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August 2008 · Vol. 20, No. 08
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MARCH 2008

Coffee and conception—what’s your counsel?

A woman drinks 4 cups of caffeinated coffee daily but reports no other source of caffeine, which means that she consumes about 500 mg of caffeine a day. She tells you that she’s concerned about the impact of caffeine on a future pregnancy.

What would you say to this patient about her consumption of caffeine when she begins to try to conceive and, later, while she is pregnant?

APRIL 2008

Failed weight loss: Take the next step

Your patient is a 27-year-old woman who has a body mass index of 41 and polycystic ovary syndrome. Her medications are an estrogen–progestin oral contraceptive and metformin, 1,500 mg/day.

She has tried to lose weight many times, without lasting success. She has consulted with nutritionists, personal trainers, and endocrinologists. The next step is yours:

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