Sep
30
2017

Parkinson’s Disease May Be Stopped

Parkinson’s disease is common in the US; new research shows that the use of an old anti-depression medication can stopParkinson’s disease The use of nortriptyline, a 50-year old antidepressant has shown to normalize a nerve cell protein. In rats nortriptyline dissolved toxic alpha-synuclein clusters in brain cells. These toxic protein clusters seem to be happening in the brain of Parkinson’s disease patients also. It is the protein by the name of alpha-synuclein that research first found in rats to cause the toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem.

But nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.

Placebo controlled trial with nortriptyline

Now a research team from Michigan State University in Grand Rapids conducted a larger clinical placebo-controlled trial. The lead researcher Collier of the study group found that Parkinson’s patients who received treatment for depression with the tricyclic agent nortriptyline needed less dopamine, the main drug used to treat Parkinson’s disease. This indicated to the researchers that nortriptyline was preserving brain cells that were still making their own dopamine. In rat experiments they could show that it was the dissolving of toxic alpha-synuclein proteins by nortriptyline that was the key to therapeutic success.

Lisa Lapidus, a co-worker on the Michigan State University research team summed up their research: “What we’ve essentially shown is that we are dealing with a drug that the FDA approved already 50 years ago. Patients tolerate the medication relatively well. This could be a much simpler approach to treating the disease itself, not just the symptoms.”

Parkinson’s disease may be stopped also by old diabetes drug

Thomas Foltynie found that the diabetes drug exenatide helps patients with Parkinson’s disease. Dr. Foltynie is a professor of neurology at the University College London and co-author of the study.

Exenatide is an injection drug. When preliminary studies showed that this drug was effective in helping Parkinson’s disease patients lose their problems with walking and balance, a formal study followed.

Professor Foltynie designed a study where 60 people with Parkinson’s disease either got injections of exenatide or placebo injections. Patient exams followed regarding their musculoskeletal system and balance at baseline and every 12 weeks. A score system of 132 points assessed their Parkinson’s disease. After 48 weeks those who had been taking exenatide had a gain of 1 point on that scale while the placebo group dropped 3 points. After 48 weeks the drug administration (exenatide) finished. But after another 12 weeks another scoring and assessment of the Parkinson’s disease symptoms took place. The experimental group on exenatide scored 3.5 points higher than the placebo group. This suggests that exenatide is helping to treat the cause of Parkinson’s disease, not just the symptoms.

Parkinson’s disease may also stop through the use of caffeine

Parkinson’s disease was in the news again because of another study that involved breaking up misfolded alpha-synuclein through caffeine.

Misfolded alpha synuclein forms clumps inside dopamine producing cells in the substantia nigra of the brain stem. Misfolded alpha synuclein acts like a toxin to the dopamine producing cells and eventually these cells die off. This is the brain region that is responsible for making muscle movements smooth and stabilizes balance. The cells that have misfolded alpha synuclein clumps in them also go under the name of “Lewy bodies”.

Dr. Jeremy Lee from the University of Saskatchewan (Saskatoon, Saskatchewan, Canada) has isolated two compounds from coffee. They are called C8-6-I and C8-6-N. They can bind to alpha-synuclein and prevent clumping, which stops the toxic effects on dopamine producing nerve cells. Like with nortriptyline the caffeine effect is a curative approach to Parkinson’s disease.

 

Parkinson’s Disease May Be Stopped

Parkinson’s Disease May Be Stopped

Conclusion

There is a new therapeutic approach to Parkinson’s disease. Researchers have detected a protein called alpha-synuclein to cause toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem. When these cells die from the accumulation of these misfolded proteins, patients come down with Parkinson’s disease. But three different methods of treatment can improve Parkinson’s disease by dissolving the protein alpha-synuclein.

  1. Nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.
  2. Exenatide, an injection drug for diabetes, has been described to help Parkinson’s patients get better.
  3. Caffeine can also dissolve misfolded alpha synuclein (two compounds from coffee called C8-6-I and C8-6-N). This helps patients with Parkinson’s disease to stabilize.

This is only the beginning of a new approach to Parkinson’s disease and an attempt to cure the disease by dissolving the underlying mechanism. So far the drugs that are in use for Parkinson’s disease are only attempting to stimulate dopamine producing nerve cells to produce more dopamine. But the underlying pathology of accumulating misfolded alpha-synuclein clumps is not yet in the treatment protocol. The new research is different, as it takes this into account in an attempt to prevent the condition.

Sep
23
2017

Close Diabetes Control Prolongs Life

 

A 20-year study showed that close diabetes control prolongs life. A study divided 160 people with diabetes into two groups. The one group continued to get standard care. Yet the other group received a multi targeted, aggressive treatment protocol. As a result after 20 years the group with the intensive treatment protocol lived 7.9 years longer than the group with the standard treatment.

Dr. Oluf Pederson was the senior investigator of the physician team that followed the diabetes group. He said that they concentrated on a number of known adverse factors and treated them aggressively. These factors were first of all high blood glucose values and clotting risks, also high blood pressure and high triglycerides and in addition cholesterol values. Behavior modification was the therapeutic method to get people with risk factors to exercise more, adopt a healthy diet and stop smoking. Medication in select cases also played a role.

More details about the study

The intervention of intensive treatment lasted 8 years. After that the patients were still in a follow-up study for 13 years. At the beginning of the study patients were on average 55 years old and were borderline obese.

The investigation team screened for complications of diabetes. This included screening for kidney disease, heart disease and blindness. Dr. Joel Zonszein, the director of the New York Clinical Diabetes Center at Montefiore Medical Center said: ”These results are impressive and most patients do not receive the correct treatment, according to national surveys.”

