Welcome To My Website

do-you-really-need-that-pillThis website will help you to avoid taking drugs you do not need, including information from my upcoming book and cutting edge news and research from the medical world. You will also find suggestions about safe alternatives such as diet, nutrition, and alternative therapies.

A silent epidemic is now imperiling our health and threatens to bankrupt our health care system: over-medication. One-fifth of all adults took three or more prescription drugs in the past month and 40 percent of people over age sixty-five take five or more daily. Adverse effects, drug interactions, and medication errors are only a few of the dangers of over-medication. Always check with your doctor before discontinuing a prescribed medication.

Sunscreen- Use It or Not?

We have all been taught to slap on the sunscreen when we head out into the sun. In fact, it has become so automatic that even on cloudy days we feel the need for it’s protection. It is built into most skin creams and moisterizers. Even make-up used as foundation has an SPF factor.

Skin cancer is the big bug-a-boo of course. But what are the facts? The vast majority of skin cancers are non-invasive and benign, although dermatology offices are filled with anxious patients waiting to have these harmless skin lesions removed. Squamous cell and basal cell carcinomas do not spread to internal organs and are not life-threatening. Yes they can be unsightly, but the fact that they are called “cancer” scares the living daylight out of most of us.

Melanoma, the dangerous type of skin cancer, is extremely rare and does not seem to be associated with daily, moderate sun exposure. Research suggests that extreme sunburn early in life is the culprit for melanoma, which metastasizes internally and can be fatal. Its lesions resemble dark moles, which should be checked out if they are new or appear to be growing.

On the other hand, sun exposure is being recognized for all sorts of health benefits. Vitamin D, the one we hear most about, is important in maintaining strong bones. Deficiencies of Vitamin D have been associated with macular degeneration, heart disease, cancer, and a decline in mental functioning. In fact, a Swedish study of more than 30,000 women found that avoiding the sun was as much of a risk factor for death as smoking!

Sunlight triggers the release of a number of other important compounds in the body–nitric acid, serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms. It reduces inflammation and dampens autoimmune responses. It improves virtually every mental condition you can think of. And it’s free.

On the other hand, many common sunscreen ingredients have been found to be hormone disruptors that can be detected in users’ blood and breast milk. The worst offender, oxybenzone, also mutates the DNA of corals and is believed to be killing coral reefs. Manufacturers are now moving away from oxybenzone to other more natural ingredients but protecting oneself from the sun may not be necessary.

Many experts in the rest of the world have already come around to the benefits of sunlight. Cancer Council Australia’s official-position paper states, “Ultraviolet radiation from the sun has both beneficial and harmful effects on human health…. A balance is required between excessive sun exposure which increases the risk of skin cancer and enough sun exposure to maintain adequate vitamin D levels.”

How much sun exposure do you need? It varies, of course, depending on your skin color and where you live. If you live in North American and have light to medium colored skin, a total of one hour each week in the sun with arms exposed should be enough. However, sunscreen with an SPF of 30 will reduce the production of Vitamin D by 97 percent.

It is worth noting that humans survived outdoors under tropical sun for thousands of centuries without sunscreen. Humans evolved a way to protect our skin from receiving too much radiation—melanin, a natural sunscreen. Our dark-skinned African ancestors produced so much melanin that they never had to worry about the sun. As people moved north, skin lightened to absorb more of the sun’s beneficial rays. In spring, as the sun strengthened, they’d gradually build up a sun-blocking tan. Sunburn was probably a rarity until modern times, when we began spending most of our time indoors.

In the end, it’s up to you as to how much sun exposure you want to have. For me, there is nothing that feels so healing as the sensation of the sun on my bare skin. And I am glad to know that I am not flirting with death by going without sunscreen.

Much of this information came from the article: https://www.outsideonline.com/2380751/sunscreen-sun-exposure-skin-cancer-science.

Doctors Disagree about Treating Blood Pressure

There is an ongoing controversy between cardiologists and internists/family practice docs about what is the optimum blood pressure in adults. Until recently, a target of 140 mm/Hg systolic or below in all adults and 150 in those over age 60 has been the consensus. Now, based on the recent SPRINT study, the American College of Cardiology and the American Heart Association have issued new guidelines setting the upper limit of normal to 130. This means that nearly half of all adults in the US (105 million people, up from 74 million before) would be diagnosed with hypertension and prescribed medication. Other doctors disagree.

“That is a lot of people and that label is not benign — it has serious consequences,” one family practice doctor commented. “It can affect their medical insurance and their life insurance, and I don’t think it is justified by the science. The SPRINT trial was a selective group — the vast majority were higher-risk patients already taking antihypertensive medications. They have extrapolated this data to the group at low risk with systolic pressures in the 130 to 140 range without treatment. We don’t have the science to support that.”

