Beautiful. Medicine.

Tired? Forgetful? Blue? These are all symptoms of a deficiency of B12, a key nutrient needed to make red blood cells and DNA and keep the nervous system working right.

Vitamin B12 deficiency is officially considered rare, affecting about 1 in 1,000 Americans, according to a 2005 study. This rises with age. The rate is also much higher among people who don’t eat meat or dairy products. B12 deficiency is much more common than the textbooks and journal articles say it is. Other symptoms of low B12 include anemia, depression, dementia, and confusion, loss of appetite and balance problems. Long-term deficiency can bring severe anemia, nerve damage and neurological changes that may be irreversible.

Sometimes the symptoms are subtle. A surprising number of our young female patients have  low levels of B12. Typically they are healthy and active, but they don’t eat much meat and they have minor mood, memory or balance problems. Dr. Juan Remos recommends weekly B12 shots. We will use different types and protocols for B12 based on your symptoms and goals.   The weekly  injections are the fastest way to correct a severe deficiency, since it does not need to be absorbed in the digestive tract and higher doses can be given.. “We have trained phlebotomists at The MIAMI Institute who give hundreds of our patients their weekly B12 shots. It’s an easy fix,” says Dr. Remos.

B12 is one of the newest of the human vitamins, identified in 1948. It originates in bacteria, yeast and microbes in soil. Plants can’t store it, so people get their B12 almost exclusively from meat, liver, poultry, fish and dairy products. Adults need just 2.4 micrograms a day, the amount in three ounces of beef, and can generally store it in fat tissue for several years. Dr. Remos speculates that some of his very lean patients are B12 deficient because they don’t have much fat to store it in. Some people have trouble absorbing B12 in the first place.

Recommended Dietary Allowances for vitamin B12:

14 years and older: 2.4 mcg
Pregnant women: 2.6 mcg
Nursing mothers: 2.8 mcg
Source: National Academy of Sciences, 1998

Tips and guidelines for boosting B12 levels:

B12 comes almost exclusively from meat, liver, poultry, fish and dairy products.
Some breakfast cereals are also fortified with the vitamin.

Selected Food Sources of Vitamin B12

Beef taco, 1 taco 0.8 13
Beef, top sirloin, broiled, 3 ounces 2.4 40
Breakfast cereals, fortified with 100% of the DV for vitamin B12, 1 serving 6 100
Breakfast cereals, fortified with 25% of the DV for vitamin B12, 1 serving 1.5 25
Cheese, Swiss, 1 ounce 0.9 15
Cheeseburger, double patty and bun, 1 sandwich 1.9 30
Chicken, roasted, ½ breast 0.3 6
Clams, cooked, breaded and fried, 3 ounces 34.2 570
Egg, large, 1 whole 0.6 10
Food Micrograms (mcg) per serving Percent DV*
Haddock, cooked, 3 ounces 1.2 20
Ham, cured, roasted, 3 ounces 0.6 10
Liver, beef, braised, 1 slice 48 800
Milk, 1 cup 0.9 15
Salmon, sockeye, cooked, 3 ounces 4.9 80
Trout, rainbow, farmed, cooked, 3 ounces 4.2 50
Trout, rainbow, wild, cooked, 3 ounces 5.4 90
Tuna, white, 3 ounces 1 15
Yogurt, plain, 1 cup 1.4 25

Women are self conscious about the neatness and appearance of their labia. They consider themselves more desirable when they feel the security of symmetrically contoured labia. So, in the present culture of constant self-awareness and self improvement, labiaplasty has become a very popular cosmetic procedure.

Women can now feel comfortable with the appearance of their personal areas.

Labiaplasty is designed for women who may have elongated labia minora, enlarged labia, loose labia, or uneven labia. Women often complain that the elongated labia get in the way of comfortable sex. For many, elongated labia cause embarrassment in form-fitting clothing. They also feel that childbearing distorts their anatomy and that they no longer look like they did before child birth.

The Surgery

Technically known as “labiaplasty,” or vaginal rejuvenation surgery, the surgery includes reshaping and trimming of the labia minora (the inner lips of the vagina), transferring the patient’s own body fat to the labia majora (the outer lips), tightening the labia majora, trimming the clitoral hood, and repairing tears from childbirth.

The procedure usually takes about an hour.

Mid to Deep level TCA peels are used to improve fine wrinkles and scars and diminish blemishes, discolorations, blotches and pigmentation abnormalities.

A TCA peel removes the outer 2 layers of skin (epidermis) and therefore decreases the depth of wrinkles and fine lines; also improves discolorations and age spots. TCA Peels can be used on hands, neck and most other areas of the body.  May require pre-treatment with Retin-A or AHA creams. After your TCA peel, you skin is lighter, tighter, smoother and more evenly textured. Repeat treatments may be needed to maintain results. Sunblock must be used for several months.

Trichloroacetic acid (TCA) Uses:

• Improves fine surface wrinkles
• Lessens superficial blemishes
• Helps blend pigmentation problems

Your MIAMI Institute TCA Peel

Typically, your skin is first thoroughly cleansed. Then the TCA solution will be carefully applied to your skin. You may feel a stinging sensation with lower level peel strengths as the peel solution is applied, but this feeling will quickly pass. The more concentrated levels will cause a burning sensation that stops in about 3 to 4 minutes. A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

Imagine replacing all of your unhealthy teeth or removable dentures with fixed beautiful new teeth in just one day…with only 4 implants and no bone grafting!

Board-certified Prosthodontist, Dr. Todd B. Barsky and his team, have developed a hybrid tooth replacement protocol that incorporates the latest in computer aided design (CAD) and engineering, and combined  it with the precision diagnostics generated by 3 Dimensional Imaging.

In one day, patients can leave with a beautiful smile and new teeth that feel and function like permanent teeth.

All on 4™ is a non-removable dental implant option designed to maximize the use of available bone with just 4 implants per dental arch. What’s most surprising to patients is that the teeth can be attached to the implants the same day!

Even patients who have previously been told by past dentists, “You don’t have enough bone for dental implants” are now able to routinely be treated by utilizing this technique. Today, virtually all removable denture patients, those who are about to lose all of their teeth, and even those with severe bone loss from gum disease can have the answer they have been seeking with this one procedure.

The technique works because it takes advantage of the dense bone that remains in the front part of the jaws.  By placing the two posterior implants at pre-determined mechanical inclinations using CT Scan technology we avoid the sinus cavities in the upper jaw and the inferior alveolar nerve in the lower jaw.

This procedure has virtually eliminated the need for costly and time consuming bone grafting and the discomfort and prolonged healing time which often accompanies these additional procedures. Today, thanks to the All-on-4™ alternative, it’s now possible for patients to have non-removable teeth placed the same day of implant placement, and most of the time without the need for bone grafting.

All of this means eliminating months of healing and saving thousands of dollars while achieving high-quality restorative results in the shortest time possible.

All on 4™ saves time and money and we are excited to make this FDA-approved option available to our patients.

Dear Dr. Fine,

Please tell me what the best aphrodisiac is. I want our Valentine’s Day celebration to be great. Lately I feel my boyfriend slipping away. I did gain a few pounds over the last year so I am hoping that you don’t say it’s chocolate.

Leslie
Miami Lakes

Dear Leslie,

Happy Valentines!