Not all medicines are affected by food, but many medicines can be affected by what you eat and when you eat it. For example, taking some medicines at the same time that you eat may interfere with the way your stomach and intestines absorb the medicine. The food may delay or decrease the absorption of the drug. This is why some medicines should be taken on an empty stomach (1 hour before eating or 2 hours after eating). On the other hand, some medicines are easier to tolerate when taken with food.

Here is a simple list covering most of common medication class and their association with food:

• ACE-Inhibitors (Blood pressure medication class), such as ZESTRIL, PRINIVIL, CAPOTEN, VASOTEC
  Take on empty stomach, 1 hour before meals. Take at the same time each day. Eat foods low in sodium and calcium. Limit potassium intake. Do not use salt substitutes.
• Diuretics (”water pill” for blood pressure and leg swelling), such as LASIX, BUMEX, DEMADEX
  May take with food or milk. Take last dose of the day before 6 P.M. (so that you don’t have to get up at night to go to bathroom)
• Erythromycins (Antibiotics), such as E-MYCIN, BIAXIN, ZITHROMAX
  Take with food if it upsets your stomach
• Glipizide (Diabetes Drug class), such as GLUCOTROL, GLUCOTROL-XL
  Take 30 minutes before a meal. Follow your diabetes meal plan. Avoid alcohol. Do not crush Glucotrol-XL tablets
• Glyburide (Diabetes Drug class), such as DIABETA, MICRONASE
  Take with a meal. Follow your diabetes meal plan. Avoid alcohol.
• Metformin (Diabetes Drug class), such as GLUCOPHAGE
  Take with a meal. Follow your diabetes meal plan. Avoid alcohol.
• NSAIDs (For Pain), such as ASPIRIN, CELEBREX, MOTRIN, NAPROSYN, VOLTAREN
  Take with food or milk
• Quinolones (Antibiotics), such as CIPRO, LEVAQUIN, TEQUIN
  Drink plenty of fluids. Do not take with antacids or iron supplements
• Statins (For Cholesterol), such as LIPITOR, ZOCOR, MEVACOR
  Take with evening meal. Follow low cholesterol diet
• Warfarin (Blood thinner), such as COUMADIN
  Avoid alcohol and limit the amount of foods high in vitamin K that you eat such as broccoli, cabbage, spinach, cauliflower and brussel sprouts. Do not take aspirin or aspirin products while taking this medication.
• Bisphosphonates (For Osteoporosis), such as FOSAMAX, ACTONEL, BONIVA
  Must be taken at least one-half hour before the first food, beverage, or medication of the day with plain water only. Patients should not lie down for at least 30 minutes and until after their first food of the day.

Additional Reading:

• Medications: Using them safely
• Medicine and Food: When they don’t mix

Symptoms of Baby Blues include:

• Mild depression
• Mood swings
• Irregular sleeping and eating patterns
• Anxiety
• Difficulty concentrating

These are normal reactions to the hormonal changes and stress that having a baby brings. Baby Blues usually don’t require treatment.

Postpartum Depression (PPD), however, is a more serious type of depression that affects about one in 10 new mothers within the first year after the childbirth. If the PPD goes undetected or untreated, not only does the mother suffer, but the child is at high risk of developing emotional, behavioral and cognitive problems. Therefore, it is important to diagnose it early so proper treatment could be given.

Signs and Symptoms of PPD are more intense and longer lasting, eventually interfering with one’s ability to function. These include:

• Constant fatigue
• Lack of joy in life
• A sense of emotional numbness or failure
• Withdrawal from family and friends
• Lack of concern for yourself or your baby
• Excessive concern for your baby
• Less interest in sex
• Severe mood swings
• Impaired thinking or concentration
• Insomnia

PPD also differs from another, more serious disorder called Postpartum Psychosis, a mental illness that require immediate medical attention. It a rare condition that develops within the first six weeks after delivery — the signs and symptoms are even more severe, which includes:

• Fear of harming yourself or your baby
• Confusion and disorientation
• Hallucinations and delusions
• Paranoia

Seek Medical Attention:

• If the signs and symptoms of depression don’t fade after a few weeks or if they’re so severe that they interfere with your ability to complete everyday tasks. Call your doctor. Early intervention can speed your recovery. 
• If you suspect that you’re developing postpartum psychosis (seek medical attention immediately). Don’t wait and hope for improvement. Postpartum psychosis may lead to life-threatening thoughts or behaviors.

