Hayfever, Allergies, and Rhinitis

Hayfever, Allergies, and Rhinitis


The medical name for hayfever is allergic rhinitis – this means an allergy affecting the nose.

This allergy may be either seasonal, such as in spring when there is plenty of pollen or new plant growth which causes the allergy; or perennial which means all year round, when you are allergic to dust, pet hair or other irritant substances. The severity and type of hayfever varies from person to person, but can make you miserable if not treated and the symptoms prevented.  Those people that have allergies causing dermatitis or asthma are generally more likely to suffer from hayfever; but for everyone the answer to relieving hayfever is to minimise the exposure to whatever is causing the symptoms.


Mast Cell with anti-body and histamine granules

Mast Cell loaded with histamine granules (red)


Mast cells are a immune cells (white blood cells), that release histamine when the interact with allergens (what ever you’re allergic to).


Most hayfever sufferers complain of sneezing, itching and burning eyes and throat, and either blocked or running nose. Other symptoms that may occur are aches in the jaw and teeth caused by the pressure of blocked sinuses, popping in the ears, headaches and generally feeling miserable.  When you have an allergy the body releases a substance called histamine, which is why the most common medicines used to treat allergies are called antihistamines. These block the effect of histamine and will prevent any more histamine release, which should prevent the allergy getting worse.

Avoiding the substance that causes the condition is always better than taking medicine to treat the result of the exposure, but unfortunately this is not always possible.  I find it much easier to get ahead of my allergies, and start taking antihistamine before they become a problem than trying to manage the symptoms once they’ve started.


The main treatments for hayfever, and other allergies, is antihistamine tablets.   There are a number of  them available, and some work better for some people than others do.  Personally I find fexofenadine, cetirizine, and levocetirizine really effective.  Others prefer other antihistamines.

There are two types of nasal sprays that can be used to treat the runny nose and sneezing by themselves or in combination with tablets, and even eye drops.  Antihistamine nasal sprays such as Livostin or Azept, work in a similar way to hayfever tablets.  Steroid nasal sprays like Beconase, Flixonase, or Telnase work in a similar way to inhalers use to prevent Asthma.  They tend to take longer to work than antihistamine nasal sprays, but their effect can last longer.

Other treatments for the nasal blockage and congestion of hayfever usually involve a nasal solution that may be either dropped or sprayed into the nostrils. These work by washing out the nostrils or by helping to dry up and prevent further secretions from the sinuses running down the nostrils or down the back of the throat. Decongestant nasal preparations should only be used for up to five days running as they can cause nasal congestion to worsen if used for prolonged periods of time. Seek advice from your community pharmacist as to the correct nasal spray that you can use to relieve and prevent ongoing congestion.

A cough may occur from persistent nasal secretions running down and irritating the back of the throat. This is called post-nasal drip, and may also be helped by antihistamines, as this should not be treated with medicines to stop coughing.


Come and talk to us at CookStPharmacy about the right medicine to treat hayfever, and seek their advice about preventing as well as treating hayfever whether you suffer from this occasionally or every day.

4 Myths about the ‘Flu

March is the official start of Autumn so it’s time to start getting ready for winter illnesses.  That means the ‘Flu season is just around the corner.

There are loads of misconceptions around the ‘flu and the flu immunisation.  So here’s a bit of back ground about the ‘flu and the vaccination.

Myth 1: Influenza is a mild illness and “not a problem”.

This probably comes from the the common cold being mis-labelled as the ‘flu or to give it’s proper name Influenza.   You’ll even hear illness described as “tummy flu” which is gastro-enteritis (or poos and spews).  Like everything different people get affected differently.  I’ve only had the ‘flu once and it’s not an experience I want to repeat.  I would have considered myself fit and healthy at the time (it was over 10 years ago, so in theory I was at the healthiest I’ll ever be) I had close to 2 weeks off work, and spent the first 5 days in bed.

In the US ‘flu is associated with over 23,000 deaths and over 226,000 hospitalisations each year.

Healthy adults may only have mild symptoms, or may not show any symptoms at all, and so carry one their usual routines inadvertently spreading the ‘flu around their friends and family.

Myth 2: Influenza is only contagious if the person with the illness shows symptoms.

Like a lot of infections that affect the airways (or respiratory tract to give it’s technical name) the ‘flu virus is transmitted in droplets of saliva that we generate when talk, cough, or sneeze.

