Mar
25
2017

How Stress Affects Our Hormone System

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

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

Metabolic activation pathways

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

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

Target areas within your system

The target areas in your system are the

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

Hypothalamus/pituitary/adrenal glands activation and clinical effects

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

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

Stress and the hippocampus

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

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

Effects of chronic stress

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

Hormone imbalance causes disease

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

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

Pathological hormone disturbances

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

Elevated cortisol

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

Increased insulin level

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

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

Decreased thyroid levels

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

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

Treatment of stressed hormone system

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

Treatment of thyroid disorders

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

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

Adrenal support

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

Pancreatic support

These supplements support the insulin production in the pancreas:

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

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

How Stress Affects Our Hormone System

How Stress Affects Our Hormone System

Conclusion

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

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 dealt with anti-aging and was entitled “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1 describes 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 the illnesses of the above-mentioned celebrities were treated, but then ask the question: “What could have been done better to prevent some of the disastrous treatment outcomes?”

Chapter 2 deals with how modern drugs seem to come and go. We learn that twenty-first century medications that are touted as the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation of “improved” arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3 deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but nothing is done about the causes of their illnesses. This is a scary thought.

Chapter 4 asks the question whether we could learn something from these poor health outcomes in the past, 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. Even though Big Pharma has the seducing concept of a pill for every ill, 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. This is a fact the suffering patient knows already! 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 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 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 delves into the question why healthy food intake matters. 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 talks about 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 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 deals with 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 checks out 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 is refining some of the thoughts 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 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 reviews 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 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. 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 the mitochondria are poisoned and as a result of toxins malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may be confined to 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.

Oct
24
2015

Best Anti-Aging Products

Every day there is some news about a vitamin or supplement that is supposed to be good for you. 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 proven.

Vitamins and supplements needed for heart attack and stroke prevention

  • Vitamin K2 has emerged in several studies as an important vitamin that removes calcium from the vascular compartment and transports it into the bones where it is stored. Osteoporosis prevention is closely linked to heart attack and stroke prevention, which in my opinion is not widely known. Another study from 2013 was using a much larger patient base of 36,282 postmenopausal women of the Women’s Health initiative in the US who were followed up for 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. The supplement compliant group when compared 7 years into the trial had 35% to 38% less fractures of the hip than the placebo group. This supplementation did not cause kidney stones in the study group, as is often cited by some physicians as the reason why they do not want to recommend supplementing 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 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 needed to condition heart and lungs. The overall effect is that osteoporosis, heart attacks and strokes are prevented. Keep in mind that sugar needs to be avoided as well to prevent oxidation of LDL cholesterol.
  • PQQ and Co-Q-10 are also needed 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.
  • Vitamin D3, alpha-lipoic acid and resveratrol are also needed for prevention of heart attacks and strokes, because of the anti-inflammatory action (see below).
  • Magnesium and green leaf tea extract have been proven to be beneficial in terms of 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”).

Mitochondrial function needs to be improved

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. Between the two supplements you will have more energy as optimal mitochondrial function is ensured.
  • 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 your mitochondria metabolism. 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 mitochondrial metabolism.

Anti-inflammatory vitamins and supplements

Since the mid 1990’s it is known by the medical profession 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.
  • Garlic: This herb has anti-inflammatory effects, stimulates the immune system and lowers blood pressure moderately. It is used as an adjunct in treating high blood pressure, prevents heart disease and 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: 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. 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 (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.
  • Vitamin B12/methylcobalamin: 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.
  • Folate (from food or folic acid): 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. Folate is needed in DNA synthesis.
  • 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 it is also needed as a supplement in 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): 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): 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: 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. 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. 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. 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. 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. Cook with coconut oil, but also use olive oil in salads. With this basic approach most of the vitamins and supplements I mentioned above are included. If you want to get more sophisticated, you may want to add some of the key vitamins and supplements I mentioned. 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 dosage needed is not contributing to health (Ref.3). Many of the issues discussed in this blog are covered 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

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Oct
03
2015

What Stress Does

We all are stressed out at times. Some people are stressed all the time and this is called chronic stress.

Acute stress

Let’s say you were involved in a minor rear-ender accident. It is annoying, but at least you were not injured. But you have to deal with the insurance company, get the repair done and maybe get a car rental during the time of repair. Yes, you may have a few days where you feel that your hands are shaky and your heart pounds, or your sleep may not be restful. But when everything is done things are back to normal. This is an example of acute stress with a shorter running time. It has a limited severity, is an inconvenience, but it does not really affect your body on the long-term.

Chronic stress

Let’s assume the car accident was more severe and you received a personal injury with a broken leg. You end up in hospital and the orthopedic surgeon fixes the fracture with a surgical plate. The leg has to be in a cast for several weeks, and you have to use crutches. Every day you feel reminded of the car accident, because it is awkward to walk with crutches. After weeks you notice that you have gained weight. Your doctor is also worried about you because your blood pressure showed higher readings. You do not sleep as well, waking up frequently and having nightmares about another fictitious accident. On top of that you came down with the flu. What happened here? The stress reaction released cortisol, which weakened your immune system and may be responsible for you catching the flu. On the long-term cortisol can also contribute to high blood pressure, but so can alcohol consumption. You may have increased your alcohol intake in the evening to relax more, but with the chronic stress and the cortisol increase this can cause high blood pressure. The weight gain that you noticed has to do with the fact that you cannot work out any more because of your healing leg fracture and you having to use crutches. Inadvertently you may also eat a bit more rich food; a lot of people do that as food can be used as comfort food. And why do you sleep less well? Chronic cortisol elevation leads to lower melatonin levels, as these two hormones are natural opponents. A high melatonin level leads to a low cortisol level and vice versa. With relaxation methods you can lower cortisol and the melatonin level increases normalizing your sleep. Chronically elevated cortisol can also lead to weight gain as sugar is converted into fatty acids that are stored as subcutaneous fat. Muscles can melt down when cortisol is high giving the appearance of spindly arms and legs.

Causes of chronic stress

Holmes and Rahe tested a stress scale in 1970, which has become the standard ever since. You get a certain amount of points for a stressful event, e.g. 100 for the death of a spouse; 45 point for retirement; 23 for trouble with the boss etc. Add up all of the points that are affect you right now; if the total score is less than 150 points there is only a minor risk of getting medical problems from the chronic stress; for 150 to 299 points the risk of illness is moderate and for 300 and more points you are at a significant risk for illness.

