Dr. Ray Schilling

Dr. Ray Schilling born in Tübingen, Germany and Graduated from Eberhard-Karls-University Medical School, Tuebingen in 1971. Once Post-doctoral cancer research position holder at the Ontario Cancer Institute in Toronto, is now a member of the American Academy of Anti-Aging Medicine (A4M).

About Ray Schilling

Dr. Ray Schilling born in Tübingen, Germany and Graduated from Eberhard-Karls-University Medical School, Tuebingen in 1971. Once Post-doctoral cancer research position holder at the Ontario Cancer Institute in Toronto, is now a member of the American Academy of Anti-Aging Medicine (A4M).

May
20
2017

Prevention Of Telomere Shortening

Dr. Mark Rosenberg gave a talk on prevention of telomere shortening. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Clinical Value of Telomere Testing”.

What are telomeres?

Telomeres are the caps at the end of chromosomes. They are very important in the aging process. Prematurely shortened telomeres are linked closely to all major diseases like cardiovascular disease, cancer, diabetes and more. Telomeres are also a measure of the aging process. Aging occurs due to a decrease of the number of cells in organs and/or because of a lack of functioning of these organs. Telomeres get shortened every time a cell divides. But when the telomeres are used up, there comes a time when cells can no longer divide. These cells become senescent cells or they enter apoptosis (programmed cell death).

The senescent cells can become a problem when they get transformed into cancer cells and their telomeres lengthen again. These cancer cells divide rapidly and this can become the reason why cancer patients to die.

What is the significance of telomeres?

Telomere dysfunction is the first sign that the telomeres are getting shorter in a person compared to the average telomere length in a comparable age group. This is not only important for aging, but also has clinical implications. The shorter telomeres are, the higher the risk for cardiovascular disease. Telomere length also provides prognostic information about the mortality risk (risk of dying) with type 2 diabetes and for many cancers. Many physicians incorporate a telomere blood test into periodic health checks, if the patient can afford it.

Interventions that help telomere length

Here are a number of things we can do to lengthen our telomeres.

  1. Rosenberg mentioned that the strongest effect on telomere lengthening comes from caloric restriction and weight loss. 80 years ago they showed at the Cornell University that rats put on calorie restriction had a 30% increase in their mean and maximum lifespan. Many research papers have confirmed that the same is true in man and that the common denominator is telomere lengthening.
  2. Next are regular physical activity, meditation, reduction of alcohol consumption and stopping to smoke.
  3. Taking antioxidants and omega-3 fatty acids regularly will also lengthen telomeres.
  4. Improving one’s dietary pattern by adopting a Mediterranean type diet that contains cold-pressed, virgin olive oil.
  5. Telomerase activators. Here is some background on the TA-65 telomerase activator, which is based on Chinese medicine. A one year trial was completed with 250 units and 1000 units of TA-65 per day. The lower dose (250 units) showed effective telomere lengthening, while the placebo dose did not. The 1000 unit dose did not show statistical significance.

Should you wish to take TA-65, only take 250 units per day, not more.

Cancer and telomeres

There is a strong correlation between cancer and telomere shortening. When cells are at the brink of dying toward the end of their life cycle the telomeres get shorter and shorter. This is the point where the cells can turn malignant. Certain genetic abnormalities help the malignant transformation, like 11q or 17q deletions or a p53-dependent apoptosis response. Once cancer cells have established themselves they activate telomerase in 85% of cases. In the remaining 15% of cancer cases telomeres are activated through telomerase-independent mechanisms. Here are a few examples.

CLL

CLL stands for chronic lymphocytic leukemia. It is a disease of the aging population. At age 90 people’s bone marrow cells have a telomere length of only 50% of the length at birth. This is the reason that in older age CLL is more common. Researchers observed a population segment and found that the shorter telomeres were, the poorer the overall prognosis and overall survival for CLL was.

Lung cancer

In patients with non-small cell lung cancer the telomerase activity was examined. When telomerase activity was present, the 5-year survival was only 55%. When telomerase activity was absent, the prognosis was 90% survival after 5 years.

Prostate cancer

  1. Telomere shortening in stromal cells was found to be associated with prostate cancer risk. Men with shorter telomere length in stromal cells had a 266% higher risk of death compared to men with normal telomere length.
  2. Another study took blood samples and determined the telomere length in lymphocytes (the immune cells). Those men who came down with prostate cancer within a year after the blood sample was taken had short telomeres. The risk for prostate cancer in these patients was 355% higher than in the prostate cancer negative controls.

Yet another study looked at surgical tissue samples from 596 men that

Underwent surgery for clinically localized prostate cancer. Patients whose samples showed variable telomere lengths in prostate cancer cells and shorter telomeres compared to prostate samples with less variable telomere length and longer telomeres had a much poorer prognosis. They had 8-times the risk to progress to lethal prostate cancer. And they had 14-times the risk of dying from their prostate cancer.

Breast cancer

Breast cancer is diverse and consists of cases that are genetically inherited (BRCA1 and BRCA2), but there are also cases where the cancer is local or more advanced (staging). In families with mutated BRCA1 and BRCA2 telomeres are significantly shorter than in spontaneous breast cancer. Increased telomerase activity in breast cancer cases is directly related to how invasive and aggressive the breast cancer is.

  1. One study was shown where blood leukocytes were analyzed for telomere length in 52 patients with breast cancer versus 47 control patients. Average telomere length was significantly shorter in patients with a more advanced stage of breast cancer than in early breast cancer. Mutated HER patients had the shortest telomeres. It follows from this that checking for the HER status and blood telomere testing adds to the knowledge of potential cancer development and prognosis.
  2. Short telomere length was associated with larger breast tumors, more lymph node metastases and more vascular invasion. More aggressive breast cancer cells have higher telomerase activity. More than 90% of triple negative breast cancers have short telomeres.

CNS disorders and telomeres

Dr. Rosenberg presented evidence that shorter telomeres are associated with dementia. But dementias with Lewy bodies and Alzheimer’s disease are also linked to short leukocyte telomeres. The length of blood telomeres predicts how well stroke patients will do and how people with depression will respond to antidepressants.

Cardiovascular disease and telomeres

Our blood pressure is kept constant through the renin-angiotensin-aldosterone system. When this system is not stable, our blood pressure shoots up and causes cardiovascular disease. This is tough for the heart, as it has to pump harder against a higher-pressure gradient. A study of 1203 individuals was examining the connection between leukocyte telomere length and renin, aldosterone and angiotensin II activity. It concluded that oxidative stress and inflammatory responses affect the telomere length of leukocytes and that the more stress there is in the renin-angiotensin-aldosterone system, the more cardiovascular disease develops. The conclusion of the study was that the overall cardiovascular stress leads to shortening of leukocyte telomeres.

Prevention Of Telomere Shortening

Prevention Of Telomere Shortening

Conclusion

Telomere length testing from a simple blood test will become a more important test in the future as hopefully the cost comes down (currently about 300$). It can predict the general aging status by comparing a single case to the general telomere length of the public. But it can also predict the cancer risk, risk for mental disease and cognitive deficits (Alzheimer’s disease). In addition your cardiovascular status is also globally assessed with this test. What can be done, if the test comes back with short telomeres?

It allows you to change your lifestyle and adopt a healthy diet. You can exercise regularly, take antioxidants and meditate. There are even telomerase activators that are gradually becoming more known. They lengthen the telomeres. The cost of telomerase activators will likely still be a problem for some time. All in all telomere length tests are here to stay, but effective intervention at this point is largely limited to healthy lifestyle choices. This is good news: healthy lifestyle choices like non-smoking, exercise and avoiding non-processed foods are either free or have a reasonable price tag. Telomerase activators are big business and at this point not really affordable!

May
13
2017

Results Of Insomnia Studies

Results of insomnia studies are focusing on all angles of insomnia. We know for some time that the circadian rhythm is linked to deep REM sleep, which we only reach about 2 hours into our nightly sleep. There are several reasons why our normal sleep pattern can get disrupted.

1. Night owls have a CRY1 mutation

A recent publication on March 27, 2017 has detected a mutation of the human circadian clock called CRY1. This is a dominant gene that is responsible for delayed sleep phase disorder (DSPD). People with this genetic feature tend to go to sleep 2 hours later than the average person every day.

It occurs between 0.2% and 10% in the general population and is inherited by the autosomal dominant mode.

This gene is responsible for the phenomenon of persons being “night owls”.

2. Sleep deprivation in nursing homes

Another publication has zeroed in to what happens in the frail elderly who live in nursing homes.

Here is what sleep researchers have found out about nursing homes.

  • Older people also need 7 to 8 hours of sleep per night, not less as previously thought.
  • Let people sleep at night, and give them undisturbed sleep. The practice of waking them up every 2 hours is unnecessary and undermines a restful sleep with normal amounts of REM sleep.
  • The color of light matters: Blue/purple light coming from TVs, iPod’s, laptops or cell phones stimulates serotonin production that wakes you up. In contrast to this orange/red light stimulates melatonin production that facilitates sleep. A nursing home owner, Guildermann said: “We have made it darker at night, and what light they do have is orange/amber/red light, and we are having phenomenal results.”
  • Sleep, exercise and nutrition are the biggest components of health.

