Dec
17
2016

Magnesium Is Essential To Life

Magnesium is an important co-factor in many biochemical reactions, so magnesium is essential to life.

Many diverse diseases and cancers can develop from magnesium deficiency. The key is to supplement with magnesium regularly to get more than the government recommended daily allowance (RDA). The RDA for magnesium is 420 mg a day for males and 320 mg a day for females.

In the following I will review the diseases that occur without enough magnesium on board.

A lack of magnesium can cause heart disease

In this 2014 study 7216 men and women aged 55-80 with at high risk for heart attacks were followed for 4.8 years. The risk of death from a heart attack was found to be 34% lower in the high tertile magnesium group when compared to the lower magnesium tertile group.

The protective mechanism of magnesium was found to be as follows. Magnesium counteracts calcium and stabilizes heart rhythms. Magnesium helps to maintain regular heart beats and prevents irregular heart beats (arrhythmias). It also prevents the accumulation of calcium in the coronary artery walls. This in turn is known to lower the risk of heart attacks and strokes.

Another study, which was part of the Framingham Heart Study, examined calcification of the heart vessels and the aorta as a function of magnesium intake.

There were 2,695 participants in this study. For each increase of 50 mg of magnesium per day there was a 22% decrease in calcification of the coronary arteries. For the same increase of magnesium the calcification of the body’s main artery, the aorta, fell by 12%. Those with the highest magnesium intake were 58% less likely to have calcifications in their coronary arteries. At the same time they were 34% less likely to have calcifications of the aorta.

In a Korean study a group with low magnesium levels was at a 2.1-fold higher risk of developing coronary artery calcifications compared to a group with normal magnesium levels.

Low magnesium increases your stroke risk

In a 2015 study 4443 subjects, men and women aged 40-75 were followed along.

928 stroke cases developed. The group with the highest 30% of magnesium intake was compared with the lowest 10% of magnesium intake. They had significantly lower blood pressure (7 mm mercury) and lower total cholesterol levels. They also had 41% less strokes than those with low magnesium intake.

In a 2015 study that lasted 24 years the authors investigated 43,000 men.

Those with the highest magnesium supplement had a 26% lower stroke risk. They had been compared to those with the lowest magnesium intake.

Among women low magnesium levels were shown to cause 34% more ischemic strokes than in controls.

This study was from 32,826 participants in the Nurses’ Health Study who were followed for 11 years.

It is clear from all these studies that supplementation with magnesium can prevent strokes.

Magnesium protects kidney function

This study examined 13,000 adults for 20 years to see how kidney function was dependent on magnesium levels. Those with the lowest magnesium levels had a 58% higher risk of developing chronic kidney disease. It makes sense when you consider that magnesium is needed to keep arteries healthy, blood pressure low, and blood sugars stable. In diabetics where blood sugar is not controlled kidneys develop kidney disease. This is called diabetic nephropathy. In the presence of magnesium supplementation and a low sugar diet people are less likely to develop diabetes or kidney disease.

Magnesium helps blood sugar control

A metaanalysis showed that magnesium supplementation was able to improve blood sugar control. This occurred in both diabetics and borderline non-diabetics within 4 months of supplementing with magnesium.

Magnesium has been known in the popular press to be an important factor in helping control blood sugar. Here is an article as an example.

Magnesium good for bones and teeth

Magnesium is important for calcium metabolism and this is helping your bones and teeth to stay strong. About half of the body’s magnesium is stored in bone. Teeth are the other location where a lot of magnesium is found.

Low levels of magnesium lead to osteoporosis, because one of the two structural components of bone (calcium and magnesium) is missing. In addition low magnesium causes inflammatory cytokines to increase. These break down bones. The Women’s Health Initiative showed that when daily magnesium intake exceeded 422.5 mg their hip and whole-body bone mineral density was significantly greater than in those who consumed less than 206.6 mg daily.

With regard to healthy teeth magnesium is important as it prevents periodontal disease.

This study found that there was less tooth loss and there were healthier periodontal tissues in 4290 subjects between 20 and 80.

Those who took magnesium supplements had healthier teeth.

Migraine sufferers improve with magnesium

A double blind randomized study showed that magnesium supplementation can reduce migraines. In this trial 600 mg of magnesium supplementation was used for 4 weeks.

This reduced migraines by 41.6% in the magnesium group compared to the non-supplemented control group.

Another study showed that both intravenous and oral magnesium are effective in reducing migraine headaches.

Intravenous magnesium showed effects on improving migraines within 15 – 45 minutes. The authors concluded that both oral and intravenous magnesium could be added as a supplement to other migraine treatments.

Cancer can be caused from too little magnesium

You may be surprised to hear that magnesium can even prevent some cancers. Two cancers have been studied in detail. I will limit my discussion to these two.

Pancreatic cancer

One study found that pancreatic cancer was reduced. 142,203 men and 334,999 women, recruited between 1992 and 2000, were included. After 11.3 years on average 396 men and 469 women came down with pancreatic cancer. On the male side they found that when the body mass index (BMI) was greater than 25.0 there was a 21% reduction of pancreatic cancer for every 100 mg of added magnesium per day. There were a lot of smokers on the female side, which interfered with the study as confounding factors undermined statistical validity.

In another study, the US male Health Professionals Follow-up Study was examined after 20 years of follow-up. Those with a BMI of above 25.0 on magnesium supplementation had a reduced risk of pancreatic cancer. The pancreatic cancer rate in the higher magnesium group was 33% lower than in the lower magnesium group. The higher group consumed 423 mg of magnesium daily, the lower group 281 mg per day. It is significant that in both studies it was the heavier patients who came down with pancreatic cancer. It is known that obesity is a pancreatic risk factor.

Colorectal cancer

A study done on Japanese men showed that magnesium could protect them significantly from colon cancer.

Men who consumed the highest amount of magnesium developed 52% less colon cancer over 7.9 years. They were compared to the group with the lowest 20% intake of magnesium. The women in this study did not reach statistical significance.

A study from the Netherlands examined colon cancer in patients. They found that only in patients with a BMI of greater than 25.0 magnesium did have protective effects. For every 100 mg of magnesium per day increase there was a 19% reduction of colon polyps. And there was also a 12% reduction of colorectal cancer for every 100 mg increase of magnesium per day.

Magnesium plays an important role in genome stability, DNA maintenance and repair. It also prevents chronic inflammation and reduces insulin resistance, all factors contributing to cancer reduction.

Live longer with magnesium

Consider that magnesium is the fourth most common mineral in the body. Add to this that magnesium is a co-factor of more than 300 enzymes in the body. Magnesium is required as an important co-factor in the conversion of chemical energy from food that we ingest. Magnesium is regulating blood sugar, blood vessel health and our brain electrical activity. 50% of our stored magnesium can be found in our bones, which helps the strength and integrity of them.

Because of the distribution of the enzymes that are helped by magnesium to function properly, virtually every cell in the body depends on our regular intake of magnesium.

Since the 1950’s soils are depleted of magnesium where vegetables are grown and fruit trees are raised. We simply do not get enough magnesium from food.

But chelated magnesium is freely available in health food stores. Take 250 mg twice per day, and you will have enough.

Because our metabolism slows down, there is a critical age where magnesium deficiency becomes more obvious than when we are younger. By the age of 70 there are 80% of men and 70% of women who do not get the minimum of magnesium-required amount they should get (350 mg for men and 265 mg for women).

At this age many people are on multiple drugs. For many proton pump inhibitors (PPI) are used to suppress acid production in the stomach. PPI’s have been associated with low magnesium blood levels.

This link explains that PPI’s should not be used for longer than 1 year.

Low magnesium levels accelerate the aging process on a cellular level. Low magnesium levels increase senescent cells that can no longer multiply. Some of them could cause the development of cancer. These senescent cells also can no longer contribute to the immune system. This causes more infections with an adverse outcome.

Remember to take chelated magnesium capsules or tablets 250 mg twice per day and you will be protected from low magnesium levels in your body.

Here is why we live longer with magnesium supplementation

Our blood vessels will not calcify as early; they keep elastic for longer, preventing high blood pressure. Our kidneys will function longer with magnesium, preventing end-stage kidney disease. We need our kidneys to detoxify our system! The more than 300 enzymatic reactions all over our body help that we have more energy and that cancer is prevented. When there are fewer strokes and less heart attacks this helps reduce mortality. It also helps that there is less of a risk for Alzheimer’s disease with magnesium supplementation, because insulin resistance is reduced, which has been shown to prevent Alzheimer’s disease.

The bottom line is we live longer and healthier; that is what is meant with longevity.

Magnesium Is Essential To Life

Magnesium Is Essential To Life

Conclusion

Magnesium is a key essential mineral. It balances calcium in the body and participates in many enzymatic reactions in the body as a cofactor. As long as we have enough of this mineral we won’t notice anything. It is with magnesium deficiency that things go haywire. You could get heart disease or a stroke. You could get kidney disease. You even could get pancreatic cancer or colorectal cancer. If this is not enough, magnesium deficiency can cause diabetes, osteoporosis and bad teeth. You may suddenly die with no obvious cause. But, if your magnesium blood level is balanced from regular supplements, you will carry on living and eliminate a lot of health problems.

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Jun
20
2015

Seventeen Causes Of Blood Vessel Disease

We tend to ask the question: “What is the cause of blood vessel disease”? Would you have expected that at this point there are not just one cause, but seventeen causes of blood vessel disease identified that can all be treated? In the May 2015 issue of the Life Extension Magazine one of the causes, high homocysteine has been stressed as being an important risk factor that not every health professional has yet appreciated.

In the following overview I will briefly address all of the risk factors for cardiovascular disease and then summarize what can be done to prevent heart attacks and strokes.

1. Excess cholesterol: Too much cholesterol can lead to clogged arteries. When we eat too much red meat too often, this extra dietary cholesterol can elevate your total blood cholesterol.

2. High LDL cholesterol: The LDL cholesterol is often labeled the “bad cholesterol”. In reality it is the cholesterol that is being transported from the liver to all of the body cells, which utilize it to replace the aging membranes that envelop the cells. What is important to know is that sugar and starchy foods (pasta, cakes, cookies, noodles, white rice, potatoes, pizza, muffins etc.) lead to a surge of blood sugar, which stimulates the liver to produce more LDL cholesterol. Any excess sugar in the blood will oxidize the LDL cholesterol, which leads to accelerated hardening of the arteries.