I agree with him. In fact, when I looked at the SPRINT study, I found that the difference in serious heart disease or death between those treated to a target of less than 140 versus 120 was less than 1 percent. Those in the lower blood pressure group had three times the incidence of kidney damage and twice the level of serious adverse effects such as fainting. Mental functioning, which can be impaired at lower blood pressures, was not evaluated in the study.

A different study, cited in my book, reported that people with systolic pressures between 130 and 139 and diastolic pressures between 60 and 79 had fewer deaths from all causes and less kidney failure than those above or below those values. Those with a systolic of 110 to 119 had twice the incidence of deaths and kidney failure. But a blood pressure over 150 increases these risks as well.

So why does the American Heart Association recommend lowering blood pressure to these lower levels? Could it be because they receive millions in funding from the pharmaceutical companies that make the medications? Could it be because several of the members of the advisory panel issuing the recommendations receive research grants and consulting fees from the same companies? You tell me.

One final point, also covered in my book, is that one blood pressure reading taken in the stressful atmosphere of a doctor’s office does not accurately reflect your actual day-to-day reading. Experts recommend that blood pressure be taken after sitting quietly for five minutes with both feet on the floor three times in a day to determine the actual value.

The Suicide Epidemic

There is an epidemic of suicide in the US, most recently the hanging deaths of two celebrities–Kate Spade and Anthony Bourdain. Suicide rates have gone up all over the country, by more than 30% in many states since 1999. Suicide is now the tenth leading cause of death in adults, nearly 45,000 in 2016. The vast majority of people who kill themselves are white and more than three-quarters are men. States with lax gun laws have higher suicide rates. Each day, 20 military veterans kill themselves.

These are the facts–what can we do about them? The CDC reports that more than half of those who commit suicide do not have a known mental health problem. But we do know that there are many factors contributing to suicide, including relationship and financial problems, substance abuse, and chronic health problems. It is hard to maintain a positive outlook facing the many problems in the world today–overpopulation, climate change, and economic inequality.

Antidepressants are not the answer. As I wrote in a previous post, the evidence that they are effective is slim, especially for people with mild to moderate depression. In fact, there is research showing that antidepressants such as Paxil, Zoloft, and Effexor actually increase suicide attempts, especially in adolescents and young adults. And the recent report that one-third of adults take medications that can cause depression makes me wonder if Kate Spade or Anthony Bourdain were victims of one or more of these drugs.

On the other hand, there is growing evidence that several non-drug treatments for depression can be effective. There are more details about each of these in my book, but here is a summary:

-Cognitive Behavioral Therapy (CBT) is just as effective as antidepressants, without danger of side effects
-Exercise can decrease depression as much as psychological or pharmacological therapies and is more long-lasting
-A dietary pattern characterized by a high intakes of fruit, vegetables, whole grain, fish, olive oil, low-fat dairy and low intakes of animal foods was associated with a decreased risk of depression.
-Omega-3 fatty acids found in fatty fish, nutritional supplements, the herb St. John’s wort, massage, yoga, acupuncture and homeopathy have all been shown effective for depression in research studies.

So why aren’t more people taking advantage of these healthier approaches to depression? One reason is that health insurance and Medicare do not cover them and people must pay for them out-of-pocket. But like many other chronic health problems, it is often easier to take a pill than make positive lifestyle changes.

The New Shingrix Vaccine

MY TAKE: As with any new drug or device, it is best to wait a year or two to find out if there are any unexpected adverse effects.

Shingrix, the new shingles vaccine, is all the rage among the over-50 set. It is hard to drive by a Walgreens without seeing a sign advertising that it is available. As you may know, shingles occurs when the same varicella zoster virus that causes chickenpox becomes reactivated in later life. In most people older than 50, shingles virus is dormant in the nervous system, and a person’s risk for shingles rises sharply after age 50.

The previous shingles vaccines, Zostavax, was made from a live, inactivated virus while Shingrix uses a protein on the surface of the virus. Shingrix also contains two adjuvants to boost the immune response, one of which has not been used in humans before now.

PROS of Shingrex–

-Provides 80-90% protection against shingles with two doses, compared to 50-60% from one dose of Zostavax
-Appears to last longer than Zostavax

CONS of Shingrex–

-Requires two shots 2-6 months apart instead of just one
-Has more side effects- 75% of people reported pain at the injection site, 17% with reactions severe enough to prevent normal activities. Also, about 1 in 10 people reported systemic effects such as muscle pain, fatigue, headache, shivering, fever, or gastrointestinal illness.
-More expensive- can cost up to $300, not always covered by Medicare or insurance.