3. Night workers

One of the news stories in 2016 was about health risks of night shifts. The Bureau of Labor Statistics reported in 2000 that 15 million workers (16.8 % of the working population) were doing alternative shifts (night shift work mixed with daytime shifts). In 2016 they reported 14.8% were working alternate shifts. Among blacks, Asians and Latino Americans the percentage of working alternative shifts was higher, namely 20.8%, 15.7% and 16%, respectively.

Shift work is more common in certain industries, such as protective services like the police force, food services, health services and transportation.

Your body rewards you, when you sleep 7 to 8 hours during the night, but it will penalize you severely, if you turn it upside down. The reason is the diurnal hormone rhythm that we all have built in. Sleep is regulated by melatonin during the night, which is released by the pineal gland (on the base of the skull). Daytime wakefulness is regulated by the stress hormone cortisol from the adrenal glands. These two hormones inhibit each other, cortisol inhibits melatonin and melatonin inhibits cortisol. All the other hormones are also regulated according to the diurnal rhythm: testosterone, for instance is highest in the morning, human growth hormone is highest between midnight and 3 AM.

There are examples of what happens when you do shift work for several years:

  1. A) A Swedish study found that white-collar shift workers had a 260% higher mortality compared to a control group of daytime white collar workers: Shift work and mortality.
  2. B) A study compared night workers in the age group of 45 to 54 with daytime workers and found a 147% higher mortality rate in the night shift workers: Shift Workers’ Mortality Scrutinized. Shift workers work at night and sleep during the day. This can be done, but it is against the physiology of your body, as I explained above. Remember that melatonin does not only regulate your sleep, it also is one of the main stimulant hormones of the immune system. If you manipulate your diurnal hormone rhythm by staying awake during the night and sleeping during the day, you pay the price by an increased risk of mortality (increased risk of death). I think this is not worth it!

4. What to do when you cannot sleep?

The first step is to take 3mg to 5mg of melatonin at bedtime. It should be taken between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame you are likely thinking too much! Relaxation before going to sleep should be part of your evening ritual. It can happen that we experience demanding, stressful days, and despite all better effort, it is difficult to be entirely relaxed. After demanding days like that I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with the melatonin should help in more than 80%-90% of insomnia cases. If you cannot sleep, see your physician. Sleep studies may be required or you may have problems of the thyroid (hypo- or hyperthyroidism), which may need to be checked. Other medical problems including depression have to be checked out as well. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems the next day or the feeling of a mild hangover.

5. Telomeres and insomnia

Some people have no problem disciplining themselves to go to sleep between 10PM and 11 PM, which seems to be the window of opportunity to catch a good night’s sleep. Others are so used to do their late night activities (reading, watching TV, being online, going to the pub etc.) that they finally drop into bed at 1 or 2 AM. People need 7 to 8 hours of good sleep; even hard-core party goers need to get that much sleep. Nature does not make exceptions! When you go to bed only at 1AM or 2AM, it is difficult to get enough sleep.

It is true that you can suffer multiple health problems, as all of your hormones depend on the resetting during your deepest sleep between 2AM and 4AM triggered by the nighttime melatonin response. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span. The reason for this is that people with shortened telomeres develop heart attacks, strokes and cancer. This is what shortens the life span. How do we avoid this risk? Go back to healthy sleep habits. As mentioned above it is best to start going to sleep between 10 PM and 11 PM and sleep for 7 to 8 hours.

6. Electronics in the bedroom

There is new research showing that electronics in the bedroom can interfere with a normal sleep pattern. Dr. Ben Carter is the lead author and a senior lecturer in biostatistics at King’s College London. He completed a study involving 125,198 children with an average age of 14½ years. There were about equal amounts of males and females. Both sexes had the same problem. When they were allowed to use electronic media, this interfered with their sleep time. What electronic devices are we talking about? Watching TV, using the computer, the cell phone, tablets and computer games. The study was originally published at JAMA Pediatrics.

The blue/purple light of the TV screen or a computer screen stimulates the brain to produce serotonin. This undermines the melatonin production and as a result the person finds it extremely difficult to fall asleep.

Here is a list that contributes to better sleep habits and better sleep quality:

  • Ensure that the bedroom is dark, soundproof, and comfortable with the room temperature being not too warm. It is important to develop a “sleep hygiene”. This means going to sleep around the same time each night, to have some down time of 1 hour or so before going to bed and getting up after the average time of sleep (for most people between 7 to 9 hours). Sleeping in is not a solution, and an alarm clock will also help to develop a sleep routine.
  • Caffeine drinks, alcohol, nicotine and recreational drugs must be avoided. Smokers should butt out no later than 7PM, as nicotine is a stimulant.
  • Getting into a regular exercise program, either at home or at a gym is beneficial.
  • Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  • It is not a sensible idea to use the bedroom as an office, reading place or media center. It paves the way to the getting stimulated by cortisol, which keeps us awake. The bedroom is a place of rest and should be comfortable and relaxing.
  • Some sleepers wake up at night, and they are wide-awake! Leaving the bedroom and relaxing in the living room for a while can help. It goes without saying that playing video games will not help! An alternative is to take 3 mg of melatonin, which will helps to fall asleep faster, but melatonin will wear off after about 4 hours.
  • A self-hypnosis recording is a useful adjunct to a sleep routine. Listening to it before going to sleep helps to focus on relaxation and to stop ruminating about the day and its events. Keep the volume low.
Results Of Insomnia Studies

Results Of Insomnia Studies

Conclusion

Recent results of insomnia studies have reconfirmed that we need our regular sleep to maintain our health. We have seen that some nursing homes have a practice of waking the client up every 2 hours. This must be abandoned as it interferes with the restorative deep REM sleep. In turn this will interfere with hormone restoration overnight.

Children and adolescents must limit their time in front of the TV, iPhones and computer screens. The blue light has the frequency that over stimulates the brain and interferes with melatonin production. Some people work overnight as shift workers or party until the wee hours in the morning. This causes your telomeres in your body cells to shorten. When you restore your sleeping pattern to normal your telomere length will no longer be shortened.

Even people who are night owls due to an inborn CRY1 gene that is responsible for delayed sleep phase disorder can normalize their sleep pattern by following a strict sleep hygiene. As people get older they lose the ability to make melatonin, but this can be replaced by taking melatonin tablets at bedtime.

Remember what I said earlier: Sleep, regular exercise and good nutrition are the biggest components of health.

May
05
2017

New Treatments For Premenstrual Syndrome

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

Symptoms are varied; they can mimic various psychological problems like anxiety, depression, panic attacks and more. But physical symptoms like abdominal bloating, acne, back aches, and asthmatic attacks are also common. There are a myriad of more symptoms of PMS: constipation, cramps, clumsiness, dizziness, drowsiness, decreased sex drive, facial swelling, forgetfulness, fatigue, headaches, a herpes-like outbreak, hot flashes, sensitivity to light and noise, insomnia, joint pains, mood swings, palpitations, restlessness, poor memory, sore throat, tearfulness, vomiting and weight gain.

What do we know about PMS?

  1. There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.
  2. PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which is called estrogen dominance.
  3. But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.
  4. Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.
  5. Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.
  6. A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.
  7. The birth control pill can bring on PMS due to the progestin component in it.
  8. Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.
  9. Pregnancies, miscarriages and abortions can also bring on PMS.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

Dr. Smith said that PMS has been divided into 4 subcategories depending on the main symptoms.

  • PMS A: Anxiety
  • PMS C: Carbohydrate craving
  • PMS D: Depression
  • PMS H: Hyperhydration

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS C is associated with sugar craving, hypoglycemia, headaches, heart palpitations and spontaneous sweating.

PMS D is leading to increased neurotransmitter degradation. Symptoms consist of depression, crying, despair, feeling hopeless, fatigue, low libido, apathy and insomnia.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

  1. When estrogen and progesterone are on the rise around the time of ovulation
  2. When a woman has hypoglycemia (due to hyperinsulinemia)
  3. When estrogen levels are changing
  4. When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Progesterone is the one hormone that is found persistently lacking in most PMS patients. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and could be used instead of the cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

  1. Black Cohosh is said to balance estrogen and is anti-spasmodic.
  2. Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.
  3. St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.
  4. Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.
  5. Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group.  Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.
  6. Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

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Apr
29
2017

Cancer By Chance

A new theory talks about cancer by chance. In other words, it likely is mostly bad luck when cancer develops. Mathematician Cristian Tomasetti and cancer geneticist Bert Vogelstein of Johns Hopkins University in Baltimore, Maryland developed a new model of cancer development. They found that stem cells in different organ systems divide at different rates. The faster they go through cycles of cell divisions, the higher the chances of a mutation. The mutations happen in the genetic material and can lead to cancer. Dr. Vogelstein applied this model to 32 different cancer types and found the following.

