Feb
05
2013

News About Your Heart Health

By | Alzheimer’s disease, Arthritis, Cancer, Diabetes, Fitness, Health, Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Introduction

Notably, this article is regarding news about your heart health. Specifically, February is heart month every year. So I thought why not review what is new regarding heart health in the last 15 years. In addition, this review also puts all the facts into perspective. I will start with a review of the older teaching about heart disease. First thing to remember, there was a paradigm shift in medical thinking. I will explain how this has changed the approach to heart disease prevention. The anatomy of the heart including coronary arteries and the heart valves has not changed over the years. The heart has always been at the center of life and will remain there.

A heart attack can develop from closing of one of the coronary arteries

It used to be thought that when a person ages one should expect to get problems with high cholesterol, which would be the cause of hardening of coronary arteries of the heart until one day the person would experience a heart attack from the closing of one or more of the three coronary arteries. Certainly, cardiologists can then offer an arteriogram, place a stent to reopen any blocked coronary artery and the patient would be OK for another 5 to 10 years. Alternatively, coronary bypass surgery can be offered by a cardiovascular surgeon to revascularize the coronary arteries.

Apart from cholesterol patients can get heart attacks from chronic inflammation

In contrast, in the mid 1990’s all this changed with the realization that 50% of heart attacks happened in patients who had normal cholesterol levels. In fact, research showed that inflammation of the heart vessels starts the process of subsequent blockage that causes heart attacks. A great deal of research in animal models and with humans took place. Indeed, this showed that a lot can be done in the area of prevention of heart attacks. Cure rates can only change very little when damage to the heart muscle has already occurred. The paradigm shift is in the understanding of what leads to a heart attack.

Too much sugar, starchy food and fat cause inflammation of the coronary arteries

We now know that too much sugar, too many starchy foods and too much animal fat will lead to inflammation of the arteries including the coronary arteries. The reason is that faulty nutrition leads to a lack of omega-3 fatty acids and a surplus of omega-6 fatty acids. This starts the inflammatory cycle, which causes inflammation in the arterial walls. Rising LDL cholesterol levels (that’s the bad cholesterol) follow and HDL cholesterol levels (that’s the good cholesterol) fall.

Nitric oxide production necessary to keep coronary arteries open

Associated with this is a lowering of nitric oxide production in the lining of the arterial walls, which leads to a narrowing of the arterial opening and simultaneous development of high blood pressure. Research of the metabolism of cells, particularly the subunits of cells called mitochondria, shed a new light on the heart as well. Mitochondria are the energy producing subunits of the cells. They are abundantly present in those organs that have a high metabolism. These organs are the heart, brain, liver and kidneys.

News About Your Heart Health

News About Your Heart Health

Life prolonging steps to prevent heart attacks

This newer knowledge allows the prevention-oriented physician to help patients not to get heart disease on the first place. The key is to prevent inflammation of the arteries and to add nitric oxide as a supplement. Also, the physician wants to change the food composition that the patient consumes. In addition, the physician wants to  intervene at the mitochondrial level. The patient achieves this with the help of supplements and by a regular exercise program. Over the years there have been impressive clinical trials that show that these preventative means when taken together can add 10 to 20 years of productive life without any disability. In the following I am going to describe the rationale for each of these life-prolonging steps:

Preventing inflammation of the arteries

Preventing inflammation of the arteries: at the moment many people eat the standard North American diet consisting of foods with too much sugar, processed foods with animal fat and lots of pasta. People need to eat a lot of leafy-green vegetables (kale, spinach, Swiss chard) and lean pork, turkey and chicken.  this will change the omega-3 to omega-6 ratio in favor of omega-3 fatty acids. This has a powerful effect on your body, as the surplus omega-3 fatty acids will suppress any inflammation in your blood vessels, which prevents heart attacks.

Eat organic foods

If you also eat as much organic food as possible, you will in addition reduce the toxic load in your body from heavy metals like lead and mercury and chemicals like herbicides and insecticides that often are contained in regular non-organic foods. By cutting out sugar and refined carbohydrates fasting insulin levels and triglyceride levels fall. This prevents diabetes and keeps your arteries open longer.

Adding nitric oxide and doing intermittent chelation therapy

By adding nitric oxide as a supplement such as “Neo40” (this supplement has hawthorn and red beet extract in it) the lining of the arteries gets a boost of nitric oxide production.  This lowers your blood pressure and widens the arteries in your body including the coronary arteries. The result is more oxygen and nutrients for your heart cells. By intervening at the mitochondrial level with the help of supplements and by doing occasional intravenous chelation therapyto remove heavy metals you can revive the sluggish metabolism of the mitochondria of your major organs. It’s like you are recharging the battery of your car, just here we are dealing with the microscopic energy packages, the mitochondria, in the cells of your vital organs including your heart.