3. Low HDL cholesterol: HDL is the type of cholesterol that is transported from the cells back to the liver. Any oxidized LDL cholesterol is also mopped up by HDL cholesterol. HDL cholesterol has been dubbed the “good cholesterol”. It is important that LDL and HDL cholesterol are balanced. It is noteworthy that HDL cholesterol is much higher in athletes and those who exercise on a regular basis (like 5 to 7 times per week). This means that there is a surplus of the protective HDL cholesterol, which prevents hardening of the arteries.

4. Oxidized LDL: As explained above sugar and starchy foods oxidize cholesterol, so does radiation. A Mediterranean diet including olive oil will stabilize your metabolism and protect LDL from being oxidized.

5. High blood sugar: In pre-diabetes and diabetes, the blood sugars are high, but they are normal in people with a normal metabolism. As explained before it is this scenario, which leads to oxidation of LDL cholesterol and accelerated hardening of arteries. This is the reason why diabetics have severe blood vessel disease with closure of major arteries like the one going to the legs. If arterial by-pass surgery is not feasible because of the severity, often a physician has no other choice but to amputate a lower leg.

6. Excess triglycerides: People with excessive weight have a change in metabolism called metabolic syndrome, where triglycerides are high. But diabetics also often have high triglyceride levels in their blood. This is an independent risk factor to develop hardening of the arteries.

7. Elevated C-reactive protein: Dr. Paul Ridker published a landmark study in 2002 where he concluded that the blood test C-reactive protein was a reliable indicator to identify people who were at risk of developing heart attack. It measures inflammation in the body. What is inflamed here is the lining of the arteries from oxidized LDL cholesterol. I hope you see a pattern. Some of these points are actually connected.

8. Low blood EPA/DHA: Essential fatty acids are not contained in processed foods. Instead the food industry puts omega-6-fatty acids into processed foods, as this is much cheaper and leads to a longer shelf life of the processed food products. Omega-6 fatty acids are the precursor for arachidonic acid, which causes inflammation, hardening of the arteries and arthritis. By introducing fish oil or wild salmon two or three times per week you can achieve a counter balance to omega-6-fatty acids. Our bodies want us to balance omega-6 fatty acids with omega-3.

9. Excess insulin: with type 2 diabetes there is a high fasting insulin level. This leads to inflammation of the blood vessel wall and triggers accelerated hardening of the arteries. It also causes the brain arteries to get narrowed, and as a result the brain develops Alzheimer’s and dementia. Alzheimer’s is now called “type 3 diabetes”. An overweight or obese person who cuts out sugar in the diet and exercises can often control excessive weight, lower insulin and normalize cognitive deficits.

10. Excess fibrinogen: Blood clotting factors are manufactured in your liver and this is balanced by fibrinolytic factors that circulate in the blood. In certain conditions like diabetes, or the metabolic syndrome too much fibrinogen is produced. This can lead to blood clots.

11. Excess homocysteine: Some people are born with gene defects that program our cells to run abnormal biochemical reactions in our cells. Correct methylation pathways are important for normal cell function. However, if there is a methylation defect, abnormalities set in and homocysteine accumulates. As we age, there is also a weakening of certain enzymes that are involved in the methylation pathway. With any of these enzyme defects you need to use appropriate supplements to normalize this metabolic defect. Vitamin B2, B6 and B12 supplementation will often stabilize methylation defects and homocysteine levels return to normal. Methyl folate 1 mg per day is also very useful. Some people in older age cannot metabolize folate very well. This is important as severe, familial cardiovascular disease, where people often suffer heart attacks during the best years in their lives, can be postponed this way by several years or decades.

12. High blood pressure: Many people are not aware that high blood pressure is a disease where the linings of the arteries are inflamed and there is too little production of nitric oxide. Nitric oxide is a signaling substance contained in many vegetables, particularly in red beets. Nitric oxide is the body’s tool to keep blood pressure normal by widening the diameter of arteries. High blood pressure leads to accelerated hardening of the arteries, because the oxidized LDL cholesterol gets deposited right under the diseased lining of the arteries. Just lowering the blood pressure with medications will not remove the other risk factors; they have to be addressed separately. The DASH diet has been developed to assist in lowering elevated blood pressure.

13. Low nitric oxide: Too much sugar and starch in one’s diet cause oxidation of LDL cholesterol as explained and this causes a dysfunction of the lining of the arteries resulting in less production of NO (nitric oxide). The lack of nitric oxide causes constriction in the arteries throughout the body, which will in turn elevate the blood pressure. Exercise will also lead to more nitric oxide production, but the right diet is the other factor. There is a supplement you can buy, called NEO-40 (one or two per day can be taken as a supplement, available on Amazon in the US, in health food stores in Canada). But make no mistake: it’s not about supplements; it is about the proper diet and lifestyle!

14. Vitamin D3 deficiency: I have blogged about the importance of vitamin D3 before. Vitamin D3 is now considered to be a hormone, as all cells have receptors for this molecule. It has anti-inflammatory qualities. It helps in the prevention of heart attacks and strokes.

15. Low vitamin K2: In this blog I have explained that vitamin K2 and vitamin D3 co-operate in removing calcium from the blood and transporting it into the bone. This way they both help in the prevention of osteoporosis. A co-factor in the prevention of osteoporosis is estrogen in women and testosterone in men.

16. Low free testosterone: Low free testosterone has been established as an independent risk factor for heart attacks and strokes. In the man there are a lot of testosterone receptors located in the heart and in the brain; this explains why with a lack of testosterone there is not only erectile dysfunction, but also the risk of developing a heart attack or a stroke.

17. Excess estrogen: When a women approaches menopause, her menstrual cycles can become irregular due to the fact that there are anovulatory cycles, and the progesterone production is starting to slow down. This hormonal state is called estrogen dominance, because estrogen dominates over progesterone. In other words, the ratio of progesterone over estrogen is less than 200 to 1 (progesterone/estrogen ratio) when saliva hormone levels are measured. This is a risk factor for hardening of the arteries. In males with a “beer belly” there is too much estrogen floating around due to an enzyme in fatty tissue, called aromatase. This enzyme manufactures estrogen out of testosterone and contributes along with other factors to causing heart attacks in that scenario.

How can we protect ourselves from these factors?

As already indicated above, there are lifestyle issues that need to be addressed as follows.

  1. First adopt a healthy diet, such as the Mediterranean diet, which includes olive oil. No sugar, no bread, pasta, potatoes, and go extremely easy on certain fruit that is high in sugar, such as dried fruit, mango, bananas and grapes, because we do not want to oxidize our LDL cholesterol for reasons explained already.
  2. Exercise regularly. If you like, go to a gym (my wife and I do this regularly). If you are insecure, ask a trainer initially to guide you through the exercise equipment. It really is not that difficult to do. You develop a routine that is good for you. Alternatively, you may want to go for a brisk walk, run or participate in dancing. If you get easily bored, rotate the activities, but do not skip days, let alone weeks! Remember that your heart works 24/7!
  3. Take some vitamins and supplements: Vitamin B2, B6, B12 and methyl folate were mentioned before. Take vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2 200 micrograms per day. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control. For more on vitamins and supplements follow this link.
  1. Have your hormones checked. Some doctors do not feel comfortable about this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles.
Seventeen Causes Of Blood Vessel Disease

Seventeen Causes Of Blood Vessel Disease

Conclusion

All of these 17 factors explained above are independent risk factors for developing hardening of the arteries, which affect mainly the heart, brain and kidneys. All you need is one of these factors, and you could develop a heart attack, stroke or kidney failure. You have no problem accepting a preventative maintenance program for your car. Think of having appropriate tests at least once a year done through your doctor. There are blood tests available to monitor hormone and vitamin levels, as well as C-reactive protein and homocysteine levels. Here are also three tests that will assess your heart function.

Your doctor may not order the tests spontaneously. Ask for it!

More info about heart attack prevention: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/prevention-heart-attack/

More info about stroke prevention: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/stroke-prevention/

More on arteriosclerosis (blood vessel disease):http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

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Apr
04
2015

Stop Suffering From Arthritis

Arthritis is an illness of the joints, mostly in older people (osteoarthritis or degenerative arthritis). However, a subgroup of younger patients can also develop a severe form of arthritis, called rheumatoid arthritis where autoimmune antibodies play more of a role.

In the 1950’s Dan Dale Alexander wrote a book called “Arthritis and common sense”. The medical establishment did not accept that simple remedy and Dan Dale Alexander was classified as a “quack”. However, Dr. Mirkin describes a study from Berlin that later confirmed that Dan Dale Alexander’s observation was correct: an emulsion made by shaking orange juice with cod liver oil and taken three times per day on an empty stomach would indeed improve osteoarthritis.

In 1964, still being a medical student I suggested to my future mother-in-law to give Dan Dale Alexander’s book about arthritis a try. Despite the well-established osteoarthritic condition in her left knee the arthritis vanished within 6 months and stayed controlled. I could not explain to her why this remedy worked, as higher doses of omega-3 fatty acids and higher doses of vitamin C were not yet known to be of value for arthritis.

This all changed with the advent of orthomolecular medicine (Ref.1). On page 76 of this book Dr. Frederick Klenner describes that ascorbic acid (vitamin C) at mega doses of at least 10,000 mg daily, but better even between 15,000 and 25,000 mg daily does have healing effects for arthritis. He stated further that repair of collagenous tissue (the joint surfaces) would require adequate ascorbic acid. On page 240 of Ref.1 Dr. Abram Hoffer, the founder of modern orthomolecular medicine reviewed the history of the use of vitamins in higher doses, particularly the use of vitamin B3 (niacin). He also mentioned that Dr. William Kaufman had used mega doses of vitamin B3 for arthritis as far back as 1950.

