It's the Holiday Season....why you so SAD?

When winter rolls around....

We all know the friends and family that say every winter that they are moving south.  They can't stand the weather or the snow or having to dress up in more layers than grandma's lasagna.  Some people actually do it and make the move to Florida, Texas, Arizona or some sunshine state.  For the rest it is a hollow threat that is blocked by the warm kindling of holiday aura or they are just too SAD.  

SAD stands for seasonal affective disorder

SAD is type of depression that one experiences due to the changes in the season.  If you are like most people, your symptoms begin and last throughout the winter season and this is referred to Fall and Winter SAD--much more common than its counterpart Spring and Summer SAD.  The result is a sapping of the body of energy, decreasing motivation and self image.  For some, this starts a cycle of depression that can last into the spring and even the summer!  Having said that, don't brush it off!  There are things you can do!

The Problem

Serotonin production falls off the charts! It is impossible to understand all the reasons why in every person but the most common denominator that is used to explain this problem in each person is sunlight.  This leads to poor choices in diet, sleep and exercise patterns.  Couple that with poor eating and drinking habits for the holidays and we have a bomb about to go off by January.   Symptoms include:

  • Irritability
  • Tiredness or low energy
  • Problems getting along with other people
  • Hypersensitivity to rejection
  • Heavy, "leaden" feeling in the arms or legs
  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain

Being indoors for months of the year is a relatively new phenomenon for the history of humans.  Even for those composes strictly of the most Nordic blood, sun exposure for at least a couple hours per day was unavoidable a thousand or so years ago.  To describe, if you have ever been in a snow covered field on a sunny day, you know how bright that can be, which was probably somewhat protective against SAD for primitive Nordic populations.  I bet the   

The Facts

Everyone should preemptively fight winter SAD as it is a serious cause or accelerator of many diseases linked to depression: 

  • Insomnia (change in Serotonin and Melatonin levels due to sunlight)
  • Diabetes 
  • Heart Disease
  • Obesity
  • High Blood Pressure
  • Substance abuse including tobacco and alcohol
  • Low Vitamin D levels

Who is at the greatest risk?

  • Females--Women have a higher incidence of SAD than men, however men have more severe symptoms
  • Younger patients--The elderly are not as commonly affected by SAD, however smaller changes can have graver consequences (e.g. over-eating, blood pressure increase, insomnia episode.)
  • Family History -- patients with SAD are more likely to have a blood relative with SAD
  • Having Clinical Depression or Bi-Polar disorder
  • Living Far From the Equator-- This one is obvious but is a serious area of inquiry in a many studies currently

Treatment

Light Therapy

Light therapy mimics natural light and appears to cause change in brain chemicals linked to mood.  It is considered the first line therapy for SAD and has positive effects within days.  How do you know which light therapy is right for you?  Our friends at TopBulb.com have made it easy for you here:  

http://www.topbulb.com/light-bulbs/full-spectrum-bulbs

Get the Serotonin pumping....naturally

Serotonin production increase is associated with numerous activities including but not limited to: exercise, playing musical instrument, listening to music, socializing with friends, get a massage or other form of body work, take a couple days south to get some rays, quit smoking (tobacco, marijuana), and sex are just a few.  

Get the Serotonin pumping.....with Medications

Because SAD is largely believed to be associated with a decrease in serotonin, SSRIs (Selective Serotonin Reuptake Inhibitors) are often relied on before natural intervention or if other interventions fail.  Medications like Lexapro, Prozac and Zoloft are commonly tried in addition to other antidepressants such as Wellbutrin.  

The Solution

Make your home brighter

For just a few dollars, you can transform the lighting in your home for a fresh new feel that will naturally improve your serotonin production.  Check out all of these full spectrum bulbs!  It just takes a few minutes: 

Get Outside

There are always fun activities in the winter that can allow you to get some exercise and the rays that you have been missing.  Check out the Zoo, walk to get coffee or hot chocolate so you have a nice warm drink on the walk back, find a cross-country ski park, find an outdoor skating rink, or find a curling court.  For the best results get your 20-30 minutes outside within 2 hours or waking up in the morning.  Even on a cloudy winter day, you can still get many of the essential sun-rays your brain is craving.

Exercise

Exercise and other types of physical activity both improve SAD symptoms.  In addition, being more fit can improve self image and motivation which will certainly help mood.  