These droplets can then be inhaled by other people, or can land on and contaminate the surroundings.   Infection occurs when we pick up the virus from surfaces, airborne droplets, or contact with mucous membranes (lining of the mouth is an example of a mucous membrane) of infected people.

Because it takes around 2 days for symptoms to occur after infection, we can be spreading the virus without realising we’re unwell.


Myth 3: I’ve never had the flu, so I don’t need a flu shot.

I’ve never been hit by a car when I’ve crossed the road.  That doesn’t stop me taking precautions like looking where I’m going or stepping out in front of traffic.

The same thing applies to the flu.  If the ‘flu has passed you by last year that’s no guarantee it’s going to miss you this year too.  The flu virus mutates regularly too, so the vaccination that you got last year may not protect you this year.


Myth 4: Nothing can be done to prevent ‘flu

There are a number of things you can do to no only protect yourself, but protect others around you.  Vaccination is an extremely effective way of reducing your risk of contracting the ‘flu.  You can reduce the risk by following good hand washing techniques, using “good cough etiquette” covering your face when you cough or sneeze, and avoiding contact with others when you’re ill.


Book you flu jab here


Men’s health and the things we don’t talk about

It’s pretty widely known that men are really bad at looking after their health, they are less likely than women to seek help[1] for a number of conditions. This isn’t just “received wisdom” it’s been going on for some time and there are many studies that show it. Not that our wives, girl friends, partners, husbands, and kids need the obvious behaviour of the men in their lives shown to them by some academic somewhere.


It’s not just Kiwi blokes either. According to the ‘Men’s Health Foum’[2] men in the UK are

  • Likely to die 3.7 years before women
  • Less likely to go to the Doctor than women
  • 3 times more likely to die by suicide than women.



Heart Disease

Heart Disease killed 5100 people in 2014[3], and it is estimated 169,000 kiwis live with heart disease on a daily basis.[4] Of the 5100 people 55.6% were male.

High blood pressure is a significant risk factors for things like heart attacks and strokes. But according to Ministry of Health statistic more women than men are being treated for high blood pressure.



According to Ministry of Health Data[5] in 2013 there were 9063 deaths from cancer. Of these 53.2% were men. Interestingly more women than men get cancer in the 25 to 64 age group[6].

Generally cancer treatments are more effective the sooner diagnosis is made. So as we’ve said before when men delay seeking treatment, they risk worse outcomes than if they had gone at he first sign of symptoms. This can be seen in the numbers when you compare deaths and number of cases.



Gout is an extremely painful condition, and is the most common in Maori and Pacifica men. In fact Maori and Pacifica men have the highest rate of gout of any population group in the world[7]. For all men if you have gout you are much more likely to have either Heart Disease or Diabetes too7.   So gout can be seen as an important flag for the other conditions.

Although not usually life threatening, untreated gout can lead to other problems. Particularly with kidneys and joints. Kidney problems are a particularly nasty effect of not treating gout. Asian (particularly from Pakistan, India, and Bangladesh area), Maori, and Pacifica men are all at more risk than Europeans (white) from kidney disease in later life and are more likely to get gout too.


Luckily gout is easily managed with tablets, and a couple of lifestyle changes.

Why should I bother?

Some people aren’t fans of taking medicine. There are almost as many reasons as people. A common one is “I’m going to die of something anyway ….”. That is true, but how *well* you live is something we can help with. Personally I’d like to spend as much time with my Grandkids as I possibly can. I haven’t met a grandparent yet who doesn’t. I’d also like to be able to do and enjoy as much as I can with my grandkids. So the idea that my health is so bad all I can do when I’m 75 is wave at them from a chair isn’t a good one.


What to do?

There are a number of things we can do to reduce our chances of getting these diseases, and reducing how they drag on our lives.


  • Stop smoking: In pretty much every way we measure health the single best thing you can do is stop smoking.
  • Eating better: reducing fizzy drinks, orange juice, and alcohol will help both controlling diabetes, and gout. It will also help with getting to and maintaining a healthy weight.
  • Exercise a bit more: increasing the amount of exercise you do be small amounts each day can have a real impact on your health. Next to smoking, it’s probably the best thing you can do to reduce your risk of developing as disease, or the disease you have getting worse.
  • Check out problems: We often start noticing changes in our bodies well before we get help. Men are particularly well known for noticing changes, and ignoring them completely. Early diagnosis usually leads to better outcomes.


