Archives for August 2017

Aug
26
2017

Decreased Sperm Counts In Men

What do decreased sperm counts in men tell us about our world? A recent study has shown that over the past 40 years males in many centers that tested for sperm counts have lost 50% of the sperm count that was normal in the 1970’s. The question is, what could have caused this? Nobody has definite answers. But here are the factors that the Mayo Clinic lists for low sperm counts.

Medical causes of decreased sperm counts in men

  • A varicocele: A varicocele is dilatation of veins close to the testicles. It is presumed that this leads to a higher temperature inside the testicles and this causes a lowered sperm count and poor sperm quality.
  • Antisperm antibodies can cause infertility. Due to low sperm counts.
  • Infections in the testicles reduce sperm production. Gonorrhea and HIV infection are some of the common infections.
  • Some men develop retrograde ejaculation. With this the sperm enter the bladder on ejaculation instead of coming out from the tip of the penis. Alpha-blockers, a type of blood pressure medication can do this as a side effect. But there are also various health problems that can cause retrograde ejaculation like diabetes, surgery to the prostate, urethra and bladder. Spinal injuries can be also a cause of retrograde ejaculations. In many cases the sperm production in the testicles is still present and sperm could be sampled from there for artificial insemination.
  • Tumors of the pituitary gland can interfere with hormone production of testosterone and sperm counts will fall or stop. But other pituitary hormones, thyroid hormone and adrenal gland hormones are needed for fertility.
  • Chromosome defects like Klinefelter syndrome and others can be a cause of abnormal development of the male genitals with low or missing sperm production.
  • Celiac disease is a bowel disease that is due to gluten sensitivity. It causes low sperm counts and infertility, which responds to a gluten free diet. Sperm counts normalize with this diet.
  • There are medications that can decrease sperm production like chemotherapy, anabolic steroid use, antifungals and certain antibiotic medications and some ulcer medications.

Lifestyle causes leading to decreased sperm counts in men

Certain lifestyles and occupations can cause a man to have a decreased sperm count.

  • Drinking alcohol excessively can reduce testosterone production, which decreases sperm count.
  • Recreational drug use: steroids to increase muscle mass cause testicular atrophy and decreased sperm count. Cocaine and marihuana also decreases the sperm count.
  • Certain occupations like welding from exposure to heat and truck driving from prolonged sitting have been associated in some studies with infertility. But there are other studies that could not confirm this correlation.
  • Smoking: Men who smoke have lower sperm counts than men who don’t smoke.
  • Excessive weight: Obese men transform some of their testosterone into estrogen through the action of the enzyme aromatase, which is amply present in fat cells. This leads to low testosterone levels and low sperm counts.

Environmental causes of decreased sperm counts in men

The environment in terms of heat production around the scrotum or exposure to chemicals or ionizing radiation can lower sperm counts in men.

  • Heat around the testicles: studies do not all agree, but there is a tendency for low sperm counts when using saunas and hot tubs frequently. Sitting for longer times or using a laptop computer for longer periods can also increase the temperature of a man’s scrotum and lead to a low sperm count.
  • Exposure to heavy metals like lead, mercury and others can be the cause of infertility.
  • Exposure to radiation can reduce sperm production. With high doses of radiation sperm production may cease entirely. With lower radiation exposures sperm counts may be down for several years before they recover to normal.
  • Industrial chemicals: exposure to fumes from certain chemicals can lead to low sperm counts; benzenes, herbicides, pesticides, xylene, toluene, painting materials and organic solvents are on this list.

Recent study about decreased sperm counts in men as an indicator

We have now reviewed the major causes of low sperm counts in men. I like to revisit the recent sperm study I mentioned in the beginning of this blog. It is unlikely that men in North America, Europe and Australia would spontaneously produce less than 50% of the sperm than men 40 years earlier had produced. The next puzzling fact is that the study found normal sperm production in men in Africa, South America and Asia.

This points to epidemiological differences that reduce the sperm count in men in North America, Europe and Australia. In view of the multitude of possible causes it will require a task force that does a comparative study worldwide looking at exposure history, diets, social habits and other factors.

