Can you really go blind from not eating your vegetables?

You may have read the recent news story of a teenager in England who went blind after eating a diet of only French fries, Pringles, and white bread. He had not had fruit or vegetables for years.  Doctors found that he his condition was caused by severe Vitamin A deficiency, resulting in corneal damage to his eyes.


What are symptoms of some common vitamin deficiencies, and how can you avoid them?


Vitamin A deficiency: Vitamin A is important for healthy skin, teeth and bones. Vitamin A is needed to produce the pigment in our eyes and lack of vitamin A can cause vision loss. Vitamin A deficiency is the world’s leading cause of blindness! Vitamin A can be found in organ meat, sweet potatoes carrots, and leafy green vegetables.


Vitamin D deficiency: Vitamin D is important for the function of our cells. Vitamin D deficiency can result in weakness, infections, and bone loss. Vitamin D is formed in our skin with sun exposure, and is also present in salmon, mackerel, trout, and egg yolks.


Vitamin B12 deficiency: Vitamin B12 is important for blood cell formation and nervous system function. Deficiency of Vitamin B 12 results in anemia. Symptoms can include fatigue, sore tongue, and pins and needles sensation. Vitamin B 12 is present in shellfish, meat, milk and eggs.


Low iron levels: Iron is important in the production of our blood cells. Lack of adequate iron results in anemia, with symptoms that can include fatigue, weakness and weakened immune system. Iron is present in meat, poultry, shellfish, dark leafy greens, nuts, seeds, and whole grains.


Low vitamin C levels: Vitamin C is important for repair of our cells and for our immune system. Deficiency of Vitamin C can result in bleeding gums, poor wound healing, bruising, nosebleeds, and frequent infections such as colds or the flu.   Vitamin C is present in fruits and vegetables.


Biotin deficiency: Biotin, also known as vitamin B7, helps convert food into energy. Symptoms of Biotin deficiency include brittle hair and nails. Biotin is present in eggs, meat, fish, dairy, nuts, seeds, spinach, sweet potatoes, whole grains, cauliflower, and bananas.


Magnesium deficiency: Magnesium is important for bone and dental strength, and is needed for multiple body processes. Symptoms can include abnormal heart rhythms, muscle cramping, and fatigue. Half of Americans don’t get enough magnesium in their diet! Magnesium is present in whole grains, nuts, leafy green vegetables, and dark chocolate.

Eye damage from vitamin A deficiency:

vitamin a


Can you make the diagnosis?

Lisa has been feeling under the weather for the last few days. She has felt very tired, and has not been hungry at all. She has been feeling nauseated and having diarrhea.

When she wakes up on Monday, she notices that her urine is dark brown. She looks into the mirror, the whites of her eyes look yellow!

What does Lisa have?


  1. Influenza
  2. A urinary tract infection
  3. Gallstones
  4. Hepatitis A



If you guessed 4. Hepatitis A, you are right!

There is currently an outbreak of Hepatitis A in the United States.  The outbreak has been linked to homeless communities and drug use, and then is spread to other individuals in the community.  There currently have been 15,000 cases of Hepatitis A since the outbreak started, and 140 deaths.

Hepatitis A is a virus that is transmitted from person to person.  Transmission of the virus can be caused by contaminated food or water.

The Hepatitis A virus results in inflammation of the liver.  It causes symptoms such as fatigue, decreased appetite, stomach pain, nausea, vomiting, diarrhea, dark urine and jaundice (yellowing of the skin).

The symptoms usually resolve within two months of infection.  Children may have different symptoms then adults.

Hepatitis A can be prevented with a vaccination.  The vaccination is given as a series.  Other important preventive measures include good hand washing, and properly cooking food.  If an individual is traveling to an area where Hepatitis A is common, they should consider getting a vaccination prior to their trip.

If an individual thinks they have been exposed to Hepatitis A, they should contact their health care provider or the State Health department.  If a patient has been exposed, they may benefit from an injection of either Hepatitis A vaccine or immune globulin but this must be done within the first two weeks after exposure.

Influenza usually is accompanied by fever, body aches, and can have vomiting and diarrhea, but jaundice or icterus (yellowing of the skin or eyes) would be unusual.  Urinary tract infection would usually cause fever, pain with urination, and can cause vomiting, but would not typically cause jaundice or icterus.  Gallstones would typically cause severe abdominal pain and vomiting, but unless other significant liver problems would be unusual to cause icterus.


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Is hand sanitizer good for you?

Hand sanitizer is an alcohol-based product used to kill germs on the skin.

Hand sanitizer contains 60-95% alcohol.  It can also contain glycerol to prevent skin drying, benzalkonium, triclosan, and other ingredients.

Hand sanitizer is flammable.

Hand sanitizer kills many types of bacteria, as well as tuberculosis and viruses such as the flu virus, cold virus and HIV.