There is physical illness and mental illness that chronic stress can cause. Physical illness can be high blood pressure, hardening of the arteries. The long-term risks from this are possible heart attacks and strokes. But chronic adrenalin and noradrenalin elevation associated with chronic stress can burn part of your brain cells in the hippocampus and medial prefrontal cortex. This can lead to memory loss, spatial memory loss and aggression. Mental illness caused by chronic stress can be anxiety, depression, social isolation, panic attacks and panic disorder. Psychosomatic symptoms can include headaches, back pain, abdominal pain and difficulties concentrating.

Job stress and cancer

Perhaps one of the best examples of job stress and cancer is a study where the amount of breast cancer was correlated to the amount of stress. I discussed this in another blog. Briefly, women with a less responsibility had the lowest rate of breast cancer, but they too had some stress as there was a higher breast cancer risk after 15 years on the job versus only 5 years on the job. The same study showed that women with high responsibility had the highest breast cancer rates. A hormone disbalance can explain this based on high cortisol levels associated with chronic stress. If cortisol is high, the cortisol binding globulin (CBG) increases; this in turn also binds more circulating progesterone, as progesterone attaches to CBG. CBG is a transport protein for both cortisol and progesterone. The end result is that estrogenic compounds get the upper hand, a condition called estrogen dominance. I have explained under the above link that this was the real reason for the increase in breast cancer in the stressed women. Similar mechanisms are causing other cancers to occur more frequently with chronic stress.

Chronic stress and cardiovascular disease

High stress jobs were found to cause a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease when compared to low stress jobs. This was based on a British Medical Journal study in October 2002. As I discussed above under a brief description of chronic stress cardiovascular disease is often what develops as part of chronic stress. People who are under chronic stress feel that they do not have enough time to prepare good, healthy food at home. They tend to eat out more often. Even well educated people just swallow a quick hamburger and other processed foods. This increases the bad fats like trans fats and omega-6 fatty acids in their system causing inflammation of the blood vessels as explained in this blog. The LDL cholesterol and triglycerides get elevated, sugar from sugary snacks oxidizes the LDL cholesterol and your coronary arteries and brain arteries get clogged up. This sets anybody on the downward pathway, and it is now only a matter of time when the chronically stressed person will develop a heart attack or stroke.

Chronic stress extremes: PTSD and burnout in soldiers

Dr. Thierry Hertoghe gave a lecture during the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014). The title was: “Burnout: A multiple hormone deficiency syndrome”. Burnout is the extreme of chronic stress. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers (teacher’s burnout scale) to monitor them whether they are heading this way. Soldiers who return from combative situations often suffer from burnout or from PTSD. Their burnout severity can be monitored using the teacher’s burnout scale already mentioned. In suspected cases laboratory tests that measure hormone levels give concrete answers about hormone deficiencies. Treatment protocols were discussed in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not life long. In addition supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? It is important, because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body. Also, by recognizing what is going on and helping the affected individuals, a lot of pain and suffering can be prevented.

Accelerated aging from telomere shortening

Chronic stress has been shown to cause telomere shortening. So does a lack of sleep (insomnia), smoking and alcohol overconsumption, all conditions that can be associated with chronic stress. What can we do about this? Learn what shortens telomeres and ultimately your life. Cut out what you can and take supplements that lengthen your telomeres.

Positive thinking combats stress

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or by getting caught up in needless anxiety. Worrying does not get us anywhere, but it depletes our energy.

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. Prayer is know to help people in sickness and in health. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Building social ties and mutually supportive relationships will also build you up. It makes you feel that you belong, you have your place in society, you help others, and they support you.

We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. He had developed end stage arthritis in his hips requiring total hip replacements on both sides. He wanted to illustrate that stress leads to physical consequences; it may be a heart attack in one person, a stroke in another, arthritis in a third. Constant overdrive has physical consequences.

What Stress Does

What Stress Does

Conclusion

Stress can be deadly, particularly if it lingers on and becomes chronic. But we can reorganize our lives to minimize stress. Some people may decide to seek a less stressful occupation. Others may elect to stay at that job, but develop hobbies and get involved in relaxation methods to combat job stress. The key is to start thinking about what stress you may be under and then develop a plan to counter it so you can allow yourself to rebalance your life.

Sep
25
2015

Testosterone

One of the driving hormones in a man is testosterone. It also is known that with age testosterone levels fall. The lesser known fact is the importance of monitoring testosterone levels in aging males, so they have the choice of intervening with the aging process. Here are the facts about testosterone, about replacement of testosterone and about the anxieties of the medical profession to deal with this.

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 testosterone 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 testosterone. 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 testosterone is replaced in an aging man with low testosterone levels, the androgen receptors in key organs mentioned above are stimulated and normal organ function returns.

Reluctance of physicians to prescribe testosterone

It used to be taught to medical students that testosterone would be the cause for prostate cancer. This was based on old observations by Dr. Huggins, a Canadian born surgeon who practiced in Chicago, that orchiectomy improved the survival of advanced prostate cancer patients by a small percentage. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both testosterone and small amounts of estrogen.

When an orchiectomy was done (because of the belief that testosterone production was the culprit) inadvertently the real cause of prostate cancer (an estrogen surplus) was also removed thus improving the survival of these patients somewhat. Nowadays we have more sophisticated testing methods. Dr. Abraham Morgentaler (Ref. 1) has compiled a lot of evidence about the importance of testosterone in men. He proved, based on a lot 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”). 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 testosterone.

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 because they were taught this way. 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.

We dealt with the myth of prostate cancer that is not related to testosterone treatment. 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. They all had venous thromboembolism and received an anticoagulant drug or an intravascular vena cava filter following their diagnosis. They also had a low testosterone level and were given testosterone replacement therapy. They were followed and monitored 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 this was related to aging, but otherwise there may also be environmental factors, called estrogen-like substances or xenoestrogens, that have contributed 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 total testosterone 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.

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 for normal functioning. This is achieved through the enzyme aromatase contained in fatty tissue. But testosterone replacement must be given as the bioidentical testosterone, so that a small amount of it can be converted by aromatase into estradiol. I have reviewed this in a blog entitled “The Full Story About Testosterone”.

