The newest DRI levels for Vitamin D are based solely on bone health indicators .  As a result, the  Recommended Daily Allowance (RDA) for infants is 400IU,  for everyone else; the RDA is 600IU which covers ages 1 to 70 years of age.   Those over 70, have an RDA of 800IU.  These are dietary recommendations and are based on the assumption that there is minimal sun exposure and were set to achieve 50nmol/L of plasma 25-hydroxyvitamin D.  New Upper Levels for Vitamin D are 4,000 IU for ages 9 years and over, with lower levels set for younger ages.

However, there is a need for more research to determine non-skeletal benefits of Vitamin D, and whether different intake levels are needed to satisfy those actions. Why?  In the past years, we have growing evidence that a focus on Vitamin D’s role in bone metabolism is potentially missing a host of other functions within the normal human physiology.

For now at least, we have updated RDA’s that update the previous levels which were set in 1997 especially since recent national surveys produced evidence that Vitamin D status was poor, especially in certain subpopulations in both Canada and the United States.   This alone suggested that the RDA levels needed to be much higher than previous established.

Expect to see more information about Vitamin D’s influence on health outcomes based on additional randomized controlled trials.

[Pfizer, Consumer nutrition and health report; Volume 20, Number 4; December 2011]

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Never assume that any product is 100% safe, even if it contains ingredients that someone claims are “natural”,  or that are “herbal”.   If any ingredient whether it be from plant, animal, or mineral has a measurable therapeutic effect then it will potentially have side effects and may produce adverse reactions, no different than any manufactured pharmaceutical.    This is what motivates us to look closely at new products especially those that are heavily promoted to be “natural” and “effective” and even sometimes “miraculous”.    Not everything can have a double blind, large population patient study but there are other ways to evaluate new products by applying what science we know and sometimes just basic logic is the best way to critically assess the effectiveness and safety of any therapeutic agent.   So that’s exactly what we are doing when presented with “what do you think about this product”.

It’s our hope that we can bring to your attention those products that make “the cut” and although our experience proves that not every product is effective for every person’s health related problem, there are product trends that continue to show promise on both sides of the therapeutic fence, so to speak.   That is, those products that represent traditional pharmaceutical agents, developed through the rigors of scientific research and development, as well as those non-traditional products representing maybe less understood mechanisms of action that still deserve some critical attention.

On that note, if there are products that you are curious about or better yet, have found to be beneficial, drop us a note and we will consider it for one of our review articles.  Please send all such messages to the e-mail address we have reserved for this purpose:   pharmacist@staffordpharmacy.com

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And a community it certainly is.  What with Facebook user numbers creeping ever so much closer to a billion, it’s hard to believe there are any people going out to the mall or to a movie or any social gathering that takes them away from places like Facebook.    Yet of course, there are the “Smart Phones” that bring all that connectivity to the handheld device.    Facebook, Twitter, LinkedIn, Google + and more, all available to the masses as they wander down the streets of our towns and cities.

What with all these eyes browsing the internet it is certainly a challenge to keep a “fresh face” on and to continue the content improvements that make a site like this of value, if only measured by the number of people who bookmark the site or just a page or two within the site.   Not to fear, we are doing both and have been fortunate to have a creative hardworking in-house crew.   We have recently updated the top of page banner to reflect the season and as a result of my own whining and whimpering have recently convinced our website architect, Jesse Johnstone to make some behind the scenes changes that might allow us to make it much easier to make certain updates to the website.

Although what I’ve referred to as our “minor face lift” refers to the look and presentation of the site, the real “heavy lifting” is being done behind the scenes with the addition of content and new pages.  We are diligently adding new pages to the Home Healthcare section although because of the size of our home healthcare product inventory, it will take the next few months to just add the product categories as we have outlined in our main home healthcare page.   However, the really large project is still hidden from sight until we are ready to launch, which will take the better part of the next year.  In the meantime we continue to make improvements to areas such as:

• Compounding for both human and veterinary patients
• Home Healthcare product sections
• Frequently Asked Questions – maybe you’ll find a question that you know you wanted to ask but didn’t.  Now you can find the answer as well.
• Valuable links – to health related sites, organizations, reliable resources
• Homeopathy – get an understanding of this powerful, yet safe complementary medicine
• Newsletter archives
• Video library

Drop by from time to time to see the incremental change and the reveal of information as we make available some of the expertise that we have accumulated over the past twenty-six years.   On that note, I’ll just remind everyone to sign up for our monthly newsletter which is written in-house and distributed both in the store as well as right to your e-mail but you have to subscribe to this.  Don’t be left out, subscribe today.

