Feb
25
2017

Heart Health Improves With Hormone Replacement

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

First of all, estrogens are the main female hormone in women that protects them from heart attacks.

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. Postmenopausal women who do estrogen replacement therapy (ERT) are helping to reduce their heart attack rates.

Difference between oral and transdermal estrogen replacement

The liver metabolizes estrogen taken by mouth. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained using many slides how estrogen prevents heart attacks. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. The production of Premarin involved pregnant mares. In other words, it is not human estrogen and it does not fit the human estrogen receptors. Also the liver metabolizes estrogen taken as tablet form, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. Postmenopausal women on ERT reduce their physical and emotional stress response compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. No proinflammatory metabolites occur in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. There was an increase of venous thromboembolism in women who took oral estrogen.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Furthermore, progesterone is the second most important female hormone, the importance of which has been neglected in the past. Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Finally, testosterone is the third sex hormone that is present in women. In men it is the main hormone, but women benefit from just a small amounts of it for libido, clarity of thought and muscle endurance.

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician replaces first with bioidentical estrogen; only then does he consider replacing missing testosterone in women. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone ca cause high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone can cause diabetes and metabolic syndrome, which in turn can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. This may be due to rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Researchers sh0wed that bioidentical testosterone does not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

The adrenal glands produce the hormone dehydroepiandrosterone (DHEA). It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial.

Hormone effects on heart muscle

Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart. Physicians can  use them therapeutically in chronic heart failure patients. When people age, their hormone glands will produce less hormones, but blood tests will show this. Replacing hormones that are missing can add years of active life. Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

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Jan
21
2017

Effects Of Metformin On The Gut Microbiome

Matthew Andry, MD talked about the effects of metformin on the gut microbiome. He delivered his talk at the 24th Annual World Congress on Anti-Aging Medicine. The congress took place from Dec. 9 to Dec. 11, 2016 in Las Vegas. A lot of the sessions that I attended dealt with the gut flora and how it affects our health. This talk belongs to the theme of what a healthy gut microbiome can do for us.

History of metformin

Dr. Andry is a clinical associate professor of the Indiana School of Medicine. He pointed out that metformin is in use for a long time for type 2 diabetes, particularly, if fasting insulin levels are high. Metformin is a biguanide. It seems like it was isolated from French lilac (also known as Goats Rue). As a matter of fact in the middle ages physicians used this herb to treat “thirst and urination”. In retrospect we probably recognize these as symptoms of diabetes. Chemists were able to synthesize the active ingredient in this herb in the 1920’s.

Metformin reduces blood sugar without raising insulin levels

At that time it got the name metformin. Dr. Jean Stern was able to show in the 1950’s in clinical studies that Glucophage, the brand name of metformin was able to reduce blood sugar without raising insulin levels. Between 1977 and 1997 metformin enjoyed wide spread acceptance for treating diabetics. Most noteworthy, several clinical investigators demonstrated that diabetic patients on metformin lived longer and had less heart attacks than patients who receive other treatments.

Metformin is the first-line drug in the treatment of type 2 diabetes in children and adults. It is very popular with physicians who prescribe this drug throughout the world with 120 million prescriptions per year.

Off-label use of metformin

Metformin is beneficial for many other clinical conditions. Polycystic ovary syndrome (PCOS), obesity, prediabetes, metabolic syndrome and nonalcoholic steatohepatitis are a few examples of off-label use of metformin. In addition, metformin is also in use as an anti-aging agent as it elongates telomeres, which helps people to live longer. Equally important, researchers also found that metformin is a possible cancer prevention agent. In prostate cancer it was found to have an effect against prostate cancer stem cells. Not to mention that without these cells prostate cancer does not recur after surgical removal.

Action of metformin

For the reason that metformin increases the action of an enzyme, AMPK, this leads to lipid oxidation and breakdown of fatty tissue (catabolism). Furthermore, in the liver metformin inhibits the metabolic pathway of making sugar from fatty acids, called gluconeogenesis. Also, metformin causes increased uptake of sugar into skeletal muscle tissue. This is the reason for the stabilization of blood sugar. Then, metformin has two beneficial effects on the liver. First it stabilizes insulin sensitivity. This means that a given amount of insulin has a larger effect on the liver. Secondly metformin decreases the toxic effect of fatty acids on the liver tissue. In other words metformin has a healing effect on non-alcoholic steatohepatitis, a precursor to fatty liver and liver cirrhosis.

Metformin suppresses appetite

Metformin also has an effect on the appetite center in the brain. It helps many obese and overweight people, but not all to lose weight. The mechanism for that effect is in the hypothalamus, where the appetite center is located. Metformin inhibits the neuropeptide Y gene expression in the hypothalamus leading to reduced appetite.

Finally, metformin also normalizes the gut flora. This last point was the main focus of Dr. Andry’s talk.

Metformin and the gut

An animal experiment on mice showed in a study published in 2014 that metformin was stimulating the growth of a beneficial gut bacterium, Akkermansia. This is a mucin-degrading bacterium. But it also affects the metabolism of the host. The authors found that metformin increased the mucin-producing goblet cells.

Akkermansia muciniphila bacteria were fed to one group of mice. This group was on a high fat diet, but not on metformin. The mice showed control of their blood sugars, as did the metformin group. In other words manipulation of the gut flora composition could achieve control of the diabetic metabolism. The authors concluded that pharmacological manipulation of the gut microbiota using metformin in favor of Akkermansia might be a potential treatment for type 2 diabetes.

Effect of metformin on the gut flora

Akkermansia muciniphila bacteria comprise 3%-5% of the gut flora. It does not form spores and is strictly anaerobe, in other words oxygen destroys it. This is the reason why it is difficult to take it as a supplement. It is mostly growing in the mucous of the epithelium layer of the gut. The colon and to a lesser degree the small intestine of all mammalian species including the human race contain the highest number of Akkermansia bacteria.

Here are the effects of metformin on Akkermansia:

  • Metformin increases the Akkermansia bacteria count both in a Petri dish as well as in the gut of experimental mice. This suggests that metformin acts like a growth factor for Akkermansia.
  • Metformin increased the count of Akkermansia bacteria by 18-fold up to a maximum of 12.44% (up from the normal 3-5%) of all of the gut bacteria.
  • Researchers observed that the mucin layer of the lining of the gut in metformin treated mice was thicker. This suggests that the thickness of the mucin layer plays a role in increasing the Akkermansia count.

Effect of the gut on the body’s metabolism

Other researchers have investigated how a high fat diet can change the composition of the gut bacteria, which in turn are altering the body’s metabolism. Essentially a shift in the bowel flora can increase the gut’s permeability. The medical term for this is “leaky gut syndrome”. It leads to absorption of lipopolysaccharides (LPS) from bad bacteria in the gut. The end result is endotoxemia in the blood. This causes systemic inflammation in the body. Insulin resistance and obesity develop and often at a later date type 2 diabetes develops. It is interesting to note that often a high fat diet leads to these changes. But increasing Akkermansia bacteria in the gut or treating the patient with metformin can reverse this process.

An interesting mouse experiment showed that the changes that take place in the gut bacteria with cold exposure could be transferred to germ-free mice with no gut flora. This changed their metabolism proving that gut bacteria have profound influences on the metabolism. The fact that the gut bacteria have a profound influence on the metabolism is not only true for animals, but also for humans.

Akkermansia Facts

Here are a few facts about the Akkermansia bacteria.

  • The amounts of Akkermansia bacteria in the gut are inversely related to how fat we are. This is measured by the body mass index (BMI). Fat people have less Akkermansia in their guts.
  • A high fat diet lowers the amount of Akkermansia in the gut
  • Systemic inflammation is present with low Akkermansia counts
  • A high fat diet causes gut permeability (leaky gut syndrome).
  • Appendicitis and inflammatory bowel disease can be caused by low levels of Akkermansia.
  • Fat storage (both in subcutaneous fat and visceral fat) can be caused by low levels of Akkermansia.
  • Low levels of Akkermansia cause insulin resistance (associated with diabetes) and high blood sugars.
  • Brown fat’s ability to burn calories increased when Akkermansia was increased , which leads to weight loss.
  • Decreased Akkermansia counts lead to fat storage (weight gain).
  • Gut-barrier integrity improves when Akkermansia increased
  • Increased Akkermansia reduces visceral and total body fat
  • Synthesis of sugar in the liver (gluconeogenesis) reduces when Akkermansia is increased

We have 10 times more bacteria in the gut than we have cells in our body. The Akkermansia percentage of the gut flora can be decreased from antibiotics or food that contains traces of antibiotics. If there is a lack of Akkermansia species, there is more gut permeability, causing LPS increase and causing increase of inflammation in the body. This translates into high blood pressure, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS. But it can also cause inflammatory bowel disease and autoimmune diseases.

What increases Akkermansia?

