caffeine side effects

[© Kjetil Kolbjornsrud |]

Do you use caffeine to help wake up in the morning or perk up in the evening? If the answer is yes, you are not alone. Millions of people use caffeine on a daily basis. According to Johns Hopkins Medicine, “caffeine is the most mood-altering drug in the world.”

On average, Americans consume about 280 milligrams of caffeine daily—about 30 milligrams alters mood and behavior and 100 milligrams can result in physical dependence. So how many cups of coffee a day is too much? The Food and Drug Administration (FDA) warns that four to seven cups of coffee is too much, however, everyone can be affected differently.

If you consume too much caffeine on a daily basis, side effects can include insomnia, nervousness, irritability, upset stomach, rapid heartbeat, muscle tremors and restlessness. Those who do not consume caffeine on a regular basis may be more sensitive and experience negative effects faster. Also, factors such as age, gender (females are more prone), medications and body mass can play a role in sensitivity.

The recent buzz
In recent years, caffeine use has been on the rise, and the industry is responding to Americans’ obsession with caffeine. While caffeine was typically consumed through coffee, tea, cola beverages and chocolate, more recently, caffeine can be found in all shapes and sizes—from energy drinks and pills, to powder you can mix into food and caffeinated gum. This addiction has become increasingly easier to form.

The addition of these products to the market has dramatically impacted public health, with thousands of caffeine overdoses, addiction and, in rare instances, death. The FDA has stepped in to warn people about the risks involved with consuming too much caffeine and has also banned various new, dangerous caffeinated products.

It’s not all perks
Caffeine can also be especially dangerous to those with existing health conditions. According to the FDA, “People with heart problems shouldn’t use caffeine because it makes their hearts work too hard.” Additionally, “People with anxiety problems or panic attacks may find that caffeine makes them feel worse.”

If you are one of the many caffeinated people out there, it is important that you monitor how much caffeine is in the food and drinks you consume and listen to your body if you think you could be experiencing a reaction or withdrawal. Speak with your primary care doctor about your caffeine intake to see what is right for you.

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anemia and your heart

[© Skypixel |] Some common anemia symptoms include lack of color in the skin, increased heart rate, fatigue, headaches, and irregular or delayed menstruation. When anemia is left untreated or is severe, it can affect your whole body—especially your heart.

Many people suffer from anemia but do not realize how it can affect your heart’s function. Anemia can cause your heart to work harder to pump blood and result in a rapid or irregular heartbeat.

What is Anemia?
Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood. “Anemia stems from a variety of conditions,” says Karl Kasamon, M.D., a hematologist on staff at Howard County General Hospital, “but the most common cause is iron deficiency.” Common symptoms include lack of color in the skin, eyes and lips, increased heart rate, fatigue, breathlessness, irritability, headaches, irregular or delayed menstruation and jaundice.

“Those at the highest risk for anemia are menstruating females and generally elderly patients who have gastrointestinal related blood loss or bleeding,” says Dr. Kasamon. When anemia is left untreated or is severe, it can affect your whole body—especially your heart.

“The connection between anemia and heart complications is clear,” says Dr. Kasamon. “Red blood cells carry oxygen from lungs to tissues. When your red blood cells are low (you are anemic), your heart has to pump and carry blood cells much faster to deliver the same amount of oxygen. This strains the heart to contract faster and more intensely than normal.”

If you already have a heart condition, the condition can worsen if you develop anemia. Other factors, such as demographics, can determine the risk of anemia linking to heart conditions. “For example, 20 year olds with severe anemia rarely have dangerous complications, whereas older adults are at a much higher risk even if they are just mildly anemic,” says Dr. Kasamon.

Getting Treatment
Anemia is a reversible disorder. To optimize heart health, seek treatment for anemia to correct the red-blood-cell level back to normal, which will take strain off and positively affect your heart. Treatment varies depending on the cause of anemia and can include iron supplements, changes in diet, vitamins, prescription medication, blood transfusions or bone marrow transplant.

Dr. Kasamon also encourages those with anemia symptoms to be screened by a physician. “Patients often assume their anemia is caused by iron deficiency and self-medicate with iron. In some cases, this can cause iron overload and ironically lead to a variety of complications, including heart failure.”

Karl Kasamon, M.D., is a hematologist with Chesapeake Oncology-Hematology Associates in Columbia.

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8 Ways to Avoid Sitting Disease

sitting disease

[© Nruboc |] One way to avoid sitting all day at a desk job is to take your calls while standing up.

You Can Start By Reading This Blog Standing Up

Sitting for many hours a day is a common practice. Without realizing it, many people are falling victim to sitting disease. The American College of Cardiology defines sitting disease as being sedentary for many hours with little movement and calls it a lifestyle risk factor for cardiovascular disease, blood clots, heart attack, stroke, diabetes and a variety of other conditions.

