It's not nice to falsify research

[Bill Glasheen]

This is why I tend to advocate things like consumer protection and corporate responsibility.

By what means?

More GOVERNMENT regulation predictably results in the following:

• Higher taxes - to pay for the personnel and processes needed to enforce the regulations.
• Higher-priced products. I just got finished visiting my dad, who lives with my sister and brother-in-law. The latter is involved in real estate loans, property management, etc. As he said last night (and my brother the lawyer as well) what used to take a few hours a year ago now takes a few days, and with a lower probability of getting a return. Right now he literally cannot make any money. Ultimately we the consumer pay for that in terms of higher prices. And that hurts the poor much more than it hurts the wealthy. There is no free lunch.
• Possibly less creativity/diversity. Regulation poorly executed can tend to stifle the creative movement in a highly adaptable and mobile business environment. There will be fewer Apple-like inventions, more boring vanilla cars, greater homogeneity of homes, etc. Imagine Obama's administration obsessing over fuel economy restrictions when you have a fully electric Tesla paradigm up and running in southern California. What's up with that? All while government subsidizes the corn industry that produces ethanol for gas that has no (zero, zilch) petroleum savings in the big picture. And Europeans are enjoying the benefits of clean diesel (sometimes produced from organic matter) while we suffer from regulations that favor gasoline-powered vehicles. Half of all cars sold in Europe are diesels. I'm still waiting for Subaru to introduce the boxer (opposing piston) diesel engine over here in their product line. Still waiting... and waiting... and waiting...
  
  I've thought of giving up and just converting one of my vans to dual fuel source. CNG vehicles are today, and they can be run cheaply. But there are these damned regulations that my mechanic and I have to overcome... All we want to do is save mega $$ on fuel and use a domestic source of energy. Sounds patriotic and ingenious to me! But nooooo, we have to keep the regulators happy. No more 1950s and 1960s style tinkering of cars allowed. Grrrr.....

Caveat emptor indeed!

Rather than forced regulation, I prefer better and faster information. Nothing kills a bad business and poor service faster than well-informed consumers. The performance of a merciless free market is on a level that government wishes for in its best wet dreams.

Everything in moderation, my friend.

- Bill

[Panther]

I actually wrote a really long response that got lost in the ether somewhere. I'm not going to and can't really take the time to recreate it.

Thanks for the really good thread. I'm not a Scientologist or a Christian Scientist. I am very glad and thankful for the help that I've gotten from modern medicine. I used to never read the labels and blindly got on a downward spiral of complaining about things which caused my MD at the time to write me yet another slip to take to the pharmacy. BAD, BAD, BAD! Caveat Emptor! I really have no one to blame but myself. I was unwittingly sabotaging myself. One day, after filling a new and refilling some other scripts, I was standing there being upset about how poorly I felt and started reading one of the inserts. It just so happened to be one of the things I'd been on the longest. At first when reading the side effects I was thinking, "no, nope, not me, haven't got that..." Then I read the "rare or extremely rare side effects". It sounded like my MD visits over the previous few years and "light dawned over marble head." I had a fist full of pills that were mainly to counter the list of side effects. (Some of those side effects included depletion of certain vitamins and minerals as well as causing problems with certain internal organs! That was also something that I was dealing with because of the infection I'd gotten in my bloodstream which screwed up my internal functions. I know I don't have to tell Ian or Bill-Sensei how bad/dangerous an infection in your bloodstream can be and it was so bad that they had told me they were afraid they were losing control of it.)

Anyway, I did go to another MD for a second opinion. Three MDs gave me essentially the same diagnosis. After spending lots of time discussing the cost::benefits of the tests (yes some of us actually do take personal responsibility for our health-care costs), the tests were run to "prove" their diagnosis was correct. They were all wrong. The MD that is my current MD (happens to be a woman, did I mention that?) did the homework with me and found a reasonable substitute for a med, I did my part with diet & exercise - still working on that with a ways to go but that was also one of the side effects , MD prescribed a multivitamin/mineral (which we replaced after a couple of months with an OTC generic that is cheaper) and things are OK. I still have some things I'm working on, but I was having those side effects for years, so we realize that I'm not going to be completely fixed in a fraction of that time. Working on it...

