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What is a myth?

A myth is a traditional story, idea, or belief, especially one concerning early history of a people or explaining a natural or social phenomenon. It is a widely held but false belief or idea. In medicine, health myths are also widely held beliefs about health issues such as medicines, herbs, treatments, cures, antidotes, etc. which are partially or totally false and unsubstantiated in the scientific literature. This is a partial list of the most common health myths:

  1. 8 GLASSES OF WATER IS ESSENTIAL FOR GOOD HEALTH
    • You don’t need to search very long to find copious information purporting the value of water to maintain good health. Sources suggest between 8 and 15 cups of water per day! Despite the plethora of contradictory information, there is no research to support an exact amount. In fact, most scientifically validated research suggests that healthy adults do not need to count cups and those who drink water when thirsty receive adequate hydration for good health. Remember, there are many water-rich foods to provide hydration; soup, fruit, vegetables, juice, coffee, and tea. However, be aware that if your urine is dark yellow you need more hydration. And, if you are very physically active or live in a warm climate, you may require more water.
  2. EATING EGGS WILL LEAD TO HEART DISEASE
    • In the late 70’s, eggs received a bad reputation when high cholesterol in the blood could increase the risk of heart disease. The love-hate relationship with eggs and egg products has continued to grow since. However, recent findings suggest that eating an egg or two a day will not raise the risk of heart disease in healthy adults. While egg yolks do contain cholesterol, the amount is relatively small and is offset by the fact that eggs also have many nutrients such as omega-3’s, which are associated with lowering the risk of heart disease.
  3. ANTIPERSPIRANTS CAN LEAD TO BREAST CANCER
    • Some research attempted to link the preservatives (parabens) used in some deodorants and antiperspirants with the activity of estrogen in the body’s cells because these parabens are found in breast tumors. However, there is no scientific evidence that parabens cause breast cancer. So, don’t sweat it!
  4. SPENDING TOO MUCH TIME IN THE COLD AIR WILL LEAD TO A COLD
    • Sometimes “old wives tales” are true…but not this one! Grandparents and parents have been telling their grandchildren and children to button up and don’t spend too much time in the cold. In fact, one study found that healthy men who spent several hours a day in cold temperatures (just above freezing) had an increase in virus-fighting activity in their immune systems. Moreover, documentation supports that spending too much time indoors, especially during winter flu season, puts you at risk for getting the flu…so circulate fresh air or get outdoors!
  5. EVERYONE NEEDS A MULTIVITAMIN TO BE HEALTHY
    • Research does not support this theory that everyone needs a multivitamin to supplement for nutrients not in your diet. In fact, most medical experts agree that healthy adults receive all necessary nutrients and vitamins from a well-balanced diet including; fruits, vegetables, whole grains, nuts and healthy oils. However, if your physician recommends a vitamin, do so. It may be that you are insufficient or at risk due to other medical conditions. If you are pregnant, for example, you will need to take folic acid to lower the risk of birth defects. 
  6. EATING A GOOD BREAKFAST IS NECESSARY TO LOSE WEIGHT
    • Some diets purport that eating breakfast is necessary to stimulate your metabolism in order to lose weight. This theory is not confirmed, and for those who enjoy breakfast, it may limit hunger sensation and prevent unhealthy snacking. However, a study from Cornell University found that those who did not eat breakfast did not overeat at lunch and dinner and consumed approximately 400 fewer calories per day. So, for some healthy adults, eliminating breakfast can help lose weight…the premise of “intermittent fasting.”
  7. GREEN MUCUS IS A SURE SIGN OF INFECTION
    • Most would agree, the slimy green mucus in your tissue is disgusting. However, without a lab test, it is not a sure sign of an infection or need for antibiotics. Often, clear mucus indicates a sinus infection, while green mucus represents a common cold.
  8. TOO MUCH SUGAR MAKES KIDS HYPERACTIVE
    • Sugar making your kids hyper? Maybe it’s just kids being kids! It is widely accepted that sugar is not good for kids (unhealthy calories leading to obesity, etc). However, Research shows that it is not the cause of hyperactivity (caffeine or chocolate may). It may be that parents are so focused on their behavior after sugar intake that they expect their kids to be wired when it may just be attributed to the normal behavior of kids just being kids!
  9. A TOILET SEAT IS A COMMON AREA TO SPREAD DISEASE
    • Believe it or not, toilet seats are not the most unsanitary item in the bathroom. So, if you can’t cover it, don’t sweat it. Bugs such as E. coli, norovirus, and other flu viruses cover bathroom doors, door handles, and floors. Thorough hand washing is essential and use a paper towel for door handles.
  10. CRACKING YOUR KNUCKLES OR OTHER JOINTS WILL LEAD TO ARTHRITIS
    • One thing is certain…cracking your knuckles is annoying to everyone around you! But studies show that it is not harmful to your joints or causes arthritis. The popping noise is not because the bones are grinding together; it is due to movement of gas bubbles in the joint capsule.  
  11. ELIMINATING FAT FROM YOUR DIET WILL MAKE YOU HEALTHIER AND HELP YOU LOOSE WEIGHT
    • Total elimination of fat from your diet is not only unnecessary to be healthy and lose weight, but is unhealthy and harmful. Fat provides essential nutrients and is an important component of a healthy diet. Due to the fact that fats have more calories per gram than protein or carbohydrates, limiting fat intake is necessary to avoid extra calories. Instead, chose low fat dairy products (milk, yogurt, cheese) and consider eating small amounts of food with healthy fats, such as avocados, olives, or nuts. 
  12. CHILDHOOD VACCINES LEAD TO AUTISM
    • Vaccines do not cause autism. Despite much controversy, there is no scientific evidence that supports a connection between autism and childhood vaccines. In fact, the original study that started the debate years ago has been disproven and retracted. Fact: childhood vaccines protect children from a variety of serious or potentially fatal diseases.