Other studies about diabetes  

Foreign studies

Study from Croatia
  • Another study from Croatia involved 200 patients. It concentrated on patients who did not respond to metformin. Physicians used alternative treatment modalities, and they observed and measured blood sugars and hemoglobin A1C in the following 6 months. The study concluded that those patients who received aggressive treatment of their condition did better than those who did not receive the same vigorous approach.
Study from Japan
  • This Japanese study documented that female patients with type-2 diabetes developed kidney damage earlier than their male counterparts.  Consequently, the investigators pointed out how important it is to treat diabetes aggressively to avoid kidney damage.
Study from Singapore
  • This 2016 study from Singapore analyzed retroactively the impact of diabetes on the long-term survival after coronary bypass grafting (CABG).  5720 consecutive patients had their isolated first CABG surgery between 1982 and 1999. The mean follow-up was 13 years. 34.6% of the patients had diabetes, 51% had high blood pressure and 46.6% had elevated blood lipids. The initial mortality after the CABG surgery was 2.4% in the diabetic group and 1.8% in the non-diabetic group. 20-year survival rates following CABG surgery were 30.9% in diabetics and 49.2% in the non-diabetics, an 18.3% difference. The 20-year freedom from cardiac mortality rates was 56% in diabetics and 68.4% in non-diabetics. Other risk factors that led to cardiac mortality were the following: female gender (1.43-fold risk), diabetes (1.51-fold risk), previous heart attack (1.54-fold risk) and a low left ventricular ejection fraction of less than 35% (2.6-fold risk). The conclusion from this study was that long-term survival in diabetics following CABG surgery was much lower than that of non-diabetic controls. Hence the key to improving long-term survival for diabetics is to treat comorbidities like high blood pressure and elevated lipids aggressively as well as getting blood sugars and hemoglobin A1C values under control.

US studies

  • In this US study 558 youth (age less than 21) between February 2012 to July 2015 received follow-up. Between 40% and 50% of these diabetics needed insulin to improve their diabetes. Unfortunately their diabetes showed poor control, as their high hemoglobin A1C values indicated. Median HbA1C was 6.7%, 8.5%, 9.6%, and 9.7% in those with disease duration less than 1 year, 1-2 years, 2-3 years and less than 4  In other words, the longer the young patients had diabetes, the less seriously they took their treatment. Only 33% treated their high blood pressure and only 11% their elevated blood lipids. Microalbuminuria, an indicator of diabetic kidney disease, and non-alcoholic fatty liver disease were present in 5% to 6% of these young diabetic patients. The authors came to the conclusion that there were serious gaps in treating these young diabetics. Further follow-up data of the same group of patients in the coming years will provide further data. In conclusion, the new hemoglobin A1C ranges of 3.8% to 4.9% as the new normal range explains why these youths who do not treat their diabetes properly are at high risk to develop complications from their poorly controlled diabetes.
Heart attacks and erectile dysfunction
  • Heart attacks are more common among patients with uncontrolled diabetes. This US study classified diabetics according to the tightness of their diabetes control. Researchers found examining 606 men and 606 women with diabetes that they could reduce their risk of a heart attack, if they controlled smoking, glycated hemoglobin (hemoglobin A1C), systolic blood pressure, and total and high-density lipoprotein cholesterol. The control of all these risk factors could contribute to the prevention of heart attacks. 35% of men and 45% of women could prevent having a heart attack. A laxer control still would prevent 36% of heart attacks in men and 38% in women. A very aggressive diabetes control could prevent 51% of heart attacks in men and 61% in women. Most noteworthy: close diabetes control prolongs life.
  • Erectile dysfunction (ED) is a big problem among diabetic men. This study from Seattle shows the investigation of 136, 306 men with erectile dysfunction. 19, 236 of these men had diabetes prior to their ED problem. Over a two-year observation period diabetic men had much worse ED problems. As a result they needed to receive secondary line treatments  like penile suppositories or injectables. Others needed tertiary treatments like penile prostheses. In those whose diabetes control was good, oral agents as first-line therapies were usually sufficient.
More studies about risks and benefits of lifestyle
  • Middle-aged women with diabetes have a 4- to 5-fold higher risk for developing heart attacks while men do not show such a higher risk. It is probably particularly important for women to control diabetes when they are diagnosed with it to reduce the risk of coming down with a heart attack.
  • In 2011 Taylor from Newcastle University showed in a group of diabetes patients that he could cure diabetes permanently with an extremely low calorie diet. The trial was simple: he took overweight or obese patients with diabetes and put them on a starvation diet of 600-700 calories per day for 8 weeks. Consequently 43% of diabetic patients received a permanent cure of their diabetes. More info: http://nethealthbook.com/news/cure-diabetes-permanently/

 

Close Diabetes Control Prolongs Life

Close Diabetes Control Prolongs Life

Conclusion

The new hemoglobin A1C ranges that are desirable are between 3.8% to 4.9%. When diabetics bring their hemoglobin A1C level into this range, they do not get complications from their previously poorly controlled diabetes. Close diabetes control prolongs life. But as can be seen from a brief review of the literature physicians tend to be lax, patients are lax, and diabetes is often not well controlled. This leads to erectile dysfunction in males, to heart attacks and kidney failure in both sexes. Blindness and painful diabetic neuropathy are also common complications of poorly controlled diabetes. Amputations from clogged arteries are also among the complications. “Close diabetes control prolongs life” is the new mantra that everybody with diabetes needs to follow.

Lifestyle changes control diabetes and prolong life

As stated above Dr. Taylor from Great Britain has shown that a brief 600 to 700 calorie diet can cure 43% of diabetic patients permanently. Quit smoking, bring the glycated hemoglobin (hemoglobin A1C) into the normal range, control your systolic blood pressure as well as your total and high-density lipoprotein cholesterol. Do all these things, exercise regularly, and your diabetes will be well controlled. Remember: close diabetes control prolongs life!

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Aug
26
2017

Decreased Sperm Counts In Men

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

Medical causes of decreased sperm counts in men

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

Lifestyle causes leading to decreased sperm counts in men

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

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

Environmental causes of decreased sperm counts in men

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

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

Recent study about decreased sperm counts in men as an indicator

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

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

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

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

Decreased Sperm Counts In Men

Decreased Sperm Counts In Men

Conclusion

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

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Dec
31
2016

What Works Against Alzheimer’s?

