Avery Dustin | Canyon View Medical

Common Household Dangers to Kids

Posted on March 18, 2020January 13, 2023 by Avery Dustin

I was a first-time mom of a hilarious and stubborn two-year-old girl (now almost 16). Her father and I were in the middle of a move, just having purchased our first home. Life was great. Trying to move furniture with a toddler in the way was sort of a nightmare, but we managed. It wasn’t until 15 minutes later that I realized the medication I was on at the time, and that I had placed on the TV stand was missing. “Have you seen my pill?” “It was right here!” Panic set in as I looked down and found a half-melted capsule on the floor next to my toddler. Long story short, I called Poison Control and spent the rest of the night at Primary Children’s Hospital. It was a night I won’t ever forget. Just thinking about it now can bring me to tears, 13 years later. I was beyond scared and felt incredibly guilty as a mother who should have known better. Since then, I have learned that these aren’t just statistics or numbers on a fact sheet. These are our kids, grandkids, friend’s kids, and the kids in our community to which this can happen.

Do you know that United States Poison Control Centers receive, on average, an exposure case every 15 seconds? Did you also know that 44% of those cases are children five years and younger? Every day, over 300 children in the United States between 0-19 years old are treated in an emergency department, and two children die as a result of poisoning. Toddlers are curious and tend to put just about anything in their mouths. It’s not only chemicals in your home that are labeled with warnings that can be dangerous to children. Everyday items in your home or purse, such as household cleaners and medicines, can be hazardous to children as well. Medication dosing mistakes and unsupervised ingestions are common ways that children are poisoned. Thankfully, there are ways you can help poison-proof your home and protect the children you love.

Here is a list of the most common household dangers to toddlers and young kids, as well as ways to help protect them from accidental poisonings.

Medications/Vitamins- Medications are the leading cause of poisonings in children. It’s essential to keep all medicines and vitamins out of the reach of children. Be particularly careful when visiting friends or relatives, especially the elderly. They often take multiple medications and keep them in reach since they don’t have young kids of their own. Children often find medicine kept in purses or on counters and nightstands. Place bags and briefcases on high shelves or hang them on hooks, out of children’s reach and sight. When dosing medications for your child, it is essential to read and even re-read the directions before you administer the medication. It’s better to be extra safe than sorry.

Household Cleaning Products- Many cleaning and laundry products are poisonous. Children are attracted to them because of their bright colors and can confuse them with things like juice, candy, or toys. Single-use laundry packets, in particular, are very concentrated and toxic. Even a small amount of detergent can cause severe injury and death. Poison centers receive many calls each year about children getting into laundry detergent. Swallowing laundry detergent usually causes mild stomach upset or even no symptoms. However, children exposed to them can experience excessive vomiting, wheezing, and gasping. Some get very sleepy or even have trouble breathing. They can also cause irritation of the skin or eyes if touched. Keep these products in their original containers and store them out of children’s reach.

Button Batteries- Small, shiny, and attractive to kids. Button batteries are found in most homes in some remotes, key fobs, and toys, but they can cause severe damage and even death if swallowed. Store extra batteries out of children’s reach. According to Utah Poison Control, a button battery can cause severe damage in as little as two hours after ingestion. Keep all devices that use button batteries out of reach of children, and make sure the battery compartments are tightly closed or even taped shut.

Liquid Nicotine- Even a tiny amount of the liquid nicotine used to refill e-cigarettes can kill a child. Liquid nicotine is sold in many different flavors, many of which are appealing to young children. Keep these products out of a child’s reach.

Carbon-monoxide Poisoning- Carbon monoxide is a gas that you cannot see, taste, or smell and because of this, it is often called the “invisible killer.” It is created when fuel-burning appliances, such as heating devices, grills, clothes dryers, and vehicles, do not burn all the fuel they need to function. Test CO alarms every month.Replace them according to the manufacturer’s instructions.

Utah Poison Control 24-Hour Service Call 1-800-222-1222

The Utah Poison Control Center (UPCC) is a 24-hour resource for poison information and educational resources. If you suspect poisoning, call the number listed above. If you have children, it is a good idea to put this number in your phone for easy and quick access. In the month of March, our Pediatric offices will have fridge magnets free to the public. Stop by and pick one up.