Overview of arthritis

Dr. Hoffer explains in Ref.2 that arthritis belongs into a group of diseases that are related to faulty nutrition, which in turn lead to vitamin and mineral deficiencies and a pandeficiency disease. Other diseases that belong to that group are cardiovascular disease, multiple sclerosis, cancer, diabetes, schizophrenia, mood disorders, alcoholism and autism. Contributing factors can be poor diets with overemphasis on refined and processed foods and consumption of sugar, allergies, diseases of the gastrointestinal tract and viral infections. Arthritis belongs into this group of illnesses as well. Niacin, vitamin B6 and zinc have been found useful to treat arthritis, but other vitamins and minerals are also needed. Here is a list of what Dr. Hoffer would suggest to use (Ref. 2):

1. Vitamin B3 from 100 mg to several thousand mg three times daily following meals. With niacin there can be skin flushing, which often goes away after the body gets used to the higher doses; but niacinamide could be used instead by those who are bothered by the flushing.

2. B complex: this contains each of the major B vitamins including vitamin B6 (pyridoxine). Take 100 mg once per day with a meal. Vitamin B6 may be needed up to 500 mg per day or more.

3. Vitamin C should be taken between 500 mg and several thousand mg three times per day after meals.

4. Vitamin D3: 4000 IU per day in the summer months. In the winter months particularly populations who live far north require 6000 IU per day.

5. Vitamin B1 (thiamine): alcoholics and very high sugar consumers need thiamine at 100 to 500 mg three times per day.

6. Folic acid at mega doses (prescription needed) works as an antidepressant, which requires 25 to 50 mg. To lower homocysteine levels lower doses of folic acid are sufficient.

7. Vitamin E: usually 400 IU to 800 daily. Muscle wasting diseases, Huntington’s disease and amyotrophic lateral sclerosis (ALS) require much higher doses up to 4000 IU per day.

8. Essential fatty acids (omega-3): It is strongly recommended to use a molecularly distilled product, which is free of mercury and PBC’s at 1000 mg three times daily following meals.

9. Selenium: The required dosage is 200 to 600 micrograms once daily (with any meal). In areas where selenium is deficient, this is particularly important.

10. Zinc: 50 mg of zinc citrate or 220 mg of zinc sulfate once per day with a meal.

11. Calcium and magnesium: Dr. Hoffer suggests 1000 mg of calcium with 500 mg of magnesium, although many experts now say that 1000 mg of calcium with 1000 mg of magnesium may be better.

Dr. Hoffer pointed out that this program is compatible with any medication and is non-toxic.

Thoughts on treating arthritis

 1. Conventional methods

The conventional approach to treatment of arthritis consists of anti-inflammatory medications like ANSAIDs. Unfortunately they have side effects like causing kidney damage after several years of use. Also, NSAIDs can lead to gastric bleeding from gastric erosions, which may require blood transfusions. Physiotherapy with reactivation and swimming have been found to be useful. Electro acupuncture can help for pain control.

2. Diet changes, multivitamins and minerals

As arthritis is found mostly in civilized nations, dietary factors have long been suspected to be of importance. Dr. Hoffer pointed out that arthritis is a pandeficiency disease meaning that overconsumption of sugar and processed foods has lead to multiple vitamin and mineral deficits that interfere with the cartilage metabolism leading to premature breakdown of cartilage and causing inflammation. It is not good enough to just take the supplements listed above; this needs to be combined with a fundamental change in diet. Cut out sugar and starchy foods. Return to homemade foods. Keep it simple with lots of vegetables, salads and organic meats. Now that you are starting to turn around your metabolism by a sensible diet the supplements listed above have a chance to work.

You will notice that Dan Dale Alexander’s idea of omega-3 fatty acids and vitamin C (from the freshly pressed orange juice) is contained in the list of supplements above. Dr. Klenner’s mega doses of vitamin C are also listed and Dr. Kaufman’s mega doses of vitamin B3 is contained in this list as well.

This list may not have been formally researched with controlled clinical trials, because the food industry and the makers of NSAIDs (Big Pharma) have no interest in this. But thousands of patients have been empirically treated with this regimen and a network of orthomolecular physicians has established that this regimen works to control the inflammation of arthritis and at the same time has no toxic side-effects.

 3.Laser, platelet rich plasma (PRP) and stem cells

Blue and green lasers have anti-inflammatory properties and are suitable for interstitial and intra articular laser treatments of arthritis. Dr. Weber has extensive experience with this treatment modality in Germany. I have discussed this in another blog.

However, prolotherapy, PRP and stem cell treatments are also an option for more severe cases of arthritis, particularly in arthritis of the knees, which can avoid total knee replacement surgery.

Stop Suffering From Arthritis

Stop Suffering From Arthritis

Conclusion

I met Dr. Hoffer in the early 1980’s during a meeting in Vancouver, BC when he wanted to establish a local orthomolecular division for British Columbia. Although I found the ideas fascinating, I felt that the College of Physicians and Surgeons (the regulatory body for physicians in BC) would scrutinize the practice of any orthomolecular member. At that time I would risk losing my license to practice medicine, which I just had received in 1978. So I decided not to join. Interestingly enough later in the 1980’s a member of the orthomolecular society of BC lost his license because of the use of mega doses of intravenous vitamin C. At this time the College considered these infusions useless or hazardous. Nowadays, any naturopathic and orthomolecular physician uses these intravenous vitamin C treatments as standard therapies. It shows how times have changed.

What has not changed is the food industry that undermines our health every day with hidden sugar contained in processed foods. In social functions it is customary to have a drink or two, if not more, which uses up our thiamine faster than we can replace it. Pandeficiency disease is alive and well as it was many years ago. It is in front of our eyes, but can we see it? Depending on what your eating habits are, do you need to make changes in your diet and perhaps take some or all of the ingredients of the multivitamin and mineral list above? Start by adopting a Mediterranean type diet, then add some of the supplements listed above. It is time to take a thorough look at natural treatment modalities against arthritis in the interest of preserving your health!

References:

Ref. 1: Andrew W. Saul, Ph.D.: “The Orthomolecular Treatment of Chronic Disease. 65 Experts on Therapeutic and Preventative Nutrition”, Basic Health Publications, Laguna Beach, CA, 2014.

Ref. 2: Chapter in Ref. 1 by Dr. Hoffer: “Pandeficiency Disease”, pages 24-30 (2014).

Apr
12
2014

Lead Still Poisoning Us

We are living in an environment that puts emphasis on quality control, and companies around us take pride in their high quality products, supervised by the FDA. This is how it ideally should be. But is it really? Unfortunately not!

I read the headlines about lipsticks on April 4, 2014 and could not believe it!

When it comes to skin care or cosmetic products, things start to get scary.  Skin is not a barrier, but it is an organ of our body. From skin cream and ointment applications in medicine it is known that pharmaceutical compounds can be applied to the skin, and this way the body can readily absorb active substances.

When it comes to cosmetics, the skin areas to which cosmetics are applied have softer skin, for example the mouth. The vulnerable skin of the lips can readily absorb any chemical substance, and this is where health concerns get even more serious.

In 2010 as the above link shows the FDA determined that all of the “400 lipsticks tested had traces of lead in them, ranging from 0.9 to 3.06 ppm. Another study from California noted that there were other toxic metals in lip sticks and lip glosses containing chromium, cadmium, manganese, aluminum in addition to lead. Even to the unconcerned this sounds like a precarious cocktail of noxious substances! On June 1, 2013 I wrote a blog about toxins in the bathroom. I mentioned the dirty dozen of chemicals that repeatedly are found in cosmetics. With this new information of traces of lead still being in cosmetics, more so than previously reported, women need to be more careful about the choice of lipsticks that they are using.

1.History of lipsticks:

This overview explains that the long-lasting lipstick was only invented around the 1950’s (“Sticks on you, not on him” was the slogan).

Traces of lead were often recorded, but not really thought to be that dangerous. The thinking of the FDA at that time was that children needed to be protected from lead in house paints, but nobody mentioned that lead was part of the red pigment and therefore had to be part of a lipstick. The FDA did know this, but the concentration was supposed to be so small and absorption was thought to be negligible, so considered to be safe for an adult.

Lead Still Poisoning Us

Lead Still Poisoning Us

2. Evidence of considerable absorption of lead:

We know from several studies summarized in this link that various components of cosmetics including lipsticks and lip-glosses get absorbed through the skin. Lead is no exception to this. A 2011 study showed in children in Africa that lead-containing cosmetics for tribal ceremonies in children had higher lead concentrations in their blood than children who did not use these cosmetics.

When doing a PubMed review on the subject I came across a very interesting study: In India there is a practice that parents apply kajal (also called kohl or surma cosmetic) around their eyes, on old traditional practice. Unfortunately this is a lead-containing cosmetic, which is absorbed into the blood and can cause lead poisoning. According to this ancient belief this application of cosmetics around the eyes would keep their eyes cool and clean and is supposed to improve vision, strengthen the eyes and prevent eye diseases. None of these belief are compatible with Western medicine (although a lot of the Ayurveda medicine is valid).

In another 2010 study done in the mountainous Aseer region in the Southwest of Saudi Arabia here there is pristine air quality, 176 pregnant patients with a single baby were followed to see whether there was an effect with regard to lead poisoning in the offspring. Two groups of women were identified, those with lead levels of more than 200 mcg/L in the blood and another group with less than 200 mcg/L. The researchers noted that there was no difference with regard to prematurity, size of the baby or premature rupture of membranes (premature birth).

The conclusion of this study was that there was significant absorption of lead from 100% lead sulfide eye cosmetic “kohl” only on those who used it. To my surprise nobody mentioned anything about the lead levels in the children, which is an example of compartmentalization of science. Common sense would dictate that these children who were at higher risk from mothers with over 200 mcg/L should have received chelation treatments to remove lead (we do this in Western medicine!).

3. Different lip sticks and lip glosses analyzed in Europe and in the US:

A European study showed that 31% of lipsticks and 4% of lip glosses tested positive for lead. All of them had less than 0.88 mg/kg of lead (less than 1 mg/kg). Pink lipstick or lip gloss (0.81 and 0.38mg/kg) tested lower than purple lipstick or lip gloss (0.88 and 0.37mg/kg) and red (0.58 and 0.25mg/kg), but purple tested the highest! I did not know that until now when I researched this.  On average the tests show that the gloss has half the concentration of the lipstick.

Don’t be fooled by the difference in recommended safe levels in Canada (10 mg/kg) and Germany (20 mg/kg). Germany has a very powerful chemical industry with lobbyists that likely lead to this higher “safe” level. In Canada it is the Health Products and Food Branch of Health Canada. No country got it right so far:  A zero tolerance (meaning a blood level of 0 mg/kg in babies and adults alike) is the only solution for humans. A little bit over a long time can lead to chronic chronic lead poisoning.

