I have many patients who come in with the latest news item in their hand asking for my opinion. One day Shirley, age 45, came in with a barrage of questions related to some recent news items.

Why is my dentist not concerned about the mercury issue?
Dr. P: I am not sure. When they start telling pregnant women to avoid eating fish high in mercury (tuna, swordfish and halibut) you would think that something was up! In several European countries mercury amalgam use is banned. I suspect it will be banned here in North America in the next 10 -20 years. In the meantime it is well researched to be a neurotoxin (implicated in Multiple Sclerosis and Parkinsons) and a carcinogen so I recommend avoiding its use and replacing amalgams whenever possible. The best replacement substances are pure gold or porcelain.  

Is there any type of tuna that is lower in mercury than others?
Dr. P: St. Jean’s, the fish store in Nanaimo uses an albacore tuna from a small tuna in their canning process, therefore their canned tuna has a lower amount of mercury.

Can I drink green tea with Coumadin? 
Dr. P: The research indicates drinking green tea or eating green vegetables such as broccoli would have to be consumed in massive quantities in order for it to interact with Coumadin. In the case of green tea it is one gallon per day and in the case of broccoli it is 4-5 cup servings per day.  These quantities are rarely consumed by the average person.

Speaking of green tea I heard on the news a few weeks ago that green tea contains fluoride and it should be avoided? 
Dr. P: It is well known that most black and green teas contain a certain amount of fluoride but fluorosis is not seen in places like China and Japan where larges quantities of green tea have been ingested for centuries. It is not seen to be that biologically active in this form.

What about taking fish oils with Coumadin?
Dr. P:  The research does not substantiate the concern that it will enhance the blood thinning effect. The good thing about Coumadin is that blood tests are routinely done for INR, a measure of Coumadin activity, so that if there is a change in the INR then the dosages can be adjusted. Of course we encourage our patients to ask the MD to lower the Coumadin dosage not to stop the so called suspect healthy food!

This time of year we do a lot of barbecuing, what do you think about that?
Dr. P: Barbecuing of meat on the open coals creates dripping of fat and the creation of smoke. This smoke is a carcinogen. The barbecue sauce that is often used on red meat creates a hardened yet delicious coating on the meat that is called in medical terms a glycated protein. This is due to the sugar in the sauces.  Your body does not know how to metabolize these sugar coated protein molecules and they tend to accumulate in the brain as AGE (advanced glycated end products) which is not good for brain health! I suggest barbecuing any meat or vegetable in tin foil to protect against these risks and still create a great taste!

I smoke a little marijuana now and then. Any harm in that?
Dr. P: As long as you know the risks. It can contribute to infertility in males primarily by lowering sperm count. But recent studies indicate it can lower fertility in women as well. It is also a common source of cadmium, a toxic heavy metal. This metal is also consumed with the smoking of cigarettes. The concern is that cadmium increases the risk of lung and prostate cancer, creates kidney damage and heart disease. Marijuana can also create psychosis in some susceptible individuals. Psychosis is people thinking unusual thoughts, hearing voices, hearing things that are not true, that are different from the rest of society. The risk of developing psychosis increases by 40% if you are an occasional smoker and from 50-200% if you smoke daily. Marijuana interrupts neurotransmitters such as dopamine, which interferes with the brain's communication systems.