Author Archives: Trudy

Tired & Weak? You May Have an Iron Deficiency

by Andrea Cuniff, MD

Do you feel weak and tire easily? Are you short of breath? Look pale?

When I see patients with these symptoms, I suspect they may be suffering from anemia caused by an iron deficiency. Iron deficiency is due to too little iron in your body. It is the most common nutritional deficiency and the leading cause of anemia in the United States, especially among women.

Iron is important because your blood needs it to carry oxygen through your body. If you do not have enough iron, your body makes fewer and smaller red blood cells, and you cannot get enough oxygen.

In my practice, I’ve seen people develop iron deficiency for different reasons:

  • Adolescent girls and women of childbearing age due to menstruation
  • Young children and pregnant women because of rapid growth and higher iron needs
  • People with internal bleeding due to ulcers, hemorrhoids or cancer
  • Those with medical conditions that prevent absorption of iron, such as celiac disease or having part of their stomach or small intestine removed
  • People whose diets do not provide enough iron sources

You may not notice the symptoms of anemia at first because it develops slowly. But as anemia gets worse, you may:

  • Feel weak and tire out more easily
  • Feel short of breath
  • Feel dizzy
  • Have headaches
  • Look very pale
  • Have trouble concentrating
  • Have an inflamed tongue (glossitis)

Also, babies and small children with anemia may:

  • Have a short attention span
  • Grow more slowly than normal
  • Develop skills such as walking and talking later than normal

Left untreated, anemia may cause fatigue so severe that you can’t even complete everyday tasks. It may also lead to a rapid or irregular heart beat (arrhythmia) and even congestive heart failure.

If you suspect you or someone in your family has anemia, see your MPCP doctor. We will do a physical exam and ask you questions about your medical history and your symptoms. We will also run some blood tests. These tests may include a complete blood count to look at your red blood cells and an iron test that shows how much iron is in your blood.

Treatment for iron-deficiency anemia will depend on its cause and severity. Treatments may include dietary changes and supplements, medicines or surgery.

I also recommend that people help prevent nutrition-based iron deficiency with a diet that includes good sources of iron. For a list of dietary sources of iron, see this article by the National Institutes of Health, Office of Dietary Supplements.

Dr. Andrea Cuniff sees patients in MPCP’s Annapolis office. She is certified by the American Board of Family Medicine.

Prediabetes

by: Lisa Meade, PA-C

Prediabetes is when your blood sugar is higher than normal, but not high enough for the diagnosis of diabetes. It is also referred to as hyperglycemia, impaired fasting glucose and impaired glucose tolerance. It is estimated that 25%, or 1 in 4, adults has prediabetes. Most people will go on to develop diabetes within 10 years.

Recognizing this condition early is very important to delay and maybe prevent the diagnosis of diabetes in the future. Diabetes affects the entire body leading to increased risk for cardiovascular disease including heart attacks and strokes, blindness, kidney failure, and loss of limb due to neurological and vascular compromise.

Lifestyle changes can make a big impact on improving your blood sugar levels. Losing just 7% of your body weight can reduce your risk for diabetes by over 50%. That is only 15 lbs if you weigh 200 lbs. Regular daily exercise and diet modifications can help you achieve this goal. You should decrease the sugar and simple carbohydrates in your diet like white flour products (bread and pasta), white potatoes, and white rice. These can be replaced with whole grain bread and pasta, brown rice, and sweet potatoes. Eating a variety of fruits and vegetables and choosing lean meats are healthy diet choices.

If you are not sure if your blood sugar has been checked within the past year or if you already know you are prediabetic and need help with the diet, call to schedule an appointment with your primary provider.

WPMeade_LLisa Meade, PA-C holds a Bachelor of Science degree in Community Health Education from Towson University. She received her Physician Assistant certification from Essex Community College in 1987. Ms. Meade has over 25 years of experience as a certified Physician Assistant in primary care medicine. Ms. Meade sees patients in the Arundel Mills office.

Rethinking Drinking: What’s the Healthy Choice?

James Chamberlain, M.D.

I am often asked questions about alcohol use, such as how much is safe and are there any health benefits. I tell my patients that drinking in moderation is fine. Alcohol is a part of our social fabric and there is nothing inherently bad about it. I tell my patients they don’t have to give up their glass of wine with dinner or a beer or two at a party, as long as they aren’t driving home. But I remind them that there are well-known downsides to excessive alcohol use and I urge caution for anyone who chooses to drink.