What bothers me the most is that the CDC panel evaluating Shingrix split 8-7 over whether to recommend it above Zostavax, a highly unusual lack of consensus. Several panel members advocated collecting safety data on Shingrix for a year or two before endorsing it over Zostavax. One member noted that the adjuvant in Shingrix that boosts the immune response “has never been out in the real world before.” So waiting a year or two before getting the vaccine seems prudent.

As for me, I’ll take my chances without either vaccine. There are several homeopathic remedies that have an impressive track record in treating shingles, should I get it. But infections more often occur when the immune system is weak and shingles is probably no exception. Eating a healthy diet, exercising, getting enough sleep, and dealing effectively with stress should make you less susceptible to getting shingles.

Should You Take Statins?

Cholesterol is only one of several factors that affect the risk of heart disease. Others include high blood pressure, smoking, lack of exercise, family history, poor diet, and being overweight or obese. One study estimated that 80 percent of heart disease could be prevented by changes in three lifestyle factors- diet, exercise and smoking. And yet the medical establishment remains focused on cholesterol levels and taking statins.

When I was in medical school, a total cholesterol below 240 mg/dL was considered acceptable, but over the years that was lowered to 220 and then to 200 by various advisory groups. In 2004, new guidelines that made LDL cholesterol the primary factor in deciding to prescribe statins were so stringent that millions more Americans were prescribed these drugs. Subsequently, it was reported that all but one of the nine members of the panel that wrote the guidelines had received funding from statin manufacturers.

A consortium of heart organizations came out with yet a new set of guidelines in 2013, based on your risk of heart attack in the next ten years, determined by an online calculator. You should take a statin, they advised, if your risk is 7.5 percent or more. Using the results of the online calculator, upwards of 70 million Americans, including almost everyone over age sixty-five, should be taking these drugs. Fortunately, a recently revised calculator (https://sanjaybasu.shinyapps.io/ascvd/) dials back the number of people advised to take statins.

Missing from these advisories is any consideration of the dangers of taking statins:

-One in five patients taking statins have side effects, with muscle pain being the most common.
-The FDA has issued safety announcements cautioning statin users about memory problems, diabetes, and liver function.
-Acute memory loss is four times more common in statin users in the first days of treatment.
-People taking statins have nearly a 50 percent higher risk of developing type 2 diabetes.
-Other side effects include cataracts, liver and kidney damage, fatigue, and mood disorders.

If you have had a previous heart attack or stroke and/or if you have a 20 percent risk of having one in the next ten years using the new calculator, you should consider taking a statin if you are not able to reduce your ten-year risk using lifestyle methods alone. In people with familial hypercholesterolemia, a genetic defect causing high levels of LDL cholesterol, statins are usually recommended. These people can also lower their risk of heart disease, as well as the dosage of statins needed, by diet, exercise, and smoking cessation.

While it is easier to take a pill, most of us could take a thirty-minute walk three times a week, up our intake of fruits and vegetables to five servings daily, and cut down on highly refined carbohydrates. Losing weight and stopping smoking are more difficult but can be done with proper motivation. Given the choice, what would you do? Change your lifestyle or take a pill? As the evidence of serious side effects from statins continues to grow—diabetes, cataracts, muscle damage, even dementia—the risk benefit equation tilts dramatically toward not taking them at all.

Should You Take Multivitamins?

I have never been a fan of high-dose vitamin or mineral supplements. My philosophy, however naive, is that if we were meant to take these megadoses, they would grow in the ground or on trees. In fact, vitamins and minerals do grow in nature- in the form of fruits, vegetables, legumes, nuts, and grains. Our bodies evolved to digest these into the nutrients that are necessary to keep us healthy. Eating a well-balanced diet should provide us with all we need.

Some people are concerned that with modern food production, many of the natural nutrients are lost. This is especially true with processed foods–any that have been altered from their original state. Unfortunately, it is difficult to eat these days without consuming some processed foods. So taking a simple daily multivitamin can help to cover your bases if you think you aren’t getting enough nutrients from food itself.

Vitamin D, which our bodies make from sunlight, is one supplement which some people should consider taking. It can be deficient in people living in northern climates with little sun exposure. My book goes into detail about how much Vitamin D to take and its benefits. Suffice it to say that depression, cancer, heart disease, and dementia have all been associated with low Vitamin D levels.

The vitamin and supplement industry is huge. Americans spend more than $30 billion a year on them and 68 percent of those over age sixty-five report using them. And yet, there has been little evidence that they are beneficial. One quandary- the people who mostly use them are well-educated and affluent, a group that is already healthier than other members of the population. So it is hard for studies to separate this factor out from the benefits of taking supplements.