SOURCES: WebMd; National Institutes of Health, Mayo Clinic

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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This article does not intend as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Antibiotic resistance occurs when bacteria no longer respond to the drugs designed to kill them. For more than a decade, the Centers for Disease Control along with other national and international agencies has supported an initiative called “Antibiotic Stewardship” the hallmark of which is the judicious, appropriate use of antimicrobials.

What’s The Problem?

It’s told in some sobering statistics from the CDC, World Health Organization, and Food and Drug Administration:

Patients and providers must take equal responsibility. When we get sick, we often feel we need an antibiotic right away. In fact, we often demand one. A study published in the New England Journal of Medicine in 2018 found that to achieve a patient satisfaction rating in the 90th percentile physicians needed to prescribe antibiotics 75% of the time. Is this the correct approach to therapy? Are we using antibiotics too readily? What are the consequences of profuse antibiotic use?

Here's a pop quiz:

In which of the following situations are antibiotics warranted?

A. Cold symptoms (runny nose, sore throat, headache) with a fever of 101F for 2 days

B. Cold symptoms lasting 12 days with persistent stuffiness and headache

C. Cold symptoms for 3 days with yellow-green mucous discharge

D. all of the above

The correct answer is B. Let’s discuss the reasons. Symptoms experienced as part of the common cold can include green/yellow sputum, cough, runny nose, stuffiness, sore throat, headache, fever, and mild muscle aches. This illness is caused by a virus, most likely a rhinovirus. Currently, 160 identified strains of rhinovirus are know.

Antibiotics work to destroy bacteria, not viruses since they have no activity against viruses. Antibiotics target specific bacterial structures or functions. Common bacterial targets for antibiotics include the cell wall (amoxicillin), ribosome activity (azithromycin), and bacterial DNA (levofloxacin). All of those are lacking in the very primitive structure of a virus. So, you could sit in a bathtub full of penicillin and not cure your cold with an antibiotic because there is simply nothing for the antibiotic to destroy in the viral structure.