Risk of prostate cancer

Having reviewed the hard facts about prostate cancer risk, it is now clear that older men get prostate cancer because of lowered testosterone in their blood and increased body weight, where fat converts androgens by the aromatase into estradiol; this leads to estrogen dominance. Estrogen dominance causes breast cancer and uterine cancer in women and 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 testosterone replacement therapy to protect his prostate from prostate cancer.

Cardiovascular disease

As 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) for proper contractility of heart cells and relaxation of smooth muscle cells in the arteries to control blood pressure. With a lack of testosterone there is hardening of the arteries, loss of muscle cells in the heart muscle and increase of blood pressure. So far there is only an indication that low testosterone is associated 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. 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 testosterone 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 and to fractures in the hip, the ankle or wrist. It is thought that with the lack of testosterone there is also a lack of estradiol via the aromatase pathway in fatty tissue. This small amount of estradiol is thought to prevent osteoporosis all his life until the testosterone drops with older age. Once again it is important to monitor his total testosterone level and replace with bioidentical testosterone when it is lower than 500 ng/dL.

Rise in cholesterol

With obesity the metabolic syndrome sets in where the LDL cholesterol is increased. This is a direct risk for hardening of the arteries. In an obese older man with low testosterone there is a double risk from the low testosterone and the metabolic syndrome. As a result the heart attack and stroke rates in obese men with low testosterone are much higher than in obese men with normal testosterone levels. 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 testosterone replacement with bioidentical testosterone.

Urinary dysfunction

A hyperactive bladder, dribbling, hesitancy and leaking bladder can all be part of testosterone deficiency. But this is not that easy to diagnose. A full consultation by an 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 with bioidentical testosterone when it is lower than 500 ng/dL

Alzheimer’s disease

Alzheimer’s disease can be due to a lack of testosterone. 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 is a sign that he needs testosterone replacement therapy to 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. This needs to be measured with blood tests. Whatever is low would have to be replaced with bioidentical hormones.

Some details regarding testosterone measurements and delivery

The deeper you delve into testosterone 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.

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, which are least absorbed; another application are creams which are often prepared by compounding pharmacies. These creams are usually well absorbed. 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 and needs to be monitored, particularly when he is aging. A careful history of his symptoms needs to be taken by a knowledgeable physician or naturopath. If blood tests show that the total testosterone is less than 500 ng/dL replacement with bioidentical testosterone is needed.

 

References:

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

Sep
12
2015

Ageless Aging

We have been exposed to a lot of clichés about aging, which makes it more difficult to dispel rumors and to clearly focus on what can and what cannot postpone aging and the associated disabilities. Here I will attempt to summarize what is known about this topic.

The American Academy of Anti-Aging Medicine (also known as A4M) has published a book where all of this is discussed in detail (Ref.1). But there are yearly conferences as well in Las Vegas and other places where further details regarding anti-aging are discussed. Since 2009 I have been attending the conferences in Las Vegas regularly every year.

Based on this knowledge let me start by reviewing the tools of anti-aging that can be used to slow down the process of aging significantly.

  1. Mitochondria

At the center of anti-aging is the preservation and metabolic optimization of the mitochondria. Each of our cells contains little particles called mitochondria, which is where our energy metabolism takes place. Mitochondria function like mini-batteries.

The citric acid cycle builds up ATP, which is subsequently hydrolyzed into ADP and orthophosphate releasing energy for cell metabolism.

Old people who shuffle when they walk and have difficulties climbing stairs have lost significant amounts of mitochondria and simply run out of energy. The key to prevent this from happening is to preserve our mitochondria. We inherited them from our mother, because only the head of the sperm, which does not contain mitochondria entered the ovum when the egg cell that was destined to become you was fertilized. Subsequently the mitochondria from mother’s egg have provided all of the mitochondria in the cells of our body.

  1. Preserving mitochondria

There are supplements that specifically preserve mitochondria: PQQ (=Pyrroloquinoline quinone) helps mitochondria to multiply. A typical dose to take every day is 20 mg. Mitochondrial aging is slowed down by ubiquinol (=Co-Q-10, 400 mg per day is a dose that I recommend). Co-Q-10 repairs DNA damage to your mitochondria.

There are simple lifestyle changes that you can make: eat less calories as this will stimulate SIRT1 genes, which in turn stimulate your cell metabolism including the mitochondria.

Resveratrol, the supplement from red grape skin can also stimulate your mitochondria metabolism. 300 to 500 mg of trans-Resveratrol once daily is a good dose.

Build in regular exercise into your day – and I mean every day– as this will also stimulate your mitochondria to multiply similar to the effects of PQQ. Lipoic acid is an anti-oxidant that counters the slow-down of mitochondrial metabolism. I recommend 300 mg per day.

L-arginine is an amino acid that is a precursor of nitric oxide (NO). Red beet is a rich source of nitric oxide, which is directly released into your system. There are also commercial products for NO. This keeps the arteries open, prevents high blood pressure and also hardening of the arteries and has a direct effect on preserving mitochondria.

Researchers from the McKusick-Nathans Institute of Genetic Medicine of the Johns Hopkins University School of Medicine in Baltimore, MD found that mitochondrial DNA content varies according to age (less mitochondrial DNA in older age), sex (yes, women have more than men) and mitochondrial DNA; it even has an inverse relationship to frailty and a direct relationship to life expectancy. This paper was published in February of 2015.

Each mitochondrion has its own mitochondrial DNA contained in 2 to 10 small circular chromosomes that regulate the 37 genes necessary for normal mitochondrial function.

In multi ethnic groups it was apparent that mitochondrial DNA content was dictated by the age of a person.

Frailty was defined as a person who had aging symptoms including weakness, a lack of energy compared to the past, activity levels that were much lower than before and loss of weight. When persons with frailty as defined by these criteria were identified, they were found to have 9% less mitochondrial DNA than nonfrail study participants.

Another subgroup were white participants; when their bottom mitochondrial DNA content was compared to the top mitochondrial DNA content, the researchers found that frailty was 31% more common in the bottom DNA content group. This means that white people are more prone to frailty and they should take steps early on to prevent this from happening.

  1. Slowing down hardening of our arteries

It makes sense that young people who do not have signs of hardening of their arteries have better blood supply to their cells and thus supply their mitochondria with more oxygen and nutrients than frail, older people. The same is true for people who exercise regularly.

