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Americans’ exposure to radiation from medical procedures has exploded over the past few decades, to six times the level of 1980, a new report shows.

In 2006, almost 380 million diagnostic and interventional radiological procedures were performed in the United States, on top of 18 million nuclear medicine examinations.

“Back in about 1980, 15 percent of radiation that the U.S. population got was from medicine and the rest was predominantly from natural background radiation,” noted Dr. Fred Mettler Jr., U.S. Representative to the United Nations Scientific Committee on the Effects of Atomic Radiation and a professor of radiology at the University of New Mexico in Albuquerque. “In the last 20 years, medical exposure has gone up between 600 and 700 percent from what it was, and it is now the biggest source of radiation to the U.S. population.”

“The issue,” Mettler continued, “is that this is a controllable source. We regulate the effluent from nuclear power plants so the public doesn’t get exposure but medical exposure is essentially unregulated. The largest source in the U.S. is essentially unregulated, and it’s up to your family doctor or any other doctor to hand it out.”

Mettler is lead author of a paper appearing in the November issue of Radiology that summarizes the conclusions of two previous reports on radiation sources in the U.S. Those reports were issued by the U.S. National Council on Radiation Protection and Measurements and the United Nations Scientific Committee on Effects of Atomic Radiation.

The findings are in line with previous studies, one of which attributed up to two percent of all cancers to CT scans alone and another which concluded that cumulative exposure to radiation from CT scans increases the risk for malignancy by as much as 12 percent.

The last comprehensive assessment of radiation exposure was conducted in 1980-1982, a veritable eternity by medical and scientific standards.

“We needed to get a grip on how much radiation the U.S. was getting and where it was coming from,” Mettler said.

In the intervening years, the number of procedures performed has risen “by leaps and bounds,” he said. “The biggest chunk of that is CT scanning, which has been growing at better than 10 percent a year while the U.S. population is growing at less than 1 percent.”

Widely used as a diagnostic tool, CT scans provide detailed images of organs, allowing more accurate diagnoses of conditions such as cancer. But CT involves a higher radiation dose than most other imaging tests. According to this paper, CT provides half of the country’s total radiation dose, even though it represents only 17 percent of total procedures.

Emergency room physicians may be at the epicenter of the surge in scan use, Mettler said. “Twenty-five to 40 percent of CT scans are ordered out of the ER,” he noted. “The emergency physicians are in a tough box because they’re worried about getting sued. And they tend to get patients who they haven’t seen before. This is a one-time walk-in and their mantra is, ‘We can’t afford to miss anything.’”

Of course, the trend is not limited to the U.S., although it may be more extreme here. Globally, the per-capita annual dose from medicine has doubled in the past decade or so.

Still the U.S. leads the pack, with 12 percent of all radiologic procedures and half of nuclear medicine procedures performed here.

“We have a little under 5 percent of the world’s population and 25 percent of X-ray studies in the world and double and triple that of other developed countries,” Mettler said. “Nobody thought about how much radiation goes with this.”

But not all of uptick in scans has been unnecessary, said Dr. Robert Zimmerman, executive vice chair of radiology at Weill Cornell Medical Center in New York City.

“We don’t really know how much of it is overuse. We do know some of it is overutilization, but CT is a valuable imaging modality. CT is a great test. There’s no question that in the appropriate cases it’s going to save lives.”

There are things radiologists can do to curb its use, including reducing the doses, while manufacturers are working on new and improved machines, Zimmerman said.

Physicians can also tailor their use, thinking twice about using this type of technology in children, who are more sensitive to radiation and have longer to develop side effects.

“When I get a call for a CT scan, my first question is, ‘How old is the patient?’ If it’s 40 or under my antennas go up and if they’re 70 my antennas don’t get so excited. Mostly my idea is a CT might be a good thing but you would like to think about radiation beforehand,” Mettler said. “There’s a lot of stuff going on now that isn’t justified. Nobody’s ever shown that many of these things we do make a difference in outcome.”

Researchers are reporting that eight weeks of treatment with large doses of vitamin D2 can eliminate vitamin D deficiency, and twice-monthly doses can keep the condition at bay for up to six years.

The dosage — 50,000 international units (IU) every week or two — was large but did not appear to be toxic, according to the study published in the Oct. 26 issue of Archives of Internal Medicine.