Get Plenty of Vitamin D

Vitamin D is produced naturally when we are exposed to sunlight.  When that is not possible or not enough, our levels crash within 5 days!  The farther you are from the equator, the more vitamin D you should be consuming during the winter months.  I recommend all of my patients to be on at least 1,000IU daily with dinner until they get an actual vitamin D level.  You can find Vitamin -D 1,000 IU here: 

 

About the Author

 

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION. 

 "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."--Kirk Heil, PharmD

I'll take the Olympic Medal in Gold, but hold the Zika

The Problem

The Olympics, much to many Chicagoans chagrin is in Brazil this year.  It may be hard to believe now, but summer will soon be here and that means so will the mosquitoes.  As you most likely know, Brazil is one of the countries most infected by Zika Virus.  Zika Virus is most commonly transmitted through mosquito bites-mainly the Aides species.  The most common symptoms of infection are fever, rash, joint pain and conjunctivitis (red eyes).  Most healthy individuals, have these symptoms for a few days and feel better, rarely requiring hospitalization.  The main concern however is for pregnant woman, who if are infected during pregnancy, have an increased risk of a serious birth defect known as microcephaly.  Microcephaly is a birth defect in which the baby is born with a smaller than expected head.  As you can imagine, this indicates slower, or in severe cases, even stopping of brain development.  

Visual of moderate to severe Microcephaly

Visual of moderate to severe Microcephaly

With change in brain development these babies have many complications including but not limited to:

  • Seizures
  • Developmental delay such as speech, walking, standing, eating, and comprehension
  • intellectual Disabilities
  • Feeding Problems
  • Hearing Loss
  • Vision Loss
  • Death

These problems are often lifelong.  

To make matters worse, a infected healthy person can transmit the virus both prior to and after displaying symptoms of the virus.  Besides mosquito bites, Zika can be transmitted via blood and sexual contact lasting in semen much longer than blood.  All of the data on the time and frequency of birth defects and transmission is currently variable and observational as the virus has only been observed in underdeveloped countries.

The Argument

Extreme caution should be taken with travelers from the Olympics or any country with a high rate of Zika Virus due to the dangers for pregnant women and their babies.  The data on Zika complications is poor at best and the CDC and WHO are constantly updating their positions.  Exposure to those infected with Zika is an unnecessary risk for American pregnant women or those in countries where the virus does not currently exist.  The rate in Brazil is an absolute disaster and it is not fair for them to share it with the rest of the world by hosting the Olympics.  See the explosion here: http://time.com/4189782/brazil-microcephaly-zika-virus-babies/

The Facts

  • Zika Virus increases the risk of severe birth defects
  • Zika Virus is currently an epidemic in Brazil
  • There is no good data on how long an infected person can transmit the virus
  • The rate of microcephaly in Brazil has skyrocketed 20x's! (Romero, Simon (30 December 2015). "Alarm Spreads in Brazil Over a Virus and a Surge in Malformed Infants"The New York Times. Retrieved 24 January 2016.)
  • Babies born with microcephaly have a poor chance at a normal life

The Solution

Require all people who have traveled to high risk regions to take a test for the virus.  The CDC has set everything up to do this, but now is the time to enforce it, especially after many travelers will be in Brazil. http://www.cdc.gov/media/releases/2016/s0226-laboratory-test-for-zika-virus.html 

Take universal precautions to decrease mosquito proliferation.  This includes eliminating standing water around your property and city officials clearing the streets of potholes that collect water and filthy streets where standing water can collect in trash.  A simple uncovered trash a few yards from your patio can lead to thousands of mosquito larva hatching within days.

Use insect repellent and follow directions for reapplying.  Usually every few hours.  All EPA-registered repellent has been shown to be safe in pregnant and breast feeding women.  If being out in nature is unavoidable, wear pants and long sleeves to decrease surface areas for the mosquitoes.  If using sunscreen with repellent, make sure you apply the sunscreen BEFORE the repellent  to maintain the effectiveness of each.

If are pregnant or trying to become pregnant, take extra precaution with partners who have traveled to high risk regions {seen here} and ask your doctor if the test is right for them.  

Summer is coming be safe!

Summer is coming be safe!

About The Author

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION. 

 "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."--Kirk Heil, PharmD

Where did my bones go?