One other interesting tidbit for those who need to apply something to their lips:

The more expensive lipsticks had much less lead in it than the cheaper varieties (don’t buy the dollar store brands).

Contrast this to an FDA initiated study between 2009 and 2012, published in 2012 that showed that the average lipstick concentration in 400 lipsticks tested  was 1.11 mg/kg, but the highest concentration was 7.19 mg/kg and 13 of them tested 3.06 mg/kg. Here is another review that shows more details (ppm equals mg/kg, so you can compare directly with the figures above. As stated before, in my opinion and that of toxicologists around the world who are the real experts in this a “0 mg/kg” level (no lead in the body) should be the acceptable norm!

Only organic lipsticks and lip-glosses are recommended, if you must wear any of such products. Here is a helpful blog that tells you more positive news (lead and chemical free products).

4. What are the effects of chronic low lead exposure?

Adult lead toxicity is not as common as in the past. Painters in the decades leading up to the 1970’s when laws became more stringent were the ones mostly affected (Ref.1). Keep in mind that more than 30 million tons of lead was released into the air in the US before the lead ban finally remedied this in the 1970’s.  This phasing out was completed in 1995. The mean blood lead levels of Americans declined by 35% since. The EPA is monitoring lead levels in public water systems.

Lead is a nerve poison. It leads to fatigue, insomnia, irritability, lethargy, headaches, difficulty concentrating, memory loss, and tremor. It can also affect the nerves of the extremities, more so in the arms than the legs, which was significant in the past century among painters using lead paints. (“Upper extremity paresis” found in painters). Chronic lead poisoning targets the kidneys and the bone marrow. In the kidneys leakage of the filtration units, called glomeruli, leads to loss of microglobulins that can be measured in the urine among other tests. Above a level of 30 mcg/dL (this is the same as above 300 mcg/L) electrophysiological studies reveal often the ulnar nerve conduction is disturbed, which is the cause for the arm weakness in painters. The bone marrow toxicity can be seen in stippling of red blood cells and anemia develops subsequently. High blood pressure and fertility issues are also common (low sperm count in men, higher rate of spontaneous abortions and stillbirths in women). The gums around the teeth show lead lines (blue discoloration).  I will not get into lead toxicity in children, as this is a big topic of its own. Needless to say symptoms are much worse as any pediatrician can tell you. It goes without saying that should you notice any of these symptoms, see your doctor and have appropriate tests done.

5. Treatment and prevention:

As we do not see acute lead poisoning as much as in the past, except sadly to say still in development countries and highly industrialized areas with lead emissions into the air, I like to emphasize the importance of prevention here.

a)    If you absolutely must have make-up and/or lip sticks or lip gloss, at least go for the expensive, organic products. You owe it to yourself. However, having said that keep in mind that anything you put on your skin anywhere is absorbed to a certain percentage. So, why mess with your body’s metabolism? I really question this. For your skin you can use a product called “Youth serum” from LifeExtension, where only a few drops will suffice to cover your face and neck with a thin film. Within a few seconds this is absorbed into the skin and it will stimulate your skin to grow where wrinkles are, so the wrinkles flatten out in time.

b)    Keep in mind that skin appearance is hormone dependent, males need testosterone as they age and women need bioidentical progesterone. The first link under point 2 above claims that progesterone would be cancer producing. This is not true: it is progestin, a synthetic copy of progesterone that does this. So, bioidentical progesterone in cosmetics would be cancer preventing in women (men should stay away from a woman who has applied this for at least two hours as skin transfer will block testosterone production). Worse still: if a manufacturer uses progestin (the synthetic version), the traces of it over a long period of time will act like xenoestrogens, which can cause breast cancer in the woman who uses such a product and through transfer can cause prostate cancer in a man.

c)    If you insist on using chemicals on your skin, you may want to consider seeing a naturopathic physician who does intravenous chelation. Lab tests are available to assess the levels of heavy metals and toxins in your body. If the levels are creeping up, chelation treatments from time to time may be needed in people with measured elevations of lead levels in blood tests and/or urinary lead level elevations.  Discuss this with your doctor.  Removal of any accumulated mercury, lead, and cadmium or other heavy metals will be an option. I have summarized detoxification methods elsewhere.

Conclusion:

In conclusion, I think that it has to be carefully considered, how much use of lipstick application is necessary. Next the choice of a high quality product is of utmost importance. Taking all the factors together, its constant use cannot be recommended, especially since there is not only lead present, which is a known health hazard. Beside lead there are many other chemicals that get absorbed and their effects have not been adequately tested by the agencies.

More information on vitamins and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References:

1. Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. Chapter 73, “Lead” by Michael W. Shannon, MD, MPH © 2007, Saunders

Last edited Nov. 7, 2014

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Mar
08
2014

Protecting Yourself From Environmental Toxins

Environmental toxins are toxins that may be in your drinking water, in what you eat, in the air you breathe, or they enter your body through your skin when you swim in contaminated water or walk on a sandy, wet beach.

In the following blog I will address some of these issues and how we can defend ourselves against toxins.

The youngest and most vulnerable

Toxins are particularly bad for infants and premature babies.

The reasons for this are the following ones: their kidney function (tubular secretion) is only 20% to 30% of that of an adult; the cytochrome P-450 enzyme system in the liver, one of the toxin eliminators is slowed down to only 25% to 50% of the adult activity and glucuronidation in the liver, another detoxification process, reaches adult levels only at the age of 3 years. The kidneys and the liver are limiting the removal of toxins by way of urine and bile in the newborn. Stomach acidity in a premature has a pH of 4.7, in a full-term newborn 2.3–3.6 and in an adult 1.4–2.0. This is important to note as a lack of stomach acid increases susceptibility of newborns and infants to gastrointestinal infections and cause diarrhea. Percutaneous absorption in newborns is much higher than in adults, which makes them very susceptible to absorbing toxins through the skin (Ref.1).

Diabetes from environmental toxins

Environmental toxins can cause insulin resistance and type 2 diabetes.

Bisphenol A (BPA) is used to make polycarbonate and epoxy resins and is found primarily in food and beverage containers. The world population has been exposed to this since 1957 and as a result 90% of US residents have detectable levels of BPA in their urine. Ref.2 explains that the higher the urine concentration of BPA, the higher the risk is for developing diabetes.

Persistent organic pollutants are another source of concern: pesticides and herbicides, dioxins, polychlorinated biphenyls, hexachlorobenzene, and hexachlorocyclohexane have all been found in humans. Several investigators have shown that virtually all of the risk in obese patients to develop diabetes comes from the fat-soluble persistent organic pollutants (Ref.2).

Inorganic arsenic is another pollutant that is found in soil and rock naturally and finds its way into the drinking water. About 8% of the public water system of the US exceeds 10 mcg/L for drinking water, which has been set as the safe limit for drinking water by the US Environmental Protection Agency’s standard. Anything above those levels is considered toxic.Ref.2 describes that people who ingest inorganic arsenic will excrete it in the urine; the highest group with arsenic in their urine had a risk of 3.58-fold to develop diabetes when compared to the lowest group. Curiously enough organic arsenic that is found in fish and shellfish is excreted in the urine unchanged and does not cause diabetes. Overall this indicates to me that nobody should consume or cook with contaminated water that contains inorganic arsenic. Reverse osmosis filters will protect you from this risk.

Protecting Yourself From Environmental Toxins

Protecting Yourself From Environmental Toxins

Other toxins around the house

Volatile organic compounds are often contained in carpets, but also in laser and inkjet printers. They are part of everyone’s life as this link shows. Varied symptoms like irritation of eyes, nose or throat, breathing problems, headaches, loss of coordination, damage to the liver, kidneys and the brain have been reported after exposure to volatile organic compounds. Long-term exposure can even cause cancer in animals and has been suspected to cause cancer in humans as well.

Air fresheners and cleaning solutions that contain ethylene-based glycol ethers and terpenes have been the subject of a study that examined concentrations in the air and interaction with ozone that can also be released by some cleaners. As this link shows the investigators concluded that with exposure to high enough concentrations and long enough exposures to these fumes lung cancer can be caused in cleaning personnel. They recommended to use cleaning solutions only in diluted form and to air out the premises well after cleaning. Another component of many air fresheners and cleaning chemicals is paradichlorobenzene, the same chemical that is contained in mothballs.

There have been problems with flame retardants: polybrominated diphenyl ethers, which are cancer producing; they have been outlawed in the US since 2004, but older mattresses, upholstery, television, computer casings and circuit boards may still contain them.

Lead and mercury poisoning, and radioactive pollutants

Manufacturers were not allowed to use lead in paints anymore since 1978. Paint from buildings older than that still may contain lead. There have been serious lead poisonings in children who were gnawing on items painted with lead containing paint. Lead causes problems with your central nervous system, brain, blood cells and kidneys. Just last year a news story about lead found in fashion jewelry surfaced warning about cheap fashion jewelry from China. Lead form these items can be absorbed through the skin and cause lead poisoning. Because of the apparent lack of regulations in China it is my recommendation not to buy anything that goes into your mouth or on your skin, if it has been grown or produced in China.

Mercury from tuna and other predator fish: It is sad that the oceans are polluted to the point where it has become unsafe to eat predator fish as there is an accumulation of mercury through the food chain.

How did things develop this way? Back 100 years and more ago gold panning and the purification process of gold caused mercury to enter into rivers and allow mercury to end up in the oceans where it has since accumulated; it just sits there as it has nowhere to go.

Coal burning (yes, there is mercury in coal) has also contributed to this by smoke being emitted from smoke stacks containing mercury vapors, which ended up returning to earth as polluted rain and drained through the river system into the oceans.

It is monomethylmercury that accumulates in the tissue of humans. It affects many organs, such as the brain, kidneys, lungs, and skin. It causes various symptoms like red cheeks, fingers, and toes; there can be bleeding from the mouth and ears; it can cause rapid heartbeats, high blood pressure, intense sweating, loss of hair, teeth, and nails. It also can cause blindness, loss of hearing, impaired memory, and lack of coordination, disturbed speech and birth defects. You may think all mercury comes from the outside. However, silver amalgam fillings in your teeth could also be the source of mercury poisoning. It is a good idea to replace amalgam/mercury fillings with ceramic fillings.

