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It’s Winter ☔️ so why Dry July?

Posted on by Dunsborough Pharmacy
Group cheering together.
03
Jul

So it’s that big month many Australian’s attempt each year, Dry July!! That’s right, not drinking any alcohol for the entire month. But is it really that hard for us Aussies to do? And what is the real reason behind Dry July?

Let’s start by tackling the easier question there. What is the reason for Dry July? No, it’s not to build awareness around safe drinking limits however this is a great spin off. It is actually to help raise funds for people affected by cancer! 

 

About Dry July & it’s important Cause

 

This year, the Dry July foundation have decided that because 2020 has been a pretty challenging one thus far, they are providing three options when it comes to Dry July. You can either go a whole 31 days without alcohol or you can do Dry(ish) July and choose either 21 or 14 days. Either way the goal is to raise as many funds as you can as well as reap the health benefits of saying no to alcohol.

 

Cancer patient during 'Dry July'

So where do the funds go? The money helps fund important services for cancer patients, their families and the carers. These services include Wellness Programs, Accommodation, Comfort Items, and Hospital Equipment. It could even help fund transport for a patient to an important appointment. This isn’t always the easiest, especially when it means driving long distances like up to Perth.

 

How can you raise money for Dry July? Sign up to the cause via their website and gain access to their money saver calculator. You may be surprised at just how much money you can raise alone by not spending money on alcohol but instead redirect it to Dry July. You will also receive a link that will allow your friends and family to donate in support of your efforts. 

 

On top of helping raise funds for this incredibly important cause, you and your health can also benefit. Did you know the recommended daily and weekly limits in Australia have recently reduced? They now recommend that adults have no more than 10 standard drinks a week and no more than 4 standard drinks on any one day. This may shock some of you and possibly prompt you to reassess just how much you are actually drinking.

 

Team together for the cause

 

Drinking Culture in Australia

 

According to Drinkwise, 20% of Australians abstained from alcohol in 2017, an 11% increase from 2007.

 

So is it really that hard for many Australian adults to stop drinking alcohol? This is a tricky and very complex question to answer however it is an intriguing one to think about. Drinking alcohol is strongly intertwined within our culture whether it be to celebrate, to relax after a day’s work or to socialise with friends. As an adult if you aren’t drinking at an event, function or social gathering you are usually questioned as to why. 

 

However is this social trend starting to change? According to Drinkwise, 20% of Australians abstained from alcohol in 2017, an 11% increase from 2007. We also found in a report by global measurement and data analytics company Nielsen, that 66% of 21-34 year old alcohol drinkers said they are making an effort to reduce their overall alcohol intake. 

 

We are now also seeing a rise in trendy non-alcoholic beverages such as Seedlip Distilled Non-alcoholic spirits, Peroni Libera (0% alcoholic beer), and Ceders non-alcoholic gin (0.01% alc.)

 

Health Impacts

 

We know that drinking above the recommended daily intake can have numerous negative impacts on your health & overall wellbeing. Including:

  • Increase risk of cancer, heart disease or liver cirrhosis
  • Depression, anxiety and mental wellbeing
  • Relationships – can increase likelihood of arguing, reduce your sex drive,  alienate your friends
  • Finances & financial pressures – excessive drinking is expensive as well as has the potential to impact your work and financial income.

 

Many of these impacts are well understood but are not the easiest to tackle. If you identify with any of the above we recommend speaking with your doctor or qualified health professional to seek help.

 

How to reduce your alcohol intake

 

On a lighter note, if you would like to try reducing your alcohol consumption to be a bit healthier or to take on the fabulous Dry July cause here are some suggestions that may help.

  • Try your hand at making some of the tasty Mocktail Recipes such as Watermelon, Strawberry & Lime Mocktail and Raspberry Lime & Mint Mocktail
  • Remind yourself of the health benefits: 
    1. improve your mood and sleep
    2. increase your energy
    3. improve your relationships with your loved ones
    4. help you perform better at work
    5. lower your risk of long-term health problems such as cancer and heart disease
    6. save you money
  • Work out a plan including: goals, triggers, strategies and who your support network is going to be.
  • Organise alcohol-free events with your friends
  • Catch up over a coffee instead of at the pubs
  • Remember you are raising money for a really important cause.

 

Best of luck to everyone who is taking part in Dry July this month. And remember, you can always speak to a pharmacist if you need more resources, to find out where to get help, and how to manage any withdrawal symptoms.

Visit the foundation website here.

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Be wise

Is Vitamin D more important that we think?

Posted on by Dunsborough Pharmacy
Vitamin D Card
23
Jun

“You are my sunshine- my only sunshine. You make me happy, when skies are grey.” by songwriter Charles Mitchell

 

Who would have thought the words of a song could actually contain a message on how to stay healthy during the winter months.