Why are antibiotics appropriate after 10 days with cold symptoms? The typical common cold lasts between five and ten days with symptoms peaking around three or four days and waning at day six. If symptoms are consistent or regress and then become worse it is likely a sign of bacterial superinfections (super = on top of).

How Does This Happen?

Usually, we carry certain bacteria with us as part of our “normal flora”. The mouth, nasal passages, large intestines, and skin host the most bacteria in the body. These bacteria work with our body and provide various “services” including protection against other more dangerous bacteria, digestion of food, and production of vitamins. A viral infection disturbs the normal balance of bacteria, allowing for proliferation and subsequent bacterial infection.

Side Effects:

Why should we be careful about antibiotic use?

Antibiotics are not innocuous substances. They have significant side effect profiles. Adverse drug reactions associated with antibiotics can be less severe and consist of mild rash or nausea. More serious reactions include heart arrhythmias, tendon rupture, Stevens Johnson Syndrome (severe skin rash resembling thermal burns), and liver and kidney damage. Remember – every drug – not only antibiotics – has the potential to cause unpredictable adverse reactions

Resistance:

The most compelling reason to be careful about antibiotic use is resistance. Each time bacteria are exposed to an antibiotic, some are destroyed but others adapt to resist the antibiotic and live to see another day (remember Darwin’s Survival of the Fittest?). Antibiotics are unique in that the more they are used, the less effective they become. When antibiotics are used inappropriately – not taking them on schedule, for the right duration, taking them for a viral illness – bacteria have a chance to adapt to overcome the antibiotic activity. The resistant bacteria may go on to set up a resistant infection in you or that bacteria may be transmitted to others.

Limiting Risk:

There are several ways we can combat this problem according to the Joint Commission on Healthcare Accreditation 2020 Standards. It is important to identify the causative agent if possible.

For example, a sore throat should not be treated with antibiotics until a throat culture or rapid strep test is obtained and a bacterial cause is identified. According to the Infectious Disease Society of America, 90 percent of adult sore throats have a viral cause, not bacterial. Avoid unneeded clinic or urgent care visits and utilize OTC and non-drug measures to manage non-bacterial infection symptoms.

Re-evaluate drug allergies:

Mislabeled allergy status leads to more expensive, less optimal antibiotic choices, more complex administration, increased resistance rates, and more treatment failures. The most common listed drug allergy in the US is Penicillin. According to the CDC, 10% percent of patients reports an allergy, however, < 1% of patients have a true allergy precluding penicillin or penicillin-like agents (the biggest class of antibiotic agents).

Vaccination:

Vaccines may prevent bacterial infections or prevent viral infections which will avert a bacterial superinfection. Here are two examples of where vaccines can lower antibiotic use. The pneumococcal “pneumonia” vaccine protects against the bacterium Streptococcus pneumoniae. Following the current guidelines for vaccination during childhood and adulthood decreases pneumococcal infections. According to the CDC, this vaccine has reduced pneumococcal infections by more than 90% in children. In addition, antibiotic-resistant pneumococcal infections have decreased in the United States since the pneumococcal vaccine was introduced.

The shingles vaccine also minimizes antibiotic use. The shingles vaccine “Shingrix”, is currently approved for individuals 50 years old (and older) as a two-dose series. Not only does it effectively prevent the occurrence of shingles, a painful, debilitating re-emergence of the chickenpox virus, but also reduces the risk of a potential secondary bacterial skin superinfection. Vaccine prevention of viral illness may subsequently eliminate antibiotic use.

Education:

Educating patients and prescribers will lead to the proper use of antibiotics to curb antibiotic resistance.

Guest Author: Dr. Gretchen Welby, PharmD, MHA

Dr. Welby received degrees from Keystone College and Philadelphia College of Pharmacy and Science. She received a Master of Health Administration Degree from the University of Scranton and a Doctor of Pharmacy degree from Temple University. She is currently the Academic Director of the Physician Assistant Program at Marywood University where she teaches Anatomy, Physiology, Pathophysiology, and Pharmacology.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!