There are many forms of other marine pollution as this link shows.

One particular concerning aspect is pollution with radioactive materials as the Fukushima disaster in Japan has shown. Following the catastrophe on March 11, 2011 there have been several leaks of radioactive material into the ocean, which are described here. Dr. John Apsley II pointed out that with the explosions in Fukushima there were also several releases of radioactive pollution into the stratosphere. This pollution has subsequently traveled around the globe and has come down as radioactive rain. He has made it his ambition to help people minimize radiation exposure from nuclear accidents such as Fukushima.

Protecting yourself from toxins

Having said that pollution and toxins are problems that we are living with, how can we protect ourselves from all of that?

1. Avoid as many unsafe chemicals around you as you can. This includes checking ingredients in hair care and body care products, toothpaste, hair dyes, cosmetics, mouthwashes and underarm deodorants.  I have written a blog about toxins in the bathroom and what you should watch for.

2. I would recommend you switch from a standard food to organic food. It has become unsafe to eat non-organic meats, leafy vegetables, vegetables and fruit. There are too many residues of herbicides and pesticides contained also in meat, not only in vegetables and fruit. Washing will not remove these substances, even though some merchants may tell you otherwise. Buyer beware!

3. Detoxification methods are available and I have reviewed them in this blog. Briefly, to remove lead and mercury a formal intravenous chelation protocol should be followed.  Depending on how many heavy metal toxins you have on board, you may need only a few treatments or else up to 20. Here is a more conservative website stating that it would be safe to have silver amalgam fillings. I think that gold and ceramic fillings are much safer.

4. Genetically modified food is another danger as I have summarized in this blog. This is another reason why I like to stick to organic food. There is evidence that GMO food causes autoimmune diseases, infertility and chronic inflammation that can eventually lead to cancer. It may take decades to prove this, but I am not willing to be a human guinea pig.

5. I have mentioned in a prior blog that we live in a toxic world. You need to carefully look at your home and remove toxins. You need to assess your drinking water. A water analysis can tell you how good the water in your home is and whether there are concerns about inorganic arsenic. Usually places that sell filter systems can advise you in that regard. Your drinking water should either be bottled pure water or else reverse osmosis water that can be part of a filter system in your house.

6.Vitamins and supplements have been shown to support your cell integrity and have anti-inflammatory and antioxidant effects that protect you from toxins. I discussed this in detail in my NetHealthBook under nutrition. For instance vitamin D3 in doses of 5000 IU or more and CoQ-10 are powerful anti-inflammatories and CoQ-10 is also an antioxidant and preserves mitochondrial function. High fish oil supplements (3 to 6 Grams per day) have anti-inflammatory effects and protect your cell membrane integrity. With these overlapping qualities of vitamins and supplements your body will be in a much stronger position to defend itself against the negative effects of toxins. When you take multivitamins, this translates into telomere lengthening of 5.1% (or converted into a survival advantage of 9.8 years when it is accumulated over a life time). Ref. 4 explains this in more detail.

7. Exposure to radioactive substances is a scary thought, but this is becoming more and more a reality, at least for those who live close to disaster areas such as the Fukushima site in Japan or the Chernobyl site in the Ukraine. But according to Dr. Apsley II low dose radiation that we have already received in the US and in Canada following the Fukushima disaster is equally disastrous (Ref.3). Many of the vitamins and supplements I have mentioned are also cell and mitochondria protective and will help with DNA repair following radiation damage, but you must avoid sugar and other refined carbs and starches to reduce the oxidative effect on cells and on LDL cholesterol to prevent premature aging and cell death. Ref. 3 contains a lot more detail about this and explains what specific supplements can be taken to detoxify your system from specific radioactive elements that function as free radicals. There are specific antidotes for radioactive iodine-129 and iodine-131, radioactive cesium-137 and others.

Conclusion

Many people shrug their shoulders when they hear that pollution has an effect on their lives. They feel that they are powerless and cannot do anything about this. The truth is far from this! Above I mentioned seven points that you can follow to counter toxins. On top of that you can get politically active and urge your government representative to create a nuclear free zone in your area. Ref. 3 contains compelling evidence why this is so important not only for us now, but for future generations and the future of mankind. We need to hold those who provide us with food and beverages accountable for the quality of these. Shrugging it off is not good enough. Get involved. Buy organic food. Avoid the section in the grocery store where sugar and high carb foods are sold. It’s good for your own health, but it will collectively change the mentality of the grocery store owners who will notice that they are stuck with the comfort foods that sold well in the past. This new trend will result in cheaper prices for healthy foods and more availability of organic food.

References

1. Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. © 2007 Saunders. Chapter 18:“Toxicologic Issues in the Neonate”.

2. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Chapter 31: “Insulin Resistance and the Metabolic Syndrome”.

3. Dr. John W. Apsley II : “Fukushima Meltdown & Modern Radiation: Protecting Ourselves and Our Future Generations” © 2011. Temet Nosce Publications, Sammamish, WA 98075

4. Xu, Qun, Parks, C.G., DeRoo, L.A., Cawthon, R.M., Sandler, D.P. and Chen, H. Multivitamin use and telomere length in women. American Journal of Clinical Nutrition 89 (April 2009):1857-63. Full text (PDF): http://ajcn.nutrition.org/content/89/6/1857.full?sid=9aab0e13-b4d2-42ad-b44c-15cffc6771c3

Last edited March 8, 2014

Jan
04
2014

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

Every year in mid December Vegas hosts the world A4M conference (from the American Academy Of Anti-Aging Medicine). This year’s conference was at the Venetian/Palazzo Resort in Las Vegas, NV from December 13th to 15th, 2013.

There were more than 3,500 attendees who participated in this yearly continuing medical education event in preventive and integrative medicine. Over 50 speakers reviewed various anti-aging topics including aesthetic medicine and stem cell topics. In addition there was a huge exhibition with over 300 exhibiting companies of health related products and books.

I attended this conference to see what is new in anti-aging medicine, which is the focus of my interest since my retirement in 2010.

Here are some highlights the way I saw it. As the topics were varied, I simply present a potpourri of snippets, all of which have some usefulness.

1. Opening remarks by Dr. Ronald Klatz and Dr. Robert Goldman

Dr. Klatz pointed out that the A4M has been very active over the years in lobbying for making supplements more available to the public. In 1995 the A4M was defending melatonin as a harmless sleep aid and the FDA agreed to allow it to be freely sold in health food stores. In 1996 DHEA followed this trend. Because of pressure of the A4M on the FDA Co-Q10, an important cardio protective supplement became available in health food stores in 1998. In 1999 the A4M stated in a public statement that newer research has confirmed that insulin is involved in obesity and diabetes and is an important aging substance. Those who continue to have high fasting insulin levels, will age faster than the average population. But those who lose weight, and exercise will reduce fasting insulin and will no longer age prematurely. The reason for this is that inflammation is the cause of high blood pressure and of cardiovascular disease like heart attacks and strokes. Reduce or eliminate fasting insulin and you eliminate the risk for heart attacks and strokes. In 2004 the A4M announced that stem cells could be used as an important tool to treat various end stage diseases to allow people to live longer. Since then this has become a huge specialty area. There was also a separate pre-conference workshop on stem cells. In 2009 the A4M announced that vitamin D3 was effective beyond bone health. Every cell in the body contains vitamin D receptors. Originally the 400IU per day RDA dose was established to fight rickets. Now it is recognized that 4000 or 5000 IU of vitamin D3 are required every day for a multitude of normal body functions. People with the poorest lifestyles have the shortest life expectancy, 66.5 years in Native Americans of South Dakota; in contrast the longest life expectancy in the US is found in Asian American women in New Jersey with 91.8 years. It just so happens that in New Jersey most of the 26,000 A4M physicians are practicing, which may be one of the reasons for the impressive longevity figures.  Dr. Katz suggested that we should recommend the following website to people: http://www.worldhealth.net/  This is the official medical news website of the A4M and deals with the latest health recommendations.

Dr. Goldman added to this that the anti-aging industry is growing rapidly (0$ in 1991; 250 billion $ in 2012; an estimated 345 billion $ in 2018).

He also emphasized that anti-aging can only be achieved, if blood tests are done early to detect any hormone or chemical abnormalities in the beginning stages before permanent organ damage sets in. Only with early detection can effective anti-aging treatments be initiated. Prevention is always better than waiting for an emergency to occur and then wanting to fix it, as it is commonly done in the conventional medical system.

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

Impressions From The 21st Annual World Congress On Anti-Aging Medicine (A4M) In Las Vegas

2. Hypertension diagnosis and treatment

Dr. Mark Houston (Nashville, TN) talked about new and revolutionary concepts in treating and diagnosing hypertension (high blood pressure). Endothelial and vascular muscle dysfunction are now in the center of the researchers’ attention. The reason for blood pressure to get elevated is from a combination of inflammation, oxidative stress and autoimmune dysfunction of the vascular system. Decades before the blood pressure shoots up, there are vascular and heart abnormalities. 24 hour ambulatory blood pressure monitoring (24hour ABM) is the most reliable test for assessing blood pressure.

Among other things a micronutrient test was suggested as this way a lack of magnesium could be detected. Too little magnesium in the blood has to be treated with magnesium citrate supplements.

