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Achilles Tendinitis

Achilles tendinitis means you feel pain in the large tendon that extends from in the back of your heel to your calf muscle. It hurts most when you get up in the morning and when you start to walk or run. It will heal only if you stop running and find another sport that doesn't hurt when you do it, such as cycling, swimming, or pulling on a rowing machine.

The Achilles tendon is made up of thousands of individual fibers, like a rope with thousand of strands. The fibers can be broken if you apply a force greater than their inherent strength. No medicines hasten healing. As soon as the tendon stops hurting, doctors usually prescribe strengthening exercises, but you have to exercise against greater resistance to become strong and strong resistance prevents healing. If you want to return to running or jogging, start out by jogging very slowly daily until your tendon starts to hurt and then quit for the day. When you no longer have any pain, you can strengthen the tendon by learning how to run fast. You must stop immediately if you feel a pulling behind your heel and each intense workout will require several easy days to allow you to recover. Try to run very fast once or twice a week, never on consecutive days.


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Dear Dr. Mirkin: Should I get vitamin B12 injections to treat pernicious anemia?

Most people with pernicious anemia can a cured by taking a 1000 microgram pill of vitamin B12 once a day; they usually do not need to take injections. Pernicious anemia is due to lack of vitamin B12 which results in progressive nerve damage that causes forgetfulness, loss of ability to concentrate and abnormal nerve sensations such as burning, itching or loss of feeling. However, many people with pernicious anemia do not have abnormally low blood levels of vitamin B12. One study showed that older people have lower blood levels of a chemical called homotranscobalamin II that carries vitamin B12 into the cells, so they need higher blood levels of B12 to have normal tissue levels.

The diagnosis of pernicious anemia is often made late in the course of the disease after a person has suffered permanent nerve damage. One report showed that two percent of Americans over 60 have low blood levels of vitamin B12, but the incidence of vitamin B12 deficiency causing nerve damage in older people is much higher than that, perhaps as high a 50 percent. Many older people who are diagnosed with senility actually suffer from lack of vitamin B12. Lack of vitamin B12 also can cause heart attacks, so all people over 60 should be screened for B12 deficiency. Those with normal levels of B12 who have symptoms of nerve damage or arteriosclerosis should also get a blood test called homocysteine. Low levels of B12 can be associated with stomach diseases, absorption problems and infections such as Helicobacter pylori. See reports #G123 on Helicobacter and #G206 on Celiac Sprue.


Dear Dr. Mirkin: My mother and two sisters have diabetes. Am I doomed to become a diabetic too?

You inherit a susceptibility to Type II diabetes; you do not inherit diabetes. A study in the Journal of the American Medical Association (October 8, 2003) shows that one of three Americans will become diabetic, with women more likely to develop diabetes than men. The authors showed that the average person who is diagnosed with diabetes at age 40 will die 11.6 year earlier than a non-diabetic and he or she will be severely incapacitated with one or more side effects of diabetes 18.6 years before a non- diabetic.

Risk factors for developing diabetes:include: a family history of diabetes; storing fat primarily in the belly; high triglycerides; low HDL (good) cholesterol; blood sugar higher than 200 thirty minutes after a meal; fasting blood sugar above 110; excess hair on the face or body (in women); or diabetes during pregnancy. A person with any of these warning signs should immediately make lifestyle changes to prevent diabetes: avoid refined carbohydrates (foods made with flour, white rice, milled corn; all added sugars and drinks that contain sugar), exercise regularly, lose weight if you are overweight, and keep your weight controlled for the rest of your life. If you do this you will be at low risk for developing diabetes, even if you have the genes that make you susceptible.


Recipe of the Week

An easy whole-meal salad with endless variations:
Seafood Tossed Salad

List of Diana's Healthful Recipes

June 27th, 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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