There is an old proverb that says that an ounce of prevention is better than a pound of cure. While it is good advice generally, when it comes to health care, one has to be cautious about overdoing prevention.
My former physician in Cleveland before he retired was very much into preventative care. At any sign of something that seemed like an early warning sign, he would suggest prophylactic measures. He would prescribe diagnostic tests and look for signs that something needed attention. So when it seemed like my bone density was slightly lower than it ought to be, a symptom known as osteopenia (which is not the same as osteoporosis which is manifestly low bone density), he suggested that I take daily doses of the drug alendronate (which is marketed under the name Fosomax) which purports to increase bone density. I bought a supply but never got around to taking it and decided to wait awhile. Why? Because in general, I try to avoid routine medicine intake. Since my bone density was still close to normal, I decided to not take any medication to treat it until the signs worsened. After all, I was being compared to the western norm while that may have been my bone density all along. I told him of my decision and he understood it.
I am also aware of how science works and know that it takes a long time before there can be a solid consensus about any treatment. And it emerged that while alendronate did increase bone density, there were serious side effects and that it should not be taken for more than three years for those with low risk.
My physician also suggested that I take a daily low-dose aspirin to reduce the risk of heart attack, a popular treatment at one time. Since I did not have high blood pressure or any risk factors associated with heart disease (other than my father dying of a heart attack but he was a smoker and drinker unlike me), I decided to not start a daily drug regimen there too and since my risk was small, my physician was agreeable with me not doing so. Now comes new studies that say that daily aspirin may not be a good idea for everyone.
Older adults without heart disease shouldn’t take daily low-dose aspirin to prevent a first heart attack or stroke, an influential health guidelines group said in preliminary updated advice released Tuesday.
Bleeding risks for adults in their 60s and up who haven’t had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its draft guidance.
For the first time, the panel said there may be a small benefit for adults in their 40s who have no bleeding risks. For those in their 50s, the panel softened advice and said evidence of benefit is less clear.
The recommendations are meant for people with high blood pressure, high cholesterol, obesity or other conditions that increase their chances for a heart attack or stroke. Regardless of age, adults should talk with their doctors about stopping or starting aspirin to make sure it’s the right choice for them, said task force member Dr. John Wong, a primary-care expert at Tufts Medical Center.
“Aspirin use can cause serious harms, and risk increases with age,” he said.
If finalized, the advice for older adults would backtrack on recommendations the panel issued in 2016 for helping prevent a first heart attack and stroke, but it would be in line with more recent guidelines from other medical groups.
My subsequent physicians are much less aggressive in prescribing preventative measures, showing the lack of consensus on some of these items. I do take regular checkups to make sure that vitals signs are stable and one measure that I do regularly are colonoscopies because the benefits of that seem to be very well established. Also, the benefits of a balanced diet and reasonable amounts of exercise and practicing moderation and avoiding excess in any area are also good things to do. They have no side effects or downsides, always a plus for me. And of course, I take all the recommended vaccinations, such as the ones for covid-19, shingles, and flu because not only is there a solid consensus on the benefits, those are all highly contagious diseases so my taking them is also an act of civic responsibility because it helps control their prevalence in the general community as well and reduces the risk to other people.
In the days of the internet one gets bombarded with all manner of unsolicited medical advice and treatments in the form of the little boxes on the web pages, some promising miracle cures, others with warnings that some everyday food can kill you. If one is easily alarmed, those pages can lead you down avenues towards all manner of quack treatments. Doctors complain of patients coming to them and demanding that they prescribe treatments that they have read about on the internet, even though those have little evidence behind them.
The best course of action is always the one taken in consultation with your physician so that you can arrive at a treatment that is based on sound science that you are both comfortable with.