Be aware of commercial interests
Zerbor/ShutterstockWe've all seen print ads and TV commercials touting medications and medical screenings, but it's way too easy to overdo it. Here's how to know if you're taking too many medications. And an even bigger problem is the fact that many tests and treatments that seem like a great idea just aren't. "The problem is the overwhelming majority of clinical trials are commercially sponsored, and there is no question that when companies study their own product, the published results are more likely to show greater benefit and less harm than when the studies are independently funded," explains John Abramson MD, MSc, lecturer in the Department of Health Care Policy, Harvard Medical School and the author of Overdosed America.
Sadly, the government-funded United States Preventive Services Task Force, which provides doctors and patients with scientific evidence to make trustworthy recommendations, is being undermined: "Consumers must now be cautious of the increasing commercial influence on the science that USPSTF recommendations are based on," Dr. Abramson says. He recommends discussing specific recommendations with your doctors but understanding that the even the best information available may have a commercial bias.
Executive physical stress test
Photographee.eu/ShutterstockKeep an eye out for the signs of an unhealthy heart—if you have any, see a doctor and consider stress testing to rule out any serious issues. But if you don't have these signs, definitely think twice before signing up for an executive physical stress test. No matter how impressive it sounds, it's just a slew of tests which include a cardiac stress test (also referred to as an exercise EKG). A basic EKG may cost a couple hundred dollars; if your doctor opts to perform a nuclear stress test which involves a radioactive dye, that could set you back about $600.
Joel Kahn, MD, founder of the Kahn Center for Cardiac Longevity and Greenspace Cafe in Bloomfield Township, Michigan, and clinical professor of medicine, Wayne State University School of Medicine says an executive physical stress test is offered by many hospitals and medical practices even for people without any known heart disease or suspicious symptoms. Therefore, getting one when you don't have symptoms is a waste of money. He points to information published in the Annals of Internal Medicine stating: "Clinicians should not screen for cardiac disease in asymptomatic, low-risk adults with resting or stress electrocardiography, stress echocardiography, or stress myocardial perfusion imaging." "That's pretty clear language," says Dr. Kahn, author of Dead Execs Don't Get Bonuses. "There is a much more accurate way to detect silent heart disease that has been available for over 15 years: a coronary artery calcium CT scan providing a "score" of zero or higher. This CT is widely available at a reasonable price often under $100, is fast and painless, and exposes one to a minimal dose of radiation equivalent to a mammogram."
Food sensitivity testing
Image Point Fr/ShutterstockBe careful of jumping on the food sensitivity bandwagon. If you have legitimate reasons to undergo testing for this issue, by all means, do so, says Amy Gorin, MS, RDN, owner of Amy Gorin Nutrition in the New York City area. She explains that food sensitivity testing such as the Mediator Release Test (MRT) has benefited herself as well as some of her clients, adding that it helps identify possible triggers of symptoms such as diarrhea or migraines. "The test can be "really helpful if you're having symptoms that you can't explain," Gorin says. But be mindful of whether or not you think it's truly necessary. "The test is expensive and often not covered by insurance, so I'd only recommend getting it if you're having symptoms that your dietitian or healthcare provider thinks may be connected with a food sensitivity." If you're ready to get going on a healthy eating plan, make sure you avoid foods that nutritionists never eat.
Hormone therapy that's not FDA-approved
Billion Photos/ShutterstockAs women approach menopause—and the Change can sneak up on you for surprising reasons—they may want to seek hormone replacement therapy to help manage symptoms, says Jonathan Schaffir, MD, associate professor of Obstetrics/Gynecology at The Ohio State University Wexner Medical Center. That's perfectly fine; however, he offers a word of caution for methods that aren't FDA-approved, specifically encouraging women to be mindful of options that claim to be more natural. Beware of phrases that seem scientifically-backed, like "bio-identical hormones;" always ask if the treatment has been approved by the FDA. "There are a lot of compounds that are not regulated, not FDA-approved, and not measured in a lab that validates content," Schaffir says of such hormone replacement therapies. They also have "various degrees of purity in their preparation," he says. He encourages women to pay careful attention to what their doctor recommends, get a second opinion before starting anything, and be wary of trendy treatments that haven't been studied enough to determine potential long-term effects.
