Everything you need is probably sitting in your medicine cabinet

OCT vs. Rx

Which is better? Cheaper over-the-counter remedies are often your best bet.

It can be tempting to run to a doctor for a prescription when you’re miserable with symptoms like nonstop sneezing or nagging knee pain, or when you’ve had a few sleepless nights. But the best relief might already be in your medicine cabinet. For common ailments like allergies, pain, and insomnia, over-the-counter drugs may be the way to go. Sure, there are prescription meds you can take. But OTC drugs can save you money, and some work just as well or better and may cause fewer or less severe side effects. In many cases, trying an OCT drug first can also save you time and money by cutting down on doctor visits. To help you find the best treatments for your symptoms, we ShopSmart teamed up with the experts at Consumer Reports Best Buy Drugs, who look for cost-saving options that are also the most effective. They recently reviewed hundreds of studies and came up with the following advice. They also calculated the potential savings of going OTC, though your actual savings may depend on your insurance coverage.

Allergies

Instead of Allegra (fexofenadine), Clarinex (desloratadine), or Xyzal (levocetirzine)

GO OTC Alavert, Claritin (or generic loratadine), or Zyrtec (cetirizine)

Save as much as $148 a month

Why switch? Antihistamines block the chemical messenger histamine, one of the body’s natural defense mechanisms and the main trigger of allergy symptoms in the nose, airways, and skin. Studies show that “newer” antihistamines – both prescription and OTC, such as those listed above – are similarly effective. They all generally bring some relief in 1 to 3 hours and continue to work for 12 to 24 hours for most people. But keep in mind that even if you have just milk allergies, you might need to try a few before finding one that works best for you. Some people respond well to one antihistamine while not finding relief with another.

When to see a doctor She will be able to tell if your symptoms are caused by an allergy. Studies have found that some people who take prescription meds don’t actually have the condition. You could have a cold, a mild case of the flu, bronchitis, or sinusitis. But if any of those symptoms persist or are accompanied by high fever, shortness of breath, or wheezing, seek help. Also consult a doctor before taking these drugs if you have high blood pressure, a heart condition, diabetes, closed-angle glaucoma, or prostate disease.

Prevent it in the first place Stay inside during peak allergy days. A Consumer Reports National Research Center survey showed that one in five Americans were “highly satisfied” with symptom relief achieved by avoiding allergy triggers. They said that when it worked this strategy was even more effective than treating their allergies with OTC drugs.

Drugstore Remedies to Avoid

Taking combo drugs that treat multiple symptoms – such as headaches, achiness, and fever – can lead to dangerous overdoses. In 2011 the manufacturer of Extra Strength Tylenol lowered the maximum daily dosage from eight pills to six pills to help people avoid taking too much acetaminophen, which can lead to liver damage. The reason: Acetaminophen is an active ingredient in hundreds of OTC products, many of which are combo formulas for colds, flu, allergies, and sinus problems but laxatives, pain relievers, sleep aids, and indigestion treatments can also contain more than one active ingredient. So before taking a second drug to treat an unrelated symptom, such as a headache when you just have a cough and sore throat, always check the active ingredients to make sure you’re not overdoing it.

Clinical Complications: How FAT Destroys The Body From the Inside Out

There is little mystery as to how a person accumulates excessive amounts of fat, and in many cases, it is controllable and preventable. Weight gain is a simple imbalance of caloric intake being higher than caloric expenditure (we eat too much and move too little). So what is wrong with being big? While the debate goes on as to whether or not obesity is an actual “disease” itself, there is no debate as to the implications on patients’ overall health.

The long list of health consequences associated with being obese is the result of two independent factors: 1) the increase in the mass of the adipose tissue or number of fat cells, or 2) the secretion of pathogenic products or metabolic effects from the enlargement of fat cells. The figure below highlights the various and numerous risks associated with obesity.

Problems linked to the increased mass of fat cells

Obstructive sleep apnea: the fat can literally choke you
The respiratory complications clinically linked to excess abdominal and upper body fat focus on sleep disorders. Air passageways and lungs become constricted by excess adipose tissue temporarily blocking the passage of air, making it difficult to breathe. Obstructive sleep apnea (OSA) is defined as episodes of cessation in breathing for at least 10 seconds during sleep.

Typically the symptoms are vague, such as fatigue, irritability, snoring, and morning headache. The lack of REM (rapid eye movement) sleep can lead to emotional and behavioral problems, including overeating which exacerbates the problem.

Complications due to OSA mostly lie within the cardiovascular system. When the bloodstream is deprived of oxygen (oxygen desaturation), patients will typical become hypertensive. This low-oxygen, high-blood-pressure state can bring on cardiac events, especially in cases where there is preexisting heart disease.

The first line of defense that physicians prescribe to these patients is lifestyle changes:

• Weight loss program to relieve constriction of the throat. Medical and surgical studies have shown that as little as a 10% decrease in weight is associated with a 50% reduction in sleep apnea severity. Even very moderate weight reduction in obese patients can lead to significant improvement in oxygenation and blood pressure.
• Avoid consuming alcohol, sleeping pills, and any medication that will promote the relaxation of the muscles in the back of the throat.
• Sleeping on your side or stomach to prevent the tongue and soft palate form resting against the back of the throat, blocking the airway.
• Use of saline nasal spray, decongestants, or antihistamines to keep nasal passages open at night.

Moderate to severe cases are addressed with non-surgical devices:

• Oral devices can be prescribed and work by bringing the jaw forward, helping keep the throat opening and prevent obstruction. These products are easy to use and can be purchased from dentists.
• Supplemental oxygen can also be supplied ruing sleep. Simply increasing the oxygen content in the blood can relieve many of the OSA symptoms.
• Continuous positive airway pressure (CPAP) has patients wear a face mask that applies constant positive air pressure during sleep. These devices keep the upper air passages open, preventing snoring and apnea.
• Bilevel positive airway pressure (BiPAP) is similar to CPAP but increases pressure during inhalation and decreases during exhalation.

For extreme cases, a surgical procedure is the only sure fix:

• The Pillar Procedure by Restore Medical places polyester implants into the soft palate. These implants add support to and stiffen the soft palate, helping reduce obstruction in the upper airway.
• Uvulopalatopharyngoplasty (UPPP) is a procedure that removes obstructive tissue from the rear of the mouth and back of the throat (tonsils and adenoids).
• The maxillomandibular advancement procedure brings the jaw forward, away form the face. The effect is similar to the oral device.