Fertility clinics are thriving because couples want children. With low sperm counts of males there is more infertility than there was in the past. Density gradient centrifugation is a reliable method of enriching sperm counts.

In the past a couple had no problem getting a successful pregnancy when they wanted it. Now couples often have to be assessed in a fertility clinic because of problems with regard to decreased sperm counts in men, which can cause infertility.

Decreased Sperm Counts In Men

Decreased Sperm Counts In Men

Conclusion

A new study has noticed that over the past 40 years many men have developed low sperm counts. This has caused significant problems with fertility among couples. Fertility clinics are busy trying to help these couples. Density gradient centrifugation has become a common technique to enrich sperm samples prior to artificial insemination. It is a puzzle why the recent study has found normal sperm counts in samples of men living in Africa, South America and Asia. In contrast men living in Europe, North America and Australia have 50% lower sperm counts. The reason may be multifactorial. It will require a team of experts to sort out this discrepancy and hopefully find an answer for men in Europe, North America and Australia to bring their sperm counts back to normal.

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Aug
19
2017

No More Macaroni And Cheese

Two years ago Kraft’s was in the news and I said then “no more macaroni and cheese”.  At that time they promised to make macaroni and cheese more nutritious by removing artificial coloring and artificial flavors. Now they are in the news because industrial chemical phthalates have been found in almost every sample of cheese powder that is used to make macaroni and cheese.

Phthalates are powerful hormone-disrupting chemicals that are toxic to children and pregnant women. Prenatal exposure to phthalates has been linked to abnormal brain development and abnormalities of the reproductive system. Potentially 725,000 American women of childbearing age are at risk. Should they get pregnant, their babies would be at the receiving end of toxic phthalates. In Europe new regulations about phthalates were introduced in 2011. In North America the FDA has been negligent in enforcing legislation to keep the US population free of phthalates in their food.

Background information about phthalates

Phthalates are industrial chemicals that are widely used in cleaning agents like soaps, plastics, rubbers, inks, adhesives and fragrances. Phthalates in plastic materials increases the durability and longevity, but also the flexibility and transparency of plastic.

The Center for Disease Control and Prevention describes on its website how a large percentage of the population has phthalates in their urine. This proves that unsuspecting customers are ingesting phthalates, which potentially poses a tremendous challenge.

Should phthalates be more vigorously legislated as they have been in Europe?

Effects of phthalates on body

It seems that males are more sensitive to the toxic effects of phthalates than females. Males experience testicular atrophy and shrinking of the prostate gland. The sperm count goes down, which can lead to infertility. Pregnant women are at risk of having babies with genetic defects due to exposure to phthalates. Many cosmetic products contain phthalates and due to lax FDA supervision many cosmetics are not even labelled, when they contain phthalates (lipsticks, make-up).

Apart from infertility issues phthalates are also responsible for allergies, some cases of obesity, asthma and breast cancer.

There are other clinical conditions that have been linked to phthalate exposure. Behavioral issues, autism spectrum disorder, type 2 diabetes, low IQ and neurodevelopmental issues. A lot of these problems could be eliminated with more awareness of the public, stricter labeling rules of the regulatory agencies and more responsibility shown by manufacturers.

Why nutritionists don’t like macaroni and cheese

Macaroni and cheese belongs into the group of junk foods. In the past it was artificial coloring and artificial flavors that were the concern. Now it came to light that phthalates have contaminated the fat-containing cheese from the packaging. The soft plastic cheese packages contain phthalates and they are easily transferred into fatty cheese, because phthalates are fat-soluble.

From a nutritional point of view macaronis are simply empty starch. This gets very quickly digested into sugar and causes a sugar peak in the blood. High blood sugar causes an insulin peak. Repeated insulin peaks have been associated with premature aging, obesity and type 2 diabetes.

