These headlines are NOT TRUE - 

Always read the small print in supplement trials!

The results of 2 recent trials have caused international headlines – claiming multivitamins do not work nor does vitamin D.
This information actually comes from 2 studies which are far from conclusive.

Multivitamins and heart disease – this is a huge study (in part funded by Pfizer) looking at doctors in the United States aged 50 years and over. 13,316 doctors were either given multivitamins (Centrum Silver) or dummy tablets and followed for 13 years. Their conclusions was slightly strange – "there was no consistent evidence of various foods, nutrients, dietary patterns or multivitamins on cardiovascular disease in points. However there were statistically significant interactions between multivitamins and B6 and heart attacks, multivitamins and vitamin D on cardiovascular mortality, and multivitamins and B12 on cardiovascular and total mortality." Then commented however that these patterns were inconsistent, and thus ignore them. They also concluded that future studies are needed.
This is not the message that the public have received.

Questions that could be asked:
1. Doctors on the whole eat well if not perfectly, and are probably the least likely populations needing multivitamins.
2. Is Centrum the best multivitamin to recommend?
3. They did show benefits on heart attacks, heart and total deaths, why did they chose to ignore them?

The 2nd study is equally puzzling, it comes from a New Zealand group studied the benefits of vitamin D and heart disease. Just over 5000 people were in this general practice study, half received monthly vitamin D 100,000iu and the other half dummy tablets for 3 years. This appeared to have no effect on cardiovascular disease. They concluded "this result does not support the use of monthly vitamin D supplements, the effects of daily or weekly supplementation requires further study."
Again this is not the message that has been publicised.
Questions that could be asked:
1. Is 3 years ready long enough to have an effect?
2. The quality of general practitioner studies is often patchy.
3. Were we ever designed to receive 100,000 international units of vitamin D monthly? This equates to 71 tablespoons of cod liver oil or 19 L of milk drunk on the 1st of the month, and then none for 30 days!

Once again the publicity against supplements shows very biased reporting.

To Pee or not to Pee?

How to make bladder catheterisation less painful.

A strange title for a web page, but many or most of us will be catheterised or have friends undergoing what is often a very painful procedure. This little gem which I read in a recent medical Journal is something I thought I should share.
We have two muscuar valves leading out of the bladder stopping the urine from leaking, and usually these are closed. They open when we go to the toilet. They are not designed to allow a structure like a small snake to pass backwards up into the bladder, and tend to slam shut. Pushing past these closed valves causes most of the pain during urinary catheterisation.
Doctors, nurses, house surgeons, medical students have been instructed to tell patients to cough or breathe slowly and deeply when the catheter cannot get past the valves - none of these work. Why should they? Why not ask the patient to open the valves by peeing?
Nobody has ever suggested this before, how can we have been so obtuse? In a recent paper in the Journal Urology (April 2017) in just under 100 patients having a catheter inserted, half were asked to lie back and grin and bear it, and half were asked to try to pee while the catheter was being inserted. The pain in the Peeing group was less than half that of the others (41%).

Almost certainly none of the people trying to catheterise us with have read this article, so just share this information if you know that one of your friends or yourself will be having this procedure. While the doctors/nurses/medical students struggle down one end, you just lie there and gently try to pee, they will never know.

To continue Shakespeare's soliloquy – "whether tis nobler in the mind to suffer" – the answer is NO!