Author: Centrum Pharmacy

LDL cholesterol, often referred to as “bad cholesterol,” silently poses a grave threat to cardiovascular health. However, a recent survey conducted in 2023 by the American Heart Association (AHA) in collaboration with the Harris Poll has unveiled a concerning lack of awareness, especially among heart attack and stroke survivors. Astonishingly, 70% of these survivors were found to be unfamiliar with the term “bad cholesterol” and its implications, indicating a significant knowledge gap and an urgent need for widespread education and proactive health management.

Cholesterol is a waxy substance produced by the liver and introduced to the body through certain foods, primarily animal sources like meat and full-fat dairy products. Cholesterol travels through the bloodstream, attached to lipoproteins. The two main types of lipoproteins are high-density lipoproteins (HDL), often referred to as “good” cholesterol, and low-density lipoproteins (LDL), known as “bad” cholesterol. Together with triglycerides, these components make up your total cholesterol level.

The pervasive lack of public awareness about “bad cholesterol” and its impact on cardiovascular health is a cause for concern. Since elevated LDL cholesterol typically exhibits no symptoms, many individuals may be unaware of their risk and how to mitigate it. Elevated LDL cholesterol can lead to the formation of fatty deposits, or plaques, in the arteries, significantly increasing the risk of heart attacks and strokes. The AHA survey found that, while 75% of heart attack and stroke survivors reported having high cholesterol, but only 49% recognized the importance of lowering it. Furthermore, 47% of survivors were unaware of their LDL cholesterol levels, despite its crucial role in preventing additional cardiovascular events.

To address this issue, the AHA recommends that all adults aged 20 or older have their cholesterol checked every four to six years, provided their risk remains low. After the age of 40, healthcare professionals should use a specific calculation to assess an individual’s 10-year risk of experiencing a heart attack or stroke. Those with a history of such events may need more frequent cholesterol checks. Knowledge is undeniably a powerful tool in this context—the more you know, the better equipped you are to reduce the risk of future heart attacks and strokes.

The journey to lower cholesterol begins with mindful eating. The AHA recommends adopting a diet rich in fruits, vegetables, whole grains, poultry, fish, and nuts, while minimizing red meat and full-fat dairy. Monitoring fat intake is crucial, particularly by reducing saturated fat to less than 6% of daily calories and avoiding trans fats.

Incorporating at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking or swimming, can have a significant impact on cholesterol levels and overall cardiovascular health. For smokers, quitting is imperative. Additionally, modest weight loss of 5% to 10% can lead to improvements in cholesterol levels and overall heart health.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer 

Erectile dysfunction is frequently associated with the same factors responsible for cardiovascular disease, such as inflammation, arterial narrowing (endothelial dysfunction), or artery hardening (atherosclerosis). Consequently, erectile dysfunction can often serve as an early warning sign or an indicator of an individual’s overall cardiovascular health. If you’re grappling with erectile dysfunction, it is advisable to consult your healthcare provider for a thorough evaluation of your heart health. This proactive approach can help identify potential cardiovascular issues and allow for timely intervention.

Engaging in regular exercise for a minimum of 30 minutes, three times a week, has been discovered to yield results almost on par with pharmaceutical options like Viagra and similar medications when it comes to enhancing erectile function. This revelation stems from a recent comprehensive analysis of the most reliable research available on the connection between aerobic exercise and erectile function.
The findings of this study, published in The Journal of Sexual Medicine, reveal that aerobic activities, such as walking or cycling, have a positive impact on erectile function for all men dealing with erectile dysfunction. Notably, this improvement occurs regardless of factors such as body weight, overall health, or the use of medication. In fact, men with the most severe cases of erectile dysfunction experienced the most significant benefits.

While the medical community has long recognized the relationship between erectile function and cardiovascular health, the evidence supporting the impact of exercise on this condition has been limited. The study’s results demonstrated that the more severe the erectile dysfunction, the more exercise aided in enhancing erectile function. On a standardized scale ranging from 6 to 30, men with severe erectile dysfunction who incorporated exercise into their routines reported a notable 5-point enhancement in erectile function. Those with mild and moderate cases of erectile dysfunction experienced improvements of 2 and 3 points, respectively.