Let’s start talking about it!

It’s easy for me to tell you what you should do “because a textbook says so” it’s another thing to have someone tell you about their life and health and what they have been through.

Another huge road block to men talking about health is fear. We fear being seen as soft by our mates if we talk about our problems, so I’d like to invite you to come and listen to former All Black Captain Buck Shelford talk about his health and problems he’s dealt with. Still think it’s soft to talk about stuff?

The other speakers are Mr Daniel Marshal is a local urologist (the water works guy), and of course me.

Tickets are strictly limited. You can reserve your seat here by following this link. http://www.cookstpharmacy.co.nz/buck/


We have corporate sponsorships available too


It’s at the Marist Club Rooms on Pascal Street on February 16th 2017. It starts at 5:30 with finger food.


It’s a Men only event (we’ll be doing a Women’s only event later), feel free to buy the man in your life a ticket.

[1] http://www2.clarku.edu/faculty/addis/menscoping/files/addis_mahalik_2003.pdf

[2] https://www.menshealthforum.org.uk/news/five-surprising-and-shocking-facts-about-mens-health

[3] https://www.health.govt.nz/publication/mortality-2014-data-tables

[4] http://www.heartfoundation.org.nz/statistics

[5] http://www.health.govt.nz/publication/cancer-new-registrations-and-deaths-2013

[6] http://www.health.govt.nz/system/files/documents/publications/cancer-new-registrations-deaths-2013-nov16.pdf

[7] https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2013/vol-126-no-1368/article-winnard

Confessions of an overweight Pharmacist part 6: My weakness

Planning things, as I’ve said before, helps you achieve your goals.  Particularly if they are “SMART”

  • S = Specific
  • M = Measurable
  • A =Agreed
  • R = Realistic
  • T = Time-Based

I’ve got part way there.

My specific parts was that I wanted to lose 15kg by the end of October 2017.

My measurable part was the 15kg.

My agreed was kinda agreed, my GP thought it would be a good idea.

Is it realistic?  I think it is.  To achieve my goal I need to lose 1.36kg per month

And the time frame is reasonable.   I’d like to achieve the 15kg goal before October and maintain that weight.

Looking at it all together, I think I can do it.

I’ve had a few attempts at starting, but I haven’t planned it very well.   So I’m going to have another crack at it but put a plan in place first.

Snack Attack!

One thing I’ve come to realise (or to be a bit more honesty stop denying) is that I have a weakness for snacks.  Particularly chocolate.  I wondering how many calories there are in some of my favourite snacks.  At Christmas we tend to accumulate packs of snack size chocolate bars, so i think that’s a great place to start.

I checked the nutritional information on the packet and 3 of the little bars (approximately 25g) contain 511 kilojoules, or in shorthand 511kJ. Or 122 Calories (to be absolutely correct we should call then kilocalories).

I guess the next question is : Is this a lot of energy?

According to The National Heart, Blood, and Lung Institute a person with a sedentary lifestyle (my work doesn’t require any heavy work at all, and I don’t do much exercise) should take in around 2200 Calories a day or 9200kJ.  So the 511kj is around 5.5% of my daily energy intake.  So not a huge amount by itself, but if it’s in addition to my usual energy intake it can be a problem.  Particularly if it’s over a long period.

Increasing Exercise

On way of losing weight or maintaining weight at a stable level is increase exercise so that energy burnt by your body better matches what you take in.  If want to “burn off” the 122 Calories/511Kj.

Here’s a neat table of energy values of some exercise.  As you’ll see from the table how much you burn depends on your weight (my 95kg translates to 209 pounds, and 185lb translates to 83kg).  As you’ll see from the table an 83kg person walking for 30 minutes at 5.5Km/h will burn 200 Calories or 836kJ.  My guess is the 3 snack bars I had will take about 15 minutes walking at a brisk pace.  To give the idea a real world setting walk around a 400m athletics track about 7 times in 15 minutes.

Back to the plan!

I started about a month ago with the intention of sticking reasonably closely to a plan.  Problem is I didn’t have it sorted.

So this weekend I’m going to be trying to get one sorted.