Life prolonging supplements

Certain vitamins and supplements help in this process as follows: D-ribose, alpha-lipoic acid and CoQ10 support mitochondria; niacin lowers triglycerides and LDL cholesterol and elevates HDL-cholesterol (the good cholesterol); magnesium is an important cofactor of many enzymatic reactions in your cells and it also lowers blood pressure by widening the arteries making it easier for your heart to pump blood through them. Omega-3 and vitamin D3 both are anti-inflammatories, which makes these two important supplements for heart attack prevention. Vitamin D3 is also important for your immune system and helps to absorb calcium from the gut. Vitamin K2 has been found to be important to help transport the calcium into your bones preventing osteoporosis, so that it does not stay in your vascular system and cause hardening of your arteries by getting into your arterial walls.

Bioidentical hormone replacement

Bio-identical hormone replacement therapy is a powerful stimulus for the metabolism of your whole body, but particularly your heart. The heart needs adequate amounts of thyroid hormones and sex hormones (testosterone in males, balanced estrogen and progesterone in females). DHEA is a precursor hormone from your adrenal glands that your hormone balance requires for support of your heart muscle. The physician can order hormone tests and replace what is missing with bio-identical hormones.

Regular exercise program

A regular exercise program rounds up your heart support program. A regular exercise program by itself has been shown to be powerful heart attack prevention by cutting heart attack rates into half when compared to a non-exercise control group. Exercise builds up your heart muscle reserves and prevents clogging up of coronary arteries.

Lifestyle changes

Lifestyle changes can have a powerful effect in terms of preventing heart attacks. Everybody knows that those who smoke will not live as long as those who don’t. Smoking accelerates hardening of the arteries and causes not only heart attacks, but also cancer. Perhaps less known is the fact that alcohol can poison mitochondria. The fact that wine contains bioflavonoids is what prevents heart attacks.  Statistics show that 1 glass of wine for women and two glasses of wine for men prolong life. The wine industry was quick to exploit these statistics for the benefit of their sales. Fact is that even small doses of alcohol are a cell poison. Bioflavonoids are much more effective when taken as part of your daily supplements (resveratrol capsules) and it is much healthier for your heart and other body parts, if you do not consume any alcohol at all.

Apart from the Framingham Heart Study what we know

Originally the Framingham study showed that high LDL cholesterol was associated with heart attacks. But now we know that it is the overconsumption of sugar, high fructose corn syrup and refined carbohydrates in processed foods as well as animal fat overconsumption (mostly omega-6 fatty acids) that lead to inflammation of the lining of the arteries including LDL cholesterol overproduction from the liver. The focus has switched from lowering cholesterol and triglycerides to reducing and preventing inflammation and to supporting the mitochondria of the heart muscle cells.

Preventing 85% of heart attacks

Simple steps as outlined above have the power to prevent about 85% or more of heart attacks. They work by treating insulin resistance through the diet changes, which in turn lowers fasting insulin levels, blood sugars and triglycerides as well as cholesterol. Inflammation is kept at bay. You prevent heart disease and in addition also arthritis, high blood pressure, strokes and Alzheimer’s disease. One of the side effects is weight loss, extra energy and a sense of wellbeing.

More information on heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

Dec
17
2012

From Wheat to Autoimmune Disease and Obesity

By | Allergies, Arthritis, Diabetes, Gastrointestinal Disease, Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity, Stroke

Introduction

This is a summary of the lessons from the 2012 Anti-Aging Conference in Las Vegas…from wheat to autoimmune disease and obesity. It is not possible to summarize all the multitude of lectures from a three day conference on one page. However, what was striking was that several topics developed into a common thread. These were the topics of autoimmunity, obesity, diabetes, hormone disbalances and more. Dr. William Davis, the author of the book “Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health” explained how the BASF, a major chemical company from Germany was able to chemically modify the genes of wheat in the 1960’s and 1970’s.

Clearfield wheat has much more gluten

The farmers liked that the new wheat (called Clearfield wheat) grew with stronger roots, shorter final stems and much larger grains so the yield per acre was higher. The developers of this type of wheat patented it under the name of Clearfield wheat. They did not publicize at the time that there was a significant increase of the gliadin content. Clearfield wheat contains much more gliadin in comparison to the old wheat strains people consumed for thousands of years. Gliadin gets rid of the glue like substance between the gut cells. This causes leaky gut syndrome, something that came out in many other lectures throughout the conference. This exposes the immune cells to foreign proteins from the gut.  The immune system in turn hyper react with the production of autoimmune antibodies.