In terms of treatment it was interesting to note that diuretics and beta-blockers are no longer recommended, because of serious side effects. Instead of these medications the treatment of choice now are calcium channel blockers (Diltiazem etc.) and angiotensin II receptor blockers (Losartan etc.):

3.  Testosterone therapy in men

This was the topic of Dr. Abraham Morgentaler, a professor of urology at Harvard Medical School. He asked whether it is a panacea, a scourge or the next big thing in medicine. He went through various literature citations that showed that there is no relationship between testosterone or DHT (de-hydro-testosterone) and prostate cancer. In a New England Journal of Medicine publication Dr. Morgentaler has shown by doing extensive prostate biopsies on men with or without prostate cancer that testosterone treatment did not cause prostate cancer or make prostate cancer worse. He found that testosterone treatment invariably made men feel better, and they had more energy using testosterone. They also lived longer. He also debunked a recent JAMA publication from November 2013 that stated testosterone replacement would have led to increased heart attacks. He explained that he called the editor after calculating the raw data and coming to the conclusion that the authors had miscalculated and misrepresented the data, as the risks of heart attacks in men using testosterone were actually half of what the controls without testosterone replacement showed. However, the editor elected to keep the false data in the publication, which has caused confusion with the public and with the medical profession. Here is another rebuttal by Dr. Trutt who came to the same conclusion. Fact is and this is in agreement with many other medical publications in the US, Europe and around the world that testosterone replacement (with bioidentical testosterone) in a testosterone deficient man will cut the risk for heart attacks and strokes into half of what it would be if he did not replace with testosterone. However, only bioidentical testosterone will show this heart and brain saving effect, as there is a key/lock mechanism between bioidentical testosterone and the testosterone receptors of heart and brain cells and the testosterone receptors in the arterial walls.

4. Keynote speaker

Suzanne Somers was the keynote speaker on the first day of the conference in a talk entitled “Our time has come”. Her books have greatly contributed to the popularity of the anti-aging movement in North America and around the world. She described how important it was for her to take charge of the health care in her own case and to explore alternatives to treat her breast cancer in the past. She allowed a lumpectomy, but she refused chemotherapy which conventional medicine wanted to force on her. Instead she changed her lifestyle completely as summarized in her books, particularly in “Breakthrough”. She also became one of the pioneers in the US to get the newly FDA approved mesenchymal stem cell/fat cell transplant done on the affected breast to restore the pre-surgical appearance. She made a plea to those who can afford it to bank their stem cells, which was later reiterated by Dr. Terry Grossman, MD whose lecture I did not review here. I noted this key sentence in Suzanne Somers’ speech towards the end: “I work prophylactically to take care of my health”. How often have I wished in the past that every one of my patients would have this attitude!

5. Hormone testing and nutrition

Jim LaValle, an adjunct professor in the College of Pharmacy, University of Cincinnati has more than 27 years of clinical experience in the field of natural therapeutics and functional medicine. He mentioned that many people are toxic from a leaky gut due to faulty nutrition, which in turn will lead to heart disease and kidney disease. Once a patient has heart failure, a leaky gut will make the heart failure worse. Leaky gut leads to multiple autoantibodies, which causes various autoimmune diseases. Another area he concentrated on in his talk is the fact that neuroplasticity in the brain can restore people’s brain after brain injuries or when autoimmune diseases have attacked the brain. Through lifestyle changes stem cells in the support tissue of the brain, called glia cells, can develop into neural progenitor cells, immature newborn granulocyte cells and eventually into mature nerve cells. In other words the same sequence that occurs in the embryo with brain maturation can also occur in adults. Researchers are only learning now how to approach this difficult subject. He pointed out that there has to be a balance between the gut, the brain and the immune system. As the gut is also an immune organ (Peyer’s patches) where Th1, Th2 and Th17 lymphocytes are produced, it is important to manage your gut through probiotics and through intake of organic foods to get away from anything that disbalances the gut/immune system/brain interaction. At the end he briefly touched on two important facts: zinc is a trace element that is important for prevention of a leaky gut as it keeps the cell bridges of the lining of the gut intact. However, when zinc levels are done on patients in the hospital setting, he found that patients are often deficient for zinc, but they are responding very rapidly to zinc supplementation. Stress, which causes high cortisol levels leads to lowered endurance, autoantibodies and allergies. By checking other hormones, which need to be in balance with cortisol the caregiver can recognize what is wrong with a patient and help restore the hormone balance with bioidentical hormones. This will also take care of the leaky gut, the autoimmune diseases and improve asthma in a person who has allergies.

6. Aging and the short telomere connection

William Andrews, PhD has worked in the biotech industry for 28 years and had obtained his Ph.D. in Molecular and Population Genetics at the University of Georgia in 1981. In the last 15 years he has focused on finding ways to extend the human lifespan by interfering with telomere shortening in human cells. He shared some interesting facts with the audience: reproductive cells do not age and their telomeres stay long. He said that in order to age gracefully it helps to know the length of your body’s telomeres. He recommended using the HT Q-Fish telomere test, which is a genetic test that gives an average of the telomere status of your body. This test will determine the %-age of short telomeres in the body, which is what is most informative about your biological age and your average life expectancy. There are several methods that are useful to know, which lengthen your telomeres: exercise, omega-3 fatty acid supplements, vitamin D3 in higher doses and not smoking are all known to lengthen your telomeres. Astragalus, a Chinese herb and extracts (expensive!) derived from this plant have also been shown to increase the length of telomeres. Other factors that help to preserve the length of your telomeres are reducing stress (yoga, meditation, enjoyable music), weight loss through a ketogenic diet, reduction of depression (rebalancing brain hormones), reducing pessimism, and being happy. Did you know that lobsters are blessed with ubiquitous telomerase expression? As a result they turn over 100 years. Humans are not so lucky, but we have access to simple steps that are protecting our telomeres! Dr. Andrews’ company has searched for telomere elongating substances. Through testing of 39 families of chemicals that are stimulating telomerase to elongate telomeres, he found a few that work. However, the main first step should be to concentrate on restoring the diet of our distant ancestors that gave us our genetic make-up. He stated that the Western diet is the worst contributing factor for telomere shortening. The macro and micronutrient difference between our ancestral diet and the modern diets have caused diseases like high blood pressure, heart attacks, stokes, obesity, diabetes, insulin resistance, dementia and cancer. Our modern diets (particularly the high carb/low fat diets) have increased oxidative stress in our bodies from increased reactive oxygen. This reduces our antioxidant reserves. It leads to malfunctioning of the endothelial lining. Other contributory factors are the overfeeding with omega-6 fatty acids from processed foods and cooking oils(such as corn oil and soybean oil and others.). These food infractions lead to a relative lack of the key vitamins A, D, E and K2 that are important to maintain cell function.

7. Telomeres, Aging and Disease

This title was the talk by Dr. Mark Rosenberg, who has been involved with drug research since 1991. This lecture reinforced what Dr. Andrews has said. However, he added a few aspects that are important to mention: “aging promotes aging”; in an aging person there are more circulating free radicals that undermine your health. So it is important, particularly for an older person to take anti-oxidant supplements to stop free radicals from aging you even faster. Dr. Rosenberg has done a lot of research with cancer cells. He noted that the circulation in a cancer or in metastases from cancer is very poor, which is the reason why chemotherapy often does not reach the cancer cells. He also found in the literature and in his own clinical experience that patients with low LDL cholesterol have increased cancer susceptibility. He mentioned that this was a new paradigm. I have recently discussed this in detail in a previous blog. Briefly, LDL cholesterol is the transport form of cholesterol going from the liver to vital organs like the heart or brain. When LDL is oxidized by free radicals from eating too much sugar and starchy foods that are metabolized into sugar, cells are starved of nutrients and oxygen. This sets the stage for cancer cells to develop, which have a metabolic advantage of being able to produce energy by glycolysis rather than by the aerobic metabolic pathway. Smoking and alcohol consumption shorten telomeres and this makes the person more prone to developing cancer.  On the other hand telomerase treatments have been shown to NOT cause cancer, which was a false belief in the past. At this point it is lifestyle changes that are needed to reduce the using up (aging) of telomeres. Resveratrol, vitamin D3, and astragalus all seem to contribute to lengthening of telomeres. The next few years will likely bring more news about this.

Conclusion

I have only been able to give a few highlights of the 21st Anti-aging Congress in Las Vegas. Another highlight was an appearance of Travis Stork, MD from the ER-doctor show on television. He gave a very down-to-earth presentation making 4 points: 1) healthy living starts in the kitchen, 2) “I need you to start working out”, 3) Mind and body are connected (stress can ruin your health) and 4) Get enough sleep (40% do not get enough sleep), because all of your hormone glands are recovering overnight. He concluded by saying: “Make health your hobby!” Another happening later in the conference was the appearance of California’s 38th Governor, Arnold Schwarzenegger. He received the highest honor of the A4M, the 2013 INFINITI AWARD for his leadership role of funding and supporting stem cell research in California.

Each A4M conference seems to have something new to offer every year. There were many other things that I learnt, but in my mind the topics I summarized above stood out from the rest.

More information on:

1. the use of testosterone and other hormones in male menopause:  http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

2. high blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

3. telomere lengthening by vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/   In this review I am mentioning a large Chinese study that proved telomere  lengthening with vitamin C and E, but no other vitamins. Other vitamins are still needed as antioxidants to prevent cancer and hardening of arteries.

Last edited Nov. 7, 2014

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Nov
30
2013

Statins Can Hurt The Consumer

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins (see this recent news article) makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): http://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

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

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

May
05
2013

Get Rid Of Toxins Safely

You often hear that chelation could be done effectively using home remedies. Is that true?

The standard chelation detoxification

I like to mention in the beginning that the proven way to reduce heavy metals in the blood (typically mercury and lead) is by intravenous chelating agents such as EDTA. However, the lowering of calcium levels as a severe side effect limits the application of it. There are also blood-thinning side effects to consider. EDTA is a chemically synthesized compound, not a natural substance. Conversely, vitamin C and Glutathione are both antioxidant substances that the body knows; they are non-toxic and can be used more easily intravenously to remove heavy metals like lead and mercury with fewer side effects than EDTA. Although I think that EDTA has a place in the hands of those who are knowledgeable about the side effects, the vitamin C/Glutathione combination is probably a more physiological detoxification method as glutathione is synthesized by the liver to detoxify our bodies. Intravenous chelation is expensive, requires access to a vein and may not be a suitable way for many people to detoxify. There are natural ways to detox for those who cannot afford chelation or cannot chelate for other health reasons.  The major detoxification organs are: the liver, the kidneys, the gut, the lungs and the skin.

What about oral methods to detoxify?

Several methods of cleansing are fasting, the major cleanse or the raw food cleanse. I would not advise to do strict fasting without fluid intake as it takes fluid intake to be able to dissolve any released toxins into urine, feces, invisible fluid from exhaled air and nasal discharge. Next there is the “master cleanse” with lemon juice, maple syrup and cayenne pepper as indicated in the link above. Some people like trendy procedures that are written up in a magazine or in a self-help book. I do not like it, as it reminds me too much of a cookbook approach.