In summer it’s relatively easy to get our share of the Vitamin D. At that time our focus needs to be in reducing UVB exposure and damage caused by UVA rays. 

Whilst studies report that only 6% of us are deficient in sunshine vitamin during the summer months, up to 39% can have sub-optimal levels over the winter months. Luckily, Vitamin D is a fat-soluble vitamin that can be stored for just such a rainy day, but more on that later.

Mom and daughter enjoying sunlight

 

So why is Vitamin D so important to us?

 

Technically, it is not a vitamin and is considered more of a hormone given it uses the same building block (cholesterol) as part of its core structure. We can and do produce minute amounts. In fact, it’s not just one chemical but a group of chemicals, many of which are inactive and must be processed by the body to provide its benefits.

So, essentially it is a fat-soluble nutrient, with the maintenance of strong and healthy bones being its best-known function, through the regulation of calcium levels in the body. It is also important for a healthy immune system and it can help moderate our inflammatory responses to infections. The interest in Vitamin D and the role it plays in other body systems as we discover even more of its influence on our health. 

 

But let’s look into the winter blues.

 

The role of sunshine vitamin in depression has also received increasing research focus. There are 3 reasons the research is focused on finding whether there is a causal link between this vitamin deficiency and depression. 

They are:

  • Vitamin D receptors have been found to be region specific in the body. Parts of the brain known to be associated with mood, show much higher numbers of receptors.
  • Depression is being increasingly linked to levels of inflammation in the body and we are only just beginning to understand this through our focus on gut health. Vitamin D also has anti-inflammatory properties through its modulating effects on our immune system.
  • This anti-inflammatory effect is also stimulating discussion about Vitamin D’s neuroprotective role.

 

Many studies have shown a link between vitamin D deficiency and depression. Researchers behind a 2013 meta-analysis (that’s a bunch of studies thrown together and tested for similarities) noticed that study participants with depression also had low levels of it. The same analysis found that, statistically, people with low vitamin D were at a much greater risk of depression.

The researchers believe that because it is important to brain function, insufficient nutrient levels may play a role in depression and other mental illnesses. Whilst no recommendations regarding supplements have yet been made, we can all ensure we have at least adequate levels of this vitally important nutrient.

Girl at the beach exposed to sunlight

 

Sub-optimal vs Deficiency of Sunshine Vitamin

 

You might be surprised to know that sunshine vitamin deficiency is common in Australia. It is estimated that over 30% of adults have a mild, moderate or even severe deficiency. There is also a difference between clinical deficiency as defined by the text books, and having sub-optimal levels. Severe lack of it causes rickets, which shows up in children as incorrect growth patterns, weakness in muscles, pain in bones and deformities in joints. So, who might be deficient? You could be at risk if you are:

You may be at risk of vitamin D deficiency if you are:

  • Elderly and housebound or in residential care through not being exposed to UVB light 
  • Ageing skin. As our skin ages it begins to lose its ability to convert the chemical in our skin to Vitamin D efficiently.
  • Naturally dark skinned (darker skin reduces the penetration of UV light)
  • Avoiding the sun for skin protection 
  • Covering your body for cultural or religious reasons
  • Affected by other medical conditions that can impact on your ability to absorb / process vitamin D such as liver or kidney dysfunction.
  • Babies of vitamin D deficient mothers

Lack of sunshine vitamin is not quite as obvious in adults. Most adults who are deficient or at the lower end of normal will experience symptoms that might include:

  • Fatigue or drowsiness.
  • Aching bones
  • Muscle weakness, muscle aches, or muscle cramps.
  • Pain in the joints.
  • Mood changes, like depression

 

Vitamin D can affect your mood

 

Getting the right amount

 

Until 1997, the recommended dietary allowance (RDA) for vitamin D was 200 IU for all adults. Faced with growing evidence of deficiencies the RDA for 51- to 70-year-olds was increased to 400 IU daily, and to 600 IU daily for people older than 70. However, this is not sufficient to treat a deficiency.

You can make your sunshine vitamin the old-fashioned way. The natural type is produced in the skin from a form of cholesterol, 7-dehydrocholesterol present in the skin. Sunlight is the key. Its ultraviolet B (UVB) energy converts the precursor to inactive forms of vitamin D which must then be processed through the liver and then the kidneys to produce active vitamin D3. 

 

But, haven’t we been told NOT to go out into the sun?

 

The good news is that it doesn’t take too much exposure to start this magical process of producing Vitamin D. So how much is enough? As you’d expect it, there are a number of variables and all of these need to be taken into account. 