Vitamin D and vitamin K2 have been shown to lower calcium in the blood vessels and to retain calcium in the bone preventing osteoporosis. This is particularly useful in postmenopausal women. This October 2014 publication mentions that apart from vitamin D and vitamin K2 resveratrol and inositol are additional factors helping to prevent heart disease and osteoporosis.

This September 2013 publication confirms that a deficiency for vitamin K2 is common in the general population. This deficiency leads to osteoporosis and calcification of the arterial wall and causes heart attacks, strokes and bone fractures. Supplementation with vitamin K2 at 200 micrograms per day every day is recommended to prevent this from occurring.

  1. Sugar and starchy foods

You need to understand that starchy foods equal sugar, once digested. As a result a refined cereal breakfast=sugar, pasta=sugar, bread=sugar, donuts=sugar, potatoes=sugar and so on. It has to do with the glycemic load. When you cut out sugar and starchy foods (meaning that the glycemic index of the foods you eat is below 50) you will shed 30 to 50 pounds of weight within 3 to 5 months, if you are overweight or obese. You will feel a lot more energy. Your blood vessels will be cleaned out as the oxidized LDL cholesterol will disappear and the HDL cholesterol will mop up what cholesterol deposits were there before.

It is certainly good for you, if you are not into the sugar and candy stuff, but the seemingly harmless pizza and all the other starchy foods mentioned above are of concern as well. All of the high -glycemic carbs stimulate the pancreas to produce insulin. This in turn produces inflammation in tissues including the brain. Alzheimer’s disease is one of the complications of this.

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats like olive oil, coconut oil and omega-3 fatty acids. As you make these adjustments to your life style you will also prevent many cancers, as you normalize the body’s metabolism and help prevent chronic inflammation, which can cause arthritis and cancer. Finally, pay attention to stress management. The body and the mind work together. Uncontrolled stress leads to heart attacks and strokes.

  1. Cut down on processed foods

Processed foods contain the wrong type of vegetable oils that are composed of omega-6 fatty acids. This disbalances the ratio of omega-6 fatty acid versus omega-3 fatty acids. This is typical for all the processed foods, but also fast food places in the industrialized world. The consequence of this disbalance is the formation of arachidonic acid and inflammation of tissues. This causes high blood pressure from inflammation of the arteries, arthritis from inflammation in the joints and can irritate the immune system to the point of causing autoimmune diseases. The end result after decades of exposure to a surplus of omega-6 fatty acids are disabilities from end stage arthritis, as well as heart attacks and strokes from inflammation of the arteries due to the hardening of the arteries.

The remedy for this is to cut out all processed food and stick to the basics of preparing your own food from healthy ingredients with no food preservatives.

Use olive oil for salads and coconut oil for cooking. Take omega-3 supplements to restore the omega-6/omega-3 fatty acid balance.

  1. Replace hormones with bioidentical ones

When I watch postmenopausal women, many look prematurely aged with sagging skin in their faces. Had they replaced their missing hormones when they entered menopause, the bioidentical hormones used for replacement therapy would have helped their skin to remain younger looking, hardening of the arteries would have been postponed and osteoporosis in the bones would also have been prevented.

With men it is now known that testosterone is vital for prevention of prostate cancer, but it is also important to prevent heart attacks, strokes and dementia as they age.

I would recommend that you see a naturopath or an anti-aging physician to have your hormones checked and if necessary start replacement with bioidentical hormones.

Ageless Aging

Ageless Aging

Conclusion

Slowing down aging and avoiding disabilities from aging are now a possibility, if we manage our lives in a way that the biochemistry of our bodies remains the same and our mitochondria continue to function, even when we get older. I discussed the details of how to do that above. I have also written a book on the subject of anti-aging, which deals with these topics in more detail.

I hope that you incorporate at least some of these steps in your life to prevent suffering from disabilities as you age and to avoid premature aging.

References:

Ref.1: 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.

Mar
07
2015

Drink Your Coffee, But…

I have blogged about coffee drinking several times in the past. Coffee consumption and health benefits have become a news item again because of yet another study. The recent media reports are based on a South Korean study that involved 25,138 men and women with a mean age of 41.3 years.

Here I like to concentrate on aspects regarding coffee consumption that are often lost in the media when studies regarding coffee consumption are discussed. I will break it down into points and then conclude at the end with my recommendations.

1. Calcification of coronary arteries and osteoporosis

The South Korean study published online on March 2, 2015 showed that with up to 4 cups of coffee there was a direct linear relationship between consumption of coffee and prevention of heart attacks. Coronary artery calcium (CAC) deposits were measured by a CAT scan as they are known to be a good measure for a future risk of heart attacks. Less than 1 cup of coffee per day resulted in a 23% reduction of CAC in the coronary arteries compared to controls without coffee consumption. 1 to 2 cups of coffee reduced CAC’s (meaning the risk of heart attack rates) by 34%, while 3 to 4 cups prevented CAC’s and thus heart attacks by 41%. The fun stops at 5 cups of coffee per day as only 19% of CAC’s (heart attacks) were saved. Clearly there is something in coffee that shows detrimental effects, if the dosage is too high.

In the past there was a question as to whether coffee consumption would lead to osteoporosis in women. However, a study showed that there was no correlation between coffee consumption and osteoporosis.

Other studies have clarified this and found that vitamin D3 and K2 are important to remove calcium from the arterial wall and transport calcium into the bone and deposit it there. Vitamin D3 and vitamin K2 seem to override all the other nutrients when it comes to osteoporosis prevention. The other factor in older women is hormone deficiency as they age necessitating bioidentical hormone replacement in addition to vitamin K2 and vitamin D3 to prevent osteoporosis.

2. Whether or not you put sugar into your coffee

is an important question. This is routinely done in Germany where I grew up. The addition of sugar changes the entire game plan, as it is sugar that oxidizes LDL cholesterol, which is directly deposited under the arterial walls. This is the root cause of hardening of the arteries. Coffee alone is beneficial; coffee with sugar is not. I use a tiny amount of KAL Stevia (which does not have the bitter aftertaste) instead of sugar to sweeten my coffee. This sweetens it to the equivalent taste of sugar, but without the detrimental oxidizing effect of sugar. Somebody like me who was conditioned to eat sugar from childhood on in Germany has been left with a “sweet tooth”; so I need to have this tiny bit of stevia as a crutch. Purists may disagree with me. Keep in mind that the Korean study was done without sugar.