Vitamin D is crucial for the body. Among its attributes, it strengthens bones by helping the body absorb calcium and phosphorus from food. Low levels of vitamin D can cause rickets in children and an adult bone disorder called osteomalacia.

A deficiency can also lead to osteoporosis, and research has suggested that it also has something to do with higher risks for such diseases as cancer, heart disease, diabetes, autoimmune diseases and flu, the study’s senior author, Dr. Michael F. Holick, director of the Bone Healthcare Clinic and the Vitamin D, Skin and Bone Research Laboratory at Boston University School of Medicine, said in a university news release.

For their study, the researchers treated 41 people who had low levels of vitamin D with 50,000 IU of the vitamin each week for two months. On average, their vitamin D levels nearly doubled after eight weeks, the study found.

Another 45 people were given 50,000 IU of vitamin D2 every two weeks. The researchers found that their levels also went up, but not quite as much.

“Vitamin D2 is effective in raising [vitamin D] levels when given in physiologic and pharmacologic doses and is a simple method to treat and prevent vitamin D deficiency,” Holick said. “While treating and preventing vitamin D deficiency, these large doses of vitamin D2 do not lead to vitamin D toxicity.”

The U.S. National Institutes of Health Office of Dietary Supplements recommends that you always talk to your health care provider before taking any supplements.

Many middle-aged adults may be walking around with a dangerous health problem and not even know it.

The condition called peripheral artery disease, or PAD, occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs. PAD affects about 8 million Americans.

PAD is as serious as heart disease, Dr. Ross Tsuyuki of the University of Alberta in Edmonton noted in a telephone interview with Reuters Health, “but, in general, it is under-recognized by the public and by our health care system.”

In 10 pharmacies in Central and Northern Alberta, Tsuyuki and colleagues had five pharmacy students screen 362 adults over age 50 for PAD. The screening procedure, which is fairly simple, compares the blood pressure in the leg to that of the arm.

Seventeen people who were screened — about 5 percent — had PAD. And, importantly, Tsuyuki said, 80 percent of the people found to have PAD were previously unaware they had the dangerous condition.

“PAD is a very strong risk factor for poor outcome, including heart disease, stroke and lower limb amputation,” Tsuyuki said.

“We informed them of what we found and followed up with them and most of them had gone to see their family physician for treatment,” Tsuyuki said, which may include aspirin or other anti-blooding clotting therapies and aggressive cholesterol-lowering treatments.

While the US Preventive Services Task Force currently does not recommend routine screening for PAD, Tsuyuki thinks it is worthwhile to screen people at high risk for PAD. “That would include people who already have heart disease and people who’ve suffered a stroke. They would be the highest priority,” he told Reuters Health.

“The second highest priority,” he added, “would be people middle-aged and beyond who are at high risk for heart disease and stroke, such as people with high blood pressure, diabetes and high cholesterol.”

The researcher reported his team’s findings over the weekend at the 2009 Canadian Cardiovascular Congress, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

In a statement from the meeting, Heart and Stroke Foundation spokesperson Dr. Beth Abramson said: “People don’t recognize that leg cramps while walking may be due to circulation problems that put them at risk for heart disease and stroke.”

While PAD may have no symptoms, there often are some warning signs, such as leg pain during exercise, open leg sores that don’t heal, feeling of coldness or numbness in one or both legs, pain in the toes at night.

Current or ex-smokers are at increased risk for PAD as are people with diabetes, high blood pressure, high cholesterol and heart disease.

Jet lag is the term for disrupted sleep when you travel between time zones, and your body doesn’t adjust to sleeping on a new schedule.

The U.S. National Library of Medicine offers these suggestions to minimize jet lag:
Stick to a good bed time and sleep schedule before departing. Don’t miss out on sleep in an attempt to beat jet lag.
Adjust your bed time by a few hours before you leave, depending on which time zone to which you’ll be traveling.
If you’re only traveling for a few days, don’t worry about adjusting to a new time zone.
Don’t sleep on the flight, unless the flight includes your usual bed time.
Don’t consume alcohol or caffeine, but do drink plenty of fluids.
Keep up with your exercise routine, just not too close to bed time.