  • 66% of cancers: cancer-promoting mutations develop by chance during cell division in various organs
  • 29% of cancers are due to environmental causes
  • 5% of cancers are inherited

Stem cells in organs can turn into cancer by chance

Key to the new theory of “cancer by chance” is that cancer likely is developing from stem cells in different organs. Different stem cells have different rates of stem cell divisions.

In pancreatic cancer they found that 5% were inherited, 18% were from environmental factors (smoking) and 77% came from chance mutations. This data was derived from the Cancer Research UK database.

For prostate cancer the rate of spontaneous mutations is 95%. When all of the cancers are looked at about 1/3 of cancers are due to either environmental or inherited factors, but 2/3 of all cancers are due to random mutations (“bad luck mutations”). They pointed out this fact in their first publication.

With the second publication, as mentioned in the beginning, Vogelstein and Tomasetti concentrated on 17 common cancers in 69 countries. They searched 423 international cancer databases. Again they found that the more stem cells divided in an organ, the more random mutations occurred. This caused cancers in that organ.

Here are a few examples for lifetime stem cell divisions:

  • Colon: 6,000 cell divisions in stem cells of the colon
  • Breast: 300 cell divisions in breast stem cells
  • Lung: only 6 cell divisions in lung stem cells

Colon cancer is very common because of the high stem cell division rate. But they also looked at environmental factors. For instance, lung cancer is rare in non-smokers because stem cells in lungs divide slowly. However, the carcinogens from cigarette smoke add a huge environmental risk. The end result: there is more lung cancer in smokers. Vogelstein said that with every stem cell division there is the creation of three new cell mutations because the body has a “poor copying machine”. During meiosis DNA breaks can occur that lead to mutations. Once they occurred, they continue to get copied.

Environmental factors versus cancer by chance

In the first paper the medical community was critical about how the authors had overemphasized that two third of cancer is caused randomly. So in the second paper Vogelstein and Tomasetti mentioned quite a bit how a change of the environment can change the final outcome of developing cancer.

This is also reflected in this summary from the CNN.

They mentioned that one mutation is not enough to cause cancer. You need three or four such mutations. As we get older there is a higher likelihood that we accumulate this number of mutations, and cancer can develop. But if we exercise, stop smoking and avoid red meat, this can contribute to a much healthier environment in the dividing stem cells. In this case we may not accumulate enough stem cell mutations in our lifetime to come down with cancer.

There is a problem with prostate cancer as indicated in this German summary of Vogelstein and Tomasetti’s work.

Japanese men have an extremely low rate of prostate cancer, namely 1/25th of the rate in the US. When Japanese men immigrate to the US, it does not take long before their risk is the same as that of US men. This is a classical case of the importance of environmental factors in cancer causation. Song Wu has pointed out in a publication in Nature that in his opinion Vogelstein and Tomasetti did not pay enough attention to extrinsic (environmental) factors in the causation of cancers.

This could explain the prostate cancer conundrum just mentioned. There may be more xenoestrogens in the environment in the US when compared to Japan, and this may have caused the additional prostate cancers when Japanese men moved to the US. Xenoestrogens are estrogen-like hormones in the environment, which can cause prostate cancer.

Prevention undermines “cancer by chance”

The role of prevention is likely larger than previously estimated. Now that we know that on average 2/3 of all cancers are due to chance mutations, it is important to realize that prevention and early detection play an enormous role.

  1. Most cancers can only be cured in stage 1 and stage 2 out of 4 stages. And this is only the case when the mutated stem cells are removed along with the clone of cancer cells.
  2. In terms of reducing the risk for lung cancer this means to stop smoking.
  3. With colon cancer it means having regular colonoscopies where the suspicious polyps are removed.
  4. For prostate cancer it means to do a mapping biopsy and to do cryoablation therapy, which has a prostate cancer vaccination effect as well.
  5. Not all cancers can be diagnosed early. Pancreatic cancer is such a difficult to diagnose cancer. But screening methods have been developed that are more sensitive and very specific such as the Oncoblot test.  With this test even cancer of the pancreas can be diagnosed years before it would be clinically detectable.
  1. We do know that chronic inflammation can lead to cancer. It makes sense therefore to start with an anti-inflammatory diet like the Mediterranean diet. Fish oil is also anti-inflammatory.
  2. Add to this regular exercise, as we know it reduces the risk for cancer development and strengthens your heart and lungs.
  3. Vitamin D3 can reduce cancer risks in both males and females. When vitamin D3 was given and blood 25-hydroxyvitamin D levels were above 40 ng/ml, the breast cancer rate was reduced by 71% compared to a low vitamin D3 group. Similarly in men the prostate cancer rate dropped by 71% with vitamin D3 supplementation.  There is more good news with vitamin D3. You can read about it in the link.
Cancer By Chance

Cancer By Chance

Conclusion

The causes of cancer have always been by chance, by environmental exposure and by inheritance. In recent years more detail about this has come to the forefront. Now we know that the majority of cancers develop by chance, but this does not mean we should sit back and do nothing. The PAP test with early diagnosis of cancer of the cervix and early treatment has almost eradicated this cancer. HPV vaccinations have added to the armamentarium. Colonoscopies have reduced the incidence of colon cancer, but only through screening at regular intervals. The PSA test has enabled men to check for prostate cancer, and early treatment for this is quite successful. More is known about cancer prevention through supplements and lifestyle.

Nature is cruel and wants to knock us off, as we get older. The only alternative we have is to fight back as follows: reducing environmental causes, increasing preventative steps and going for early treatment, when cancer is diagnosed.

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Apr
22
2017

Only Moderate Alcohol Consumption Benefits Your Heart

A new study from England finds that only moderate alcohol consumption benefits your heart. The study was released on March 22, 2017 in Great Britain. 1.937 million people (51% women, 49% men) had participated in this investigation over 6 years. The lead author, Dr. Steven Bell is a genetic epidemiologist. He said that this study was done to clear up some of the confusion from previous studies. He wondered why the control group without alcohol exposure had more cardiac problems than the moderate group. It did make sense though, that the high alcohol group had worse cardiac problems.

But he and researchers from Cambridge University and University College London did this study to get more detail. They wanted to know why the current non-drinking group used as a control was not looked at more carefully. It consisted of a mix of lifelong abstainers; people who drank formerly, but then gave it up. And the other group was those who drink on an occasional basis.

With this in mind the researchers designed their study. They also used also larger numbers to increase the reliability of the study.

Details of English study

The data comes from the Clinical Practice Research Datalink providing anonymous patient records from general practices in England. The patients upon entry into the study had to be older than 30 years, but have no evidence of cardiovascular disease. A total of 1,937,360 patients qualified to be part of the study.

Based on patients’ records and patients recollections people, researchers looked at 5 classes of drinkers:

  • Non-drinkers (14.3%)
  • Former or ex-drinkers (stopped drinking at one point, 3.7%)
  • Occasional drinkers (drinking rarely, 11.9%)
  • Moderate drinkers (drinking within sensible limits, 61.7%)
  • Heavy drinkers (hazardous alcohol use, 8.4%)

The end point of the study researchers concentrated on the frequency of cardiovascular diseases like angina, heart attack, sudden cardiac death, stroke, peripheral arterial disease, abdominal aortic aneurysm and others. I only listed 6 of the 12 cardiovascular diagnoses as otherwise it would get too technical.

More information: Most study participants were non-smokers, their BMI was within normal limits, and they also did not have diabetes.

Findings of the study

There were significant differences among subclasses of alcohol consumption and the development of cardiovascular diseases over 6 years.

  1. The findings were in line with a number of previous similar studies that showed a U-type dose response curve between developing cardiovascular diseases and alcohol consumption. The group of non-drinkers (where former and occasional drinkers were removed) often had a 20% to 56% increased risk of developing cardiovascular disease, while moderate drinkers had no added risk.
  2. On the other hand the heavy drinkers were at risk of developing cardiac arrest (50% increased risk) or heart failure (22% increased risk). A death from a sudden heart attack occurred in heavy drinkers with a risk of 21% increased risk. A former drinker had a 40% increased risk for this, but a non-drinker a risk of 56% increased risk!
  3. A non-drinker had a 32% increased risk of getting a regular heart attack, a former drinker had a 31% increased risk, an occasional drinker 14%, a moderate drinker no added risk, and a heavy drinker had a 12% reduced risk! This seemed to show that drinking alcohol keeps the coronary arteries open and clean. I have had pathology demonstrations with Professor Dr. Adalbert Bohle at Tübingen University during my medical training in 1969. At that time he pointed out how clear and wide open the coronary arteries were in chronic alcoholics. It was not heart disease that killed those patients; they had died from end stage liver cirrhosis, and we saw pathological slides of that.
  4. Heavy drinkers get more ischemic strokes (33% increased risk) and more intracerebral hemorrhages (37% increased risk).
  5. Obstruction of blood vessels in the lower legs (peripheral arterial disease) is common with heavy drinkers (35% increased risk) and even former drinkers (32% increased risk). Non-drinkers have a 22% increased risk while moderate drinkers have a 0% risk (no increased risk).
  6. There was no association between heavy drinking and aortic aneurysm. On the other hand, non-drinkers (32% increased risk) and former drinkers (23% increased risk) showed an increased risk of aortic aneurysm formation.

