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RadioMD Presents:Healthy Talk | Original Air Date: March 9, 2015
Host: Michael Smith, MD

You're listening to RadioMD. It's time to ask Dr. Mike on Healthy Talk. Call or email to ask your questions now. Email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call: 877-711-5211. What are you waiting for? The lines are open.

I'm going to start this segment with some follow up questions. I did some of these. I answered some of these questions in some past shows and got some follow ups from some other listeners, which is awesome. It means people are listening. Yeah!

Alright. I do love my listeners and I appreciate everybody who tunes in.

So, this first one, I guess...I don't remember when. It was a while ago, but I do remember vaguely talking about hand sanitizers and how we overuse them. So, the question is:
"You mentioned we over use hand sanitizers, so how often can we use them?"

Well, there's not a number here. I mean, it's not like once a day or twice, something like that, but I think a good rule of thumb is if you are around soap and water, use the soap and water. I was traveling recently for Life Extension and in the airport bathrooms, they obviously have the sinks and the water and the soap, but, also, as you leave, they have the hand sanitizer at the exit. That shouldn't be replacing washing your hands. Gosh, I hope people aren't doing that, right? That they're just leaving and just doing a little squirt of the hand sanitizer. So, there's no number. I think the rule of thumb is, if there's soap and water, use the soap and water. There's no reason to do the hand sanitizer. Soap and water works just fine. I guess that's a good rule of thumb then. That's maybe what we should practice.

So, no number. When you don't have soap and water, that's when the hand sanitizers are pretty good. Or, if, when you're on the plane, for instance. You know what? Those planes are kind of dirty. I'll use a hand sanitizer at times when I'm in the seat using the tray and stuff like that. So, there are times when it's appropriate to use them. It's just that if there's normal soap and water, you don't need to. Alright?

Okay. Next question. Okay. This question refers back to...I don't know if this was a question, actually, or if this was a whole segment. I don't remember. But, I talked about Acetaminophen—the big brand name Tylenol. I talked about the dangers of Acetaminophen, specifically to liver health, right? Just a quick review here.

Acetaminophen—and the main form, the main brand, is Tylenol. If you get too much of it, you can deplete the glutathione level in the liver and that's not good because the liver is doing so much detoxification that it needs glutathione as an antioxidant to protect itself from all those toxins. When you deplete glutathione in the liver, that increases the chance of severe liver disease, even acute liver failure. That's exactly what Tylenol does is Acetaminophen depletes glutathione, so I talked about that. The question here—this follow up question is:

"Well, what is the maximum dose of Acetaminophen?"

So, if you look on the label, or you can go to a site that I like to use for these kinds of questions is Drugs.com. It's just straight information on Drugs.com. It's not biased either way. Just real simple. Drugs.com says 1000mg every 6-8 hours would be the max. So, that comes out to about 3000mg a day.

They go on, Drugs.com says in the precautions: "Cases of acute liver failure, some resulting in liver transplant that have been reported with Acetaminophen. Most cases of liver injury are associated with doses greater than 4 grams a day and often involve more than one Acetaminophen containing product."

That's exactly what I talked about in that segment. It's not that in and of itself, by itself, Acetaminophen is dangerous. I mean, if you keep it within the dose range, it's fine. You're not going to deplete glutathione.

Everything's good. When you get up to that 4 gram, 5 gram a day, that's when we have an issue. That's when you deplete the glutathione and what happens, Acetaminophen is in so many different products now, so people aren't adding up all those doses. That's the problem. They just don't know they're overdosing on it.

So, if you're not feeling well, if you have fever, pains, whatever it is, before you take something with Acetaminophen, make sure you know how much of it is in there and if you take something else a little bit later, make sure there's no Acetaminophen in it or at least make sure you're adding up those doses. It's 3000 mg a day or less and you should be okay. I love follow up questions.

Okay. Next question. Actually, this is three questions that came from a listener:

"Dear Dr. Mike: I have a few questions. I am a 60 year old female. Basically healthy. I've been taking aspirin, 81 mg enteric coated ever since 2006. But, a few months ago, I started taking ginseng. Should I stop the aspirin? I don't have a heart problem at this point. I have no hypertension and I read a Mayo Clinic report that taking daily low-dose aspirin is not good."

Well, let's address that Mayo report. Yes, there was a recent study looking at is it efficacious, is it really worth it, taking a baby aspirin every day? If you have low cardiovascular risk, the answer is "no". You don't need it in those cases. So, that report wasn't addressing people at high risk or moderate risk or people who have already had a heart attack or a stroke. In those cases, the aspirin is beneficial. So, if you don't have any heart issues whatsoever, you're at low risk, right? And your doctor has said you're at low-risk for heart disease, there's probably no reason to take a baby aspirin.

That's really what that Mayo report was talking about.
As far as the combination, though, of aspirin and ginseng, I mean, there's nothing in and of itself that's wrong with that. You just have to realize that both of them are blood thinning, right?

I mean, as a matter of fact, ginseng, just like aspirin, will affect platelets. Before a clot actually forms, the first thing that happens is platelets will bind to the area where there's a wound and then the clot forms on top of the platelets.

So, if you take something that's anti-platelet, you're making it really hard for any clot to form. So, that's what we call "blood thinning". So, aspirin and ginseng kind of do the same thing. As a matter of fact, when people talk about blood thinning supplements, a vast majority of them are affecting platelets.

A vast majority of the blood thinning supplements are affecting platelets. So you need to be aware of that if you're doing over the counter or prescription anti-platelets because you don't want to knock them out too much. You might bleed a little bit too much.

So, how do you know? Well, if you get too much of an anti-platelet effect in your body, in this case, let's say between ginseng and aspirin, you won't see a bruise which would be an indication of a problem clotting blood, but what you see with anti-platelet, when you overdo the anti-platelet medications, is you get what are called "petechial hemorrhages"—little red spots all over your arm or a leg or something like that.

You'll see a collection of these little "petechiae" is what they call them. That would be a sign of your platelets are really knocked out. So, here you have a situation where you don't have a heart problem and based on some current research, there's probably no reason to be on a baby aspirin.

I love ginseng for a variety of reasons. Ginseng kind of gives you some of the same benefit as the aspirin, so I would probably say stick with the ginseng, forget the aspirin. That would just be my opinion. I'm not telling you to do anything. I can't. Okay.

The next question she had:

"I also take DHEA. Should I take that on an empty stomach?"

Yes. I take DHEA as well. I consider it an anti-aging supplement. I take mine in the morning right when I get up. So, there are some rules there. Amino acids, proteins, hormones, those are usually done better on an empty stomach.

The last question was:

"I know that Vitamin K2 is good from your talk, and I tried several times taking it, but each time, my lips felt numb, so I stopped. I learned I can eat more cheese to get my Vitamin K2. Is that true?"

Yes.

Vitamin K2 is found in a lot of the foods we don't want you overeating. Animal protein, fats, cheeses, dairy. But, yes. You can get your Vitamin K2 from those sources as long as you don't overdo it.

Alright. This is Healthy Talk on RadioMD. I'm Dr. Mike.
Stay well.