In comparison, pharmaceutical treatments like phosphodiesterase-5 inhibitors, such as sildenafil (commonly known as Viagra) or tadalafil (Cialis), could lead to improvements within the range of 4 to 8 points, as pointed out by the study authors. Similarly, testosterone replacement therapy was found to result in an improvement of 2 points. These findings highlight the valuable role of exercise in addressing erectile dysfunction, particularly for those with more severe cases, while also underlining the effectiveness of established pharmaceutical treatments.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer

For women grappling with obesity and undergoing treatment with drugs such as semaglutide (known as Ozempic) or tirzepatide (referred to as Mounjaro), the benefits of these medications are remarkable. Belonging to a novel category known as GLP-1 receptor agonists, they offer substantial and rapid weight loss, improved blood sugar management, and an enhanced quality of life. These drugs represent a significant departure from the long-established view that surgical procedures were the most effective long-term solution for obesity.

However, the quest for accelerated weight loss and enhanced blood sugar control carries an unexpected caveat. Many women dealing with obesity, who are also taking oral contraceptives, might be unaware that these medications, particularly Mounjaro, can impede the absorption and efficacy of birth control pills, potentially increasing the risk of unintended pregnancies.

One of the mechanisms through which drugs like Ozempic operate is by delaying the transit of food from the stomach to the small intestine. While research in this area is still evolving, it is theorized that this delay in gastric emptying may influence the absorption of birth control pills. Another hypothesis suggests that vomiting, a common side effect associated with these medications, might also interfere with the contraceptive’s effectiveness. At lower doses, the impact on absorption and gastric emptying may be minimal. However, as the dosage increases, these concerns become more prevalent, sometimes resulting in diarrhea, which is another factor that can disrupt the absorption of any medication.

In the United States, approximately 42% of women are obese, with 40% of them falling between the ages of 20 and 39. While these new drugs hold the potential to improve fertility outcomes for obese women, particularly those with polycystic ovary syndrome (PCOS), only one drug, Mounjaro, currently carries a warning about its potential impact on birth control pill efficacy. Regrettably, it appears that some healthcare providers may not be fully informed about or may not be advising their patients regarding this risk. Furthermore, the data remains inconclusive regarding whether other drugs in the same class, like Ozempic, pose similar risks.

For patients seeking to safeguard themselves from unplanned pregnancies, it is advisable to use condoms when commencing treatment with GLP receptor agonists. While the effect on gastric emptying is generally minimal at lower doses, it becomes more significant with higher dosages or the onset of diarrhea. While this aspect was not a conventional subject of discussion, it is now recommended that patients consider adding a barrier contraceptive method such as a condom, at least four weeks before initiating their initial dose or when adjusting the dosage. Additionally, it is advisable to schedule the GLP receptor agonist injection at least one hour apart from any other medication, including oral contraceptives.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer

On October 13th, 2023, the Ministry of Health issued a guidance document.  The Ministry have updated the EO Notice to include information regarding the newly approved Pfizer and Moderna XXB.1.5 vaccines.

Effective October 13th, 2023, the Ministry is recommending that: 

All individuals eligible to receive a COVID-19 vaccine this fall should be offered the Moderna or Pfizer COVID-19 XBB formulations. 

Individuals who have previously been vaccinated, meaning they have completed their primary vaccination series and are now eligible for a booster dose, may be offered the Moderna or Pfizer XBB vaccine if it has been at least 6 months since their last COVID-19 vaccine dose or since their last COVID-19 infection. A minimum interval of 3 months since the patient’s last COVID-19 vaccine dose or COVID-19 infection may also be considered based on the judgment of pharmacy professionals and specific patient factors. 

The XBB formulation is the preferred product for individuals who have not been previously vaccinated against COVID-19.

The new XBB formulations will be made available to the general public beginning on October 30th, 2023.

Thyroid hormone medications, thyroxine and L-thyroxine, rank among the most frequently prescribed drugs. However, not every elevated thyroid-stimulating hormone (TSH) value requires immediate therapy. TSH values can fluctuate and should be interpreted cautiously. Here’s a concise breakdown:

1. Check Again:

A slightly elevated TSH value may not warrant treatment. Reassess TSH levels 2-6 months later, especially if the patient shows no symptoms. 50%-60% of cases see TSH values normalize without treatment.

2. Reasons for Elevated TSH:

TSH levels fluctuate with the time of day and year, sleep patterns, and age. Sex and obesity can also influence TSH values. Biotin supplements, commonly used for hair and nail health, can affect TSH measurements.