Things you will need to know when calling:

The exact name of the product
Amount ingested
When the ingestion happened
The age and weight of the person exposed
How the person is doing
Phone number where you can be reached

References:

Center for Disease Control and Prevention: https://www.cdc.gov/safechild/poisoning/index.html
Utah Poison Control: http://poisoncontrol.utah.edu/index.php#householddangers
American Association of Poison Control Centers, 2018 Data Snapshot https://piper.filecamp.com/uniq/op8yK0HrOC738v8L.pdf

Fad Diets vs Real Nutrition

Posted on March 10, 2020December 19, 2022 by Avery Dustin

Canyon View Pediatrician – Richard Paxton, MD, and Wellness Expert – Lisie Byington talk about the differences between Fad Diets vs. Real Nutrition. The presentation was given in January 2019 in Springville, Utah, as part of the Community Health Seminar Series.

Skin Protection – More Fun in the Sun

Posted on March 4, 2020January 17, 2023 by Avery Dustin

Spring – a common time for sunburn

Spring is a wonderful time of year for many reasons. The days are getting longer, the winter illness season is coming to an end, and many outdoor activities are beckoning once again. However, it is also the time of year when many severe sunburns occur. There are several reasons for this:

Many people’s skin is quite pale after the long winter, and more vulnerable to burn.
The air is generally cooler than in the summer, so it is more difficult to feel when a burn is occurring.
The sun is getting higher in the sky, so the rays are becoming more direct, and are therefore more likely to cause skin injury.
Spring sports and yard work can abruptly increase the amount of time people spend outdoors.
Some people are anxious to get tan after winter and try to do it all at once.
While we associate many summer activities with the need for sun protection, spring activities often don’t trigger this thought.

Preventing sunburn is important

There are many health hazards associated with sunburn, the most serious of which is the aggressive form of skin cancer known as melanoma. Occasionally, this type of cancer is diagnosed in people in their teens. Exposure to the sun’s radiation increases the risk of genetic mutations in our skin cells which can lead to this dreaded condition.

But that’s not the only reason to avoid getting burned. These are true burns and can range in severity from superficial first degree burns with only mild discomfort, to deep second degree burns with blistering, extreme pain, and sometimes permanent skin changes. The younger a child is when sunburn occurs, the more severe the damage is likely to be.

Another concern with sunburn is the increased risk of other heat-related injuries. Someone with a severe sunburn is more likely to suffer heat exhaustion or heat stroke, which can lead to severe illness and even death. Occasionally, sunburns can affect a large enough portion of the body to cause the serious conditions associated with other significant burns, including susceptibility to infections and temperature regulation problems.

How to protect our children (and ourselves)

As with many things relating to our health, an ounce of prevention is worth a pound of cure. We should think about sun protection every day. Here are a few specifics that may help:

Sun protective clothing and hats are usually the most effective means of preventing skin injury due to the sun, especially in infants and toddlers.
Sunscreen, with an SPF of at least 30, is important to use on exposed skin.
1. It should be applied about 20-30 minutes before sun exposure, sweating, or getting wet.
2. Be sure to use enough. For an adult, this might mean up to 1-2 ounces per application.
3. Reapply after getting wet, even if the sunscreen claims to be waterproof.
4. Sunscreen can be used on babies, but the time spent in the sun should be very limited in this vulnerable population.
5. Remember that sunscreen and insect repellent often don’t go well together, and may even inactivate each other. Read the labels carefully.
Beware of reflected sun, whether from snow or water or even concrete, as this can greatly increase sun exposure, especially in young ones.
Pay attention to the UV index, found on most weather reports and apps, to know when the sun will be most likely to cause harm.
Avoid being outside between the hours of 10:00 AM and 3:00 PM as this is when the UV index is typically highest.
Wear sunglasses which block 100% of the UVA and UVB rays, because eyes can get sunburned too.
Avoid the use of tanning oils and creams as these do not block the sun’s harmful rays.
Never use tanning beds, especially children and teens, as this direct exposure to harmful UV rays greatly increases the risk of the problems mentioned above.

As pediatricians, we strongly encourage outdoor activities because of the many health benefits they provide. Most adults, and many children, would do well to spend more time out of doors. We should also focus on doing so in a safe manner, so as not to cause unintended harm. By keeping these simple ideas about sun protection in mind, we can all better enjoy this wonderful spring season and the summer which is just around the corner.

Keeping “Heart Healthy”

Posted on February 27, 2020January 17, 2023 by Avery Dustin

February is appropriately named Heart Health Month. I often associate this month with Valentine’s and thoughts of love toward my wife and family. What better way to show your love for those closest to you than to do things to stay healthy?

