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Why Do My Eyes Twitch? Part 2 — Neurological Causes, Nutritional Deficiencies, and Treatment
Persistent eye twitching may be more than a harmless annoyance. While most eyelid spasms are benign, some involve neurological conditions such as blepharospasm or hemifacial spasm. Nutritional deficiencies, electrolyte imbalances, and medications may also contribute to abnormal muscle activity. Learn how doctors distinguish common eyelid myokymia from neurological disorders, which warning signs require evaluation, and what treatments can provide relief.

David Stephen Klein, MD FACA FACPM
3 days ago9 min read


Why Do My Eyes Twitch? Common Causes, Deficiencies, and Warning Signs: part 1
Why do my eyes twitch? Eyelid twitching, medically known as myokymia, is usually harmless but can be frustrating. Common triggers include stress, poor sleep, caffeine, dry eyes, and ocular irritation. Although magnesium deficiency is often suspected, it is rarely the proven cause. Learn what causes involuntary eyelid spasms, how to relieve them, and which warning signs may indicate an underlying neurological condition requiring medical evaluation.

David Stephen Klein, MD FACA FACPM
Oct 158 min read


Your Ferritin May Be Low or “In Range”—But Is It Too Low for Healthy Hair?
Your ferritin may be marked “normal,” but does that mean your iron stores are adequate when you are losing hair? Iron deficiency can develop before anemia, and lower ferritin has been associated with telogen effluvium. But there is no proven universal ferritin target for hair growth—and low ferritin should not automatically mean taking iron. Learn why ferritin is a diagnostic clue, what can cause depleted iron stores, and why unexplained hair loss deserves a broader evaluatio

David Stephen Klein, MD FACA FACPM
Oct 110 min read


Your Fasting Glucose Is Normal—but Is Your Insulin?
A normal fasting glucose does not always mean normal metabolic health. During early insulin resistance, the pancreas may compensate by producing more insulin, keeping glucose deceptively normal. Measuring fasting insulin alongside glucose may reveal this hidden metabolic stress earlier. Learn why fasting insulin, HOMA-IR, A1c, triglycerides, waist circumference, and other markers can provide a more complete picture of insulin resistance and metabolic health.

David Stephen Klein, MD FACA FACPM
Sep 298 min read


Dandelion Extract for Urinary Tract Infections: An Adjunct to D-Mannose and Antibiotic Therapy
Dandelion extract may offer supportive benefits for urinary tract infections by promoting urine flow and helping the urinary tract naturally flush itself. Its role is adjunctive—not a replacement for appropriate treatment. When used alongside D-mannose, adequate hydration, and antibiotics when clinically indicated, dandelion may become part of a broader strategy for urinary health, particularly in patients with recurrent or persistent urinary symptoms.

David Stephen Klein, MD FACA FACPM
Sep 249 min read


When One Diagnosis Follows you Everywhere: The Value of an Independent Second Opinion
A second opinion is not necessarily about finding a doctor who disagrees. Shared electronic health records provide tremendous continuity, but previous diagnostic impressions may sometimes influence how later physicians approach a case. Learn about diagnostic momentum, outdated problem-list diagnoses, and why an independent second opinion may provide valuable fresh thinking when symptoms persist, treatment fails, or the diagnosis simply does not fit.

David Stephen Klein, MD FACA FACPM
Sep 2112 min read


Environmental Heat, Alcohol, and Hyponatremia. Deadly in Summer
Hot weather can create more than dehydration. Sweating causes water and sodium loss, while heat-related vasodilation can lower blood pressure. Add alcohol, medications, poor food intake, or excessive plain water and the result may be orthostatic dizziness, hyponatremia, instability, and falls. Learn why older adults are especially vulnerable, which medications increase risk, when electrolyte replacement may matter, and which symptoms require urgent medical evaluation.

David Stephen Klein, MD FACA FACPM
Sep 1014 min read


Extreme Heat, Heavy Sweating, and Salt Loss: When Water Is Not Enough
Extreme heat and prolonged sweating cause the body to lose more than water. Sodium losses during hiking, exercise, gardening, landscaping, and outdoor work can become substantial. Learn how much salt may be lost through sweat, when water alone is sufficient, when electrolyte replacement becomes important, why drinking too much plain water can also be dangerous, and which symptoms mean it is time to stop self-treatment and seek medical care.

David Stephen Klein, MD FACA FACPM
Aug 199 min read


Uric Acid and Hypertension: Is Your Uric Acid Helping Drive Your Blood Pressure?
Uric acid is best known for gout, but elevated levels are also associated with hypertension, kidney dysfunction, and cardiovascular risk. Research suggests that uric acid may influence blood pressure through oxidative stress, reduced nitric oxide, renin-angiotensin activation, renal vasoconstriction, and altered sodium handling. Learn how uric acid, kidney function, and hypertension may form a self-reinforcing cycle—and why lowering uric acid is not always the same as lowerin

David Stephen Klein, MD FACA FACPM
Aug 179 min read


Pulse Pressure, Aging, and Stroke Risk: Why the “Ideal” Number Changes With Age
Pulse pressure is the difference between systolic and diastolic blood pressure. For example, 120/80 mmHg produces a pulse pressure of 40 mmHg. Pulse pressure often widens with age as large arteries become stiffer. In older adults, a persistently wide pulse pressure may indicate increased arterial stiffness and cardiovascular risk, including stroke risk. It should be interpreted together with age, systolic and diastolic pressures, medical conditions, and overall cardiovascular

David Stephen Klein, MD FACA FACPM
Aug 149 min read
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