Medicine Outside the Box: Clinical Experience as Evidence Base 

By Gerard Guillory, MD - 2/24/16

Standardized clinical practice guidelines have become the norm in modern medicine. The National Heart, Lung, and Blood Institute publishes guidelines for the management of cholesterol; the American College of Rheumatology publishes guidelines for the management of arthritis; and the American College of Gastroenterology publishes guidelines for the management of inflammatory bowel disease. The list goes on. There is certainly merit to these (and other) practice guidelines. They set quality standards and make the practice of medicine more consistent. Published medical studies inform practice guidelines and establish what has become known as “evidence-based medicine.”

Studies Suggest Calcium May Not Strengthen Bones 

Older adults are currently advised to consume a total of 1000-1200 mg of calcium per day to prevent osteoporosis and bone fractures, but this recommendation has recently come under scrutiny. Two comprehensive reviews of the literature, published in the online version of the British Medical Journal, suggest that neither dietary calcium nor supplemental calcium strengthen the bones. One review analyzed 59 studies and concluded that increasing calcium intake provides an initial and small increase in bone mineral density with no ongoing benefit after 1 year.[i] Another review analyzed 52 studies and concluded that increasing calcium intake does not reduce the risk of fracture.[ii] This information adds fuel to the calcium controversy, which was spurred in recent years by evidence that supplemental calcium may increase the risk of heart attacks and other cardiovascular events.[iii]

Calcium Intake Does Not Reduce Fracture Risks

Vitamin D – An Effective Treatment for Insommnia

By: Dr. Gerard Guillory, MD

Vitamin D is sometimes referred to as “the sunshine vitamin” because our bodies synthesize vitamin D when our skin is exposed to ultraviolet rays from the sun. It is also categorized as a fat-soluble vitamin because it is found in a few fatty foods, including fish liver oil, beef liver, and egg yolks. More accurately, however, vitamin D should be categorized as a hormone. Vitamin D has activity in most cells of the human body. It increases our ability to absorb calcium, assists in fighting infections, and even improves mood.

What Should I Look For in a Vitamin B9 Supplement?  Folate vs. Folic Acid 

Dr. Gerard Guillory, MD  
4/6/16

The main physiological difference between the effects of folate and folic acid are a result of the way that the two substances are processed by the body. Folate, the natural substance found in foods, is made up of a variety of different derivatives of tetrahydrofolate (THF).  THF is metabolized in the small intestine providing all the benefits of vitamin B9 or folate which include:      

-          Aids in development of red blood cells

-          Helps to slow memory decline with aging

-          Protects against lung, colon and cervical cancer                           

-          Helps to decrease homocysteine levels

-          Supports nervous system

-          Prevents neural tube defects in newborns

-          Supports adrenal function

-         Needed for key metabolic processes 

        

Protect Your Heart—Donate Blood!

Dr. Gerard Guillory, MD  
4/26/16

We have known for decades that donating blood can offer protection against heart disease. A 1998 study of almost 3000 middle-aged men in Finland reported that blood donors had an 88% reduced risk of heart attack when compared with non-donors. Since that landmark study, recent research has revealed even more cardiovascular benefits of donating blood. Blood donors, for example, have been found to have lower total cholesterol and lower LDL-cholesterol than non-donors. In addition, a randomized, controlled trial found that patients who have metabolic syndrome (sometimes called pre-diabetes) can lower their blood pressure, improve blood sugar control, and reduce markers of cardiovascular risk by donating blood.

        

Will Private-Practice Medicine Survive?

Dr. Gerard Guillory, MD

In recent years, physicians have been making an exodus from private practice to take salaried positions in hospitals or with managed care organizations. Whereas 57% of all US physicians were in private practice in the year 2000, that statistic dropped to 37% in 2013. A recent report predicts that only 1 in 3 physicians will be practicing independently by the end of 2016.