Unofficial start to summer!
June 2024
Dear Members,
Happy unofficial start to summer!
Reminder as you head to the beaches and engage in more outdoor activities it is advisable to wear sunscreen and to reapply it every 2 hours. We recommend using mineral based sunscreens that have titanium dioxide and/or zinc oxide as the active ingredients rather than a chemical based sunscreen. Environmental working group (ewg.org) has a list of best sunscreens to use if you need more guidance.
Ticks:
As always, they are predicting this to be the worst season for tick bites that we have yet to encounter. By the calls we are already receiving, we would have to agree! If you spend time in tick infested areas, we recommend that you do DAILY tick checks from head to toe on yourself and all your family members (and pets). If you find a tick and wish to test it for diseases, we recommend that for peace of mind. However, if your tick is positive for a disease, it doesn’t automatically mean you will contract that disease. It does help to narrow down which diseases are potentially there and when not to worry at all. For those of you who own homes or visit people in those areas often, we recommend that you have a supply of doxycycline on hand to take 200 mg (2 tablets) whenever you do find a tick on you as a prophylactic dose (the sooner the better). You can schedule a telehealth appointment with your provider about this to discuss more.
Are fish oil supplements harmful?
As you may have recently read, a new study out of BMJ medicine states that regular supplementation with fish oil in those with no underlying heart disease had a 13% increase in atrial fibrillation and 5% heightened risk of stroke. The study did show that EPA in general was more beneficial than DHA (components of fish oil) but that for primary prevention (i.e. in healthy people), it was still not recommended due to these findings. However, the findings were supportive for those who already had heart disease or atrial fibrillation in showing that fish oil was beneficial. It has also been shown to be beneficial for other health matters. So it really depends on if you have any risk factors. As well, this was a study on fish oil supplements, without regard to brand, dosage, and purity or impurity of the supplements. The authors and critics think the prescribed fish oil capsules (lovaza and vascepa among others) are purer and should not be assumed to have the same risks as mentioned in this study. Also this study was not a randomized placebo controlled study which is the only kind that can truly account for these potential claims and causality. With this new study, we currently do NOT recommend fish oil supplementation in healthy individuals at this time as more studies are needed. Instead try to consume more fatty fishes or flax seeds/oils. It’s always best to eat your vitamins/minerals in foods. If you are already taking for another reason such as to address inflammation, arthritis etc you can discuss with your provider the benefits verse risks of continuing.
Injectables for weight loss:
Discussions about GLP-1 medications for weight loss and health improvement are currently everywhere. While there are many beneficial effects to these medications there are nutritional concerns to be aware of. We often see more people consuming less healthy diets (just less in general) and developing anemia. Our dietician Abigail is offering a 1-hour consultation for patients starting or continuing GLP-1 medications to discuss balanced meals, optimizing gut healthy fiber intake, resistance training to promote lean muscle mass and troubleshooting any side effects of the medication, like constipation. She is offering her comprehensive 5 session package that helps patients with weight management, lowering cholesterol, and controlling blood sugar, meal planning and medical nutrition therapy. She can be reached at abigail@flatironfamily.com or www.abigailnutrion.com/contact for further information and scheduling.
We do understand the frustration of not being able to find stock of your medications due to the shortage. However, at this time we do not support using unregulated compounded semaglutide products. The FDA has specific warnings against the use of this compounded product. Our office is in touch daily with many pharmacies to try to find stock for our patients.
Alzheimer’s disease - The current best prevention is a multimodal one to decrease risk factors for Alzheimer's disease. Studies are now showing a very clear link between sugar consumption and increased risk of Alzheimer’s. It is thought that up to 81% of Alzheimer patients have type 2 diabetes. The biggest risk factor you can change is cutting down on your sugar consumption (which includes alcohol). The other risk reduction efforts are keeping a healthy, more plant based diet and keeping physically active. Your provider can help you to attain these goals.
Microplastics and nanoplastics (MNP) - A recent study in the New England Journal of Medicine looks at how microplastics and nanoplastics are emerging as a risk factor for heart disease. In patients who had carotid plaque and were undergoing surgery for its removal - those that were found to have MNPs in the plaque were at a higher risk for MIs, strokes and all causes of death, than those were not found to have MNPs in their plaque (specifically polyethylene and polyvinyl chloride). The study was small and didn’t prove causality but it’s definitely an emerging topic that is worth taking note. So what can you do? It’s literally impossible to avoid all MNPs as they are ubiquitous. However, to reduce your exposure you can use natural fabrics in your clothing (non-synthetic) and drink filtered water and use a refillable stainless-steel water bottle, keeping clear of plastic water bottles.
COVID - Yes, it is still here and yes we know you are tired of hearing about it. So are we! However, it is not going away and there are new guidelines for those who contract it. With the combination of being vaccinated and previous infections, most do fine with dealing with a COVID-19 infection. However, the senior population and those who are immunocompromised still have a higher morbidity and mortality rate and for this reason, we expect our members to be thoughtful about their infections and contagiousness. The new guidelines are basically the same as with any illness, if you have a fever and/or don't feel well, stay home. If you feel fine, you can go to work, etc but please keep in mind that until you test negative on a home test, you are still contagious. We are available for virtual visits for those who do yes positive and want further guidance and help with symptoms and to discuss the risks and benefits of the anti-viral Paxlovid.
Some new partnerships and possible benefits of your membership:
We are always seeking out ways to improve your membership benefits and have been listening to your suggestions. We are excited to share some discounts we have obtained exclusive to our members. (By obtaining these discounts, we want to remind you that this does not mean we think you should all partake in these tests or services and more importantly, be assured that Flatiron Family Medical does not obtain any compensation from these entities. It is truly a way to enhance some of your membership benefits).
Prenuvo - many of your have been inquiring about the prenuvo (or equivalent) full body scans. As such, we have been able to obtain a $400 discount exclusive to our members. To decide whether this scan is appropriate for you, please contact your provider. You can visit www.prenuvo.com for more information as to what this scan entails.
Galleri - Galleri is a cancer detection blood test that tests for 50+ cancers with a single blood test. It is recommended for those 50 or older or who have an elevated risk of cancer. It detects if you have cancer at the time of the test. It is not a genetic test. It does not predict future risk. The hope is that it detects a cancer signal earlier in someone than they would otherwise know, thereby allowing for earlier treatment. There are false positives and false negatives as with most tests. It seems to do best for the 12 most common types of cancers and the more aggressive cancers such as pancreatic. The more aggressive the cancer the more cell-free DNA it releases into the blood stream which is what this test looks for and so this test is best for these types of cancers (sensitivity of 76.3%). Less aggressive cancers, such as thyroid cancer, it isn’t as good at detection as less is released. So there are caveats but it reportedly helped detect twice as many cancers in patients who used this test than in those that didn’t. For this test, we have obtained for our members an exclusive $200 discount. The test can be performed in our office with one of their kits. www.galleri.com for further information on this test.
Sollis Health - We have many patients that utilize Sollis health for their emergencies and we have reached out and obtained a 20% discount on their annual fees for our members. Sollis Health is basically a private emergency room. They have 4 locations in the city, one in the Hamptons, a few in South Florida and California as well. They are staffed by ER physicians and open 24/7 (not all locations) and have advanced imaging on site. They are able to take care of over 90% of usual ER visits. They also communicate with us regarding your care whenever you utilize them so it is very much coordinated. For pricing and further information on Sollis Health you can reach them at Sollismembership@sollishealth.com or 646-687-7600 or www.sollishealth.com.
We hope you have a good and safe summer and we are available to you as always!
Flatiron Family Medical
@flatironfamily