3. What’s the difference between real and decaffeinated coffee?

The recent study showed that you need to drink the real thing (caffeinated coffee), if you want to reduce your risk to get the dreaded pigmented skin cancer, melanoma. Decaffeinated coffee did not have this melanoma protective effect. This points to the fact that there are several substances in real coffee and decaffeinated coffee that have different effects. Ref. 2 shows that there was a clear reduction in the risk of developing type 2 diabetes in people who drank either coffee, decaffeinated coffee or tea. Unfortunately many studies do not distinguish clearly between caffeinated coffee and decaf coffee.

4. Micronutrient components of coffee

As this link shows there are many micronutrient components in coffee such as caffeine, diterpenes, chlorogenic acids, and melanoidins. There is about 100 mg of caffeine contained in a tall (240 ml) Starbucks cup of coffee. This will stimulate the nervous system and your adrenal glands getting that energy rush.

Diterpenes consisting mainly of cafestol and kahweol are substances that have been found to increase the LDL cholesterol. The fact that we are dealing with a concoction of mostly beneficial, but also some less beneficial micronutrients in coffee is responsible for the lower beneficial effect of 5 cups of coffee mentioned in the South Korean study. Filtered coffee seems to largely remove these undesirable substances.

This link explains more details about the micronutrients in coffee.

5. Clinical conditions that are partially prevented by coffee consumption

The last link mentioned a study where a large group of people were followed and monitored for Parkinson’s disease. Those who had consumed only 1 cup of coffee per day were compared to controls without coffee consumption. This one cup of coffee per day prevented Parkinson’s disease by 40 to 60%. Similarly, in a study that investigated prevention of type 2 diabetes 4 to 6 cups of coffee per day prevented 28% of type 2 diabetes. In postmenopausal women decaf coffee was also significantly effective in reducing the risk to develop diabetes.

The Linus Pauling Institute link summarized that there were several studies that showed that colorectal cancer could be partially prevented by consuming real coffee (4 or more cups), which lowered the risk by 24% compared to non-coffee drinkers. Another study noticed that 1 to 2 cups per day of decaf coffee reduced the risk for colorectal cancer by 48%.

Cirrhosis of the liver, often due to excessive alcohol use can be prevented by 40% when at least 2 cups of coffee were consumed. More astounding than that is that the risk of death from liver cancer can be reduced by 50% when at least 1 cup of coffee was consumed compared to those who never consumed coffee.

However, liver and colon cancer are not the only ones that can be prevented to a large extent by drinking coffee. Breast cancer, prostate cancer, endometrial cancer, uterine cancer, oral cancer, brain cancer and lung cancer can also be significantly prevented by a regular cup of coffee. As there is a risk of increasing miscarriages in pregnant women, it is best not to consume coffee during pregnancy or at the most limit it to one cup per day. Also, nursing mothers should avoid coffee (even decaffeinated coffee) as caffeine gets transmitted into mother’s milk.

People with high blood pressure may be better off to not drink coffee or to drink decaf coffee, because caffeine has been shown to elevate blood pressure substantially.

6. What are the risks of drinking coffee?

Seeing that coffee is an effective drug-like compound with many benefits, it is worthwhile asking the question: what are the side effects of coffee consumption? There are people who are very sensitive to caffeine. They get over stimulated and experience heart palpitations, a lack of sleep and anxiety. They should refrain from coffee. They may even be over sensitive to decaffeinated coffee that still contains about 3% of caffeine. People with rheumatoid arthritis have been shown to deteriorate with coffee consumption, making this another subgroup of people who should stay away from coffee.

7. What is the process of decaffeinating coffee?

Essentially there are 4 processes of decaffeination that have been developed over time. As this link shows, all of the decaffeination processes are done with the green coffee beans. There are two solvent-based processes and two non-solvent based processes. The latter two are the healthiest: the Swiss water process and the carbon dioxide process. The problems with the older solvent-based processes are the chemicals used to extract the caffeine. They can be harmful to the body.

Organic decaffeinated coffees are manufactured with the environment-friendly Swiss water process.

Drink Your Coffee, But…

Drink Your Coffee, But…

Conclusion

There are some people who simply are too sensitive to caffeine. They should refrain from drinking coffee. Pregnant women and nursing mothers should either severely reduce coffee consumption to one cup per day or refrain from coffee altogether. Those with high blood pressure and rheumatoid arthritis patients better refrain from drinking coffee as well. The majority of us will benefit from coffee consumption, if this is your taste. You may prefer green tea or Oolong tea instead. As I explained above there is compelling evidence in the literature that many cancers, heart attacks, strokes and diabetes can be partially prevented by regular coffee consumption. Decaffeinated coffee can prevent type 2 diabetes to some extent and colorectal cancer as well. The majority of evidence shows that coffee drinking is healthy. So, go ahead and enjoy!

References:

Ref. 1: Ding, Ming; Bhupathiraju, Shilpa N; Satija, Ambika; van Dam, Rob M; Hu, Frank B. “Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies.” Circulation – February 11, 2014; 129 (6); 643-59.

Ref. 2: Huxley R, Lee CM, Barzi F, Timmermeister L, Czernichow S, Perkovic V, Grobbee DE, Batty D, Woodward M. “Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis.” Arch. Intern. Med. – December 14, 2009; 169 (22); 2053-63

Jan
30
2015

Prolotherapy And Stem Cell Therapy

This blog is the 5th blog and the last one of a series that dealt with telomeres, lifestyle and stem cells, topics that were on the agenda of the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014). Here are summaries of two talks from this conference that dealt with methods of repairing damage to your joints or bones without surgery. Treatments consist of stimulating local stem cells through a treatment called “prolotherapy” where needles are used to inject concentrated dextrose. I will explain below why this method is effective. A modification of this original prolotherapy is when the effect of it is amplified by growth factors from so-called platelet rich plasma (PRP), which is mixed with the dextrose injection. The ultimate healing jerk occurs when you mix in stem cells with the PRP into the injured tissues. Images before the procedures and images some time after the procedures were shown at both lectures with impressive results.

1. Dr. Fields’ talk was entitled “Repairing joints and spine without surgery: prolotherapy/PRP/stem cell therapy”.

This talk concentrated on the use of prolotherapy with concentrated dextrose and prolotherapy with platelet rich plasma (PRP) with or without the addition of stem cells in the treatment of various musculoskeletal injuries.