Cheese in macaroni and cheese is the cheapest processed cheese. Here is a table of contents of what macaroni and cheese contains. In this recipe the cheese portion is derived from processed cheddar cheese. But in many macaroni and cheese packages the cheese portion is made up of a mix of protein, fat and milk powder and this mix has nothing to do with cheese. It just tastes like cheese. But all of the cheese powder packages have in common that in 29 out of 30 of the packages tested phthalates were contained in the cheese powder.

The package was made with a plastic coating that contained the phthalates and this leeched into the cheese powder, because phthalates are fat-soluble.

No More Macaroni And Cheese: Toxic “food” is non-food

The problem with macaroni and cheese in today’s society is that it is processed food. The more food is processed, the higher the risk that valuable nutrients get lost. Unfortunately with food processing there is the need to use a food container where the food is stored. But up to now nobody thought that the ubiquitous phthalates that keep the plastic material of the food container flexible and longer lasting could pose any threat to our health by leaking into fatty foods.

However, we did have problems with PBA’s not long ago; they were leaking from baby bottles into baby food. The solution was to abandon BPA bottles.

We have to rethink the whole scenario. As this link shows there are many other chemicals in plastic that can also be toxic.

We can work on the food side and avoid as much processed food as possible. Buy fresh ingredients that you bring home and store in your fridge. Avoid plastic bags. Use glass containers as they have been found to be safe (not leaking chemicals into food).

What can you do, if you want no more macaroni and cheese?

Stop buying macaroni and cheese as processed food. Buy ingredients to make them yourself at home. Here is a recipe of how to make macaroni and cheese: You may in the past have thought that it is much easier to just buy macaroni and cheese in the store. But this is where the phthalates come in. It is our laziness that allows food processors to slip chemicals into our food that could damage us; and some of these potentially harmful chemicals are phthalates. Phthalates probably slipped into our food unintentionally because they are so extremely fat-soluble that they get into the cheese part of macaroni and cheese.

If you want to eat macaroni and cheese, make it yourself as per the recipe provided with the link above.

But I went one step further. I have abandoned macaroni and cheese altogether. I have decided that I don’t need the extra insulin response from the macaroni as I digest them; I also do not need the extra processed cheese, as the fats are not the healthiest. If I want some cheese, I can cut a few slices from an honest organic cheese that was made from organic milk of grass fed cows.

I like eating diversified food from many healthy sources.

No More Macaroni And Cheese

No More Macaroni And Cheese

Conclusion

Sometimes we need to rethink the food that we eat. Do we want to eat macaroni and cheese, because it reminds us of how we grew up? When you hear that toxic phthalates are contained in processed foods you may also say as I do: “No more macaroni and cheese!” As I mentioned, if you really want to eat it, cook it yourself from the basic, healthy ingredients. But I decided no more macaroni and cheese for me, because it is not that healthy. There are healthier foods that I’d rather eat instead.

If more of us would shun processed foods, then the food industry would have to adapt to the population’s healthier food habits and come up with healthier products. We also would not be exposed as much to phthalates that find their way into the food chain from food containers. Rethink your food habits and perhaps one day you can agree with me: “I don’t want non-nutritious processed food! No more macaroni and cheese!”

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Aug
12
2017

Curcumin And Cancer

Many clinicians give their attention to curcumin and cancer. It may not be used as a primary treatment, but may be added as an adjunct to other cancer treatments. Curcumin is the effective ingredient of the old Indian spice, turmeric. The question is how effective curcumin is against cancer? Is it safe to use? What is the evidence?

Frequency of cancer

According to the American Cancer Society there will be 1,688,780 new cancer cases diagnosed in 2017 and 600,920 cancer deaths will occur in the US.

Causes of cancer

Cancer can be caused in many different ways. Hidden in the many causes may be the possible solution to new cures.

