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Were you given Antibiotics prior to your health problems?

Discussion in 'Diabetes Discussions' started by AliB, Sep 25, 2009.

?

Were you given antibiotics prior to weight issues, health problems, etc. ?

  1. As a Child?

    16 vote(s)
    66.7%
  2. As a Teenager?

    17 vote(s)
    70.8%
  3. As an Adult?

    16 vote(s)
    66.7%
  4. Have you experienced weight gain issues?

    21 vote(s)
    87.5%
  5. Have you experienced weight loss issues?

    5 vote(s)
    20.8%
  6. Do you, or have you experienced other health problems?

    18 vote(s)
    75.0%
  7. Do you have T1 Diabetes?

    6 vote(s)
    25.0%
  8. Or T2?

    17 vote(s)
    70.8%
  9. Do you have Candida or other fungal infections or issues?

    11 vote(s)
    45.8%
Multiple votes are allowed.
  1. AliB

    AliB Type 2 · Well-Known Member

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    I just thought it might be an interesting exercise to see how many people who read this thread were given antibiotics at some point prior to acquiring their health problems, weight issues, etc. Diabetes (especially type 2) is often the culmination of a period of other health issues and/or weight problems.

    I was given quite a range of AB's as a child for normal childhood illnesses and undoubtedly the majority were given quite unnecessarily.

    I believe that just one course of antibiotics will undermine the gut flora and consequently the immune system enough that we are then far more susceptible to subsequent illnesses and more reliant on ABs. It's a vicious circle.

    The move has now been away from Anti-biotics toward Pro-biotics which may be a good move (if it is done properly), but for many, the damage may have already cost them years of problems.

    Certainly, rather than destroying the gut flora we should be doing everything we can to support and strengthen it, because it is such a crucial part of the immune system. Things like Swine Flu are a testing ground for the strength of the nations' immunity. Some will succumb badly, others may succumb lightly, and still others may not even realise they had it. Many will not catch it at all. Why? Because they have a strong immune system.

    If we have a gut that has had the 'soldiers' destroyed and rogue pathogenic microbes have got their feet under the table then who knows what damage they could inflict. They consume vital nutrients, produce copious amounts of different toxins, alter processes within the body for their own ends and just behave very parasitically, so the fact that we end up with Diabetes, Obesity, Arthritis, Depression, et al is not so much of a surprise.

    On top of that we provide them with a continuous feast of yummy carbs and remove the saturated fats that would help to destroy them. Is it any wonder that the NHS is groaning under the weight of sick people? Of course, the only treatment they can offer you for bacterial overgrowth is more antibiotics which don't cure it but just knock it all back for a while until it comes back with even more vengeance!
     
  2. Useless Pretty Boy

    Useless Pretty Boy · Well-Known Member

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    Antibiotics several times, all through life. No health issues but type 1 diabetes, which is currently believed to be due to a genetic flaw. So no detrimental effect. Chalk up a victory for antibiotics.

    And I'd like to point out that if someone takes antibiotics and doesn't take a course of probiotics following the completion of their prescribed course, then they're just ASKING for trouble. Sigh. Not that that'll do anything to disuade you, will it?
     
  3. sugarless sue

    sugarless sue · Master

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    Antibiotics, like all other medications , have side effects. I'm sure that everyone , at some point of their life, has taken them. To add them to the 'scare' list of 'drugs that maybe caused my diabetes' is , in my opinion, irresponsible. Do you really want to be responsible for someone refusing antibiotics and endangering their health ?

    I saw this happen when there was a scare about the whooping cough vaccine and watched , with sadness , as a good friend's child died because her parents had not allowed the vaccine , they still blame themselves all these years after.

    Antibiotics have their place in helping us. The overuse of them however, is a different story.
     
  4. cugila

    cugila · Master

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    I had antibiotics at various times of my life without any problems at all. I have to say I agree totally with what Sugarless Sue said. Every person reacts to things individually and I do not think that you can blame Antibiotics for all the ills that befall a Diabetic.
     
  5. catherinecherub

    catherinecherub · Guest

    I have just read your opening post and so voters on this poll would also need to let you know if they support your views on antibiotics, health concerns, fats and carbohydrates. Anyone who votes also needs to write a post about their point of view don't they? Is this two polls in one?
     