It depends on:

  • The season- winter vs summer- longer exposure times are required in winter
  • The time of day- we recommend to avoid 10-3pm when UV rays are highest.
  • How much of the body is exposed? Full arms and half legs are the recommended amount of skin exposure. Keep the face covered or use sunscreen. A little difficult in winter.
  • The color of a person’s skin- the darker the skin, the more melanin and the more exposure required.
  • Whether a person is wearing sunscreen- Sunscreens block the UVB (or vitamin D activating) effect on the skin.

 

Recommended sun exposure based on location

 

Exposure to sun by Australian Territory

Image Source – https://www.osteoporosis.org.au/vitamin-d

 

Diet can help, but it’s very hard to reach the recommended levels with food alone. Fish and shellfish provide natural source (oily fish are best), but you’ll have to eat about 100g of salmon, or nearly two cans of tuna to get just 400 IU. An egg yolk will provide about 20 IU, but since it also contains nearly a day’s quota of cholesterol, you can’t very well use eggs to fill your tank with Vitamin D. And although cod liver oil is rich in vitamin D, it has too much vitamin A for regular use.

 

Is more better?…. Not always.

 

Many authorities are recommending 800 or even 1,000 IU a day given the growing evidence of the benefits of this vitamin. Remember, though, that you can get too much of a good thing. 

Like the other fat-soluble vitamins, it is stored in the body’s fat tissue. Excessive doses of Vitamin D can build up to toxic levels. Doses up to 2,000 IU a day are considered safe but we would recommend doing this under supervision of a healthcare professional.

 

 

Your take home messages

 

Our goal is to help you live your healthiest life, and so we definitely DON’T recommend just adding a high dose Vitamin D supplement to your daily intake.  Firstly, we’d rather you just increase your intake a little more through choosing healthy foods or maybe whilst the sun is not so damaging get out and enjoy the sunshine a little more during the winter months. The bonus will be an uptick on your mental health as well as your sunshine vitamin levels.

If you feel that you are experiencing symptoms of a deficiency, please come in and talk to us or arrange a consultation with our nutritionist to assess your personal risk of deficiency depending on your baseline health, food intake and other conditions.

The shortest day of the year, the Winter Solstice has just passed us by and we all know what that means.

We are slowly, but surely making the journey back to those glorious days and the summer vibe we all love. Bring on the sunshine.

 

Linda Keane, Pharmacist

Building a wellness community

 

Extra Information: List of Vitamin D Sources in food. 

Food source of Vitamin D

Fish

  • 100g of cooked salmon: 570 IU or 14 mcg.
  • 100g of drained canned tuna: 240 IU or 6 mcg.
  • 100g of drained canned sardines: 165 IU or 4 mcg.
  • 1 cup of 1% fortified milk: 120 IU or 3 mcg.
  • 200g of yogurt: 80 IU or 2 mcg.

Oily fish, as well as oils from fish, have some of the highest quantities of vitamin D in food sources.

 

Mushrooms

For vegetarians or vegans, specific mushrooms may be an option. Some types of mushroom contain high amounts of vitamin D.

 

Eggs

1 large hard-boiled egg: 45 IU or 1 mcg.

 

Milk

Some milks are fortified with Vitamin D (check the labels)

 

References for Vitamin D blog

 

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Be wise

Reasons why you should beware of expired medication

Posted on by Dunsborough Pharmacy
Expired medication?
14
Apr

Why you shouldn’t take expired medication and what’s the ONE medication we recommend you keep past its expiry date?

We’ve all done it. You’ve got a headache, you’ve rummaged around your medicine cabinet and found something that’s been there for months (or years!), but before you pop that expired medication read on. 

In this blog we explain the difference between BEST BEFORE, USE BY, DISCARD AFTER and EXPIRY DATES and explore the reasons some medications have shorter expiry dates than you would expect.

Firstly, what about food?

On food products you will often see BEST BEFORE dates. These dates refer to the quality of the product, not its safety. Food may no longer be at its freshest or best and may be beginning to lose its flavour, texture or nutrients. It doesn’t necessarily mean that the food is no longer safe to eat. Foods with a BEST BEFORE date can be legally sold after that date. Many of you will have seen and grabbed the grocery bargains that are heavily marked down once this date is reached.

USE BY dates on food are different. These foods must be eaten before this time for health or safety reasons. Foods can’t legally be sold if their USE BY date has passed and should be avoided.

Ok. Got it. So, what about my expired medicines?

Most medications, last for years and years. A study by the American Military showed many medications were still as effective 15 years after manufacture, with some 80-90% potent after 30 years. 

What this doesn’t consider is storage conditions. Yes, we mean those musty mouldy bathroom cabinets, those hotter than hell car glove boxes and now we have climate change to worry about. 