  1. A lack of exercise may contribute to the development of cancer because of a lack of tissue circulation. And exercise will help to support your normal cell metabolism (explained below). Wrong foods may or may not have a contributory role regarding cancer development (a high sugar and starch diet causing insulin response, which changes the metabolism). The Mediterranean diet is an anti-inflammatory diet and has been credited to prevent a lot of cancers.
  2. Cancer can be caused by chemicals, called carcinogens. But it can also be caused by oncoviruses. It can be genetically caused, that’s why it tends to run more often in certain cancer prone families. But Warburg has researched the metabolism of cancer almost 100 years ago, even got the Nobel price for it in 1931 and yet the elusive cancer cure has not materialized yet.
  3. Following Warburg’s research Watson/Crick detected DNA in our cells. Ever since geneticists were fascinated by it. They also found that a cancer suppressive gene, regulated by the p53 gene could develop mutations and then cancer would occur: Tumor Suppressor Genes For decades this was the “in” thing. But in the last 5 to 10 years there is a revitalization of the original Warburg idea that one should concentrate on the metabolic differences between cancer cells and normal cells. This is starting to show some timid results.
  4. Cancer cells are more acidic from lactic acid and burn glucose for energy without requiring oxygen (anaerobic pathway), while normal cells burn glucose in the aerobic pathway in the mitochondria. This difference is important. Cancer cells were found to be more vulnerable to be killed by certain manipulations.
  5. Take cryoablation therapy for prostate cancer. Cryosurgery for prostate cancer. The more vulnerable cancer cells are preferentially killed over the normal cells through a local deep freeze method. Another example is photodynamic therapy for cancer that has been used for lung cancer and esophageal cancer.  This method may be a lot more universally applicable than believed so far. A photosensitized dye is injected and later when normal cells have eliminated the dye, but the defective cancer cells are still containing the dye a laser beam is used to kills the cancer cells preferentially, absorbing the specific laser wavelength that is specific for the dye.
  6. Nobody knows which way cancer research is going. But I think it will be consumer driven: consumers want better cures, and when new methods appear that have better cure rates, these will be pushed forward while less effective methods will become history. I think that Warburg will be revitalized and new therapies will continue to be developed from this as I indicated.

Curcumin and cancer: malignant conversion

There are three development stages for any cancer to develop.

This was originally researched with skin cancer, but also confirmed with cervical cancer. It is called the “malignant conversion” that needs to take place before a normal cell has become a cancer cell. There are three stages.

  • Initiation
  • Promotion
  • Progression

This is important to know in the context of curcumin. Basic research has shown that curcumin interferes with all of these stages of tumor development, both in terms of prevention as well as in terms of being curative. Here is a link that points out the complex multiple steps of cancer growth that curcumin interferes with.

As can be seen from it, curcumin interferes with the initiation of multiple cancers, reduces inflammation, and interferes with angiogenesis and this reduces the amount of metastases that can form. But curcumin further interferes with proliferation of cancer cells, reduces invasion, prevents resistance and improves survival. The underlying molecular and genetic reasons for curcumin’s actions are all contained in that link.

Curcumin and cancer: research in tissue culture and animal experiments

When it comes to cancer research, you usually hear about in vitro culture experiments and animal experiments. This type of research is used to establish that there is an anti-cancer effect, that it is reproducible and non-toxic. The September issue of the 2016 Life Extension Magazine reviewed this in detail. It was entitled “How Curcumin Targets Cancer”.

But as a former clinician I am more interested in seeing cancer patients cured. This has to be verified by clinical trials first. When I looked through PubMed.com for objective evidence of the effects of curcumin in cancer patients, this type of information was more difficult to find. But in the following there are a number of examples that I did find.

Curcumin and cancer: clinical trials

1. Reduction of tumor necrosis factor-alpha

A 2016 meta-analysis of eight randomized studies investigated the effect of curcumin in patients with various inflammatory diseases including cancer. They found that curcumin consistently reduced tumor necrosis factor-alpha. In cancer patients this inflammatory substance is responsible for further cancer growth and developments of metastases.

2. Poor bioavailability of curcumin

A study with increasing amounts of curcumin showed poor absorption of curcumin into the blood. In this study dosages between 500 mg up to 12,000 mg per day of curcumin were given. 500 mg to 8000 mg of curcumin did not result in any positive serum level of curcumin. Only the higher dosages, 10,000 and 12,000 mg of curcumin were associated with positive curcumin levels in the blood serum. In order to have effects of curcumin, higher amounts have to be taken. Higher amounts of curcumin have been tested for toxicity and were found to be safe and were fairly well tolerated.

