Dear Dr. Roach: My integrative medicine MD habitually takes a blood sample from the earlobe, puts it on a slide and looks at cell activity/quality using dark-field microscopy. The findings are seemingly impressive 鈥� inflammation? stress? mineral deficiencies? If this is of true value, why don鈥檛 more physicians do it?
B.A.
Dark-field microscopy is a useful tool for certain types of medical tests, especially those looking for parasites, such as spirochetes and malaria. However, it is useless for identifying stress, inflammation or nutritional deficiencies. Laboratory analysis can identify markers associated with inflammation, such as the C-reactive protein, and specific minerals can be analyzed by a reputable medical laboratory. 聽
Proponents argue that looking at live blood cells leads to medical diagnoses; however, studies have shown poor reliability, meaning two trained specialists often disagreed with each other (and themselves, when they looked at the same slide more than once) about the diagnostic meaning. 聽
Dear Dr. Roach: I鈥檓 a 79-year-old man who jogs 3-6 miles every day. Two months ago, I had a hernia operation, and the anesthesiologist said my pulse dropped to 17 during the surgery. He gave me a drug to bring it back up. (My heart rate normally is slow, in the 40s.) Since the surgery, I am unable to resume my jogging routine. I鈥檓 unable to jog 3 miles without stopping and walking for a short distance. Did I suffer some kind of cardiac trauma?
G.S.
After the forced rest necessary after hernia surgery, it鈥檚 possible that you just haven鈥檛 yet gotten back your stamina. However, the combination of that dangerously low pulse rate and the very significant change in your exercise tolerance makes me concerned that you might have had some heart damage during the operation. A heart rate in the 40s can be a sign of an athlete鈥檚 heart, but I also would be concerned that the electrical system to your heart is not adequate, as a change in exercise tolerance can be a sign that your heart rate is too slow. I recommend a visit to your internist or cardiologist.
Dear Dr. Roach: I have read that taking calcium supplements can affect your arteries. I know that it is preferable to get your calcium from foods. However, I drink soy milk that is fortified with calcium carbonate, and orange juice that contains calcium lactate and tricalcium phosphate. Is that comparable to taking supplements?
N.M.
It鈥檚 a great question, and one I have wondered about, since I recommend calcium from food sources as being preferable to supplements. However, what you are asking about is an enriched or fortified food, and there just isn't a lot of data about them. My guess is that they fall somewhere between foods naturally high in calcium and supplements, but probably more similar to taking a supplement along with your food.
The evidence that calcium supplements increase coronary disease risk is mixed. 聽
My recommendation is that people who really need calcium 鈥� such as those being treated for osteoporosis 鈥� get enough calcium, preferably through food, but via supplements or fortified foods if you need to. People with known coronary artery disease or those at high risk should avoid calcium supplements. People with kidney stones also should avoid calcium supplements. For people who have no particular risk, calcium-containing foods are better than supplements, with enriched foods in between.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
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