I understand the whole "math" thing... I do math as part of my work. But I can't help but be concerned and get emotional when I read about the person who's been harmed by medicine. A LOT of people do get harmed. Sometimes it's the 1 in a million, sometimes it's negligence, sometimes things just happen, sometimes it's because someone just doesn't care. I guess for me I've become more of a "trust but verify" type in most aspects of my life. I personally don't believe that's a "bad" thing, but it can be a time-consuming thing.

[Valkenar]

By what means?

More GOVERNMENT regulation predictably results in the following:

Government has a role to play in it certainly. To some extent it's just wishful thinking that instead of everyone shrugging and saying "well, that's just how it is" people would seriously stop buying stuff from people who take advantage of the impossibility of vetting everything that crosses your path.

• Higher taxes - to pay for the personnel and processes needed to enforce the regulations.

Meh, whatever. Whatever tiny little tax-burden this extra regulation proposes is practically nothing. Certainly less than the $5/mo I pay to consumer reports.

Furthermore that's not really a salient point. If you think the regulation is bad, that's one thing, but "the police are too expensive" isn't a reason to legalize anything.

[*] Higher-priced products. I just got finished visiting my dad, who lives with ...
And that hurts the poor much more than it hurts the wealthy. There is no free lunch.

Well hold on here. Real-estate and property management isn't "products" in the usual sense. But I'll accept your point that regulation *can* cause overhead that raises prices. However, part of this regulation is to cut down on things like doctors proscribing the drugs they have pens for. That's going to save money.

And the more important argument is that, sure, it may cost more, but you're getting something for that money. What we would get from the Goods and Services Administration would be equivalent to what we get from the FDA; a reliable level of safety and quality for the things we buy. Now the FDA is far from perfect, but it's better than any alternative I've heard suggested.

Obviously the answer isn't "total government control" just like the answer isn't "total government inaction." We don't need 10 year waiting periods for every new Lego set that comes out.

No more 1950s and 1960s style tinkering of cars allowed. Grrrr.....

That's true, and so be it. The tinkering that prevents you from doing what you want to with a diesel car also prevents people from making wildly unsafe deathmobiles that will blow up a city block when their rocketfuel packs explode. It also prevents people from taking off their catalytic converters and mufflers so they can have loud, polluting cars in the name of manliness. I really think that happens more than smart guys like you trying to save a buck.

Rather than forced regulation, I prefer better and faster information. Nothing kills a bad business and poor service faster than well-informed consumers.

But can you actually come up with a way for that to work? Because as far as I can tell it's utterly impossible for people to get enough reliable information to make wise decisions in any kind of reasonable time. Sure, in theory the well-informed consumer makes everything work beautifully. In reality, consumers aren't well-informed, and, as I argue, it's actually *impossible* to be well-informed at this moment in history.

[Bill Glasheen]

I argue, it's actually *impossible* to be well-informed at this moment in history.

You're going to have a hard time defending that hypothesis in the information age.

You have no idea how much easier my job has gotten (as a professional researcher) since I started graduate school. Gone are the trips to the library where I spent hours and hours taking notes out of Index Medicus, and hunting down the articles. Now even YOU can find this stuff out in a few minutes with a few keystrokes.

The other issue is the timeliness of the information. With news and information being a 24/7 proposition, something important can go viral in a matter of hours. Like last night, when Steven Strasburg was pitching. It got so much attention that nobody knew Wakefield beat Cy Young's and Roger Clemens' record for most number of innings pitched by a Red Sox hurler. And if you can't find a real-time video feed (which usually I can), someone will post it on YouTube. And hundreds of reporters will write about it within an hour.

Local news also gets lots of coverage. We now know about the health department inspection results of all the local restaurants - thanks to WWBT Channel 12. When the cook doesn't wash his hands after taking a sheet, *I* know about it. And I'm glad I do. Yes, LOCAL government was involved there in data collection. But private industry - and not government - put the information to work in ways that help the consumer.