3. Avoid Hasty Prescriptions:

Not every high TSH value signifies hypothyroidism. Patients with thyroid nodules due to iodine deficiency may be overprescribed thyroid hormones. Iodine supplementation, not thyroid hormones alone, is recommended for iodine-deficient individuals.

4. When to Consider Treatment:

Treatment is warranted in young patients with TSH values > 10 mU/L. Young symptomatic patients with TSH values between 4 and < 10 mU/L may require treatment. Treatment is necessary after thyroid surgery, radioactive iodine therapy, or in cases of a diffuse enlarged or severely nodular thyroid gland. Pregnant women with elevated TSH values should also be treated.

Standard TSH determination may not be sensible; instead, clinicians should investigate patients with symptoms and conduct comprehensive thyroid function assessments. Autoimmune-related hypothyroidism (Hashimoto thyroiditis) is a common cause of high TSH levels. In summary, not all elevated TSH values require immediate action, and careful evaluation is key to determining the appropriate course of treatment.

A recent study has shed light on the connection between exercise and cancer prevention, specifically in individuals with Lynch syndrome, a genetic condition associated with a heightened risk of early-onset cancer. Researchers at the University of Texas MD Anderson Cancer Center discovered that engaging in intense exercise for just forty-five minutes, three times a week, can significantly reduce the risk of cancer in these patients.

The study’s findings revealed that this level of exercise had a profound impact on the immune system’s ability to combat cancer cells. All twenty-one participants in the study had Lynch syndrome and were divided into two groups: one received a 12-month exercise program, while the other did not. Researchers closely monitored their cardio and respiratory fitness levels and tracked immune cells, including natural killer cells and CD8+ T cells, in both their blood and colon tissues.

These immune cells play a crucial role in targeting foreign entities, such as cancer cells, and the exercise group exhibited heightened activity in these cells. Additionally, individuals in the exercise group experienced a decrease in the levels of the inflammatory marker prostaglandin E2 (PGE2), which was closely associated with the increased activity of immune cells. Both of these changes suggest a more robust immune response. Scientists believe these changes are linked to an enhanced “immune surveillance” system in the body, which helps detect and eliminate cells that could otherwise become cancerous.

Scientific evidence has long supported the idea that regular exercise can contribute to cancer prevention. A comprehensive systematic review conducted in 2019, comprising over 45 studies and several million people, provided strong evidence that exercise can reduce the risk of various cancers, including bladder, breast, colorectal, and gastric cancers, by as much as 20%.

According to the American Cancer Society, lifestyle factors, such as physical inactivity, excessive body weight, alcohol consumption, and poor nutrition, contribute to over 15% of cancer-related deaths in the United States (excluding tobacco-related cancers). To mitigate cancer risk, the society recommends 150 to 300 minutes of moderate-intensity exercise per week. Remarkably, the study participants experienced a significant immune response with just 135 minutes of high intensity exercise each week.

Unfortunately, we do get less flexible as we get older. Clinicians even have a test called ‘Sit to Stand’ (measuring the ability to stand up from a chair), widely used to examine physical function and screen older people at risk of falls and frailty.

There are lots of reasons why standing up gets harder as we age. It’s thought that our tendons get tighter around joints and the cartilage between our joints deteriorates. There is also a general deterioration in ligaments and a reduction in fluid within the joint (synovial fluid) along with tightening of muscles surrounding the joint.

Our muscle mass also reduces as we get older, especially muscles such as the quadriceps (around the front of your thighs), which are needed to help us stand up from a chair.

But the good news is that these changes may be slowed down. Regular physical activity is thought to slow down the deterioration in our flexibility, along with the other benefits it has for bone density, cardiovascular health and our mental health.

Studies have shown that people who are physically active can achieve a greater range of motion than sedentary individuals, even in older age. It is recommended that older adults should do activities that improve strength, balance and flexibility at least twice a week, as well at least 150 minutes of moderate-intensity activity a week (or 75 minutes of vigorous-intensity activity if you’re already active).

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The reason statins can make your muscles sore or weak was unclear—until scientists accidentally stumbled upon an answer.

Statins, one of the most extensively studied drugs on the planet, taken by tens of millions of Americans alone, have long had a perplexing side effect. Many patients—some 5 percent in clinical trials, and up to 30 percent in observational studies—experience sore and achy muscles, especially in the upper arms and legs. A much smaller proportion, less than 1 percent, develop muscle weakness or myopathy severe enough that they find it hard to climb stairs, get up from a sofa, get up from the toilet.

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