.

A Very Sick Nurse

She was the sickest patient, who survived, that I can recall.  A nurse in her 30s,  barely able to move and to tell me about her medical condition that winter day. The thermometer that I placed under her tongue reported 108 degrees (in the "heatstroke" range), which is as high as those thermometers read. The physical exam showed nothing diagnostic except for neck stiffness.  She looked as if she was going to die. I did a spinal tap (lumbar puncture) which suggested a viral infection of the nervous system. The diagnosis was confirmed by laboratory testing. A week later, after intensive supportive care, this nurse left the hospital, and a few weeks later she was back to work, recovered.

This was the picture of measles, a disease which killed a significant portion of the Native American population in the 1700 and 1800s. A diseases which vaccination now prevents - if mature adult judgment recognizes that parents are responsible for protecting their children from measles by having them vaccinated. It is irresponsible to withhold measles vaccination from a child who has no contraindications to vaccination.  Bluntly: parents who love their kids protect them from serious infectious diseases by vaccinating them.

Read about measles and other diseases for which vaccination saves lives, prevents misery and saves health care dollars.. And make sure that your kids, and their friends and friends' friends, are vaccinated.*

My blogging has been intermittent because of personal health issues. I hope to get back to my schedule of two to three times a week. Stay well!

*Link added July 3, 2011