Jun
16
2018

Writing A Medical Book

In my 40’s when I was practicing medicine, I was dreaming about writing a medical book. This was in the mid 1980’s and I was busy seeing 30 to 40 patients a day. I would never have found the time to write a medical book at that time. I thought, perhaps I could show how patients could stay younger for longer by adopting the right life style in order to stay well. Fast forward 3 decades, and the medical book writing began. But instead of one book the project turned into 4 books. There were too many topics to cover to fit them all in one book.

Prior to writing a medical book

First of all, in 2002 I published a large website. Its structure is like a book on the Internet: Net Health Book . It contains descriptions of the major diseases, mental and physical, and their current treatment modalities. I still maintain this work. Furthermore, I started another website in 2003, a weekly blog, called “Ask Dr. Ray” . This is a compilation of interesting research. Some medical research papers can get too scientific. For this reason I translated it into easier language. The topics tend to be anti-aging topics. This blog comes out Saturdays.

Retirement hobby

When I retired in 2010 I revamped my websites. In the process the web developer suggested I should add to Net Health Book a blog (nethealthbook.com/news) where I review current health news that I find interesting. This is a weekly blog, which I publish on Wednesdays. All of this is still going on, and it gave me lots of opportunities to write and publish on a smaller scale. In addition, I finally started publishing books.

A Survivor’s Guide To Successful Aging

My first book came out with Amazon in 2014. I had joined the A4M (American Academy of Anti-Aging Medicine) in the early 2000’s. The lectures at their conferences were very open-minded and pointed out details of what one could do to delay aging and avoid premature deaths. My own experience with changing our diet in 2001, starting bioidentical hormone replacement and changing my lifestyle became topics that were part of this book. I dedicated this book “to those who are willing to work on prevention in order to achieve a longer life without disabilities”. This is still the basis of prolonging your life.

Lifestyles can be deleterious

I start out in this book describing the obesity wave and how this changes the metabolism (metabolic syndrome). I used statistics from the Framingham Heart Study to show the detrimental effects of various lifestyles on mortality. Subsequent chapters deal with food, exercise, stress and missing hormones as life-shortening factors. There is a separate chapter on vitamins and supplements. They as a group can create 5.1% longer telomeres, which translated into 9.8 years of longer life expectancy (see also a study by Dr. Xu  in the book). Subsequently it describes how a change of your lifestyle can have a positive impact. Changing your eating habits and exercise activity will make a tremendous positive difference on the long term.

Successful Aging in the Kitchen

The book ends with an appendix, written by my wife: “Successful Aging in the Kitchen”. You are presented with recipes for 7 breakfasts, 7 lunches and 7 dinners. In addition she has provided 7 healthy desserts for you. Bon Appétit!

Healing Gone Wrong, Healing Done Right

In another book, which got appeared in 2016 I gave a few examples of how famous people were failed by medicine. It started already in the past: Ludwig van Beethoven’s physicians did harm instead of healing their patient. However, this is happening now as well: physicians mismanaged the health care of Elvis Presley, Churchill, Michael Jackson and JF Kennedy. The physicians treated symptoms, but they never properly attended to the causes of the ailments of their patients. The end result was premature death in all of them. Churchill who had good genetics made it to age 90, but during his last 15 years he suffered of severe disabilities.

Treatment of symptoms will fail, treatment of causes succeed

These examples of famous people’s health problems resemble to what happens to today’s patients in various office settings. Their symptoms are mostly being treated, but their causes often not. Simply treating symptoms will not work on the long term. It did not work in the past, and it does not work now.

Other chapters in this book

Other chapters in this book deal with preventing disease, keeping a healthy brain and keeping a healthy heart. Next I discuss why food matters, followed by the health of limbs and joints. Subsequently I am discussing how to keep toxins out. The next chapter deals with how to reduce the impact of cancer. It is always important to diagnose cancer as early as possible as removal by surgery has the highest success rate at an early cancer stage. The next chapter is entitled: “Stable hormones key to health”. If any of your hormones are missing (particularly around the age of menopause and/or andropause) it is time for nature identical hormone replacement. The next chapter gives you general thoughts on anti-aging. This is followed by “supplements yes, but do not overdo it”.

Alternative treatment for ADHD

A final chapter gives you an example of an alternative treatment for ADHD, where the idea of not just treating symptomatically, but treating causes is included. References and an index are also provided for the book.

