Jan. 16, 2012
Can seemingly trivial details such as the length of your fingers and
whether you wear high heels actually be important clues about your risk
for serious medical conditions?
According to Dr. David Agus, author of the new book "The End of
Illness," finger length and shoe type are two potentially important
pieces of information people can use to unlock their body's secret code.
By learning to interpret the body's signals, Agus says people can
prolong their health and live their lives free of illness.
"The end of illness is closer than you might think," Agus, also a
professor of medicine at the University of Southern California Keck
School of Medicine, wrote in the introduction to his book. But to
achieve that, he continued, people must look at their bodies in a whole
new way.
"Medicine today is, 'I treat the individual condition. Your joint hurts,
I'll give you something to help the joints.' But I want to figure out
why. What in your system allowed that joint to hurt. And I want to
change the whole system in a different direction," Agus told ABC News.
In the book, Agus offers much medical advice he believes people should
carefully consider, and there are many recommendations on gathering
information that may never have seemed important before, such as the
color of the fingernails. While patients should not consider these
indicators definitive indicators of illness, he said taking note of them
may help patients and their doctors determine next steps in terms of
diagnostic tests.
"All these tickers, I want all that data put together before you go to your doctor," he said.
Some of the tips, he says, may seem contrary to what the medical
establishment has long recommended, but are important because they show
how every part of the body plays a role in maintaining good health. For
example, he talks about what it could mean if unpolished nails are a
certain color or if people notice they are losing hair near their
ankles.
Not all agree that these indicators are always relevant. Doctors in
preventive medicine who were not involved in writing Agus' book say
while some of the advice he offers is thought-provoking, current
scientific evidence suggests these risk factors may not be issues upon
which people should necessarily focus.
Still, Agus, who has garnered numerous accolades and is widely know as a
cutting-edge figure in medicine, said these seemingly minor signs may
offer clues to overall health. On the following pages are some of Agus'
hidden health indicators he said people need to be aware of, and how
medical experts weigh in.
Nails
Although nails often get attention only as part of a beauty regimen, Agus said they can hold vital health clues.
"Discolored nails can signal certain conditions, from a simple infection
to diabetes," he wrote. "If your nails have a yellowish hue to them,
it's time for a diabetes check."
Previous research has found diabetes can cause yellowish nails, possibly
due to diabetics' inability to properly break down sugar. Thus, the
finding of yellowed nails could be a clue that testing for diabetes is
in order.
But those with yellow nails must bear in mind that this does not necessarily mean they have diabetes.
"I know many people with diabetes that have normal-colored nails, and
people with yellowish nails that don't have diabetes," said Dr. Robert
Schwartz, chair of the Department of Family Medicine and Community
Health at the University of Miami's Miller School of Medicine.
Nails can become yellow because of other conditions, such as lung
disease or heart disease, which cause a lack of circulation to the
extremities, fungal infections and age. As people age, the nails can get
thicker and grow slower, leading to a susceptibilitiy to fungal
infections. Many smokers also have yellowed nails.
Agus also notes a lack of the white crescent normally present above the cuticle can signal a problem with low iron levels.
Hair is another part of the body that can harbor hidden health signs.
Graying and baldness can certainly indicate aging, but what about
finding hair where it's never been before, or losing hair in previously
unnoticed places?
"Have you lost hair around your ankles? This could be a sign of a
circulatory problem, especially noticeable in men," Agus wrote.
Circulatory problems can indeed cause men and women to lose hair around
their feet and lower legs. But those concerned about unusual hair loss
should also be aware that it could also be due to something else.
"In men, most of the time they're wearing very tight socks that can cause hair loss," Scwartz said.
According to the National Institutes of Health, excessive hair growth,
known as hirsutism, can indicate a medical issue, but it often has no
cause at all and can be hereditary.
But it can also be a result of a hormonal imbalance. Women, Agus said,
often start growing hair on their face or arms, which could mean
hormonal changes.
Polycystic ovary syndrome, caused by multiple cysts in the ovaries that
lead to an excess of male hormones, is one cause. Cushing's syndrome,
characterized by an excess of cortisol that causes a sex hormone
imbalance, is another possible cause. Obesity, tumors and certain
medications can also cause hirsutism.