Did you know that the number one cause of death in the United States is heart disease? What is your personal risk for heart attack? You can find out how likely you are to have a heart attack in the next 10 years by going to http://www.cvriskcalculator.com/ with these three numbers: 1) your total cholesterol, 2) your good HDL cholesterol, and 3) your blood pressure. With this information, you can easily do the calculation yourself. If you don’t know these numbers and have had these tests done, you are able to access your results via your patient portal. If you don’t remember how to access your patient portal, call our office. We can help to get you access or give you results from a previous test. If you haven’t had these tests recently, visit your doctor right away to get tested.

The recommended goal is to have a risk factor under 7.5%. If you have a percentage above that, it is recommended that you intervene with medication and/or changes in lifestyle and diet.

Here are ways to reduce your risk of a heart attack:

Controlling blood pressure: The goal is to be under 140/90. Controlling blood pressure is a great way to prevent heart attacks and strokes.
Control your cholesterol: Finding out what your cholesterol numbers are is the first step. The next thing is to act on those numbers.
Don’t smoke: Smoking dramatically increases your risk for heart attack and stroke. Smoking is also a leading cause of cancer.
Diabetes: Controlling weight and increasing exercise are the best ways to prevent diabetes. Diabetes doubles your risk for heart attack, and experts recommend that everyone that has diabetes be on a statin.
Exercise regularly: The goal is to have at least 150 minutes of exercise each week. Not only do you reduce your risk of heart attack and stroke, but you also improve your physical and mental well-being.

Other general ways to improve your health include:

Adequate sleep: The recommended amount is 7-9 hours per night.
Don’t smoke: If you want to stop smoking, the state of Utah provides a free cessation program with counseling. You can reach them at 1-800-Quit-Now.
Manage stress: Stress is linked to heart disease because it raises your blood pressure. Stress can even be a “trigger” to heart attacks. Positive ways to manage stress can be exercising, journaling, meditating, drawing, and listening to music. Find something you enjoy that brings you peace and stick with that!
Have a healthy diet: What we put in our bodies has a major effect on our heart health. Try to eat plenty of fresh fruits, vegetables, whole grains, limit alcohol, and drink plenty of water. Keeping processed foods to a minimum will make your heart happier in the long run.
Maintain a healthy weight: Being overweight or obese can increase your risk for heart disease because of other heart-related factors like high blood pressure, diabetes, and high cholesterol. Implementing a healthy diet with a moderate exercise schedule can greatly reduce your risk of becoming overweight or obese. Try to have a body mass index between 20 to 25. If you are curious as to what your BMI is, click on the link for a BMI calculator: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

During February show your love for your family and yourself by keeping “heart-healthy.”

Healthy Habits for the New Year

Posted on February 13, 2020January 13, 2023 by Avery Dustin

Canyon View Medical Group Provider, John Taylor, MD; talks about how to create healthy habits and then how to keep them a part of your life. The presentation was given January 2019 in Springville, Utah as part of the Community Health Seminar Series.

The Dreaded Pap Smear – Why It’s Important.

Posted on February 11, 2020January 13, 2023 by Avery Dustin

There are fewer preventative visits a woman detests more than the dreaded Pap smear (a close second is most likely a mammogram, and third would likely be that “puff of air” into your eyes). So, you are in good company when you groan after remembering today is “that wellness visit.” With that said, let’s discuss why we put you through this emotional and physical discomfort.

First, we want to catch any concerns early. Generally, it is easier to treat illness in the early stages, instead of waiting until it is widespread. Some of you may remember when it was recommended that we did annual Pap smears. If you remember those, you are probably wondering if my previous statement is contradictory to our screenings. Surprisingly, it is not. When we did yearly Pap smears, we found we did a lot of unnecessary testing for false positives. (That means you test positive for something concerning, but upon further examination, we find out it was nothing.) Sometimes the body can clear abnormal cells and viruses when given time, hence the birth of our newer guidelines.

Now, what are we looking for with Pap smears? Besides being able to literally look for any abnormalities, we take samples of cells from the cervix looking for two major things. First, abnormal cells (aka cancer). Like I said, some cells we just monitor. With these results, we may do nothing. We may choose to repeat the test in one year to monitor if the body has cleared these out without intervention, or we may need to do further testing. Your provider will be able to explain why they go in one direction or the other. Second, we are also looking for HPV (Human Papillomavirus). HPV has several different strains, but there are some linked to cervical cancer. If you test positive for high-risk HPV, most likely, we will encourage further testing. Again, let’s catch and treat it early.

