Iodine Deficiency in Hypertensive Patients


Iodine deficiency in hypertensive patients

Patients diagnosed with hypertension are routinely advised to limit salt intake. However, the correlation between hypertension and salt intake has been questioned by some, while salt-less food is found tasteless by many. Also, salt iodized with KI (Potassium Iodide) is an important source of iodine in many countries, especially in areas, where iodine insufficiency has been detected. Insufficient intake of salt if coupled with nutritional iodine deficiency from other sources may lead to hypothyroidism with resulting myriad of related symptoms, such as lack of energy, sadness, and fatigability, sleep and eating disturbances, difficulty concentrating, etc., as part of the overall slowed down metabolism.

That includes hyperlipidemia and depression, both independent variables, which may lead to Coronary Artery Disease (CAD).  The Recommended Daily allowance (RDA) for iodine is 80 to 100 µg, with the optimal diet intake between 150 and 300 µg. Doses, which greatly exceed the RDA can lead to either hypothyroidism or hyperthyroidism. Iodine deficiency in adults also occurs when iodine intake is less than 20 mg/day. Most of iodine is obtained by ingestion of iodized salt (70 mg/g), some from water (varies from 2 to 10 mg/L depending on proximity to the sea), soil, seaweeds (in Asia), and from fish.   Iodine sufficiency is assessed by measurement of urinary iodide excretion, which is expected to be more than 10 mg/dl.

The deficiency of iodine causes thyroid enlargement,  which is an attempt to concentrate iodine.  This deficiency could be due to deliberate avoidance of salt in iodine-poor environment, as often the hypertensive patients are advised to do. Once a diagnosis of iodine deficiency related hypothyroidism is made, iodide supplementation then becomes essential as in the form of KI  to prevent a further progression to a more advanced stage . Plasma thyroid-stimulating hormone (TSH) levels are monitored until they are in the normal range. By monitoring TSH levels, and responding therapeutically to even the low normal ones, one can prevent a cascade of events leading not only to hypothyroidism but also to depression, myocardial infarct and many other complications.

There is a need to inform the public about proper iodine supplementation, especially so when advising to use (iodized) salt sparingly, as in the case of hypertensive patients.

Adam H. Zynger Feb.20, 2004


Save Energy: Go Naked! And Shave Your Head Too!



We are in the midst of a hot and humid summer. Many of us consume tremendous amount of energy by using AC to cool down. Well, here is an alternative. Drop your clothes and go naked, shave your head, too! And turn the fan on instead of AC if need be. Thermographic images confirm what’s known about the loss of heat by human body. The head, torso and groin are the main heat generators while the extremities, especially fingers, toes and the nose are most sensitive to cold. If lucky, you may actually get your own thermal photo. Just ask the local insulation specialist when he comes to assess your house for heat loss using thermographic photography to do your naked photo as well. It is a reverse situation- you want to prevent the heat loss of your house but facilitate your body’s heat loss!


A schematic representation of the greatest heat loss area (red) and the greatest sensitivity to cold (blue) as revealed by a thermographic image

Thus a decent exposure of these areas becomes a mandatory answer to the quest for energy, which triggered many conflicts worldwide and to a global warming as well. Take a stand and be counted. Try this new approach: the secret’s in the crotch!

Of course, in the winter a reverse would be true. You want to protect the same areas from heat loss. So bundle up and wear you ski cap and gloves as well, and turn down that thermostat!

As always, consult your personal physician, to find out if he/she agrees with this forward thinking.


Medical Malpractice Aches and Pains

Medical Malpractice Aches and Pains …


These problems arise when patients, doctors, lawyers, insurances, etc., abuse their respective roles. The gross national product depends on the actual worth of the nation’s resources, be it natural or intellectual, etc. The excessive middlemenship and cost overruns can actually destroy the nation’s economy despite very sophisticated technology. Good example was the Enron scandal, which caused a man-made blackout and a near-collapse of the state of California!

Similarly, the function of health professionals, especially doctors, is to maintain members of society in an optimal health. Excessive malpractice costs can compromise this task. And yet, doctors’ economic ambitions can be equally destructive. Say, a patient develops calf pain due to artery occlusion/stenosis, which may be solved by a simple angioplasty and at a low cost. However, the hospital may find the profits from a by-pass surgery too tempting to advise an alternative treatment, and the patient undergoes a mutilating procedure, ending in an amputation. It causes a spouse of the patient (a chain-smoker) to get a heart attack. The hospital and doctors reap considerable profit from both incidents, which may require a long-term care as well. However, society suffers because of loss of labor, needless expenses incurred for care of disease, which could have been avoided, not to mention the “pain and suffering” of the patient and her immediate family.