Women who favor high heels have probably noticed how much their feet and
legs hurt after a long day of wearing them, but Agus says the risk to
women is much greater than aching feet.
"Aching feet means inflammation. Inflammation in the long term is bad
for heart disease, for cancer, for neural degenerative diseases. We
want to prevent inflammation," Agus said, calling heels and platform
pumps "hidden, sneaky sources of chronic inflammation."
The idea that uncomfortable shoes could lead to problems beyond strained muscles and joints is a controversial one.
"Chronic inflammation can affect the heart. It can lead to an increase
of C-reactive protein that is associated with heart disease, but this
isn't necessarily caused by wearing high heels," said Schwartz.
"High heels definitely pose more of an issue with the musculosketal system," said Bergquist.
According to Agus, too much sitting can be just as unhealthy as smoking.
"Researchers at the American Cancer Society released a study published
in 2010 in the American Journal of Epidemiology that pretty much said
sitting down for extended periods poses a health risk as 'insidious' as
smoking or overexposure to the sun," Agus wrote.
He cited one study that found women who reported sitting for more than
six hours a day outside of work were 37 percent more likely to die than
those who sat less than three hours a day. Other research, he added,
has linked sitting to obesity, type 2 diabetes, cardiovascular disease
and an unhealthy diet.
It's not so much the sitting, he explained, it's the physiological processes sitting causes that are the big culprits.
Even if people exercise once a day, sitting too much can cause increased
blood sugar, higher blood pressure and higher triglyceride levels, all
linked to cardiovascular disease, obesity and other chronic problems.
And the negative health impacts of sitting is a topic on which many health experts agree.
"The lack of physical activity is the root cause of many diseases," said
Bergquist. "It's important to be active and continually move."
The End of Illness: Personal Health Inventory Questionnaire
The following Personal Health Inventory Questionnaire is adapted from The End of Illness
by Dr. David B. Agus. Find out more about The End of Illness
at the ABC News special section.
***
This questionnaire was originally designed to help you prepare for a
checkup with your doctor, giving you clues to discuss during your visit.
However, while piecing this book together, I realized that the same
questionnaire should be filled out before even reading the book, which
will help you to know yourself better before embarking on this
adventure. I also know that you want to be told what to do as soon as
possible, and even though you'll find lots of "health rules" to consider
throughout this book, many of which will be called out at the ends of
chapters, at least the following questions will equip you with concepts
to think about as you read further and incorporate my advice into your
life. This questionnaire is also downloadable online at
www.The End of Illness.com/questionnaire, where you'll find a version that you can respond to directly on the page to print for your records and/or take to your doctor.
Overall feeling: How do you feel? It's arguably the most important
question to ask of yourself. You might feel great today, but how about
yesterday? When do you have your low moments? Is there a pattern? Is it
hard for you to get out of bed in the morning?
Energy levels: How would you rank your energy level on a scale of 1 to 10? How has it changed in the last year?
Schedule: How regular is your schedule of when you eat, exercise, and sleep? Is every day the same or different?
Breathing: Anything abnormal to report? Do you hear or feel rattles when
you breathe? Does it hurt to breathe deeply? Do you cough when you take
a deep breath?
Answer these questions when you are at rest and after
exercise.
Exercise tolerance: How much can you comfortably tolerate? How does this
amount of physical activity compare with how you felt and how hard you
moved your body last year? Does anything hurt or feel funny when you
move or exercise?
Walking: Are you walking the same way you always have? Do you lean to
one side and never did before? Do you hunch over more? Is it hard to
walk fully upright?
Sensations: Anything unusual or out of the ordinary to report in any
part of your body? For example, how is your sense of smell? Is it as
strong as ever? Weak?
Skin: When you scan your skin for any strange marks, growths, or bumps
while naked in front of the mirror, do you find anything? Has anything
changed since the last time you examined your skin? Do your socks leave
indentation marks on your ankles/legs? (If so, this could indicate that
your heart isn't working properly and fluid is getting stagnant in
areas, increasing your risk for a blood clot.)