Prostate Cancer Unmasked

Furthermore, I did not intend to write this book. But in early 2016 my PSA (prostate specific antigen) level jumped from 3 to 8.6. For years it had been in the 1.5 areas, then slowly increased to 3. But 8.6 was too high for comfort! I had an MRI scan done, which showed one lesion in my left prostate, which was suspicious for prostate cancer. I was referred to a urologist at the Vancouver Prostate Centre, one of the top clinics in Canada. But I had already researched the literature and came across research by Dr. Gary Onik from Ft. Lauderdale who warned me about the pitfalls of “standard therapy”.

The conservative urologist in Vancouver

The urologist in Vancouver told me that without a positive biopsy he cannot accept that the shadow on my MRI scan would be prostate cancer. And the only way they do a prostate biopsy was by random trans-rectal biopsies. He also wanted to include me in a random clinical trial where they would compare active intervention with active surveillance. I politely declined the trans-rectal prostate biopsy and the inclusion into a trial.

Assessment by Dr. Onik

I booked a flight to see Dr. Onik in Ft. Lauderdale. His method is well researched and orchestrated.

Initial assessment

He assesses you with a rectal ultrasound and he sees the prostate on a TV screen. He said right away that I had three separate lesions, one in the left as shown on the MRI scan and two in the right lobe, which was missed by the MRI scan. False negative lesions are common on MRI scans, which can become a source of cancer recurrence.

3-dimensional prostate biopsy

The following day he booked me for a 3-dimensional prostate biopsy via the perineal approach. The perineum is easy to sterilize, so there is no risk of septicemia. A metal grid with holes for biopsy needles was used to get 96 biopsies of my enlarged prostate. For a normal size prostate, Dr. Onik said about 60 biopsy needles are normal. You don’t feel anything, because you are asleep.

Cryoablation prostate surgery

Next was the cryoablation surgery of the 3 prostate cancer lesions. This happened one month after the biopsy. I was seen at the hospital in Ft. Lauderdale. The same grid from the biopsy was used to relocate exactly where the cancer lesions were. The pathologist had confirmed them as Gleason 6 and 7 prostate cancers. This was treated with Argon sounds and frozen twice. I felt nothing, because I was under a general anesthetic. But Dr. Onik told me that everything went very well. Some cancer was too close to the neurovascular bundle, so he used the NanoKnife, an invention where nano-size holes get blasted into cancer cells, but it leaves normal tissue intact.

I needed to do self-catheterization for about one month to empty my bladder, as there was a lot of swelling from the prostate hypertrophy and the surgery. But eventually my normal water works returned.

Follow-up blood work

My follow-up PSA blood work 3 months after the surgery was down to 1.0. Prior to the surgery the Oncoblot test was positive for prostate cancer. A repeat Oncoblot test 3 months after the surgery was now negative for prostate cancer. I realize that not every physician accepts this new cancer-screening test, but I felt a lot better to know that all the cancer markers were now gone.

9 cancer treatments reviewed

In my book I described a total of 9 prostate cancer treatments and their 10-year survival statistics. None of the other treatment methods were as good as Dr. Onik’s statistics. I believe it is linked to the precision of the 3-dimensional biopsy and the surgery being done through the same grid. If you do not perform the surgery this way, you miss cancer lesions and this becomes the source of failure 10 years down the road. My book details all these alternative treatments. It also has a section on lifestyle modifying factors. I needed to write this book as a service to any man who suddenly is faced with a possible diagnosis of prostate cancer.

Unmasking prostate cancer

Like me he needs to unmask the cancer. Is it really there? How far advanced is it? Which way to safely biopsy it (definitely NOT through the rectum for fear of blood poisoning=septicemia)? What is the best method to remove it? I came to the conclusion that Dr. Onik’s method was best for me. But with the information in this book you can decide what is best for you.

Medical Questions Answered

Finally I wrote my 4th book. From more than 4400 medical questions that I have answered on the site Quora.com I selected the most popular questions for this book. The editorial board of Quora said that I own the publishing rights for my answers. The questions were rephrased without changing the meaning. I selected more than 120 questions under 44 different headings.