In this town if you aren't good in the restaurant business, you're toast. You will go out of business faster than a burger place can be erected.

Most people aren't suffering from a lack of information. I would argue that the problem is instead information overload. You need a good real-time filter to get what you really need from all that is available.

- Bill

[Valkenar]

Most people aren't suffering from a lack of information. I would argue that the problem is instead information overload. You need a good real-time filter to get what you really need from all that is available.

What is it you like to say? "You argue best when you argue my point?" This is exactly my point. There's too much going on for people to keep track of. Sure, information exists, and you can get to it. But you don't have time to sort through it all. To really examine it all, sort the good from the bad is damn near impossible for people to do.

And some tasks are easier than others. Sure, it's easy to find out when some silly entertainment event takes place, whether that's whoever pitching or someone's skirt falling off in public. But some things aren't. Again, I'll quote you to prove my point

It got so much attention that nobody knew Wakefield beat Cy Young's and Roger Clemens

Bingo. There's a lot of information eclipsing in the world. The useless stuff is plentiful and available. The good stuff is rare and hard to find by comparison.

Here's a challenge, based on my own life:

Find a good plumber in Marlborough, ma (I've asked bunches of people, searched online... nobody has ever even heard of a good plumber, maybe they don't exist).

Tell me the top ten doctors in the Waltham, Ma area who don't take any pharmacy bribes.

What is the cheapest container that will take a quart of hot soup, not explode in the freezer, and not leech chemicals into my food?

These are not easy questions to get an answer to. And there's a million other smaller daily questions that you can't answer quickly either. Everything you pick up off the shelf at the store... what goes into it, how are they making it? Is it more ecologically sound to buy the local, but pesticidey apple, or the organic apple from 3000 miles away? Is this chicken *really* free range, or is it the kind where they pack them in tight in a barn and call it free range?

[Bill Glasheen]

Justin I would tell you that you are asking all the right questions. The biggest problem I see is that you may not like the answers you get.

• You may not like that a salaried MD is the one least likely to be free of Pharma bribes. Unless you have health insurance with Kaiser or a similar staff model HMO, influences will be there.
  
  Ian is a salaried MD, but I believe it's because he's a hospitalist. I doubt he could be your PCP.
• You may not like that one container isn't best for everything, just like one tire for your car can't do everything perfectly. So maybe you have a summer and a winter set of tires for your BMW... or just accept the shortcomings in a fairly pricey "all season" tire. And maybe you cook and microwave with your Corning, but use your Tupperware for storage. Works for me!
• I don't know what to tell you about the best plumber in some area of MA. Every time I find a good one, he quits. I have this bathroom that's 95 percent finished... and will stay that way until I can find another person to pick up the pieces. Uugghh!!!!!
  
  Like my father did when he ran his own construction company, I will pay more for someone who will do it right - and complete the job - the first time around.

I say keep your subscription to Consumer Reports, but get an online version. (You don't really need it until you need it...) And look for objective sources to rate a product you wish to purchase, or an individual you wish to do work with.

Having done MD profiling, I can tell you that it's an evolving technology. So it can be hit-and-miss here. I recommend talking to people in the business. If two MDs from two different health systems tell you that this person is the oncologist you want to go to, well... That's the man who's going to be my dad's oncologist.

- Bill

[IJ]

"You're going to have a hard time defending that hypothesis in the information age."

Provided you're one of the people with access, that's cool. Most of my patients are too busy being high, crazy, homeless, impoverished, uninsured and so on to do much more than smile while I stress the importance of adherence to their regimens.

Even then, it's frequent that the doctors don't know what's going on, or what med to use, and they've had years to decades of training. Sure, do your homework, but if it were that easy, we wouldn't need doctors.

Incidentally, you can find whole institutions of bribe free physicians, such as the UC system. We don't allow drug samples, or pharma reps, on site, and we forbid free items, pens and up. It's not an individual choice--this is an example of "snobbish intellectuals" changing the behavior of all of their charges by governmentish decree. And it's long overdue. The same strategy just made UCSD and several other places smoke free--no designated areas, even. Nice!