Sources:

• Postpartum Depression - MayoClinic
• Recognizing Postpartum Depression - NMHA.org (PDF)

What is Alcohol Abuse?

Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

• Failure to fulfill major work, school, or home responsibilities;
• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

What is Alcoholism?

Alcoholism is more severe pattern of drinking that includes the problem of alcohol abuse plus persistent drinking in spite of obvious physical, mental and social problems causes by alcohol. It includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
• Loss of control: The inability to limit one’s drinking on any given occasion.
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
• Tolerance: The need to drink greater amounts of alcohol in order to “get high.”

Source: “Alcoholism – getting the facts”, National Institute of Alcohol Abuse and Alcoholism.

For More Information:

• Susbtance Abuse and Mental Health Services Administration. The National Clearinghouse for Alcohol and Drug Information. 800-729-6686.
  www.health.org
• National Institute on Alcohol Abuse and Alcoholism
  www.niaaa.nih.gov
• Alcoholics Anonymous
  www.alcoholics-anonymous.org
• Al-Anon Family Group Inc. 888-425-2666
  www.al-anon.alateen.org

Women who have at least one of these characteristics is likely to get gestational diabetes:

• they have had a previous stillbirth;
• they have had babies that weigh more than nine pounds;
• they have had babies with birth defects;
• they have a family history of diabetes;
• they have had obstetric complications, such as high blood pressure;
• they have had gestational diabetes with a previous pregnancy.

Of course it is also possible that even when none of these are present, the condition may still develop.

It is especially important for a woman with this type of diabetes, or any form of this disease to get early prenatal care. The doctor will require a thorough history, so he can spot any of the risk factors and test and treat the pateint accordingly. Uncontrolled diabetes is not healthy for the baby or the mother. It can cause birth defects and death for the baby if it is not fully treated. The good news is that proper treatment can prevent such tragedies.

Of course, a woman who had diabetes before she becomes pregnant will not be “cured” by the delivery of her baby - she will still be diabetic afterwards.

The material contained here is “FOR INFORMATION ONLY” and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.

Having children, especially a first child after age 35 is riskier than having them at a younger age, but such pregnancies are not higher risk if the mother is healthy. Until the 1970’s, obstetricians rarely saw women older than 35 expecting their first child. Now, more and more women are delaying their childbearing and physicians have gotten used to seeing such patients. Part of the increased risk after age 35 stems from the fact that older women are slightly more likely to have high blood pressure or diabetes, both of which can cause complications during pregnancy. Older women are also slightly more likely to bear a chromosomally abnormal child, such as a child with Down’s syndrome; but until age 45 such births are still a relatively small fraction of all live births. Chromosomally abnormal fetuses often abort spontaneously, which increase the miscarriage rate among older pregnant women. Still, with good care, a healthy woman who is pregnant after age 35 is likely to have a healthy baby.

The material contained here is “FOR INFORMATION ONLY” and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.

Screening tests, such as mammograms and Pap smears, can find diseases early when they are easier to treat. Some women need certain screening tests earlier, or more often, than others. Talk to your doctor about which of the tests listed below are right for you, when you should have them, and how often.

The Task Force has made the following recommendations, based on scientific evidence, about which screening tests you should have.

• Mammograms: Have a mammogram every 1 to 2 years starting at age 40.
• Pap Smears: Have a Pap smear every 1 to 3 years if you have been sexually active or are older than 21.
• Cholesterol Checks: Have your cholesterol checked regularly starting at age 45. If you smoke, have diabetes, or if heart disease runs in your family, start having your cholesterol checked at age 20.
• Blood Pressure: Have your blood pressure checked at least every 2 years.
• Colorectal Cancer Tests: Have a test for colorectal cancer starting at age 50. Your doctor can help you decide which test is right for you.
• Diabetes Tests: Have a test to screen for diabetes if you have high blood pressure or high cholesterol.
• Depression: If you’ve felt “down,” sad, or hopeless, and have felt little interest or pleasure in doing things for 2 weeks straight, talk to your doctor about whether he or she can screen you for depression.
• Osteoporosis Tests: Have a bone density test at age 65 to screen for osteoporosis (thinning of the bones). If you are between the ages of 60 and 64 and weigh 154 lbs. or less, talk to your doctor about whether you should be tested.
• Chlamydia Tests and Tests for Other Sexually Transmitted Diseases: Have a test for Chlamydia if you are 25 or younger and sexually active. If you are older, talk to your doctor to see whether you should be tested. Also, talk to your doctor to see whether you should be tested for other sexually transmitted diseases.

