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Aspirin Can Cause Hyponatremia

Several recent studies show that aspirin, Indocin, Celebrex and other arthritis pain medicines may cause some cases of hyponatremia. These medications, often taken to relieve muscle and joint pain, can cause the body to retain fluid during exercise (Medicine & Science in Sports & Exercise, May 2005).

For more than 40 years, sports medicine experts have told athletes in endurance events to take fluids frequently during events lasting more than one hour. However, on rare occasions, novice athletes have died of hyponatremia in these endurance events. Hyponatremia is caused by drinking too much fluid and is not caused by excessive loss of salt in sweat. The extra fluid expands blood volume and dilutes blood salt levels, which forces fluid to enter and swell the brain, causing nausea and vomiting, weakness, headache, and extreme tiredness. Since these same symptoms can be caused by dehydration alone, the only way to diagnose hyponatremia is with blood tests.

How much fluid should you drink? Experts do not agree because thirst is a late sign of dehydration. The American College of Sports Medicine recommends three to six cups of fluid per hour. For a person who is not exercising near his maximum, this could be too much. The person who is exhausted and exercising significantly below his capacity probably should take in only two to three cups per hour. Above all, do not take aspirin or any arthritis pain medicines before you compete in events taking more than an hour. More on hyponatremia


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Dear Dr. Mirkin: How can I get rid of the fat on my thighs?

If you are woman who is thinking about getting liposuction to rid yourself of the fat in your thighs, think again. Dr. Anne B. Newman, of the University of Pittsburgh found that thigh fat may be good fat (Journal of Clinical Endocrinology & Metabolism, August 12, 2005). Older women with lots of fat in their thighs are at much lower risk for ''metabolic syndrome," a condition associated with high blood sugar, cholesterol and blood pressure that increase risk for diabetes and heart disease. The bad fat appears to be stored in the abdomen and wraps around organs. In post-menopausal women, heavy thighs and buttocks are associated with lower triglycerides, blood sugar and blood pressure. However, women who also stored lots of fat in their bellies lost much of their advantage.

We aren’t sure how thigh fat prevents disease. It may be a receptacle that draws triglycerides and other fats from the bloodstream or it may draw fat from the abdomen and around organs where it could be lethal. Sadly, there is no way to store fat only in the thighs. When you gain weight, you add fat everywhere. But it’s safer to look like a pear than an apple.


Dear Dr. Mirkin: I’ve heard that baldness in men is linked to heart attacks; is this true for women also?

Male-pattern baldness is very common in men and fairly common in women. Male pattern baldness may be caused by high blood insulin levels caused by eating large amounts of refined carbohydrates. It is associated with high insulin levels and an increased risk for heart attacks in women also (Dermatology Online Journal, November 2005). Although not an established treatment, you may be able to halt further hair loss by eating a diet that is low in refined carbohydrates. More on baldness and heart attacks and treatments for baldness


Dear Dr. Mirkin: Why doesn’t Diana put nutrition data on her recipes?

We think it's more important to have a big picture of what you should be eating -- plenty of fruits, vegetables, whole grains, beans and other seeds and not a lot of anything else -- and choose recipes accordingly. See

However, many of you have asked for the nutrition information, so we will look for a software program that makes it easy and accurate. So far, the ones Diana has tried give counts that are often misleading or just plain wrong. Meanwhile, enjoy the recipes; they are all "good for you" foods.

Recipe of the Week:
Spicy Garden Pea Soup

June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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