The Problem

As your pharmacist was walking towards Lagom today to open the shop, a beautiful Porsche revved its engine.  As an interested man may do I had to take a glance and give me eyes the pleasure that my ears had just experienced.  In doing so, I missed seeing the ice in front of me and slipped, and got to inspect the ash-fault  at the corner of Aberdeen and Randolph.  Luckily, I am a good faller and proped right back up, went on my way and decided to not gawk at such things of beauty with slippery pavement.  

Cover that up, that might cause accidents!

Cover that up, that might cause accidents!

As I snapped up and brushed off the snow I thought about bone strength and how so many people's lives are changed in an instant  due to a simple lapse of attention to the simple task of walking. 

When we look at the numbers, it is alarming, especially for women.  Worldwide, a woman fractures a bone every 3 seconds.  And believe it or not, this statistic is getting worse.  

Many people with weakened bones, a condition known as osteoporosis are treated with medication, Vitamin-D, and calcium supplementation.  These are great treatments, however, as you could imagine, work slowly.  Your bones are one of the slowest growing tissues in your body.  Therefore, by the time someone is diagnosed, they are in the danger zone for increased fractures before their bones are stronger again.

The Argument

Many environmental factors are contributing to brittle bones.  Before we go there, I am not going to deny that with increased life expectancy, we begin to see more health problems.  However, there is an alarming increased amount of osteopenia (pre-osteoporosis) seen in non-elderly individuals.

There are many environmental factors that may be causing weakening bones.  

  1. Fluoride -- yea that stuff in your toothpaste.  It actually inhibits bone mineralization in higher doses.  In countries where people drink a lot of water and tea made with with high levels of flouride (e.g. China, India) the rate of bone fractures is disproportionatly high
  2. Proton pump inhibitors (PPIs) use is an epidemic.  These medications were designed to be used for 2 to 12 weeks depending on the condition.  Yet people take them for years.  The problem is they severely block the absorption of Calcium.  These are Prilosec, Nexium, Prevacid, etc.
  3. Many young women work out to hard and eat too little which consequently starts them out with a low bone mass that they never recover from
  4. Use of anti-anxiety medication and anti-depressant use has been shown too increase fall risk--especailly in the elderly.  The use  of these medications has skyrocketed.
  5. Sedentary lifestyle today is expanding with  addictions to internet, smartphones and even work environment.  This destroys bone strength.  
  6. Newly adapted diets by individuals do not account for adequate intake of essential calcium and vitamin D.

The Facts

  1. A 50 year old woman has a 16% lifetime risk of experiencing a vertebral fracture 
  2. Nearly 75% of all hip fractures occur in women.   Up to 20% of patients die in the first year following hip fractures  Less than half those who survive the hip fracture regain their previous level of function
  3. A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures
  4. Worldwide, 1 in 3 women over age 50 will experience osteoporotic fractures, as do 1 in 5 men aged over 50
  5. Evidence suggests that many women who sustain a fragility fracture are not appropriately diagnosed and treated for probable osteoporosis

The Solution

Don't play from behind.  

Supplementation

Make sure you are consuming enough calcium and vitamin D.  If you live farther north or have darker skin, vitamin D supplementation is even more important for you.  

Usual recommended calcium intake.  Lexicomp. 

Usual recommended calcium intake.  Lexicomp. 

 

Medications

You should avoid long term use of medication that depletes calcium absorption (PPIs) and medication that increase fall risks (anti-anxiety medications and certain antidepressants).  

Exercise

Childhood and adolescence is the best time to build bone strength but if you are lagging , there is still something you can do.  

  1. Strengthening back muscles can decrease the chance of vertebral fracture.  
  2. Exercise can improve balance and decrease the chance of falling to begin with.  In addition, when falling, exercisers have a better chance of falling properly.
  3. Weight bearing exercise can build strength
  4. Specifically designed yoga classes can do all three, targeting the back, hips, wrists and ankles.  (shameless plug for Lagom's bone building class)

About the Author

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION.   "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION. 

 "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."