Missed Part 5? Click Here


Confessions of an overweight Pharmacist Part 4 Metabolism; or how come I loose weight really quickly in the first few days but it slows down?

Just about everyone who has tried to lose weight before will tell you that the first couple of kilos go quickly, then the rate of weight loss slows down dramatically.

You can blame you ancestors for that.  In their defense, they we’re just adapting to their situation to try and make the best of it.

It all comes down to your preference for energy sources.  You make choices everyday about where you should get your energy for daily life from.  Not that you personally can do anything about they choice that gets made (well in some cases you can but that’s another day).

A molecule of glucose.

A molecule of glucose.



We like glucose, particularly our brains really like glucose.  In mammals it’s the “food” of choice for mammal brains.  To put it in perspective the brain usually makes up about 2% of our body weight, but consumes 20% of the glucose our body uses.





The problem is you don’t get a lot of energy out of glucose for a given weight.  As you can see from the table below fats “contain” more than twice as much energy per gram than carbohydrates.  (Table was from http://www.nutritionfoundation.org.nz/nutrition-facts/Nutrients/energy ).



Carbohydrate 17kJ (4 kcal) per gram
Protein 17kJ (4 kcal) per gram
Fat (Lipid) 37kJ (9 kcal) per gram
Alcohol 29kJ (7 kcal) per gram


So why do we prefer to use glucose over fat (lipids to give them their technical name), when they can release so much more energy?

It’s all about convenience.

The process of converting glucose to usable energy is much simpler and quicker than turning lipid in to usable energy.  When your ancestors needed to get away from something that wanted to eat them, they needed the energy instantly.  So we decided way back in time that we’d use fats or lipids as a way of storing energy, and carbohydrates (glucose) as the fuel for immediate use.  So we mainly store excess carbohydrates (sugars) as fat (lipid), and for most of human history it’s been an advantage to accumulate and store excess more efficiently.

We do store some carbohydrate, as glycogen, in the liver.  So if we need more quick energy, we can get at it quickly.

So how does this relate to the quick loss of weight in the first few days of a new diet?

Each gram of stored glycogen has 2 grams of water associated with it (for reasons of deep biochemistry).

The glucose stored as glycogen is released when our blood sugars start to drop. Our blood glucose level are usually kept in a narrow range by our body.  Usually between around 5 and 7 mmol/l.  As blood glucose levels start to drop the body starts breaking down glycogen to bring this level back up again.  When you breakdown glycogen the water used to store it is released too.  The water released then ends up being peed out quickly after that.

So when you start reducing your food intake, your body recognises that blood glucose isn’t where it should be and so starts using glycogen.

What happens when the glycogen runs out?

Most people only have between 100 and 120g of glycogen stored, and that runs out pretty quickly.  If you’ve ever worked or exercised so hard that you’ve just run out of energy or “hit the wall” you’ll know what this feels like.   Luckily fats come to the rescue after a little while and you get your second wind and can get up and carry on.

As you can see if we could manage a smoother change between burning carbs and fats it would make losing weight a bit easier.

Fortunately we can.

That’s coming up in a later post.


Well actually this one ended up being the next post:

Shake it baby!

Missed Part 3?  Click Here



In pervious posts we’ve talked about the negative effects of poor or reduced sleep, today we’re talking about insomnia, or not being able to either get to sleep or not getting enough sleep because of waking during the sleep cycle.

Most people at some point in their life will experience a sleepless night. Although this is quite annoying and can be disruptive to routine, it’s normal. Insomnia on the other hand is a persistent period of sleeplessness. It can either be trouble getting to sleep, staying asleep, or both.

Insomnia can be both a symptom of another problem (underlying) problem, or influenced by lifestyle factors.

Types of sleep

There are two board “types” of normal sleep recognised. The technical terms are orthodox and paradoxical, and they relate to distinct differences in the level of consciousness during sleep. Orthodox or Non REM sleep (NREM) takes up 75% of normal sleep, and is divided into 4 “stages” called stage 1-4.  Stage 3 and 4 are also called slow wave sleep (SWS), and are the deepest level of sleep, and tends to be earlier in the sleep cycle.

Paradoxical sleep or Rapid Eye Movement (REM) sleep makes up the other 25% of normal sleep. REM sleep and SWS are very different. REM sleep is where most dreams and hallucinations occur, and tends to occur most closer to waking time.  Whereas SWS is associated with a variety of repair and reorganisation functions. SWS is necessary for not only good general health, but survival.



