You’re probably aware of whether you tend toward a type A or type B personality, since those labels are part of our lexicon. What you may not know, however, is that there is a third type — type D — and it’s not a great category to find yourself in. The D stands for distress, and a growing body of research links this personality type with a variety of health risks and even early death — so it may be especially important for these inhibited and gloomy folks to do everything they can to lighten up.

Remember Eeyore — the sad, self-conscious donkey character in Winnie-the-Pooh? To my mind, he is a perfect illustration of the type D personality. He always expected the worst and therefore, that’s what he usually got. Traits associated with this personality type include social inhibition, a negative self-image, depressed mood, hostility, tension, chronic anger and a tendency to overreact to stressful events.

Type D & Death Risk

It’s already known that having this type D personality elevates risk for people who have had heart attacks, cardiac bypass surgery and/or stent implants. In new research from the University of Tilburg in the Netherlands, scientists set out to determine the impact of these characteristics on people with a common condition called peripheral artery disease (PAD), a circulatory problem in which narrowed arteries reduce blood flow to the limbs. People who have PAD have four to five times greater risk for heart attack and stroke.

Researchers asked 184 patients (average age 65) diagnosed with PAD to fill out a 14-item personality questionnaire to assess character traits, such as negativity and social inhibition. They rated statements such as “I would rather keep people at a distance” and “I often find myself worrying about something” as false or true on a scale of zero to four. During the next four years, 16 patients (9%) died — six of cardiovascular disease, seven of cancer and one each from emphysema, pneumonia and acute pancreatitis. After factoring in other variables such as age, gender, diabetes and kidney disease, investigators learned that those with type D personalities were more than three times as likely to have died as those who were Type A or B.

How Distress Raises Risk

There are numerous pathways linking this particular personality type with poor health outcomes, I learned from study coauthor Johan Denollet, PhD, a professor of medical psychology at Tilburg University. Some are physical, other behavioral. For instance, Type D individuals tend to…

• Experience chronic anxiety and negativity. Living in such a state has a variety of physical effects on your body, none beneficial. Chronic stress drives up levels of inflammatory proteins called cytokines, which leads to increased oxidative stress and contributes to disease. The adrenal glands respond to stress by pumping out cortisol, the hormone that helps us meet perceived threats. Having high and prolonged levels of cortisol in the bloodstream causes serious problems, including blood sugar imbalances, reduced immunity, slower wound healing and increased abdominal fat.

• Have poor health habits. Research has shown that people with type D personalities often neglect their health by eating improperly, not having medical checkups and being sedentary.

• Are unlikely to be proactive in seeking medical care. Perhaps because they are unable to express their emotions and are tense, insecure and uncomfortable in social situations, type D individuals are often slow to seek the medical help they need. In one study, type D patients with chronic heart failure experienced more cardiac symptoms and worried more about them than other people but, paradoxically, were less likely to discuss them with health-care professionals. Other research demonstrates that heart failure patients with “inadequate consultation behavior” face a six-fold increased risk for impaired health.

What Can Help

Generally speaking, you can’t change your personality — but if you recognize these traits in yourself or a loved one, there are plenty of things you can do to address the issues and minimize the impact on your health. For example, Dr. Denollet notes that type D personalities are more likely to experience anxiety and depression — and points out that these can be managed to a significant degree with counseling and/or medication. Other strategies include…

• Adopting healthier lifestyle behaviors, such as better diet and regular exercise.

• Participating in programs or counseling to conquer addictions, such as smoking or alcohol abuse, or to improve social skills and learn to relax.

• Using techniques such as guided imagery, breathing exercises, meditation, tai chi and yoga to help manage stress and mood and learn to control anger and hostility.

While you can’t change who you are, if you have a type D personality, you can take these concrete steps to make yourself healthier and, I’llbet, happier.

Source(s):

Johan Denollet, PhD, professor of medical psychology, Tilburg University, Tilburg, The Netherlands.