Here are some of the areas that are covered: Acne, the best home remedies. Aging: can it be reversed? What is the limit for a human? Alcohol: how does it affect your body? Alzheimer’s disease: which foods promote brain health? Arthritis: what can you do about osteoarthritis? Back pain: what can I do about it? Cancer: why can cancer still not be cured? There are as well 15 other answers about cancer. Depression: will my depression ever go away? Diabetes: will a 600-calorie diet help diabetes control?

Further topics discussed

Diet: I want to get rid of sugar in my diet. How can I do this long-term? Other answers about diet are included. Exercise: How useful is cardiovascular exercise? Gut disease: Is “gluten free” food healthy? Heart disease: What can I do to clean out my arteries and reduce my risk for heart disease? Hormones: Is estrogen present in the male body? Life Expectancy: What is the theoretical life expectancy of humans? Lifestyle Habits: Can good habits change your life completely? Pain: Pain relief for a headache or other pain: Aleve, Advil or Tylenol? Pregnancy: Best age for a successful pregnancy? Prostate Cancer: How dangerous is prostate cancer? Does it kill you? Schizophrenia: What complementary approach may help a patient with schizophrenia? Sleep: What happens when you go to bed late every night? And many other answers under this topic.

And the book finishes with these topics

Sugar: will I be OK living without sugar? Vaccinations: Is there a connection between vaccinations and autism? Vitamins and supplements: Are taking vitamins and supplements healthy or are they harmful? Weight loss: I am working out every day, but I am not loosing weight. What should I do? There are many more answers under this topic. Younger for longer: What are three things I can do every day to stay younger for longer?

These are only a few selections of all of the topics dealt with in this book.

Writing A Medical Book

Writing A Medical Book

Conclusion

I have reviewed briefly why I published the books mentioned above. My prostate cancer book developed out of the necessity that I had to deal with my newly diagnosed prostate cancer in 2016. I felt that the review process I went through would be good for those men who have to face a similar situation. The anti-aging book comes from my interest in anti-aging medicine. “Healing Gone Wrong, Healing Done Right” developed from the observation that physicians in the past and often even now tend to only treat symptoms. But if a cause can be found, this should be treated, as this often leads to a permanent cure.

Treating symptoms only will not improve the patient’s condition

Treating symptoms only will not improve the patient’s condition. “Medical Questions Answered” is a collection of medical topics where I answered various medical questions. It was a way for me to cover a vast array of medical topics. Some of the topics are dealt with in depth (acne for instance); others are very short. I have also two medical blogs that come out on Wednesdays and Saturdays. I hope that some of that medical information will be useful to you.

Aug
26
2017

Decreased Sperm Counts In Men

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

Medical causes of decreased sperm counts in men

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

Lifestyle causes leading to decreased sperm counts in men

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

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

Environmental causes of decreased sperm counts in men

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

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

Recent study about decreased sperm counts in men as an indicator

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

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

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

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

Decreased Sperm Counts In Men

Decreased Sperm Counts In Men

Conclusion

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

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Sep
17
2016

Seven Steps To Live Over 100 Years

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Explanation:

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

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

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

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

Oct
17
2015

Depression Needs Treatment

Depression is common: 10% of all men and 20% of all women have a period of depression in their lives. In people with medical illnesses depression is more common: 20% to 40% (Ref.1).

The peak age for depression is usually the age of 25 to 44. There are special groups where depression is also common. In adolescents 5% are affected with depression and 13% of women tend to get depressed after delivery, a condition called postpartum depression.

In any age group with depression there is a risk of suicide, but with adolescents this is particularly true.

About 10% to 15% of people with general medical illness are developing depression, such as patients with Parkinson’s disease, stroke, Alzheimer’s disease, cardiac disease, HIV infection, end-stage renal failure and cancer.

Causes of depression

Officially it is not known what causes depression. That is what medical textbooks say. However, other books like Datis Kharrazian’s book “Why isn’t my brain working?” offers several scenarios that can cause depression and he has examples of cases that were cured of depression (Ref.2). He points out that deficiencies in two major brain transmitters can cause depression: serotonin and dopamine.