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Surgery to stop periods
marinafrost/ShutterstockYou may ask your doctor for help temporarily pausing menstruation—for a wedding, for example, or an upcoming vacation. But Dr. Schaffir says that in some cases, women come in asking for surgery to permanently end their periods strictly for convenience's sake and not for medical reasons. Called an endometrial ablation, he says this surgery can cost upwards of $6,000. Some women even request a total hysterectomy for the same reason, which can cost double that amount. "It's extreme," Dr. Schaffir says. "It seems overboard to subject yourself to possible risks from surgery all in the name of convenience." For this and any other medical considerations, he encourages people not to rely on the Internet or get caught up in celebrity recommendations: "There's a lot of misinformation out there."
Early hip replacement
Image Point Fr/ShutterstockNot everyone believes that hip replacements are reserved for the elderly. People can—and have—requested the surgery as a precaution, even though their hips are perfectly fine, according to Kevin D. Plancher, MD, MPH of Plancher Orthopedics & Sports Medicine in Greenwich, CT and New York City, clinical professor for Albert Einstein College of Medicine and Montefiore Medical Center, also in New York City.
He recalls a young woman who, despite "pristine Xrays and MRIs," wanted a total hip replacement. She reasoned that it was best to do it now since it would be inevitable down the road. Dr. Plancher tried to talk her out of it, but she ultimately went through with the hip replacement at another institution only to encounter an infection. "When a hip replacement is necessary, it can be phenomenal," he explains. Otherwise, patients can encounter problems. And it's important to know that even though replacements are getting better all the time, the materials in the artificial joint may wear out after 15 to 20 years—and you may need another replacement.
Unnecessary shoulder surgery
suriya yapin/ShutterstockThink again before getting shoulder surgery the moment an injury strikes, advises Dr. Plancher. Depending on the extent of the injury, you may be fine without it. In the case of a separated shoulder, he says certain injury levels like Type I or II typically heal without surgery. In other instances, physical therapy may improve shoulder injuries—no surgery required. He suggests speaking with an orthopedic expert to discuss your activity level, lifestyle and injury type. Doing so assesses the full picture in order to determine your ideal next steps.
Testing for Alzheimer's gene
Evgeniy Kalinovskiy/ShutterstockUnderstanding what a genetic test means—and being emotionally prepared for what it reveals—is a lot more complex than being tested for strep throat. "What if you get tested for the Alzheimer's gene?" Dr. Plancher asks. "Do you really want to know the result? Because if you have the gene, it may change your whole psychological profile for the next 40 years." Genetic tests also reveal a tendency or slightly elevated risk—they're no guarantee that you will develop the condition you're being tested for. For that reason, think long and hard about tests that do nothing more than satisfy your curiosity or happen to be trendy. See a genetic-testing counselor before you make the leap, and get a good read on your risk factors before you sign up. Here's some more information on whether genetic tests are worth the trouble.
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Bone density tests
Syda Productions/ShutterstockYour bones are important so use caution when it comes to bone density tests. You may hear a lot about osteoporosis, but the test doesn't really make sense unless you're over 65 (70 for men). Proceed wisely, Dr. Plancher encourages. He explains that simply for checking for vitamin D and calcium levels through a simple blood test can provide a great deal of insight. Here are 30 simple things you can do to boost your bones.
Breast cancer gene testing
science photo/ShutterstockSure, Angelina Jolie made headlines in 2013 when she announced she tested positive for the breast cancer gene and opted to have a double mastectomy. Experts maintain that BRCA testing (specifically for BRCA1 and BRCA2 mutations) is recommended only if you have a family history of breast or ovarian cancer. Consider your own personal health history and choose your next medical steps based on those factors. If you still want to get tested despite not having a family history, you better save up: According to BreastCancer.org, it's estimated that the cost for BRCA testing may set you back more than $5,000. That's quite an expense if you're not at risk! Here are 15 myths about breast cancer you can safely ignore.
Lyme disease testing
StudioLaMagica/ShutterstockCheck out these surprising reasons behind common back aches and pains before chalking up your symptoms to Lyme disease. According to the American College of Rheumatology, signs of Lyme infection include a rash around the bite, joint and muscle pain, headache, and fever. And you're at higher risk if you live in the Northeast and Middle Atlantic states—here's a list of the most dangerous areas for Lyme in the U.S. Your likelihood of Lyme disease decreases even more depending on how you spend your time. If you're outdoors frequently, especially in rural locations during the late spring and early summer, you may be more prone to a tick bite; if you rarely walk in the woods, don't have pets that would bring ticks indoors, and you live in, say, Nebraska, Lyme is an unlikely source of trouble. Plus, the two-stage Lyme disease blood test is notorious for yielding false positives.