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Resist The Resistance: How to Combat the Global Antibiotic Crisis

Image Courtesy of The Economist – “The Spread of Superbugs”

“The growth of antibiotic-resistant pathogens means that in ever more cases, standard treatments no longer work, infections are harder or impossible to control, the risk of spreading infections to others is increased, and illnesses and hospital stays are prolonged.”


Antibiotic resistance is one of the most significant public health crises this planet faces today. Every year, the human species grows increasingly resistant to antibiotic treatment, largely due to the overuse or improper application of these medications. As a primary care doctor, I am frequently asked to prescribe antibiotics for illnesses that are not caused by bacterial pathogens.

The implications of this kind of abuse of antibiotics are so extreme that recently the CDC created its own FAQ homepage dedicated to informing and educating the public on antibiotic resistance, calling this issue “one of the world’s most pressing public health problems.”

So today I would like address some of the issues surrounding antibiotics and antibiotic resistance and also explain how you, as a savvy patient, can naturally boost your body’s immunity to bacterial infections so you’ll have less need for antibiotics.

Q: What is antibiotic resistance and how can it happen to me? 

A: Antibiotic resistance occurs when harmful bacteria and other microbes learn how to work around or sabotage antibiotic medications  used by doctors, veterinarians and agricultural producers to kill them off (examples: Amoxicillin, Cipro and Zithromax). Bacteria are clever and can “learn”: the more often and longer harmful bacteria “see” antibiotics, the better chance they have to transform themselves in ways that they become resistant. This is happening more and more, principally from the improper use of such medications.

Antibiotics are ineffective in treating illnesses caused by viruses such as the common cold, the flu, and actually the majority of common coughs and other common illnesses like sore throats. Yet because members of the general public do not understand this fundamental difference, these antibiotic drugs are often prescribed for problems not associated with bacterial infections – causing long-term resistance to treatment on part of the bad bacteria while the good bacteria in our bodies gets killed off unnecessarily. (In future blogs we’ll talk more about the importance of “good” bacteria in our guts.)

Q: Why should I care about antibiotic resistance? 

A: Progressive resistance by bacteria to treatment with antibiotics is a major public health crisis happening RIGHT NOW! Scientists find that most bacteria  have become resistant to antibiotic treatment due to non-discretionary use of such treatments. Over time, this has made it increasingly more difficult to properly treat serious illnesses caused by bacteria. While this is most devastating to weak or immune-compromised individuals, everybody’s health is at risk due to this resistance, so more discretion needs to be used to avoid escalation of this public health problem.

Q: How might I be inadvertently causing resistance in my body?

A: One common dangerous mistake is when you only take part of a prescription of antibiotics you DO need before your infection is fully treated. You’ll kill the susceptible bacteria, and the resistant ones left behind will grow wild. Always complete the course of treatment.

Side effects?  Call your doc, don’t just stop early!

Q: How can I naturally boost my immunity to bacterial infections? 

A: It’s easy! You can start with these simple steps:

1) Try taking an over-the-counter probiotic supplement once per day. “VSL3” is one probiotic that I particularly like, however there is a wide variety of probiotic products available at grocery stores and pharmacies which will all be helpful in aiding your immune system.

2) Taking 10 mgs of a zinc supplement daily has also been shown to be quite useful in preparing your body for a bacterial attack – it has beneficial effects on our immune cells, particularly CD3 and CD4 cells which help our bodies fight off infections. (Disclaimer: DO NOT TAKE ZINC IF YOU HAVE KIDNEY PROBLEMS!) If you prefer to get your nutrients from foods, here is a list of high-zinc foods:

3) Take 100-200 mg of Ginseng per day. Ginseng has been used for thousands of years in traditional Chinese medicine for effective immune enhancement and is another fabulous (and natural!) way to limit your need for antibiotic treatment.

4) WASH YOUR HANDS! Only plain soap and warm water are necessary. Wash your hands thoroughly for 30 seconds in the sink after potentially coming in contact with bacteria. Anti-bacterial soap is not required to make this effective, in fact the FDA has recently warned that these soaps may be posing an additional problem for bacterial resistance to antibiotics.

5) Most importantly: Talk to your primary care doctor when you are sick and work with her/him cooperatively on the best treatment. Many illnesses can be treated without antibiotic medications – and these drugs should not be used thinking they are a “fool-proof” method for becoming well every time you’re feeling under the weather.

Stay well and here’s to hoping you’ve learned something new!

Dr. Nolfo

Fighting Bad Cholesterol With GOOD Methods!