Eli Lilly’s promising drug solanezumab failed; so, what works against Alzheimer’s? This drug was supposed to dissolve the amyloid deposits that function like glue and make the patients lose their memory. This phase 3 trial was to test the drug on patients to assess efficacy, effectiveness and safety. But instead it showed that the new drug did not stop the loss of memory.

Now all those who were hoping for solanezumab to be effective, will jump on another drug, aducanumab. Biogen from Cambridge, Massachusetts, has developed this drug. Out of 165 subjects only 125 completed preliminary studies. 40 patients who discontinued it, had negative side effects. These included fluid building up in the brain, which was thought to be due to removal of the plaques. But others, had brain bleeding.

Although the drug manufacturer is still hoping that aducanumab will work out as an anti-Alzheimer’s drug, I have my doubts. A drug that can have potential brain bleeding as a side effect does in my opinion not qualify as an anti-Alzheimer’s drug.

Factors that help prevent Alzheimer’s

1. Diet can be as effective as a drug in treating Alzheimer’s

In September 2015 researchers from Rush University published results of putting Alzheimer’s patients on the MIND diet. The MIND diet was a prospective study where 923 people aged 58 to 98 years participated. Researchers followed these people for 4.5 years. Three groups of diets were tested: Mediterranean diet, DASH diet and MIND diet.

The MIND diet study result

The adherence to the diet was measured: those who stuck to the diet very closely, another section of participants that were less diligent, and finally one segment of people who did not take the entire thing too serious. With regard to the MIND diet the group with the highest adherence to the diet reduced the rate of Alzheimer’s by 53% compared to the lowest third. This is like a highly effective Alzheimer’s drug! The second group still was able to reduce the rate of Alzheimer’s by 35%, which would be like a regular strength drug. The control diets were the DASH diet and the Mediterranean diet. The group that was strictly adhering to the DASH diet reduced Alzheimer’s by 39%, the group that was very conscientious in adhering to the Mediterranean diet reduced Alzheimer’s by 54%. The middle thirds of both control diets did not show any difference versus the lower thirds. The conclusion was that a strict Mediterranean diet had a very good Alzheimer prevention effect, as did a strict MIND diet. However, when patients did not adhere too well to a diet, the MIND diet was superior still yielding 35% of Alzheimer’s prevention after 4.5 years. The other diets, when not adhered to that well, showed no difference from being on a regular North American diet. Here is more info about the MIND diet.

Conclusion:

Avoid the Standard American Diet. Adopt a Mediterranean diet and stick to it in a strict fashion or adopt the MIND diet. The other benefit is that there are no side effects!

2. Stress and Alzheimer’s

2010 study from Gothenburg University, Sweden examined 1462 women aged 38-60 and followed them for 35 years.

Psychological stress was rated in 1968,1974 and 1980. 161 females developed dementia (105 of them Alzheimer’s disease, 40 vascular dementia and 16 other forms of dementia). The risk of dementia was reported higher in those women who had frequent/constant stress in the past and was more severe the more stress they were exposed to in the past. Women who were exposed to stress on one, two or three examinations were observed to have higher dementia rates later in life, when compared to women who were not exposed to any significant stress. Specifically, dementia rates were 10% higher when exposed to one stressful episode, 73% higher after two stressful episodes and 151% higher when exposed to three stressful episodes.

Conclusion:

Avoiding being stressed and seeking counselling when stress occurred could prevent Alzheimer’s.

3. Be creative, prevent Alzheimer’s and dementia

In an April 8, 2015 publication from the Mayo Clinic in Rochester, MN and Scottsdale, AZ 256 participants aged 85 years and older (median age 87.3 years, 62% women and 38% men) were followed for 4.1 years.

Mild cognitive impairment (MCI) was measured using psychological tests. At the time of recruitment into the study all of the tests for MCI were normal. As the study progressed it became apparent that there were various risk factors that caused the onset of MCI, which is the immediate precursor of dementia/Alzheimer’s disease. The finding was that the genetic marker APOE ε4 allele was associated with a risk of 1.89-fold to develop MCI and later Alzheimer’s disease. If there were current depressed symptoms present at the time of being enrolled into the study the risk of MCI development was 1.78-fold. Midlife onset of high blood pressure led to a 2.43-fold increase and a history of vascular diseases was associated with 1.13-fold higher MCI development. The good news was that four activities were associated with a lower risk to develop MCI with aging. When the person engaged in artistic activities in midlife or later in life the risk for MCI development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations. This would be equivalent to highly effective anti-Alzheimer’s drugs.

Conclusion:

If you stimulate your mind in older age, even browsing on the computer this will help you to prevent Alzheimer’s disease.

4. Lifestyle factors contributing to Alzheimer’s

a) Sugar consumption: Sugar consumption and too much starchy food like pasta (which gets metabolized within 30 minutes into sugar) causes oxidization of LDL cholesterol and plaque formation of all the blood vessels including the ones going to the brain. On the long-term this causes memory loss due to a lack of nutrients and oxygen flowing into the brain.

b) Lack of exercise: Lack of exercise is an independent risk factor for the development of Alzheimer’s disease. Exercise increases the blood supply of the brain, strengthens neural connections and leads to growth of neurons, the basic building blocks of the brain. Exercise increases mood-regulating neurotransmitters like serotonin and endorphins.

c) Sleep deprivation leads to memory loss, but so does the use of aspartame, the artificial sweetener of diet sodas. Make your own homemade lemonade. Squeeze the juice of half a lemon. Add mineral water to fill an 8 oz. glass. Add a tiny bit of stevia extract for sweetening. Stir and enjoy. Stevia has been used for thousands of years.

5. Hormone changes

A lack of testosterone in men and estrogen in women interferes with cognition and memory. For this reason it is important after menopause and andropause (=the male menopause) to replace what is missing with the help of a knowledgeable health professional.