Sleep Hypnogram


Causes of insomnia

Insomnia itself is divided into two types; primary and secondary.

Primary insomnia is insomnia that can’t be attributed to another cause be it medical, psychiatric, or environmental. Secondary insomnia is a sign or symptom of another disease or illness.

There are several common causes of secondary insomnia, and most people will be able to relate to some of them. Particularly stress and anxiety.


Anxiety & Stress

Worries about life events can contribute to insomnia and most people can relate examples of this, even worries about getting to sleep can cause insomnia!

More serious general anxiety problems, and specific problems like Post Traumatic Stress can contribute to insomnia.


Changes in environment or lifestyle

Changes in shift pattern, or working later or earlier can disrupt your body clock or circadian rhythm which can take time to readjust. Jet lag too!



One of the cruellest aspects of depression is that people who battle with depression frequently describe having no energy and feeling tired all the time. They also describe not being able to get to sleep at night or have difficulty in staying asleep. When sleep patterns of people with depression are studied they tend to have frequent awakenings, have quicker onset of REM sleep, and less NREM sleep than non-depressed people.


Having a large meal close to bedtime can sometimes cause problems. Particularly if the meal is rich in Tyramine*. Light snacks are usually OK. Lying down after large meals can also make reflux worse, which can be extremely uncomfortable can cause insomnia in it’s own right.


Some medications have a stimulant effect on the body. The most commonly used of these are cough and cold medicines. They usually contain a medication call phenylephrine, which is used as a decongestant (it stops production of mucous or snot). We generally don’t advise taking them after 4 or 5pm.

The most commonly used prescription medicines that can cause insomnia are steroids. Most asthmatics will have used prednisone at some point in their life to help regain control over a bad episode of asthma (usually with a course of anti-biotics too). Steroids can be quite stimulant in some people and are generally best taken with breakfast to minimise this. Kids in particular.

Stimulants such as Ritalin can also cause problems with insomnia.

Some anti-depressant mediciations can also cause insomnia. As can some blood pressure and heart medications.

Some medicines for other long term conditions can also cause insomnia. Some times this can be minimised by changing dose times. If you think this applies to you, talk to one of our Pharmacists there may be ways to minimise this.

Weight loss medications (from your Doctor, Pharmacy, or other providers) can be stimulant. If you have any questions about them you can always call in and ask our advice.

Mental Health

Other than depression, which is the most common mental health issue in NZ, Post Traumatic Stress Disorder (PTSD) is frequently associated with vivid, recurring nightmares.

People suffering from schizophrenia tend to have altered sleep patterns, and schizophrenia is also associated with increased dreaming and nightmares.

Physcial Health

Underlying health problems such as Pain, Heart Burn, Asthma, Hyperthyroidism, Prostate problems, Parkinson’s, and Alzheimer’s can all cause probems getting to and staying asleep.

The best way to tackle insomnia caused by these conditions is to sort out the condition itself. With some of these problems it’s not possible to completely get rid of the symptoms that contribute to insomnia, but minor changes in when and how medicines are taken can improve your quality of life.

Recreational Drugs

Alcohol is by far and away the most commonly used recreational drug used to induce sleep, and although it is sedative it changes sleep patterns later in the sleep cycle[1].   Alcohol in breast milk can also change a breastfeeding infants sleep pattern too[2].

P (Methamphetamine) is strongly stimulant with reports of chronic users not sleeping for 3-15 days[3] depending upon level of use. It doesn’t take a genius to realise that this isn’t healthy.

Caffine is another very commonly used drug. It’s found in a wide range of drinks and foods. Most people associate caffine with their morning Tea or Coffee, but it’s also found in energy drinks (along with other psychoactives), sports drinks, foods such as chocolate, and soft drinks. If you are having trouble sleeping, and drink any of those things mentioned above a good place to start is not consume caffine after midday.

Nicotine is also a stimulant.
* Tyramine rich foods include mature cheeses, cured meats like bacon & salami, some beers, pork, & chocolate.

Next post we’ll talk about treating insomnia with medication, and more importantly addressing some lifestyle changes that can be surprisingly effective.