I feel differently about a raw food cleanse as I will explain. First, I like to point out that raw food is not easily digested as your gut absorbs only about 30 to 40% of the nutrients. The cell walls of the vegetables you use are the barrier towards absorption. This is much different, if you put the raw fruit and vegetables into a blender with a high power motor. (There are several brands like the BlendTec or the Vitamix.) The powerful blending process breaks up the cell walls and releases the content of the plant cells including their enzymes and nutrients, so that 80% of the nutrients are absorbed in your gut.

Get Rid Of Toxins Safely

Get Rid Of Toxins Safely

If you use organic ingredients (they do not contain toxins, artificial fertilizer residues etc.) you cannot go wrong! Use spinach, kale, banana, mango, greens, lemon juice, and for fat add some nuts like walnuts, Macadamia nuts, almonds (provided you are not allergic to them). With the help of a powerful blender all this will turn into a liquid drink that actually tastes OK. For protein supplementation I would also add some protein supplement like vegan protein from the health food store, whey protein or egg white protein (good to rotate these protein supplements). This mix is a complete nutritional program as it contains complex carbohydrates from fruit and vegetables, fat from nuts, protein from the protein supplement and fiber (from the whole vegetables and fruit). You will not get hunger pangs as with a fast or the master cleanse. Use the signs of your body as guidance. If you feel energized after 5 days, stop then and return to your normal food intake (zone type diet, a Mediterranean diet or South Beach diet as explained below). Some people have the will power to do 7 to 10 days of the liquid diet described. Good for them, at least they do not starve themselves as the calories and total nutrient content are there while they detoxify. What are the agents that lead to the detoxification process? It is the enzymes released from the fruit and vegetables, the lack of toxins as you only consume organic ingredients , the extra vitamin C from the food and the glutathione contributed from your liver that are working together.

Are there supplements that can help you to detoxify?

Chlorella powder, which you can buy in health food stores, is one of the few supplements that can detoxify your body from heavy metals. As Dr. Mercola describes that in Japan chlorella powder is one of the most popular supplements to detoxify. It is difficult to get a complete, non-biased picture about chlorella. I did an extensive research in MD Consult about the scientific evidence for detoxification by chlorella in humans. Unfortunately the search results came back only for experiments with mice and rats, but there were no human detox results. Perhaps the Wikipedia description about the history of algae and chlorella as a possible food supplement sheds some light on the difficulties getting real hard data on chlorella detoxification. In rats that were deliberately poisoned with cadmium (a heavy toxic metal) no convincing detoxification with chlorella could be detected when cadmium poisoning was stopped. However, the article goes on to say that chlorella did prevent absorption of cadmium from the intestines to a certain extent (in rats).

Liver detoxification and colonic detoxification

Dr. Max Gerson invented coffee enemas many years ago when he treated end stage cancer patients with natural methods. He found that when he detoxified them with raw juices, many cancer patients died from the toxic breakdown products of dying tumor cells. So he was in dire need of a procedure that would remove the toxic tumor substances efficiently.  This is when coffee enemas were used. As the link above describes, coffee given through the colon as an enema (we would perhaps call it “coffee colonics” today) stimulates the liver and the bile flow thus detoxifying the blood effectively of toxic materials. In addition the secretory capability of the large surface of the colon wall also helps the detoxification process. Juicing in combination with coffee enemas improved Dr. Gerson’s end stage cancer cure rates dramatically. Subsequently, Dr. Kelley developed his nutritional-metabolic therapy for end stage cancer patients where he added large amounts of pancreatic enzymes in addition to coffee enemas. Dr. Denis Burkitt is credited for recognizing the importance of fiber in the diet. He noticed that there was a striking difference between the colon cancer rates in England versus the rates in Africa. He analyzed food habits and came to the conclusion that back home there was not enough fiber consumed. A large study done by the Harvard Medical School showed that it was not so much the fiber that helped to prevent colon cancer. Further large scale studies were done and it was shown that a diet high in vegetables, fruits, and whole grains was what was responsible for a reduction in colon cancer rates. This type of diet will also help detoxify your system from carcinogenic substances in general and from other toxins as the soluble fiber inside the gut will attach to it and go down the toilet instead of being reabsorbed in the colon into your system causing cancer.

Skin detoxification

The skin is the largest body organ with a lot of skin surface where skin pores can help detoxify under the right circumstances. This can be achieved with infrared saunas, with exercise that leads to production of sweat and by soaking in Epsom salt baths. Traditionally this has been done for centuries in the European spas, originally described by Sebastian Kneipp. The medical establishment in Europe (France, England, Germany, Austria), unlike American physicians, embraced the concept of natural therapies under the term “balneology”, at least for a number of decades. But  overuse by patients (abusing the system), badmouthing the relatively weak effect of detoxifying by Big Pharma and lack of funds from the health insurance companies put a damper on his movement. Part of this approach was the use of skin detoxification with healing baths (using Epsom salt and other salts) and physical exercise to the point of sweating. In addition “Waechselbaeder” according to Sebastian Kneipp (alternating hot and cold baths) were also used to stimulate the circulation and the immune system. The major component of Epsom salt is magnesium sulfate, which can be absorbed through the skin to a certain degree. So, some of the healing effect of Epsom salt baths may have come from an indirect balancing of low blood magnesium and the normalization of many metabolic processes that require magnesium as co-factors. Here is another, more vernacular description of Epsom salt use. Some of the assumptions such as improvement of diabetes, improvement of digestive absorption or relief from migraine headaches may be a combination of exaggeration and placebo effect rather than reality.

Kidney detoxification

The kidneys along with the liver are the major, natural detoxification organs of the body. However, they need enough fluids to dissolve water-soluble toxins and eliminate them from the body through the urine. Clean water should be consumed intermittently during the day (reverse osmosis water in glass bottles or BPA free bottled water). Because alcohol is a cell poison damaging the vital organs like the brain, heart, liver and kidneys it is best to minimize any alcohol intake to the absolute minimum (best to avoid alcohol altogether). The main filtration devices in the kidneys are the glomeruli, little packages of convoluted capillaries, which filter the blood several times per day. High salt intake, too much sugar and too much starch interfere with normal function of the glomeruli. Insulin resistance as is the case with metabolic syndrome and diabetes (often associated with obesity) will damage the filtration devices of the kidneys and cause toxin accumulation. To prevent damage of the kidney capillaries you need a healthy, basic diet like the Zone diet, South Beach diet or the Mediterranean diet as mentioned in this link.

This will keep fat deposits out of your arteries and the capillaries of the glomeruli of your kidneys, so the filtration process continues to work until a ripe old age. Your doctor can order tests (creatinine clearance) to assess whether the filtration capacity of your kidneys is normal.

Many toxins are fat-soluble and are stored in the fatty tissues. When you lose weight, you will need to drink more fluids to get rid of the water-soluble toxins through the kidneys and use coffee enemas to rid yourself of fat-soluble toxins (through bile and bowel movements).

There are a lot of websites that want to sell you herbs that should cleanse your system. They have a marginal effect, but I would stress that you want to adopt one of the diets mentioned above first to start with a healthy baseline. Such herbs as Buchu (Agathosma Betulina), Burdock, Echinacea and Yellow Dock Root (Rumex Crispus) are supposed to help the kidneys to detoxify. I am not certain whether there is medical proof for this.

Conclusion

Detoxification starts with adopting healthy food and lifestyle habits first. A low carb, low fat type diet as indicated (zone diet, a Mediterranean diet or South Beach diet) will be the footing from which the other detoxification methods will work. Some of the toxins will leave you when you work out and sweat. More will leave you when you enjoy an Epsom salt bath. This will give you some extra magnesium, which in turn will help to detoxify your system through several biochemical reactions where magnesium is a co-factor. Colonics or enemas will help remove toxins through your colon and they are more effective when coffee enemas are used (stimulation of your liver through the splanchnic nerves).

Infrared saunas can help to mobilize toxins and detoxify them through your skin. Take ample amounts of fluids as this will help remove some toxins through the kidneys and the urinary system. If major heavy metal poisoning were detected, the traditional intravenous chelation treatments described at the beginning of this blog would be more recommendable. A naturopathic physician or A4M physician (anti-aging physician) could advice you what is best in your case. Overall the thought is that by removing toxins the mitochondria in our cells, particularly in the brain, heart, liver, and kidneys can work more effectively giving you more energy and preventing the major diseases like cancer, cardiovascular disease (heart attacks and strokes), diabetes, arthritis and loss of cognitive function (Alzheimer’s disease and dementia).

More information about:

1. Chelation therapy: http://www.askdrray.com/tact-study-proves-effectiveness-of-chelation/

2. Vitamins, minerals and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

Last edited Nov. 7, 2014

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Apr
21
2013

World Health Day 2013, Focus on Hypertension

In the US high blood pressure causes 348,000 American deaths per year, in the world its death toll amounted to 9.4 million every year. This is unfortunate as high blood pressure is an illness, which can both be effectively treated and prevented. Uncontrolled high blood pressure (hypertension) causes heart attacks and strokes, can cause kidney failure, heart failure and blindness. You control blood pressure with lifestyle changes and/or medication,  and these risks go away.

The age standardized death rate  (Ref. 1) for both sexes in the US for heart disease is 80.5 per 100,000 and for strokes 25.4. In Canada these rates are 66.2 and 22.9; in Germany 75.0 and 31.2; in Italy 51.7 and 34.9, in Japan 31.2 and 36.7. The death rates from cardiovascular disease per 100,000 people in the same countries is as follows: in the US 172.2, in Canada 130.7, in Germany 200.2, in Italy 153.5 and in Japan 107.1.

There are obviously significant differences in these countries, which I will discuss further below.