Do you know zilch about zinc? Let’s rectify that, as this essential trace element is vital to your health and well-being. According to some reports, as many as 12% of Americans may have a zinc deficiency, a figure that may rise to as much as 45% in people over age 60. Among the important functions of zinc in our bodies — it boosts the immune response… protects cell membranes from harmful oxidants and structural damage… repairs DNA… and supports nearly 100 different enzymes that regulate the chemistry of cells and organisms.

Regular Daily Health News contributor Mark Stengler, NMD, told me that zinc is also helpful in stabilizing blood glucose… contributes to neurological function… and helps the formation of testosterone, thereby potentially boosting sexual function. (So the reputation of oysters as an aphrodisiac has a scientific basis — they have more zinc than any other food.) And, of particular interest to the older population, says Dr. Stengler, is that zinc helps prevent or reduce the damage of age-related macular degeneration, a leading cause of blindness in adults over age 60.

Why Do We Lack Zinc?

Our ability to absorb zinc may decline with age. On top of that, many older folks take medications known to deplete zinc, in particular thiazide diuretics and ACE inhibitors (used to control blood pressure) and acid-suppressing medications. Additionally, having a digestive disorder that prevents proper nutrient absorption — such as irritable bowel syndrome (IBS) or Crohn’s disease — can contribute to deficiency. And since animal products are a primary source of zinc, eating a vegetarian diet can also mean that you don’t get enough.

With so many people at risk, you’d think there would be good tests to measure zinc levels, but alas, the only ones available are not sensitive enough to be useful — so it is important to be aware of deficiency symptoms. Severe deficiency causes severe problems (such as rashes, chronic diarrhea and night blindness), but that’s rare in developed countries. Lower level deficiency is far more common, but its symptoms can be troublesome, too — including depression, a loss of appetite and libido, and frequent colds and other infections.

Zinc and Colds

When you get a cold or respiratory infection, supplementing with zinc can help relieve your sore throat and shorten your suffering, a benefit that has been demonstrated in many studies. This has made zinc-based cold fighters, including the Zicam Cold Remedy line, quite popular. There was considerable concern last year when the FDA issued a warning about use of Zicam products delivered nasally (its gels and sprays). These are no longer being sold, and according to Dr. Stengler, Zicam lozenges are safe (a daily dose — six lozenges — has 80 mg of elemental zinc). Dr. Stengler likes even better lozenges that contain 15 mg to 25 mg of elemental zinc, and in particular the brands Bluebonnet and LifeExtension. At the first sign of a cold, have one every two hours away from meals, since zinc supplementation may also interfere with the absorption of iron and calcium, and competes with copper for uptake from the gut. Note: Zinc may hinder absorption of antibiotics, so if you’re on them, be sure to use it at least two hours before or after the time you take the drug.

For Health in General

The zinc Recommended Daily Allowance is 11 mg a day for men and 8 mg for women. You can obtain this much from food (see below), but if you have signs of deficiency or are not eating a zinc-rich diet, Dr. Stengler says 15 mg per day is generally a good supplemental dose. The upper limit for a zinc supplement is 40 mg — too much zinc has been associated with prostate cancer. Pregnant and nursing women should not take zinc unless instructed to do so by a doctor.

Zinc-rich foods include…

• Beef
• Crab
• Turkey
• Oysters
• Liver
• Dairy including milk, yogurt and cheddar cheese
• Cashews, almonds, peanuts
• Crimini mushrooms
• Spinach
• Pumpkin seeds

For most people at most times, he says, eating a varied, healthful diet and taking a daily multivitamin with zinc should be sufficient to prevent deficiency.

Source(s):

Mark A. Stengler, NMD, a naturopathic medical doctor and leading authority on the practice of alternative and integrated medicine. He is editor of Bottom Line’s Natural Healing newsletter, author of The Natural Physician’s Healing Therapies (Bottom Line Books), director of the La Jolla Whole Health Clinic in La Jolla, California, and adjunct clinical professor at the National College of Natural Medicine in Portland, Oregon. To learn more about his work, visit www.drstengler.com and www.lajollawholehealth.com.

Russell K. Portenoy, MD
Beth Israel Medical Center

Every day, 36 million Americans take an over-the-counter (OTC) painkiller, usually acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or aspirin.