Re-calibrating Our Views On Cholesterol

As a doctor of Internal Medicine, I find that one common misconception many of my young adults (ages 35 and below) have is that “bad” (LDL or non-HDL) cholesterol is a problem of older age.  Too often the sentiment “Live while you are young!” is taken out of context by people in their teens, twenties and thirties to mean “Don’t worry about your health till you are older.” While it is true that after we reach the age of 20 our cholesterol levels begin naturally to increase, there are many factors besides age that determine the levels of bad cholesterol in our blood. While some of that is hereditary, many of these factors can be monitored and controlled from quite a young age. While I am a firm believer in living life to the fullest – I also am adamant that the choices we make about our health and wellness in our formative years provide a strong baseline for our bodies and minds of the future.

The Problems of Waiting Out Your Youth To Correct Cholesterol Levels

Patients of mine above the age of 50 are certainly at a higher risk of cardiovascular complications related to bad cholesterol than their younger counterparts. However, even children with poor dietary habits can have alarmingly high bad cholesterol levels and even the beginnings of blocked arteries before high school!

When one of my older patients at high risk has a very high LDL cholesterol (>190) and we have not been able to improve it with lifestyle changes such as exercise and diet, I may decide to use a prescription treatment for lowering those levels  to minimize the risks of complications like strokes or heart attacks. The most widely prescribed are statins, which quickly reduce bad cholesterol levels in the blood . Statins, such as Lipitor, Crestor or Zocor, work by inhibiting HMG-CoA reductase,  a liver enzyme which promotes cholesterol production in the human body.

(By the way, I have always advised my patients to CONTINUE their lifestyle efforts and to take Coenzyme Q10 whileon the statin, because statins deplete this substance which is a vital co-factor in your cells’ energy production.)

Despite the fact that I prescribe these medicines, as an advocate of a natural approach to health whenever possible, I’d much prefer that my patients never reach the point where taking a statin becomes their best option. While statins have proven to be extremely effective in reducing levels of bad cholesterol – their efficacy can be trumped by an array of side effects: muscle pain (not uncommon), liver problems (very rare) and increased risk of diabetes among them.

Today I’d like to talk specifically about one somewhat surprising side effect of statin use which has recently been highlighted by researchers in the peer-reviewed journal, Obesity.

In a new study, based on over 10 years of data collection, researchers found that patients prescribed statins “significantly increased their fat intake and calorie consumption, along with their BMI, in the last decade,” 

Why, you ask?  Patients taking these enzyme inhibitors are well aware of their positive benefits and therefore have a propensity for poor diet and lifestyle choices while prescribed them. Too often the mindset of “I take pills to lower my cholesterol – therefore I can eat whatever I want without getting sick” apparently becomes commonplace in those suffering from these kinds of health issues. Patients can become complacent with a poor, unhealthy lifestyle after viewing remarkably improved blood work results from a course of statins – and this is NOT a trend that doctors and patients should continue! When I read this I remembered that when the first statin, Mevacor, came out, one of my fellow doctors in my residency program told me he took it so he could “keep eating bacon and eggs”!

“Ok – I get it, Dr. Nolfo. You’d prefer I didn’t have to take statins if I had the choice. So what do I do instead? “

 I am SO glad you asked! There are many ways to keep our cholesterol at a healthy level:

1. Exercise!

Yes, I know I say it a lot. But countless other physicians and researchers like myself agree: Lack of physical activity can increase bad cholesterol (LDL) – and even DECREASE the good cholesterol! (HDL)

   2. DON’T SMOKE!

Smoking has been proven to lower your good cholesterol – BAD, BAD, BAD! And I seriously hope we don’t need to review the thousands of other health complications that can arise from such a terrible habit. Please don’t smoke! I like you just the way you are! 😉

3. See Your Primary Care Doctor Regularly

General health plays a large role in our cholesterol levels. It is best that you make regular visits with your primary care doctor so you can be screened for other health complications such as diabetes or hypothyroidisim, which can cause high cholesterol. Plus, it’s just the smart thing to do!

4. Eat Healthy, Real, Unprocessed Foods!

Clearly you saw this one coming! Diet is one of the most crucial factors in our cholesterol. Highly processed foods like chips, cookies, margarine, etc. can easily raise our levels of bad cholesterol. I have posted an array of healthy recipes of all kinds throughout this blog – please review for some great meal ideas to start changing your diet today! Vegan and Mediterranean diets have been shown to help cholesterol profiles. There is a little controversy about the effect of the Paleo diet on cholesterol, but my Paleo patients’ cholesterol profiles are usually quite good.\ because they don’t limit themselves to all meats and eggs and eat tons of fruits and veggies.