Many of these systems also have salaried PCPs. Ours are salaried, for example. I am a hospitalist, but that's not why I'm salaried; many hospitalists "eat what they catch" and sometimes there's a mix even at the same institution. The ones that eat what they catch, by weird coincidence, see 20-25 patients a day and spend much less time with each--go figure!

[Bill Glasheen]

Panther

I feel your pain.

My dad is 88 and has all kinds of health issues - one of which will eventually take him to his grave. He's asked me to help him with his care. Without my work, I can confidently say he'd be dead now. I've really managed to pull some strings, and get him bleeding edge care that few know even exist.

All that said, I'm spending just as much time seeing to it that he gets only as much medication as he absolutely needs - and not a pill more. You see the thing is... His doctors may be worried about his metastatic cancer or his blood pressure that's far from controlled. But my dad cares more about whether he can pee and take a dump. And he'll go to his urologist to complain about a groin muscle pull. Uugghh!!!

Just last week my twin sister visited. Well she called me up and informed me that she was going to get him stronger pain meds. Naproxen and ibuprofen weren't working, and he needed something stronger. Well... I know my sister is a nurse, and I know she means well, and I know my dad was hurting, but...

I told her what the possible side effects were. He complains about his bowel movements, and a narcotic will constipate him. He has problems getting around, and a narcotic will mess with his balance. If he falls as his mom did when she started taking cough medicine with codeine... But nooo! My sister argued and argued, and said how much pain my dad was in, and yada yada yada. I finally said "Look, I gave you the information and you are going to do what you're going to do, so..."

So she gets the Dr. to prescribe a medicine that's a mixture of Tylenol and a narcotic (Darvon).

And my dad doesn't take a sheet for 4 days...

And it turns out that the real problem was that my dad's urinary tract was blocked, and his body was telling him he needed to do something about it right now or...

I visited him this week in Virginia Beach. I got rid of the narcotic, worked with the urologist on how we might stent his prostate (at his age, after two TURPs, and with cancer, sheet keeps happening), and worked on coffee and OTC meds to unclog his bowels. Twenty-four hours later, he's calling me and thinking I walk on water.

Poor quality in medicine is about the over-use, under-use, and mis-use of health care services. When patients become complex, it's so damned hard to get the therapies in optimal mode. It's much, much easier to screw everything up.

Ninety percent of the time, less is more.

And the only time you really need high-powered pain meds are special situations like end-stage cancer, brand new trauma, DURING surgery, etc.

And boy can you screw up a body with antibiotics. But I know you know that by now, Panther. Meanwhile... think probiotics!

- Bill

[Panther]

Your Dad is lucky to have you, Bill-Sensei.

Poor quality in medicine is about the over-use, under-use, and mis-use of health care services. When patients become complex, it's so damned hard to get the therapies in optimal mode. It's much, much easier to screw everything up.

Ninety percent of the time, less is more.

Well, I've gone from someone who was really good and helped me, but who ended up with health problems of their own and had to retire much too early...
to someone that was basically the "eat what you catch" type Ian mentioned and was ultimately in it for the money pushing scripts out...
to someone who understands the concept of less = = more and spends the time with me. (Also happens that this MD lives down the road, was my wife's MD for years before we met, and humors my "if you start looking for problems, you'll find them" attitude.)

And the only time you really need high-powered pain meds are special situations like end-stage cancer, brand new trauma, DURING surgery, etc.

And boy can you screw up a body with antibiotics. But I know you know that by now, Panther. Meanwhile... think probiotics!

- Bill

I also know that pain meds can be addictive as well. I'm starting to look into the probiotics and related things. I hope that Ian doesn't think that by taking that type of thing makes me somehow a "scientologist". There is so much information out there and much of it is contradictory that it is hard to wade through it all... information overload... but when I have specific things that I need to look into, I do the research, weigh all the opinions, look at as many numbers as I can, and do my best to make the best, most informed decision for ME. Over time, I've learned to stop wasting my time on some sources and focus more on others. (The internet isn't good or bad, it just is... the info there can be wild from one side to the other. I've found that usually those extreme claims are just "claims" with a selective touch of reality tossed in.)