Drug interactions and Marijuana

The Problem

Illinois is about to embark on the marijuana experiment along with many other states.  Although just a pilot program in Illinois, the fingerprint left on the public will certainly be evident.  In Illinois, the physician and the patient will each be required to subscribe to an Illinois state database that they have met requirements that include a very long list.  Some of the requirements include: 

  • pay stub
  • voter registration card
  • notarized proof of residency
  •  bank statement
  • deed/title, mortgage, rental agreement
  • proof of renters/homeowners insurance
  • letter from a physician registered in the state who completed his/her own checklist

So now that the patient has that list together, look at your medications and look at this chart below to make sure you're good to go!

Physicians and pharmacists are in school for years learning to interpret charts like the one above quickly and meaningfully.  The main predictions these clinicians must try to make is the significance of increased, decreased or blocked metabolism of one substance from another.  This does not account for genetic variabllity in these metabolizing enzymes or the clinical studies that validate the significance.  Altering or continuing therapy is based on this ability.   Both of the primary care physician and pharmacist are eliminated from the care process because the marijuana physician is not the patient's primary care provider and the worker at a marijuana dispensary is not a pharmacist.

The Argument

Patients deciding to use medical marijuana are at increased  risks of drug interactions from not having the proper monitoring or warnings from qualified medical professionals.  There is a significant risk of the drug interactions causing increased hospital visits and possible deaths in patients who are not properly monitored.  

This is so because many of the medications that marijuana interacts with include heart medications, antibiotics, blood thinners and blood pressure medications.  In addition, the starting dose for patients to begin marijuana is highly variable depending on medications the person is taking.  The biggest area of concern are those medications that will block marijuana metabolism causing overdoses of marijuana.  This can lead to confusion, decreased consciousness, vomiting, anxiety, and rapid heart rate to name a few--all very concerning for patients with a lot of health conditions. 

With there being 558 medications that interact with marijuana, this is going to be a guessing game for emergency response teams and hospital staff alike.  When regulators have spent time creating hurdles for patients and prescribers, they should have spent resources to assure public safety from drug interactions and misuse--like prescription medications.  

The Facts

  • Marijuana is known to interact with 558 different medications 
  • Marijuana, whether smoked or eaten will cause the same drug interactions
  • Most patients' primary care provider will not be prescribing marijuana
  • Dispensaries do not have the ability to educate or interpret drug interactions like a pharmacist in a licensed pharmacy could
  • Studies for safety with all 558 interactions with prescriptions drugs have not been done 

The Solution

Marijuana use is still in an experimental phase.  It should be used in extreme caution or even avoided for patients taking certain medications.  Your primary care physician and pharmacist are going to be your best resource for interactions between marijuana and your current medication list.  Not only do they have the best understanding but they also know your history the best.  Do not stop or alter your current medications in anticipation of interactions without consultation with your doctor or pharmacist.  Your pharmacist can interpret the data for you physician to help them make a decision to prevent or treat drug interactions you may have.  

About the Author

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication.   "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication. 

 "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."


Stop pulling a Lucy on your body...have the Lagom amount of sugar

The Problem

We all remember Lucy pulling the football making Charlie Brown wipeout.

We all remember Lucy pulling the football making Charlie Brown wipeout.

When you consume artificial sweeteners you are not just pulling a Lucy on your digestive system but on your entire body.

Believe it or not, digestion doesn't just begin when food first hits your stomach or mouth.  At the scent or sight of food, your salivary glands begin to increase production.  This begins the digestive pathway.  Your stomach begins to growl, enzymes are released, insulin production begins and your body prepares to take in and break down energy for utilization.  With artificial sweeteners, all of this effort and all the energy your organs are relying on go for naught and actually stress the body to produce its own energy.  Studies have shown that the stress hormone, cortisol, is increased in regular consumers of these artificial sweeteners.  Yes that ugly hormone, that disturbs sleep, decreases concentration, and causes belly fat among other things.  In addition, studies have shown that the reward center in the brain is not stimulated following consumption of artificial sweeteners, leading to increased hunger and overeating in the future.

No prescription may be dispensed when a pharmacist is not physically present in the establishment and on%2.png

The artificial sweetener market is an $8billion per year market and growing every year.  It continues to grow along with the diabetes epidemic.  It seems like every 2-3 years, there is a new found artificial sweetener that is healthier and more natural than its predecessors.  The reaction is the same every time.  The public devours it like they haven't eaten for days, studies come out how it is actually bad for you, the consumer continues to fight obesity more and more, then they try the newest sweetener fad. 