Stages of autoimmune diseases

Dr. Aristo Vojdani explained in his lecture that there are three stages of autoimmune disease. First, there is the silent stage where there are no symptoms, but the immune system is starting to react. Next there is autoimmune reactivity, which is the second stage. The third stage is autoimmune disease where there are signs of loss of body function. Autoimmunity develops in about 1/3 of identical twins in families who are prone to this. When the researchers examined non-identical twins as a control group, only 2% to 5% of twins developed it.

Autoimmune diseases due to genetics and the environment

This tells us that genetics are responsible for only about 1/3 of the cases of autoimmunity. The other 2/3 come from the environment such as genetically modified foods. In addition, fat cells secrete toxic chemicals and inflammatory cytokines.  Dr. Vojdani emphasized that gliadin in our foods has become one of the major factors of driving autoimmune diseases up in the last few decades. The immune cells with the name of T cells determine whether they accept our own cells as “self”.  Alternatively, they consider other cells as “foreign” and attack them. This occurs in autoimmune diseases such as Celiac disease, ulcerative colitis, lupus, rheumatoid arthritis, MS and others.

Las Vegas December 15, 2012v

Las Vegas, December 15, 2012

There are regulatory T cells, which are good. But there are also T cells whose genetic material underwent a change and became Th17 cells. These cells are a kind of “Pac Man” cells that attacks body cells. Altered gut flora (called gut dysbiosis) in connection with a leaky gut syndrome contributes to the formation of these aggressive Th17 cells. It is the combination of gliadin with bowel dysbiosis that drives the development of autoimmune diseases. Behind this is the fact that the gut plays a major role in the normal functioning of the immune system. Normally there is a tight connection between the gut cells that form the lining of the gut so that there is no exposure of immune cells from the blood to the contents of the gut flora.

Antibody titer tests

We are fortunate that researchers have developed antibody titer tests for the major food groups and these can be valuable pointers that can be used as a tool during the first two stages of autoimmunity before autoimmune disease causes permanent damage. Using these tests on large population groups researchers have found that common food allergies develop against wheat, dairy products, soy and eggs (as Dr. Pamela Smith remarked and Dr. Thomas Alexander explained in detail). A few blood drops suffice to determine IGG, IGA and IGE antibodies.  The test includes a whole battery of antibodies against common foods. This helps the physician to monitor the development and treatment of autoimmune diseases.

Obesity wave

Back to the leaky gut and obesity. The obesity wave in North America and the rest of the world started when the newly patented Clearfield wheat was introduced. With the higher gliadin in wheat products the balance in the gut was changed, more gliadin entered the body, it bound to the opiate receptors of the appetite center (although it is structurally differently from opium) and caused a hunger for more of the same product. The excess calories –in this case from wheat products- are stored as fat.

Aromatase in fat cells causes estrogen dominance

Fat cells by themselves have their own hormones and inflammatory substances causing various diseases. Diabetes, high blood pressure, heart disease, strokes and even cancer are among these. Add to this that with obesity the enzyme aromatase from fat cells causes elevated estrogen production. This causes estrogen dominance and results in heart disease and breast cancer in females. In males too much estrogen causes heart disease and prostate cancer.

Leaky gut syndrome

The story of the A4M conference 2012 in a nutshell: Wheat products with the increased gliadin (gluten) content caused increased leaky gut syndrome in the population since the 1970’s. This is the cause of the wheat addiction, which was further fueled by the obsession of the regulatory bodies to recommend eating according to the food pyramid (a splendid marketing pyramid for wheat consumption, as one of the recommended products are cereals and wheat). With these findings the cause of the obesity wave can be clearly seen. Along with obesity comes the flood of autoimmune diseases, which have developed from the action of the Pac Man type TH17 immune cells that attack various tissues in the body. The common denominator in the body is a low-grade chronic inflammation that Dr. Vojdani explained in more detail. This causes blood vessel diseases culminating in high blood pressure, heart attacks, strokes and cancer.

There were many other lectures that I attended. Some dealt with bio-identical hormone replacement. Others discussed telomere health and the effect of fitness on an ongoing basis to achieve longevity. In almost every lecture various speakers discussed the importance of lifestyle issues. This went through the conference lectures like a red thread. Nutrition is not the only factor in longevity. Exercise on a regular basis has a powerful healing effect. It can be instrumental in preventing about 50% of diseases, especially the main killers like heart attacks, strokes and cancer.

