Saturday, May 20, 2006


My brother the MBA introduced me to this accounting concept. Last in, first out in a business sense means that the last units added to inventory are recorded as the first units sold. LIFO in a medical sense means that when I ask patients how that new drug is working out for them, they often answer "What new drug." And when I inquire about the fledgling exercise program that we talked about on a previous visit, they'll deny the conversation ever happened.

I'm definitely feeling a bit LIFO about my vitamins. As some of you know, I take quite a handful each day. The last in--turmeric--was the capsule that sent my stomach over the edge. For three days straight, I'd feel so nauseous after dinner that I assumed (who wouldn't?) that I was getting hepatitis. Finally I realized that my inner lump of supplements was the source of my distress. Not that a turmeric pill is nauseating, but it was just one pill over the tolerance line for me.

My friend Jean from France sent me a news item this week that an NIH panel has reported that Americans may be taking too many vitamins. I think they mean me.

Don't, however, give up on those calcium and vitamin D supplements. The recent report out of a sub-study from the Women's Health Initiative concluded that calcium and D are necessary to prevent postmenopausal bone loss but they may not be sufficient as the only strategy for bone protection. Somehow reports in the media took the evidence and concluded that calcium was no longer recommended.

In fact, Walter Willet MD, Harvard's nutritional guru suggests that most healthy adults should take 1,000 units of D each day. He commented, "This is a conservative amount, and higher intakes may prove better." So 500 mg. calcium and 400 units of D twice daily will stay in my vitamin pile. FILO.

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