Finally, what are the guidelines? For normal Pap smears, women between 21-30 years old are recommended to have a Pap smear every three years, despite what age they became sexually active. For women who are in a committed, monogamous relationship, and have low-risk factors, we recommend a Pap smear every three to five years. For those 30-65, we recommend having a PAP/HPV test every five years.

Just remember, every woman dreads “Pap Smear Day.” However, no one ever regrets catching and treating problems early.

Coronavirus – Is it a concern?

Posted on January 31, 2020January 13, 2023 by Avery Dustin

You have likely seen the news about coronavirus and China. We want to reassure our patients about this because we have been receiving a lot of calls with questions regarding this issue.

Basic Information

2019 Novel Coronavirus (2019-nCoV) is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Chinese authorities identified the new coronavirus very recently, and this new strain has now been found in thousands of patients in China. Additional cases have been identified in a growing number of other international locations, including the United States. There are ongoing investigations to learn more.

In the United States

The fact that this virus has caused severe illness and has spread from person-to-person in China is concerning, but it’s unclear how the situation in the United States will unfold at this time. Imported cases of 2019-nCoV infection in people have been detected in the U.S., but at this time, this virus is NOT currently spreading in the community in the United States. To see a map of where these infections have been confirmed in the United States, click here (https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html).

It’s important to note that “person-to-person spread” is different for different viruses. Some viruses are highly contagious (like measles), while other viruses are much less contagious and thus harder to spread. While the US Centers for Disease Control (CDC) considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is deemed to be low at this time.

Symptoms

For confirmed 2019-nCoV infections, reported illnesses have ranged from people being mildly sick to people being severely ill and dying. The CDC believes at this time that symptoms of 2019-nCoV may appear in as few as 2 days or as long as 14 days after exposure. Symptoms can include:

Fever
Cough
Shortness of breath

Keep in mind that these same symptoms can be caused by many other illnesses and do not necessarily indicate you have coronavirus.

Prevention

There is currently no vaccine to prevent 2019-nCoV infection. The CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

Cover your mouth and nose with a tissue when you cough or sneeze, or you can cough or sneeze into your sleeve. Try not to cough into your hands.
Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact with people who are sick.
Stay home when you are sick.
Clean and disinfect frequently touched objects and surfaces.

Treatment

There are no specific treatments for illnesses caused by human coronaviruses. Most people with common human coronavirus illness will recover without treatment. However, you can do some things to relieve your symptoms:

Take pain and fever medications (Caution: do not give Aspirin to children).
Use a room humidifier or take a hot shower to help ease a sore throat and cough.
If you are mildly sick: drink plenty of liquids, stay home, and rest.

More Information

For the latest information on this developing issue, we recommend you check out the CDC or Utah Department of Health’s websites.

CDC – https://www.cdc.gov/coronavirus/2019-ncov/index.html

Utah Department of Health – https://health.utah.gov/coronavirus

If you have recently traveled to China or are concerned you may be infected; please call one of our offices to schedule an appointment with one of our providers. When you make an appointment, let us know you have been in China so that when you arrive we can get you back to a private exam room as quickly as possible. For details on locations and contact information visit www.CanyonViewMedical.com.

Every Day Strong – Combating Anxiety and Depression by Building Resilience

Posted on January 13, 2020January 13, 2023 by Avery Dustin

Every other year children in Utah schools are given a survey that asks: During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? In 2011, 13% of youth responded yes, but when the survey was repeated in 2017 that number had risen to 25%. (Utah County Student Health and Risk Protection (SHARP) survey data.)

While not all of these children who answered yes would meet the criteria needed to diagnose a Depression or an Anxiety Disorder, this trend illustrates the increasing challenge our children are facing. Frequently I’m asked if the causes of this increase are known. While there are many theories about contributing factors, such as the use of smartphones, living at elevation, changes in family structure, helicopter parenting, and social media, none of them fully capture what is going on, and more importantly, they do not provide any guidance on what parents should do for those kids who are suffering.

To address this, the United Way created a program called Everyday Strong, which focuses on building resilience in kids to help them combat anxiety and depression. This is achieved by focusing on our physical needs, our need for safety and our need for connection, which when met, allows us to feel confident and hopefully thrive in life.

Below is a brief discussion of these concepts, but for more details and ideas you can read through the EveryDay Strong Handbook, attend a live presentation, or watch a recorded presentation here.