The FDA has stated that there is no proof that hand sanitizer is superior to soap and water, and that some of its ingredients may lead to health risk.  “Consumers may think antibacterial washes are more effective at preventing the spread go germs, but we have no scientific evidence that they are better than plain soap and water,” the director of the FDA stated.

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Will Medicare go bankrupt?

Medicare is currently predicted to become insolvent by 2026, according to MedPAC commissioner Warner Thomas.  How has this happened?

Medicare is the health insurance for those who are 65-years-old or older, and for some younger people with disabilities.  Medicare started in 1966.  Currently 60 million Americans have Medicare coverage.  For those covered, Medicare covers about half of their health care bills, and the rest the patient has to pay themselves such as for copays.

Medicare enrollment has been rising as the baby-boom generation starts joining the ranks.  But at the same time, the number of American workers who fund the program is declining.

The total Medicare spend is about $528 billion a year.  However, Medicare pays out about $50 billion in fraudulent payments per year.  In addition, health care costs and pharmacy costs have been rising.

What are options for fixing Medicare?

  1.  Medicare needs to control their fraud spend.  Other insurers such as United and Aetna have aggressive measures to combat fraud, and Medicare needs to implement those ideas in order to control fraudulent payouts.
  2. Medicare needs to begin instituting standard guidelines to ensure that medical care and surgeries performed are medically necessary and appropriate.
  3. Controlling prescription drug prices will be important.  Currently 20% of Medicare spend is on medications.  Controlling the prices that pharmaceutical companies are charging will be paramount in controlling spending.
  4. If those steps fail, Medicare beneficiaries may have to have higher co-pay costs, and payroll taxes may have to go up to fund Medicare.



Can you make the diagnosis?

Carrie has been waking up at night with a burning sensation in her thumb and fingers.  Her forearms are aching, and she has a tingling sensation in both of her hands.   She has tried taking Advil and changing her sleeping position, but it seems to be getting worse.

Carrie is otherwise a fairly health person  She is about 20 pounds overweight but has been exercising and dieting.

What is causing Carrie’s pain?

  1.  She is having a heart attack
  2.  She is sleeping on her arms and compressing the nerves
  3.  Carpal tunnel syndrome
  4.  Arthritis


If you guessed 3.  Carpal tunnel syndrome, you are right!

Carpal tunnel syndrome is caused by compression of the median nerve as it travels through the wrist.  Symptoms are pain, numbness, and tingling in the fingers, with aching and pain up the arm.

Carpal tunnel syndrome can cause weakness of the hand and loss of dexterity.  Risk factors include obesity, repetitive wrist work, pregnancy, and family history.

Carpal tunnel syndrome can be diagnosed by physical examination, and can be confirmed with electrodiagnostic tests.

Carpal tunnel syndrome is treated by wearing wrist splints and steroid injections, but sometimes surgery is necessary to decompress the nerve.

Heart attacks can cause arm pain, but also typically have associated symptoms such as chest, neck or jaw pain.  Sleeping on the arm can cause numbness, but it would be unusual to have symptoms on both sides.  Arthritis can cause joint pain, but does not typically cause numbness or tingling.



Why is the United States throwing away kidneys?

There are 100,000 Americans waiting for a kidney transplant, and 12 people die each day waiting for a new kidney.   But every day in the United States,  10 kidneys that could be used for transplant are thrown away.


Why does that happen? In the United States, kidneys are thrown away if the donor had high blood pressure, diabetes, or a had a prior heart attack.  Over 3500 kidneys are thrown away a year.  In other countries, those kidneys are still used for transplant because the kidneys are still considered useful and functional.


The alternative to not getting a kidney transplant is being on dialysis. The mortality rate for dialysis patients is 20% per year. So the average patient on dialysis only lives for 5 years.


What is being done to fix this problem?  New guidelines for transplant centers and hospitals have been written to try to address this issue.  But at this time the issue is still unresolved.


You can sign up to be an organ donor at the DMV and it will be noted on your driver’s license.  It is also helpful to be sure your family knows that you would want your organs donated.



Are wraps really healthier than regular sandwiches?

Wraps are popular, and thought to be more nutritious than regular sandwiches. But are wraps really a healthier option?

A wrap is typically a flour tortilla. They may have additional spices added, and are usually whole-wheat, plain flour, or can be gluten-free.

The only difference between bread and wraps is that bread is leavened with yeast, and the wrap is flat.

One wrap equals two slices of bread nutritionally. But most wraps have more calories than two pieces of bread, and wraps have almost double the sodium content.  And wraps have only half the protein of bread!

What about colorful tomato or spinach wraps? These do not have any additional nutritional benefit as they have negligible amounts of tomato or spinach powder, and often have food coloring added as well.