  1. Serotonin is produced in the midbrain from the amino acid tryptophan in two biochemical steps. These biochemical conversions require iron, vitamin B6, vitamin B12, niacin, folic acid and magnesium as co-factors. But you also need the “large neutral amino acid transporter” (LNAA) to transport tryptophan through the blood/brain barrier into the brain.
  2. Dopamine is a neurotransmitter that is produced in the frontal lobes of the brain. It is also necessary for learning. Dopamine is synthetized by the brain from tyrosine, which has to be manufactured in the liver from the amino acid phenylalanine. You need to have a healthy liver to produce tyrosine, which needs to be transported through the blood/brain barrier into the brain; similar to tryptophan this requires the “large neutral amino acid transporter” (LNAA). People with hepatitis, fatty liver, insulin resistance or diabetes may have problems with the LNAA transporter, which can cause dopamine deficiency (Ref.2). But as mentioned earlier they may also have low serotonin because tryptophan was not transported into the brain. This will happen with sugar overconsumption, as insulin resistance develops and affects the LNAA transporter resulting in both low serotonin and dopamine (Ref.2).
  3. Since the 1990’s it is known that inflammation is also a possible factor in the causation of neurological disease including depression. Ref. 2 points out that gut issues can become brain issues as inflammatory substances can leak trough a leaky gut into the blood stream and trough a leaky blood/brain barrier into the brain. Hypothyroidism can activate brain inflammation and lead to an imbalance of the neurotransmitters. Gluten sensitivity is also an important cause of depression through the inflammatory connection, but few physicians recognize the full impact of this.

Tests for depression

There are no laboratory tests that would define depression. However, every patient should be checked for hypothyroidism, a common cause of depression. If hypothyroidism is found, this can easily be treated by thyroid hormone replacement.

Otherwise the diagnosis of depression is made based on mental status examination, history and review of symptoms. A good start is to ask: “In the past 2 weeks how little interest or pleasure in doing things have you had?” and “Have you been feeling down, depressed, or hopeless in the past 2 weeks?” (Ref.3).

There are detailed psychometric questionnaires available such as the Beck Depression Inventory that can assist the physician to establish the diagnosis.

Myths of depression

One of the myths regarding depression is that it would be contagious. A study on 2000 high school students showed that depression was not infective. The contrary was true: human interaction with friends who had a “healthy mood” improved depression. By the same token, when you constantly compare yourself with your Facebook friends, and you are not in the best mood, your mood may worsen and you could become depressed.

Treatment of depression

Despite advances in the treatment of depression the response rate with antidepressant therapy is limited to 60% to 70%. According to Ref.4 inadequate dosing and misdiagnoses account for the fact that 30% to 40% of treated people with depression have treatment failures. Typically the first antidepressant involves a selective serotonin reuptake inhibitor (SSRI), but newer trials have shown that the older monoamine oxidase inhibitors (MAOIs) have a higher success rate when treating depression initially (Ref.4).

A good antidepressant for mild to moderate depression is St. John’s wort, which is recommended by Ref. 5 as having less side-effects as other antidepressants.

In treatment resistant depression the psychiatrist often employs other combinations of antidepressants. In addition cognitive/behavioral therapy is added, which makes the overall treatment more successful. It goes without saying that complicated cases of depression belong into the hands of an experienced psychiatrist.

Suicides

Unfortunately there is still a stigma attached to have a mental disease like depression and people are in deep denial. Friends who do not understand depression may inadvertently say things that make the symptoms of the depressed person more severe and distance themselves at a time when they would need support from friends. The end result is loneliness, feelings of being misunderstood and having suicidal thoughts. Often it is men who will resist seeking treatment for depression, women are better in getting treatment started.

This is where a psychiatrist needs to intervene. If this does not happen, people start attempting suicide and finally commit suicide. In the US committed suicides have a gender ratio of male to female of 3:1 to 10:1. These situations become very difficult. The family needs to step in and talk to the patient. It is best to accompany the patient to the hospital for an assessment. Going to the hospital may be done privately or by ambulance. Don’t be shy to call 911 for an ambulance. Better to be cautious than have a major crisis that ends in completed suicide.

Alternative depression treatments

There are alternative treatments for depression.

1. Magnetic therapy for depression: This therapy is also called transcranial magnetic stimulation (TMS) and was approved for Canada and in 2008 by the FDA.

But it is not as powerful according to Ref. 3 as unitemporal electroconvulsive therapy.

2. Bifrontal electroconvulsive therapy (ECT): Electroconvulsive therapy with two pedals applied to the front of the skull appears to have the best results in terms of treating depression.