  6. jopar

    jopar · Well-Known Member

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    I like most people had antibiotics and before I was 3 months old as I had pneumonia and verious courses for infection over the years...

    I doubt that there is a connection whats so ever that Antibiotics are the cause of Diabetes, as well there be one hell of a lot more of us around... In reality we are still a small number of the total population indeed...

    AliB, it seem that you far from dealt with becoming a diabetic and are searching for an answer an explination to why! sadly there isn't an answer to this very important coping mechanism that as humans we need to know an reason why to cope better... some of us will come to terms with it a lot quicker others as I did take a lot longer to get there to learn that the answer to the why question is actually there is no answer!!!

    But to suggest or even hint that we should avoid antibiotics is irresponsible indeed... I know your feelings about what are the plights of modern man, but many many Induit Indians who's diet is used often to underpin the low carb theory died of infections and some of these would had survived if only they had access to antibotics, this is the same in many many poor countries around the world... Adults and children are dying every day because they never had access to simple cheap antibiotics..

    Yes I would agree sometimes these are prescribed when they are useless, the blame for this is partly an doctors fault, but alas some of the over prescription is based on the demaned of the patient who argues and bemoans a doctor who dare tell them that they have a virus, to which antibiotics are compeltly useless to treat with...
     
  7. AliB

    AliB Type 2 · Well-Known Member

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    Sorry to say, the poll system didn't really do what I hoped it would, but you live and learn. Not sure if I can take it off now.

    I do feel that antibiotics may have their place and be necessary in certain circumstances - I for one would not like to be faced with something like Necrotising Fasciitis without them, but my issue with them was over the indiscriminate use of them over the last 50 years.

    Fleming stated when he introduced Penicillin to the World that not only should their use be 'restrained' but that yoghurt should be consumed as a support to the gut. If anyone ever had taken any notice of him in that regard, it soon went out of the window. When being given them I have never been told by anyone in the Medical Profession to take yoghurt.

    The Medical Profession has pulled back from dishing them out willy-nilly now (there are posters in our local surgery stating that) - they have finally witnessed enough bacterial resistance to facilitate that, and resistance is where antibiotics fall over. Sooner or later the bugs get the better of them and for certain things they often are only a temporary fix until the beggars come back stronger than ever.

    But in making the bugs stronger, they are also making us more vulnerable and less able to fight them off. So they create a vicious circle. And we are stuck in the middle.

    I was given them as a child on many occasions - for childhood bugs that were generally viral and didn't even need them. I became a podgy teenager, became very fatigued by the age of 15, had systemic Candida, and gained weight over the next decade or two peaking at 16 stone. I knew there had to be a link somewhere, and the antibiotics-kill-all-bugs-both-good-and-bad-but-don't-touch-the-yeasts concept has made more sense than anything.

    Although I have lost some weight I haven't yet got much energy back, and I don't expect to until I have beaten off the gut bugs. They are robbing my body of my energy and nutrients. I have been fatigued for nearly 40 years and I am blowed if I am gonna let the blighters get me!

    If you read my previous thread about stomach bypass curing Diabetes and the possible link with SIBO, perhaps this thread will make more sense.
     
  8. Manogwent

    Manogwent Type 2 · Well-Known Member

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    In the past i was given antibiotics to deal with chest infections, septic cuts etc and never had side effects apart from the normal 'runs' occasionally. i have never picked any serious illnesses and have always been active, never been in hospital with an illness,only for 'wear and tear' on shoulders.i agree that GP's used to give out AB's willy nilly and bugs became resistant ( just like rats) and that is why we have MRSA and associated nasties plaguing our hospitals etc but i certainly wouldn't blame my Diabetes on AB's although having gone for an audiology assessment yesterday,I was asked about AB prescribing as apparently it can be linked to hearing loss/damage lol. as if we didn't have enough to contend with!! :lol: :lol:
     
  9. Spiral

    Spiral · Well-Known Member

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    The diabetes.co.uk poll tool is a very blunt instrument. Antibiotics are prescribed so widely that there is nothing to compare it with. You might as well compare the explosion in all the modern ills with the growth in families owning a car or television :?

    I avoid antibiotics if at all possible, yet I know that they can make me feel much better for example when I have had a dental abcess, a strep throat, a chest infection that has not cleared up, ear infections, eye infections etc etc My mum's ulcer improved after the antibiotics.