On the other hand, there have been studies showing increased risks of cancer and heart disease in people taking megadoses of certain vitamins. These studies are not conclusive, but gives one a reason to be cautious. High-dose Vitamin E, once thought to lower the risk of heart disease, was found to increase the risk of heart failure, prostate cancer, and death from any cause.

One final note–it is possible that the chemicals in the fruits and vegetables on our plates work together in ways that scientists don’t fully understand — and which can’t be replicated in a tablet. So go to the food store or a farmer’s market and enjoy nature’s bounties!

Do Antidepressants Really Work?

There was much brouhaha in the news last week about a new study claiming that once and for all the debate about anti-depressants was over. Headlines proclaimed that “It’s official – antidepressants work“, “Study proves anti-depressants are effective“, and “Antidepressants work. Period.” But what did the study really find?

The analysis looked at the first 8 weeks of treatment from 522 placebo-controlled studies of patients with major depressive disorder (MDD). This is a type of severe depression that occurs in an estimated 3 percent of the US population over age twelve. Researchers reported that all antidepressants were more effective than placebo but the results were mostly modest. The dropout rate was 2-4 times greater in those taking the medications compared to placebos.

The study did not include people with the more common types of mild to moderate depression, which comprise 75 percent of people taking antidepressants, nor did it evaluate the efficacy of these drugs for more than 8 weeks. Other studies have reported that exercise and cognitive behavior therapy are just as effective as anti-depressants, without the risk of side effects. In fact, in the long-term, patients using exercise have a much lower relapse rate than those taking drugs.

Other critics of this study have pointed out that many of the studies in the analysis were unpublished and had not been through a rigorous peer-review process and that 80 percent of the studies reviewed were funded by pharmaceutical companies. Finally, some of the authors of the analysis reported consulting fees from companies that manufacture the very drugs they were studying.

So what did we learn from this study? There is a modest benefit in taking anti-depressants for the approximately 3 percent of people with severe depression for the first 8 weeks of treatment. Maybe. Does this study provide a definitive answer about the usefulness of anti-depressants in the vast majority of people who are taking them? Not by a long shot.

More information on non-drug treatments for depression as well as the dangers and side effects of anti-depressants can be found in my book, Do You Really Need That Pill? Now available for pre-order at https://www.amazon.com/Really-Need-That-Pill-Overmedication/dp/1510715649

Shocking Drug Statistics

You might be interested in a preview of these shocking drug statistics from Do You Really Need That Pill?

  • The FDA reported in 2017 that there are 450 deaths in the US each day from adverse drug events and 2500 serious adverse effects daily. Can you imagine the outcry if that many people died or were injured in terrorist attacks or plane crashes every day?
  • In 2016, there were 64,000 deaths from drug overdoses, which have topped traffic accidents as the leading cause of accidental deaths since 2009.
  • $487 billion was spent in 2015 in the United States on prescription drugs, including retail pharmacy sales and those in hospitals and doctors’ offices.
  • Pharmaceutical companies spend $14 million each day on advertisements directly to consumers, more than $5 billion a year. The US and New Zealand are the only countries in the world that allow direct-to-consumer drug ads.

Food for thought.

Book Publication News!

Great news! The publication date for Do You Really Need That Pill? has been set for June 5, 2018. I am grateful that the book, revised and updated, will finally get into the hands of all of you who have been waiting. And I am pleased that this important information will reach many  of the people who may unknowingly be taking medications that they don’t really need and which are making them sicker.

I will be scheduling book signings, media events, and speaking engagements in many of the places where I have lived and/or worked. If you have suggestions about locations, contacts, or would like to help coordinate an event, please let me know on the comment form.

The reviews of the book from leading figures in integrative medicine have been stellar, including the following:

“Overdiagnosis and overmedication are major public health issues in the United States and, if the trend continues, will only increase with the growing senior population. Dr.Jacobs gives practical, evidenced-based advice for dealing with some of the most common health problems we face in today’s society. Read this book—it may just save your life!” —BRIAN BERMAN, MD, director, Institute for Integrative Medicine, University
of Maryland School of Medicine

“Dr. Jennifer Jacobs’s Do You Really Need That Pill? is a sound, sympathetic, practical guide to the risks of excessive prescription drugs and safe, effective alternatives to them. I recommend it to anyone concerned about a chronic health problem they, or
someone close to them, suffers from who wants to reduce medication and find safer, effective alternatives.” —DR. PETER FISHER, physician to HM The Queen, director of research, Royal London Hospital for Integrated Medicine

“A thorough and well-documented resource on the pharmaceuticals prescribed today. A good reference for anyone interested in learning more about the medications they or their loved ones are taking.” —PATRICIA M. HERMAN, ND, PhD, senior behavioral
scientist, RAND Corporation