We can increase Akkermansia bacteria in the gut by eating Oligofructose-enriched prebiotics. Oligofructose belongs into the inulin type soluble fibers. It is found in a variety of vegetables and plants. This includes onions, garlic, chicory, bananas, Jerusalem artichokes, navy beans and wheat. But wheat can be problematic. Clearfield wheat is the modern wheat variety which is now grown worldwide. It is much richer in gluten and can cause problems with gut permeability.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria.

Metformin as pointed out earlier can is in use as pharmacotherapy. But I must emphasize that the use of metformin for dysmetabolic syndrome is off-label. There are real side effects of metformin. Lactic acidosis with an unusual tiredness, dizziness and severe drowsiness can develop. Also chills, muscle pain, blue/cold skin and fast/difficult breathing can occur. Slow/irregular heartbeat, vomiting, or diarrhea, stomach pains with nausea are other side effects.

Effects Of Metformin On The Gut Microbiome

Effects Of Metformin On The Gut Microbiome

Conclusion

Our gut bacteria are important for us, more so than you may be aware of. An anaerobe bacterium, Akkermansia makes up 3%-5% of the gut flora. This bacterium lives in the mucous layer of the lining of the gut and ensures that the gut wall is tight. When these bacteria are lacking (due to consumption of junk foods) the gut wall becomes leaky, which is why this condition has the name “leaky gut syndrome”. Irritating toxic substances can now leak into the blood stream and lipopolysaccharides are among them. This causes inflammation in the gut wall, but can go over into the blood vessels and the rest of the body including the brain. High blood pressure, obesity, diabetes, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS can develop from the inflammation. But it may also cause inflammatory bowel disease and autoimmune diseases.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria. In particular, onions, garlic, chicory, bananas, Jerusalem artichokes and navy beans provide lots of oligofructose to support Akkermansia in your gut bacteria.

As pointed out earlier metformin as a drug is in use to treat dysmetabolic syndrome. I need to emphasize that the use of metformin is off-label. It is also important to remember, that with effects there are side effects of metformin.

It may be news to you, how our overall health depends so much on the health of the gut. With the knowledge that food can be your medicine, choose your foods wisely. Add some or all of the above named foods that help you support beneficial gut bacteria, and take care of your health!

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Apr
02
2016

Women Win Turning Older

Supercentenarians may teach us something about the question “Why do women win turning older”? Supercentenarians are people who are 110 years or older. Presently there are 53 of them distributed over the world, 51 are females and two are males. According to Ben Dulken and Anne Brunet this is not by chance: in other mammal species females often live longer than their male counterparts. They theorize that stem cells live longer under the influence of estrogen and this may be the explanation for the difference. They wanted to answer the burning question: “Is life expectancy linked to gender and stem cells”?

Observations regarding why women win turning older

Ben Dulken and Anne Brunet describe that several pieces of evidence are important to note.

Human eunuchs live longer than average males

Castrated males, called eunuchs, live on average 14 years longer than the average male.

Treatment of male mice with estrogen caused longevity

Experiments with male mice treated with estrogen increased their lifespan compared to untreated male controls.

Estrogen receptors on some stem cells in women

Neural stem cells (NSCs) and hematopoietic stem cells (HSCs) have estrogen receptors in females. This leads to extra stimuli during pregnancy, but also during the menstrual cycle in women or the estrus cycle in female mammals.

Faster wound healing in women may be from extra X-chromosome

It gets more complicated: There are non-estrogen regulated stem cell niches in the liver, skin and subcutaneous tissue (important for wound healing and resident muscle stem cells, called satellite cells (SCs). For some reason liver regeneration and wound healing, but also healing of muscle injuries in women and female mammals occurs at a faster pace. Scientists still do not have an answer for this. Theories are that perhaps women with their two X-chromosomes are at an advantage in comparison to males (only one X-chromosome) with respect to certain wound repair mechanisms.

Longevity and self-repair capacity may be related

There is the question whether longevity and self-repair capacity would be related, either through stem cell populations (NSCs, HSCs, SCs), other repair mechanisms or tissue proliferation.

Telomere length in older persons longer in females than in males

There are gender differences in aging patterns of stem cells. For instance studies in dizygotic twins showed that telomere length of blood cells in the female twin was much longer than in the male twin. Genetic factors appear to be the dominant factor to explain this phenomenon rather than hormones. But again this was favoring the female.

Comparison between muscles in older men and younger men

A study in males showed that there is an accumulation of damaged DNA in SC’s of muscle tissue with older age that leads to muscle senescence. In older men there is a delayed response to a specific exercise stimulus with regard to the satellite cell division (SC) when compared to the response in young men.

Women’s telomeres in stem cells grow longer

In females estrogen stimulates telomere growth of stem cells (NSCs and HSCs), which prevents premature stem cell exhaustion.

Effects of diet and exercise on life expectancy

The Potsdam study analyzed 4 healthy behaviors in 23,153 German participants aged 35 to 65 years over 7.8 years. They looked for the development of cancer, heart attacks, strokes and cancer as end points. The 4 healthy behaviors were: to be a lifelong non-smoker , having a body mass index lower than 30, performing 3.5 h/week or more of physical activity, and adhering to healthy dietary principles (high intake of fruits, vegetables, whole-grain bread and low meat consumption).

Those who had adopted all 4 healthy lifestyles reduced the development of serious disease by up to 80%. Dr. David Katz delivered a keynote address at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Integrative Medicine: A Bridge Over Healthcare’s Troubled Waters”. He mentioned the Potsdam study. And he mentioned what the new logic of a healthy lifestyle is: a healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age.

Life Expectancy Linked To Gender And Stem Cells

Life Expectancy Linked To Gender And Stem Cells

Conclusion why women win turning older

It seems that women and female mammals are more protected by nature than males. The previously called ”weak sex” is in fact a lot stronger! This may be the reason that among supercentenarians there are only a few males remaining. But we don’t know how many males take the lifestyle factors of the Potsdam study serious. Males who want to age gracefully have to pay more attention to healthy lifestyles. This leads to longer telomeres and this allows for stem cell and somatic cell renewal. There are still many unanswered questions, but life expectancy is definitely related to how well we preserve stem cells throughout our body. This in turn depends very much on our lifestyle patterns.

Mar
19
2016

Book Review: “Healing Gone Wrong – Healing Done Right”, By Ray Schilling, MD

This book entitled “Healing Gone Wrong – Healing Done Right” (Amazon, March 18, 2016) is dealing with the practice of medicine then and now. Medical errors, false diagnoses and wrong treatments are nothing new in the history of medicine. It happened in the past, and it is happening now. My first book was about anti-aging. The title was “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1

Here I describe describe that famous people like President Kennedy, Elvis Presley, Churchill, Beethoven or more recently Michael Jackson have something in common: all of them suffered the consequences of blatant medical mistakes. In Beethoven’s time lead containing salves to plug the drainage holes from removing fluid from his abdomen caused lead poisoning. In this chapter I review also how doctors treated the illnesses of the above-mentioned celebrities, but then ask the question: “What better treatments have offered to prevent some of the disastrous treatment outcomes?”

Chapter 2

Modern drugs seem to come and go. We learn that twenty-first century medications that are supposed to be the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3

This chapter deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but the doctor does nothing about the causes of their illnesses. This is a scary thought.

Chapter 4

What does it take to prevent these poor health outcomes, so that we will be able to prevent any disastrous outcomes pertaining to our own health care in the present and future? As we will see, the problem today is still the same as it was in the past, namely that many physicians still like to treat symptoms instead of the underlying cause of an illness. Big Pharma has the seducing concept of a pill for every ill, but it is not always in your best interest, when these medications have a slew of side effects. “Gastric reflux” means a mouthful of stomach acid. Big Pharma simply offers the patient with the symptom of gastric reflux a multitude of medications to suppress this symptom. But it is more important to dig deeper to find the reason for the illness and treat the underlying cause.

Chapter 5

We all need our brain to function. This chapter concentrates on the brain and how we can keep our brains functioning optimally until a ripe old age. This review spans from prevention of head concussions to avoiding type 3 diabetes (insulin sensitivity from overconsumption of sugar). It manifests itself in Alzheimer’s disease. It is a form of diabetes of the brain that leads to deposits of a gooey substance. Prevention of this condition is also reviewed .

Chapter 6

This chapter reviews what we now know about how to keep a healthy heart. Certain ingredients are necessary such as regular exercise, a healthy Mediterranean diet, supplements etc. The good part is that what is good for the heart is also good for the brain. You are preventing two problems (brain and heart disease) at the same time.

Chapter 7

What should we eat? And why does healthy food intake matter? Without the right ingredients of our body fuel, the body machinery will not work properly. The Mediterranean diet is an anti-inflammatory diet that is particularly useful.