More info

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Dec
11
2012

What a Wonderful World

By | Anti-aging medicine, Arthritis, Cancer, Diabetes, Heart Disease, Men's Health, Nutrition, Prevention, Stroke, Weight loss, Women’s Diseases

Recently I traveled from Palm Springs to the Caribbean and back and I had to think: what a wonderful world! There were connecting flights and there was waiting at various airports. I had lots of time to watch people and to observe what was happening around me.  Louis Armstrong’s song (1967) “What a Wonderful World“ came to mind. I thought that this would be a fitting title for this Blog. Earlier we had come from Canada escaping the winter. The deep blue sky of Southern California and the sight of palm trees (instead of pine trees) is something that makes our hearts beat faster.

The desert is a special place

The desert is a special place. We had friends join us for a week and we had visited Joshua Tree Park with the grotesque looking rock formations. During the flight it was interesting to see the landscape, as we crossed the desert areas of Arizona and New Mexico, seeing what difference people make when large areas are irrigated and the desert transforms into lush, green areas. It is also very visible, where the desert has taken back the land that no longer is irrigated.

Travel to Dallas Fort Worth and Miami

We came to Dallas Fort Worth and the sky was clear. We traveled on to Miami and the sky was showing signs of pollution, although it was a sunny day. After our take-off from Miami we saw the ocean. I have flown over that region many times before, but this time I detected oil slicks on the surface of the ocean of the Gulf of Mexico, leftovers from previous oil spills. So, the Armstrong song of a “wonderful world” came back to me in a different context. I looked at the landscape and what industries can do to it. Erroneously we had just seen several BP commercials while waiting for our plane at the airport where BP was congratulating itself for the role it plays in cleaning up the environment having spent several billion dollars. But there are still oil slicks…

What a Wonderful World

What a Wonderful World

Watching people on the plane

I looked at the people around me in the plane. More than 35% of them were obese; many of their faces looked sagging and prematurely aged, particularly in women. Males, even middle aged ones looked like they were pregnant (abdominal fat) and often their hair was receding, thinning on top and quite a few were bald. All of the texts I had read about anti-aging medicine came back to me. Too bad that people were eating the wrong foods and obviously did nothing to counter their built-in aging clock from depleting hormones as we age.

Menu of the airline

I looked at the menu of the airline. I won’t mention the name of the airline, but I can assure you that 10 different airlines would have almost the same menus. There would only have been one chicken salad that I could have eaten. In the past I tried to order this and I was told that due to popular demand this item was sold out. Instead they wanted to offer me potato chips, cheese and crackers. My wife and I had anticipated this scenario and we had bought a chicken salad and water before we boarded the plane. We also had packed healthy organic energy bars and a trail mix consisting of nuts and raisins to use as snacks during the trip.

Cutting out starchy foods, eating fresh vegetables and lean meat instead

While travelling we stuck to the same principal of cutting out starches, bread, rice, pasta and only eating fresh vegetables, salads and lean meat (chicken, grass fed beef, ribs, lean pork and veal), which we always do since the fall of 2001.  We also avoid all alcoholic beverages and sugar containing sodas. When we returned to Southern California we were delighted to see that our body compositions when measured with the body composition scales were identical to what they were before the trip.

I think we can all contribute to this wonderful world, if we participate in whatever we can do such as these steps.

End wars

End wars because on the long-term they do not lead anywhere to solve conflicts (in my lifetime I am thinking about the Vietnam war, long-winded Ireland crisis, the Korean war and the German reunification at the end of the Cold War). Right now there is the Middle East conflict, which screams for a peaceful solution. As we are conscious about the devastation that is caused by wars, we have to start with ourselves. We have to resolve our own conflicts that may be present in our own lives. Tolerance, acceptance and forgiveness are the tools.

Address pollution 

Pollution needs to be addressed by the US and all of the world’s countries (including Canada where I live most of the time). This means that anti-pollution devices need to be installed in industrial plants and chimneys. Recycling needs to be done on a larger scale. China and India and other emerging market countries need to be taught how these new anti-pollution measures work. This is an ongoing project, but we need more co-operations between government, industry and countries all around the globe. Also we have to start with our own behavior: we can become more aware of reusing and recycling instead of creating more waste in our landfills.

Become better caretakers of our bodies

What can we do to make us part of this wonderful world? We need to become better caretakers of our bodies. Instead of looking at quantity we must look at quality in choosing  natural food wherever possible. Growing up in Germany after the Second World War in the 1960’s and early 1970’s made me witness that high consumption of fat, sugar and starchy foods (potatoes, pasta and bread) caused people to age prematurely and get heart attacks, strokes, high blood pressure, arthritis, obesity, diabetes and cancer. At that time the “Wirtschaftswunder” (translated into English it means “economic miracle”) had propelled Germany into a nation of  high consumers. During the war they had been poor and often went hungry, they were slim and heart attacks were at an all-time low.