3. Precancerous colonic polyps reduced in number and size

A smaller study consisted of 5 subjects with familial adenomatous polyposis (FAP). This is an autosomal-dominant disorder where hundreds of colorectal adenomas develop in the lining of the colon. From these colorectal cancer can arise. Five patients received 480 mg of curcumin and 20 mg quercetin orally three times per day. After 6 months the number of polyps and the size had reduced by 60.4%.

4. Premalignant colonic lesions suppressed by curcumin

44 eligible smoker subjects received a baseline colonoscopy where aberrant crypt foci (ACF) were determined. ACI are the very first focal areas in the colon from which colon cancer develops. Smokers are known to have more of these lesions, which was the reason that smoker subjects were used for this trial. The patients received either a supplement of 2000 mg of curcumin or 4000 mg of curcumin for 30 days. These are fairly high doses, but they were used to overcome the poor absorption of curcumin. Colonoscopies were done again after one month of curcumin supplementation. 41 subjects completed the study. In the 4000 mg curcumin group the ACF numbers were reduced significantly by 40% compared to the 2000 mg group, which showed no reduction. The 4000 mg group showed a 5-fold increase of curcumin blood levels compared to baseline. There was no change in blood levels in the 2000 mg group.

5. Reduction of radiation dermatitis with radiation therapy in breast cancer patients

30 breast cancer patients were divided into an experimental group and a placebo group. All of them had a mastectomy first, which was followed by radiation therapy. The experimental group received 6 grams (2 grams three times per day) of curcumin during the time of radiotherapy following mastectomy. The severity of radiation dermatitis following radiotherapy was significantly reduced in the experimental group when compared to the placebo group. Only 28.6% had significant radiation dermatitis in the curcumin group versus 87.5% in the placebo group.

6. Chronic multiple myeloma patients

An Australian study involving chronic multiple myeloma patients found that curcumin at 4 Grams per day and even more so at 8 Grams per day stabilized the disease and improved kidney function.

7. Descriptive studies

Descriptive studies investigating the effect of various doses of curcumin have been done regarding breast cancer,  and advanced pancreatic cancer. But these clinical trials were all rather small.

8. Chemoprevention of cancer

A phase II trial enrolled 21 patients with end-stage pancreatic cancer patients. The only FDA approved treatments for this are gemcitabine and erlotinib, but this would normally only lead to clinical responses in less than10% of patients. In this study the investigators used curcumin to enhance the anti-tumor response of either gemcitabine or erlotinib. The study summary stated: “Oral curcumin is well tolerated and, despite its limited absorption, has biological activity in some patients with pancreatic cancer.” 2 of the 21 patients had stable disease for more than 18 months; one of the 21 patients had a brief tumor regression of 78%, but then relapsed and died.

9. Chemoprevention of prostate cancer

Chemoprevention of prostate cancer is discussed in this publication: There was specific reference made to prevention of prostate cancer and the opinion of the researchers was: “At present, there is no convincing clinical proof or evidence that the cited phytochemicals might be used in an attempt to cure cancer of the prostate.”

Curcumin And Cancer

Curcumin And Cancer

Conclusion

For years there have been reports to indicate that curcumin was a promising natural supplement that can improve cancer survival. There are poorly founded reports of effects of curcumin on colorectal cancer, pancreas cancer, prostate cancer, breast cancer, ovarian cancer and others. But on closer look the hype seems to come mostly from in vitro studies (tissue culture experiments) or from animal studies. Clinicians, however, demand well-constructed randomized clinical trials with clear research objectives before they can accept a new agent like curcumin to be effective. These clinical trials are missing! Instead there are many in-between trials of questionable quality as listed above.

There have been problems of bioavailability due to poor absorption of curcumin. To a certain extent this could be overcome by pushing the dosage to 6000 to 8000 mg per day. But a significant percentage of people (around 30%) suffered from abdominal cramps and nausea and had to discontinue these high doses of curcumin. Newer curcumin compounds have been developed, but at this point it is not known what the bioequivalent dosage is of these newer curcumin agents in comparison to the original curcumin dosages.