Other effects of alcohol consumption

The study above did not take into consideration that alcohol consumption has many other consequences beside cardiovascular effects. One for instance is the effect on the brain and the increase of serious car accidents. Another effect is the causation of cancer.

The American Cancer Society clearly states that alcohol consumption has been causatively associated with the following cancers.

  • Cancer of the mouth
  • Cancer of the pharynx (throat)
  • Cancer of the larynx (voice box)
  • Cancer of the esophagus
  • Cancer of the liver
  • Cancer of the breast
  • Cancer of the colon
  • Alcohol also plays a role with cancer of the pancreas

Many studies have shown a dose-response curve between alcohol consumed and the development of these cancers. In other words there is never a safe low dose, below which no cancer would be caused over time.

These authors conducted a metaanalysis of 16 prospective cohort studies including 6,300 patients. It showed that alcohol caused cancer of the colon and rectum. High intake of alcohol showed a 50% increased risk of causing colon cancer. With regard to rectal cancer the risk was 63% higher. In both cases the highest alcohol intake was compared to the lowest category of alcohol intake.

These authors concluded their discussion by pointing out that 6% of the worldwide cancer deaths are attributed to alcohol intake. They also stated that colorectal cancer risk increased by 50% in the heaviest alcohol users. Among the group of heavy drinkers the cancer death rate would likely be 9%. There would a reduction of mortality from cardiovascular disease by one third in middle and old age. The end result would be 6% mortality again; essentially there is no change.

No matter how you try to solve this equation, there is a risk of cancer deaths from exposure to alcohol. There is also a risk that heavy drinking can cause significant cardiovascular diseases mentioned.

Only moderate alcohol consumption benefits your heart

Only moderate alcohol consumption benefits your heart

Conclusion

Everything we do in life has consequences. With regard to drinking you know that accidents are more common in drinkers; with prolonged exposure to higher alcohol consumption you can get dementia. Moderate amounts appear to have significant protection from heart disease, but the risk for several cancers is not negligible. This point was not mentioned in the study I discussed in the beginning of my blog. In the latter part I included some data about cancer risks from alcohol consumption.

The paradox remains that non-consumption of alcohol is associated with a significant cardiovascular risk because of a U-shape dose response curve. Moderate alcohol use is associated with the lowest cardiovascular risk. The question is whether we can balance moderate drinking with staying in the low cancer risk area. The recommendation of 1 glass of wine for women and 2 glasses of wine for men has been confirmed by the above study. This is considered a healthy preventative dose with respect to cardiovascular risk. It is the official recommendation for cardiovascular disease prevention. The cancer literature clearly states that there is a small cancer risk from moderate alcohol intake. This is particularly true for the 8 cancers discussed.

Dr James Nicholls, the director of research and policy development at Alcohol Research UK had this to say. He pointed to the fact that there are other ways to prevent cardiovascular disease. For those who do not drink at present it would not make sense to take up drinking. You can strengthen your heart by starting a Mediterranean diet and starting to exercise regularly. The beneficial substance for your heart in red wine is known as resveratrol that can be taken as a supplement. Resveratrol has no side effects and does not have the cancer risk of an alcoholic drink. Dr. Nicholls added, “If you drink within the existing guidelines it is unlikely that alcohol will either lengthen or shorten your life.” It is really up to every individual to balance the wine glass with personal health!

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Apr
15
2017

What Foods Lower Insulin Resistance?

When people get diabetes or prediabetes, what foods lower insulin resistance? You may have heard that eating too many carbs and gaining weight can cause high insulin values. This causes the body’s insulin receptors to become sluggish, a condition called insulin resistance. Continuing to eat too many refined carbs leads to a critical point. You can suddenly run out of enough insulin and would develop type 2 diabetes at this time.

So, what foods lower insulin resistance?

Low glycemic food

Insulin resistance and type 2 diabetes occur because people do not pay attention to the glycemic load of the food they choose. Many people eat bread, pasta and starchy vegetables like potatoes. They also eat excessive sugary sweets, such as cupcakes, ice cream, or chocolate bars. All the pancreas can do is keeping blood sugar stable by overproducing insulin. But you can assist your pancreas to not overwork itself.

Leave the high glycemic index foods alone. Instead eat low glycemic foods like non-starchy vegetables (peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. Have a dessert with berries that are rich in antioxidants. Blueberries, strawberries, raspberries and black berries are all low glycemic foods, rich in vitamin C and antioxidants. They are “nature’s candy”.

Research on insulin resistance

In a study from Singapore differences of insulin sensitivity were found between lean Asian Indians and Chinese and Malays, living in Singapore. The Asian Indians had less insulin sensitivity, which means they had higher insulin resistance. This is presumed to be due to a genetic variant of insulin sensitivity.

Another lengthy publication investigated the connection between metabolic syndrome and insulin resistance. In addition it examined the connection of heart attacks and strokes to wrong diets. It also pointed out that diabetes and cardiovascular disease could be reduced significantly. How can this be achieved? By adopting a healthy diet that also leads to weight loss.

Diets in the US and in the Western world have major shortfalls, due to the fact that people consume not enough vegetables, fruit and whole grains. Instead we see a higher intake of red and processed meat. In addition there was higher intake of sugar-sweetened foods and beverages. Refined grains and flour products are another unhealthy food source. In the US and other westernized countries we see an overconsumption of sodium and saturated fat.The key to a healthy diet was adopting a Mediterranean diet. A study was described where a group of patients with metabolic syndrome were encourage to consume whole grains, vegetables, fruits, nuts, and olive oil. The control group simply followed a “prudent” diet. Two years later the group on the Mediterranean diet was found to have the following results: they had a higher intake of monounsaturated fat (olive oil) and polyunsaturated fat (fish oil) and fiber. Their omega-6 to omega-3 ratio had decreased. The high-sensitivity C-reactive protein, a general measure for inflammation, had decreased. Other inflammatory kinins like interleukins had also decreased. The insulin sensitivity endothelial function score showed improvement. The important part overall was that the Mediterranean diet prevented the metabolic syndrome compared to the “prudent” control diet.

In 2013 a study from Spain was looking for positive effects when supplementing with olive oil or nuts. A Mediterranean diet with extra olive oil or extra nuts reduced the risk of heart attacks in a high-risk group compared to controls. The study included 7447 persons and these were the results after 4.8 years: the Mediterranean diet group that used more olive oil had 28% fewer cardiovascular events compared to the control group. The Mediterranean diet group with nuts had 30% less events. Heart attacks, strokes or death from cardiovascular disease were these “events”!

What foods are unhealthy?

In order to be able to avoid unhealthy foods it is important to identify what harms us. Foods to avoid are listed in this link. Sweetened beverages, fountain drinks, sodas and fruit juices are loaded with sugar. They will cause an insulin response and on the long-term insulin resistance. Avoid starchy vegetables, such as potatoes, pumpkin, corn, and yams. Also avoid processed snacks and boxed foods. Starchy foods are broken down into sugar, which stimulates insulin release again. Your no-food list continues with excessive sugary sweets, such as cupcakes, ice cream and chocolate bars. White bread, rice, pasta, and flour are also starchy, and the body breaks down starch into sugar and stimulates insulin production.

Some saturated fats are acceptable, but hydrogenated fat must be avoided altogether.

Epigenetic factors regarding insulin resistance

A recent publication on March 14, 2017 investigated the effect of exercise on insulin sensitivity in a mouse model where the mother mouse was obese.

Pregnant, obese mice were insulin resistant and the offspring came down with diabetes. But when the pregnant mice were exercised, the insulin sensitivity came back to normal. In addition the offspring were not diabetic. This effect was not due to genetic factors. Instead the authors believe it was due to epigenetic factors, in this case treating insulin resistance with exercise. When the pregnant mother turns insulin sensitive, the offspring is programmed to regulate their blood sugar metabolism normally.

An April 2017 study from Korea investigated the effects of healthy nutrition on patients with metabolic syndrome and insulin resistance. They noted that avoiding unhealthy foods could normalize markers of disease.

The authors discuss how nutritional factors can contribute to inheritance of epigenetic markers in the next generation. They also showed how dietary bioactive compounds could modify epigenetic factors. Taking dietary components that regulate epigenetic factors contribute significantly to health. The authors concluded that a healthy diet could prevent pathological processes that otherwise would cause metabolic disease.

What Foods Lower Insulin Resistance?

What Foods Lower Insulin Resistance?

Conclusion

It is interesting to note that insulin resistance can be reversed into insulin sensitivity by eating healthy foods. Research papers are now describing how a healthy diet of the mother can affect her offspring positively. These effects are due to epigenetic factors, as genetic factors have not changed.