    I'm currently using an antibiotic cream for a long term skin problem. Ironically, Roseaca is not an infection but the antibiotics have been a very effective treatment for me.

    Whenever I take oral antibiiotocs I get thrush about 2 weeks after they finish, as well as problems with irritable bowel.
     
  10. AliB

    AliB Type 2 · Well-Known Member

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    I think your last sentence says it all. Yes, getting thrush after taking antibiotics is very common and the IBS is a reaction to that. After all the antibiotics kill the gut bacteria both bad and good but don't touch the yeasts.

    That gives them house room and nothing to defend the gut from them. As I often quote 'kill the soldiers and the city is undefended'. Because people are not advised to take probiotics to replace the bacteria then it can only get worse.

    Unfortunately we can't see what is going on down there and what the beggars are up to.

    I have spent a lifetime battling against yeasts, fungal issues and SIBO. Whilst I have managed to get the yeasts under control, the SIBO is a different matter. Yes, I could take antibiotics, but what normally seems to happen is that whilst the ABs knock it all back for a while, they soon come back again and with a vengeance. They are now stronger and more resistant. So you try a different one, and so it goes on. What if I get to a point where they are so strong nothing will touch them?

    Perhaps they may be necessary in certain circumstances, and maybe they work in certain situations, but in others they just make the whole thing a lot worse.

    People find with many drugs that the common element seems to be that they end up having to take more, or different , or stronger as time goes on.

    People have an antibiotic, then they get thrush. They go to the Doctor and get Nystatin, or Flagyl or some other prep. That works for a few weeks, or maybe a few months and then they have to go back. Funnily enough it doesn't have the same effect the next time round. That has happened to me.

    An antibiotic will work if it is used for the first time on a particular problem that can be dealt with and done and dusted. If there is any risk of any residual 'survivors', the next time it won't work nearly as well. In the meantime though it may have weakened our natural defences.

    I think really that my argument, to a certain extent is surely, if you build the walls strong enough and have a full and efficient fighting force then they will fight off any attackers or intruders. The stronger the gut flora, the easier it is to fight off any pathogenic bugs and stop them getting a hold.

    Antibiotics destroy and undermine - and I think the undermine bit is more insidious. Probiotics build and support. And that is the big difference.

    If we have a very strong immune system we won't get problems with 'Strep throat' or 'tooth abcess' because the immune system will deal with it.

    As I just posted on another thread, we have a friend. She is in her late 60's and looks at least 10 years younger. She has hardly had a days' illness in her life. She has never had antibiotics. And she eats raw garlic sandwiches. She has such a strong immune system she fights everything off.
     
  11. Useless Pretty Boy

    Useless Pretty Boy · Well-Known Member

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    If she eats raw garlic sandwiches, I'd assume that includes male suitors.

    Tell me though, did you ever finish the courses you were prescribed? Because if you didn't, then don't complain about infections coming back. You're trying to create a scare situation because you messed up and want to blame your situation on doctors because then it wouldn't be your fault.

    You want to talk about insidious? THAT'S insidious.
     
  12. Luiseach

    Luiseach · Member

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    I am the daughter of a very 'alternative health' mother, and there is absolutely no way that she [my mother] would advocate not taking antibiotics if you were prescribed them. Everyone who has chosen to educate themselves about the pills they may or may not be prescribed by a doctor knows that if you take antibiotics, you take probiotics after your course has finished to replace the 'good' bacteria.

    AliB, I don't know you and I mean this in an entirely respectful way, but I have seen in other posts that you are size 18 and a Type 2 - is it not diet and lifestyle that have caused this, rather than antibiotics?
     
  13. AliB

    AliB Type 2 · Well-Known Member

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    Undoubtedly diet has played its part - if you have read any of my other posts you will also see that that I believe that the very high-carbohydrate Western Diet has played it's part in fuelling the epidemic rise of obesity and diabetes, etc., but the fact that there are people out there who don't get fat on this diet and who are still relatively healthy does raise questions.

    As I keep repeating, I am not against antibiotics per se, or sensible use of them when absolutely necessary, but I do believe that the indiscriminate use of them has caused problems.

    I have been given antibiotics over the years - did I ever state that I have not finished any courses? Please don't make assumptions from words that aren't there - UPB, you are a master at that! In fact I don't think I made any mention of unfinished courses at all.