When prolotherapy is done by itself 12.5% Dextrose is used to inject into the area of injury. Dr. Fields said that the reason it works is that local stem cells in the injured area are getting activated where the Dextrose is injected and these activated stem cells will do the healing (details explained in an interview with Dr. Reeves). This result can be improved by injecting a small amount of PRP very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are discarded, but the platelet fraction and some of the plasma is use as the PRP preparation. To amplify the effect of the PRP stem cells from bone marrow and from fatty tissue are mixed into the injection. Dr Fields explained that bone marrow is aspirated from the pelvic bone and in the same patient a liposuction is also done to receive adipose tissue. Both tissue samples are put through a cell separator to obtain bone marrow derived stem cells and adipose derived mesenchymal stem cells. Both fractions are combined as they make a superior stem cell mix and are activated by adding platelet rich plasma. This mix was used for bone fractures that were slow to heal, for ruptured tendons, ligaments, Achilles tendons and rotator cuff tears. Dr. Fields showed before-slides and several weeks to months after-slides with MRI scans of the original injuries and the final healed tendons and ligaments. I have never seen such beautiful healing with no residual scar. Stem cells are the specialists of healing such defects because they change into whatever cell type is required and they fill in the defects. This explains the perfect function after the injury is healed following stem cell and PRP injection. It also explains why many athletes who had this done went on to winning more medals after the repair. You do not hear about success stories that often after conventional surgery, because the range of motion and strength suffer from scarring following conventional surgical repairs.

Case histories: several patients with knee injuries that were treated with prolotherapy were shown on video testimonials explaining that their procedures only involved needles in the injured area, that they experienced almost complete pain relief on the day of the procedure and that they could rehabilitate right away.

Slides were also shown of specific knee ligament injuries involving the medial collateral ligament (MCL), the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL). These are very important support ligaments within the knee.

But this was not all: there were lower back injuries with ruptured discs. Conventional medicine would have offered a discectomy, but here these patients were treated with prolotherapy. They experienced a stabilization of the weak areas, spontaneous resorption of the prolapsed disc and stabilization and strengthening of the weak spine. MRI scans of the spinal injury before treatment and several months after the treatment were shown with a complete normalization of the spine. In my work as a Medical Advisor for Workers’ Compensation cases that I was doing for 16 years I have never seen a single case like that.

A similar spinal injury in the neck was shown as well with a testimonial from that person. Again there was minimal pain, immediate rehabilitation and a full range of motion several weeks after the injury had been treated with stem cells.

What is treated with prolotherapy?

Basically all of the major joints can be treated with prolotherapy: the shoulder, knee, back, the neck, ankle, elbow and hip. The types of injuries that are treated are sports injuries, fibromyalgia, sciatica, muscle tears, tendonitis, arthritis, bursitis and temporomandibular joint problems (TMJ).

Dr. Fields also stressed (and so did Dr. Purita, which we will learn below) that activated platelet rich plasma needs to be used to activate stem cells.

Two special cases were presented, namely patellar tendinitis and Achilles tendinitis, which both respond very well to prolotherapy and PRP plus stem cell therapy. This provides complete healing of these otherwise very difficult clinical entities.

An image was shown from the late C. Everett Koop, MD, the former Surgeon General of the Untied States who had this to say about prolotherapy: ““I have been a patient who has benefited from prolotherapy. Having been so remarkably relieved of my chronic disabling pain, I began to use it on some of my patients.” This may yet be the strongest argument to at least consider prolotherapy in otherwise hopeless cases.

2. Dr. Joseph Purita gave a lecture on the “Effects of PRP And Stem Cell Injections”. As explained above PRP stands for platelet rich plasma, which is a “soup” of various growth factors and exosomes =cell-to-cell mediators). He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They can be seen with the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental when stem cell injections with PRP were done in the past (poor survival rate of stem cells). Now it has been detected that photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections. Soft laser stimulation with red, green and blue soft lasers have been shown to improve tissue healing significantly when stem cells and light activated PRP are used. As already described in Dr. Field’s talk the main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). Dr. Purita also explained that nitric oxide and electrical stimulation also help to improve stem cell survival and reduce inflammation. All of these methods are revolutionizing orthopedics where injured tissues can be mended with the help of injecting stem cells, light activated PRP and using laser treatments. Dr. Purita showed very detailed technical aspects of these procedures with various applications. For instance, he showed a slide regarding treatment for osteoarthritis of the knee. All this is contained in the plasma that is used to inject PRP into a joint with degenerative arthritis. When you mix this with bone and adipose tissue derived stem cells and inject it into the knees of a person with degenerative arthritis, you get the ideal remedy to calm down the degenerative process with instant pain relief and the stem cells are transforming into cartilage cells (chondrocytes) building up hyaline cartilage. The end result is a new knee surface where the old and the new repaired knee surfaces are knitted into one seamless unit.

PRP by itself can be used successfully for repairing bursitis of shoulders and rotator cuff tears, muscle tears and sprains, meniscus tears of the knee, mild to moderate osteoarthritis of various joints and spine disorders, particularly facet joint problems.

Prolotherapy And Stem Cell Therapy

Prolotherapy And Stem Cell Therapy

Dr. Purita gave a thorough overview of stem cells. He pointed out that stem cells fulfill two criteria:

  1. They are undifferentiated and they are capable of self-renewal by replication
  2. They can undergo differentiation into specific cell lineages.

From a practical point of view as already mentioned in Dr. Field’s talk there are two sources for stem cells that are important: stem cells derived from adipose tissue (also called MCS or mesenchymal stem cells) and bone marrow derived stem cells, obtained usually from the pelvic bone. When they are mixed and stimulated with PRP they are the miracle mix that will help heal all these injuries.

What does the FDA say to stem cell therapy? “The FDA states it is ok to use these cells as long as they are put back into the same patient and they are minimally manipulated.”

Dr. Purita listed a host of other factors beside platelet rich plasma that supports stem cells, increases their survival on transplantation and stimulates them to differentiate and heal the defect at the recipient site as quickly as possible. Photoactivation of platelet rich plasma with low level lasers (soft lasers) will release exosomes, which are tiny particles, released by platelets and white blood cells. They contain proteins and genetic material required for wound healing and stimulation of stem cells.

