The symptom of cough is one of the primary reasons patients come to see me. It is also one of the most annoying and persistent symptoms for patients and one of the most difficult to treat. Across the United States, evaluation and management of cough can account for up to 40 percent of patient visits to doctor's offices. 

Acute cough, which lasts up to 3 weeks, is most commonly attributed to upper respiratory infection. Other causes include asthma, COPD, pneumonia, and blood clots. Cough that persists beyond 3 weeks but less than 8 weeks is defined as subacute cough. A cough that lasts longer than 8 weeks is defined as a chronic cough. 

Interestingly, patients who go to their doctor for chronic cough are more likely to be female. Women also tend to cough more often and to have heightened cough reflex compared to men. 

The most common causes of chronic cough are upper airway cough syndrome, asthma, and gastroesophageal reflux (acid reflux).

Upper airway cough syndrome is often caused by allergies, post-nasal drip (drainage), runny nose, or sinus issues. Treatment includes addressing the underlying cause including treatment with antihistamines or decongestants. 

Asthma is often associated with night time cough and/or wheezing. Treatment includes inhalers and steroids. 

Gastroesphogeal reflux or acid reflux is often associated with night time symptoms as well and patients often report a sour taste in their mouth in the morning. The cough is typically better during the day. Treatment includes addressing the underlying factors contributing to acid reflux and sometimes reflux medications like Nexium or Pepcid. 

A post-infectious cough is also a common cause of subacute and chronic cough with symptoms often persisting well beyond when other symptoms have resolved. A post-infectious cough may be the cause of subacute cough in half of all cases. 

Other causes include blood pressure medicines (ACE inhibitors) like Lisinopril, bronchitis, lung disease, or cancer. 

When to be concerned?

Common reasons to be concerned and to consult with your doctor include cough persisting longer than eight weeks, a history of smoking, fever, weight loss, or worsening cough. In general, I recommend getting a chest xray for cough persisting beyond 8 weeks or sooner if there are other warning signs. 

The good news is that upper airway cough syndrome, asthma, and gastroesophageal reflux are responsible for the vast majority of cases of chronic cough. These conditions are very treatable in most cases.

For those with questions or concerns about a persistent cough I advise you to consult with your doctor. I am happy to help as well. 

One of the common misconceptions out there is that eating Thanksgiving dinner will inevitably make you sleepy and lethargic. While it is the case that the majority of people feel that way after Thanksgiving dinner, it doesn't have to be that way.

The post-Thanksgiving Dinner blues have been attributed to many causes. Many people think that eating a lot of Turkey is the cause of the lethargy they feel 1-2 hours after eating Thanksgiving dinner.  Tryptophan, which is an amino acid present in turkey meat, was thought to be the culprit. 

However, there is evidence that Tryptophan may not have a significant effect on the lethargy we feel after Thankgiving dinner. This is because many meats such as pork have just as much or more Tryptophan than turkey yet they are not associated with the same sleepiness. 

There is more evidence that a few other variables may be involved.

One of most important variables is the volume of food that is eaten. Overeating is very common during the Thanksgiving meal and a full stomach can induce feelings of satiety and lethargy as resources are diverted to digestion. 

It is also very common during Thanksgiving to consume a large amount of carbohydrates. This comes in forms of potatoes, bread, and deserts. Eating a high carbohydrate load triggers insulin release and can sometimes lead to transient hypoglycemia after the meal. This is often associated with fatigue and lethargy as the sugar and insulin level equilibrate. 

So how do you avoid the Thanksgiving blues?

Here are a few tips:

1. Eat in moderation: Keep your portion size as low as possible.
2. Eat less carbohydrates and more turkey, fat, and  vegetables. Instead of filling up on potatoes, bread, and deserts eat more turkey, fat, and especially more vegetables. This will decrease the carbohydrate surge and insulin response.
3. Exercise: If you do consume a significant amount of carbohydrates do some exercise or strength training after the meal to help burn off the excess carbohydrates.
4. Drink plenty of water: With all the food that is eaten don't forget to drink plenty of water. This will help you feel more full and help you eat less. 
5. Fast:  If you happen to overindulge this Thanksgiving then a good way to compensate is to fast soon afterward. I recently posted about my experience with a 7 day fast if you want more information. 