    We have a friend (yes, another one) who was put on to antibiotics for 14 months. 14 months!!! Anyone in their right mind knows that if two courses haven't worked then your health problems need further investigation. She didn't know that. As a young woman she trusted her doctor implicitly. What that did to her was completely trash her immune system. She has one health problem after another and succumbs to everything going - in fact it is a miracle she is still here.

    Yes that was an extreme experience but even if our antibiotic exposure is spaced out it will still decimate the gut flora and weaken the immune system.

    Yes, I am size 16 -18 (thank goodness after years at 24-26!) and T2, but both the weight issues and the diabetes came along long after the exposure to antibiotics. Of course I knew in later years when I had 'educated myself' that probiotics/yoghurt should be taken with and after AB courses, but I didn't know that when I was a child. I didn't know that when I was a teenager. I didn't know that when I was a young adult. By the time I knew that I had got to the point where I was fed up with crawling with Candida and jolly well was going to avoid taking antibiotics if I could help it and so far I have managed ok without them. That's not to say that I won't need or take them in the future though.

    I am just trying to look at this logically. Yes, antibiotics kill pathogenic bacteria. But they also kill good bacteria - some of which is not replaced by taking probiotics or yoghurt. Gut bacteria is not just Lactobacillus - there are hundreds of different types doing different things. Who knows what the optimum gut bacteria should be? Once it is destroyed, how can you ever get it back?

    Medical Science acknowledges that their understanding in this field is very limited. They don't understand the role of a lot of these bacteria and they don't often even know whether a bacteria is good or bad! It is only comparatively recently that the role of gut bacteria and 'probiotics' has been investigated.

    But even the Medical profession can see the benefit of probiotics - our local Hospitals have been conducting a trial of giving pre-op patients probiotics to boost their immunity against Hospital-acquired infections like MRSA and C.Diff, etc.

    Babies guts are pretty much sterile when they are born and they pick up their gut bacteria predominantly from their mother, but if her gut bacteria is compromised, how can she pass good flora on to her child? The child then itself has already compromised bacteria and then as the weak gut flora constitutes a weak immune system, succumbs to different infections, has to have antibiotics, which further destroys the delicate gut balance.

    Yes, yoghurt is a great probiotic source, but how many people today consume plain live probiotic yoghurt? You may, and I may, but there are an awful lot of people out there whose idea of yoghurt is a sweetened and flavoured dead custardy muck which will do nothing except encourage and feed pathogenic microbes.

    I actually ate a pretty good diet. As a child my Mum grew her own veg and some fruit, cooked delicious home-made meals, baked her own, usually wholemeal, bread with flour purchased from the mill. She made jam, wine and all sorts of other wonderful things. She made fruit cake sometimes but we didn't always have a dessert.

    I followed her lead. We had wholemeal bread and butter, I would make my own preserves, bake cakes, cook delicious dinners. I did not then, nor do I now serve rubbish to my family. But despite that, my weight issues and fatigue began in my mid-teens for no apparent reason and have bugged me for the last 40 years.

    Of course I want to know why. Doesn't everyone? Sorry, but I am not just one of those people who accepts that this is it. it is people like me - those who challenge established ideas and beliefs and who won't give up looking for answers, who very often find them. And those answers don't always come from where we expect them to...........
     
  14. Spiral

    Spiral · Well-Known Member

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    I'd hardly call my use of antibiotics indiscriminate. I think my GP must find me an infuriating patient as I invariably refuse the antibiotics, prefering instead to treat problems with rest, homeopathic medicine or herbal medicine (depending on the problem) and simply letting nature take its course, whilst increasing my fluid intake and spending a lot of time in the shower with chest or sinus infections. Usually, when I go to see him I want him to tell me that I'm not dying and write me a sick note.

    I rarely use antibiotics, when I do I take them as exactly as prescribed, and I ALWAYS take a probiotic with them. This makes no difference to whether or not I develop thrush - sure as anything, I get thrush 2 weeks after they finish, along with a fair bit of "intestinal distress". This is why I usually refuse the antibiotics, I shorten my illness a few days and spend about another month trying to sort out the upset in my physiology.

    I have very clear personal criteria for taking antibiotics - one being the physical distress of the bronchitis I have developed after the oilseed rape season hayfever in 2 out of the last 3 years. I treat the thrush with Canestan or something similar.