And just to give you a head start on the eating part – try this delicious and healthy black bean, corn and edamame salad! Not only is it perfect for the start of summer, but a new study shows that beans can help significantly reduce our bad cholesterol!

Go ahead, try this stuff!

Dr. Emily Nolfo

New Study: Exercise As Effective As Prescription Drugs

                                                           REJOICE! FANTASTIC NEWS IS HERE! 

As a physician who strives to provide the best treatments to all of my patients in my practice, I was incredibly overjoyed to read this week that researchers at Stanford Medical School were able to make an evidence-based conclusion that physical exercise can be as effective as prescription drugs in reducing the number of deaths caused by various common and serious conditions like heart disease and diabetes.

WOW! Now THAT is music to my ears!

*** IMPORTANT DISCLOSURE! Before we begin our discussion, as doctor of medicine, it is important that I emphasize that these findings do not change my belief the use of medications – all of my patients, clients and subscribers reading this should continue to take their medications as directed unless told otherwise by their primary care physician.


Imagine a world where the power to improve and maintain our health was inside of our minds and bodies instead of a bottle of pills – what would that look like? For many who are already sick, sometimes a trip to the pharmacy is the only option. But, scientists already know that exercise is an extremely effective method of prevention for various chronic illnesses. So these new findings imply with significant data that with the right approach, engaging our bodies in regular physical activity may not only prevent but also help to cure certain illnesses without the use pharmaceuticals!

For some of you who aren’t very enthusiastic about physical exercise,

Here are a few reasons why the implications of this study are worth getting excited about!

  •  In 2013, the Organization for Economic Cooperation and Development found that Americans spend on average $1,000 per year on prescription drugs…..That’s A LOT of cash!  Not only that, each year Americans are spending 40% more on these medications than the rest of the world – and because of the high cost of these treatments, 1 out of every 5 Americans are not filling our prescriptions or are skipping doses to alleviate this financial burden. What would you do with your extra money?


  • A study conducted by the U.S. Geological Survey in 1999 and 2000 found measurable amounts of one or more medications in 80% of the water samples drawn from a network of 139 streams in 30 states – showing that the pharmaceutical industry is a significant contributing factor to water pollution. As it is, the oceans of the world are already in a great amount of duress from millions of tons of plastic deposits and other pollutants – something every human should be extremely concerned about. Ridding ourselves of our dependency on pharmaceuticals will improve water quality and make the earth a greener place. 


  • Prevention should ALWAYS be the goal of a healthy lifestyle as well as the focus of any interventions conducted by physicians. NOBODY wants to get sick! Instead of treating our ailments with prescription pills, wouldn’t it be better to not have health problems at all? If you knew that exercising for 30 minutes a day would prevent you from contracting diabetes, heart disease or cancer – would you participate? Hundreds of studies on physical exercise and its use in the prevention of chronic illness have revealed a strong connection between working out and staying healthy throughout a lifespan. Think about it!


  • Unlike many prescription drugs which can result in an array of complications, exercising is a treatment method with very few negative side effects. So if exercise can be used as a treatment in the event that we do get sick – we’re not only treating the illness but also preventing stress, strengthening our skeletal system and boosting our metabolism! Do your medications have those positive side effects???


There are myriad of additional reasons why every single individual should engage in regular physical activity – the trick is to find those reasons that are most important to you. It is fairly common knowledge that exercise is a very empowering tool for our minds and bodies – these findings by Stanford University only serve to emphasize that evidence.

I hope I have made a convincing argument for putting some spring in your step and getting in some workouts this summer! For those of you who aren’t interested in joining a gym or paying for a workout program, I highly recommend checking out the YouTube Channel “FITNESS BLENDER”! FitnessBlender is a free service created by an adorable young couple from Washington State that has hundreds of FREE exercise videos of all kinds, from yoga to High Intensity Interval Training. My youngest daughter Mariella and I frequent these videos – and they have really inspired us to get fit from the comfort of our own homes! The couple, Dan and Kelli, do a fantastic job of inspiring their viewers and creating realistic fitness goals. All of their videos are quite doable by most able-bodied individuals.

Give it a shot! Here is one of our favorite total body routines for beginners:


For this Summer 2014 – I urge all of you to not only get fit with me but GET HEALTHY too in the process!

Dr Emily Nolfo


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