Unhealthy foods and snacks

After the war they made up for times of deprivation and overindulged:  pretzels, buns, bread, butter, French fries, sweets, cakes, cookies, jams, chocolates, pralines-everything was consumed with gusto!  What happened to Germany in the 1960’s and 1970’s is happening again right now in front of our eyes with the obesity wave in the US, Canada and all the other civilized countries around the world. Food companies have been very successful with their advertising through the media. Already kids get hooked to the wrong foods! Hyperinsulinism will ensure that we get hungry every two or three hours. Refined carbs and extra calories are turned into fatty acids by the liver and stored as fat. It shows that we have to resist the wrong food temptation and cut out all refined carbs.

Healthier alternatives

It is healthier to stick to salads and vegetables like broccoli, cauliflower, asparagus, and spinach and eat a small piece of lean meat with it. Have probiotics as plain yoghurt (0% to 2% fat). If you need a sweetener, use a small amount of Stevia, which is a natural sweetener that leaves your body chemistry untouched. Have some fruit as a dessert like blueberries, cherries or strawberries. Eat an apple, the occasional grape. Drink lots of purified water or mineral water.

Buy organic food

Buy ORGANIC food whenever possible. Farmers treat most of the vegetables and fruit with insecticides, which contain residuals in them. When these are ingested, they act like estrogenic substances causing breast cancer in women and prostate cancer in men. The safest in our society is to stick to organic foods. More expensive, but the best insurance against future disease. Question politicians whenever possible to make yourself heard. You want unadulterated food and water. And as I’m writing about water, have a water filter under the kitchen sink with a carbon filter. In addition, it is good to have reverse osmosis to get rid of chloride or fluoride from the city water. This is what you use to cook your food. You may want to take an iodine tablet once or twice a day to counteract the negative effects of chlorine from having a bath or shower (the skin absorbs chlorine). Why? Because chlorine and fluoride can displace the iodine of the thyroid hormones and make you hypothyroid.

Regular exercise

Exercise every day. Nobody gets fit in their muscles from sitting in front of the TV for hours. You also don’t get fit from spending hours and hours of computer work. If you have to, counterbalance this with an exercise program of 1 hour per day. Walk 30 minutes on a treadmill and do 30 minutes of weights or use specific exercise machines in a gym to strengthen your upper and lower extremity muscles.

Replace missing hormones with bioidentical ones

Did I mention hormones? Yes, I did above when I mentioned depleting hormones as we age. We know for some time that each hormone of the body has its own peak in life and then it declines in production as we age. Or should I rather say, we age when these hormones decline? I like the latter way of wording it, because we can measure hormone levels and when one of the hormones is too low, we can replace it with a bio-identical hormone and the person’s energy comes back and whatever function was missing is restored. This is in essence what anti-aging medicine does. Many conservative physicians and clinics do not like to hear this. Big Pharma does not like to hear this when I am talking about replacing hormones in the body with bio-identical hormones. But the patented cheap copies that are mass manufactured and sold at inflated prices are no fit to the hormone receptors in the body and therefore are dangerous. The artificial drugs cause heart attacks, strokes and cancer as the Women’s Health Initiative has shown in 2002.

What people need to do

What did I think the people I watched on the plane should have done? Their physicians should have tested the hormones of many of them. Many of the overweight or obese patients would likely have had high fasting insulin levels. The extra fat does not just sit there; it is a hormone producing factory for inflammatory compounds and estrogen-like substances. This causes heart attacks and strokes in women. It causes prostate cancer and hair loss in males as well as impotence (“erectile dysfunction”). What I said above would help these people that I met. When you lose fat through changes in the diet and when you start an exercise program, the body mass index slowly comes down as fat melts away. The estrogen production comes down, the inflammatory substances abate. The person feels more energetic and may even think straighter. This is when you realize what a wonderful world it is.

Saliva hormone test

One special test is a saliva hormone test that looks at 5 steroid hormones: DHEA-S (storage form of DHEA), testosterone, estradiol, progesterone and cortisol. Every man and every woman needs a certain balance between these hormones and this test should be done when there is a change in energy or appearance (hair loss) somewhere when we are 35 to 40 years. In women it is important that the progesterone level is 200 times fold higher than the estradiol level (progesterone/estradiol ratio) or she is at risk of developing breast cancer and other cancers (ovary, colon etc.). In a man it is important that his testosterone to estradiol ratio is higher than 20 to 1. This protects him from cancer of the prostate or other cancers.

Bioidentical hormone creams

The physician or a knowledgeable naturopath can prescribe whatever hormones are missing. The health care provider needs to be familiar with the use of bio-identical hormone creams. This program can prevent diseases like osteoporosis, diabetes, cancer and arthritis. It also prevents disabilities.