Towards the end of the talk Dr. Purita showed an MRI scan of a knee with avascular necrosis (dead bone) before and after treatment with stem cells, PRP and low level laser therapy. There was a complete resolution of the avascular necrosis without any surgery. A second case was shown where the initial MRI scan showed a complete tear of the medium collateral ligament (MCL tear) of the knee and the follow-up scan showed the same ligament intact. This was achieved without surgery, just by treating the patient with an injection of stem cells; PRP and using low-level laser therapy to activate PRP.

Conclusion

Prolotherapy and stem cell therapy are the hottest new treatment modalities for ruptured tendons, ligamentous injuries, and disc herniations in the neck and in the lower back. You will not get this from your primary care physician or from your regular orthopedic surgeon at the present time, because they profit from the conventional procedures. But you owe it to your health to try these alternatives first as they are much less invasive and they involve your own cells that will heal the defects with a very high probability. You still have the option to seek the advice of an orthopedic surgeon, should these alternative procedures fail (which is unlikely). Unfortunately most insurance carriers will not pay for this service at this time.

Disclaimer: Dr. Schilling has no conflict of interest with regard to Regenexx or any of the other companies of which images were shown; they simply displayed the best images with regard to the many illustrations in this blog.

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Oct
14
2014

New Material To Fill Bone Defects

Disfiguring head injuries from car accidents, work injuries or personal injuries left plastic and cranial surgeons with the problem of how to fill the gaps. This problem may soon be medical history as a new polymer foam material has been invented that serves as a scaffold. With its interconnected pores it allows bone to fill the gaps and subsequently gets absorbed leaving new bone in the place where the scaffolding foam had been placed by the surgeon. Texas A&M and Rensselaer Polytechnic Institute researcher Melissa Grunlan who is an associate professor in the university’s Department of Biomedical Engineering develop this material together with her co-workers.

It has interesting properties. The shape of memory polymer foam (SMP foam) is malleable when treated with warm saline water and can be fitted into the bone gaps from the injury. After a short time it hardens in place and provides the scaffolding needed for new bone growth.

This new material lends itself to fill gaps from birth defects (like cleft palates), from facial injuries or from the removal of bone tumors in the head, jaw or face.

Traditionally, bone grafts were used to fill gaps. They had to be taken from an area like the hip, but there were problems attaching these grafts to the underlying bone to which the graft would hopefully attach to in the future. Many complications could occur like graft absorption leaving the original defect or infection of the grafted material.

With the new polymer foam material there is instant attachment, instant shaping of the surface of the material and very quick population of the foam with bone cells from the surrounding bone. In addition, the polymer foam has all its surfaces coated with a bioactive substance that attracts bone-forming cells, called osteoblasts. Experiments have shown that after only three days the coated sponge channels attracted five fold more osteoblasts than that of uncoated control foam material.

New Material To Fill Bone Defects

New Material To Fill Bone Defects

Traditional bone grafting

Traditionally, bone grafts are used to help with complicated fractures in the healing process. In spinal surgery bone grafts may be required to over bridge facet joints with end stage arthritis, as following successful healing after fusion surgery the back pain will improve significantly. Bone grafts have also been used when bone defects were present from severe infection, injury or congenital defects. In these cases the bone graft is used to fill in the defect. Finally, bone grafts are sometimes necessary to fill in bone following surgical hip joint replacements or after repairs of fractures with plates and screws. More about these traditional bone graft techniques can be found through this link.

Complications of traditional bone grafting

Complications depend very much on the location of the surgery and what type of procedure is being used. For instance when it comes to fusion surgery in the lower neck or lower back region, the traditional success rate of fusion surgery is about 70%, which means that in 30% of cases the procedure did not work. On the one hand the combination of mechanical stabilization through instrumentation with bone grafting has increased the success rate of fusion surgery above 70%. But smoking, older age, osteoporosis, obesity, diabetes, and prior spinal surgery have decreased the success rate as indicated in this review.

This overview about autografts (bone graft in the same patient), allografts (bone grafts with bone from a bone donor center), xenografts (bone from an animal) as well as synthetic bone grafting explains more details about these topics.

Another website also contains useful information about this topic.

Other applications for memory polymer foam

In the same facility Duncan Maitland, associate professor in the university’s Department of Biomedical Engineering, is researching the use of SMP foam for the treatment of brain aneurysms in humans. A flat piece of SMP foam is introduced into the aneurysm, a sac-like pouch of a brain blood vessel and activated through heat from a laser beam. This actives the foam to become round and fill the pouch of the aneurysm, closing off the area that could have ruptured and led to bleeding. This application has to be proven in clinical trials as well as does the use of the SMP foam for bone defects.

Conclusion

Often in medicine new ideas were necessary to lead to progress in treatments. For instance when hemoglobin A1C was detected by an Iranian team of doctors, all of a sudden a powerful  tool to monitor treatment of diabetes had become available. Prostate specific antigen (the PSA test) is another example of a test that allows for a much earlier diagnosis of prostate cancer. Earlier detection of prostate cancer leads to a more successful treatment of this cancer.

With memory polymer foam (SMP foam) physicians will soon be given a new tool of closing big bone gaps to help their patients overcome unsightly appearances or unstable situations in the spine or in other body locations. The brain aneurysm application will help prevent brain hemorrhages. More research is needed for these clinical applications, but the initial research shows a lot of promise.

More information on bone cancer where following surgery large bone defects can remain: http://nethealthbook.com/cancer-overview/bone-cancer/

Last edited Nov. 8, 2014

Aug
02
2014

Keep Your Muscles In Older Age

Intuitively you may have noted that older folks who have very little “meat” on them are not as healthy as people of the same age with well-developed muscles.

A research team under the supervision of Dr. Preethi Srikanthan and Dr. Arun S. Karlamangla from the David Geffen School of Medicine at UCLA, Los Angeles, CA decided to measure the muscle mass index instead of the body mass index. They did this using bioelectrical impedance (simple electronic body composition bathroom scales) and they wanted to see whether there would be any correlation with regard to mortality statistics in an older population.

The study group consisted of 3659 participants from the National Health and Nutrition Examination Survey III (average age for males 55 and older, females 65 and older). The survey took place between 1988-1994. Mortality rates were computed by the end of 2004. The median length of follow-up per person was 13.2 years.

The authors of the study compared mortality curves for four subgroups of muscle mass from low to high: 0-25%, 25-50%, 50 to 75% and 75 to 100%. When the lowest muscle mass group was compared to the highest muscle mass group, there was a 20% increased mortality rate for the lowest muscle mass group.

