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.

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

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

Is Exercise Better Than Statins?

If you are one of the 36 million Americans taking a statin drug, or if you have been advised to take one, you should know about a new study that compares statins to exercise. Statins (Lipitor, Zocor, Crestor) are the most widely used drugs in the world, with $29 billion in sales in 2013. They are prescribed to lower cholesterol, which most doctors think contributes to heart disease.

Whether or not to take a statin is a dilemma for many, since official guidelines recommend them for virtually everyone over age 65. But as many as one in five people taking statins develop muscle aches and pains, which causes them to stop exercising. This is bad news, since exercise is important for preventing heart disease. So a group of researchers looked at ways that people taking statins could avoid muscle problems and continue to exercise.

Their surprising conclusion after analyzing dozens of studies? People are better off stopping their statins and exercising instead! The researchers reported that:

Exercise is equivalent to statins in preventing heart attacks and strokes, but it is better in reducing overall deaths.
Exercise can delay or prevent diabetes while statins increase the risk of diabetes.
Exercise is associated with decreased obesity while statins sometimes cause weight gain.
Exercise has been shown to increase quality of life, while statins have not.
Exercise benefits the elderly (over age 75) while statins have not been shown to do so.
There is more evidence of the benefits of exercise over the long-term (more than 10 years) than with statins

Not mentioned in the study were the many other side effects of statins, including memory loss and dementia, cataracts, liver and kidney damage, excessive fatigue, mood and sleep disorders, and sexual dysfunction. You can read more about these in my book.

How much exercise is enough? The authors were not specific, but a minimum of 30 minutes of moderate exercise (fast walking, biking, dancing, swimming, running) three times a week is the recommendation by many expert groups.

For those of you interested in more details about the study, it was published in the Journal of the American Board of Family Medicine in 2016, Volume 29, pages 727-740.