With this I leave 2012 behind and I am looking forward to a new year (2013). I am looking forward to the time when more people can see Louis Armstrong’s vision of a “What a wonderful world”.

More information on:

1. Pollution: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

2. Obesity: https://www.askdrray.com/stop-obesity/

3. Processed food: https://www.askdrray.com/caution-processed-food-ahead/

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Sep
01
2008

Runners Live Healthier Lives

By | Arthritis, Fitness, Heart Disease, Nutrition, Weight loss

It has been known for some time that exercise is healthy for you. But how do runners do on the long-term? This has been investigated in a recent study spanning 21 years from 1984 to 2003 published in the August edition of the Archives of Internal Medicine. 538 members 50 years or older of a nationwide running club were compared to a sample of 423 healthy controls. In the beginning of the study the members (all males) were 50 years or older. Disability levels were assessed with a health questionnaire and classified into a scale from 0 (no disability) to 3 (unable to perform). Death rates were also determined.The results showed that disability scores were always lower in runners (0.17) than in controls that did not run (0.36), which translated into 39% less disability. In 2003 the death rate was 34% in the controls, but only 15% in the runner group, in other words a 38% better survival of runners compared to the controls. In 2005 a further follow-up showed that the survival curve was still increasing for the runners who had now entered their eighties.

Runners Live Healthier Lives

Runners Live Healthier Lives

The authors of this study pointed out that length of life, health status and disability status can all be significantly improved with regular moderate exercise such as running. Other studies have suggested this as well, but none has followed this up over such a long period (21 years). Increasing healthy lifestyle behaviors will also reduce health care costs and prevent disabilities from chronic diseases.

Choose your fitness activity as reviewed here: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Arch Intern Med. 2008;168:1638-1646

Last edited November 5, 2014

May
01
2008

Early Use of Immunosuppressive Drugs for Early Crohn’s Patients

By | Arthritis, Gastrointestinal Disease, Pain

So far the strategy of treating patients, who were newly diagnosed with Crohn’s disease, was the use of corticosteroids to control abdominal pain and bloody diarrhea. The conventional mode of treatment consisted of a “step-up” treatment: after corticosteroids the use of immunosuppressants and finally antibody treatment would follow to curb the inflammatory response. International data which were published in the Lancet (February 23 issue) points to a safer and more effective treatment protocol. It consists of a “top-down” approach rather than of the conventional “step-up” approach. Patients receive immunosuppression early in the form of azathioprine and also the antibody infliximab, known as Remicade. Another study examined patients who were on maintenance therapy with adalimumab (Humira). They experienced sustained improvements in the symptoms that are associated with Crohn’s disease. After 4 weeks of induction therapy with the medication patients with mild and severe depression had improved to such an extent that they returned to the normal range. They were also assessed regarding fatigue and after treatment they showed a significant improvement in their daily functioning. The two treatment protocols were compared in a trial involving 129 patients with Crohn’s disease who had no previous treatment. At the end of the trial the researcher found that 65% of the group that had received the “top-down” treatment was symptom free after 26 weeks of treatment. Contrary to this only 36% of the “step-up” patients went into remission during the same time.

Early Use of Immunosuppressive Drugs for Early Crohn's Patient

Crohn’s before and after immunosuppressive drugs

When the patients were examined after 1 year, 62% of the “top-down” group was still symptom free, but only 42% of the “step-up” group had no symptoms. Dr. Brian Feagan of the University of Western Ontario coordinated this trial involving international sites in Belgium, Holland and Germany. He points out that the newly diagnosed Crohn’s disease patient that has the worst prognostic signs will benefit from this form of treatment. The top-down modality also is safer, as it protects the patient from high exposure to steroids. Similar results were demonstrated in patients with rheumatoid arthritis. The results of these trials and Dr. Feagan’s research suggest that the top-down treatment option could also give the best chance to patients with other chronic autoimmune diseases such as ulcerative colitis.

More information about Crohn’s disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/crohns-disease-crohns-disease/

Reference: The Medical Post, March 4, 2008, page 2; April 1, 2008, page 17

Last edited November 3, 2014

Apr
01
2008

Short Daily Exercise Helps Chronic Pain Patients

By | Arthritis, Fitness, Health, Pain

Chronic pain can be an affliction that turns normal living and functioning upside down. Quality of life will be negatively affected, and often depression and anxiety are resulting mental problems. Effective pain relief is crucial, but often there are undesirable side effects to pain medication, and the patient will explore other avenues that bring a measure of relief. Amy Burleson, Psy.D. of the Cleveland Clinic’s chronic pain rehabilitation program found that chronic pain patients were physically deconditioned due to chronic pain and a chronic lack of physical activity. Depression and other mood disorder also were very common. A 10 minute exercise program was added to the treatment of a group of 28 patients who suffered of various chronic pains: back pain, fibromyalgia, neuropathy and migraines. Patients started a simple routine of walking on a treadmill, starting with a low speed of 1 mile per hour and increasing the speed every few minutes, till they walked at a speed of 3 miles per hour, a speed which was manageable for all patients. After 3 weeks patients found that their physical endurance had increased. They also experienced less depression and anxiety. Even more remarkable was the fact that the patients’ pain perception had diminished.