It is quite possible that new trials will one day be performed that may bring better news on survival rates of various cancer patients involving curcumin therapy. But in my opinion right now it is not yet prime time for curcumin!

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Aug
05
2017

Death From Heartburn Drugs

A study was recently published showing that death from heartburn drugs can come early, when compared to controls. The study was published in June 2017 in the online British Medical Journal Open. The researchers were located at the Washington University School of Medicine, Saint Louis, Missouri, USA.

349, 312 US veterans on proton pump inhibitors (PPI) were compared to an equal amount of veterans on conventional H2 blockers. Over a follow-up period of 5.71 years there was an increased risk of death of 25% when patients took PPI drugs. It did not matter to what the PPI group was compared, there were always more deaths in the PPI group compared to other control groups.

Causes of death

According to the senior author, Dr. Ziyad Al-Aly many deaths were due to kidney disease, dementia, fractures, pneumonia, Clostridium difficile infections and cardiovascular disease. Out of 500 patients who took the PPI drug there was one death within one year. But over the years the deaths increased. Dr. Al-Aly thinks that the PPI drug is interfering in some way with the genetic expression of some genes and suppressing others. These genetic differences may explain the early deaths.

As this was a retrospective study, it can only show an association of PPI drugs with earlier deaths, but this does not prove causation. It would require a prospective random study to prove causation.

Other studies regarding the risk of PPI drugs

  1. An Icelandic study from May 2017 showed that there was a 30% increased risk of fractures in males and females following PPI drugs when observed over 10 years. Opiates were associated with an almost 50% risk, sedatives with a 40% risk of increased fractures. Control groups of NSAIDs, statins and beta-blockers showed no increased fracture risk, nor did histamine H2-antagonists.
  1. An article from March 2017 is a critical review of the safety of PPI drugs. It notices that with long-term use there are adverse effects like fractures of the long bones, enteric infections and hypomagnesemia. PPI’s can increase the risk for heart attacks and can cause kidney disease and dementia. One of the problems is that gastroesophageal reflux usually dictates the long term use of anti acid drugs like PPI’s, but the longer patients are taking these drugs, the higher the death rate and side-effect rate. The physician should only use PPI drugs initially and after a few weeks switch to the less potent histamine H2-antagonists (like ranitidine).
  2. A Danish study from April 2017 noted an increased risk for listeriosis in patients who were on PPI drugs. Over 5 years there was a 2.81-fold higher risk of developing listeriosis in patients on PPI’s compared to a control group. If patients were on corticosteroids and a PPI the risk was even higher, namely 4.61-fold increase to develop listeriosis. In contrast, the use of histamine H2-antagonists was associated with a risk of only 1.82-fold of developing listeriosis.
  1. In a Dec. 2016 study from Dublin, Ireland patients older than 65 were examined with regard to their PPI drug use. Data was compiled for 1997 and for 2012. It was noted that the maximal PPI dose for long-term use was prescribed to 0.8% of individuals in 1997 and to 23.6% in 2012. The risk of getting high dose PPI drugs prescribed in 2012 was 6.3-fold compared to 1997. Examination of the health records showed that the indication for prescribing PPI drugs was not associated with significant gastrointestinal bleeding risk factors. The study concluded that there was definitely room for improving prescribing habits.
  1. This January 2016 paper describes the standard treatment of H. pylori and gastric and duodenal ulcer treatment, which involves the triple therapy consisting of a PPI and two antibiotics. It pointed out that this treatment protocol “improves healing and prevents complications and recurrences”.
  2. A paper from Leipzig, Germany dated July 2016 reviews the usage of PPIs. It mentions that there has been a significant increase of prescriptions in the past 25 years. Patients on PPI’ are at a greater risk for fractures. There is also a risk of low B12 levels from malabsorption of B12. This should be checked from time to time, and if necessary B12 injections should be given.
  3. A Canadian study from May 2015 found that Clostridium difficile infections (CDI) were linked to chronic antibiotic use or to prolonged use of high doses of PPI drugs. There was a 1.5-fold risk of recurrent CDI in patients older than 75 years who were taking PPI drugs continuously. There was a 1.3-fold recurrence of CDI after antibiotic re-exposure.

