Life Insurance or Disability Insurance and Confidentiality – the MIB and Limits of HIPAA

Peter Forster About GPS, Costs of Treatment, Physical Conditions and Health Leave a Comment

The Health Insurance Portability and Accountability Act (HIPAA) has a few limitations that should be considered when you are applying for life insurance or disability insurance. Life insurance and disability or long term care insurance companies ask you for the names of all the doctors who have treated you and your consent to get records from the doctors. The consent …

TSH or Free T4 for Assessing Thyroid Function?

Peter Forster Best Practices, Physical Conditions and Health, Testing Leave a Comment

There are many reasons why thyroid status is important in a clinic treating people with mood disorders. For one thing, hypothyroidism and hyperthyroidism can mimic some of the symptoms of mood disorders. For another, lithium, a medication we often prescribe, is associated with hypothyroidism in a significant minority of patients taking the medicine. One of the questions we wrestle with …

Inflammation Testing and Antidepressant Selection

Peter Forster Best Practices, Major Depression, Physical Conditions and Health, Testing Leave a Comment

Inflammation and C Reactive Protein Inflammation is often seen in people with depression. And there is evidence to suggest that it predicts treatment response. The most widely accepted standard test to measure inflammation is the C-reactive protein, or CRP. This is a protein that is produced by the liver in inflammatory states. The American Heart Association and the Centers for …

Coronavirus CDC

COVID-19 or Coronavirus and GPS

Peter Forster About GPS, Basic Science, GPS Update, Physical Conditions and Health Leave a Comment

The current projections for COVID-19 coronavirus expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April. We have been monitoring the news from the CDC and the American Medical Association and will continue to do so. Here at Gateway …

Lithium Associated Hypothyroidism May Be Reversible

Peter Forster Bipolar Treatment, Physical Conditions and Health Leave a Comment

People who develop hypothyroidism while using the mood stabilizer lithium may return to normal thyroid function after the drug is discontinued, according to a study in the Journal of Psychopharmacology. Hypothyroidism—a condition in which the thyroid gland does not produce enough thyroid hormone—has long been known to be associated with the use of lithium. Recent studies have clarified the nature of this association. …

Pharmacy Apps

Pharmacy Apps

Peter Forster About GPS, Best Practices, Physical Conditions and Health Leave a Comment

One of the most perplexing things about our healthcare system is how complicated it can make even simple tasks. This is particularly true when the issue involves sharing information among providers of care. Elsewhere we have talked about the “silo” problem and why it has motivated us to develop a clinic that tries to provide integrated care. Here I want …

biofeedback

Biofeedback at Gateway Psychiatric

Nathaniel Abad Anxiety, Other Psychiatric Disorders, Physical Conditions and Health, Self Care Leave a Comment

Biofeedback is a stress management technique that uses devices that give you information about your body’s physiologic response to stress. The idea is to provide you with information that would ordinarily be outside of your conscious awareness, such as your body temperature, blood pressure, or heart rate.  Generally, there are three stages of biofeedback: Developing increased awareness of the body …

Home Blood Draws

Peter Forster About GPS, GPS Update, Physical Conditions and Health Leave a Comment

Would home blood draws (or office blood draws for that matter) be helpful? Obtaining routine blood work can be an essential part of your treatment if you have a mood disorder and are on medications as it is very important to know the levels in your blood reached by mood-stabilizing drugs. Finding time however to get your labs done can …

Finger Stick Lab Tests

Finger Stick Lab Tests

Peter Forster GPS Update, Physical Conditions and Health, Testing Leave a Comment

Finger stick lab tests have the potential to significantly improve the quality of the care at Gateway Psychiatric. Regular monitoring of labs are an important part of good care for many of our patients, but some find it difficult to get labs done on time. A new technology from clinical laboratory provider OpAns may allow us to perform many of …

Antidepressant Diet

Antidepressant Diet Cookbook

Peter Forster Major Depression, Physical Conditions and Health, Self Care, Treatments of Depression Leave a Comment

Two recent studies suggest that the Mediterranean diet may be an antidepressant diet as well as the diet that reduces heart disease, inflammation, and the risk of dementia. In the SMILES trial 65 patients with depression were randomized to a Mediterranean diet based intervention (a diet support group) or a social support group. The group excluded people who were treatment …