Progesterone is manufactured inside the brain, spinal cord and nerves from its precursor, pregnenolone, but in women it also comes from the ovaries until the point of menopause. Progesterone is needed in the production of the myelin sheaths of nerves and it has a neuroprotective function. In menopausal women bioidentical progesterone is a part of Alzheimer’s prevention.

Melatonin is a hormone, a powerful antioxidant and a neurotransmitter at the same time. It helps in the initiation of sleep, stimulates the immune system and protects from the toxic effects of cobalt, which has been found to be high in Alzheimer’s patients. In an aging person it is wise to use melatonin at bedtime as a sleep aid and to preserve your brain.

6. Genetic risk of Alzheimer’s

At the 22nd Annual A4M Las Vegas Conference in mid December 2014 Dr. Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She pointed out that there are about 5 genes that have been detected that are associated with Alzheimer’s disease and in addition the apolipoprotein E4 (APOE4). About 30% of people carry this gene, yet only about 10% get Alzheimer’s disease, which shows how important lifestyle factors are (in medical circles this is called “epigenetic factors”) to suppress the effect of the APOE4 gene. She also stated that our genes contribute only about 20% to the overall risk of developing Alzheimer’s disease. This leaves us with 80% of Alzheimer’s cases where we can use the brain nutrients and hormones discussed above and exercise to improve brain function.

7. Vitamin D3 protects your brain from Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease of old age. We know that it is much more common in patients with type 2 diabetes where insulin levels are high. Studies have shown that Alzheimer’s disease can be termed type 3 diabetes.

The resulting neurofibrillary tangles and amyloid-beta deposits damage nerve cells, which are responsible for the memory loss and the profound personality changes in these patients.

What does vitamin D3 have to do with this?

A 2014 study showed that a low vitamin D level was associated with a high risk of dementia and Alzheimer’s disease.

Specifically the following observations were made.

  • Vitamin D level of less than 10 ng/ml: 122% increased risk of Alzheimer’s
  • Vitamin D level 10 to 20 ng/ml: 51% increased risk of Alzheimer’s

The same research group found in two trials that vitamin D deficiency leads to visual memory decline, but not to verbal memory decline.

Generally supplements of vitamin D3 of 5000 IU to 8000 IU are the norm now. But some patients are poor absorbers and they may require 15,000 IU per day. What the patients need in the dosage of vitamin D3 can be easily determined by doing repeat vitamin D blood levels (as 25-hydroxy vitamin D). The goal is to reach a level of 50-80 ng/ml. The optimal level with regard to nmol/L is 80 to 200 (according to Rocky Mountain Analytical, Calgary, AB, Canada).

8. Avoid sugar overload

We already mentioned sugar consumption under point 4. But here I am mentioning it again because of the insulin reaction. An overload of refined carbs leads to an overstimulation of the pancreas pouring out insulin. Too much insulin (hyperinsulinemia) causes hormonal disbalance and leads to diabetes type 3, the more modern name for Alzheimer’s. All starch is broken down by amylase into sugar, which means that anybody who consumes starchy food gets a sugar rush as well. Too much sugar in the blood oxidizes LDL cholesterol, which leads to inflammation in the body. The consequence of chronic inflammation are the following conditions: hardening of the arteries, strokes, heart attacks, Alzheimer’s due to brain atrophy, arthritis, Parkinson’s disease and cancer.

What Works Against Alzheimer’s?

What Works Against Alzheimer’s?

Conclusion

In the beginning we learnt about a failed phase 3 trial regarding an anti-Alzheimer’s drug. Next we reviewed several factors that can all lead to Alzheimer’s and that have been researched for many years. It would be foolish to think that we could just swallow a pill and overlook the real causes of Alzheimer’s disease. I believe there will never be a successful pill that can solve the increasing Alzheimer’s problem. It is time that we face the causes of Alzheimer’s. This means cutting down sugar to normalize your insulin levels. We need to supplement with vitamin D3 because we know that it helps. For women in menopause or men in andropause it is time to replace the missing hormones with bioidentical ones. We need to handle stress and avoid sleep deprivation. And, yes we need to exercise regularly. Following a sensible diet like the Mediterranean diet or the MIND diet makes sense. And let us keep our minds stimulated. Chances are, when we do all of this; no Alzheimer’s pill will be needed. This is not good news for the drug companies, but will be very good news for you. Last but not least, there are no side effects, only health benefits!

Additional resource on how to preserve your memory.

Nov
26
2016

Chronic Shoulder Pain Treatment

This overview is about chronic shoulder pain treatment. A 71- year old health conscious patient was exercising in a gym. When he used the shoulder machine, he suddenly experienced a stinging pain in his left shoulder. The pain seemed to be localized in the upper (superior) portion of the trapezius muscle. With this he also felt pain in his left neck.

This was fitness gone wrong! It can happen, that exercise is overdone or lack of judgment leads to injury. Trainers caution us, when we embark on exercise programs, and yet, it happens! Often the road to recovery is a bumpy stretch, and if the problem is not corrected, it can lead to chronic pain. With this knowledge the patient sought help. The first approach was visiting a

Chiropractor

He sought the help of a chiropractor and had 6 manipulations in the neck and thoracic spine. The spine had good range of motion, but the left shoulder pain in the trapezius muscle stayed.

He found that heat application to the trapezius muscle helped, so he bought an electric heating pad that he applied once or twice a day for pain relief. He also sought the input of his G.P. He was offered

Pain pills

This was the predictable regimen, but the patient was concerned about the side effects of pain pills, and he declined. He had heard of a supplement, called Trilipotropic (from Trophic), which contains 300 mg of choline bitartrate, 300mg of inositol and 300 mg of methionine in one tablet. He learnt at a medical conference that two of these tablets were as effective in relieving the pain as one tablet of Motrin, an anti-inflammatory drug. He took two of these pain relievers from the health food store a couple of times per day alternating with the heating pad to control his pain.