We take those medications to stop a headache… ease an arthritis flare-up… soothe a sore shoulder after a weekend of yard work… or relieve any one of the everyday aches and pains that inevitably disrupt our lives.

But do you know which painkiller to take first for maximum effectiveness and safety?

Here are the latest guidelines…

HOW painkillers WORK

All three of the most common pain relievers — acetaminophen, ibuprofen and aspirin — reduce the production of cyclooxygenase (COX) enzymes. These enzymes play a key role in the formation of prostanoids, biochemicals that sensitize the nerve fibers that produce pain and trigger inflammation.

What you may not know: There is no “best” OTC painkiller for every pain problem. That’s because not everyone responds to pain relievers in the same way — none of these drugs works consistently for everyone or for every type of pain.

You may find that ibuprofen relieves your headaches, but it may do nothing for your spouse, who swears by aspirin when his/her temples start to throb.

Even if ibuprofen works for both your and your spouse’s headaches, the amount each of you needs for pain relief may be different — and the amount that one person needs may cause a distressing side effect that never troubles the other. How can you determine the right drug and dose for you, and you alone? Follow the three-step plan below.

Important: This self-care plan is best for relief of mild-to-moderate acute pain, such as a toothache or headache. It is not appropriate for chronic pain. Long-term use of any painkiller should be monitored by a doctor because of the risk for side effects. All dosages listed are for adults. Also, don’t use products that combine two or more of these ingredients, such as Extra-Strength Excedrin, which includes acetaminophen and aspirin. Combination products have not been proven to work any better and may have an increased risk for side effects.

START WITH ACETAMINOPHEN

Because there’s no way to tell which OTC painkiller will work best for you, it’s sensible for most people (though not all) to start with the safest — the one that decades of clinical use has shown poses the lowest risk for side effects. That drug is acetaminophen.

Starting dosage: 500 milligrams (mg) to 1,000 mg.

Maximum dosage: Two extra-strength 500-mg capsules, four times daily. If you take acetaminophen repeatedly over many days, don’t exceed 4,000 mg a day.

Warning: The biggest risk from acetaminophen is liver damage, which can occur when more than the maximum dosage is taken. Don’t use acetaminophen at any dosage without a physician’s supervision if you have a liver disease, such as hepatitis C, or a history of heavy drinking (three or more drinks a day). Although ibuprofen generally would be preferred over the other painkillers in these cases, all painkillers have added risks for people who have liver disease or who are heavy drinkers.

If you haven’t been drinking heavily for several months, it is probably safe to use acetaminophen unless there is a history of liver damage.

NEXT, TRY IBUPROFEN

If acetaminophen doesn’t relieve your acute pain, switch to ibuprofen or one of the other nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) or ketoprofen (Actron).

Starting dosage: 200 mg to 400 mg.

Maximum dosage: Use of more than 2,400 mg daily requires monitoring by a physician because high dosages can cause serious side effects.

Precautions: Like all NSAIDs, regular use of ibuprofen can damage the gastrointestinal tract, causing problems ranging from heartburn to bleeding ulcers. Other possible side effects…

• Kidney damage, with swelling of the legs, worsening of high blood pressure and/or kidney failure.

• Risk for blood clots, which increase the likelihood of angina, heart attack and/or stroke. If you have unstable angina (not effectively controlled with medical care), PAD (narrowing of the arteries in the legs) or have had a heart attack, a transient ischemic attack or a stroke, or have otherwise been diagnosed with cardiovascular disease, do not take ibuprofen regularly. The more severe the circulatory disease, the greater the need for caution with ibuprofen. Acetaminophen is probably the better choice, but talk to your doctor.

ASPIRIN IS the LAST choice

If acetaminophen and ibuprofen don’t work, you can try switching to aspirin, with the understanding that aspirin is the most likely of these drugs to cause side effects in most people.

Starting dosage: Two 325-mg tablets.

Maximum dosage: Do not exceed 4,000 mg daily.

Precautions: The greatest risk with aspirin is bleeding ulcers.