Medications
1) Levofloxacin (Levaquin)
Levofloxacin (Levaquin) is an antibiotic often prescribed for routine infections like bacterial sinusitis, urinary tract infections, and pneumonia, but recent warnings from the FDA should diminish levofloxacin’s popularity in 2019. Severe—and potentially permanent—side effects of levofloxacin include tendon rupture, nerve damage, dangerously low blood sugar, and mental health issues. The FDA advises that levofloxacin only be used for certain serious bacterial infections.
2) Addyi
Addyi, popularly known as the female Viagra, was a flop. Leave it behind in 2019. Addyi is the only drug approved to improve sexual desire in women, and works by modifying the effects of serotonin (the happy chemical) in the brain. Daily use of the drug may modestly increase the frequency of sexually satisfying events and improve sexual desire, but the frequent side effects of nausea, sleepiness, and dizziness limit its use. I’ve not had a single patient ask for a refill.
3) Carisoprodol (Soma)
Carisoprodol (Soma) is a muscle relaxant categorized as a schedule IV drug because of its potential for abuse. Given much better muscle relaxants that aren’t sedating or habit-forming, like methocarbamol (Robaxin) or cyclobenzaprine (Flexeril), carisoprodol should be phased out. If prescribed, carisoprodol should only be used for short periods (2-3 weeks)—there’s no evidence that it remains effective with prolonged use.
4) Atenolol (Tenormin)
Atenolol was commonly prescribed years ago for high blood pressure, but new guidelines say it’s inferior to today’s first-line blood pressure medications in terms of protecting the heart. Atenolol may also have negative effects on blood sugar and cholesterol levels, which isn’t the case with newer beta-blockers like bisoprolol (Zebeta), carvedilol (Coreg), and nebivolol (Bystolic).
Dietary supplements
1) Calcium
We’d all like to believe that taking calcium supplements can help prevent fractures, especially since fractures are such a common cause of disability in old age. But multiple research studies show that the benefit of calcium supplements is at best very small. After all these years of recommendations to take calcium supplements, it may be hard to change your beliefs, but obtaining calcium through foods like dairy products and greens appears to be all you need.
2) Fish oil
We know that eating more fish is linked to a lower risk of coronary artery disease and stroke, but taking fish oil supplements does not appear to provide the same protection. Years of clinical studies have not shown that taking fish oil supplements with omega-3 fatty acids reduces the risk of heart attacks or strokes. This was made even more clear in 2018 when yet another study—this time involving over 77,000 patients—was published showing no benefit.
3) Magnesium
Don’t take magnesium unless you need it. Yes, magnesium supplements may help prevent migraines, upset stomach, and constipation, but companies claim these products also provide relief from leg cramps, benefit the heart, and lower blood pressure—which is unlikely.
For some reason, 2018 sent a message to folks that we were all not getting enough magnesium. Know this: You don’t need to take magnesium supplements. Instead, get your magnesium from foods—like nuts, green leafy vegetables, cereals, and seafood.
Pro tip: Magnesium found in water is absorbed by the body 30% faster and better than magnesium from foods. While the amount of minerals in tap water varies by state, tap water contains all the magnesium you need. Most bottled waters, even Perrier or Evian “mineral waters”, have low levels of minerals like magnesium.
4) Vitamin E
Too often, patients come into my office taking vitamin E despite the fact that it has no clear benefit in terms of preventing dementia, cancer, or heart disease. Please know that even as far back as 2011, research revealed that men who regularly took vitamin E had a 17% increased risk of prostate cancer compared to men who took nothing (a.k.a. a placebo). Several other studies have also found an increased risk of lung cancer in those taking vitamin E supplements.
You may have heard of AREDS, a supplement that contains vitamin E (among other ingredients) and is used to prevent a specific form of eye disease. Unless you’ve been told by your eye doctor to take this supplement, do not routinely take vitamin E. Period.
Dr O.
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