Since the condition improved only marginally, he looked at the option of

Prolotherapy

When the chiropractor mentioned after 5 treatments that he could not treat the pain successfully, the patient decided to try prolotherapy, because he had heard that this would be good for chronic musculoskeletal pain. The naturopath whom he saw examined thoroughly and determined that the patient would be a good candidate for 2 to 4 prolotherapy treatments. After one treatment on the left side along the cervical spine and the left trapezius area the pain was reduced by 30% of what it was before. The second prolotherapy treatment was given again to the left side and also to the right side to keep it symmetrical. The naturopathic physician told the patient that he would see him for follow-up in 4 weeks. The treatment of the right asymptomatic side did not cause any pain, but the left side started flaring up after the second treatment, causing pain that was almost as bad as the original pain. When the patient returned to the naturopath and told him about the flare-up of pain in his left shoulder, he was told that this is what sometimes happens when treatments are not spaced far enough apart. He felt that this should be observed now and reassessed in 6 months in case there was

No progress. It was time to look at other options:

IMS treatments

When the chiropractor had admitted that he could not help removing the pain, he suggested that maybe a physiotherapist trained in intramuscular stimulation treatment (IMS), also known as dry needling could be of help. The patient was waiting for the appointment with the naturopath for prolotherapy when he saw the physiotherapist for IMS treatments. He examined the patient and noticed a persistent trigger point in the upper trapezius muscle, which he thought was causing the chronic pain.

Two IMS treatments relieved the pain by about 50%. But about two or three days later the pain came back to about 75% of the original pain after the gym injury. The appointment for the prolotherapy by the naturopath had taken two months to wait for, so he had already had 3 IMS treatments just before the prolotherapy to get some pain relief. The IMS trained physiotherapist thought that perhaps a few more treatments, up to five or six might be able to take the pain away. So the patient continued treatments on a weekly basis.

Unfortunately the hope for pain relief did not materialize. The pain improved to about 30 to 40% of the original pain, but it always came back just 2 or 3 days later. Fortunately for him he could apply the heating pad and the pain would stay away for 3 to 5 hours. It also responded to taking two tablets of the choline bitartrate/inositol/methionine combination that took the residual pain away for several hours. Self-massaging the trigger point also gave some relief. But occasionally the pain came back with a vengeance and felt like a charley horse that suddenly could occur in his left shoulder making it difficult to move his left arm, particularly when he needed an outstretched arm for ballroom dancing, lifting of heavy objects or for working out in the gym. Even just holding on to the rails of the treadmill when doing a fast walk on the treadmill for half an hour could lead to a flare up of the left shoulder pain. It is frustrating, when there is only temporary relief, but no real cure, but giving up is no option. Often we find more information on the Internet. What came up was

Low-dose laser therapy

The patient remembered having heard of low-dose laser therapy that might be useful in treating chronic pain. This method, called interstitial low-laser therapy was used to treat his trigger point in his left shoulder. A physician who is the president of ISLA –the international society for laser applications- specializing in laser treatment treated him by inserting a cannula into his left trapezius muscle close to the trigger point. He injected a small amount of procaine (local anesthetic), then 5 ml of normal saline. This was followed by three low-laser beam treatments for 10 minutes each, first blue, then green and finally yellow color, all given interstitially after which the cannula was removed.

He was surprised to feel relief almost instantly. There was still a bit of pain from the interstitial needle for about two days, but he noticed that the trigger point in the trapezius muscle had completely vanished. Finally after 6 months of intermittent pain there was relief of about 50% of the original pain. This time the pain in that particular trigger point stayed away, which was encouraging.

But there were two other trigger points that were bothering him. After one month he got a second interstitial low dose laser treatment by the naturopath who had previously given him the prolotherapy into another trigger point, and finally 2 weeks after this, the third laser treatment was given for yet another trigger point. This continued on for another few months. The pain disappeared, then it crept in slowly again, but at a lower level. It became a quest to eradicate the trigger points! Each time the latest trigger point that was still palpable was treated with the same low-dose laser treatment method. It took a total of 9 interstitial treatments to finally reach the point where all of the pain was gone.

It felt strange: the chronic left shoulder pain had disappeared!

Chronic Shoulder Pain Treatment

Chronic Shoulder Pain Treatment

Conclusion

When pain lasts for more than 3 months, it is referred to as “chronic pain” and is often termed neuropathic pain that is difficult to treat. You may have guessed by now that I was the patient in this blog, and so I had a vested interest in getting rid of this pain. I had previously described a similar pain in my lower back that was relieved with just one interstitial low-dose laser treatment at that time and my back has remained pain free since. Shortly after that successful treatment I developed the left shoulder pain from a soft tissue injury in the gym as mentioned. I was fortunate that Dr. Weber could treat me again, this time at his clinic in Lauenförde, Germany on occasion of a Germany trip that I had booked for holiday purposes.

I was lucky that this treatment responded similar to the one in my lower back. The difference was that my left shoulder required a total of nine low-dose laser treatments to be resolved and my pain had lasted a total of 14 months!

It occurred to me that a successful outcome of treating pain requires collaboration between patient and therapist. Call it trial and error. In my case it was only the fourth treatment modality, the low-dose laser therapy that worked permanently.

I feel that the chiropractor did his best to ensure there was no nerve root irritation and told me when he had reached his limits.

The IMS trained physiotherapist treated me before and after the prolotherapy and also told me after a total of 12 visits that he likely could not help me any more than he did.

The naturopath who did the prolotherapy said that he had strengthened the ligaments along the spine on the left side, but that the trigger point from the gym injury likely was not responding to prolotherapy.

The final answer came from the treatment by Dr. Weber in Germany and the naturopath in Kelowna using the same Weber system machine with low-dose lasers. I think that this is an under-recognized treatment modality of musculoskeletal injuries, including sports injuries. You can find treatment providers for low-dose laser therapy throughout the US, Canada and Europe where many physicians and naturopathic physicians use it as part of their pain management methods. The equipment has been FDA approved; Health Canada approved and is approved by the Medical Devices Directive in Europe. Please note that this type of laser (low-dose laser) has nothing to do with laser treatment for cosmetic purposes.