Now, the patient and her family with total income of, for example, $30,000.00/yr files a suit for $50,000,000.00, which is much in excess of what they would ever expect to make. The jury, taken aback by the dramatic story and the persuasiveness of the trial lawyer, awards the huge reimbursement to the family (it’s not the shirt off their skin!). The plaintiff gets her money and 30% goes to the lawyer, deservedly or not. This drives the cost of insurance affecting all doctors, most of whom may have been hard working and honest practitioners. Of course, the companies offering malpractice insurance are not charitable organizations either (as they possibly should). They are here to make a profit, and the huge jury awards give them an excuse to jack up the premiums well beyond the reasonable limits. The doctors leave town …

Another cost (if not corners) cutting measure was to hire 25% foreign doctors in the hospital residency programs. These doctors were expected to leave the country after completing their “training”. The “training” concept is frequently used to hire cheap and expandable labor. And, of course, the nurse practitioners, the physician’s assistants – are recently created professions designed to cut the expense of treating the patient at the expense of the quality of care.

In essence, we are dealing here with laws of the jungle – nature rules supreme. In a civilized society though, apart from the effective regulations, we have right to expect to, and rely on ethical conduct of the involved parties. Maybe a little bit a preaching and repetitive moralizing on moderation would help? Or, do we have to go thru a roller coaster of fall and redemption?

Imposing a cap on “pain and suffering” should not be overlooked either. Could some simple cases be handled by caseworkers following a preset fee-schedule? And should the jury be allowed to award someone else’s money or just determine the liability and have the awards made based on overall availability of funds set for this purpose and the number of expected cases calculated statistically? Ultimately, an uninvolved and impartial party may act in a preventive manner by consulting both the patient and doctors of the available treatment options.



On Dogs and Gods


It’s quite fortuitous that in English language dog spelled backward reads god, because there is some overlap between these two…The dog owners often value their proud possessions more than other humans, which may lead to severe injuries to passerby. The dog owners usually blame the victims for bites and lacerations, because the victim failed to understand the dog’s mentation. For example, you are not supposed to walk quickly, let alone run, when you see a dog, since this would trigger dog’s innate instinct to follow the potential pray. In essence, if you get bitten, it’s your fault.

Similarly, God’s subscribers devalue the infidels as subhuman, the consequence being their massive slaughter, torture and resettlements. There is also a similarity between dog training and initiation of believers into a cult. The ‘sit down’, ‘stand-up’, ‘roll-over’, ‘fall-flat with the rump up’, ‘bend’, ‘kiss’, etc. drills, all lead to an absolute submission and obedience to the overlord or the clergy acting as a servant of God. And then there is a Shepherd and his flock (believers) guarded by a guard dog (religious police).

There is also a story about certain 15th c. Italian monk, fratello Canino (little brother Little Dog), who declared the liking for Jesus but not for the Vatican. His fate was sealed. By the decree of the bishop of Florence he was burned alive on a stake, a practice still followed in the Middle East. The same happened to Giordano Bruno for holding a conviction that Sun is the center of Solar System (rather than planet Earth), and to many others for similar reasons. Ultimately, the defiance of authority, no matter how absurd its requisites, was the reason for such harsh and cruel penalties. Thus, Socrates, a Greek philosopher, was sentenced to death by drinking a poison (hemlock) for disrespect to state religion – a Greek mythology. Jews were often expelled from towns for such enigmatic crimes as insulting a ‘Holy Spirit” or cracking a hostia wafer, which surely caused the blood of Jesus to spill out! The Easter holiday was often accompanied by torturing Jews and pogroms as a punishment for deicide. That was also due to a refusal to subscribe to the Christian network. The story of Joshua (Jesus), if at all true, followed the same trend of defying the existing power structure of the Roman invaders and its Jewish subjects, leading to his crucifixion.

So the message is, if you yield like a dog, you may actually live like a ‘god’ but if you set your own rules, no matter, how logical, i.e., play ‘god’; you may wind up living and dying like a dog! And yet, we would be still in the Dark Ages, if it were not for a few daring individuals who defied the existing order, guiding humanity to the next stage in evolution of civilization.


Is BAK Wacky or just Tacky?



For those of you who use eye drops for any reason, you might be familiar with BAK, short for benzalkonium chloride. It is quite ubiquitous preservative designed to stave off microbial insults. It is also a detergent, capable of permeating through various anatomical structures of the eye. While that makes it useful as a carrier of the active ingredients, by the same token it may be harmful to the eye. At least that’s what some ophthalmologists suspected for a long time.

They think that BAC may be damaging to the cornea, to the trabecular meshwork, which facilitates the drainage of aqueous humor and to the lens itself! And, of course, others disagree. A pharmacist at the Poison Control Center recently argued that the amount of BAK in the eye drops is infinitesimally small and its control of infection far outweighs the potential for injury. Yet that small amount is also an effective carrier, i.e., able to reach various internal tissues. Now, how much damage can it really cause?

We know that in a concentration of 0.1% it’s definitely caustic. But the usual concentrations are in a range of 0.004%- to 0.02%. So again can such small concentrations be as harmful as they are useful? Well, the damaging concentration for the trabecular meshwork lab tests was as low as 0.00002%! And what are the alternatives?

A readily available alternative is the single dose container, which is preservative-free, just costs much more. Pharmaceutical industry came up recently with different preservatives as well. These are ionic-buffered systems, which, however, offer slightly less protection against infection. For this very reason some doctors suspect that the BAK alarm is just a marketing scheme to promote the more expensive brands.

Needless to say, all these medications have also inherent side effects as well.