Chapter 8

We need healthy limbs, bones and joints. We are meant to stay active in our eighties and nineties and beyond. No osteoporosis, no joint replacements, no balance problems that result in falls! Learn about how to deal with problems like these in this chapter.

Chapter 9

This chapter deals with detoxification. What do we do as we are confronted with pollution, with radiation in the environment and poisons in our daily food? A combination of organic foods, intravenous chelation treatments and taking supplements can help us in that regard.

Chapter 10

I am dealing here about reducing the impact of cancer in our lives. A lot of facts have come out in the past 10 years telling us that reduction of sugar and starchy food intake reduces cancer. Curcumin, resveratrol and vitamin D3 supplements also reduce cancer rates as does exercise and stress management. All of this is reviewed here.

Chapter 11

This chapter tells you all you need to know about your hormone status. Women need to avoid estrogen dominance; both sexes need to replace the hormones that are missing. By paying attention to your hormonal status and replacing the missing natural hormones with bioidentical ones, most people can add 10 to 15 years of useful, active life!

Chapter 12

Here you will learn more about anti-aging. You will learn about the importance to keep your mitochondrial DNA healthy. Apart from that there are ways how to keep your telomeres longer; certain supplements that are reviewed will help. Also your lifestyle does make a big difference in how old you can turn.

Chapter 13

This chapter investigates the limits of supplements. Many supplements are useful, but you do not want to overdo it and get into toxic levels. More is not necessarily better!

Chapter 14

Here is a review of an alternative approach to treating ADHD. Attention deficit and hyperactivity disorder has been over diagnosed, has been neglected and has been over treated with dangerous drugs. An alternative treatment plan is discussed, which includes a combination of therapeutic steps.

Chapter 15

This gives you a brief summary of the book.

Kirkus Review

Kirkus Reviews reviewed the book on March 17, 2016: “A retired physician details how various preventative measures can fend off disease and disability in this consumer health guide. Schilling (A Survivor’s Guide to Successful Aging, 2014) had a family medicine practice in Canada for many years before retiring. Although Schilling ventures into some controversial territory in his latest book, it’s generally an engaging, helpful synthesis of ideas that draws on reputable research from the Mayo Clinic and other sources. Overall, it serves as an intensely detailed wake-up call to the importance of preventative health. He largely brings an accessible and even-tempered tone to his narrative, warning readers, for example, that preventative health measures can only aid in “a delay of aging, not ‘eternal living.’ ” A thought-provoking, impassioned plea to be proactive about one’s health.”

Healing Gone Wrong – Healing Done Right

Healing Gone Wrong – Healing Done Right

Conclusion

In this book it becomes evident that it is better to prevent an illness whenever possible rather than to wait for illness to set in and cause disabilities or death. You heard this before: “Prevention is better than a cure” or “an ounce of prevention is better than a pound of cure”. I will give an explanation, based on scientific data that there is indeed evidence to support these notions on a cellular level.

Mitochondria, the energy packages within our cells

The mitochondria, the energy packages within our cells, are the driving force that keep people vibrantly healthy well into their nineties. All this can only happen when the mitochondria function properly. If toxins poison the mitochondria and as a result they malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may use a wheelchair. If you want a life without disabilities, a life without major illnesses and enjoy good health to a ripe old age, you are reading the right book.

The book is written in American English.

Available in the US: http://www.amazon.com/gp/product/1523700904

In Canada: https://www.amazon.ca/Healing-Gone-Wrong-Done-Right/dp/1523700904/  

In other countries the book is available through the local Amazon websites.

Feb
06
2016

Effects Of Hormones On The Heart

Since February is heart month, this is a good time to discuss the effects of hormones on the heart. I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group received testosterone replacement therapy, another did not receive replacement therapy and one group received replacement with testosterone, but the testosterone levels did not normalize.

Mortality reduction with testosterone replacement

The observation time for the various groups was between 4.6 years and 6.2 years. The results were impressive. A comparison between the results of men on testosterone replacement and the results of men without testosterone replacement, showed that there was a 56% reduction in overall mortality. Furthermore, there was a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the control group without testosterone replacement and the partial testosterone replacement group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where the physician monitors testosterone levels and corrects the levels, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic was confusing for many years because of the insistence of the medical profession to use horse estrogen extracts from pregnant mares (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

Revisiting the Women’s Health Initiative

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When a woman is progesterone-deficient, she needs replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally.

Estrogen

KEEPS study

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

700 women in early menopause participated in this study. Treatment consisted of 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

It is a disadvantage to the woman, if she does not receive bioidentical hormone replacement after menopause 

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following
  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that physicians often overlook. It balances the effects of estrogens, but the body can also metabolize it into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. In premenopause the ovaries already reduced progesterone production. She should receive progesterone replacement by transdermal bioidentical progesterone cream in premenopause.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

Age-related GH production declining

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. You achieve this using a similar pen that is in use for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Most people think of melatonin as the “sleeping hormone”. The pineal gland releases melatonin. It rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease often have very low blood melatonin levels. Physicians can use melatonin intravenously in patients who have heart attacks. This will reduce the amount of damage to the tissue and stabilize the heart rhythm.

Age-related decline of melatonin production

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. You can take another 3 mg, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome. In addition, vitamin D deficiency also causes enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

More on the effect of vitamin D3 preventing mortality

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked. Thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.

Other effects on the heart

  1. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  2. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, the physician can measure the levels of both hormones and if low he can replace what is missing.
  3. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.

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Jan
23
2016

Life Extended By Several Decades

Have you ever thought about the possibility to prolong your “Freshness Date”? At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. Dr. Hertoghe explained that it is possible to extend life by paying attention to the factors that prolong life and combining them as an anti-aging type lifestyle. He made a distinction between

  1. normal aging: up to age 82
  2. healthy aging: up to age 100
  3. anti-aging medicine: up to age 122
  4. reversing aging medicine: much more than 122, perhaps to age 150 or more.

Normal aging (up to age 82)

Life expectancy is on average about 82 years. From the age of 50 to 60 onwards you may encounter problems with increased cholesterol, high blood pressure leading to heart attacks and strokes. Coronary artery by-pass surgery may extend an individual’s life by 10 to 15 years. But hardening of the arteries in the general circulation will eventually cut down the blood supply to vital organs leading to premature death that could have been avoided.

Around the mid 60’s to mid 70’s 12.4% of African Americans or 2.9% Caucasians get Alzheimer’s disease. These figures worsen rapidly with further aging: in their mid 70’s to mid 80’s 32.5 % of African Americans and 9.8% of Caucasians suffer from Alzheimer’s disease. At the age of 85+ years 54% of African Americans and 27% of Caucasians have Alzheimer’s disease. With normal aging Alzheimer’s has already increased, and this trend likely is continuing.

Loss of memory, depression and musculoskeletal pain

Memory loss also leads to a shortened survival curve; people with memory loss live two years less on average than compared to a group with no memory loss.

Add to this loss of life because of depression, common in older age. Compared to a non-depressed group over 2 years of older people the depressed group lived 30% shorter.

Musculoskeletal pain in younger age (18-44) was 38%; the next demographic group aged 45-64 reported 61% of musculoskeletal pains; seniors between 65 and 74 had 68% of musculoskeletal pain, and in the demographic group of 75 and up 71% of persons suffered of musculoskeletal pain. As we will learn later there may be hormone deficiencies behind these neck and back pains. If the patient does not seek treatment, this can lead to falls, fractured hips and premature loss of life. Those who survive accidents often become wheel chair bound and end up in nursing homes.

Patients with rheumatoid arthritis and patients with other disabilities have a lower life expectancy

One specific subgroup of patients with musculoskeletal pain are rheumatoid arthritis sufferers. After 10 years of having rheumatoid arthritis patients will have a survival of only about 50%. With involvement of more than 30 joints  (more severe form of the disease) only about 40% will survive. In other words, rheumatoid arthritis is an important factor for lowering people’s life expectancy.

At an age of 65 to 74 men have 23% of disabilities, while woman have 27.5% disabilities. This increases between the ages of 75 or older to 40% for men and 44.5% for women. At the age of 65 disabled men have a 3.5% higher death rate than the average population; disabled women’s death rate is 2.5% higher than the normal population. In other words, disability kills.

Obesity, and heart disease

Urinary urgency and incontinence leads to a 3.13-fold higher mortality rate than a control group of men who do not have these symptoms.

65% of men and 85% of women above the age of 50 have abdominal obesity. This is not just a harmless condition. There is an association between increased triglyceride levels and increased mortality due to cardiovascular disease and diabetes.

By the age of 65-74 heart disease has a frequency of 32% in men and 23% in women. At the age of 75 years and older this jumps to 44% in men and 32% in women. Once the doctor diagnoses heart disease, it causes a lot of premature deaths: an average person with heart disease lives 10 years shorter than those who do not have heart disease!