At the most basic level, we all have physical needs that must be met. Examples include sleep, food, water and rest. We all know that person who becomes “Hangry”, but once you give them a little food, they return to a more productive version of themselves. When I was on Active Duty in the Navy, I learned that when marines, soldiers, sailors or airmen had experienced combat stress, the most effective intervention is “3 Hots and a Cot”, or in other words three hot meals, a chance to get good sleep, with a plan to return to their unit as soon as possible.

Once our most basic needs are met, we need a place to feel both physically and emotionally safe. As parents, we can focus on creating an environment where it is safe to talk, safe to feel emotions, safe to explore, and safe to fail. Because even if a child is safe, they may not feel it. It’s better to listen more than you speak while withholding judgment about what they are feeling and discuss failure as a chance to grow. This is easy to say, but much harder to do.

As you strive to create a safe environment, this should lead to opportunities for you to connect with your child. One of the most common complaints of teens experiencing anxiety and depression is feeling alone even when they are surrounded by people. You can connect by playing together, laughing together, learning about their interests even if you think they are boring, and apologizing to your child when you’ve done something wrong. Sometimes this is easy when you and your child share similar interests, but other times it is a real stretch. For example, what if they love playing the video game Fortnite or enjoy being in theatre, (things that don’t necessarily appeal to you)? Taking time to learn the basics, even making a fool of yourself by participating can go a long way to making that connection. Every child is unique and taking time to find that uniqueness is what brings about connection.

Ultimately, it is impossible to make someone else feel confident, but there are things you can do to encourage your child to find confidence. Some examples include trusting your child’s ability to solve problems, role-playing solutions, and remember when they have been successful. One specific tool that can help when dealing with Anxiety and Depression is naming the problem the child is facing. If every time a child is about to go to school they get overwhelmed worrying about all the things that can go wrong, you can start a conversation that what they are feeling is Anxiety. At times, giving this feeling of anxiety a specific name such as the “Bossy Pants” or “Stinky Head” helps externalize what they are feeling and allows them to get back in charge.

As you meet a child’s basic needs, help them feel safe, create meaningful connections, and build confidence, your child will have an opportunity to thrive.

The information provided by the United Way is not meant to replace professional mental health care. If you feel like your child’s needs surpass the given advice, please make an appointment with one of the Pediatricians at Canyon View Pediatrics.

https://www.unitedwayuc.org/images/pdfs-doc/UnitedWay_ResilienceHandBook_Web.pdf

Avoiding and/or Treating Diabetes

Posted on December 12, 2019January 17, 2023 by Avery Dustin

Years ago, I had a gentleman come into my office not feeling well. He couldn’t figure out what was going on, but he knew something was wrong and couldn’t explain his severe fatigue. After running some blood tests it was determined he had type 2 diabetes and his sugar levels were very elevated. Talking further with him, he mentioned he had been seeing another provider years ago and was told he had prediabetes but didn’t think he needed to do anything else about it. I was saddened to hear this and wondered if somehow the healthcare system had failed him. We discussed how it wasn’t all of a sudden that he now had type 2 diabetes but that generally type 2 diabetes slowly develops over the years. He expressed many concerns about how to treat his diabetes, whether to use medications or not and the cost of treatment. Slowly we developed a treatment plan and over the next couple of years, he was able to manage his diabetes to the point where he has been able to stop all his diabetes medications.

While this example is possible, it is generally an exception to the norm. Diabetes is complex and each person is unique in the approach, however, working with this gentleman I learned some valuable lessons that can be applied even if one does not have diabetes.

Diabetes needs to be looked at as a continuum. There are many risk factors for developing diabetes. Some of these risk factors such as diet, being overweight, and inactivity can be modified to delay or even prevent diabetes. Therefore, early detection and education can be very important. More importantly, developing healthy lifestyle choices early on can have a significant impact on one’s health.

Regular office visits with a healthcare provider are important. This gentleman expressed concerns over the cost of healthcare. We discussed how studies show that regular follow up visits can help decrease or even prevent complications from diabetes. He realized that by preventing the complications from occurring, he may in fact decrease costs, prevent future hospital stays, and see the improved overall quality of life that he desired.

This gentleman expressed the desire to limit medications, especially expensive ones. There are many wonderful diabetes medications, but some of them are very expensive. We discussed the importance of medications when treating diabetes, but set goals to work on other areas in addition to medications. We set goals for weight loss, increasing activity levels, and healthier nutrition choices. We found that creating small goals at first was easier for him to keep focus, find successes, and build upon.

He started simply by cutting out sugary drinks, eating smaller portion sizes, and limiting certain food choices to special occasions. We set small exercise goals such as standing more during the day and walking after eating dinner instead of sitting down to watch television.