Thanks for helping without professional compensation!

[IJ]

1) Darvon is a stupid drug. I never use it. Found this: http://www.doitnow.org/pages/157.html

It's not from a great source but I agree with most of the detail. LOTS of side effects and meager pain relief and far better choices.

2) Narcotics can block up your urination, not just your defecation. I saw a 50 year old man who was healthy except his few percocet a day made him stop peeing and his kidney test (creatinine) was up a factor of 17 because he had 2 liters of urine in his bladder and none coming out of the proper tube.

3) Tell your doctors if you have 2 liters of urine in your bladder and can't pee BEFORE your kidney failure makes you delirious and twitchy.

4) There are lots of people who can't seem to function or at least be happy before they reach the "end stage" cancer point of powerful narcotics. Thing hurt; many people can't take NSAIDs, or who have side effects if use is chronic, and tylenol doesn't do much. IF people go on narcotics, especially at an older age, they should definitely start a bowel regimen with it and proceed very cautiously and not use stupid drugs like Darvon (or prescribe them). One issue is dose: I gave 16 mg of IV morphine within 30 minutes to a young woman who had a perirectal abscess ripped open in our ER for drainage, and I gave a quarter mg of morphine to a sweet, 105 year old lady who was skin and bones and multiple pain sources. The young lady was still screaming and the great great grandmother went to sleep peacefully and woke a bit later without any confusion. Bill, maybe your dad needed a quarter of a vicodin or something. Myself? Codeine saved my life when I had pertussis. And a half of a 5 year old percocet was super one evening for a broken finger. People with addictive tendencies should avoid these things at all cost.

5) Panther, the devil's in the details with those supplements and herbals and so on. If it does something at all (contrast: diluted homeopathics), it can cause problems as well as improvements. Each must be considered just like a drug. Each should have a genuine indication. Interactions should be considered. Herbals carry the risk of non-use of active substances too (ask my lady who quit her insulin to go on bitter melon extract, the diabetes "cure" from the Phillipines). But I doubt you're a scientologist.

[Panther]

Hi Ian,

I understand and agree... I could have easily become addicted to a codeine containing drug (percs, roxies, vics, etc.) I recall coming very close to abusing them when I was released from the hospital... Fortunately, something in me "clicked" and I reduced the dosage to the point where it was juuuuuust enough to take the proverbial "edge" off. (I was cutting them into 1/4s or less... I asked my MD for a refill and when they checked to see that it had been literally years since I'd had any, I got more... I'd taken an amount that was supposed to last a month and made it last years... literally.)

Anyway, I was tested specifically to see where the vit/mineral numbers were. One thing (since BP was just over the "high" mark) was the thought that I had high sodium levels... without testing, the doc told me to cut out salt. I told the doc that I don't use salt, but he didn't seem to believe me. My current MD ran the test to see what my levels were when I told her that the other doc had told me to get potassium salt, but I never did and didn't use it. (I just have never cared for salt with the exception of a very small amount of murasaki with sushi.) Anyway, when she got the test results back, lo & behold I had a sodium deficiency! (potassium was normal...) She said she was hesitant to tell me to use salt. We check that when we do blood work now.

I'm not in any danger of taking a whole bottle of vits/minerals (or otherwise going overboard. I understand that sometimes less is better). I had specific work done to see where my numbers were. One of the reasons for the prescription vits/minerals to start was to get the right combination. After awhile, when things were closer to being in line, OTC stuff was more cost effective and did/does the trick. Since the blood infection, my betraying body has been somewhat screwy in what it does with various things and how it does it. That's clearing up slooooooowwwwly. But I have an MD that's working with me on it.

Interesting that a couple of months ago she mentioned the probiotics just like Bill-Sensei. I took the task of looking into them (have an upcoming appt/check-up & will discuss it more), but like I told Bill-Sensei, there are so many (seemingly wild) claims about this-or-that brand that it is difficult (and time consuming) to wade through all of the hype. (and there are few people that I trust to give me good information on it...)