Healthy aging (up to age 100)

Improving lifestyle factors increases life expectancy

If we look at normal aging, we realize that all these diseases and disabilities we discussed are eventually killing us. In order to live longer we have to take steps that are known to interfere with some of these factors. For instance, quitting smoking will prevent heart disease, several cancers and chronic obstructive lung disease (emphysema). Positive thinking, social support and transcendental meditation will increase survival by preventing mental illness and depression, which in turn will prevent suicides. A healthy diet such as the Mediterranean diet or the Pegan diet will avoid cardiovascular disease and cut down cancer rates.

Live longer with better diet

One dietary change is called the “polymeal”. It consists of fish, fruit, vegetables, garlic, almonds, a moderate amount of wine and dark chocolate. Compared to the Standard American diet this type of diet would add 9 years for men and 8.1 years for women regarding their life expectancy. For instance, prostate cancer showed a 7-fold increase in a group of men who ate a lot of pickled vegetables, fermented soy products, salted fish and preserved meats, when compared to a control group who did not include these foods. In a group of women who had their meat well done and ate three servings of beef per week, breast cancer risk was 4.62-fold higher compared to women who ate meat done rare or medium rare. Overall cancer and cardiovascular mortality dropped by 35% in a study where 5 or more servings of fruit and vegetables were eaten per day.

Regular exercise and supplements of vitamin C and omega-3

A regular exercise program will strengthen the heart and lungs, keep your weight stable, reduce heart attacks and strokes and reduce the probability to develop cancer. A group of men between 61 and 81 were observed over 12 years and divided into those who did not exercise versus those who walked more than 2 miles per day. The exercising men had 19% less mortality compared to the sessile men. Vitamin C from fruit and vegetables or from taking supplements reduces global mortality from all causes by 46% compared to controls that did not. Similarly taking omega-3 fatty acid supplements (fish oil) daily reduced all cause mortality by 20%.

Dr. Hertoghe calls this “healthy aging” and this would allow you to be able to reach an age of about 100 years.

Anti-aging medicine (up to age 122)

Low thyroid hormones

Dr. Hertoghe told the audience that further attention to anti-aging factors could reduce mortality even further. He found over the years that paying attention to correcting hormonal weaknesses would have profound effects on how old a person becomes. Thyroid hormone replacement has been one of the steps that has helped people to feel more energetic, have less muscle pain, less falls, less fractures and complications. It also translates into longer lives.

One slide showed that a low free T3 level (low thyroid) was associated with a 3.6-fold higher death rate. A low free T3 level is an accurate predictor of cumulative death rate in cardiac patients.

T3 is also important for the maintenance of the immune system, which shows in patients with tuberculosis: the one-year mortality rate from TB in thyroid deficient patients was 75%, while patients with a normal thyroid had a mortality from TB of only 7%.

Replacement of missing sex hormones

Secondly, replacing missing sex hormones can add more life because cardiovascular disease is postponed (less heart attacks, less strokes), there is less cancer and better cancer survival, if a person comes down with cancer. Many statistics were quoted.

One interesting slide showed the longitudinal survival follow-up of congenital dwarfs in comparison with their normal brothers or sisters. Untreated male dwarfs turned only 56 years on average, while their unaffected normal brothers turned 75 years on average (19 years longer). With female dwarfs the difference is even more striking: untreated females dwarfs turned 46 years on average, while their normal sisters turned 80 years on average (a difference of 34 years).

Bioidentical hormone treatment prolongs life, lowers heart attack rates and lowers cancer rates

Another publication showed that the heart attack risk was 3.8-fold higher in a group of patients with hypopituitarism (under function of the pituitary gland), but the treatment group (treated with GH) had a normal rate of heart attacks.

11606 men aged 40 to 79 years were followed for between 6 and 10 years. The group who had the top 25% range of testosterone had a 19% lower mortality rates from heart attacks or cancer.

Older women, particularly aged 100 in Okinawa had 2.3-fold higher testosterone levels than women in the US at age 70. On the other hand 70-year old Okinawan women had 2.7-fold higher estrogen levels than US women.

Bioidentical hormone replacement therapy (BHRT) prior to developing breast cancer showed a 27% longer survival among 984 breast cancer patients in Sweden compared to those without prior hormone treatment.

Lower mortality rates for bioidentical hormone replacement therapy of breast cancer patients

In another group of breast cancer patients (2755 patients) aged 35 to 74 who were treated with bioidentical hormone replacement therapy (BHRT) after their breast cancer diagnosis, 50% had a lower recurrence rate (compared to no-BHRT treatment) and there was a reduction of 66% of mortality from breast cancer compared to controls without BHRT treatment. Another study showed that breast cancer patients would have a mortality rate of 33.3% without hormone treatment. After non-estrogen hormone treatment the mortality rate dropped to 12.5% and to 6% after estrogen/progesterone use. This shows the healing results of the various natural hormones.

Treating the cause rather than the symptoms

A group of 280 men and women around the age of 50 were treated with anti-aging hormone replacement for 2 or more years. In the beginning there were 34% of women and 15% of men with coronary artery disease. There were also 36.4% of women and 34.1% of men with high blood pressure. After replacing all of the missing hormones with bioidentical hormones for more than 2 years, coronary artery disease had dropped to 1.6% of the women and 1.08% of the men; high blood pressure had dropped to 2% of the women and 3% of the men. No drugs, just hormones! Of course, initially the doctors prescribed drugs to stabilize their condition, but they could gradually drop them safely. The reason was that the doctors treated the underlying hormone deficiency. The doctors were treating the cause of the cardiovascular disease rather than only the symptoms.

Low mortality of women on bioidentical hormone replacement

Dr. Hertoghe presented data of 6.38-year follow-up of 286 consecutive patients using anti-aging medicine (replacement of missing hormones with bioidentical hormones). These patients had an overall cancer rate of 2.1%, which compared very favorably to the 3.2% cancer rate among US women. The overall cancer rate was  3.1% in French women and 3.1% in Belgium women on no hormones. This is the type of information that is needed following the Women’s Health Initiative (WHI) that scared women into the false belief that hormones would be “poisonous”.

Synthetic hormone do not fit the hormone receptor

In the WHI synthetic hormones caused cancer and heart attacks; the reason for this was that synthetic hormones are not the identical shape as the natural hormones. But hormones and hormone receptors have to fit like a key into a lock; otherwise they are not effective or even block the natural life prolonging action of the natural hormone. This is why in the WHI study the outcomes were poor. Using bioidentical hormones the doctor can prevent heart attacks and strokes and they are also cancer-protective.

Reversing aging medicine (much more than 122, perhaps to age 150 or more)

General medicine has the goal to make patients as healthy as possible. With reversing aging medicine the goal is to make patients as young as possible. They are at their healthiest and feel younger again.

With anti-aging medicine using a healthy diet, exercise and bioidentical hormone replacement therapy the patients can add 15 years of good life. Add to these organ transplants, if necessary, telomerase activators and stem cell therapy. This can add another 25 years of life expectancy to a total of 40 years.

Growth hormone deficiency

Growth hormone deficiency is the one factor that has been underestimated. The discussion of dwarfs in comparison to their healthy brothers and sisters showed us the following. Growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many are deficient with regard to GH production. These were patients where Dr. Hertoghe already replaced their thyroid hormones, if abnormal and replaced their sex hormones when they were low. But they lost hair, developed old looking faces with wrinkles. In addition, a loss of subcutaneous fatty tissue is giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands.

Replacement of growth hormone

He replaced their missing GH using daily GH self-injection with a tiny needle (similar to diabetes injections). Within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of GH daily. This is not inexpensive, but some health care plans pay for this, as a lack of GH is a true hormone deficiency.

About organ transplants

Often it is a single limiting organ that determines when we die, typically the heart, lungs, brain, liver, kidneys, small bowel, pancreas or bone marrow. Organ transplants can add years of life, but it can be cumbersome to find a suitable donor. One study showed that only 40% to 60% of organ transplants are surviving 8 years after the surgery.

Stem cell therapies are other ways to prolong life. More research will perfect this, but essentially stem cells can provide 220 different cell types for in-vitro organ culture. This can probably be of use in the future to replace malfunctioning organs.

Life Extended By Several Decades

Life Extended By Several Decades

Conclusion

The dream of staying younger for longer can be a reality today. You just need to be willing to discipline yourself and watch what you are eating (Mediterranean type diet). Also, exercise regularly and have a positive psychological attitude. If the outdoor air is poor where you live, you may want to consider moving. Move to a place with good air quality. Sleep well for 7 ½ hours every night and retire not later than 10 to 11PM. You need to be asleep between midnight and 3AM as the growth hormone peak occurs at that time.