What we have is a safety issue and a need for consistency trumping long expiry dates.  Once a medication leaves the controlled environment of a manufacturer or pharmacy, the temperature variations, exposure to light, air, water and bacterial contamination pose too many variables for companies to risk guaranteeing the safety and effectiveness of their product.  

To this end an arbitrary expiry date of 5 years from manufacture has been chosen as suitable for all long-term stable medications.

Two parameters must be considered with medication – potency and safety. 

  • With regards to potency, the expiry date is calculated to be when the loss of active drug is less than 10% of the medications stated strength.
  • Safety must be considered by weighing up the risks. When do the adverse effects or risks start to outweigh the benefits? 

That’s all good and well, but what expired medication shouldn’t I take?

We strongly recommend you don’t take or use the following medications or groups of medications beyond their expiry date.

  1. Antibiotics. Most antibiotics have a shorter shelf life than the five-year maximum and often struggle to get to two years. There are some reports of toxic effects which have occurred with patients taking old antibiotics and with infections it is better to get a new infection checked to make sure you are treating the infection with the right antibiotic and not just any antibiotic.
  2. Reconstituted medications. Some medications have had water added by the pharmacy.  These often include antibiotic mixtures for children. The clue here is if they are so unstable that the pharmacy must add water at the very end of the manufacture process, they aren’t going to be last long. Pharmacists will add a DISCARD AFTER date to the label, based on days AFTER it reconstituted. They can become contaminated with bacteria or may lose their effectiveness after the DISCARD DATE, so out they go. The discard date in these cases overrides the manufacturer’s expiry date.
  3. Eye drops, eye ointments and some ear drops. Although, these products contain preservatives to reduce bacterial growth, they keep concentrations low to minimise eye irritation.  With these products the exposure to air and the possibility of introducing bacteria into the bottle through accidental touching of the infected eyes or lids mean the risk of using them after their expiry is much higher. These medications will often have DISCARD DATES added by the pharmacist based on time from when they are opened. Again, the DISCARD DATE trumps the manufacturer’s expiry date.
  4. Nasal sprays. A bit like eye drops, nasal sprays are used where levels of resident bacteria are high and regular use opens the door to contamination with bacteria getting into the liquid inside the spray.
  5. Products containing ASPIRIN. Aspirin is highly unstable when exposed to air, hence they are usually wrapped in foil. Taken out of the foil the tablets rapidly degrade to acetic acid and begin to smell like vinegar. Great for your salad dressing but not so effective for your headache.  Those of you still cutting aspirin tablets in half to help thin the blood, take note. That second half should be thrown away.
  6. Tablets for Angina or Chest Pain. These medications need to be carried with patients so that if they develop chest pain, the medication can be used in an emergency.  The problem is they degrade quickly in the heat and even body temperature (think pockets of your clothing) is not really a suitable storage environment. Don’t rely on these past their USE BY date which will have been added by the dispensing pharmacy. Read the label on the bottle and mark your calendar, so that you don’t run short of these vital medications.
  7. Refrigerated items. There are also many other drugs with short use by dates, that can be stored in the refrigerator at the pharmacy long term but once home have a much shorter expiry date when stored below 25 degrees as a concession to your convenience. If you want to prolong the expiry of these medications, then you can do this by popping them straight back into the fridge when you get home from the pharmacy. These include common medications such as hormone patches, thyroid tablets and even insulin which can all be safely used out of the fridge. Check each individual medication for specified dates that relate to non-refrigerated expiry dates, or ask the pharmacist if you are unsure.

So, what’s the ONE expired medication you should keep?

EPIPENS

Shortages and an inconsistent supply have plagued the whole of Australia for the last couple of years for the life-saving adrenaline filled pen. 

WE RECOMMEND

  • The safest way is to always renew your Epipen when it expires. Keep a note or reminder to replace your Epipen whether it’s on an old school calendar or on a phone app. Put this date in as soon as you pick up new pens from the pharmacy.  Epipens have an Expiry Date that is barely 12 months from the date of manufacture and let’s be honest, they are expensive, but worth it if you need to use them.
  • In times of shortage, an expired pen is still better than no pen when it comes to saving a life, so keep them on hand until you get a chance to replace it with a fresh batch.  Depending on the emergency, one pen also may not be enough, or may be used incorrectly, so in a panic situation, it is handy to have a backup even if it is expired.  Please check to see that the liquid is still clear and colourless before you use it. 

If you have any questions, about taking any expired medication, please contact our Dunsborough pharmacists before you take the dose. We are happy to help you with guidance and the best storage conditions for your medications, just ask. No question is a silly one, and it’s better to make informed decisions specific to your situation.

 

Check our video on Flu Vaccine. Till our next blog. Be Wise Be Well.