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If you would like the ultimate in convenience, subscribe to have our Newsletter and other important information sent directly to your e-mail. This is information you can trust because it has been researched, reviewed and written by staff Pharmacists. Don’t take a chance that the information you have stumbled on via the World Wide Web is dependable. Get the information from the healthcare professionals that you trust every day.

SUBSCRIBE TODAY.

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Some of these risks are in the form of adverse effects, also known as side effects. Anyone who has taken most any prescription medication will have been counseled about these risks, which can range from relatively common to darn right rare. As healthcare practitioners we usually take the position that the better a patient understands the medication they are taking the greater the benefits at the same time, the less likely these adverse effects will cause serious problems.

This is because many of the adverse effects are of low incidence or are of short duration. We commonly explain that some of these effects are a result of your body learning how to behave in the presence of that new medication. Any new drug is a “foreign” chemical which your body has to learn how to absorb; how to metabolize – how to detoxify; how to eliminate and of course, how to function given the particular influence of that drug. It’s unfortunate that what with all our science, and all our technologies, we are still far from finding that “magic bullet” drug, that goes only where we want it to, has no other effects other than the desire effect and is easily detoxified and eliminated once its job is done. That drug just doesn’t exist.

That’s why it’s important to understand what adverse effects are possible, which are the minor side effects and which might present the greater risk to your health. Although I’m not certain that the website AdverseEvents is necessarily at any one audience in particular, they certainly have accumulated substantial detailed information about drugs and their adverse effects, data on the incidence of specific adverse effects as well as statistical data describing the occurrence rates of adverse effects on a per drug basis. Keep in mind if you do visit this site, that it is an American company which means many of the drug names are those brand names used in the United States and not necessarily are those same drugs available here in Canada or that they are being marketed under the same brand name.

You are encouraged to check out this site yourself and make your own conclusions. Whether you are the consumer of medications or a healthcare practitioner or even a drug manufacturer, there is something of interest for everyone.

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It’s unfortunate that the term “snake oil” became associated with that description of salesman, because snake oil per se, has a very different story, based on some good science.   Historically, snake oil saw use by the Chinese who immigrated to North America, many to labour on the building of the railways.  Their labours were very physical, as they worked to lay the track that gradually connected all of North America. 

Of course, as a result of their labours, they found the need to alleviate muscular and joint aches, a result of this very physical work.  What they brought with them was in fact snake oil, that when rubbed on the skin above the area of pain brought relief, or at least as it was reported.  This story had to wait until 1989 before a nutrition-oriented physician from California; Dr. Richard Kunin decided to find out just what was in snake oil that may have given it this pain relieving ability.  

He went to San Francisco’s Chinatown obtained the snake oil and had it analyzed.  What he found was that it contains 75% unidentified carrier material, likely emulsifying ingredients which would help the oil mix with other ingredients and including the liquid base, as well as to aiding the oil to penetrate the skin and tissue when applied.  He also found this product to contain camphor, but the remaining 25% was oil from Chinese water snakes, which contains 20% of the important omega 3 derivative eicosapentaenoic acid (EPA) as well as 48% oleic acid and 7% linoleic plus arachidonic acids.  At 20% EPA, Chinese water snake is the richest known natural source of the parent of Series 3 prostaglandins, which inhibit the production of pro-inflammatory Series 2 prostaglandins. 

These are naturally occurring lipid compounds in the body derived from the enzyme-controlled oxidation of fatty acids and have a long list of important functions.   At the risk of over simplifying, Series 1 and 2 prostaglandins are the “good” prostaglandins.  Where the Series 1 prostaglandins, made from linoleic acid lower blood pressure, decrease inflammation, improve nerve function, the Series 3 prostaglandins are derived from EPA and can prevent the production of the “bad” Series 2 prostaglandins.   

 Like essential fatty acids and their other derivatives, EPA can be absorbed through our skin.  Salmon Oil, the next-best source of EPA, contains a maximum of 18% EPA, with other fish oils containing less.

 Those eyeing our native Rattlesnake should approach with caution for several reasons, one being that not all snake oils contain 20% EPA and in fact, Rattlesnake oil contains only 8.5% EPA with many other snake oils never being tested. 