Take supplements

Take supplements that contain longevity micronutrients (magnesium, vitamins A, C, D, E, B6, B12, Co-Q-10, selenium, zinc, iron in premenopausal women etc.). Replace all missing hormones with bioidentical ones, like thyroid hormones (T3 and T4), sex hormones, DHEA and GH. Stem cell therapy and telomerase activators for cell rejuvenation will also have more of a place in the future.

Even, if you do only part of this reversing aging program you will slow down aging.

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Nov
07
2015

Eat Your Avocado

“Eat your avocado” is an appropriate invitation to eat this super food with many positive effects on people’s health. That is to say, first, it helps arthritis, in addition it is good for your vision, besides it protects against cardiovascular disease, moreover it fights metabolic syndrome, further it helps in weight maintenance and finally, it even protects against some cancers. Avocado contains healthy oils and many vitamins and minerals.

Avocado composition

80% of an avocado is fiber making it a valuable food to prevent colon cancer. Among the minerals it is noteworthy that avocados are rich in boron and potassium. In terms of vitamins it is rich in vitamin E (alpha-tocopherol), vitamin B6, folate, vitamin K and pantothenic acid. It does not contain cholesterol, but contains monounsaturated fat (oleic acid). In fact, oleic acid is the compound in olive oil responsible for lowering your blood pressure. The oils in avocado contain first 71% monounsaturated fatty acids, secondly 13% polyunsaturated fatty acids and thirdly 16% saturated fatty acids. This mix promotes healthy blood lipids, but also helps in the absorption of fat-soluble vitamins and phytochemicals. In addition to all that avocados contain phytosterols, a number of carotenoids, non-carotenoid antioxidants, alpha-linolenic acid (an omega-3 fatty acid) and glutathione.

Cardiovascular disease protection

The combination of fiber and folate in avocado help to reduce LDL cholesterol. Oxidized LDL leads to hardening of arteries. The folate reduces homocysteine, which is a risk factor for heart disease. Phytosterols that are similar in structure to cholesterol compete with cholesterol absorption in the gut.

In a 2015 study several diets were compared with regard to LDL lowering potential, either a low fat diet, or two forms of medium fat diets, where one contained one avocado per day. The results were surprising in that the low fat diet led to a reduction of LDL by 7.4 mg/dL while the avocado diet caused a reduction of LDL by 13.5 mg/dL.

The oils in avocados also seem to suppress the appetite center in the brain helping people to eat less and controlling obesity and diabetes.

Arthritis prevention

In a 2014 study hip osteoarthritis was examined for over 3 years. Researchers could show that an extract from avocados and soybeans was protective of osteoarthritis. The anti-inflammatory components of avocado like omega-3 fatty acids, carotenoids, phytosterols and non-carotenoid antioxidants all work together in countering joint inflammation. Boron abundantly contained in avocado also was found to be essential for healthy joints.

Eye protection

Avocado has its own mixture of carotenoids, like alpha- and beta-carotene, lutein, zeaxanthin, neochrome, chrysanthemaxanthin and others. The green pulp contains these. They have anti-inflammatory properties. The fatty acid profile of avocados helps to absorb carotenoids, as they are fat-soluble. Researchers conducted a a two phase clinical study to show that avocado added to salsa or to salad was leading to a 5- to 15-fold higher absorption of the carotenoids in salsa and salad when compared to avocado-free salsa and salad.

This is an important observation that we should remember: always eat some avocado with any fruit or vegetable that contains carotenoids, as this will improve the absorption of the carotenoids tremendously.

Why is that so important for eye disease? In a 2008 study a total of 1802 women aged 50 to 79 years from Iowa, Wisconsin, and Oregon were followed who had intakes of lutein and zeaxanthin above the 78th percentile. Researchers compared these women to women below the 28th percentiles in the Women’s Health Initiative Observational Study. This involved eye examinations in both groups. The eye specialists examined their eye lenses for nuclear cataracts. The surprising finding was that women with the highest quintile category of diet or serum levels of lutein and zeaxanthin had 32% less nuclear cataracts than women in the lowest quintile of lutein and zeaxanthin.

The conclusion was that carotenoids of avocados have vision protective effects.

Metabolic syndrome and obesity

This 2013 study included 17,567 US adults and part of the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Researchers compared avocado eaters and non-avocado consumers. Interestingly, avocado eaters had a much better overall food quality in their diet. They ate more vegetables, fruit, fiber and less added sugar. Calorie and sodium intake were identical in the two groups. But body weight, body mass index and waist circumference were significantly lower in avocado eaters than in the non-avocado control group. The cardio protective HDL cholesterol was significantly higher in the avocado group. The odds ratio for developing metabolic syndrome, the change in metabolism due to obesity was 50% lower in avocado consumers than in non-consumers. All of this is good news for the consumer, if we eat some avocado.

Skin, beauty and anti-aging

We don’t like to develop too many wrinkles, as they are a sign of premature aging. The oils of avocados have been used for some time in skin care products as they stimulate collagen production in the skin and reduce wrinkles. But when you eat avocados, the carotenoid substances (such as lutein and zeaxanthin) serve for skin protection, protecting you from UV light damage. In addition, avocados contain vitamin E and glutathione, which help to scavenge free radicals. Otherwise the skin would prematurely age and wrinkle. The end result is that you see a reduction in the development of wrinkles, when you consume avocados. The beneficial effects on your blood vessels in combination with protecting your skin will age your body slower, a point that has been noted in the anti-aging literature.

Cancer blocking properties

In the following I will briefly review the findings of several cancer research groups, but this review is by no means complete.

Leukemia

This 2015 study describes a new chemotherapeutic agent, derived from avocado that they named Avocatin B. Avocatin B is active against the difficult to treat acute myelogenous leukemia (AML). It works by targeting mitochondrial components of AML, but does not affect healthy leukocytes or leukocyte progenitor stem cells.

Colon and esophageal cancer

The authors of this study from Iran describe four phytoextracts of avocado for treatment of patients with esophageal cancer and colon cancer. They noted that the phytoextracts have a much lower toxicity than standard chemotherapeutic agents and significantly slow growth of these cancers. They plan to use these phytoextracts as complementary treatments of esophageal and colon cancers.

Oral cancers

This paper describes that avocado extracts were shown to be successful in treating oral cancers.

Cancer prevention

In this paper it is discussed that the phytochemicals in avocados arrest cancer cells in their cell division cycle and lead to apoptosis, which is natural cell death. The authors believe that eating avocado regularly can help prevent a whole array of different cancers by this mechanism.

Eat Your Avocado

Eat Your Avocado

Conclusion

Avocados are a super food, which has many beneficial effects. Perhaps one of the outstanding effects is prevention of obesity and the metabolic syndrome as discussed. Women may want to eat it because of the beneficial effects on skin and beauty. We all should have an interest in wanting to prevent heart attacks, strokes and cancer.

But who does not want to prevent cataract surgery and keep good vision until a ripe old age? It is possible by eating avocados. And would you not want to prevent osteoarthritis? Eat avocados and add some omega-3 fatty acid from distilled fish oil as well to get the full anti-inflammatory effect. Your joints will thank you and let you swiftly move wherever you want to go.

I thought you should know about the health benefits of eating avocados. They make a nice addition to your food, not only as guacamole, but in a wide variety of dishes. Use a few slices on your salad. Make a tasty dip. And find inspiring recipes online that you can easily find and copy.

Oct
30
2015

There Is Help For Hair Loss

It is good to know that there is help for hair loss. One area where aging shows is the head! Often people who are aging are experiencing hair loss. Some individuals have a genetic trait that makes them vulnerable to early hair loss, while others are keeping their hair until a ripe old age. With regard to hair pigment it is similar: some people keep their own hair color well into their 40’s or 50’s, but later the grey hair shows. Loss of hair color is about loss of hair pigment. One or more genes regulate whether or not we lose the hair pigment early or not. While there is not much we can do about our hair pigment other than coloring our hair every 3-4 weeks, there is something we can do about hair loss on our scalp.

Androgenic alopecia

Physicians call male and female hair loss “androgenetic alopecia”. It occurs in individuals who are genetically exposed. Interestingly baldness is rare in Chinese, Japanese and in Native American populations. Baldness more commonly affects men of Caucasian descent.

Onset of hair loss

In people who are prone to hair loss baldness typically starts in the temporal areas.

The genetic factors that lead to baldness can be inherited either from father or mother’s side. They are polygenic, meaning that there is not only one cause of hair loss. Gene frequency is most commonly associated with Caucasians. In Africans the frequency is lower and lower still in American Indians, Asians, and the Inuits.

Types of hair loss

The Norwood scale is used as classification of hair loss in men. In women hair loss is classified using the Ludwig and Savin scale. This helps to record the findings of a hair examination and is useful for research purposes as well.