3. Omega-3 fatty acids (EPA and DHA) are powerful anti-inflammatory agents, which will take care of the inflammatory component of depression. Both fish oil and krill oil in combination give the optimal response as outlined here.

4. Vitamin D3 is also anti-inflammatory and will contribute to an improvement with existing depression, but it also helps prevent the development of depression when taken in regularly as a supplement.

5. Light box therapy: The observation of seasonal affective disorder (SADS) can develop as a result of lack of light. This has led to the discovery that light boxes are helpful for treating depression and also for prevention of depression due to seasonal affective disorder.

A light box should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often it takes up to 4 weeks to reach its full benefit.

6. It is known for a long time that alcohol is a depressant; it can actually cause depression and in persons with bipolar disease it can trigger a flare-up of that disorder as well.

7. Finally it matters what you eat: sugar and too much starchy foods (high glycemic index carbs) lead to insulin overproduction and insulin resistance. This causes inflammation, and this will cause depression. As mentioned earlier it also lowers the two key brain transmitters, dopamine and serotonin.

The solution is an anti-inflammatory diet, the Mediterranean diet without sugar and high glycemic index carbs; only low glycemic index carbs are allowed. This will normalize insulin production and eliminates inflammation.

8. Vitamin supplements: Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.5). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

9. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.6).

10. Exercise on a regular basis helps to equalize the mood and seems to exert a slight anti-depressant effect on the person who engages in regular physical activity.

Depression Needs Treatment

Depression Needs Treatment

Conclusion

I have attempted to show the complexity of depression and what is known about its causes and treatment. Very likely there are several causes for depression and further research will hopefully bring more clarity to this. Treatment modalities, both conventional and unconventional have been developed over the years by trial and error. The physician and patient need to use common sense: if a treatment is working, stick to it and use it. If it does not work, move on and try something else. More difficult cases should be referred to a psychiatrist who has the most experience with difficult to treat cases. Do not neglect life-style factors and alternative depression treatments as they can often help to stabilize depression significantly. We all must be vigilant about suicide risks in depressed patients and act by calling 911, if necessary to intervene.

More info on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

1. Depression, Major: Fred F. Ferri M.D., F.A.C.P., Ferri’s Clinical Advisor 2016, by Elsevier, Inc.

2. Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

3. Goldman-Cecil Medicine “Major depressive disorder” 2016, by Saunders, an imprint of Elsevier Inc.

4. Massachusetts General Hospital Comprehensive Clinical Psychiatry, Second Edition: Theodore A. Stern MD, Maurizio Fava MD, Timothy E. Wilens MD and Jerrold F. Rosenbaum MD © 2016, Elsevier Inc.

5. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders.

6. George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Feb
14
2015

Laser Therapy Going Beyond Skin Deep

There was an interesting workshop alongside of the A4M conference mid December 2014 organized by Jonathan Schwartz who gave an overview of the use of low-dose laser therapy for various clinical applications. It involved the use of the Dr. Michael Weber low-dose laser machine, which has a lot of versatility.

  1. First there are 5 laser light frequencies in the rainbow colors (infrared, red, yellow, green, blue) and the colors have very special characteristics as will be explained further below.
  2. There are a multitude of applicators like skin acupressure point applicators, a shower for hair loss applications, a head adapter, which looks like a crown. With this device red light will penetrate into the brain through the skull bone. There is also a mouth shower and various lengths needle applicators that can be used to access the body intravenously or interstitially (direct tissue approach). At the center of the equipment is the Weberneedle Compactlaser, which can be attached to the various applicators.

Laser characteristics

The blue laser penetrates about 1 cm (0.39 inch) under the skin, a green laser penetrates only 0.5 cm (0.19 inch); like the blue laser the yellow laser penetrates through the skin with a depth of 1 cm (0.39 inch). The red laser has a penetration depth of 2-3 cm (a bit more or less than 1 inch) and the infrared laser penetrates 5-7 cm (2 to 2 1/2 inches).