We are already hearing that diseases like heart attacks, high blood pressure, strokes, diabetes and others can largely be prevented by a proper diet. The key is to avoid high glycemic foods and eat low glycemic foods instead. It is not complicated. Eat non-starchy vegetables (leafy greens, peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. The end result is that insulin resistance disappears and metabolic processes return to normal. This was what Hippocrates had in mind when he stated “Let food be thy medicine and medicine be thy food.”

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Apr
08
2017

Breast Cancer Risks

Dr. David Zava, PhD gave a talk on breast cancer risks. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Role of Hormones, Essential Nutrients, Environmental Toxins, and Lifestyle Choices on Breast Cancer Risk”.

He pointed out that both estrogens and progesterone are safe hormones, as long as they are not overdosed and they are balanced. Unfortunately many women in menopause have too much estrogen on board as the ovaries are still producing them, but there is a lack of progesterone, the moderating hormone that makes estrogen safe.

In the following I am summarizing Dr. Zava’s talk with regard to the essential messages, but leaving away much of the highly technical detail that was presented as this would dilute the message of this blog. I will include a few links for those who are inclined to read more details about the topic.

Balance between estrogen and progesterone

Most of her life a woman is used to cyclical hormone changes between estrogen and progesterone. When a woman no longer ovulates in premenopause and menopause there is a surplus of estrogen and a lack of progesterone. Having no ovulation means that there is no corpus luteum developing, where in the past progesterone was made. This creates a disbalance where estrogen is dominating; it is called “estrogen dominance”.

This is a dangerous hormone disbalance, because the breast ducts are stimulated to grow and the modifying, calming effect of progesterone is missing. Mixed into this is that the stress hormone, cortisol also can make the effect of estrogen worse. On the other hand Dr. Zava showed slides from studies where progesterone was replaced through a skin progesterone cream (percutaneous bioidentical progesterone cream). Plasma and breast tissue concentration of progesterone were measured in 40 premenstrual women. They had been diagnosed with breast lumps and were scheduled for surgery. One group was treated with progesterone cream for 10 to 13 days; the other group was the placebo group. At the time of surgery the plasma (blood) values were unchanged, but progesterone levels in breast tissue were elevated more than 100-fold over the values from the placebo group who had been treated with a neutral skin cream. The same experiment also showed that progesterone reduced the number of proliferating epithelial cells (experimental progesterone group). Estrogen on the other hand was shown to increase the number of proliferating epithelial cells (placebo group).

Another example that Dr. Zava gave was a study where 25 mg of bioidentical progesterone cream applied directly to breasts of premenopausal women increased breast tissue progesterone 100-fold, while blood concentrations of progesterone remained the same. Again breast stimulation by estrogen of normal epithelium cells was decreased by progesterone.

How to measure progesterone levels

Dr. Zava who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way. He said that these experiments and others that he also projected tell a clear story. Blood (serum) progesterone levels do not adequately reflect what tissue levels in a woman’s breasts are. On the other hand saliva hormone levels do give an accurate account of what breast tissue levels are like. A woman received 30 mg of topical progesterone application. She then had hourly progesterone levels in the serum and in the saliva done. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream, which leads to overdosing progesterone. With salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava said: avoid using venipuncture blood or urine in an attempt to interpret hormone test levels, as you will underestimate bio-potency and overdose the patient.

Historical failure of estrogen replacement therapy (ERT)

A review of breast cancer would not be complete without mentioning the Women’s Health Initiative (WHI). The U.S. National Institutes of Health (NIH) initiated this trial in 1991.

  1. The WHI ended suddenly in July 2002. The authors stated: “The overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2 year follow-up among healthy postmenopausal US women.” The study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease, a doubling of blood clots. The recommendation made by this study was to discontinue PremPro.
  2. Another study that was mentioned was “Breast cancer and hormone-replacement therapy in the Million Women Study”.  In this study postmenopausal women were given HRT with synthetic hormones, either estrogen alone or estrogen mixed with a progestin (in British English “progestagen”. After 5 years estrogen alone was associated with a 30% increased risk of developing breast cancer. HRT with an estrogen-progestagen mix was associated with a 100% increased risk of developing breast cancer.
  3. Unfortunately in both of these human experiments the wrong hormone substances were used, namely synthetic estrogens and synthetic progestins. They are NOT identical with natural estrogens and progesterone that a woman’s body makes. As long as the hormones used for hormone replacement therapy are chemically identical to the natural hormones, the body will accept them as they fit the natural hormone receptors in the body. It is the misfit of synthetic hormones that blocks the estrogen receptors or the progesterone receptors. You can readily see from the illustrations of this link that there is a fine balance between the workings of these receptors and there is absolutely no room for patented side chains that Big Pharma introduced into synthetic HRT hormones. The other problem of both these studies was that every woman was getting the same dose of hormones and that nobody measured their estrogen blood or estrogen saliva hormone levels. In retrospect the regulatory agencies should never have allowed these “hormones” to hit the market.

Breast cancer develops in three stages

Dr. Zava explained that it has been known for some time that there are 3 stages involved in the development of breast cancer.

  1. Initiation

Damage to the DNA of one of the cells types in the breast is what starts the process in the development of breast cancer. This can be done by catechol estrogen-3,4-quinones as was shown by these researchers.

Aromatase inhibitors can be used to reduce estrogen in overweight or obese women where aromatase is present in fatty tissue. The reason obese women have more breast cancer is likely from the extra estrogen production from androgens, male hormones produced in the adrenal glands that get converted by aromatase into estrogen.

Iodine/iodide has been shown to alter gene expression, which reduces breast cancer development, but also slows down cell division in existing breast cancer. The authors suggested to use iodine/iodide supplements as adjuvant therapy in breast cancer treatment.

  1. Promotion

The next step is that something has to promote the DNA mutation into becoming part of a cancer cell. Estrogen quinones are dangerous estrogen metabolites. They can form from catechol estrogens (other metabolites of estrogen) by reactive oxygen species. But selenium, a trace mineral can interrupt the formation of estrogen quinones, which stops the breasts cancer promotion process. A study from the Klang Valley, Malaysia showed that selenium showed a dose-response effect with respect to prevention of breast cancer; the more selenium in the food, the less breast cancer occurred.

  1. Progression (includes invasion and metastases)

Several factors can help the breast cancer cells to progress, grow bigger locally and eventually move into other areas of the body as metastases. Dr. Zava showed several slides where details of metabolic processes were shown and how changes in some of these would lead to progression of breast cancer. Estrogen excess is a common pathway to breast cancer. The key is to balance it with progesterone, supplements, remove anything that causes estrogen overproduction like obesity (via the aromatase pathway).

The fallacy of overdosing or underdosing

When estrogen is overdosed, it becomes aggressive as indicated before; it can initiate DNA mutations that can cause breast cancer. If it is under dosed, the lack of estrogen can cause heart attacks, strokes and osteoporosis. When estrogen is balanced with progesterone a postmenopausal woman feels best and she is protected from the negative effects of estrogen.

Measures that help prevent breast cancer

  1. When supplementing with bioidentical hormones, keep estrogen within physiological limits and don’t overdose. This can be measured through blood tests or saliva hormone tests. Your most important natural opponent of estrogen is progesterone, which is usually missing in menopause. Measure hormones using tests (progesterone only with saliva tests, estrogen either by blood tests or saliva tests). Don’t rely going by symptoms.
  2. Keep the progesterone to estrogen ratio (Pg/E2) at an optimal range, which is in the 100- to 500-fold range. Measure the saliva hormone level of both progesterone and estrogen and calculate. Remember that progesterone serum levels are meaningless. The much higher progesterone level protects the postmenopausal woman from estrogen side effects. Here is a statement worth noting: “Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.” This was the conclusion of a study using bioidentical hormones, where the protection from breast cancer and heart attacks and strokes was also noted.
  3. Increase fiber intake and reduce red meat consumption. This will eliminate conjugated steroid hormones in the stool. It also increases the sex hormone binding globulin in the blood, which limits the bioavailability of estrogens. Fiber absorbs bile toxins and removes them from the body.
  4. Calcium-D-glucarate is a supplement that will decrease beta-glucuronidase. The estrogens were conjugated with the purpose to be eliminated, but beta-glucuronidase causes the conjugated estrogens to be reabsorbed.
  5. Probiotics likely stimulate the immune system and help reduce the risk of breast cancer.
  6. Avoid toxins like petrochemical pollutants and toxic chemicals. Avoid trans fats. If toxic, heavy metals are present (arsenic, cadmium, lead, mercury) remove these. Some naturopaths use EDTA chelation to do this.
  7. Supplements: sulforaphane (broccoli), EGCG (green tea), alpha-lipoic acid (antioxidant), cruciferous vegetables, resveratrol, selenium and iodide/iodine, N-acetyl cysteine-glutathione. All these supplements/nutrients will prevent estrogen to go to the “dark side”. The dark side is the formation of toxic 4-OH estrogen that could further be converted into catechol estrogen-3,4-quinones that can damage DNA and cause mutations.
  8. Increase methylation of catechol estrogens: vitamin B1, B6, B12 and folic acid. Methyl donors also are useful for this purpose: MSM (methylsulfonylmethane), SAMe, and Betaine.
  9. Improve your diet (Mediterranean type), exercise moderately, reduce stress, and replace hormones in physiological doses as discussed under point 1 and 2.
Breast Cancer Risks

Breast Cancer Risks

Conclusion

Dr. David Zava, PhD gave an interesting talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It became clear that estrogens, when unopposed by enough progesterone, could cause mutations in breast tissue of women and cause breast cancer. He also reviewed two major clinical trials where hormone replacement therapy (HRT) was used. The problems with these were the synthetic estrogen hormones that caused breast cancer and the synthetic progestins that also behaved like estrogens (not like progesterone) and caused even more breast cancer. The lesson to be learnt from this is that only bioidentical estrogens and progesterone can be used in hormone replacement for menopause. Also, the hormones must be balanced as discussed under point 2 of measures that help to prevent breast cancer. In addition there was a list of other useful supplements given that can be taken to reduce the danger of breast cancer.