Even those who incorporate exercise into their routine can have sitting disease. “Going to the gym three days a week to get your heart rate up is not sufficient. You actually need to incorporate movement throughout your daily routine as well,” says Kabir Yousuf, M.D., a cardiologist on staff at Howard County General Hospital. “Often people try to plan out their physical activity too much and get wrapped up with a trainer or a gym class exercise regimen instead of getting out and just moving. My philosophy is to just get up and move—the more the better. This is especially important if you have a sedentary job. Moving doesn’t have to be scheduled—every step and minute you spend doing physical activity counts and can reduce your risk of cardiovascular disease.”

Desk Jockeys: 8 Ways to Stay Fit

  • Take the stairs
  • For every hour you sit, move for five minutes. If you can’t do this every hour, do it every two hours and increase your movement to 10 minutes.
  • Instead of sitting while on the phone, stand.
  • Park further away in the parking lot to take advantage of walking.
  • Have walking meetings instead of sitting in meetings throughout the day. If you even take a quarter of your meetings outside of the conference room and walk somewhere, it is beneficial.
  • When you are at a store—instead of shopping right away—take a lap or two around the store before buying anything.
  • Get a partner or a friend to motivate you—you will be more apt to be active when you have a partner.
  • Incorporate technology—using activity trackers, websites and apps, you can track your activity and be reminded to move throughout the day.
Kabir Yousuf, M.D., is a cardiologist with Maryland Cardiovascular Specialists. To schedule an appointment, call 410-740-0549


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heartburn, GERD

[© Atholpady |] Acid reflux occurs when stomach acid or its contents flow back and irritate your esophagus lining. Over time, the inflammation can cause complications. Healthy lifestyle choices (like avoiding tight clothing and eating smaller meals) can make a big difference in your symptoms.

Gastroesophageal reflux disease (GERD) or acid reflux disease is a chronic digestive disease that occurs when stomach acid or other stomach contents flow back into the esophagus irritating the lining. Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, esophageal narrowing or Barrett’s esophagus (a precancerous condition).

What are common causes?
Causes include an abnormal weakness or relaxation of the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus that allows food and liquid to flow into your stomach — or structural problems, e.g., hiatal hernia, which weaken the mechanism that prevents acid reflux into the esophagus.

What are signs and symptoms?
Symptoms vary and include:

  • Burning in the chest, throat or upper abdomen (heartburn)
  • Acid reflux into the throat causing voice hoarseness, cough, throat irritation; and/or angina or chest pain

How is it diagnosed?
Your doctor may be able to diagnose GERD based on frequent heartburn and other symptoms. Other tests include pH testing, endoscopy and X-rays of the upper digestive tract.

What sort of lifestyle changes can help?
Maintain a healthy weight.
Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If you are at a healthy weight, maintain it. If you are overweight or obese, work to slowly lose weight.

Avoid tight-fitting clothing. This puts pressure on your abdomen and the lower esophageal sphincter.

Avoid food and drink triggers. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion and caffeine may make heartburn worse.

Eat smaller meals. Too much food in your stomach may put pressure on your esophageal sphincter and not allow it to close.

Don’t lie down after a meal. Wait at least three hours after eating before lying down or going to bed.

Elevate the head of your bed. If you regularly experience heartburn at night, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by six to nine inches. If it’s not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.

Don’t smoke. Smoking decreases the lower esophageal sphincter’s ability to function properly.


Common GI Procedures, What you Should Know: March 23, 2016, 7-8:30 p.m. Register now for this free seminar presented by Rudy Rai, M.D. Held in the Howard County General Hospital Wellness Center.

How is it treated?
Most people can manage GERD with lifestyle changes and over-the-counter medications that neutralize stomach acid. Antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.

Medications to reduce acid production, called H-2-receptor blockers, don’t act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions of these medications are available in prescription form.

Proton pump inhibitors are stronger blockers of acid production than are H-2-receptor blockers and allow time for damaged esophageal tissue to heal.

If you don’t experience relief within a few weeks, you may need stronger medications, or even surgery, to reduce symptoms. New surgical options are offering promising results.

Are there any new treatments available in the management of GERD?
In situations where medications aren’t helpful or you wish to avoid long-term medication use, your doctor may recommend surgical options to relieve your symptoms.

Rudy Rai, M.D., is a gastroenterologist in Columbia. To schedule an appointment, call 410-290-6677.



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gluten-free diet

Celiac disease is a genetically predisposed autoimmune disorder that affects the small intestine when gluten is consumed. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily. [© Andresr |]

The Gluten-free Phenomenon

In the last few years, the phrase “gluten-free” has become a household term. Whether you are walking down a grocery store aisle or reading a menu at a restaurant, it is no longer uncommon to see these words. For those suffering from celiac disease, these new additions are a welcome sight.