In addition the various lasers have different inherent qualities: The red laser is good for tissue regeneration, which lends itself for chronic pain. Green and blue lasers have anti-inflammatory effects, which helps in acute pain. The yellow laser can be used for detoxification, has antidepressant qualities and photosensitizes hypericin, a substance derived from St. John’s wort, which is known to have antidepressant qualities. The various types of laser mentioned can be used interstitially, intravenously and just on the skin surface over acupuncture points. Dr. Weber explained that detailed research has revealed that the low-dose energy beam sends out energy that is taken up by the surrounding tissues and cells. The mitochondria of the cells get activated to produce more ATP, which the cells use to heal themselves.

Meeting in Placentia

Forward to a meeting in Placentia, CA on Feb. 7, 2015 where Dr. Michael Weber and several other speakers gave presentations on the use of the Dr. Weber laser system. A number of local doctors who had an interest in learning more about the low-dose laser system were there as well. It was a daylong mini conference.

Three volunteers were used to demonstrate the use of the system. I was volunteering about a chronic left lower back pain that various chiropractors had problems adjusting in the past year. I have a strong family history of arthritis on my mother’s side and my maternal grandmother’s side as well. The health professionals thought that I likely have developed arthritis in the left sacro-iliac joint. Dr. Weber used the interstitial needle, which is 4 cm (1.57 inches) long. The skin was injected with a local anesthetic first, and then the needle was inserted, which I could hardly feel. Now he injected 5 cc of normal saline. This was used, so that the laser light would spreads more into the surrounding area. Dr. Weber explained that he was very close to the SI joint with the tip of the needle on the left. He attached a blue laser to it for 20 minutes and switched it to a green laser for another 20 minutes.

In the meantime the other two volunteers were treated.

One was a physician in the group who had a chronic planter’s fasciitis. He was treated with an intravenous laser application. First a special butterfly was inserted, through which a sterile laser probe could be threaded and then attached. He received a red laser.

The third volunteer had a chronic right knee problem from congenital Osgood Schlatter disease. In him Dr. Weber used an approach of intraarticular injection and he attached a blue laser for 20 minutes, followed by a yellow laser for another 20 minutes. A physician with a California license supervised all of these procedures.

I woke up the following day with no pain in my left lower back, but at the same time the lesser right lower back pain had also disappeared. I figure that due to the fact that my back mobility is back the untreated right side must have normalized as well. It is now 7 days following the procedure and I still have no back pain. Yesterday I saw my local chiropractor in Southern California and he confirmed that my back was much easier to adjust than the month before (Update April 12, 2015: my lower back is still pain free!).

Normally a case like mine would require 5 to 6 weekly treatments before the problem is resolved. Dr. Weber explained that more complicated problems like fibromyalgia would take 15 to 20 treatments in succession or more. The principal is always that you treat where the symptoms are; in the follow-up visit the healthcare practitioner treats the remaining symptoms until all of the symptoms have resolved.

The intriguing fact is that low-dose laser therapy seems to fit right into gap where conventional medicine has failed.

Clinical cases that respond to laser therapy

Dr. Weber has collected clinical cases that improve with laser treatments, such as diabetes, chronic liver diseases, chronic pain syndromes, rheumatoid arthritis, polyneuropathy, chronic inflammatory disease, cancer (with photodynamic therapy), fibromyalgia, high blood pressure, ringing in the ears (tinnitus), macular degeneration, multiple sclerosis, chronic fatigue syndrome, Lyme disease, allergies and eczema. This, however, is just a partial list.

Photodynamic cancer therapy is made possible by the fact that certain substances have absorption spectra that are activated by different wavelength. This amplifies the effect of the natural substance that is used by several folds. For instance Chlorin E6 absorbs a red laser (around 660 nm). A blue laser activates Curcumin. A yellow laser activates Hypericin. Here is a website that explains the principle of phototherapy.

Various cancers can be treated where conventional medicine has so far failed. Examples are lymph metastases from breast cancer, pancreatic cancer, and bladder cancer. I have blogged regarding a combination treatment for breast cancer before, where phototherapy with lasers and immunostimulation were combined. Esophageal cancer is treated through esophagoscopy combined with a laser that activates curcumin, which had been taken orally well before the procedure. Not all of the cases are successful, but the majority of them are.

Otherwise routine low-dose laser applications are used for tendinitis, tennis elbow, sprains and soft tissue injures.

Laser-Therapy-Going-Beyond-Skin-Deep

Laser-Therapy-Going-Beyond-Skin-Deep

You can combine the laser system with prolotherapy. Prolotherapy is done first by injecting hyperosmolar dextrose solution, which is a strong stimulator of stem cells. Using the same needle, but attaching the Weber low-level laser therapy will activate the stem cells and protect them from dying off.