 The moral of this story – traditional snake oil is natural and therapeutic.  The true snake oil salesman you could say, has been vindicated.  What about the report by Dr. Kunin?  Well, he submitted his findings to the New England Journal of Medicine but they were unwilling to publish it.   Although we were certain that our readers would be interested in the information. 

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Other dosing options may simply be a beef flavoured suspension for a medication that otherwise is not available or just not very palatable for your furry member of the family.    So for your dog we might flavour with beef or liver or chicken; and for your cat it might be fish flavour such as Tuna, Salmon or a combination.   We even have a “ham” flavour for the discriminating canine or feline.   You can start to appreciate the options available.   In fact, we now have flavoured oral capsules that will be used to incorporate an animal’s medication, as we find that the taste of a medication actually begins with the “smell” of that oral dosage form.

The selection of video clips also includes an excellent series on “Compression Therapy” explained by Laura Shaskin our on staff Registered Nurse and the person in charge of our Home Healthcare department.   There are in fact SIX video clips discussing different aspects of Compression Therapy, from general introduction, to support stockings and on to compression sleeves for the treatment of post-surgical edema.   As well, in two of the video clips you will see and hear Laura introduce some of the Post-Mastectomy fitting services that we provide.   Although any fitted product must be done so professionally and accurately, this is especially true for Post-Mastectomy fittings.   As Laura explains, if properly fit no one should know that a women is wearing a breast prosthesis and that is exactly the goal for every fitting done for any post-mastectomy product.  

You are invited to visit and experience this new feature.    We think you will enjoy the feature and invariably everyone learns something new that they did not know before whether it be about a product or service we offer or even a little valuable background information about the topic being discussed.  We hope to add to our selection and already have plans for the use of video to better inform our customers, our patients about products; about services offered; and the information that better helps you gain the most benefits from those products and services that you receive from us.

Special thank you to our project partners:

• CTV and CFCN Lethbridge
• Jesse Johnstone (Web design)
• Video actors and patients: Carissa, Deanna, Andrew Shaskin  and  “Nova”

So, what does that mean?

Well, to a pharmacist such as myself I’ve taken that to mean that consumers have come to trust pharmacists for their knowledge, honesty, integrity and professionalism.   That’s a mouthful but it says that consumers look to pharmacists as reliable sources of accurate health and drug information.    This hasn’t happened over night by the way, as the profession has been working for years to establish a professional culture that includes raised standards of practice as well as new practice authorities.

Before entering the profession pharmacists must complete five to six years of University study to gain the knowledge base and the clinical background necessary for a pharmacist.   After completing their education they must then pass a comprehensive national exam that tests their knowledge from those four years.  Finally they must pass a licensing exam which is done in person as an experiential test.   Then and only then will the pharmacist gain license to practice in that particular province.   Of course, every year we are required to maintain our continued education through lectures, courses, self-study and online learning.

As a result of legislative changes, pharmacists can now make certain adaptations to prescriptions as written.   For example, changes can be made to the prescription with respect to brands of medication, or even therapeutic substitutions within specific guidelines.   Pharmacists can adapt a prescription to the extent that a patient requires say an additional two or three weeks of their prescribed medications, despite the fact that their prescription refills have been all used.   That means the pharmacist under his/her own authority can prescribe say another three weeks of medications for a patient, giving them time to make an appointment with their physician and to get the prescription re-prescribed.

Of course the most significant new authority given to pharmacists has been the ability to prescribe new medications.   This can only be done after a pharmacist has applied and been accepted for advanced prescribing, a very thorough and demanding process.  This explains why there are only approximately 150 pharmacists who hold this advanced designation, when there are about 4000 pharmacists currently licensed in the province of Alberta and able to pursue this designation.

Yes, pharmacists should be ranked highly as one of the most trusted individuals.   It’s not easy to become a pharmacist and it’s not easy maintaining the required standards and competency.   We do this however, not to make it difficult but to ensure that the pharmacist that you meet with at the community pharmacy, maintains the highest professional standards which are second to no other profession.    So, it’s nice to know from time to time that all our efforts are being recognized.   And we’ll keep working to become the number one trusted professional.

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Recently published studies have stated that supplementing with calcium can increase the risk of cardiovascular problems.  In particular, these studies found that in patients over the age of 40 taking 500 mg or more of calcium may experience increased cardiovascular risk.  They found that supplementation with calcium significantly increased the risk of heart attack by 27-31% when compared to those who were not supplementing with calcium.