    However, this happens rarely because I rarely take antibiotics. When I take antibiotics I am really ill. I'm not saying that other people are not really ill, simply that I may make a different judgement on when to use antibiotics. If my ailment involves high levels of pain (as opposed to discomfort) or green/yellow fluid is coming from my ear/eye :shock: my antibiotic threshhold is much much lower.

    Interestingly, I have taken more oral antibiotics in the last 2-3 years than the whole 10 years (or more) previously. I rather suspect I have had undaignosed diabetes as I was insulin resistant about 3 years ago. Interestingly, this year, with my blood sugar under much better control I didn't get bronchitis. My last lot of antibiotics was last year (May 08), at a considerably earlier stage in the bronchitis process than the year before 9May 07), when I had been really unwell.

    I'm not good at western medicine :| And I feel somewhat vindicated in my skepticism since I realised the Healthy Plate was making me ill.

    What health benefits are associated with male suitors? And are the health benefits of garlic improved by the addition of an occasional male suitor to the sandwich? And were these suitors cooked or raw, like the garlic? Might the health benefits of the garlic be improved simply by leaving out the bread, even though the male suitor would probably be low carb? What is the relevance of your comment? I think we need to be told :roll:
     
  15. hanadr

    hanadr · Expert

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    Ali
    I was one of the first civialians to be treated with pennicillin after it was no longer restricted to use on military personnel in the early 1950s. I had what might have been Glue ear, but I was certainly deaf. the injections were very painful to a young child and didn't work. I ended up having some kind of surgery to resote my hearing.
    It's a long time ago. I also had streptomycin treatment when I had septicaemia with osteomyelitis in my early teens. That one certainly did a lot of damage. Including infertility, but without it, I might be dead.
     
  16. valattrevear

    valattrevear · Well-Known Member

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    I have fairly regular courses of both antibiotics and steroids to combat massive chest infections which occur sometimes three times a year, and always have a "rescue pack" of both at home so that I can start my own treatment when necessary. I realise that ten years of taking regular courses of both have helped my diabetes along the way, more so the steroids, but I am here to be able to say that and so I am very grateful for the scientists who developed these vital resources!
    Val
     
  17. AliB

    AliB Type 2 · Well-Known Member

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    Thanks so much for the rip-roaring giggle Spiral. That was pretty classic!

    Hana - yes, I do believe that antibiotics save lives, but I also feel that they are something of a double edged sword, dispensing help on one hand but damage of some kind or another on the other. I am sure that if you can bounce back from having them without any apparent problems (but then we can't always see what is going on or recognise the signs), then you have done well - many of us are not so fortunate. Granted, many lives have been saved by them, but would those people have been so sick if they had not been exposed to them earlier in life and still had strong immune systems. Other people have had lives blighted by them.

    I feel like Spiral, that unless something was pretty bad, I would just let nature take it's course and allow my body to heal with good support. Certainly I have done that over the last 15 years or so, once I realised the pitfalls of taking antibiotics (and any drugs for that matter). I have concentrated more on building my immune system and supporting healing with things like Vitamin C on the rare occasion I do catch anything now (I used to get everything that was going but it passes my by now, generally).

    There was an interesting article today in the Daily Mail. It looks at identical twins and the difference between them in some cases, health-wise. One of the experiences is of twin girls, both of whom apparently have the gene for leukemia. One has the disease, the other doesn't. The one with leukemia apparently had a bout of tonsillitis earlier and Doctors believe this may have been the 'trigger'. But, of course, thousands of people get tonsillitis without getting leukemia.

    Why blame the illness? Why not blame the treatment? Tonsillitis is the body's normal way of trying to off-load toxins - they are windows to the health of the body and another 'clue-giver'. They are evidence of the macrophages going to work. Although the article doesn't say so, it is pretty likely that she was given antibiotics for the infection. What if they undermined her immune system enough to allow the leukemia to take hold?

    I know this may seem pretty controversial, but believe me, I am but one voice in a million who are realising the pitfalls of antibiotic treatment. There are plenty of books and articles and research out there that support this thought and people like Leon Chaitow warned of this 20 or 30 years ago. Some of them make for very uncomfortable reading. Just Google 'antibiotic danger' or something similar and see what comes up.