Clearly, the key is moderation. According to the Mayo Clinic, that is one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Examples of one drink include:

  • Beer: 12 fluid ounces
  • Wine: 5 fluid ounces
  • Distilled spirits (80 proof): 1.5 fluid ounces

Risks of Heavy Drinking

Heavy drinking is defined as more than three drinks on any day or more than seven drinks a week for women and for men older than age 65, and more than four drinks on any day or more than 14 drinks a week for men age 65 and younger. Binge drinking is four or more drinks within two hours for women and five or more drinks within two hours for men.

Heavy drinking can increase your risk of serious health problems, such as:

  • Certain cancers, including breast cancer and cancers of the mouth, pharynx, larynx and esophagus
  • Pancreatitis
  • Sudden death if you already have cardiovascular disease
  • Heart muscle damage (alcoholic cardiomyopathy) leading to heart failure
  • Stroke
  • High blood pressure
  • Liver disease
  • Brain damage and other problems in an unborn child

When to Avoid Alcohol

In certain situations, even moderate drinking may pose health risks. Ask your doctor whether you should avoid alcohol if:

  • You’re pregnant or trying to become pregnant
  • You have liver or pancreatic disease
  • You have heart failure or you’ve been told you have a weak heart
  • You take prescription or over-the-counter medications that can interact with alcohol
  • You’ve had a hemorrhagic stroke (when a blood vessel in your brain leaks or ruptures)
  • Any time you are going to get behind the wheel
  • In combination with a variety of medications – always consult your doctor about the “drug interaction” potential of your medication with alcohol

Warning signs of problem drinking

  • You feel guilty or ashamed about your drinking
  • You lie to others or hide your drinking habits
  • Your friends or family members are worried about your drinking
  • You need to drink in order to relax or feel better
  • You “black out” or forget what you did while you were drinking
  • You regularly drink more than you intended to
  • You have had problems in relationships, with work or with the law related to drinking
  • You have had medical problems related to alcohol use

Are There Benefits?

Over the years, several studies have suggested possible benefits for moderate alcohol use, including:

  • Reducing risk of developing and dying from heart disease
  • Lowering risk of ischemic stroke (when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow)
  • Reducing risk of diabetes
  • Slight reduction in overall mortality for moderate drinkers when compared to non-drinkers

The key again is moderation. Many people find it difficult to stay under one or two drinks a day. A glass of wine or a beer each evening followed by heavier drinking on weekend nights is too much. It’s the average consumption per day that matters. If you know you will be drinking on the weekends it’s best to avoid those weeknight drinks. And everyone should be aware of the signs of problem drinking and seek help if they find themselves unable to control their alcohol use.
Talk to your family doctor if you are concerned about your drinking. We can help you figure out if it’s a problem and get you the help you need if it is.

Additional resources:
http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/symptoms/con-20020866
https://ncadd.org/learn-about-alcohol/signs-and-symptoms

James Chamberlain, M.D.Dr. James Chamberlain is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He received his medical degree from University of Maryland School of Medicine in 1985 and completed his residency program in Family Practice at The Medical University of South Carolina in 1988. Dr. Chamberlain sees patients in the Queenstown office.

Family Medicine Practitioners: Care for the Whole Family – Even Babies

A Q&A with Lyn N. Dea, D.O.

Q. I know family medicine specialists see children and adults, but babies too?

A. Yes! Many of our MPCP family providers are trained and experienced in pediatric care. Family medicine as a specialty is devoted to the comprehensive health care of individuals of all ages, and particularly in the context of family and community.

Q: Are there advantages to bringing my infant to MPCP?

A. Since MPCP focuses on primary care and family medicine, chances are we already know your family and your medical history, so there’s no learning curve when a new baby arrives. Your child can easily be integrated into your family’s program of care – plus you don’t have to find a separate healthcare provider just for your child.

Q. Does MPCP see many babies?

A. Yes, many families entrust their infants’ care to us. But that’s only part of the story. Our doctors care for many three-generation families ─ child, parents and grandparents – and even some four-generation families. We provide care for everyone under one roof. Only family physicians can do that!

Lyn Dea, D.O. Dr. Dea is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. She received her medical degree from the Philadelphia College of Osteopathic Medicine in 1998 and completed her residency program in Family Practice at Franklin Square Hospital Center in 2001. Dr. Dea treats patients of all ages, from newborns to adults.