Hair: Has your hair changed at all in terms of thickness, texture,
growth/loss, and so on? Have you lost hair around your ankles? This
could be a sign of a circulatory problem, especially noticeable in men.
Conversely, do you have hair growing in odd places, such as your arms
and face? This could signal hormonal changes, especially in women.
Nails: These dead tissues can actually tell you a lot. Have they changed
in appearance or color lately? Discolored nails can signal certain
conditions, from a simple infection to diabetes. If your nails have a
yellowish hue to them, it's time for a diabetes check. Nails can also
indicate iron levels. Look for a whitish crescent C at the base of your
nails, which indicates good iron levels.
Fingers: Do your joints ache after using them? If you're a woman, is
your ring finger longer than your index finger? If so, you may be twice
as likely to suffer from osteoarthritis. That's according to a 2008
study in the journal Arthritis & Rheumatism, which discovered this
odd connection and hypothesized that longer ring fingers are linked to
higher levels of testosterone exposure in the womb. Higher prenatal
levels of testosterone lower the concentration of estrogen, which is
critical to bone development. If you're a man whose index finger is
longer than your ring finger, your risk of prostate cancer drops by a
third.
Joints: Do they hurt? More in the morning when you get up, or after a long day? What makes the aching joints better?
Appetite: Is it the same as it used to be? Stronger? Weaker? Do you have serious cravings? If so, for what?
Breasts: If you're a woman, do you see or feel any lumps, bumps, or dimples when you perform a breast exam?
Digestion: Any feelings of discomfort to report? Do you have to use any
over-the-counter medications for your digestion/stomach on a regular
basis (e.g., Tums, Pepto-Bismol, Tagamet, Zantac, Prevacid, laxatives,
and the like)? If you have symptoms, are they better or worse after
eating a meal? Do you experience an intolerance, sensitivity, or allergy
to certain foods?
Headaches: Do you experience headaches regularly? Migraines? Do you know
the triggers for such headaches? Do you find yourself taking
over-the-counter painkillers consistently (e.g., Advil, Aleve, Tylenol,
Excedrin, aspirin, and the like)?
Allergies: Do you have any? Have your allergies changed over the years? How so?
Sleep: Do you sleep well? Do you resort to sleep aids on occasion? Do
you wake up feeling rested most of the time? How consistent are your
bedtimes and wake times? Does your bed partner say that you snore?
(Sleep apnea, which is often characterized by snoring, is incredibly
common today and is a known risk factor for a heart attack. Luckily,
sleep apnea can be treated pretty successfully.)
Pain: Is there any area where you feel discomfort or pain?
Passing colds and flus: Do you get sick a lot? How many fevers have you
had this past year? When you get sick, does it seem to take you longer
than your friends or family members to get better? Did you get a flu
shot this year?
Mood: How stable is your mood? Do you have feelings of depression?
Hormonal cycle: If you're a woman, is your cycle regular? Are you in perimenopause or menopause?
Previous diagnoses: What have you previously been diagnosed with? Is there anything that you deal with chronically?
Stress level: On a scale of 1 to 10, how bad is it? Is it chronic or
just once in a while? Does the stress affect your lifestyle? If your
stress is work-related, do you love or hate your job? (Turns out that if
you love your job despite the stress, you're much better off than if
you hate your job and it causes you stress!)
Weight: Are you happy with it? Have you tried to change it? What
happened when you did? Do you have a paunch that you cannot get rid of?
Medications (prescription and nonprescription): What do you take, for
what conditions, and for how long have you been taking them? This
includes all vitamins, supplements, additives, and occasional
medications (such as a few Tylenol or Advil for a headache).
Health-care prevention: Are you up-to-date with things like routine
exams/wellness checkups, vaccines, screenings (e.g., Pap smear,
colonoscopy, etc.), and blood tests? Do you know what foods you're
supposed to be eating given your underlying disease risk factors?
Overall satisfaction: If you had to rank how you felt about yourself in
general, on a scale of 1 to 10, what would your number be? What kind of
report card would you give yourself? What do you want to change in your
life?
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