The Facts

  • There are now 5 widely used artificial sweeteners on the market
  • Artificial sweeteners are significantly cheaper than natural sugars making their use more profitable for food and drug companies
  • Artificial sweeteners have very long shelf lives compared to traditional sugars
  • There are over 6,000 food products on the market with artificial sweeteners
  • Humans have evolved to digest and process many types of sugars and rely on it for energy
  • Stevia is the fastest growing artificial sweetener, presumably has the same endocrine problems and has many trade names (Stevia, Truvia, PureVia)

The Argument

Artificial sweeteners have a very limited role in food and medicine.  Tricking the body that it is going to get an energy source and then pulling it away stresses the body and may be a significant contributor to diabetes, depression, insomnia, lethargy, and weight gain. 

Due to low cost of artificial sweeteners and public perception that it is healthier than consuming calories, it is going to become more and more difficult to determine the risks and benefits of using them over traditional sugars.  

As studies continue to evolve, artificial sweeteners will soon be viewed as one of the greatest contributors to weight gain and diabetes. 

Raw honey and pure cane sugar in moderation are the two best sweeteners.  Raw honey in particular actually offers many health benefits.   *Warning: Raw Honey should never be given to infants due to serious health risks**   

The Solution

  • Read labels for artificial sweeteners
  • Only allow for artificial sweeteners in products that are not a meal/snack substitute (i.e. cough medicine, vitamins, mouth wash)
  • Use raw honey as a sweetener when possible
  • Pure cane sugar is not lethal but should be consumed in moderation.  Or as we like to say, the Lagom amount.

About the Author

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication.   "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication. 

 "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."



 

Shot of B-12 please...hold the cyanide...

The Problem

Vitamin B-12 is a crucial nutrient important for nerve health and blood cell production.  It is constantly under investigation to prevent and treat many ailments.  Surprisingly up to 40% of the population is B-12 deficient leading to the misdiagnosing of patients due to mystery symptoms.  Vegetarians and vegans have a much higher incidence of this deficiency but it can even be seen in many meat eaters too due to absorption issues.  The word is out there of this problem and vitamin manufactures, energy drink companies and pharmacies have responded by producing a laboratory invented form--cyanocobalamin.  Read closely.  Is it? Really?  Yes cyanide, that stuff used to murder people.

So why would vitamin companies be giving you cyanide?  It's about 100 times cheaper to produce cyanocobalamin than methylcobalamin.  The cyanide containing form of B-12 is converted by your body to methylcobalamin and adenosylcobalamin which your body can actually use, leaving the cyanide for your body to eliminate.  This isn't an amount to kill you but it does stress the body to be eliminated.  The incidence of increased blood pressure and chest pain for patients following cyanocobalamin injection is surprisingly high leading one to believe it may be due to this stress.  In addition, because your body must convert this cheap, low-grade substitute, it is impossible to estimate the amount of vitamin B-12 and cyanide your body is actually absorbing.

The Facts

  • Cyanocobalamin is a synthetic compound not found in nature
  • Using cyanocobalamin is 100x's cheaper to produce than methylcobalamin
  • Cyanide is a byproduct from cyanocobalamin conversion
  • Vitamin B-12 is important for nerve health and blood cell production
  • Your body must convert cyanocobalamin to methylcobalamin and adenosylcobalamin in order to use it
  • The rate of cyanocobalamin activation is unpredictable
  • Anticipating public outcry, vitamin manufactures and energy drink manufacturers have all changed their labels in the last few years to only put B-12 on the package, avoiding "cyanocobalamin" in an obvious location

The Argument

Food and vitamin manufactures over the last 100 years have had the difficult task to produce large quantities of foods and supplements at a low cost to feed a growing population.  However the more we understand, the more we realize that it is time to catch up with all the data.  Cheap and mass production is not necessarily the safest.  From processed foods loaded with sodium and dangerous preservatives, to genetically modified meats(http://www.fda.gov/animalveterinary/developmentapprovalprocess/geneticengineering/geneticallyengineeredanimals/) to wood flooring containing formaldehyde(http://www.epa.gov/formaldehyde/questions-and-answers-regarding-laminate-flooring-0)  we are constantly asked to calculate how much low cost and convenience makes other risks acceptable.