Most of the studies that have been done to date have limitations.  They were not originally done to directly measure the risk of cardiovascular risk that arises due to calcium supplementation.  Additionally, these studies did not look at whether using calcium supplements in combination with vitamin D supplementation lowers this risk in any way. 

In conclusion, we need more studies to look directly at the cardiovascular risk that may be associated with the use of calcium supplements.  The study should also look at whether or not concurrent supplementation with Vitamin D yields the same risk as calcium supplementation alone. 

Current recommendations suggest the following amounts of calcium and vitamin D be consumed on a daily basis via a combination of diet and/or supplements:

Adults <50:  Calcium 1000 mg/day and Vitamin D 800-2000IU/day

Adults >50:  Calcium 1200 mg/day and Vitamin D 800-2000IU/day

If you are able to consume the required amount of calcium in your diet, supplementation is not required.  Those who have osteoporosis or osteopenia or are at risk of developing these diseases should talk to their pharmacist or doctor about supplementing with calcium and vitamin D.   To find out how much calcium you are getting in your diet ask your pharmacist today!

A German physician, who earned his Doctor of Medicine degree in 1779, saw much was wrong with the treatment practices of the time. At the time of his graduation, scientific advances were beginning to be seen in the fields of chemistry, physics, physiology and anatomy.  The clinical practice of medicine, however, was rife with superstition and lack of scientific rigor.  The treatments of the day, such as purgatives, bleeding, blistering plasters, herbal preparations and emetics lacked a rational basis and were more harmful than effective.  Hahnemann recognized this and wrote critically of current practices in several papers on topics such as Arsenic poisoning, hygiene, dietetics and psychiatric treatment.

Homeopathy seeks to stimulate the body’s ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called “like cures like”)., is a whole medical system, with a complete system of theory and practice that has evolved over time in different cultures and apart from conventional medicine. Examples of whole medical systems include traditional Chinese medicine, Ayurvedic medicine, homeopathy, and naturopathy that was developed in Germany more than 200 years ago and has been practiced in the United States since the early 19th century. Homeopathy is used for wellness and prevention and to treat many diseases and conditions. This fact sheet provides a general overview of homeopathy and suggests sources for additional information.

Fundamental Principles

• The “Law of Similars” (or “like cures like”) is a central homeopathic principle. The principle states that a disease can be cured by a substance that produces similar symptoms in healthy people.
• Most analyses have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition; although, some studies have reported positive findings.
• There are challenges in studying homeopathy and controversies regarding the field. This is largely because a number of its key concepts are not consistent with the current understanding of science, particularly chemistry and physics.
• Inform your health care providers about any complementary and alternative practices you use.  Give them a full picture of all you do to manage your health.  This will help ensure coordinated and safe care.

An Overview

The term homeopathy comes from the Greek words homeo, meaning similar, and pathos, meaning suffering or disease. Homeopathy seeks to stimulate the body’s ability to heal itself by giving very small doses of highly diluted substances. This therapeutic method was developed by German physician Samuel Christian Hahnemann at the end of the 18th century.  Hahnemann articulated two main principles:

• The principle of similars (or “like cures like”) states that a disease can be cured by a substance that produces similar symptoms in healthy people. This idea, which can be traced back to Hippocrates, was further developed by Hahnemann after he repeatedly ingested cinchona bark, a popular treatment for malaria, and found that he developed the symptoms of the disease. Hahnemann theorized that if a substance could cause disease symptoms in a healthy person, small amounts could cure a sick person who had similar symptoms.
• The principle of dilutions (or “law of minimum dose”) states that the lower the dose of the medication, the greater its effectiveness. In homeopathy, substances are diluted in a stepwise fashion and shaken vigorously between each dilution. This process, referred to as “potentization,” is believed to transmit some form of information or energy from the original substance to the final diluted remedy. Most homeopathic remedies are so dilute that no molecules of the healing substance remain; however, in homeopathy, it is believed that the substance has left its imprint or “essence,” which stimulates the body to heal itself (this theory is called the “memory of water”).

Homeopaths treat people based on genetic and personal health history, body type, and current physical, emotional, and mental symptoms.  Patient visits tend to be lengthy.  Treatments are “individualized” or tailored to each person—it is not uncommon for different people with the same condition to receive different treatments.