Short Daily Exercise Helps Chronic Pain Patients

Short Daily Exercise Helps Chronic Pain Patients

Likert scale scores which were used in the assessment of pain perception showed a drop from 7.32 in the beginning of the program to 2.75 at 3 weeks. It is obvious that even mild exercise has benefits for patients with chronic pain: the overall well being receives a noticeable boost through an approach that has no pharmacological impact, no side effects and has no high cost of health care.

More information on the right dose of exercise: http://nethealthbook.com/health-nutrition-and-fitness/fitness/right-dose-exercise/

Reference: Pain Medicine, Volume 9, Issue 1, Page 88-141 (January/February 2008)

Last edited November 3, 2014

Feb
01
2007

Avoiding Back Pain By Relaxed Sitting

By | Arthritis, Health, Pain, Prevention

This article is about “avoiding back pain by relaxed sitting”. Notably, parents and educators often reprimand children and students to “sit up straight”. The results however are not that favorable. Truly, a 90 degree angle in this position is causing problems. Specifically, it causes the largest movement of the spinal disc and a lot of strain. To put it another way, conventional wisdom has it that sitting up straight avoids back pain. It must be remembered, this has important implications for a large population group that has work situations with mostly sitting jobs. In addition, consequences of bad posture are also quite visible: lower back pain is the leading cause of disability in the U.S. and Canada and a major cause for missed work days.

Improper posture and back pain are related

Investigators have presented evidence, that a 135 degree body/thigh sitting position, leaning back, is the optimal position to avoid back pain. The author of the study, Dr.W. Bashir from the department of radiology and diagnostic imaging at the University of Alberta Hospital in Edmonton emphasizes, that the angle of posture has been under question for some time, and improper posture and back pain are related.

Positional MRI scans 

Positional MRI scans have shed more evidence on the spine. There are special MRI machines that take images when the patient is not in a supine position, but in a position that allows the patient free motion during the test. Spinal angles can be measured and spinal disk movement can be observed in various positions and angles.
The 90 degree angle showed most spinal disk movement, creating stress for the spine. Another unfavorable position is a slouching posture.

Avoiding Back Pain By Relaxed Sitting

Avoiding Back Pain By Relaxed Sitting

Scan results showed a reduction in spinal disk height, signifying more wear and tear of the lumbar spine. Spinal disk movement was least pronounced with the 135 degree angle. This more relaxed position poses less strain on spinal disks and the associated muscles and tendons. Employees sitting comfortably versus sitting up straight can make the job place friendlier to people’s backs.

More about back pain: http://nethealthbook.com/arthritis/lower-back-pain/

Reference: The Medical Post, January 16, 2007, page17

Last edited November 2, 2014

Jan
01
2007

Acetaminophen Overdosing Hazards

By | Arthritis, Infectious Disease, Pain, Prevention

The FDA has expressed some concerns about the self-medicating with acetaminophen as this can led to an acetaminophen overdose. The over-the-counter medication is commonly used and especially in the winter season many sufferers of colds or influenzas will keep it handy. It is readily available, not only in pharmacies but also in supermarkets under the generic name or under brand names such as the commonly used Tylenol. It exists in dosages for adults and there are pediatric preparations like Children’s Tylenol. Acetaminophen is also a common ingredient in cold remedies. Every vial displays a clear warning that the content is enough to cause serious harm. Dosage instructions are also clearly spelled out.
More than 200 million people take Tylenol each year and 400 people die of liver failure every year, as they have accidentally taken too much.
Dr. Charles Cain from the New York Presbyterian Hospital has cautioned that overdoses can happen relatively easy. A patient is not to exceed 4 grams of acetaminophen per day. If the pain reliever is taken every 4 hours instead of the recommended interval of 6 hours, such as 2 extra-strength Tylenol at 500 mg each and some cold medication is added to that, patients may easily reach 4-6 grams of acetaminophen per day. If this practice continues for a few days, it can lead to liver damage, because the liver cannot keep up with the elimination of the drug. Other substances metabolized by the liver such as alcohol can become a serious hazard, if they are combined with acetaminophen. The effects of alcohol slow down the elimination of Tylenol by the liver.

