Latest evidence says fasting not needed before blood tests
Dear Dr. Roach: My daughter is a registered nurse, and she tells me that when getting blood tests, it is not necessary to fast eight to 12 hours even though my doctor says to do so. Four hours is enough, she claims. Is this true, or is my daughter trying to be a doctor? — L.C.
A: I probably agree with your daughter more than I do with your doctor in this case. Most routine blood testing does not require fasting. There is controversy about whether cholesterol testing is best done fasting or not: Most recent evidence suggests that fasting is not necessary. However, many physicians still continue to use fasting levels, as that is what they are used to. Nonfasting numbers may reflect the true state of risk to the arteries more so than fasting levels.
However, I still recommend following your doctor’s orders.
Dear Dr. Roach:
Can hypnosis bring a person out of depression? — J.C.A.
There is limited evidence that hypnosis, or hypnotherapy, is a potential treatment for depression. A 2010 study of 84 patients showed approximately equal benefit from hypnotherapy compared with cognitive behavioral therapy, which is an accepted treatment for depression. I did not find a study comparing hypnotherapy with medication treatment. However, it may be worth considering hypnotherapy in someone with mild depression and no good response to other treatments, or for one who is unwilling to use medication. I would not recommend hypnotherapy for severe depression.
Dear Dr. Roach: Do you recommend exercise after a stroke so that someone can make a comeback? — C.T.S.
A: A stroke is the name for damage done to the brain, usually by death of brain cells, and may be caused by lack of blood flow caused by a blood clot or by bleeding inside the brain. Strokes can involve very small areas of the brain, with loss of very specific function, or much larger areas with loss of motor control of an entire side of the body. Other kinds of strokes can affect other brain function besides muscle control.
For strokes involving loss of muscle control, exercise is a critical part of therapy after a stroke. Exercise should be begun soon after a stroke, whenever possible, and should be supervised by an expert. Frequent, precise, skilled physical therapy can sometimes make the difference between a person suffering residual problems and one making much more complete recovery. Unfortunately, physical therapy cannot always bring about recovery, especially in a large stroke.
Nearly all the benefit from exercise after a stroke will occur in the first year afterward, which is part of why starting soon is so important.