[2] http://pubs.niaaa.nih.gov/publications/aa41.htm

[3] http://www.cesar.umd.edu/cesar/drugs/meth.asp

Natural Health and the Common Cold

One of the most frequent questions I get asked is “What can I do to help with my cold?”

Mostly treatment is all about controlling the symptoms, and given that close to half of all time taken off each year in New Zealand is due to colds, the number of questions isn’t surprising!

  • For blocked & runny noses Otrivine Plus works well 
  • Preparations like Codral, Sudafed & Maxiclear are also helpful with body aches, headaches, and fevers that come with colds.
  • Difflam lozenges are particularly useful for sore throats

There are also a number of natural health products that can help you get on top of a cold.  Some of the results may surprise you.



Vitamin C

Vitamin C is only really effective if you take it every day.  If you’re taking Vitamin C before cold symptoms start there is some evidence that the duration of the cold may be reduced the duration of the cold, but Vitamin C doesn’t appear to reduce the number of colds you catch. There are advantages to taking Vitamin C if you are out in the cold for a short period of time or do severe physical exercise.  People who fall in to this category, and take Vitamin C do catch fewer cold than those who don’t.



Echinacea however, does reduce your risk of catching a cold, and reduces your need for medicines to control symptoms.  The science behind this is strong.  The study that reached these conclusion was a large (about 700 people), randomised, double blind trial.  It found that taking Echinacea every day had:

  • Decreased symptom recurrence
  • Fewer viral infections
  • and used less medication to control cold symptoms

Even if you don’t want to take Echinacea every day, taking it after the onset of a cold does have benefit in reducing the severity, and duration of the cold.  There are some issues for asthmatics, so it’s best avoided if you suffer from Asthma.



Zinc is the real deal, or at least it is if you take the right dose. Several placebo controlled studies have been reviewed that used Zinc Acetate, and other zinc compounds.  The pooled results showed the following;

  • Dose of Zinc needs to be greater than 75mg of Zinc Acetate (or equivalent) per day
  • Doses below 75mg had no effect on the duration of the common cold
  • Trials using Zinc Acetate at > 75mg doses reduced the duration of the common cold by at least 2 days, and in some studies up to 4 days.

Most people have around 3 colds per year, and most colds last for around a week.  So you you possibly have 12 more cold free days a year.

You do have to start sucking the zinc lozenges within a day of the cold starting, so it’s a good idea to keep them handy.


Acne Causes and Treatments

What is Acne?

Acne is a common chronic disorder affecting the hair follicle and sebaceous gland, in which there is expansion and blockage of the follicle and inflammation. There are several variants.

Acne is caused by the pores of the skin becoming clogged up with oil, old cells and bacteria. It commonly occurs on the face, shoulders, back or chest. It may start as a few raised white bumps and develop into small pustules. In severe cases, firm, painful lumps called cysts can develop under the skin.

Different Types of Acne

Acne has many stages

What causes Acne?

Anyone of any age can develop acne, but it appears more troublesome in teenagers, mainly because it can be triggered by hormonal changes. It is also worsened by some medicines and cosmetics. There is no evidence that acne is affected by fatty foods, such as chocolate, although diets high in sugar (particularly high glycaemic index foods), and dairy(1)  may worsen acne.

What can I do about Acne?

How can I get rid of Acne is a common question we get at CookStPharmacy.  All acne is helped by regular cleansing of the skin and hair with gentle non drying cleansers that are available from CookStPharmacy. Mild acne with blackheads and occasional small pimples will be improved by gentle cleansing.  Avoid squeezing and picking at the spots as this can cause scarring. 

Moderate acne may require over-the-counter preparations that dry up skin oils. More severe acne with reddened areas around the pimples, deep painful cysts or significant scarring may benefit from prescription medicines to treat these over a long period of time. Many of these medicines have side effects and advice about the use of these medicines is also available from CookStPharmacy.  There is also evidence that Pantothenic Acid (Vitamin B5) is very useful in treating Acne(2).


(1) https://www.dermnetnz.org/topics/acne/


Mums who take Omega-3 fish oil during pregnancy decrease the risk of asthma in their children by 30%.

The on going saga around the benefits or otherwise of Omega-3 oils has taken an interesting turn.