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Apr
01
2017

When Food Causes Inflammation

Dr. Hal Blatman gave a talk about when food causes inflammation. His talk was presented on Dec. 9 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “Food, Pain and Dietary Effects of Inflammation”.

Dr. Blatman is the medical director of Blatman Health and Wellness Center, Cincinnati and Batman Medical Services, Manhattan.

General remarks about nutrition

Dr. Blatman pointed out that mistakes of nutrition are often behind chronic diseases and illnesses. The physician’s task is to explain to patients how their food intake can be changed to improve inflammation in the body and how the body can heal itself.

Hippocrates said 400 BC “Let food be thy medicine and medicine be thy food”.

In this context Dr. Blatman stated that nutrition could exacerbate symptoms or relieve symptoms and there must be rules for good nutrition. If we do not take care of our nutrition, the gut flora composition changes and causes leaky gut syndrome. But if we consume healthy foods all of this improves.

Mathematical formula for when food causes inflammation

To make it easier to understand the impact of food on our health the speaker offered this formula: G-B+R=P

G stands for good, beneficial things you can put into your body.

B = bad, toxic things that affect your body negatively.

R = reserves that your body has since birth (minus the amounts you have used up)

P = pain and problems you are going to experience

It is P (pain and other medical problems) what brings the patient to see the doctor. G and B is what the patient can change. When done right, the P value in the formula reduces and the pain or medical problems go away.

Nutritional rules

Dr. Blatman said there are three rules about nutrition.

Rule #1 is to not eat fake or toxic foods

He listed NutraSweet, Splenda, Saccharin, margarine and olestra.

  1. Aspartame experiments on rats showed that it can cause cancer: Dr. Blatman said that in man it has been shown to cause multiple myeloma and Hodgkin’s lymphoma. Aspartame worsens depression, 10% is metabolized in the liver into methanol, a nerve poison.
  2. Splenda (sucralose) is made from chlorinated sugar. It reduces beneficial microflora in the gut. It also interacts with liver enzymes that are known to interfere with the bioavailability of oral drugs.
  1. Saccharin alters gut bacteria and increases glucose tolerance.
  2. Hydrogenated fat and margarine. Insects don’t eat margarine, mold will not grow on it, and it will not support life. Merchants like it because food does not turn stale on shelves. Hydrogenated fats like margarine are considered to be poisons. They raise the bad LDL cholesterol levels and reduce beneficial HDL cholesterol levels. The prostaglandin balance changes so that inflammation occurs. There is increased evidence of diabetes and the cell membrane composition changes. Proinflammatory cytokines can cause pain in the dorsal root ganglions. It follows from all of this that it is best to cut out all hydrogenated fat and margarines.
  1. Partially hydrogenated vegetable oil. The cell membrane consists of two lipid layers at a specific ratio of omega-6 essential fatty acids and omega-3 essential fatty acids. It also contains triglycerides, phospholipids and protein. It is expected that the cell membrane absorb nutrients to move into the cell and eliminate waste out of it. The cell membrane needs to remain flexible and within neurons needs to transmit electrical information. The membrane composition is critical for the cell membranes to perform optimally. It is here that the physician has to explain this to the patient. All the fats we eat are the raw material, which will make up our cell membranes. So what fat we eat that day is built into the cell wall that is made that day or is repaired. If we eat hydrogenated fat that day, this is built into the cell wall.  A membrane with hydrogenated fat will:
  • Not transmit nutrients inside the cell
  • Will not transmit waste out
  • Causes the membrane to lose flexibility
  • In a nerve cell there will be abnormal neuron transmission

If we eat hydrogenated fat, we become like a “genuine GM truck fixed with inferior parts”, so Dr. Blatman. The interesting observation is that it takes 4 months after eliminating hydrogenated oil from the diet to get it out from red blood cells. Be aware that French fries increase pain for 4 months, so why eat them?

  1. Olestra, an artificial fat: Olestra has been developed as an artificial fat and is used in chips. It can cause diarrhea, abdominal cramps and weight gain with long-term use. Olestra belongs into the group of fake/toxic foods. Don’t eat Pringles or chips that are made with this.
  1. Healthy oils

There are two types of essential fatty acids, omega-6 fatty acids and omega-3 fatty acids. Many processed foods contain only omega-6 fatty acids, because this is the cheapest way to produce them (they are based on vegetable oils). Instead you want to eat healthy fats like omega-3 fatty acids contained in nuts and fish. You can also add molecularly distilled, high potency omega-3 fatty acids (purified fish oil) as a supplement to help restore the balance between omega-6 and omega-3 in your food intake. Avoid omega-6 fatty acids from corn oil, safflower oil, grape seed oil, soybean oil, cottonseed oil, canola oil and peanut oil.

Compare the metabolism of omega-6 fatty acids with that of omega-3 fatty acids.

The linoleic acid of omega-6 fatty acids gets metabolized into arachidonic acid, which causes pro-inflammatory mediators, PGE2 and LTB4. On the other hand with omega-3 fatty acids alpha-linolenic acid (ALA) is metabolized into EPA, DHA and the anti-inflammatory mediators PGE3 and LTB5.

It is easily understandable why a surplus of omega-6 fatty acids from processed foods will disbalance the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Be particularly careful in avoiding soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio through processed foods.

When it comes to balancing omega-3 and omega-6 fatty acids in your diet, be aware that nutritional balancing can help you restore the ideal omega-6 to omega-3 ratio of 1:1 to 3:1. An easy way is to cut out processed foods as much as possible. Supplement with molecularly distilled fish oil capsules to add more omega-3 fatty acids into your food intake. Dr. Blatman gave the example of rheumatoid arthritis patients that were put on omega-3 supplements. After 24 weeks their joint swelling and tenderness went down.

Rebalancing the omega-6 to omega-3 ratio was able to treat depression as this research showed. This makes you wonder how much depression may be caused by overconsumption of processed food.

Dr. Blatman suggested the following doses of omega-3 supplementation for various purposes:

  • 1 gram/day as supplementation for healthy adults with a good diet
  • 1-3 grams/day for people with cardiovascular disease
  • 5-10 grams/day for patients with an autoimmune disease, with chronic pain or with neuropsychiatric conditions

He mentioned that these doses are empirical, but in his opinion definitely help. Due to quality differences he suggested that you buy fish oil capsules in a health food store where the quality is best. Stay away from discount stores (the quality is the worst) and drug stores.

Other healthy oils are olive oil and coconut oil. They are also useful for cooking.

Rule #2 is not to eat inflammatory foods

Our body functions like a luxury car; it needs pure food to function. Anything less leads to inflammation, particularly when you eat sugar and processed foods.

Inflammatory foods are sugar, white flour, fruit juice and white/red potatoes. A medium potato=1/2 cup of sugar! Other problematic foods are wheat grain contained in breads, pasta, cereal and thickeners in soups and sauces.

What is the problem with these foods? They break down the zonulin proteins that are a bridge between the lining cells of the gut.

This leads to an increase of intestinal permeability, and leaky gut syndrome can develop. Inflammatory cytokines from visceral fat add to the gut inflammation, and cardiovascular disease and high blood pressure can develop.

Fried potatoes, in particular the consumption of French fries, have been identified as the cause of inflammatory bowel disorder (IBD). Countries with the highest consumption of French fries have the highest incidence of IBD.

A Mediterranean diet and the DASH diet are anti-inflammatory diets.

Rule #3 is to not disturb the bowel flora

A healthy bowel flora is symbiotic with the body. You achieve this by eating green leafy vegetables. A toxic flora from dysbiotic microbes comes from eating white flour, white sugar and red meat. Red meat leaves residues on which dysbiotic bacteria thrive.