Hormonal factors regarding male pattern baldness

There are several hormonal factors that are involved in the development of male pattern baldness. 5-alpha reductase converts testosterone (T) to dihydrotestosterone (DHT). DHT is more powerful than testosterone, causes shortening of the hair cycle and miniaturization of hair in the balding areas. After several years those who have genetically predisposed androgen receptors in balding areas come down with baldness. There are two isoenzymes of 5-alpha reductase, type 1 and type 2. Individuals born without type 2  5-alpha reductase do not develop androgenic baldness.

Aromatase can cause baldness

Another factor for baldness can be an enzyme, aromatase, located in the fatty tissue that converts testosterone into estrogenic hormones. A lack of testosterone can lead to baldness by this mechanism. Many men in their 50’s and 60’s who are overweight or obese are balding because of this mechanism. The other mechanism, as explained above is via DHT in genetically susceptible men. This process starts to occur mostly in individuals who are in their forties.

Treatment of hair loss

Mild cases of hair loss

This may respond to topical treatment with minoxidil that can be used on the scalp as liquid or hair foam. Systemic treatment in men is possible with finasteride (Propecia) or Dutasteride (Avodart). It helps to block the hormonal pathways regarding 5-alpha reductase and DHT that leads to baldness. In aging men in their 50’s and 60’s it may be that testosterone levels are low. Blood tests can test for this: the total testosterone level should be above 500 ng/dL. If it is less, testosterone replacement by bioidentical testosterone cream or by injection should be considered and usually works quite well with respect to regrowth of scalp and body hair.

Moderately severe hair loss

This can be treated with PRP (platelet rich plasma). This treatment modality cures about 30% of hair loss. There have to be enough hair-rejuvenating stem cells around the bald skin to stimulate hair growth. However, when baldness has set in for some time in an area of the scalp with previous hair growth, there comes a point where the hair follicles die off and even stimulation with PRP will not help. When dermatologists used extracellular matrix (called “A cell”) in combination with PRP the success rate for hair growth in a bald area jumps up to 70 to 80%. The A cell material recruits stem cells from the blood that create hair follicles in the bald skin starting hair growth again.

Severe hair loss

A cell and PRP treatment are not sufficient for this. It requires more invasive treatment: the bald skin usually does not contain any hair follicles. So, what can one do in such cases? Dermatologists detected that dense hair from the back of the head (nuchal area) is transplantable to a bald skin area. It will usually grow very well there. In the beginning of doing hair transplants little discs were transplanted and this looked at times like checkered hair growth in the previously bald area. Newer research showed that miniaturized transplants with perhaps three hair follicles harvested under the microscope from the dense area and transplanted into the bald area give a smooth, natural looking appearance. These are “follicular unit hair transplants”. Nowadays hair transplant physicians will only do this type of hair transplant procedure because of the superior cosmetic result.

There Is Help For Hair Loss

There Is Help For Hair Loss

Conclusion

Baldness is no longer a stigma in today’s society, particularly with males. So many men just shave off whatever hair they still have and live with baldness. However, other men and women want something done about the bald scalp; they can do so in various stages, first treat topically with minoxidil, then by trying PRP or PRP with the A cell treatment. Finally follicular unit hair transplants can restore a full head of hair where there was baldness before. In women with crown baldness follicular unit hair transplants can be very useful. This elegant method gets rid of this annoying crown baldness, and women who went for this procedure seem to be very happy with the results.

More info on hair restoration.

More info on hair loss.

References

Ref. 1: Hair disorders, from: “Lookingbill and Marks’ Principles of Dermatology” Fifth Edition: James G. Marks MD and Jeffrey J. Miller MD, Copyright © 2013, Elsevier Inc.

Oct
24
2015

Best Anti-Aging Products

It seems like every day there is some news about a vitamin or supplement that has the reputation of being good for you, so here are the best anti-aging products. But the ordinary person does not really know what will have an effect on anti-aging and what will not.

In the following I will review the key vitamins and supplements that have published anti-aging effects. With this I mean that there has been a consensus of anti-aging experts that several studies have shown a positive clinical effect of vitamins and supplements. Not all claims in the media are true.

Vitamins and supplements needed for heart attack and stroke prevention

Several studies stressed that vitamin K2 is a key vitamin. It removes calcium from the vascular compartment and transports it into the bones for storage. Osteoporosis prevention and prevention of heart attacks and strokes have a close link.  In my opinion this is not common knowledge. Another study from 2013, the Women’s Health Initiative in the US used a much larger patient base of 36,282 postmenopausal women. Researchers followed these women for up to 7 years. Initially there was some confusion as to how compliant the patients were in taking the required 1000 mg of calcium carbonate and 400 IU of vitamin D3. To clarify, the supplement compliant group when compared 7 years into the trial had 35% to 38% less fractures of the hip than the placebo group.

Vit. D3 did not cause kidney stones and needs to be taken in higher doses

This supplementation did not cause kidney stones in the study group, as some physicians often cite as the reason why they do not want to recommend supplementation with vitamin D3 and calcium. In other words all of these kidney stone concerns you have so often read in the media are not true.

  • The second vitamin (beside vit. K2) needed is vitamin D3 in doses of 4000 IU to 5000 IU per day. This helps to absorb calcium in the gut, but also helps to transport it into the bones away from the arteries. Apart from these vitamins and supplements regular exercise is necessary to condition heart and lungs. The overall effect is that osteoporosis, heart attacks and strokes are prevented. In addition, keep in mind that patients also need to avoid sugar as well to prevent oxidation of LDL cholesterol, which causes heart attacks.

PQQ, C0-Q-10, magnesium, hawthorn

  • You also need PQQ and Co-Q-10 for heart attack and stroke prevention (see below). These two supplements strengthen the mitochondria, the tiny power packages within the heart muscle cells and the brain cells. The better the support, the more resilient the heart and the brain are to the changes with aging. The heart and the brain are particularly rich in mitochondria.
  • There is a need for vitamin D3, alpha-lipoic acid and resveratrol in combination for prevention of heart attacks and strokes, because of their anti-inflammatory actions (see below).
  • Studies showed that magnesium and green leaf tea extract are effective in preventing heart attacks
  • Hawthorn is an herb that has been found useful for prevention of heart disease and treatment of mild heart failure (in Germany known as “Crataegutt”).

Improvement of mitochondrial function

If we want to have energy when we age, we need to take care of our mitochondria. This is where the biochemical processes take place that produce energy for us.

As I have summarized in this blog, there are several steps and supplements that will help us preserve mitochondria:

  • Mitochondrial aging is slowed down by ubiquinol (=Co-Q-10). Co-Q-10 repairs DNA damage to your mitochondria.
  • Another supplement, PQQ (=Pyrroloquinoline quinone) stimulates your healthy mitochondria to multiply. Thus, between the two supplements you will have more energy as optimal mitochondrial function is ensured.

Lifestyle changes, resveratrol, alpha-lipoic acid

  • There are simple lifestyle changes you can make: eat less calories as this will stimulate the genes, which in turn stimulates your cell metabolism including the mitochondria.
  • Resveratrol, the supplement from red grape skin can also stimulate the metabolism of your mitochondria. Exercise more and regularly as this will also stimulate your mitochondria to multiply similar to the effects of PQQ.
  • Alpha-lipoic acid is an anti-oxidant that counters the slow-down of the mitochondrial metabolism.

Anti-inflammatory vitamins and supplements

Since the mid 1990’s the medical profession knows that inflammation plays an important role in the development of heart attacks, strokes, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, Alzheimer’s disease, diabetes mellitus, arthritis (both rheumatoid arthritis and osteoarthritis), multiple sclerosis, just to name a few. Here is a list of vitamins and supplements that counter inflammation:

  • Vitamin D3: Vitamin D3 is an anti-inflammatory helping to prevent heart disease and cancer.
  • Alpha-lipoic acid: This anti-inflammatory is both water and oil soluble. It is an antioxidant protecting from cardiovascular disease, diabetes, and may reduce the size of a stroke.
  • Bioflavonoids: Bioflavonoids are found in fruit and vegetables. One of the most potent ones is resveratrol. Resveratrol prevents oxidation of LDL cholesterol, which prevents heart attacks. It also prevents Alzheimer’s disease and helps prevent insulin resistance as well.

Garlic, ginger tea, ginseng, green tea extract

  • Garlic: This herb has anti-inflammatory effects, stimulates the immune system and lowers blood pressure moderately. It is in use as an adjunct in treating high blood pressure, also for prevention of heart disease and of various cancers. It helps to reduce inflammation with osteoarthritis.
  • Ginger root extract: Ginger root is an anti-inflammatory, but also has anti-nausea effects and is useful for seasickness, morning sickness and side-effects from chemotherapy. Arthritis is also helped by it.
  • Ginseng: Ginseng is a popular herbal medicine; it has anti-inflammatory effects and improves immune function. Often people take it during the cold and flu season.
  • Green tea extract: Green tea extract is anti-inflammatory and has anti-oxidant effects. It is used for cancer prevention, stomach upsets, and diarrhea. It also helps in patients with Crohn’s disease and helps prevent heart disease.