In an article published in the New England Journal of Medicine this week researchers at the University of Copenhagen found that children of mothers who took 2.4g of fish derived Omega-3 oil had a lower risk of developing asthma or persistent wheeze(1).

In the study mothers were randomly assigned to test or control groups.  The mothers were given either 2.4g Olive Oil or 2.4g Fish Oil  daily from week 24 of pregnancy.

Children of control group (Olive Oil) mothers had a 30% greater risk of developing Asthma or Persistent Wheeze than children of test group  (Fish Oil) mothers at the 3 year follow up. (23.7% vs 16.9%)

There was also reduced risk of children of test mothers developing chest infections. (31.7% vs 39.1%)

What makes this study powerful is that the study was well constructed.   There were 695 children taking part in the trial initially, with 95% of them taking part in the 3 year follow up.   Both investigators and mothers were unaware which group they had been assigned to.


Christmas and New Year

When we think of Christmas, most people think of spending time with loved ones, celebrating the year that has been and the one to come. Perhaps eating and drinking a bit too much, and generally taking it easy.

Unfortunately at Christmas time some of our fellow Kiwi’s don’t feel uplifted by holidays, or look forward to the New Year. Christmas for some brings home their feelings of isolation and loneliness, and memories of happier times with family and friends. It may come as a bit of a surprise that suicide rates in New Zealand increase over the holiday season.

In New Zealand most suicide victims are male, and Maori men are over represented in suicide statistics. Risk factors that increase a person’s risk of suicide are social isolation, mental health issues, exposure to trauma (like natural disasters, or violence, suicide of a relative or someone close), stressful life events (like chronic pain, relationship stress, death of a friend or family member, or job loss).

There are things that we can do as friends and neighbours to help reduce the risk. The biggest thing we can do ties in well with the Christmas season’s spirit of good will. With more families spread across the country and the world there has tended to be a loss of family connection, and this is particularly felt at Christmas. Make contact with your neighbours who might be alone, particularly newly widowed, or who have had an otherwise rough year. Share a meal, or even a cup of coffee.

If you’re feeling the pressure this Christmas one of the best things you can do is talk about it. You’d be surprised at how simply sharing things can put them in perspective. It’s a great first step in tackling depression and anxiety. You’ve probably seen JK on the TV talking about depression, and how it affected his life. So you know you’re not alone. As many as one in five New Zealanders (that’s 20%) suffer from depression at some point in their life, and as many as a quarter of New Zealanders suffer from anxiety at some point in their life. The person you talk to is more than likely to have been through it, or had a close friend or family member who has.

If you’re feeling like it’s all too much and are thinking about hurting yourself pick up the phone and call one of these numbers

  • Lifeline 0800-543-354
  • Suicide Prevention Helpline 0800-TAUTOKO (0800-828-865)
  • Samaritans 0800-726-666

Depression is described by sufferers as constantly feeling flat, “down”, or hopeless. People also describe getting no pleasure or enjoyment from things they used to enjoy. Other symptoms include

  • feeling tired all the time, or lacking in energy
  • irritability or restlessness
  • changes in sleep pattern (not being able to sleep, or sleeping all the time)
  • trouble concentrating
  • reduced sex drive
  • changes in appetite (both eating more and not eating at all)
  • changes in weight (both gain and loss)
  • thoughts about self harm or suicide

We see an enormous number of prescriptions for anti-depressants of one type or another everyday. But medication can only do so much, and there are things you can do to help too. Mild to moderate depression has been shown to respond to

  • music therapy1
  • moderate exercise2
  • relaxation techniques (such as yoga)3

although results are a bit variable. As there is no “down side” to any of these, it’s worth trying them in the first instance if you’re feeling a bit down or using them as an add on to medications.

There are also non-prescription medications that have been shown to be helpful. The two most commonly used are s-adenosyl-methionine (SAM-e)4, and St John’s Wort5. Both however need to be taken with caution if you are using other medications. If you are considering taking either come in to CookStPharmacy and get advice from one of our Pharmacists.

New Years Resolutions

Hot on the heals of Christmas is New Year, and with it New Years resolutions. According to Nielsen6 the most common New Year’s resolutions in 2015 were;

  1. Stay fit and Healthy
  2. Lose weight
  3. Enjoy life to the fullest
  4. Spend less, save more
  5. Spend more time with family and friends.