What Is Gluten?
Gluten is the name used for the proteins found in wheat, rye and barley. It acts as glue in foods, helping them maintain their shape, and is found in many foods.

Celiac and Gluten Connection
Celiac disease is an autoimmune disorder that affects the small intestine when gluten is consumed. According to Johns Hopkins Medicine, “When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Tiny fingerlike protrusions, called villi, which line the small intestine and enable the absorption of nutrients from food into the bloodstream, are lost. Without these villi, malnutrition occurs, regardless of how much food a person consumes.”

Celiac disease can be confused with irritable bowel syndrome (IBS) or other bowel issues. Patients are diagnosed most often with a blood test, which is a noninvasive approach. However, the gold standard to diagnose celiac disease is through an endoscopy with biopsies of the small intestine. Before any testing for celiac disease, you should continue to include gluten in your diet to ensure accurate results. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily.

Signs of celiac disease can include bloating, gas, indigestion and diarrhea. However, some patients could have constipation or no GI symptoms at all. If you are having digestion issues, you should see your primary care physician first. If there is no diagnosis and symptoms don’t resolve, then you should visit a gastroenterologist who specializes in conditions of the digestive tract.

Anyone can get celiac disease. In fact, about one percent of the population, or nearly three million people, likely have celiac disease and are unaware of it. Celiac disease is a genetically predisposed disorder. Once a family member is diagnosed, you should be aware that you are at a higher risk of having or developing the disease and may want to be tested. However, you can be a carrier of celiac disease and never show symptoms until later in life, if at all. Being a carrier of the gene means you may not have the disease, but may be prone to it. It does not mean you will definitely develop it. Additionally, people with autoimmune disorders such as rheumatoid arthritis, Type 1 diabetes, osteoporosis, abnormal liver function and/or disease, or anemia are at higher risk for celiac disease. If you have one of these autoimmune conditions, you should consider being tested for celiac disease if you have symptoms and are not improving.

Although there is no cure for the disease, there is a lot of research underway for treatment, including prescription drug studies. Currently, the only treatment that is known to ease the symptoms of celiac disease is to eliminate foods containing gluten from your diet.

So What Should I Eat?
The Celiac Foundation’s website or the National Foundation of Celiac Awareness website have a lot of good information on diet options. The most important consideration when choosing your food is to be mindful of reading labels as many unsuspecting foods, and even some medications, contain gluten.

When Am I Going to Feel Better?
If you have celiac disease and start reducing your gluten intake, you should feel better within a couple of weeks. In some cases it takes up to a month before you notice a difference and start feeling better. Often this occurs because you have unknowingly consumed gluten.

Mahmood Solaiman, M.D., is a gastroenterologist with Gastro Associates in Elkridge. Appointments: 410-590-8920.


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flu fighting tips

The best defense from the flu is a flu vaccine, and December is not too late to get one. The best defense from a cold is to wash your hands and avoid contact with airborne germs from coughs or sneezes of others. [© Racorn |]

If you’ll be home for the holidays, you’ll likely socialize with family and friends, travel on an airplane or be one of the crowd at the mall… and someone there inevitably will be sick. All it takes is one projectile sneeze, a handshake, a kiss at a party, or a taste of the dip after someone else double dipped and wham! You’re down with a cold or the flu.

Some people may think the flu isn’t all that serious; but you need to remember that it can be a very dangerous—even fatal—illness, especially for the very young, the very old and the immune-compromised. It descends upon our local communities every year, often causing serious illness and sometimes death. And after the holiday season, we begin seeing more cases.

The best defense from the flu is a flu vaccine – and December is not too late to get one. According to the Centers for Disease Control (CDC), it takes about two weeks after receiving the shot to develop antibodies to fight flu. The best defense from a cold is to wash your hands and avoid contact with airborne germs from the coughs or sneezes of others. Eating and sleeping well can also help boost your immunity. Here are some tips for safe socializing this holiday season:

      • wash your hands often
      • don’t share drinks or food
      • let your faithful friends gather near but not too near – try to stay away from people who are sick
      • stay home if you are sick, and
      • cover your cough with a tissue or cough into the inside of your elbow so your hands don’t transmit germs.

What should I do if I get the flu?
If your illness is mild, stay home and avoid contact with other people. Call your doctor’s office to see if a prescription antiviral drug is right for you. You should stay home for at least 24 hours after your fever is gone. However, if you have symptoms and are in a high-risk group, contact your doctor for advice.

What is the difference between the common cold and the flu?
In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness and dry cough are more common and intense. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections or hospitalizations. Special tests done within the first few days of illness can determine if you have the flu.

If you practice good infection prevention, you may be able to avoid looking like Rudolph the Red-Nosed Reindeer this season. Healthy Holidays!

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