It has to be stressed that chronic pain treatment requires attention to detail, feedback from the patient to the healthcare provider and persistence on behalf of the patient to follow through until the chronic pain is resolved. It also shows that giving up is not an option!

Sep
17
2016

Seven Steps To Live Over 100 Years

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.

Explanation:

There are two comments I like to make. One is that when you have calm nerves, and your emotions are balanced, your stress hormones are controlled. We know that people who are laid back and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly uneducated about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. Life expectancy can be prolonged by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium. http://www.askdrray.com/life-extended-by-several-decades/

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

People have always been fascinated about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!

Aug
06
2016

Pain Treatment

General practitioners see a lot of patients with various pain symptoms for which they seek pain treatment. The underlying conditions might be from an arthritic problem that suddenly becomes symptomatic, or an acute back injury may send pain from the lower back into one of the legs. Others may experience excruciating headaches like migraines or tension type headaches. Often these painful conditions require some immediate pain relievers to treat the pain, but this can turn into a nightmare of drug dependency and may even lead to the development of chronic pain. Here I like to review an article that I found in the June edition of ConsumersReports.org.  In my review I included most of the content, but added a few newer pain treatment modalities.

Acute pain

Here I’m discussing back pain as an example. When a disc bursts in the lower back because the person was lifting an object too heavy to lift, acute pain develops in the lower back. This is often located at the lower lumbar spine level (L5/S1) causing radiating pain into one of the legs.

In a case like this it will often take several weeks before the body can heal this condition.

Chronic pain

It can happen in many cases that the pain will still be there 3 to 6 months down the road. If a disc fragment pushes on the nerve root in the nearby canal through which the nerve root travels, this will cause the muscles supplied by the nerve root to melt away in the leg of the affected side. If nothing is done about this, the acute pain turns into chronic pain, which is much more difficult to resolve. The initial physician may refer the patient to a neurosurgeon who will review the case together with the help of an MRI scan that shows the underlying pathology. The neurosurgeon may determine that a mini discectomy will reduce the pressure onto the nerve root. This surgery may be able to prevent chronic pain from setting in. Once the pressure is relieved, the nerve can start the healing process. It is critical to not miss the point where acute pain crosses over into chronic pain. This happens at around 2 to 3 months into the pain condition. Chronic pain is much more difficult to treat as some of the neurological pain pathways that form after such injuries can persist within the spinal cord or even within the central nervous system, even after successful disc surgery that is done too late. With respect to the example given above, if the patient is operated on too late (1 to 2 years after the injury), the procedure may not be effective in relieving the pain. A chronic pain syndrome has started.

How pain treatment is done

  1. Avoid bed rest

In the past (up to the late 1970’s to mid 1980’s bed rest was the accepted initial mode of treatment. Even though patients often felt some relief of pain initially, this led to muscle atrophy (literally a melting away of muscles) in the muscles that are supporting the spine. These structural changes destabilized the spine and often made the pain more chronic until physiotherapy treatments and active exercises rebuilt the supporting muscles again.

  1. See a physiotherapist

Physiotherapists can use different treatment modalities like traction, a TENS machine, active exercises that all can help to alleviate back pain due to muscle spasm. If there is only a strain, this will often help to resolve your back pain within 4 weeks. But if there is an underlying disc herniation as previously explained, you need to be assessed by a physician in an urgent care center, primary care setting or by an emergency physician in the emergency department of a hospital. When the examination confirms an abnormal reflex from a nerve root compression, a referral to a neurosurgeon or orthopedic surgeon is usually made as previously explained.

  1. Chiropractic treatment

Some people have their backs treated periodically to prevent back troubles. When they get an acute back pain they likely will see the chiropractor again. In cases of a back strain, where one or more muscles are pulled, this approach will be helpful together with some home exercises and swimming to build up muscle strength along the spine. However, in the case of a herniated disc chiropractic adjustments should not be done (physicians say they are “contra-indicated”). Instead the patient should be referred to either a neurosurgeon or an orthopedic surgeon.

  1. Medication for pain

Often physicians prescribe Tylenol with codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) or morphine for pain relief. All narcotic medication have side-effects; they can cause constipation, can cause vomiting, make you feel dizzy and can lead to falls, particularly in elderly patients. These falls can cause hip fractures and other fractures that complicate the recovery from the original pain. Never exceed the dosage of pain medicine prescribed on the label, and if it does not relieve the pain, see your physician again for a reassessment to rule out any complications. Often people with back pain also have depression. To address this issue your physician may prescribe an antidepressant like duloxetine (Cymbalta), which has been approved by the FDA for treatment of lower back pain. But there are two rare, but important side effects to know about. Cymbalta can cause lowering of blood pressure, which leads to dizziness. This can cause serious falls with the danger of fractures. The other complication is the risk of liver failure.

Side effects of pain treatment

  1. While there seems to be an urgency to treat a patient who is in pain with pain medication, the treating physician must not forget that pain medication is potentially addicting and patients often use higher doses than advisable. However, pain medication has a narrow therapeutic window meaning that the toxic levels are not much higher than the drug levels necessary to relieve pain.
  2. There are medications that are only marginally effective, if at all. Glucosamine and chondroitin are used for relief of arthritic pain in osteoarthritis sufferers. They are eliminated by a liver enzyme system that also eliminates blood thinners. If a patient is on blood thinners, the addition of glucosamine and chondroitin can lead to dangerous bleeding. Instead of using glucosamine and chondroitin when you experience pain and inflammation in joints, reduce your activities, but stay as active as you can to avoid your symptoms from getting worse.
  3. When a patient has a severe migraine headache it is tempting to want to rule out a brain tumor. But a CT scan exposes the patient to dangerously high radiation doses that over time could cause brain cancer or leukemia. There are physical examination methods to rule out a brain tumor. If the findings are positive, an MRI scan can be used to get much more detail of the brain than a CT study would reveal. MRI scans do not have undesirable side effects.
  4. Before you rush into using anti-inflammatory drugs, use gentle movement to remobilize the painful joint, back or limb. Activities like swimming, walking or yoga can reduce pain and allow you to recover from a painful condition according to a Cochrane Library analysis of 61 studies.
  5. For more pain relief NSAID (non steroidal anti inflammatory drugs) pain relievers like ibuprofen (Advil) or naproxen (Aleve) for a brief period will also help. The problem with long-term use of NSAIDs is that it can cause kidney damage. With longer use of NSAIDs there is also a danger of stomach bleeding, heart attacks and strokes.
  6. The pain drug acetaminophen (Tylenol) has a narrow therapeutic window and is less effective in pain relief than the NSAIDs. The FDA has recommended as the highest daily dose 4000 mg of acetaminophen. But if you are a heavy drinker or you have liver disease, your daily dose of acetaminophen should not exceed 3250 mg to avoid liver toxicity. Long-term use of acetaminophen can also damage your kidneys, therefore the recommendation to use acetaminophen only for a short period of time (a few days).
  7. Migraine headache drugs: The newer migraine drugs, called triptans temporarily narrow widened blood vessels. This relieves severe migraines within about 2 hours. However, these medications are not recommended for those with high blood pressure, chest pain, heart disease or circulation problems in the legs, as blood vessel constriction could bring on heart attacks or worsen circulation problems.