Acetaminophen Overdosing Hazards

Acetaminophen Overdosing Hazards

It is for this reason that it is important to observe closely how much of the medication is taken in total: if a patient is already taking Tylenol for headaches, more acetaminophen (Tylenol) in the form of an over-the-counter cold medication should not be added as  would be reached.
These medications have to be used with an eye to overall daily use and the amount used over a period of time. Used with care acetaminophen remains very safe.

Reference: December 20, 2006 online issue of Time

Last edited December 5, 2012

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Jul
01
2006

Benefits Of Arthritis Drug Outweigh Cancer Risk

By | Arthritis

Any medication that is very effective in one area may also have side effects.
An analysis of randomized trial has confirmed, that rheumatoid arthritis patients who are treated with anti- tumor necrosis (TNF) antibodies, are at an increased risk for cancer. A study from the Mayo Clinic and other studies from institutions in the U.K. showed that patients who are treated with the monoclonal antibodies infliximab (Remicade) and adalimumab (Humira) are at a higher risk for serious infections.
This may sound like a blow to any patient with rheumatoid arthritis. Treatment with Monoclonal antibodies and anti-Tumor necrosis antibodies has revolutionized the care of these patients. The medications are highly effective and have made a difference for many affected with rheumatoid arthritis.
Dr. Eric Matteson, a study co-author and professor of medicine in the division of rheumatology at the Mayo Clinic points out, that the concerns about infection and malignancy are not new. They are already mentioned in the drug labeling. The risk for cancer was statistically significant only in the high-dose groups. It was also impossible to draw any conclusions about whether any type of malignancy occurred more often than another. He also emphasized, that doctors and patients have to be alert to signs of infection, and age-appropriate cancer screening is of great importance for the patient who takes these particular medications.
Dr. John Esdaile from the University of British Columbia mentions some additional points. These medications are not handed out freely to any patient with R.A. The treatment cost of about $18,000 per year does not make this a standard medication for anybody with R.A. Patients with severe disease who have failed to get relief from any conventional medications would be the ones who are considered for this treatment. Most patients would likely be receiving doses in the lower range of the spectrum, and patients usually know within 3 months, whether the medication is helping them. The medications do not work in everyone, but for 50% of the patients the effect is dramatically positive. The patient, whose joints were being destroyed by rheumatoid arthritis, can go from a state of terrible pain and disability to being able to return to a good quality of life.

Benefits Of Arthritis Drug Outweigh Cancer Risk

Benefits Of Arthritis Drug Outweigh Cancer Risk

The key is close screening of patients regarding the suitability of the therapy. The possible increased risk for malignancies and infection must be discussed with candidates for anti-TNF therapy. Finally close monitoring for infection and cancer screening is necessary.

More information about rheumatoid arthritis: http://nethealthbook.com/arthritis/rheumatoid-arthritis/

Reference: The Medical Post, June 2, 2006, page 1 and 7.

Last edited Nov. 1, 2014

Apr
01
2006

Back Pain Improves With Acupressure

By | Arthritis, Pain

This article is about “back pain improves with acupressure”. Generally, lower back pain can be a frustrating condition for patients. In addition, it is a major cause for disability and a source of depression. In particular, for the physician it becomes a vexing problem to find successful therapies. Pain medications and their side effects are often not acceptable for long-term use, and surgery very frequently will not be an option at all.
Additional therapies, which have been frequently used, are chiropractic treatment, massage therapy and physiotherapy. Frequently, the results can vary a great deal depending on the condition. Acupuncture has gained a solid position in the therapeutic approach of back pain, however the modality of acupressure treatment has not received much attention in conservative circles.

Conservative physiotherapy versus acupressure treatment

So far conservative voices could dispute the efficacy of acupressure due to a lack of research data, but new studies are now available coming from the National Taiwan University in Taipeh. Specifically, under the leadership of Professor Tony Hsiu-His Chen and a team of specialists, a randomized controlled trial with 129 patients suffering of chronic low back pain has been conducted. To clarify, the patients received physiotherapy or acupressure for one month as a modality of treatment.

At the end of treatment, the group treated with acupressure showed significantly less disability than the group treated with physiotherapy. The improvement in the disability score of patients treated with acupressure remained at six-month follow up examinations. Pain scores also remained reduced after treatment and at 6-month follow-up in the acupressure group.

Back Pain Improves With Acupressure

Back Pain Improves With Acupressure

These results point to the use of acupressure treatment as a very promising therapy for patients suffering of chronic low back pain.

More information on:

1. back pain: http://nethealthbook.com/arthritis/lower-back-pain/

2. Electro-acupuncture: https://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

Reference: BMJ 2006; 332:696-700 (25 March, 2006)

Last edited Oct. 31, 2014