This study had careful controls built in and could demonstrate that the difference was not due to better or worse LDL cholesterol values or triglycerides; it was not due to differences in diabetic rates or other factors. This is the first study that shows in a US based population that a lower than average muscle mass is an independent risk factor for premature death in an older population.

The authors were aware of Danish study that had previously shown that a lower muscle mass was associated with a higher mortality rate in 50 to 64 year-olds.

I like to comment regarding this study by putting it into the context of other medical findings.

Keep Your Muscles In Older Age

Keep Your Muscles In Older Age

1. Older people tend to have more falls

Several studies have shown over the years that older people fall more often because of a combination of balance problems with slower reaction time, and also because of poorer muscle development when compared to a younger age group. The medical costs are staggering when older people reach the age of 85 where about 20% of that subpopulation experience serious falls resulting in hip fractures and hospitalizations. There is a mortality of about 25% associated with hip fractures in that age group. And about 50% of those who survive will not be living independently at 1 year following a hip fracture. Fortunately fractures from falls can largely be prevented by making physical changes to the home to prevent tripping and having extra guard rails where needed. But another important factor is to exercise regularly within the capabilities of the older person to maintain muscle mass, which will balance the body and control upper and lower extremity strength as the person moves around.

2. Fit people live longer

A Stanford University study followed 6000 middle-aged men for 10 years and found that the fittest who exercised regularly were 12% more likely to stay alive for every metabolic equivalent; this is the energy that a sitting person uses in terms of oxygen consumption. They also found that the least fit had a 4.5-fold higher death rate within 6 years from the beginning of the study compared to the fittest.

To put this into perspective: a regular walk at less than two miles an hour would be equivalent to 2 metabolic equivalents, a brisk walk at 4 miles per hour is worth 5 metabolic equivalents and running 6 miles an hour is worth 8 metabolic equivalents. This is how the math works: a regular walk every day translates into 2×12% = 24% more likelihood of staying alive in the next 6 years compared to a sedentary person. A person exercising with a brisk walk with a speed of 4 miles per hour every day would be 5×12% = 60% more likely to be alive in 6 years compared to a sedentary person who does not exercise. Not smoking and having a normal weight would add to your probability of living longer. Pushing yourself to the extreme (running 6 miles per hour) may be problematic for the majority of us as there are issues of getting into adrenal gland insufficiency that can develop, if you over-stress yourself. (This is my comment, not part of the study).

Now you may have wondered about the woman’s side (as the previous study was an all-male study). The answer comes from a recent paper that studied 10 clinical trials throughout the world (US, Denmark, Germany, Sweden, Taiwan and Japan) involving only postmenopausal women. Yes, there is the same surprising finding that regular brisk exercise makes the women live longer with less disabilities and less mortality!

The bottom line: exercise regularly and live.

3. Exercise develops your muscles and maintains them

We were born to use our muscles daily (designed as hunter/gatherers), but in the meantime this is what we do: sitting in front of the computer or TV, in cars, in class (school, university, work) or in the movie theatre. So we need to discipline ourselves to get into a routine that balances all of the other activities. Muscle strength exercises or activities as indicated in this link are the answer.

The earlier we adopt this type of a routine, the better off we are when we reach the golden years of retirement. I am one of the examples of former non-exercisers. Apart from liking to go for long walks 3 to 4 times per week I did no formal exercises until 8 years ago when my wife and I got into ballroom and Latin dancing inspired by “Dancing with the stars”. But it is only about 2 years now that we took up regular gym workouts for 45 to 60 minutes every day. It is now easier for me to walk up on a steep hill in our neighborhood that has an 18% incline than 2 years ago.  Muscles need regular exercise. You put a limb in a cast and within 3 weeks most of the muscle strength has melted away. You remove the cast and it will take 3 to 6 weeks of regular exercise to regain the muscle strength. So why not maintain your muscle strength in the first place?

4. Exercise develops cardiovascular fitness

The aerobic part of my daily exercise program (treadmill) develops cardiovascular fitness as the lungs have to work harder and the heart is being activated. Doing this regularly is mimicking going through the landscape looking for food and hunting.  Of course most of us drive in our cars to the grocery store and get our food that way. So my balance is to go to the gym and at least once a day get that work-out. What can we expect from fitness training? An NIH study showed that with a moderate work-out of only 2.5 hours per week you will gain 4.5 years of life due to cardiovascular fitness. This is better than money in the account. It is free healthy additional life!

5. Sensible nutrition will help preserve muscle mass

No, I am not taking your food away. I am suggesting that we watch the quality of the food we are consuming. If you are like the average consumer, you may be eating too many carbs in form of pasta, bread, rice and potatoes. Some of you have read in past blogs that my wife and I cut out sugar and starchy foods as well as wheat since 2001. We both lost 50 pounds and kept it down. I know that if I would restart sugar and starchy foods, my fat content would go up, my muscle content down and the BMI up. How do I know? I weigh myself every day on body composition scales (which works by the principal of bioelectrical impedance analysis), which show all of these indicators. Recently I got into some organic Bing cherries. They were delicious, but it also is a fruit with significant sugar content! Within a day I knew that I’d better watch the quantities I consume (fat composition was up, muscles mass down). It took 3 days for my values to be back to normal.

When it comes to muscle mass, overconsumption of refined carbs is one problem; however, our bodies do need quality lean meat and some fish (salmon, mackerel; low mercury fish) as a source of protein. I buy organic meats to get away from the problem of pesticide pollution as much as possible. Some people like vegan food, they may need to supplement with protein supplements.

Conclusion:

It may sound like common sense that a body with well-developed muscles will live longer. You may want to compare this to a well-maintained car (less rust, good maintenance) and the car will still drive well once it has a high mileage.

We have bodies that need maintenance (exercise) and good nutrition (no junk food, sensible diet). If we make this our regular lifestyle, we will develop and maintain muscles. It will keep us in the group with a lower mortality rate compared to sessile persons and junk food consumers.

Nothing happens without any effort. We need to earn muscle fitness for ourselves! Think about it, improve where you need to improve and then maintain it. More than anything else this will pay dividends well into your future.

More information on:

1. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Arteriosclerosis (hardening of the arteries and how to avoid it): http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

 

Last edited Nov. 8, 2014