Melatonin, rutin, selenium

  • Melatonin: Melatonin is a natural hormone produced in the pineal gland. It is a powerful anti-oxidant and anti-inflammatory. It also helps you to sleep. In higher doses it is used as anti-cancer medicine as it stimulates the immune system.
  • Rutin: Rutin is a bioflavonoid that is used to strengthen blood vessels, helps in stroke prevention and helps with osteoarthritis.
  • Selenium: Selenium is a trace element and an important anti-oxidant and anti-inflammatory. In other words, it stimulates the immune system, helps in prevention of cancer, and converts T4 thyroid hormone into the more active T3 thyroid hormone.

Cod liver oil, coenzyme Q-10, flax seed

  • Cod liver oil (omega-3) and krill oil are both omega-3 fatty acids. Krill oil contains more DHA, while fish oil derived omega-3 fatty acids contains more omega-3. Both krill oil and fish oil are needed as supplements to prevent arthritis, strokes, heart attacks, osteoporosis, diabetes, dementia, Alzheimer’s and inflammation.
  • Coenzyme Q10 has antioxidant properties, but also anti-inflammatory properties and helps to prevent cancer and heart disease.
  • Flax seed: Ground flax seed has anti-inflammatory omega-3 in it, cancer-protective lignans, blood pressure lowering properties and mild blood thinning activity. Flax seed has a rather tough shell. With a cheap coffee grinder you can easily grind your flax seed. In a few seconds it is ground. It is important to wipe out the grinder after use with a damp cloth to prevent future rancidity of leftover ground flax seed.

Methylation defects and vitamin supplementation

Some people are born with enzymatic defects in the methylation pathways. They are more prone to diverse diseases like autism, depression, anxiety, schizophrenia, adrenal dysfunction, addiction, cancer, allergies, immune weakness, diabetes etc.

Here is a list of the methylation pathway vitamins and trace elements important for those who are born into families where mental illness or diabetes is frequent, as they are the ones who often have methylation defects, many of which can be corrected (Ref.1).

  • Vitamin B2/riboflavin: Riboflavin is used for neonatal jaundice as part of phototherapy. Some adult patients experience relief from migraines.
  • Vitamin B6/pyridoxine: Pyridoxal phosphate is a co-factor of many enzymatic reactions in amino acid, glucose and lipid metabolism.

B-vitamins supporting nerves and bone marrow function

  •  Vitamin B12 is essential for your nerve function, bone marrow function (or severe anemia follows). It gives you energy and keeps you normal, but it is not a cure all. Sometimes in older patients absorption is a problem, but B12 injections every couple of months can easily overcome this.
  • Research about neural tube defects (spina bifida) in the baby of a folate deficient mother led to the discovery of folic acid. Heavy smokers and drinkers can get folate deficient.DNA synthesis requires folate as a co-factor.

Magnesium and zinc

  • Magnesium: Magnesium is involved in more than 300 biochemical reactions within the body. It helps with asthma, bone health, muscle pain and prevents heart attacks. It also cures psychiatric disease like anxiety and agitation. Magnesium is a co-factor for many enzymes reactions.
  • Zinc: Because zinc is an essential trace element, it is involved in many organ systems and zinc is used for many health problems. People may have heard that zinc is an important supplement in male infertility and erectile dysfunction. But patients with diabetes, high blood pressure, psoriasis, macular degeneration and night blindness. Zinc is a natural opponent of copper meaning that when zinc is low, copper levels in the blood are often high. This constellation can cause insomnia.

What makes a vitamin or supplement an anti-aging product?

If a vitamin or supplement fits into one of these following classes, it helps slow down aging and thus would be considered an anti-aging product:

1. Antioxidants (fight oxidant stress)

First of all, a typical representative would be vitamin C, which prevents oxidative damage of our DNA. Others are B vitamins (B1, B3, B6, B12 and folate), acetyl-L-carnitine, alpha-lipoic acid, bioflavonoid, garlic, ginger root extract, Gingko biloba, ginseng, green tea extract, L-glutathione, magnesium, manganese, melatonin, N-acetyl cysteine, potassium, rutin, selenium, vitamin E, and coenzyme Q10. We have discussed them above.

2. Anti-inflammatory action (fighting inflammation)

Secondly, vitamin D3 comes to mind, which suppresses inflammation in nerves (MS) or in blood vessels preventing heart disease. Others are alpha-lipoic acid, bioflavonoid, garlic, ginger root extract, ginseng, green tea extract, melatonin, rutin, selenium, cod liver oil (omega-3), coenzyme Q10, and ground flax seed.

3. Preserving mitochondrial function

Thirdly, B-vitamins and coenzyme Q10 are examples that do this. Mitochondria are important to provide energy in the body. Others are acetyl-L-carnitine, alpha-lipoic acid, ginger root extract, ginseng and selenium.

4. Prevent insulin resistance

Furthermore, there are vitamins and supplements that will prevent insulin resistance. This is pretty important as diabetes, where insulin resistance is present will shorten life expectancy. Ginseng, green tea extract, magnesium are examples of supplements that prolong life through countering insulin resistance. Others that do this are B vitamins (B1, B3, B6, B12 and folate), vitamin D, alpha-lipoic acid, beta-carotene, chromium picolinate, garlic, ginger root extract, manganese, potassium, and selenium.

5. Providing membrane integrity

In addition, other supplements are prolonging life by providing membrane integrity: beta-carotene, garlic and selenium belong into this group. Others are ginger root extract, ginseng, cod liver oil (omega-3), and ground flax seed.

6. Cure of partial methylation defects

Finally, partial methylation defects can be cured with B vitamins explained earlier and this has been shown to help improve some mental disorders significantly, improve life quality, prevent suicides and prolong life.

Many vitamins and supplements have not only an action in one of those categories, but in two or more (Ref. 2).  B1, B3, B6, B12 and folate belong into category 1, 3, 4 and 6, so there is a huge overlap and this is what anti-aging physicians consider an advantage. Often conventional physicians shake their heads and say that the overlapping actions would prove that they are worthless.

Overlapping actions of supplements and vitamins

However, as time went on conventional physicians have started to adopt more and more the anti-aging concept, because science is proving in large trials from the Karolinska Institute in Sweden, from various Chinese universities, from American universities like Loyola University and Harvard Medical School, Salk Institute and others that the overlapping concept is valid.

Because of the overlapping effect of vitamins and supplements you may not need to take all of these listed here as long as you have a good overlap. I have listed dosages of vitamins and supplements in this link (scroll half-way down to the table entitled: Vitamins and supplements, your basic “life insurance”).

Best Anti-Aging Products

Best Anti-Aging Products

Conclusion

Although the topic seems to be complex, the basic idea is simple. We need to get away from processed food and return to eating whole foods, preferably organic foods. A good diet is the Mediterranean diet with an emphasis on vegetables, fruit and lean meat. Use mostly olive oil in salads. With this basic approach you will receive most of the vitamins and supplements I mentioned above. You can get more sophisticated and add some of the key vitamins and supplements I mentioned.

Some lab tests may help with supplements

It is also useful to use lab tests to establish, whether there are vitamin deficiencies, and it is equally important that vitamin levels-such as vitamin D3- are not too high and not too low. Supplementation without verifying the need for it or exceeding the required dosage is not contributing to health (Ref.3). Many of the issues, which you find in this blog you will also find in more depth in my anti-aging book (Ref.4).

References

Ref.1: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Ref.2: Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

Ref. 3: Ronald Klatz, MD, DO and Robert Goldman, MD, PhD, DO, FAASP, Executive Editors: “Encyclopedia of Clinical Anti-Aging Medicine & Regenerative Biomedical Technologies”. American Academy of Anti-Aging Medicine, Chicago, IL, USA, 2012.

Ref. 4: Dr. Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling

Sep
25
2015

Testosterone

One of the driving hormones in a man is testosterone. We also know that with age this hormone level falls. The lesser known fact is the importance of monitoring testosterone levels in aging males. This way they have the choice of intervening with the aging process. Here are the facts about testosterone and about replacement of it when it is low. I will also discuss the anxieties of the medical profession to deal with this. Some feel uncomfortable about hormone replacements.

Androgen receptors contained in key tissues

Androgen receptors are situated in the key organs like the brain, heart, muscles, bones, kidneys, fat cells, genitals, hair follicles and skin. They respond to all male hormones, called androgens, like testosterone, dihydrotestosterone (DHT) and DHEA. DHT is produced by metabolizing testosterone with the help of an enzyme, called 5α-reductase in the adrenal glands. This is responsible for hair loss in males and some females. There is a genetic factor for this. It is important that the man continues to have all tissues stimulated by his male hormones when he ages or the key organs mentioned are going to suffer.