Feel free to pass on any other tips that you might have in the comments section below and have a happy and joyous Thanksgiving!

There are few things more annoying than body odor. I hadn't realized how pungent body odor can be until my oldest son started to produce some of his own over the past couple years. If you have a teenage boy you can probably attest to what I am talking about.

Of course, our first reaction was to get him some antiperspirant and deodorant. 

But why do we smell? 

Our bodies have two different types of sweat glands. One type of sweat glands, the apocrine glands, are mostly located in areas of dense hair and associated with body odor. These glands secrete fluid into the hair follicles which when combined with bacteria leads to body odor. This happens because bacteria thrive in warm and moist environments such as the armpits. The products of these bacteria are called thioalcohols. These chemicals are responsible for the smell.  

So what makes body odor worse?

For me personally, I notice increased body odor and sweat when I am consuming more carbohydrates or when I am stressed. I generally have very little body odor when I am eating a very low carbohydrate diet.

Some of the major causes of body odor include:

1. Anxiety: Increased levels of cortisol increase the release of sweat.
2. Medications: Some medications may increase sweat production like NSAIDs.
3. Food: Various foods like onion, garlic, curry and meat may change body odor.
4. Carbohydrates: Foods high in sugar may affect body odor.
5. Deodorant/Antiperspirants: These may actually increase the number of bacteria living under your arm.
6. Hair Growth: The more hair in the underarms the more potential for body odor. 
7. Medical Conditions: Several conditions like diabetes, thyroid problems, and obesity can affect body odor. 

To combat body odor our first reaction is often to reach for antiperspirant or deodorant.

But are there potential risks for using traditional deodorants?

The answer is definitely yes. I personally cannot use either traditional deodorants or anti-antiperspirants with either Aluminum or alcohol. I get horrible rashes and irritation. My symptoms only resolved when I found high quality products that don't contain these chemicals. 

The ingredients of these products may even penetrate the skin and be found in your blood. 

So what are 5 of the most common potentially hazardous chemicals in these products?

Aluminum
Aluminum helps block your sweat glands and reduce the amount of sweat your secrete. Aluminum has been potentially implicated in breast cancer. 

Parabens
These chemicals are used as preservatives. Parabens are associated with changes to the productive of estrogen and other hormones in your body. This may increase the estrogen effects in your body. 

Phthalates
These compounds make these products sticky. These compounds may effect androgen function in the body. 

Triclosan
This chemical is used to kill bacteria. It may also be associated with hormonal abnormalities. 

Fragrances
Some people may develop allergic reactions to certain fragrances. 

So what options are available to fight body odor?

There are various options available. Some treatments like rubbing Lemons or Limes in your armpits may kill bacteria. Vinegar, Hydrogen Peroxide, Tea Tree/Coconut Oils may also kill bacteria. Odors can be neutralized by baking soda. 

Besides these natural options I have found a couple products that work well for me and are completely free of the potentially dangerous toxins that I listed above. One of these products that can be purchased by anyone at my practice is Schmidts 100% natural deodorant. There are many different natural scents available with this brand and it works very well to eliminate odors and I have had no side effects with the use of this product like I get with other products that I get from the grocery store. 

For those that want a natural option feel free to reach out to me for more information. See the products below. 

I have always wanted to share with others the products that I personally use and believe in. These products are natural and effective and can now be purchased at Murdock Health. 

Instead of buying substandard products from the grocery store why not support an independent practice like Murdock Health and stay healthy at the same time. 

This brings me to the product line up which can be purchased at my clinic. You don't need to be a patient to pick up these products so please pass this information on to friends and family.