Alternative remedies for heartburn

  • Dr. Weil recommends the use of deglycyrrhizinated licorice (DGL) for heartburn or early ulcers.
  • Here is a clinical study with 56 patients with duodenal and gastric ulcers that was published in 1968. It could be shown both radiographically as well as clinically that the ulcers healed and that stomach spasms subsided with DGL treatment. At that time it was not known that DGL had antibacterial effects and that often chronic heartburn, stomach and duodenal ulcers can be made chronic by H. pylori infections that are simultaneously present.
  • A December 2016 study showed that probiotics could be a valuable adjunct in triple therapy for H. pylori infection. The study also points out that H. pylori is present in about 50% of the world’s population.

Antibacterial effects of DGL

  • A paper of December of 2012 shows that an important tooth decay bacterium responds to DGL.
  • In a 1989 study 20 patients with aphthous mouth ulcers were followed. DGL mouthwash led to a 50 to 75% improvement in 15 patients within one day of treatment and by the 3rd day there was complete resolution.
  • Here is a suggestion of a four-step approach against H. pylori.
  • DGL has been shown to be useful in gut regeneration in patients with Clostridium difficile infection.

Discussion

I started with a review of a recent paper that pointed out the side effects of PPI drugs. PPI’s are used for acid reflux disease, stomach and duodenal ulcers, either alone or as part of the triple therapy. Because many of these problems are associated with a chronic infection of H. pylori, I reviewed the literature surrounding deglycyrrhizinated licorice (DGL), a natural antacid remedy. It turns out that DGL can be quite useful either as a parallel treatment or instead of the triple therapy.

The problem over the past 25 years is that physicians have been treating acid problems with higher and higher doses of PPI’s. They are also using ASA prophylaxis against heart attacks and strokes more often. This has caused gastric erosions that are bleeding, which in turn caused physicians to prescribe more PPI’s. The side effects of PPI’s can be viewed as iatrogenic (doctor- induced) disease. This is an artificial disease that occurs from the side effects of overprescribed medicine. PPI’s are a very useful short-term anti-acid medication. But this medication should not be used for more than 4 to 8 weeks. But as patients receive years and years of this medication, serious problems like heart attacks, fractures, kidney disease, dementia, and pneumonia as well as Clostridium difficile infections become the consequence. Overall there was an increase of the death rate of 25%.

It sounds quite reasonable that doctors should return to a more conservative approach as the FDA has suggested. Alternative natural methods including DGL and probiotics can also be utilized.

Death From Heartburn Drugs

Death From Heartburn Drugs

Conclusion

A recent study from the online British Medical Journal Open has pointed out a high death rate among long-term proton pump inhibitor (PPI) drug users. These drugs are used to suppress acid formation in the stomach. They are helpful, if there are significant gastrointestinal bleeding risk factors present. But prolonged use of PPIs causes severe side effects as described, including a chronic persistent Clostridium difficile infection (CDI) of the gut that can become resistant to antibiotic therapy. In cases of recurrent CDI one important step is to discontinue PPIs. The physician should consider switching to one of the conventional histamine H2-antagonist drugs (like ranitidine). Overusing PPIs in an older population is not responsible, as this leads to disease that is caused by a physician! There is no need for this to happen. The prescribing physician has to exercise caution and restraint and the patients, and their loved ones need to be aware of multidrug interactions. PPIs belong to the drugs that are eliminated in the liver through the cytochrome P450 enzyme system (CYP2C19). But this enzyme system interfering with the drug elimination process may also eliminate other drugs taken by the patient. The end results can be toxic drug levels of PPIs. It can potentiate the side effects and become responsible for the 25% increased risk of death when the patient takes PPI drugs chronically. Even though PPIs are the newer medication, newer does not always mean better.

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