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February 2018

New Shingles Vaccine soon to be available

In October 2017, the FDA approved a new shingles vaccine, called Shingrix. In January of this year, the CDC officially recommended that adults 50 and over get the new vaccine to prevent this painful, blistering disease instead of the previous one, Zostavax.
Shingles is an infection of an individual nerve and the skin surface that is supplied by the nerve. It is caused by the varicella-zoster virus, the same virus that causes chickenpox. Anyone who has recovered from chickenpox can develop shingles. There are an estimated 1 million cases of shingles each year in the United States, with 1 in 3 people developing shingles during their lifetime.
Healthy adults 50 years and older are recommended to get two does of Shingrix, two to six months apart. The second dose is really important for long-term protection.
If you have already gotten the Zostavax vaccine, you should now get Shingrix as well. Officially, the CDC states that Shingrix is the preferred vaccine over Zostavax. Even if you’ve had shingles, you should get the Shingrix vaccine, since shingles has been known to reoccur.
What’s the difference between Shingrix and Zostavax?
Shingrix is more than 90% effective at preventing shingles and a patient complication called postherpetic neuralgia (PHN) in all age groups. Conversely, Zostavax is only 51% effective against shingles and 67% against PHN.
Zostavax contains a live, but weakened version of varicella zoster—the virus that causes shingles and chickenpox.
Shingrix has a dead version of the zoster virus. It also contains an adjuvant which causes your body to produce more antibodies to fight shingles than Zostavax.
The CDC recommends getting the Shingrix vaccine when your chances of contracting shingles rises. Initial studies indicate that its protection remains strong for at least four years, but researches hope it will last much longer because the immune response is stronger.
Who should get the Shingrix vaccine?
The CDC says healthy adults ages 50 and over should get the Shingrix vaccine, even if you’re not sure if you ever had chickenpox.
The CDC also recommends that you get the Shingrix vaccine if you’ve already had Zostavax, because it’s more effective. However, you should wait at least two months after you have Zostavax to get Shingrix.
If you’ve already had shingles, you should get the vaccine. The Shingles can come back after you’ve had it.
Who shouldn’t get Shingrix?
Anyone who has had a severe allergic reaction to any of the ingredient in Shingrix should not get the vaccines.
Anyone who has tested negative for immunity to the varicella zoster virus. If you test negative, you should get the chickenpox vaccine.
If you currently have shingles, you should wait to get the vaccine. This can prevent a second bout with the disease.
If you are pregnant or breastfeeding, you should wait to get Shingrix.
The CDC’s Advisory Committee on Immunization Practices hasn’t confirmed whether the vaccine is safe for people who have a weakened immune system because of a disease or medicine they take. One worry is that taking drugs that weaken the immune system might make the shingles vaccine less effective. It’s also possible that by stimulating the immune system, Shingrix could worsen certain diseases, like leukemia.
What are the side effects of the vaccine?

  • Soreness, redness and swelling where you get the shot
  • Headache or tired after the shot
  • Fever
  • Upset stomach

About 1 out of 10 people said the side effects were severe enough to disrupt their daily life. Yet most felt better within 3 to 5 days.
These side-effects are minimal compared the pain and potentially blistering rash caused by shingles where a typical episode can last from 2-4 weeks.
Once the Shingrix vaccine is available, we’ll let everyone know. Then you can stop by one of our pharmacies and get your shot. We want to keep you healthy!
Sources: CDC, Web MD and Consumer Reports

Smoking and your digestive health

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We’ve all heard that smoking increases the risk of many life-threatening diseases—including lung cancer, emphysema, and heart disease. But did you know that smoking also contributes to many cancers and diseases of the digestive system? Estimates show that about one-fifth of all adults smoke, and each year at least 443,000 Americans die from diseases caused by cigarette smoking.
Smoking has been found to increase the risk of cancers of the:

  • Mouth
  • Esophagus
  • Stomach
  • Pancreas

Research also suggests that smoking may also increase the risk of cancers of the liver, colon and rectum.
What are the other harmful effects of smoking on the digestive system?
Smoking contributes to heartburn, gastroesophageal reflux disease (GERD), peptic ulcers, and some liver disease. Smoking increases the risk of Crohn’s disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones.
Heartburn is the painful, burning feeling in the chest caused by reflux. Smoking weakens the lower esophageal sphincter, the muscle between the esophagus and stomach that keeps stomach contents from flowing back into the esophagus. This causes heartburn and can possibly damage the lining of the esophagus.
GERD is persistent reflux can can lead to serious problems such as bleeding ulcers of the esophagus, narrowing of the esophagus that causes food to get stuck, and changes in the esophageal cells that can lead to cancer.
Peptic Ulcers
Smoking increases the risk of peptic ulcers. Peptic ulcers are sores on the inside lining of the stomach. The two most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen.
Studies suggest that smoking increases the risk of H. Pylori infection, slows the healing of peptic ulcers, and increases the likelihood that peptic ulcers will recur. Smoking increases the production of substances that may harm the lining of the stomach and the duodenum (the first part of the small intestine). Smoking also decreases factors that protect or heal the lining including:

  • Blood flowing to the lining
  • Secretion of mucus, a clear liquid that protects the lining from acid
  • Production of sodium bicarbonate, a salt-like substance that neutralizes acid, by the pancreas.

Liver Disease
The liver is the largest organ in the digestive system. The liver carries out many functions, such as making important blood proteins and bile, changing food into energy, and filtering alcohol and poisons from the blood. Research has shown that smoking harms the liver’s ability to process medications, alcohol, and other toxins and remove them from the body. In some cases, smoking may affect the dose of medication needed to treat an illness.
Smoking may worsen some liver diseases, including:

  • primary biliary cirrhosis, a chronic liver disease that slowly destroys the bile ducts in the liver
  • nonalcoholic fatty liver disease (NAFLD), a condition in which fat builds up in the liver

Crohn’s Disease
Current and former smokers have a higher risk of developing Crohn’s disease than people who have never smoked.
Crohn’s disease is an inflammatory bowel disease that causes irritation in the GI tract. The disease, which typically causes pain and diarrhea, most often affects the lower part of the small intestine; however, it can occur anywhere in the GI tract. The severity of symptoms varies from person to person, and the symptoms come and go. Crohn’s disease may lead to complications such as blockages of the intestine and ulcers that tunnel through the affected area into surrounding tissues. Medications may control symptoms. However, many people with Crohn’s disease require surgery to remove the affected portion of the intestine.
Among people with Crohn’s disease, people who smoke are more likely to:

  • have more severe symptoms, more frequent symptoms, and more complications
  • need more medications to control their symptoms
  • require surgery
  • have symptoms recur after surgery

The effects of smoking are more pronounced in women with Crohn’s disease than in men with the disease.
Researchers are studying why smoking increases the risk of Crohn’s disease and makes the disease worse. Some researchers believe smoking might lower the intestines’ defenses, decrease blood flow to the intestines, or cause immune system changes that result in inflammation. In people who inherit genes that make them susceptible to developing Crohn’s disease, smoking may affect how some of these genes work.
Colon Polyps
People who smoke are more likely to develop colon polyps. Colon polyps are growths on the inside surface of the colon or rectum. Some polyps are benign, or noncancerous, while some are cancerous or may become cancerous.
Among people who develop colon polyps, those who smoke have polyps that are larger, more numerous, and more likely to recur.
Pancreatitis
Smoking increases the risk of developing pancreatitis. Pancreatitis is inflammation of the pancreas, which is located behind the stomach and close to the duodenum. The pancreas secretes digestive enzymes that usually do not become active until they reach the small intestine. When the pancreas is inflamed, the digestive enzymes attack the tissues of the pancreas.
Gallstones
Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.
Gallstones are small, hard particles that develop in the gallbladder, the organ that stores bile made by the liver. Gallstones can move into the ducts that carry digestive enzymes from the gallbladder, liver, and pancreas to the duodenum, causing inflammation, infection, and abdominal pain.
It’s never too late to quit!
Quitting smoking can reverse some of the effects of smoking on the digestive system. For example, the balance between factors that harm and protect the stomach and duodenum lining returns to normal within a few hours of a person quitting smoking. The effects of smoking on how the liver handles medications also disappear when a person stops smoking. However, people who stop smoking continue to have a higher risk of some digestive diseases, such as colon polyps and pancreatitis, than people who have never smoked.
Quitting smoking can improve the symptoms of some digestive diseases or keep them from getting worse. For example, people with Crohn’s disease who quit smoking have less severe symptoms than smokers with the disease.
 