Symbiotic gut bacteria produce vitamin K, cobalamin, pyridoxine, biotin, riboflavin, pantothenic acid and short fatty acids. They also degrade metabolic toxins, prevent pathogens from colonization and they stimulate the immune system to mature.

Dysbiosis occurs when the wrong diet consisting of sodas, white flour, sugar and red meat is over consumed. There are toxins that are produced by the dysbiotic microbes. These injure the bowel wall and make the immune system work harder. Immune system dysfunction, fatigue and fibromyalgia can follow.

Dr. Blatman stated that gut dysbiosis that causes leaky gut syndrome could also cause ulcer disease, diabetes, heart disease, fibromyalgia, chronic fatigue syndrome, chronic pain and even cancer.

When Food Causes Inflammation

When Food Causes Inflammation

Conclusion

This was a whirlwind tour through a talk given by Dr. Blatman during the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. What food we eat determines what gut bacteria we harbor, symbiotic ones or toxic ones. This in turn determines which way our health develops. But the content of what we eat is also important. If we consume processed foods we end up consuming way too many omega-6 fatty acids, which cause inflammation, arthritis and heart disease. This is happening in front of our eyes, if we start seeing things the way they are. I was aware of this since the mid 1990’s. In a lecture I attended at a continuing education conference a cardiologist pointed out that inflammation was the determining factor of whether or not our patients would get a heart attack. The lecturer mentioned then that the older cholesterol concept would be replaced by the newer inflammation concept. He was right, but it goes even further! There is the important omega-6 to omega-3 ratio, and fish oil supplementation helps. At the same time it is necessary cutting out processed foods. But there is the newer insight that our bowel flora and red meat consumption can culture toxic bacteria in our own gut. It is in our power to start eating more vegetables and cut out sugar and starchy food. It is time to see chips and French fries not as a “convenience” but a hazard to your health. Food does not have to cause inflammation; right food choices will help us to stay well and live longer.

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Mar
25
2017

How Stress Affects Our Hormone System

Dr. Andrew Heyman gave a talk recently about how stress affects our hormone system. His talk was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman stressed that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). We need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can derail, we develop obesity and fatigue. When balanced we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. He stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. Too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which gets activated by TSH (thyroid stimulating hormone), but can also be affected negatively by autoantibodies).
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.
  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. If the brain is stressed, the hypothalamus sends a cascade of activating hormones via the pituitary gland and the adrenal glands. This leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can develop from this.

Hypothalamus/pituitary/adrenal glands activation and clinical effects

The main hormone axis of the stress reaction goes from the hypothalamus via the pituitary gland to the outside surface of the adrenal glands where cortisol is released. It is also called the HPA axis. Stressed people make too much cortisol, which weakens immune functions, reduces human growth hormone production, increases belly fat, increases blood pressure and reduces insulin action. Stress also reduces estrogen production in women and testosterone production in men.

The final clinical presentation is osteopenia, then osteoporosis with spontaneous fractures of bones. There is cardiovascular disease leading to heart attacks and strokes, and cognitive decline with memory loss. There are complications with infections. Also the metabolic syndrome can lead to obesity and type 2-diabetes.

Stress and the hippocampus

In the center of our brain there is a memory-processing unit, the hippocampus that converts short-term memory into long-term memory. Repeated stress interferes with normal hippocampus function. High cortisol levels interfere with the proper functioning of the hippocampus causing memory problems.

Chronically elevated cortisol levels from chronic stress have been shown to lead to hippocampus atrophy and can cause Alzheimer’s disease.

Effects of chronic stress

Chronic stress leads to cardiovascular disease, to diabetes, chronic inflammation, Alzheimer’s disease, thyroid disorders, cancer, neurological disorders and autoimmune diseases. Inflammation research has shown that with chronic inflammation tumor necrosis factor-alpha (TNF-alpha) is released, as key player of chronic inflammation. This however leads to the release of other inflammatory kinins like IL6 and others. The resulting chronic inflammation can cause Crohn’s disease, rheumatoid arthritis, insulin resistance, dementia, metabolic syndrome, obesity and atherosclerosis with associated markers (decreased HDL, increased LDL, CRP and triglycerides).

Hormone imbalance causes disease

  1. Excess cortisol production from stress leads to Th2 type inflammatory kinins; usually associated with this is a reduction of DHEA (a male hormone in the adrenal glands), which leads to reduced Th1 type kinins. The end result is chronic inflammation. When chronic stress has tired out the adrenal glands, a four-point salivary cortisol level test shows a flat curve. This indicates adrenal gland fatigue or, if worse, even adrenal gland insufficiency. Such a pattern is found in patients with leukemia, breast cancer, uterine cancer, prostate cancer, pituitary gland cancer and lung cancer.
  2. The metabolic syndrome is associated with dysregulation of the HPA axis. People who have this syndrome have a high morning serum cortisol level. High cortisol increases the risk to develop metabolic syndrome.
  3. Metabolic connections: high cortisol leads to a partial blockage of thyroid hormones, which in turn leads to hypothyroidism. Hypothyroidism will affect glucose tolerance, and if not treated leads to type 2 diabetes.

In a large study involving 46,578 members of Kaiser Permanente Northwest it was determined that for every 1 point above a fasting glucose level of 84 mg/dL there was an additional 6% risk to develop type 2 diabetes over the next 10 years.

Pathological hormone disturbances

The following hormone patterns were discussed in detail, an increased cortisol level, increased insulin level and decreased thyroid levels.

Elevated cortisol

Prolonged elevation of cortisol leads to atrophy of the hippocampus with brain atrophy and Alzheimer’s or dementia. The immune system gets altered, there is lower DHEA hormone leading to weaker muscles and weakened immunity. There is insulin resistance (decreased insulin sensitivity), decreased serotonin and increased depression. Carbohydrate cravings lead to weight gain (central obesity). Changes in the thyroid metabolism leads to hypothyroidism.

Increased insulin level

People who develop high insulin levels are usually sugar or carbohydrate addicts. As they gain weight they change their metabolism into the metabolic syndrome. The extra insulin that is floating around triggers the insulin receptors to become less sensitive (also called “resistant”). The people love to eat. They snack frequently on protein bars and candy bars. As they gain weight, their energy goes down and they often develop painful joints. This prevents them from being physically active. They notice episodes of foggy thinking. Women complain of frequent yeast infections.

The body tries to compensate by slightly decreasing thyroid hormones and slightly increasing cortisol levels.

Decreased thyroid levels

There is increased lactic acid production and decreased insulin sensitivity. Oxidative stress is increased. The patient is depressed and cognition and memory are reduced. The gut has slower motility. The mitochondria, the energy packages in each cell are reduced and functioning less productively. Cardiac function is reduced.

The body tries to compensate for the primary thyroid weakness by slightly elevating insulin and cortisol.

Treatment of stressed hormone system

Before the doctor can treat a disbalanced hormone system, blood tests have to be done that show what kind of hormone constellation is present. Dr. Heyman suggested the following support with supplements.

Treatment of thyroid disorders

Thyroid supplementation may involve any of these: Selenomethionine, iodine, chromium, thyroid glandular, tyrosine, ferritin, Ashwagandha, coleus forskohlii, 7-keto DHEA, ferritin and iron. Other possible supplements that were mentioned by Dr. Heyman were Rhodiola, schisandra, ginseng, Rg3, eurycoma longifolia, neuromedulla glandular, DHEA, tryptophan/5 HTP, licorice, Cordyceps.

This, however, is not all. Missing thyroid hormones have to be replaced with a balanced T3/T4 medication like Armour thyroid.

Adrenal support

The following supplements are used to support adrenals: Adrenal glandular, vitamin C, adrenal cortex extract, Holy Basil, Pharma GABA, Magnolia/Phellodendron, L-theanine, sterols & sterolins.

Pancreatic support

These supplements support the insulin production in the pancreas:

Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil, micro PQQ, bitter melon, cinnamon, arginine, vanadium, benfotiamine (synthetic derivative of B1 vitamin) and Bergamot.

Dr. Heyman completed his talk by giving a few patient examples, explaining what blood tests showed, what the hormone disbalance was, and which treatment options were helpful.

How Stress Affects Our Hormone System

How Stress Affects Our Hormone System

Conclusion

Dr. Andrew Heyman gave a talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. He talked about how stress affects our hormone system. Symptoms from stress can stem from different causes including hormone disbalances. Conventional medicine would simply treat the symptoms. However, this will not be successful with stress-induced hormone disbalances, because it does not treat the causes. Causal treatment of the hormone disbalance will restore the person’s wellbeing and the symptoms will disappear at the same time. Anti-aging medicine and integrative medicine are attempting to follow this approach.

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Mar
18
2017

What’s new about testosterone?

Dr. Gary Huber recently gave a lecture on what’s new about testosterone. His talk was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Evolution of Testosterone – Dispelling Myths & Charting a Future”.

History of testosterone

There are some notable historic landmarks with respect to the discovery of testosterone.

1869: Dr. Charles Brown-Sequard suggested that the “feebleness of older men” was due to a lack of testosterone. He injected himself with testicular extracts from dogs and guinea pigs.