On the occasion of the World Health Day, which was celebrated on 7 April 2013 to commemorate the founding of the WHO in 1948, with the topic of high blood pressure the World Health Organization has edited a PDF publication of 155 pages entitled “Global Atlas on cardiovascular disease prevention and control” (Ref.1, be patient, loads slowly). In it prevention and treatment for high blood pressure are discussed in detail. This text points out that there has been a remarkable decline in death rates from heart attacks and strokes (collectively called “cardiovascular disease”) between 1981 and 2000 in the United Kingdom. A thorough analysis of this showed that 58% of this decline was due to risk factor reduction in the whole population (reduction of smoking and heavy alcohol consumption, reduced salt intake, combatting physical inactivity and reduction of saturated fat intake). The other 42% of the decline in cardiovascular disease is due to treatment by a physician. So, it is clear from this that the majority of mortality prevention comes from the patient, less than 50% comes from the treating physician. However, it is important that physicians will educate their patients to cut out risk factors themselves in order to prevent hypertension.

World Health Day 2013, Focus on Hypertension

World Health Day 2013, Focus on Hypertension

Risk Factors for High Blood Pressure

In the past it was thought that most cases of high blood pressure would be due to “essential hypertension”, a term saying “we don’t know what causes high blood pressure”. Many physicians still use this term. Only a small amount of cases were considered “secondary” hypertension where the causes were known (e.g. kidney disease, hormonal imbalance, pregnancy). But in the meantime research by Harvard University and other research institutions has shown that there are a number of specific causes that contribute to high blood pressure, either alone or in combination.

Here are the commonly known causes: too much salt in our diet; we tend to not eat enough vegetables and salads; we like to sit in cars, in front of the TV or in front of the computer (physical inactivity). Many people still smoke, although tobacco is known to cause high blood pressure and lung cancer. Too much alcohol is known to cause hypertension as well. So the following steps will prevent high blood pressure :

  1. consuming less salt
  2. eating a balanced diet (preferably the DASH diet)
  3. engaging in regular physical activity
  4. avoiding tobacco use
  5. avoiding harmful use of alcohol (more than 2 oz. or 60 Grams per day)

Diabetes is known to worsen the risk for heart attacks and strokes and increases the risk of high blood pressure as well. So, some hidden risk factors for high blood pressure related to diabetes are as follows: a high fasting blood sugar; obesity; food with too much fat, too much sugar and too many starches (not enough complex carbohydrates).

What Can Be Done To Reduce Death Rates From High Blood Pressure?

As Canada is one of the countries where the death rate from strokes and heart attacks is lower than in the US or Germany, I like to point out some of the reasons for this. I practiced medicine in Canada for many years. The “Canadian Hypertension Education Program” have been guidelines for practicing physicians to follow providing effective screening and treatment of high blood pressure. Cardiologists at various continuing education conferences have promoted this. At my office I had a hypertension recall program where my staff called every patient with high blood pressure into the office every 3 months. We would review the home-measured blood pressure readings from the patient (recorded in a little booklet). I also took the blood pressure of the patient and so did my staff on the patient’s arrival. We reviewed the blood pressure medication and reviewed the possible side effects. The patient was also told what to do, if the blood pressure would be higher than normal (possible adjustments of the medication at home). I also encouraged my patients with regard to the life style issues (the 5 points mentioned above). Over the years the number of patients who developed heart attacks or strokes declined, as one would expect.

A recent review in the Canadian Family Physician mentions that there is room for improvement regarding the Canadian statistics. As mentioned above Italy and Japan are doing better with regard to mortality from heart attacks and strokes compared to Canada. We have a health care system in Canada that is available to every Canadian resident and funded by provincial taxes. In this system patients do not have to pay for office visits (although they pay for it indirectly through taxes). For the patient with high blood pressure it means that there is a system in place, which helps prevent cardiovascular disease and treats high blood pressure effectively. In my opinion the home recording of self-measured blood pressure readings at least once per day with a home blood measure monitor is vital to encourage the patient to be engaged with regard to his/her blood pressure problem.

Newer Findings About High Blood Pressure

For years physicians did not know where high blood pressure came from. In the last few years research has shown that nitric oxide plays an important role in preventing high blood pressure. It is produced by the lining of your arteries (by the so-called “endothelial cells”) and is the natural artery relaxer.

Foods that produce nitric oxide in the body are spinach, kale, red beet, cabbage varieties and other vegetable greens. These foods, which are also contained in the DASH diet, and regular exercise will stimulate the lining of your arteries to produce nitric oxide, which prevents high blood pressure, heart attacks and strokes. If all these measures and the above recommendations to prevent high blood pressure do not help, it is time to treat it. As already indicated above it is important that the patient who has been identified as needing high blood pressure treatment with medication, takes the medicine regularly (called ”compliance”). By keeping the blood pressure reading below 120/80 you prevent your risk of getting a heart attack, a stroke, heart failure or blindness from broken retinal vessels. If the patient develops any side effect from the medication, it is important to see the physician about this right away. It may be that the medication has to be adjusted or altered.

Nitric oxide can be taken as a supplement (Neo40), which allows the endothelial lining to be regenerated as indicated in this interview with the inventor, Dr. Nathan Bryan from the University of Texas Health Center in Houston.

The older we are, the more likely it is that our blood pressure will be high. As this link shows, 2 out of 3 people above the age of 60 in the US have systolic hypertension (the upper value of the blood pressure is elevated). As we age, it appears that the lining of the arteries do no longer produce the required amount of NO (nitric oxide) to prevent high blood pressure and prevent hardening of the arteries. So, it would be wise to adopt the Mediterranean diet with lots of vegetables, spinach, kale, bok choy, Swiss chard and others to boost your NO production, but still measure your blood pressure regularly. If you do not have a home blood pressure monitor, go to a pharmacy that allows you to check your blood pressure for free. If it is above 120 over 80 seek the advice of a health professional. You can find more information in Ref. 1.

In essence, what World Health Day 2013 asks us to do is to pay attention to your blood pressure and make sure it is normal.

More on high blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

References:

Ref. 1)  http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited Nov. 6, 2014

Feb
12
2013

Stem Cell Treatments That Are Currently Available

Stem cells got a bad reputation in the beginning, because it was thought that embryonic stem cells would be required to treat degenerative conditions. Immediately this raised an ethical flag, as embryonic stem cells would have been derived from a dying fetus. This created a lot of unnecessary division among the public and scientists. It turns out that for most treatments there are enough stem cells in the body, as I will explain below,  but initially this was not known.

The next bad rep came from Dolly, the sheep that was born on July 5, 1996. She only lived for 6 years, because the telomeres were short like that of an old animal and she died of a progressive lung disease. To create Dolly a complicated stem cell technique was used called “somatic cell nuclear transfer”. Three animals were required to achieve this. One animal provided an unfertilized egg cell from which the nucleus was extracted. From the second animal a breast gland cell was used to donate a cell nucleus and a third animal was used as a surrogate mother. After some cell divisions the blastocyst was transferred into the uterus of the surrogate mother who carried baby Dolly until birth.

Fast forward to 2013. We now know that stem cells are fragile cells that do not like too much manipulation. Stem cells have long telomeres so they are younger than the typical cells of the body. We know that stem cells can be found in the bone marrow, in fatty tissue and many other organs. In the last few years a lot of research has been done and this has already translated into practical applications. Originally stem cells were considered to be cells that could develop into any variety of body cell. At that time they were thought to only derive from the bone marrow or from fetal tissue. Scientists called these cells “pluripotent cells”. In the last years it was noted that turning off a gene called SP100 could also prompt a body cell to become such a versatile, pluripotent stem cell. They are called “induced pluripotent stem cells” to distinguish them from embryonic stem cells, which have been highly contentious with religious groups. In recent years matters have been simplified with the observation that mesenchymal stem cells are distributed freely throughout the body and can be harvested fairly easily from fatty tissue by liposuction. This latter technique is preferred, as it does not involve any manipulation of the stem cells themselves.

 

Stem Cell Treatments That Are Currently Available

Non-Surgical Space Lift, Before and After

Here are a few examples of what is being done now and what is expected to come:

Minimal invasive face-lift, called “space lift”

The fact that mesenchymal stem cells are freely available in fatty tissue has already been employed by plastic surgeons in the US and elsewhere for a minimal invasive plastic surgery called “space lift” where fat is removed by liposuction, the fat graft is separated with a cell separator into a fat cell fraction and into a mesenchymal stem cell rich fraction, which are injected together into various areas of the face where subcutaneous tissue is needed. The mesenchymal stem cells enable the fat cells that were transplanted to latch on to the small vessels in the transplanted area so that they survive permanently, and the result is a more youthful appearance of the face (see image). This is the secret of film stars in Hollywood. Nowadays the plastic surgeons in Beverly Hills do not do the conventional facelifts so much as they lead to artificially looking faces, but rather do the minimal invasion space lift for the natural look.

Knee problems, hip problems and lower back problems

Why wait with degenerative diseases of the knees, hip or of the lower back until there is permanent scarring and disabilities? With a similar technique described under point 1 above one can inject the mesenchymal stem cell rich fraction (without the fat cells this time) into the joints that are affected with degenerative changes (knee joints, hips, facet joints along the spine). The result is that cartilage is recreated by the transferred mesenchymal stem cells and the patient becomes pain free and regains mobility! But as with other diseases it is important to intervene early enough before permanent damage has set in.

Organ failures

Another exciting development is intravenous injection or injection via an arterial catheter into failing organs. Heart failure is an end-stage heart disease, where conventional medicine has nothing to offer other than symptomatic supportive medication. However, mesenchymal stem cells can be injected into the blood and the pluripotent stem cells will find the weak areas in the heart muscle where they transform into heart cells and give the existing heart cells a boost.

The result is that the heart pumps more forcibly and the symptoms of heart failure disappear. Similarly, there are trials that show that Parkinson’s disease can be positively influenced with injections of the mesenchymal stem cell rich fraction.

Treatment of patients with liver failure using mesenchymal stem cells is being investigated, but is still in its infancy.

With regard to mesenchymal stem cell treatment of chronic kidney failure early human experiments on 30 patients showed very encouraging results.

Although this field is very promising, more caution is in order with regard to laboratory-manufactured stem cells. More trials are needed to show that they are ready for use in regenerative medicine. In other words they have to show similar or even better successes as the present results achieved with mesenchymal stem cells that were directly harvested and left unchanged as described above.

More information on:

1. stem cells for stroke victims: http://nethealthbook.com/news/stem-cells-help-stroke-victims/

2. stem cells for knee osteoarthritis: http://www.askdrray.com/joint-replacement-for-osteoarthritis-of-the-knee-will-become-obsolete/

Last updated Nov. 6, 2014