With any change planning is critical. At CookStPharmacy we can help you with the planning, as well as achieving your goals. We’re also here to give you encouragement and support as you help strengthen positive habits, and get rid of the negative ones. Be it quitting smoking, changing your diet, loosing weight, or refocusing your outlook on life.

So here’s looking forward to a healthier, happier 2017. Drive safe, swim safe, play safe these holidays from all of us here at CookStPharmacy.

2 http://www.cochraneprimarycare.org/pearls/exercise-may-improve-depression

3 http://www.cochraneprimarycare.org/pearls/relaxation-techniques-have-some-benefit-depression




The plan! The plan!

Hervé Villechaize

In the last post I talked about how having a plan was an important tool in helping achieve goals.   We talked about SMART goals (Specific, Measurable, Agreed, Realistic, and Time-based).

I find plans really useful because they help me keep focus (or probably more accurately remind me to refocus) on the longer term.   I find in day to day life I tend to get distracted by the things in front of me at that point in time and so having a little nudge in the background that just keeps reminding me where we are headed is really useful.

Another useful thing is RTFM or Read the Fabulous Manual!  Again something I didn’t do when starting with the Vita Diet shakes.

Get Smart

My plan breaks down like this

The SPECIFIC goal is to loose 15Kg and maintain that weight by the end of October 2017

The MEASURABLE part is the weight loss of 15Kg (I’m currently 95Kg and my BMI is 28Kg/M²

The AGREED part is that I have agreed with myself that I need to loose weight (which isn’t as stupid as it sounds.  The first step to solving a problem is acknowledging that there is one) as part of looking after my health.

The goal is REALISTIC because the weight loss is spread over 10 months.

It’s TIME BASED the target date for achieving and maintaining the weight loss is set as the end of October 2017.

Now that we have targets set, and all the parts of the SMART goal set up I’ve got to RTFM.

What does the Manual say?

The Vita Diet Manual  offers this advice;

Dieting involves changing your usual eating habits

this is something I will need to focus on.  I have a sweet tooth that I struggle to keep on top of.  I’m expecting this to be a real challenge for me.  Modifying behaviour is difficult in just about all situations, particularly when “pleasure” is the feedback that drives the habit/behaviour.

The Medical Vita Diet works by replacing 2 meals a day with meal replacement shakes for the initial weight lose phase.  It is what is called a Very Low Calorie Diet (VLCD), or a Ketogenic Diet.  Remember in Part 4 we talked about glucose and fats (lipids) as fuel for the body?   The principle behind VLC or Ketogenic diets is that you reduce the available glucose (and other sugars and starches) in your diet and force the body to make the switch to burning fat (this is called lipolysis).

There somethings you need to be careful with with any diet.  That’s making sure your aren’t doing more harm than good be not giving you body the nutrients required to repair and maintain your body in good health.   Protein is particularly important.

From the Vita Diet Manual 

  • Replace 2 meals per day with Vita Diet supplements
    • you can add salads or vegetables from the list they provide to add bulk and give a “full” feeling.
  • The third meal of the day should consist of lean protein (120g for women and 200g for men) as well as salads and vegetables from the list.

They also encourage drinking plenty of water through the day to replace the water lost when glycogen is broken down.

Taking the first step

I think I can manage this.  I will have to ditch a couple of my favourite things for a while.  Like cheese, salami, & ham, but I like cottage cheese, and eggs so it may not be all bad.

I’m not sure which meals I’m going to replace with the sachets.  I tend to get a bit hangry if I don’t have breakfast so  I will probably start with lunch and dinner and see how I go.








Missed Part 6? Click here.

Confessions of an overweight Pharmacist part 5: Shake it baby!

I’ve been reading a bit about ketogenic diets lately so I can better understand what’s going on.    I’ll be writing something about them later.

Today I tried the Vitadiet Swiss Chocolate Shake. It mixed easily with water, and after a quick shake formed a reasonably smooth drink.

VitaDiet Swiss Chocolate Shake. 48g $3.99

VitaDiet Swiss Chocolate Shake. 48g $3.99

It didn’t taste too bad either.  Don’t go expecting a rich creamy shake, but wasn’t like some diet shakes that taste like watered down watery milkshake either.

I’m quiet expecting to be a little bit Hangry this afternoon.  I’ll let you know.


Missed Part 4?  Click Here

Part 5: My Wekness