News Flash about HOT FLASHES!

A new research study in JAMA, using Citalopram (an inexpensive generic medication) shows promise in reducing hot flashes in approximately half the women in the study.
Taking 20-40mg of Citalopram was effective and safe. This medication is an ‘anti-depressant’, but is being used for broader indications.
If you are having problems with this issue or know someone who is, and who does not want any hormone therapy, this is a worthwhile consideration. That said, it is not as good as hormone therapy in preventing hot flashes.


Taking the shingles vaccine reduces your risk of getting shingles by 50%…a large amount. This is reassuring and confirmatory information indicating the benefits of this immunization and I recommend it to everyone over the age of 50 who is interested in it.

This data is based on a recent study of more than 300,000 people.

There has been some issues with obtaining the vaccine due to production problems, but it has become more generally available now, and we can put you on a list to get the vaccine if you wish.

The vaccine costs a bit over $200 through our office (due to the high cost of the vaccine itself). It is safe and effective and I’ve not seen any reactions or side effects from it.
Do call us if you are interested in getting your shingles vaccine.


Yes….I said Bully (I love TR!)
A recent study from England shows improved strength and muscle function after a stroke if patients are given 20mg of Prozac( standard dose) in the days following a stroke and for the 3 months after that.
Very interesting. We commonly use anti-depressants after strokes, as depression is a common chemical accompaniment to stroke, due to the alteration in brain chemistry from the injury. Now, we will have even more reason to begin medication early.
I presume that other anti-depressants would work similarly, but that said, we will likely try Prozac as our ‘first line’ therapy in such settings.


Of late, the generaly tenor of medical recommendations on hormone replacement are that it is generally a negative as regards increased cancer risk (breast in particular), increased heart disesae, and increased risk of dementia. These latest thoughts are completely opposite to recommendations only 15 years ago.
This remains a confusing topic, but a recent report on dementia and hormone use shows the complexity of the associations.
In this study 5000 woman using hormones and assessing for dementia they found:
If you use hormones immediately when you go into menopause, they reduce your risk for dementia
If you wait to use hormones until several years after menopause, there is an increased risk of dementia.
If you use hormones immediately and for the long term, there is no difference in dementia as compared to women without hormone therapy.

This research suggests a ‘window’ of opportunity for hormone benefits, and explains why there is such contradictory information on hormone use more generally.
Based on my analysis of the research data I believe that:
Estrogen use alone (Premarin or similar) should be started after menopause and will lead to reduced heart disease, reduced breast cancer, reduced osteoporosis, and reduced dementia.
Estrogen + Progesterone combined will lead to reduced heart disease, a slight increase in breast cancer, reduced osteoporosis, and no effect on dementia.

The balance needs to be analyzed in each woman’s situation and is very specific. There is no ‘pat’ answer for everyone.


Aspirin was found to have anti-cancer effects in a large study of 25000 people, published in the Lancet (a British medical journal of high repute.)

This is consistent with much previous data confirming the preventive effects for aspirin on colon cancer.

Aspirin, 100 years old (invented the same year as Heroine…by Bayer, Inc.), continues to have a plethera of positive effects.

Of course, not everyone should take aspirin due to the bleeding issues and potential for stomach ulcer. If you have specific concerns with these particular conditions, then aspirin is not best, but generally speaking, the anti-inflammatory effects and the blood thinning effects of aspirin continue to provide a general healthy effect and is worthwhile in most adults.


Recently there has been controversy about the safety of ARB medications. These are medicines used commonly for high blood pressure and for heart failure. Going by the common names Cozaar, Avapro, Diovan, Benicar, Tevetan….they were implicated a year ago as a causing an increased risk of cancer in patients taking for the long term.
A recently published Lancet article shows that these medications do not appear to have any cancer-causing effects, or at least, if this study doesn’t put the entire issue to rest, it is very reassuring.

The FDA is reviewing the ARB class of medication in ongoing studies and will provide a final report in about a year. In the meantime, one can feel safe on these medications and not worry about taking them. Good news.


Metformin (Glucophage) is the most common medication used to treat type 2 diabetes (non-insulin requiring). It has been available for over 30 years and it’s beneficial effects continue to be identified.

A recent study showed that patients taking Meformin had a reduced risk of death from all causes, compared to alternative medication regimens for diabetes. This means that the medication is somehow reducing serious medical conditions ‘across the board’, including all forms of heart disease, stroke, and even cancer.

This is a very exciting finding and is consistent with other recent studies showing the multiple positive effects of Metformin.


More good new for those patients taking PPI (proton pump inhibitor) medications for the long-term for such conditions as GERD and ulcer disease. It appears that these medications are safe in pregnancy, without evidence of birth defects.

Of course, if you are not pregnant, you might think that this is not important to you….yet such safety information suggests strongly that these medications have a great track-record and safety profile. All good news.

So…if you take Prilosec, Nexium, Protonix, Prevacid, Aciphex…or other similar medications….this is more reassurance.