Be Heart Smart

A healthy diet and lifestyle, along with making smart healthcare decisions, can be a pathway to a healthier heart. Your family history can have some impact on your chances of heart disease, but there are some simple steps one can follow that, if you stick to them, can offer long-term heart-health benefits.
The American Heart Association notes that a heart-healthy diet should include:

  • A variety of fruits and vegetables
  • Whole grains
  • Low-fat or non-fat dairy products
  • Skinless poultry and fish
  • Nuts and legumes
  • Non-tropical vegetable oils

Make sure the foods you eat are “heart healthy.” Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard and foods made with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods. Limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, select lean cuts.
Use up at least as many calories as you take in. Find out how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000-calorie diet. You may need fewer or more calories depending on your age, gender and level of physical activity. Control your calories through portion control. Eat until you are comfortably full but not stuffed. If you eat out, this can lead to yummy leftovers.
If you aren’t sure how to eat right, ask us about our new Creative Pharmacist program. We can help you with planning meals to help lower fat and calorie content in your diet to reach and maintain a healthy weight. This program also provides specific exercises tailored to your specific goals.
Lifestyle choices are important. Smoking significantly increases your chance for heart disease. If you smoke, quit. Your doctor can tell you about ways to help you quit smoking. Try to avoid even secondhand smoke. And avoid drinking too much alcohol. This can raise your blood pressure and increase your risk of heart disease.
Regular exercise can help you maintain your weight, keep off weight that you lose and help you gain greater cardiovascular fitness. Each week, try to get at least 150 minutes of moderate physical activity, 75 minutes of vigorous physical activity or an equal combination of both. Aim for at least 30 minutes of exercise most days of the week. Sounds like a lot for you? This is easier than you think! Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. And park at the far end of the lot. If you are not able walk for long periods of time or take the stairs, talk to your doctor about other exercises that will work for you.
If you don’t know your numbers for cholesterol, blood pressure or blood sugar, make an appointment with your doctor and have them checked. Your healthcare provider should test your blood levels of cholesterol at least once every five years. If you have already been diagnosed with high cholesterol or have a family history of the condition, you may need to have your cholesterol checked more frequently.
If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease. These can be diet or lifestyle changes, and/or medications prescribed by your doctor.
Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
 

Sources: American Heart Association; Centers for Disease Control and the U.S. Department of Health and Human Services

 

Know Your Numbers

BMI
Your Body Mass Index (BMI) is the number used to assess if you are underweight, normal weight, overweight, or obese. It is calculated using your height and weight and is a good gauge for the risk of diseases that can occur with more body fat. The higher your BMI, the higher your risk for  diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. The recommended range is 18.6 x 24.9.
Although BMI can be used for most men and women, it does have some limits:

  • It may overestimate body fat in athletes and others who have a muscular build.
  • It may underestimate body fat in older persons and others who have lost muscle


 
Blood Sugar
Blood sugar, or glucose, is the main sugar found in your blood. It comes from the food you eat, and is your body’s main source of energy. Your blood carries glucose to all of your body’s cells to use for energy.  When your blood sugar levels are too high, it causes diabetes. Over time, diabetes can cause other health problems and put you at higher risk for heart disease. A healthy blood sugar level should be less than 100 following an 8-hour fast.
Waste Size
Having extra body fat around your stomach increases your risk of heart disease and diabetes. The target for women is less than 35” and for men less than 40”.
Blood Pressure
High blood pressure has no warning signs or symptoms, and many people do not know they have it. So, it’s important to measure your blood pressure regularly. It is quick and painless, and it is the only way to know whether your pressure is high. You can check your blood pressure at a doctor’s office, at a pharmacy, or at home.The top number (Systolic) should be under 130. The bottom number (Diastolic) should be under 80.
Cholesterol
Did you know that 1 in 3 American adults has high cholesterol? Are you one of them? Too much cholesterol puts you at risk for heart disease and stroke, two leading causes of death in the United States. High cholesterol has no signs or symptoms, so the only way to know if you have it is to get your cholesterol checked.
Schedule an appointment and talk to your doctor about your all of your numbers and how they impact your overall health.
 

Sources: CDC and NIH
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