I am passionate about helping to prevent illness whenever possible. In some situations, this may not be possible, but healthy lifestyle choices are important in the prevention of disease, especially diabetes.

Medical Marijuana and CBD: Miracles or Menace? (Part 2)

Posted on December 9, 2019January 17, 2023 by Avery Dustin

What is CBD?

Cannabidiol (CBD) is an essential component of medical marijuana but is just one of the over 100 active components found in the plant. (Of note, tetrahydrocannabinol or THC is one of the main chemicals that causes the “high” that goes along with marijuana use. It is fat-soluble after ingestion and is quickly distributed to fat tissue, the spleen, liver, and lungs.) CBD by itself does not cause intoxication and doesn’t have addictive potential, according to reports from the World Health Organization.

CBD can be extracted from the marijuana or hemp plant. The vast majority of CBD on the market is derived from the hemp plant, which is a cousin of marijuana. (They are both in the Cannabis family.) It is interesting to note that the two plants are produced very differently. Marijuana is bred for high concentrations of psychoactive content (THC) and grown in different ways to selectively maximize these qualities. Hemp is grown to generate fiber and seeds and other common items while containing only traces of psychoactive compounds. Industrial hemp is versatile, durable and sustainable. It grows quickly, in various environments, and doesn’t require pesticides. In fact, hemp actually benefits the soil by removing toxins.

What is it used for?

CBD is typically used by people suffering from anxiety, insomnia, certain types of chronic pain and spasticity. CBD may help decrease pain and inflammation from arthritis and may help treat neuropathic pain. It has been shown to be effective in treating certain types of epilepsy in children.

Is it legal?

The federal government still considers CBD in the same class as marijuana, although the DEA enforcement efforts tend to target criminal activity. Each state has its own laws regarding CBD with varying degrees of restriction.

Is it Safe?

A review of the literature, which is a thorough summary of previous research on the topic of CBD was done. The purpose of this review was to summarize, objectively evaluate and clarify previous research related to the safety and side effects of CBD. Overall, they found that CBD is safe. The authors of the review acknowledged that the European Industrial Hemp Association commissioned and paid them to do this comprehensive review. Most of the studies had some limitations that should be noted. Some studies were only carried out for a few weeks or contained only a small number of participants, hence extracting the safety of long term use or generalizing results to the population as a whole is difficult to do. The studies in the review had minimal data looking at the effect CBD has on the immune system or hormones. CBD has been shown to increase the level of Coumadin in the bloodstream and blocks the ability of certain enzymes to break down medications for proper elimination (using the same mechanism that grapefruit juice does to alter the metabolism of certain medications). This may cause the level of the medication in the bloodstream to rise, leading to potential side effects or toxicity.

CBD is typically used orally or topically. The most common side effects when CBD is taken by mouth are nausea, fatigue, and irritability.

The biggest concern is that CBD is marketed and sold as a supplement, therefore the FDA doesn’t have the ability to regulate and ensure the purity or safety of the supplement you may be taking. There is no guarantee that the product you buy has any of the active ingredients listed on the label or in the dose they say it is. A supplement may contain various unknown elements, which could have unfavorable effects, also.

Without proper studies, we don’t know the therapeutic dose of CBD for specific medical conditions nor the upper limit in order to prevent or minimize side effects.

Summary

CBD may be an effective way to help manage insomnia, anxiety and chronic pain but more high-quality studies are necessary. Be thoughtful and steer away from companies that claim it is the cure-all for almost everything. You should discuss over-the-counter medications and supplements you are taking with your provider to avoid drug interactions, potential side effects or toxicity.

Conclusion

It is understandable that many patients are embarrassed to bring up the topic of medical marijuana or CBD with their health care provider. Many physicians and clinicians have not embraced the concept of medical marijuana or CBD because there aren’t rigorous studies and proof of the benefits and risks. There are side effects and potential drug interactions. However, individual providers are learning and doing their own research to understand the applications of its use. Be open and honest with your provider. Be willing to discuss all types of therapy and medications and cooperatively make the best decision regarding the treatment of your symptoms or condition.

Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569602/

https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476

https://www.health.harvard.edu/blog/medical-marijuana-2018011513085

Gillespie, B. (2019) Marijuana: Ancient Medicine, the Devil’s Playground, or Medical Miracle? Elite Healthcare Nursing Continuing Education, 50-62.

https://www.healthline.com/nutrition/cbd-oil-benefits#section1

https://www.medicalnewstoday.com/articles/320984.php#1