1912: The Danish physician Dr. Thorkild Rovsing transplanted the testicles of a young soldier killed in battle into an old man with gangrene. The gangrenous wound healed completely.

1918: Dr. Leo Stanley sampled fresh testicles from executed prisoners at the San Quentin Prison and transplanted them to prison inmates. Some regained their sexual potency.

1930’s: Professor Adolf Butenandt collected 25,000 liters of urine from willing policemen. He was able to isolate a breakdown product of testosterone, androsterone. Eventually he isolated both progesterone and testosterone. He received the Nobel prize for his work with sex hormones in 1939.

Historical detours and misguided opinions about testosterone

1935: Because natural hormones cannot be patented, Big Pharma came up with the idea of modifying testosterone by adding a methyl group at the 17-alpha position of testosterone.

This allowed the new substance, 17 alpha-methyltestosterone to be swallowed as a pill. But the liver changed 17 alpha-methyl-testosterone into 17 alpha-methyl-estradiol, a strong estrogenic compound. This was not well metabolized. Shortly after introduction into patients it became evident that 17 alpha-methyl-testosterone caused liver cancers. This “testosterone equivalent” was used for 50 years until the FDA outlawed it because I caused liver cancer. It also caused suspicion among physicians about any testosterone replacement, even the bioidentical hormones that are safe.

Prostate cancer myths

Prostate cancer myth

Conventional medicine teaches (and I have believed this for many years) that testosterone would be the cause for prostate cancer. This was based on old observations by Dr. Huggins, a Canadian born surgeon who practiced in Chicago, that orchiectomy improved the survival of advanced prostate cancer patients a bit. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both testosterone and small amounts of estrogen. When an orchiectomy was done (because of the belief that testosterone production was the culprit) inadvertently the real cause of prostate cancer (an estrogen surplus) was also removed, thus improving the survival of these patients somewhat. Nowadays we have more sophisticated testing methods. Dr. Abraham Morgentaler (Ref. 1) has compiled a lot of evidence about the importance of testosterone in men. He proved, based on a lot of more modern references, that it is not testosterone that is the cause of prostate cancer. We know now that estrogen dominance is responsible for prostate cancer and that this develops as stated above because of the low testosterone and low progesterone during the male menopause (also called “andropause”).

It is important, when testosterone deficiency is present in an aging man, to replace the missing testosterone with bioidentical testosterone.

The old method of hormone depletion therapy in advanced prostate cancer cases is still practiced today, but has been proven wrong by Dr. Morgentaler and other researchers.

10% absorption rule myth

For years there has been a persistent myth that only 10% of testosterone would be absorbed through the skin. This was never proven, and newer studies could demonstrate that about 90% of testosterone gets absorbed through the skin.

Misleading science created myths

Unfortunately three key medical journals, JAMA, NEJM and PLOS ONE have published misleading studies. The content did not discuss physiology, mechanism of actions, appropriate dosing or true science. But their conclusions were that testosterone therapy was associated with heart attacks and strokes. There was an outcry about this particular study in the medical community reflected in the demand to retract this misleading article.

Unfortunately there were more similar false “studies” where controls were wrong or unequal groups were compared that should not have been compared. It is reminiscent of previous effort of the tobacco industry wanting to cover up that cigarette smoke causes lung cancer.

Here we have the problem that testosterone cures so many conditions for which the Pharma industry has many patented medicines that control the symptoms. But testosterone can actually treat the cause of the illness, testosterone deficiency, which leads to a cure of many other symptoms.

For a long time physicians were confused. But younger physicians are replacing the older generation and they treat testosterone deficiency with bioidentical testosterone in the proper dose.

Clinical observations about a lack of testosterone

There is evidence that men have lower testosterone as they age and this has worsened when we compare data from early 2000 to the 1980’s and 1990’s.

As this paper shows, men investigated in the 1980’s were still having higher testosterone levels in older age. But in the 1990’s and more so in 2004 these values have declined even more. This fact coincides also with other studies, showing decreased sperm health and increased infertility. The reason for this is also a lack of testosterone!

Causation of low testosterone

Dr. Huber pointed out that many studies have pointed to a variety of causes for low testosterone levels in men.

  • BPA, toxins and pesticides that occupy testosterone receptors and interfere with the hypothalamus/pituitary hormone function that stimulates the Leydig cells to produce testosterone.
  • The more stress men are under, the less testosterone production there is. Sleep deprivation below 5 hours per night leads to a significant lower testosterone production. Most testosterone is produced during the sleep in the early morning hours.
  • Weight gain and sugar overconsumption poison the testosterone producing Leydig cells.
  • Poly-pharmacy. Many drugs lower testosterone production: statins, diuretics, metformin, spironolactone, opiates, antidepressants, verapamil, alcohol, chemotherapy for cancer, antihistamines, ketoconazole, beta blockers, H2 blockers, finasteride, estrogens and alpha methyldopa.

Many references were provided that support these data. In one paper it was noted that the risk of a heart attack climbs to 4 times the risk of normal, when the man sleeps less than 6 hours per night. As sleep hours lower, the risk for metabolic syndrome increases by 42% and this leads to heart attacks. Testosterone replacement can reverse this risk as it a lack of testosterone production that caused the risk.

Link of low testosterone to cardiovascular disease

The literature is overwhelming that low testosterone has adverse effects on the cardiovascular system. To be more specific, the metabolic syndrome, heart disease (and strokes), diabetes and high blood pressure have their root in low testosterone.

Metabolic syndrome

Inflammation is mediated by cytokines such as IL-6. Dr. Huber mentioned one study where healthy men received IL-6. This promptly suppressed testosterone levels. He said that there are many cytokines that work in concert to suppress testosterone. One useful clinical test for inflammation is the C-reactive protein, which indicates whether or not inflammation is present in a person. Metabolic syndrome is common in obese patients. In a study CRP was found to be significantly associated with obesity. When CRP is high, testosterone levels are low. When the CRP level is high, there is a risk of getting the first heart attack.

On the other hand, when men with high inflammatory markers from low testosterone levels were replaced with testosterone, the tumor necrosis factor was reduced by 50%, IL1b by 37%, triglycerides by 11% and total cholesterol by 6%.

In the Moscow study a group of obese men with low testosterone levels were treated with testosterone injections. There was an impressive reduction of insulin (17%), CRP (35%) weight reduction of 4% and TNF-a reduction of 31% within 16 weeks.

Heart disease (and strokes)

Hardening of the arteries (medically called atherosclerosis) is due to chronic inflammation. A new heart attack/stroke specific biomarker has been developed. It is a ratio of oxidized LDL, divided by HDL. This has an odds ratio of 13.92 compared to a control without a risk for a heart attack or stroke.

Administration of testosterone hormone led to dilatation of coronary arteries. The Rotterdam study showed that low testosterone levels were associated with high risk for heart attacks and strokes, but that treatment with testosterone removed this risk. Testosterone increases AMP kinase for energy production in heart muscle cells, but also dilates coronary arteries for more blood supply to the heart.

Diabetes

Among men with diabetes 20-64% have low testosterone levels. In another study men with higher testosterone levels had a 42% lower diabetes risk. Testosterone levels are inversely related to body mass index and insulin resistance. Men with diabetes have lower testosterone levels than men who were not diabetic and were weight-matched. Most diabetics have high CRP values.

High blood pressure

Experience with androgen deprivation therapy for prostate cancer has shown that blood pressure gets elevated due to testosterone deficiency. Testosterone increases LDH, the protective subunit of cholesterol, and decreases LDL cholesterol and triglycerides. Testosterone also lowers inflammatory markers and reverses clotting factors making blood thinner. All of this leads to a widening of the arteries and lowering of blood pressure.

Treatment options for low testosterone

It is important to support the hypothalamic /pituitary/adrenal gland axis and remove other causes, such as stress and lack of sleep. Younger men can be stimulated in the pituitary gland through Clomiphene. Men older than 60 likely have true secondary hypogonadism and need testosterone replacement. Topical testosterone creams are available commercially or from compounding pharmacies. Injectable testosterone preparations that can be metabolized by the body are available. One such preparation is Delatestryl. A small dose (like 50 mg) is self-injected subcutaneously twice per week, which keeps the testosterone level stable. The last resort, if the creams or injections don’t work, is the use of testosterone pellets that a physician can implant under the skin.

What’s new about testosterone?

What’s new about testosterone?

Conclusion

At a recent Anti-Aging conference in Las Vegas that I attended, Dr. Huber gave an overview of testosterone. There has been an objective reduction of testosterone levels in men since the 1980’s due to pollutants in our environment. Testosterone plays a key role for heart and brain function. It affects sex drive, fertility and potency. But it also prevents diabetes, high blood pressure and weight gain. On top of that it prevents prostate cancer and likely many other cancers. The key with low testosterone is to replace it to high normal levels. Blood levels should be measured every two months, when replacement has been instituted, in order to ensure adequate levels.

References  Ref.1 Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

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