Homeopathic remedies are derived from natural substances that come from plants, minerals, or animals. Common remedies include red onion, arnica (mountain herb), and stinging nettle plant.

Some Statistics

According to the 2007 National Health Interview Survey, that included a comprehensive survey of complementary and alternative medicine. This represents a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. (CAM) use by Americans, an estimated 3.9 million U.S. adults and approximately 900,000 children used homeopathy in the previous year.

People use homeopathy for a range of health concerns, from wellness and prevention, to the treatment of diseases and conditions such as allergies, asthma, chronic fatigue syndrome, depression, digestive disorders, ear infections, headaches, and skin rashes.

Regulation of Homeopathic Treatments

Homeopathic remedies are prepared according to the guidelines of the Homeopathic Pharmacopeia of the United States (HPUS), which was written into law in the Federal Food, Drug, and Cosmetic Act in 1938. Homeopathic remedies are regulated in the same manner as nonprescription, over-the-counter (OTC) drugs. However, because homeopathic products contain little or no active ingredients, they do not have to undergo the same safety and efficacy testing as prescription and new OTC drugs.

The U.S. Food and Drug Administration (FDA) does require that homeopathic remedies meet certain legal standards for strength, purity, and packaging. The labels on the remedies must include at least one major indication (i.e., medical problem to be treated), a list of ingredients, the dilution, and safety instructions. In addition, if a homeopathic remedy claims to treat a serious disease such as cancer, it needs to be sold by prescription. Only products for self-limiting conditions (minor health problems like a cold or headache that go away on their own) can be sold without a prescription.

The Status of Homeopathy Research

Most analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition, and that many of the studies have been flawed. However, there are some individual observational studies, randomized placebo-controlled trials, and laboratory research that report positive effects or unique physical and chemical properties of homeopathic remedies.

Research Challenges

Homeopathy is difficult to study using current scientific methods because highly diluted substances (known as ultra-high dilutions or UHDs) cannot be readily measured, making it difficult to design or replicate studies. In addition, homeopathic treatments are highly individualized and there is no uniform prescribing standard for homeopaths. There are hundreds of different homeopathic remedies, which can be prescribed in a variety of different dilutions to treat thousands of symptoms. On the other hand, many aspects of the interactions between the homeopathic practitioner and his or her patients may be quite beneficial, and can be studied more easily.

Controversies Regarding Homeopathy

Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a remedy containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. For these reasons, critics argue that continuing the scientific study of homeopathy is not worthwhile. Others point to observational and anecdotal evidence that homeopathy does work and argue that it should not be rejected just because science has not been able to explain it.

Side Effects and Risks

Although the side effects and risks of homeopathic treatments are not well researched outside of observational studies, some general points can be made about the safety of these treatments:

• A systematic review found that homeopathic remedies in high dilution, taken under the supervision of trained professionals, are generally considered safe and unlikely to cause severe adverse reactions.
• Liquid homeopathic remedies may contain alcohol.  The FDA allows higher levels of alcohol in these remedies than it allows in conventional drugs.  However, no adverse effects from alcohol levels have been reported to the FDA.
• Homeopaths expect some of their patients to experience homeopathic aggravation (a temporary worsening of existing symptoms after taking a homeopathic prescription). Researchers have not found much evidence of this reaction in clinical studies; however, research on homeopathic aggravations is scarce.
• Homeopathic remedies are not known to interfere with conventional drugs; however, if you are considering using homeopathic remedies, you should discuss this with your health care provider first.

If You Are Thinking About Using Homeopathy

• Do not use homeopathy as a replacement for proven conventional care or to postpone seeing a doctor about a serious chronic medical problem.
• Look for published research studies on homeopathy for the health condition you are interested in.
• If you are considering using homeopathy and decide to seek treatment from a homeopath, ask about the training and experience of the practitioner you are considering.
• Women who are pregnant or nursing, or people who are thinking of using homeopathy to treat a child, should consult their health care provider.
• Tell all your health care providers about any complementary and alternative practices you use. Give them a full picture of all you do to manage your health. This will ensure coordinated and safe care.

Watch this blog for future articles about homeopathy, homeopathic remedies and how to treat common health related problems using these remedies.   This author certainly is of the opinion that homeopathy continues to be a very safe and effective treatment modality when used appropriately.