Low-grade vitamin manufactures and cheap big-box pharmacies are going to continue to give you whatever is cheapest as long as they can get away with it.  They currently hide in the ingredient label that they are using the low-grade form of Vitamin B-12 in their cheap supplements.  Look at a label for Vitamin B-12 from Walgreens.  They all contain cyanocobalamin and they even have FD&C Red 40, a controversial food dye that has for long been accepted as a likely carcinogen (http://ntp.niehs.nih.gov/ntp/roc/content/profiles/cresidine.pdf).  Even if it is safe, why add it to a vitamin?   And even though it is 100x's cheaper to produce the cyanide containing form, it is not 100's cheaper for you--it saves you just a couple of dollars.

The Solution

  • Look at your vitamin bottles for "cyanocobalamin" and if they have it throw it away
  • Don't trust energy drinks that just read "vitamin B-12"
  • Ask your doctor for Hydroxocobalamin if you receive B-12 injections
  • Do not buy vitamins that hide the chemical name in the ingredient panel instead of the front label or nutrition panel
  • If you need vitamin B-12, use methylcobalamin for a couple dollars more

About the Author

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication.   "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication. 

 "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Vitamin B-12.  Without the cyanide.  Available everyday at Lagom Rx.

Vitamin B-12.  Without the cyanide.  Available everyday at Lagom Rx.






Navigating the Overmedicated American Medical System

The Problem

Purchasing prescription drugs directly from a manufacturer without a prescription is illegal yet having prescription drug ads bombard you in your home via television ads is legal.  Prior to 1997, these ads were illegal.  As a result, on average, big pharma now spends more on product advertising than product development.  This has undoubtedly been one of the biggest contributors to creating the most medicated country in the world.
Today the United States and New Zealand are the only countries in the world that allow for DTCA (direct to consumer advertisement) for prescription medications.  The main goal of these ads is to relay a symptom to the consumer and promote you to "ask your doctor" about the medication.  This leaves the clinician down the difficult path to denying care and possibly losing a patient.  The psychological reason a prescriber may give in is limitless however the numbers don't lie.  In a recent study published in Medical Care, 50% of patients asking their doctor for a medication they saw in a television ad get a prescription.  In the same study, patients requesting a prescription for OxyContin were 20% successful!
Despite FDA regulations, DTCA is still the wild west.  The FDA has rules and regulations in place to regulate the message to consumers but with 75,000 pharmaceuticals currently available and the seemligly endless streams to advertise, it is truly the wild west for drug advertisers. 

The Facts

  • Nearly 70% of Americans are on a prescription medication
  • Nearly 50% are on 2 medications
  • 100,000 deaths per year can be attributed to prescription medications
  • 9 out of 10 prescribers accept gifts from the drug industry
  • the U.S. ranks 17th in life expectancy among developed nations and by far ranks 1st in prescription consumption

The Argument

Big pharma wants you to live longer and they want to make money.  The industry would argue that they are improving lives and feeding the human nature of survival.  This is a noble cause and there is certainly some truth behind it but many have gone too far in many instances.

Big pharmacy chains such as Walgreens and CVS want to keep you sick so you keep coming back for more medication.  It would be very pressing to determine the difference between a modern big box pharmacy and a pharmacy in the 1950s.  One might even argue that it has even taken a step back by promoting the overmedication of Americans.  In fact, every pharmacist at Walgreens and CVS is given a bonus for increasing the number of prescriptions dispensed per patient.

The Solution

  • Trust what your doctor prescribes
  • Ask your doctor what has been shown to avoid health problems
  • Do a personal training session
  • Know your family history
  • Get a nutrition/dietician consultation
  • Avoid buying into advertisement claims about your health
  • Avoid conversations with pharmacists at the big box pharmacies that say, "you will be on this the rest of your life"
  • Find a pharmacist that understands your Doctor's entire prescription (Diet, Exercise, Sleep, Stress, Medication)

About the Author

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication.  According to Kirk:  "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Kirk Heil, PharmD is the pharmacist and founder of Lagom Rx.  He believes in fixing diet, exercise and daily habits before adding a medication.  According to Kirk:

 "Everything in my design of Lagom Rx was done to inspire you to live a longer, healthier life.  From the space I have created, to the team I have assembled, to the supplements I have designed that mission is relentless."

Flagship store: 114 N Aberdeen, Chicago, IL

Flagship store: 114 N Aberdeen, Chicago, IL