Health questions answered

This month I’m answering three health questions asked by Facebook followers.


The first question asks, “…sadly a lot of us are prone to develop certain diseases (heart disease, for example) due to genetics. What are some essential tests that you’d recommend having done and at what stages in life?”

First, it’s important to understand that having a genetic predisposition for a disease does not necessarily mean that you will get the disease. Certain genetic changes are more strongly associated with diseases than others, but very few will cause disease 100% of the time. Many factors influence genetic diseases, including lifestyle habits.

Knowing the type of genetic mutation(s) you have is essential to understanding its management. For example, familial hypercholesterolemia (high cholesterol) occurs due, in large part, to two specific mutations, APOB and LDLR. These mutations prevent the normal degradation of cholesterol leading to an accumulation in the arteries. This accumulation increases the risk of atherosclerosis and coronary artery disease. Patients that know they have one of these mutations can help prevent the negative impact by choosing healthy lifestyle choices and using medications to help bring down their cholesterol levels. Staying proactive and working with a physician to monitor cholesterol levels and atherosclerosis development is important for people with these genetic mutations.

Identifying the type of genetic mutation can help your doctor and you plan a course best suited for your risks. This includes proactive testing for known markers of disease risk, like cholesterol, working with dieticians to guide proper nutrition, ensuring adequate and appropriate exercise, stress management, and eliminating environmental risk factors like smoking. Knowing the type of genetic risk factor you have can also help guide the timing of risk assessment testing. For some genetic mutations, testing is prudent as early as childhood while others can wait until adulthood.

The bottom line…know what type of genetic mutation you have and develop a plan for the future that includes lifestyle modifications, disease assessment and marker testing, and possible drug prevention strategies.

 Our second question, one I’m asked frequently, “…how different are those over-the-counter sleeping aids and actual sleeping pills? How can the former be non-habit forming? Is the latter really addictive? Are there any long term effects of taking prescription sleeping pills?”

Sleep aids and sleeping pills are available either over the counter (OTC) or by prescription (Rx). The most common OTC sleep aid is Benadryl. You may be familiar with this as an anti-allergy medication. Besides acting to curb allergic reactions, Benadryl also causes sleepiness. For this reason, it is the most common ingredient found in many of the drugstore sleep aids.

Some of the most common prescription sleeping pills include Ambien, Lunesta, and Sonata (but there are others). These medications vary in their ability to help you get to sleep and stay asleep. And like all medications, have their own set of side effects.

Benadryl and the many Rx sleeping pills target different biologies and, therefore, have different sleep effects and side effects. There is both dependence and addiction related to the sleep aids and sleeping pills. Using either for a prolonged period can induce a dependence (habit-forming) where individuals cannot get to sleep or stay asleep without the use of these medications. Addiction is more common with the Rx sleeping pills than OTC sleeping aids like Benadryl. Other health-related side effects are dependent upon your health and any medications that you may be taking in addition to the sleep-related medications.

Bottomline…use sleeping aids and pills sparingly and consult your physician about side effects specific to you.

And our third question, “….I would be interested in woman’s health from a post-menopausal view. Seems like it’s harder to lose weight, stay strong, focus and sleep. Tips?”

This question would certainly benefit from a full blog post or even its own course! But, I’ll be brief and give you the top tips, like you asked.

Post-menopausal symptoms are a result of changes related to hormone levels. Hormones have the powerful ability to influence many of the body’s systems and physiology which is why the symptoms of menopause are broadly felt. Post-menopause also coincides with the impacts of aging so it can sometimes be difficult to tell if weight gain, muscle loss, and sleep disruptions are a result of menopause or age. The good news is that regardless of the cause, there are certain lifestyle choices that you can make to positively influence these issues.

Unfortunately, as we age we do have to work a little harder to keep muscle mass and prevent weight gain due to increased fat tissue but it can be done. First, if you haven’t already, re-evaluate your nutrition and exercise needs for your post-menopausal state. Do you know how many calories per day you need? Fat, carbs, and protein? How about your micronutrients, are you meeting your new needs? And with exercise, strength exercises are more important than ever! Improper nutrition and exercise post-menopause can lead to fatigue, brain fog, and poor sleep. Of course there are other reasons as well, but modifying your exercise and nutrition is a good place to start.

Thanks for the questions! And remember, if in doubt or if you have any concerns, always consult your physician.

Until next time, stay well!

Dr. Tobi Schmist

2 Thoughts on “Questions About Health: Genetic Diseases, Sleep Aids, and Menopause

  1. Kerri Barbour on November 27, 2016 at 3:32 PM said:

    Thank you so much Tobi; great information and tips to follow.

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