Should You Take Medicines to Prevent Disease?

• Hormones: According to recent studies, the risks of taking the combined hormones estrogen and progestin after menopause to prevent long-term illnesses outweigh the benefits. Talk to your doctor about whether starting or continuing to take hormones is right for you.
• Breast Cancer Drugs: If your mother, sister, or daughter has had breast cancer, talk to your doctor about the risks and benefits of taking medicines to prevent breast cancer.
• Aspirin: Talk to your doctor about taking aspirin to prevent heart disease if you are older than 45 and have high blood pressure, high cholesterol, diabetes, or if you smoke.
• Immunizations: Stay up-to-date with your immunizations:
  • Have a flu shot every year starting at age 50.
  • Have a tetanus-diphtheria shot every 10 years.
  • Have a pneumonia shot once at age 65.
  • Talk to your doctor to see whether you need hepatitis B shots.

What Else Can You Do To Stay Healthy?

• Don’t Smoke. But if you do smoke, talk to your doctor about quitting. You can take medicine and get counseling to help you quit. Make a plan and set a quit date. Tell your family, friends, and co-workers you are quitting. Ask for their support. If you are pregnant and smoke, quitting now will help you and your baby.
• Eat a Healthy Diet. Eat a variety of foods, including fruit, vegetables, animal or vegetable protein (such as meat, fish, chicken, eggs, beans, lentils, tofu, or tempeh) and grains (such as rice). Limit the amount of saturated fat you eat.
• Be Physically Active. Walk, dance, ride a bike, rake leaves, or do any other physical activity you enjoy. Start small and work up to a total of 20-30 minutes most days of the week.
• Stay at a Healthy Weight. Balance the number of calories you eat with the number you burn off by your activities. Remember to watch portion sizes. Talk to your doctor if you have questions about what or how much to eat.
• Drink Alcohol Only in Moderation. If you drink alcohol, one drink a day is safe for women, unless you are pregnant. If you are pregnant, you should avoid alcohol. Since researchers don’t know how much alcohol will harm a fetus, it’s best not to drink any alcohol while you are pregnant.
  A standard drink is one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits

Reference: U.S. Preventive Services Task Force (USPSTF)

What are Good Dietary sources?

EPA and DHA are found almost exclusively in seafood.Fish do not produce EPA and DHA. Rather, these oils are synthesized by single-celled marine organisms that fish eat. These fatty acids are essential for fish as well as for humans.
Generally speaking, the “oilier” the fish, the more EPA and DHA are present. Fish that tend to have high concentrations include tuna, sardines, salmon, mackerel, and herring.

What is the recommended intake of Omega-3 fatty acids?

The American Heart Association recommends about 1 g of long-chain omega-3 fatty acids per day for those with known coronary heart disease. People with no known heart disease should eat oily fish at least twice a week.

As the fish oil capsules dissolve in the stomach and release the oil, many people experience a “fishy burp.” Although obviously not a “side effect” in the usual sense, it can be bothersome. Taking the capsules at bedtime and freezing them can minimize or even eliminate this problem.

NOTE:

Since mercury toxicity is mainly a concern for fetuses and breast-fed infants, the US Food and Drug Administration’s advice to avoid contaminated fish is directed primarily at pregnant women, those wanting to become pregnant, and nursing mothers.

For More Information:
Harris WS. Fish Oil Supplementation: evidence for health benefirts. Cleveland Clin J Med. 2004; 71:208 (PDF version)http://www.ccjm.org/PDFFILES/Harris304.pdf