A lack of testosterone as the man ages (around 55 to 65) leads to a slowdown in thinking, osteoporosis in the bones, muscle atrophy (melting in of muscle tissue), and a lack of sex drive. Mood swings can turn the male into the “grumpy old man”. The skin gets thinned and is more brittle.

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding in these animals is the fact that this condition is reversible by replacement of the male hormone. In healthy males of a younger age all organs are working well. The problems starts when males age and the hormone regulation in the brain slows down, which ultimately leads to andropause in males, the equivalent of menopause in women. When the physician replaces testosterone in an aging man who has low testosterone levels, the stimulation of androgen receptors in key organs, which I mentioned before return organ function to normal.

Reluctance of physicians to prescribe testosterone

In the past medical students were taught that testosterone is causing 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 by a small percentage. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both the male hormone and small amounts of estrogen.

History of hormone ablation therapy for prostate cancer

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 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”).

Rebuttal of Dr. Huggins’ research

Dr. Morgentaler, a urologist from Harvard University has taken prostate cancer patients and put them on testosterone. To his and everyone else’s surprise testosterone treated prostate cancer patients improved, their prostate cancer either disappeared or become much less aggressive, which can be measured with the Gleason score based on its microscopic appearance. The result was that they did better, not worse on male hormone replacement.

Older physicians still hold on to the belief that testosterone would make prostate cancer worse

Unfortunately the history of testosterone, orchiectomy and prostate cancer as explained led to confusion among the medical profession. We now know that testosterone is innocent with respect to prostate cancer, testicular cancer or any other cancer. But some of the old-timers among the physicians doggedly hold on to their false belief from the past. If a man asks one of these physicians for testosterone replacement he may not only be told that he/she could not do that, but will also receive a tirade of false statements about testosterone.

No blood clots with male hormone replacement

We dealt with the myth of prostate cancer that is not related to treatment with the male hormone. There is another myth that older physicians often cite: that testosterone would supposedly be causing blood clots. At the University of Texas Medical Branch at Galveston (Texas, USA) a large study was done involving 30,572 men, ages 40 years and older. All had venous thromboembolism and received an anticoagulant drug or an intravascular vena cava filter following their diagnosis. Because they also had a low testosterone level physicians gave them testosterone replacement therapy. In addition, they followed them and monitored them for further venous thromboembolism. None were found in any of the men. The conclusion of the investigators was that filling a testosterone prescription was not associated with any clotting condition.

Aging and testosterone

The Massachusetts Male Aging Study showed that testosterone has been declining in the male population over a period of 20 years. Partially there is a relationship to aging. Otherwise estrogen-like substances or xenoestrogens, which are environmental factors, contribute to it as well. Although age is a factor, there is so much variation from man to man, that it is best to just measure testosterone and determine whether the mail hormone level is above or below 500 ng/dL. This seems to be the most reliable indicator in determining whether a man needs hormone replacement, apart from symptoms due to testosterone loss. These are: increased risks for prostate problems and/or cancer, cardiovascular disease, loss of bone density, a rise in cholesterol and urinary dysfunction. Dr. Randolph describes this in detail and also discusses who needs bioidentical testosterone replacement.

The aging male and hormone replacement

A New England Journal of Medicine study from September 2013 explained that apart from testosterone the male body needs a small amount of estradiol, the female hormone. The enzyme aromatase within the fatty tissue achieves this. But the physician must prescribe testosterone replacement as the bioidentical testosterone, so that a small amount of it converts into estradiol by the action of aromatase. Synthetic male hormone compounds with chemical side chains do not provide this small estrogen metabolism.

After a review of the hard facts about prostate cancer risk, it is now clear that older men get prostate cancer because testosterone in their blood is low and their body weight elevation. The extra fat converts androgens by the aromatase into estradiol. This leads to estrogen dominance. This causes breast cancer and uterine cancer in women, prostate cancer in men. When the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs male hormones to protect his prostate from prostate cancer.

Cardiovascular disease

The cardiovascular system has a lot of androgen receptors on its cell surfaces. It is important that the man continues to have the proper stimulus from androgenic hormones (testosterone, dihydrotestosterone and DHEA). This will allow him to have proper contractility of heart cells. It will also allow for relaxation of smooth muscle cells in the arteries to control blood pressure. With a lack of male hormones there is hardening of the arteries, loss of muscle cells in the heart muscle and increase of blood pressure. So far researchers have only noticed an association of low testosterone with diabetes, high blood pressure and heart attacks. It has not been proven that it is the cause (so webmd.com says). But careful replacement with bioidentical testosterone helps patients to get rid of their symptoms, have the energy to exercise and feel better.

Is it safe to replace missing hormones in a male?

Long-term studies have already shown that hormone replacement saves lives, but the medical profession is slow to accept this (Ref.1). Here is a link that explains this a bit further.

If a man who is low in male hormones wonders whether it would be worthwhile to go on testosterone therapy, here is the clear answer: would you like to have a 47% lowered risk of dying, a reduction of 18% in heart attacks and 30% reduction in the risk for a stroke? This is what a 14-year follow-up study published in the European Heart Journal in August, 2015 found.

The same is true for cardiovascular disease as stated above: if the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs testosterone replacement therapy to protect his cardiovascular system to prevent heart attacks and strokes.

Loss of bone density

Older men can get osteoporosis, which can lead to compression fractures in the spine. In addition fractures can also occur in the hip, the ankle or wrist. Current thinking is that with the lack of male hormones there is also a lack of estradiol via the aromatase pathway in fatty tissue. This small amount of estradiol is able to prevent osteoporosis all his life until testosterone drops with older age. Once again it is important to monitor his male hormone level and replace with bioidentical testosterone when it is lower than 500 ng/dL.

Rise in cholesterol

With obesity there is a metabolic change, called metabolic syndrome. This leads to an elevation of LDL cholesterol, which is a direct risk for hardening of the arteries. In an obese older man with low male hormones there is a double risk. First, there is the low testosterone and secondly the metabolic syndrome, if he is overweight or obese. As a result the heart attack and stroke rates in obese men with low testosterone are much higher. In obese men with normal male hormone levels there are less heart attacks and strokes. Men with obesity need to lose weight by changing their diet to healthier eating habits and starting a regular exercise program with swimming and walking. At the same time those with a testosterone level of lower than 500 ng/dL should have bioidentical testosterone replacement.

Urinary dysfunction

A hyperactive bladder, dribbling, hesitancy and leaking bladder can all be part of male hormone deficiency. But this is not that easy to diagnose. A full consultation by a urologist may be necessary to assess various other causes that could hide behind these symptoms. Part of the work-up though is to measure the total testosterone level and replace what is missing.

Alzheimer’s disease

Alzheimer’s disease can be due to a lack of male hormones. It is therefore important to measure the total testosterone level in a man. If it is lower than 500 ng/dL, as mentioned before , it means he needs male hormone replacement therapy. This will prevent Alzheimer’s disease.

Burnout

According to Dr. Thierry Hertoghe, an endocrinologist from Belgium, there are several hormones that can be missing in a person with burnout: a lack of cortisol, thyroid, growth hormone, testosterone/estrogen, progesterone and oxytocin. The middle-aged manager with burnout would have other hormones missing apart from testosterone. The physician needs to order blood tests to measure whether other hormones are missing. Whatever is low needs replacement with bioidentical hormones.

Some details regarding testosterone measurements and delivery

The deeper you delve into male hormone replacement, the more details there are to consider.

First, there is a sex hormone-binding globulin that is mostly produced by the liver and circulating in the blood.

It is like a storage form of testosterone and only 1 to 2% of the total testosterone is unbound. This is called the free or bioavailable testosterone. Some physicians measure just that portion of testosterone.

Hormone replacement in a man

Second, when it comes to replacement of testosterone in a man who is deficient for testosterone, there are several delivery systems, which some people find a little confusing. There are testosterone gels with less than optimal absorption. Another application are creams that compounding pharmacies provide. The patient absorbs these creams are usually well. But some men do not absorb either creams or gels. They need testosterone injections or testosterone pellets. The goal is to replace testosterone in a manner that there is a fairly equal amount of testosterone available at all times. Some men achieve that only with testosterone pellets, others with testosterone cypionate injections. For this reason blood test that determine the levels of free testosterone are necessary.

Testosterone

Testosterone

Conclusion

Testosterone is a key hormone in the male that requires monitoring, particularly when he is aging. A knowledgeable physician or naturopath needs to take a careful history of his symptoms. If blood tests show that the total testosterone is less than 500 ng/dL the physician needs to replace with bioidentical testosterone.

 

References

Ref.1: Dr. Abraham Morgentaler: “Testosterone for Life – recharge your vitality, sex drive, and overall health” McGraw-Hill, 2009

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