Conclusion

Low dose laser therapy using the Weber Medical technology is a new treatment modality available to the interested physician. I think that it will cause a revolution within medicine. It is scientifically sound and it fits right into the difficult to treat patients; the patients that otherwise would be unlikely to respond. However, they will respond well to these new treatment modalities. Apart from musculoskeletal problems, various cancers will also respond to this. The Mayo clinic is starting a study on treating cancer using phototherapy and the Dr. Weber low-dose laser system.

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Jul
02
2014

Focus On Health Rather Than Disease

Not too long ago I came across a blog that summarized the “18 Biggest Problems with Modern Medicine”. Although this is a useful list, it occurred to me that these problems could be compressed into about 9 underlying themes. Below I am describing the same type of problems regarding modern medicine in a somewhat abbreviated fashion.

Points 1 to 4 below cover points 1 to 9 of the “18 Biggest Problems with Modern Medicine”:

1. The patient is seen as a complicated machine with parts that could break down. When there is a breakdown of the machinery, symptoms develop, which are quickly fixed with a patented medicine, but without really addressing the underlying problem. 

This type of approach soothes pain, but changes nothing for a chronic illness like MS. Nobody has all the answers to this complicated illness, but we know that it is an autoimmune disease. So it makes sense to avoid foods that could make the patient worse. This is exactly what Dr. Terry Wahls is describing in her YouTube video.

Also, vitamins and supplements for multiple sclerosis that support the immune system would be useful. Vitamin D3 in high doses, but monitoring blood levels by doing 25-hydroxy vitamin D blood tests from time to time would also be useful.

2. A holistic approach to building up health rather than fixing a clinical problem, which belongs to a disease, is not part of modern medicine.

In the past a stomach acid problem was treated with H-2 receptor antagonists like cimetidine or ranitidine. The newer proton pump inhibitors, like omeprazole were added and were supposed to be better in suppressing the acid formation. But they did nothing to cure the ulcer or gastritis problem. The problem often was that chronic stress allowed a bacterium, H.pylori to multiply in the stomach wall causing stomach acid and a burning sensation. This did respond to the antacid medications for a period of time, but came back when the medication was stopped. A simple over the counter licorice compound, called DGL or a simple mastic gum from the health food store can cure the helicobacter infection and cure your peptic ulcer disease without the need for the expensive patented H-2 receptor antagonists or proton pump inhibitors.

Focus On Health Rather Than Disease

Focus On Health Rather Than Disease

3. Everybody with the same disease is treated with the same medical treatment schedule, often agreed on by consensus expert panels. The body’s self-healing capacity or the placebo effect, which is an expression of the same natural healing response, is ignored.

Here is a study that was done on patients with irritable bowel syndrome (IBS) on placebo pills. Placebo pills were 24% more effective than the control group who took no pills in controlling symptoms of IBS. Why not utilize this in conventional medicine?

4. The disease is treated, not the patient; numbers from lab tests count, not clinical signs of the physical examination. What used to be called the “art of medicine” has been abandoned.

The art of medicine is important to establish a rapport with the patient, but also to pick up silent features during the examination that may otherwise be overlooked.

Points 10 to 18 of the“18 Biggest Problems with Modern Medicine” are covered by points 5 to 9 below:

5. Diet, lifestyle, hormone changes (due to chronic stress and older age) are all ignored. If there are the hormone changes of menopause or andropause, only synthetic hormones are given and only for a limited time not exceeding 5 years. Bioidentical hormone replacement invokes butterfly feelings in the physician’s stomach and must therefore be rejected. It’s almost a knee-jerk response. The reason for that is the fear that bioidentical hormones would have the same devastating side effects as the synthetic hormones. However, this is a fallacy, as a young person with fully functioning natural hormones will not come down with nefarious side effects of strokes, heart attacks or cancer.

This link to Dr. Lee’s website explains why bioidentical hormones fit the hormone receptors better than the synthetic concoctions.

6. The thought that the body may have been exposed to toxins (like heavy metals, xenoestrogens etc.) from the environment that are taken up and stored in the body like a sponge and should be detoxified from time to time is foreign thinking to modern medicine except for a small group of dedicated physicians and naturopaths who offer various forms of chelation therapy.