    The pitfalls of antibiotics have been known about since their inception into use over 70 years ago and Fleming warned about the likelihood of resistance, but it has taken all that time for The Establishment to suddenly realise the truth of and the danger in those words.

    We have developed this inherent fear of disease. Typical of the Medical Profession, instead of helping us to put up barriers against it, they wait until it gets in, then try to deal with it. Prevention is far better than 'cure'. People have even gone to the Doctor for antibiotics when they have a fever. Fever is the body's way of dealing with unwanted microbes. It raises the core temperature of the body to kill them. They cannot survive over 100 degrees. Not only that, but it will also generally limit the area to the source of the infection. If you cut your finger and microbes enter, your finger will get hot. Fever is not something to be stopped unless it threatens to overwhelm the body and then that is probably because the bacterium/microbe is overwhelming.

    One of the biggest culprits of antibiotic exposure in humans now is the use of them in animal welfare. They are thrown at domestic animals, farmed fish and anything else they can throw it at. But we are eating it. They don't have to keep animals alive any longer than it takes to get them into the food chain, but it is having a profound effect on us and our health and constantly weakening and undermining our immunity.

    Diseases that we thought had been eradicated, like Tuberculosis, are now making a comeback, and they are proving to be very resistant. MRSA - Staph Aureus is now becoming resistant to the last and strongest antibiotic - Vancomycin. Where will it stop?

    Once upon a time we had bugs without antibiotics. Now we have the terrifying prospect of superbugs without antibiotics. The more we learn, the less we know............

    Some reading material -

    http://innovation.edf.org/page.cfm?tagid=31088

    http://www.aphroditewomenshealth.com/ne ... news.shtml (and asthma too is on the increase - what else might they cause!)

    http://www.orthomolecular.org/resources ... 4n14.shtml

    http://www.typesofbacteria.co.uk/how-do ... teria.html (5500 different types of bacteria in the gut!!!)

    http://www.amazon.com/Antibiotic-Parado ... 05&sr=1-14
     
  18. Spiral

    Spiral · Well-Known Member

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    I didn't mention it before, but one of the reasons I became a vegetarian in 1985 was because of my problem with modern farming methods, which I find very cruel and which just don't make sense.

    It uses antibiotics to deal with the problem of keeping so many animals in one place in intensive factory farming. It uses hormones to make animals grow much faster to much larger sizes than they are supposed to grow. Look at some of the illnesses farmers get - especially those that handle organophosphates (neurotoxins), supposedly safer because they degrade to safe compounds, which organocholorides (things like DDT) don't.

    What happens to those chemicals as they get more concentrated at each step in the food chain? We are at the top of the food chain.
     
  19. Pickwick

    Pickwick Type 2 · Member

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    I'm with Spiral - well on the way to becoming an involuntary vegetarian.

    I live in a rural area, and have been alarmed at the constant trickle of stories about antibiotics and other drugs in our meat - not just the regular vet-prescribed drugs, but the illicit unmarked stuff that quietly goes into the feed. The stories are just too persistent to be entirely fictitious. There are some farmers it seems who will stop at nothing to turn a profit. And forget the son-of-the-earth image - most of them are very astute businessmen.

    Unfortunately meat isn't the only victim. On crop spraying days, I've found birds dead in the gutter by the dozen - in the middle of a small town. And clouds of insects in hot weather because there's nothing left to prey on them. If that's what the chemicals do to the wildlife - what on earth do they do to us?

    Quite apart from antibiotics, a survey of geographical concentrations of diabetes might be very revealing.
     
  20. IanS

    IanS · Well-Known Member

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    I have been prescribed antibiotics fairly regularly for several years. I have a recuring abcess on the base of the rear most tooth on the lower jaw. It's location makes it difficult to treat by other methods. I therefore requires a jolt of penicillin every few months or so when it decides to wake up and complain (though a type of penicillin has been found in recent years that seems to quieten it down for longer).

    There is no evidence of the antibiotic itself causing any side problems. My diabetes is definitely genetic and although technically overweight at diagnosis, I was only a little bit on the wrong side of the line. Since diagnosis and alteration of my diet to match, I have lost over half a stone in weight.

    The antibiotics don't seem to have caused weight gain, because my weight has, in fact, been stable for a few years (and I certainly like my food).

    I know regular antibiotics are frowned upon and I fully understand why, but where needs must...
     
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