[IJ]

Hmm, that's helpful, but doesn't quite get all the way to it...

Doing a test for "sodium deficiency" is a tricky business. A least it's not intuitive. We usually run our sodiums 138-142, almost all at 139-141. One would think that a sodium of 130 might suggest salt deficiency and a sodium of 150 might suggest salt excess, but in fact, it's the opposite. That's because what you've got is a sodum concentration not total body sodium. People with low sodiums generally have a condition in which they are either acutely ill (pneumonia etc) which promotes the release of a water retaining hormone, ADH, or they've got something like liver, kidney, or heart disease and are sodium avid, retaining too much BUT they retain even more water than sodium and end up with too much sodium diluted by even more too much water. These people generally need sodium, and sometimes water, restriction.

A patient with a sodium of 150 probably got that way from water deprivation or diarrhea or something. If you don't drink enough you lose salt and water plus some water from breathing, etc, and you are salt deficient and even more water deficient. These people need salt water and extra plain water. You can also get a low sodium from dehydration, if you lose salt water and replete only with water (say, marathoners).

None of this applies to a relatively healthy person who will have the same serum sodium concentration of 140 whether they eat 2g daily or 6g daily; the difference will be in blood pressure (a little, more in others) and in water retention. If you wanted to know if THEY were salt replete you'd check a 24 hr sodium excretion, on the assumption it equals intake, and get a sense of whether they are having too much BUT it's simpler just to advise a low salt diet, since almost no americans are actually salt deprived. In short, there's no real lab testing for sodium deficiency in common clinical use.

My point here is to bore you to salt water tears, and also to illustrate that a "low" level can mean the opposite of what someone claims. So I'd be skeptical of claims they tested you for an array of vitamins and minerals. Mineral deficiency in the USA is very rare (eg, copper), others may be helpful without testing for deficiency (potassium, after certain conditions have been excluded--see a doctor, but the ratio of sodium to potassium intake more closely tracked BP than total sodium intake), and some mineral levels are just sketchy (serum mag is only 1% of the total body stores).

Many vitamin deficiencies are diagnosed clinically (eg, scurvy / vit c) and others can be replaced without testing (eg, vitamin D, established use in the elderly at 1000 units daily OR after testing of levels) and others we don't send levels for and were not helpful and may have been harmful in some situations (E, beta carotene, respectively). B12 and folate are the only vitamins we test for deficiency of commonly, altho we look for vitamin K deficiency indirectly by measuring clotting time.

Anyhoo, those "take a bunch of V+M" routines are usually scams or misguided attempts to be helpful and natural.

[Panther]

Wow... That does it... I guess I just never will see a good MD. That long discussed battery of tests that took so long and lasted so long didn't really tell the MDs anything and it's probably all wrong. (I do NOT just go through costly tests... I do everything based on going through the cost::benefit and I put a LOT of $$$ into the system in various ways while making damn sure I only use the system when absolutely necessary. I spent years basically not using the system and when circumstances beyond my control happened that meant I needed the system I felt and feel ZERO guilt about taking advantage of SOME of the account balance that I built up and am actually STILL building up.)

You say taking vits & minerals are a scam, but my numbers are coming in line and I'm feeling much better. (You're going to say now that is the placebo effect, so I guess I shouldn't even spend the modest amount for vits & minerals.)

I guess knowing that it all started with bad injuries & infections, the months spent treating specific illnesses, learning causes, etc. didn't really give me an accurate diagnosis. I should probably just go and eat all raw veggies. (Actually, that has become the major part of what I eat...)

End result... We're all gonna die, so I should just quit complaining, stop using up the valuable medical resources that are needed for people who have "real" issues like STDs, unwanted pregnancies, tobacco use (no wait, that's a no-no now), drug addictions, and/or who don't pay for insurance but should get care ahead of me on my dime. I knew I shouldn't have shared... back to lurking like I did successfully for a few years...

[Bill Glasheen]

I would never tell you to stop taking supplements when your body showed you were in need of them. They have their role.