Common sense approach to pain treatment

The key for any pain condition is to treat the pain right away to minimize the impact that pain has on you and to prevent developing chronic pain, which is more difficult to treat.

Here are some examples.

  1. Migraine headaches

    If you have a migraine headache, use an over-the-counter pain reliever like naproxen or ibuprofen to treat the migraine pain very early. A combination of acetaminophen, aspirin and caffeine (like Excedrin Migraine or a generic copy) will also do. This will stop the release of prostaglandins, which would send pain signals to the brain. Heat packs or cold packs on your head can also help in the treatment of a headache. A 2013 study from Germany has shown that migraine sufferers can get rid of their migraine headaches in 60% by having sex. It sounds like a nice idea, but what they have not considered may be the fact that somebody who has a splitting headache is not feeling like sex at all! If your home remedies did not help, see your physician for one of the triptan pills. Sumatriptan or a similar drug constricts blood vessels to the brain. The doctor will also look for common triggering factors that can bring on a migraine. Weak neck and shoulder muscles may respond to physiotherapy strengthening. In women a condition called estrogen dominance is associated with migraines and can be treated with bioidentical progesterone to balance estrogen and progesterone in the body by elevating progesterone concentration.

  2. Acute lower back pain 

    Acute lower back pain usually follows an event where the person lifted something too heavy or injured the back from a fall. The important part is to rule out a fracture. Most of the time there is no underlying fracture, just a muscle strain. A muscle strain usually sorts itself out in time. Stay active as much as possible. But if the back pain does not resolve within a few days, see your physician for more tests. An X-ray may be required to rule out structural changes like a fracture. As explained earlier, an MRI scan may be required to rule out a disc herniation. Instead of neurosurgery, further options nowadays are prolotherapy, stem cell therapy or a combination prolotherapy/stem cell therapy. This type of therapy will also work for knee injuries (meniscal or ligamentous tears).

  3. Hip or knee pain

    Conventional medicine usually treats osteoarthritis with NSAIDs, but may not warn you about the possibility of gastric erosions that can lead to massive stomach bleeding, heart attacks or strokes when using NSAIDs. It also can lead to kidney damage that can cause sudden kidney failure. The key is to use anti-inflammatory medication only for a few weeks. If arthritis persists, it is wiser to seek the advice of a naturopathic physician for prolotherapy treatment. Pain relief is usually achieved with one or two treatments of prolotherapy. If prolotherapy does not succeed, it is best to move on to mixed stem cell therapy with bone marrow and mesenchymal stem cells (from fat cells) as well as PRP (platelet rich plasma). This usually leads to complete healing of osteoarthritis and eliminates the need of total knee or total hip replacement.

  4. Neck and shoulder pain

    This often develops because of poor posture, shoulder tendinitis or neck muscle spasm. Physiotherapy is often successful treating this. If not, intramuscular stimulation (IMS) with acupuncture needles can be used. This may be more successful in interrupting the abnormal neuropathic pain pathways. Alternatively electro acupuncture with a TENS-like device can also be successful. The newest treatment modality is the Weber medical system using a low-dose laser applicator. Prolotherapy can also be used for shoulder and neck problems, if the ligaments are lax. It requires a lot of experience on behalf of the health professional to choose the right treatment protocol for the condition.

  5. Tension headaches

    Anxiety, stress and fatigue can all lead to tension headaches. Initially you may want to drink liquids, as dehydration is related to tension headaches. If your headache is still present after one hour, use naproxen or acetaminophen. Take a warm or cold shower and lie down with a cool cloth on your forehead. If you still have a headache, check with your doctor whether it is indeed a tension headache or a migraine. You may have jaw clenching or teeth grinding during your sleep. If your bite seems off, see a dentist. For stress control use relaxation techniques. Some suggestions sound mundane enough, but they can be effective: Get enough sleep, get enough exercise, and work on improving your posture. A physician trained in trigger point injections with local anesthetics (often anesthetists or general practitioners) can freeze your suboccipital and supraorbital nerves with lidocaine, which I have seen to work in 60% to 70% of cases in my former practice.

Pain Treatment

Pain Treatment

Conclusion

Pain treatment can be confusing as pain itself can be very multifaceted. The key is to search for the cause of the pain and then treat pain very quickly before it has time within 2 to 3 months to turn into a chronic pain condition. Chronic pain is much more difficult to treat. Every effort should be made to treat acute pain successfully. Conventional medicine has to yet learn from naturopathic medicine and alternative medicine practitioners that prolotherapy, stem cell therapy, IMS, trigger point injections with local anesthetics and low-dose laser therapy (Weber medical system) are valuable alternative methods that can successfully treat pain conditions and get incorporated into general medical practice.

