The potential pool of new practicing allergists is diminishing, even as the number of current practitioners is shrinking due to retirement. There are only 5,000 to 6,000 board-certified allergists out of 600,000 practicing MDs in the United States, and as of late 2009, just over 300 doctors were in accredited training programs for allergy and immunology, compared to more than 22,000 for internal medicine. Since allergy programs are at least two years, roughly 150 new allergists are produced each year. (Figures are from the Accreditation Council for Graduate Medical Education.) If allergists have a thirty-year career, then some 170 to 200 retire each year, for a net loss in the pool of board-certified allergists. The problem is complicated further by the fact that many of those residents will go into research, not into clinical practice at the same time many allergists are getting older. There's no way to measure exactly how many of my colleagues are retiring, but when we go to conferences, there are more doctors who look the way we do now than there were thirty-five years ago.
Allan V. Wang, MD
Specialty: Allergy / Immunology
Location and Office HoursAllan Wang MD PhD
Kailua Kona, HI 96740
- HMSA (BC/BS)
- Select HMO/HMSA
- Kahi Mohala Behavioral Healthcare
- Kapiolani Medical Center for Women & Children
- Queen's Medical Center
Is the number of allergists shrinking?
Paul Ehrlich, MD, Allergy / Immunology, answered
Why am I always hungry?
Georgianna Donadio, PhD,MS,DC, Health Education, answeredHunger is a natural response by the body when it has used up the caloric intake from our last meal and we need to replenish. When we are in a constant state of hunger, or hungry very shortly after our last meal, this can signal a health problem such as hormonal imbalance or other either genetic or chronic health conditions. The hormones from the thyroid, pancreas, reproductive glands, and pituitary or adrenals glands are all possible contributors to constant hunger.
There are also other factors that can play a large role as well. A diet that is very low in fat can create a constant hunger. Our bodies require a certain amount of fat each day to regulate our metabolism and these healthy fats (such as avocado, nuts or olive oil). These fats trigger a hormone called leptin that curbs or stops the appetite.
When any one of many things that can create imbalances or that can override the body’s normal metabolic function occurs, we can short circuit the body’s ability to sustain normal appetite and food consumption. Most commonly these are hormone or neurotransmitter imbalances that create hunger due to the interruption of the normal hunger/hormone chemical.
Stress can play a large role in this condition, as well as excessive or chronic long term carbohydrate intake. Excess carbohydrates can result in both a decrease and an increase in insulin secretion which can then trigger several metabolic problems and syndromes.
If you are experiencing, chronic persistent hunger it is important to consult with your physician. There are many situations that can also contribute to your hunger such as hyperthyroidism, menstrual irregularities, Von Gierke disease, bulimia, Prader-Willi syndrome, diabetes, medications or hypoglycemia.
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Are animal proteins addictive?
Joel Fuhrman, MD, Family Medicine, answeredSugary foods with a high glycemic index can fuel toxic hunger (physical addiction to an unhealthful, low-micronutrient diet) eating frenzy, but consuming too many animal products can do it too. Americans are now accustomed to eating animal products, including beef, chicken, eggs, and cheese, at every meal, but eating such a high quantity of these very high protein foods can overload the liver's ability to eliminate excessive nitrogenous wastes. The excessive consumption of animal proteins and the elevated amount of waste products puts a stress on your body's detoxification channels and you wind up not feeling well -- or detoxifying more -- between meals.
Some people are more sensitive to this excess nitrogen than others. It is not unusual to find people who are forced to eat a diet rich in protein and animal products. Otherwise, they feel too ill. They must remain on a continual high-protein binge all day. They feel terrible if they try to stop eating high-protein foods or if they delay eating. These individuals may feel better when eating animal products at regularly spaced intervals, but this is the same as drinking more coffee to feel better.
It leads to more and more addictive symptoms and they never get better. Just like a caffeine addict, they may have to feel worse for a short time for these symptoms to resolve. Even though the overeating of animal protein causes the problem, the high-protein food also temporarily allows them to feel better and to feel better longer after the meal because high-protein foods take longer to digest and can delay the discomfort of withdrawal.
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