With someone like my dad who comes up low in protein and vitamin D, the least we can do is get him the D supplement and then fill the kitchen with some Glucerna shakes instead of the donuts and pie and pastries he likes to eat all day (since mom passed away and doesn't watch over him). Knowing my dad had cancer... knowing that he's on lupron... knowing he eats cr@p... knowing his skin now reacts badly to the sun... Long story short - we got his Vitamin D levels within the normal range with supplements and are now manipulating his diet so that we can work with - if not around - his penchant for bad habits.

I also do the little things, like refuse an offer to go out for pie and instead arrange a cookout where he gets fresh (not farm raised), baked salmon. Says it was the best meal he had in a long time. No doubt. Walk the talk. Facilitate good habits.

I PERSONALLY take the following supplements.

• A partial does of a mutivitamin and multimineral supplement designed for men from TwinLab.
• Extra calcium, magnesium, zinc, chromium, K2, and D3. This supports many goals, including the following: strong bones, good sugar management, a pro-anabolic metabolism, and a cancer unfriendly environment. As someone who does contact martial arts and weight training, all this fits in with the big picture.
• Glucosamine, chondroitin, MSM, and an extra supplement with Type II collagen, hyaluronic acid, etc. I have no lateral meniscus in my right knee (as of 1974) and doing what I can to slow down the course of advancing secondary arthritis. My "witch's brew" is ever-evolving, and grows as I see the literature supporting or refuting the benefits of various constituents. It's all about the joint cartilage.
• A prostate formula with lycopene, saw palmetto, pumkin seed oil, pygeum, etc. I supplement that supplement with pumpkin seeds on my cereal in the AM (shredded wheat with bran, protein powder, and unsweetened almond milk). I have a family history of prostate cancer and BPH. So far so good. No meds needed yet, which beats out my brother (with BPH) by half a dozen years and counting.
• Fish oil supplement. Good for the joints, brain, and cardiovascular system.
• A broad spectrum probiotic. Good for GI tract and immune system. Mostly needed if you get on antibiotics, where your body's "bugs" in the intestines get out of population balance.
• Acai powder, blueberries, and other fruit goodies. Good for your body in so many ways.

As you can see, it's difficult to tell where my supplements end and my diet begins. It's all part of the big plan.

One thing I try to keep OUT of my system is sugar and high fructose corn syrup. Fresh fruit is the operating paradigm. I also avoid land-animal fats and manufactured fats that you find in processed food. I want all my fats to come from fish, nuts, olives, and vegetables. And I get them raw when I can. For example better to cook fat-free and THEN add a touch of olive oil for flavor. Sashimi good; fried fish poison.

Oh and one more thing. Grown men don't need an iron supplement unless blood tests show otherwise. You (a grown male) will live longer with a low iron diet. Proof? Men who give blood live longer. Reason? Iron acts like free radicals in your body. Women? Different. They give iron once a month. And... they live longer, don't they? Children also need good iron sources - particularly when very young. So... stay away from the Geritol and red meat. Fish and white meat are better for you.

- Bill

[Bill Glasheen]

Panther

Here's a good online review on Probiotics. And it gives some recommendations based on their grading scale.

Top Probiotic Supplements on the Market

This is a generic brand I take which fits the bill.

Ultimate 10 Probitic by Vitamin Shoppe

But I've been jockeying amongst different companies ever since I started taking them. (With a previous C difficile infection subsequent to augmentin therapy, I had a good clinical reason to do so.) The technologies are getting better, and competition is getting stiff in this supplement space. And that's good for the consumer. Understand what it is that you want, and get what makes the most sense for your budget and your pattern of using supplements.

Store in the refrigerator - alongside the fish oil supplements. These are live cultures.

- Bill

P.S. If you live out in the country and have a septic system, these kinds of supplements can't hurt all that. Bacteria have very important roles in nature. It maybe schit to you, but it's vital to waste management. Harsh cleaning chemicals can screw a septic system up. Supplementation with bacteria can bring the waste management process back in order. I'm all for Rid-X and the like, but there's nothing better than really good schit.