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Jun
11
2016

Drugs Can Cause Dementia

An April 2016 study from Indiana University found that drugs can cause dementia. There were 451 people enrolled in the study with an average age of 73. 60 of them were taking at least one or more anticholinergic drugs. Anticholinergic drugs are drugs that inhibit the neurotransmitter acetylcholine in nerves or in the brain. The end result is that spasms in the stomach, bowel or bladder are relieved. Also the many over-the-counter sleep medications that may contain anticholinergic drugs help you to fall asleep easier. In the above-mentioned study researchers measured the effects that the drugs have, using different tests. They used memory and cognitive tests to check for memory loss, reasoning and judgment. PET scans were used for measuring brain metabolism. MRI scans were used to look for structural brain changes.

Results on how anticholinergic drugs can cause dementia

Memory tests and cognitive function tests showed that those taking anticholinergic drugs did worse on memory tests, verbal reasoning, problem solving and planning. The PET scan showed that glucose utilization by the brain was down in those who were taking anticholinergic drugs. The hippocampus was particularly affected with lower glucose utilization. This is the center where short-term memory is processed. It is also the area where Alzheimer’s patients have been found to have problems with early memory loss.

MRI scans showed that there were structural brain changes in the patients that were using anticholinergic drugs. Their brains had reduced brain volume (brain atrophy) and the brain cavities in the brain, called ventricles were enlarged. Overall this meant that their brains had much less brain cells when compared to controls that did not take anticholinergic drugs.

In a 2013 study from the Indiana University researchers had established that it took only 60 days of taking cholinergic drugs to cause cognitive problems. Using drugs with only weak anticholinergic side effects, it took up to 90 days before the same cognitive deterioration could be measured.

The researchers concluded that it would be wise for physicians to consider switching a patient to medication that does not include anticholinergic side effects to prevent development of dementia or Alzheimer’s disease.

Anticholinergic drugs can cause dementia

In the study above it was stated that it was the group of anticholinergic drugs that was particularly problematic. These are over-the-counter-drugs like sleep aids, antihistamines, and incontinence drugs etc. that were having anticholinergic side effects. The more of these types of drugs are taken, the more interaction can take place, leading to full-blown anticholinergic symptoms. As people age, they collect more and more symptoms and diseases. Physicians tend to treat the symptoms with various medications, so it is not unusual for an elderly person to be on 5 or 6 different drugs. If one or more of these drugs have anticholinergic side effects, this can add up and cause the kind of observations the above mentioned clinical study showed: dementia symptoms and proof that the brain metabolism has been slowed down. The brain also experiences the structural changes of dementia that I mentioned.

Possibility that herbs and drugs can cause dementia

The problem does not stop here. It is possible that over-the-counter herbs that you may innocently get in the health food store can participate in the overall metabolic interaction of anticholinergic substances. Many herbs have pharmacological substances in them that have specific helpful effects. But whenever a drug or herb has a positive effect, quite often there is an undesirable effect or side effect.

Historically Belladonna is a poisonous plant that has medicinal values. Unfortunately many Belladonna preparations are available in health food stores that are not regulated by the FDA. Belladonna has strong anticholinergic side effects that interfere with other anticholinergic side effects.

There are many other herbs that are available without prescription.

Kava-kava is an herb and a hallucinogenic that has anticholinergic properties. Keep in mind that the more you use Kava-Kava, the more your brain gets shut down. Why? The anticholinergic effect of Kava-Kava shuts down acetylcholine, the main stimulus in your brain cells to help you think.

Passionflower is an herb that sedates and is often used as a tincture to help you to fall asleep. What is perceived as a natural effect is merely the anticholinergic effect on the central nervous system.

Hops is the calming compound found in beer. It is also often used together with other sedating herbal sleeping remedies in teas.

St. John’s wort is also on the list. In smaller doses this herbal antidepressant may be useful and may have less side effects than commercial antidepressants. But there are possible side effects of dry mouth and constipation, which are the result of the anticholinergic side effect.

Skullcap is often used in tea to help a person to fall asleep. But keep in mind that the effect of helping you fall asleep comes from the anticholinergic effect of skullcap on brain cells.

All of these herbs are not any different from the medications discussed earlier, except that they are a bit weaker with regard to the anticholinergic effect.

Street drugs can cause dementia

Many street drugs are sedating and they have anticholinergic effects. It is therefore no surprise that with chronic use of street drugs drug users can come down with dementia, even at a relatively young age. Long-term use of anticholinergic drugs is associated with delirium and dementia.

Particularly benzodiazepines, meperidine (an opioid), antidepressants and many other drugs when taken together cause dementia, in part because of additive anticholinergic activity.

In an Edinburgh study from England 34 deceased patients, who were heavily using street drugs were autopsied. Their brains were compared to healthy 16-year-old non-drug users. There was nerve cell damage in the brain area involved with learning, memory and wellbeing. The pathologist found the same dementia findings that would be present in much older Alzheimer patients. We have to conclude from this that the damage was done by the anticholinergic effect of the drugs that were used as a mix in the years prior to their deaths. There can be added toxicity to nerve cells from interacting drugs and their side effects.

Drugs Can Cause Dementia

Drugs Can Cause Dementia

Conclusion

Whenever you have a substance that helps to get you drowsy so you can sleep better, be careful and check that it is not because of the anticholinergic effect of an herb or an over-the-counter drug. Melatonin is an exception, because this is your body’s own sleeping hormone that your body knows. Whenever anticholinergic drugs or herbs act on your brain they can over time cause an irreversible brain atrophy, which can been shown by MRI scans as in the study mentioned above. This leads to cognitive problems including memory problems. PET scans have also shown a permanent slowdown of glucose metabolism of the brain cells of the hippocampus, where short-term memory is located. Without that function you get permanent dementia. Instead of being treated symptomatically ask your physician for the cause of your symptoms and have the cause treated. You may not always get the answer you need from conventional medicine. As the next step you may want a second opinion from a naturopath to see whether there would be an alternative treatment available that does not involve anticholinergic medications. Go to the root of the problem, avoid drugs that cause damage, and keep your brain healthy and your mental capacities without cognitive deficits!

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