The TART trial has shown that there was a 18% reduction of heart attack rate in the group that received 40 chelation therapy treatments. Chelation therapy can easily be combined with traditional treatment methods, but mostly his option is ignored.

7. Similarly the idea that supplements and vitamins would be essential to support the body in the fight against free radicals that form inside the body every day is not something every doctor will feel comfortable in recommending.

In Ref. 1 (chapter 8) I have cited evidence from a clinical trial that multivitamins elongate telomeres by 5.1% and add 9.8 years of productive life in those who take multivitamins over a long period of time versus those who do not.

8. In the health care industry we are still working in a hierarchical system where the doctor is on top and the patient is on a lower level and dependent. In the future medical system the doctor and the patient are equal partners who try to solve a health problem as a team.

The doctor may have more experience in diagnosing, prescribing and monitoring health problems, but the patient is the one who owns the problem and is encouraged to comply with the prescribed treatment and to report back to the doctor, if there are new symptoms that may lead the doctor to new insights resulting in improving the treatment plan.

9. Big Pharma influences doctors to prescribe their patented medicinesNew drugs and old drugs are sold like the latest invention against the dreaded disease XYZ (you can fill in whatever the diagnosis is). But none of these drugs is effective against a hormone disbalance, stress, a lack of sleep, lack of exercise or malnutrition. The patient’s co-operation is needed to work on these issues.

I have explained in Ref.1 that the metabolic syndrome, which is responsible for much of our modern diseases (diabetes, heart attacks, arthritis, strokes, cancers, Alzheimer’s disease) can be overcome by a combination of steps: paying attention to our food intake, cutting out sugar and high glycemic starchy foods and excessive fats. Regular exercise will help you to build up and maintain muscle mass and at the same time to melt in excessive fat. Yoga, self-hypnosis, meditation and prayer can remedy stress. Bioidentical hormones can replace any hormone deficiencies. Detoxification, vitamins and supplements complete this program, which allows you to successfully age without disabilities. All these steps taken together allow your body to recover and find a new balance where drugs are rarely needed.

Conclusion:

The reason Medicare is so expensive is that life style issues are not often addressed. By only treating symptoms the underlying causes of an illness are not removed. This means that the illness will not be cured. Take for instance heart attacks. If you want to go down the road from angina to heart attack to bypass surgery or stents, you will soon run out of options. The next level of curative medicine approach is a heart transplant after heart attack number 4 or 5. Comprehensive medicine would approach this differently by paying attention to what you eat and motivate you to cut out starchy foods, wheat, and sugar. This would address obesity, which is a problem in many Western countries. You would engage in regular physical exercise. Stress would be overcome in yoga classes or self-hypnosis sessions. Bioidentical hormones would replace your missing hormones based on saliva hormone tests or blood test samples. The heart muscle that has a lot of testosterone receptors would respond to this. As mentioned above a series of chelation treatments to remove heavy metals could also be offered in this combined, comprehensive heart attack prevention program with a reduction of 18% of heart attacks. This all is available now, but regrettably few people make use of it.

References:

1. Dr. Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

Last edited July 3, 2014

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Jan
18
2014

The Super Powers Of Vitamin D

Originally, when vitamin D was found to be the missing ingredient in preventing rickets in growing children the recommended daily allowance (RDA) to prevent rickets was found to be 400 IU of vitamin D. The active metabolite has been identified as vitamin D3 for which the body has receptors on all vital organs (heart, brain, bones, kidneys, liver). In recent years new insights have been gained as it turns out that the RDA’s were set much too low for many diseases that can develop when vitamin D intake is too low, particularly in the aging population. Higher doses of vitamin D3 in the range of 800 to 1000 IU per day have been shown to prevent osteoporosis, falls and fractures in older adults and in nursing home populations. But the immune system of everybody is dependent on higher doses of vitamin D3. Recently (Dec. 12 to 15, 2013) I attended a lecture at the A4M conference in Las Vegas where Dr. Eisenstein reviewed the latest on vitamin D3. It is now known that 2/3 of the US population is deficient for vitamin D as measured by blood tests (less than 25 ng/ml).  The standard test is the 25-hydroxy-vitamin D level (abbreviated as 25(OH)D level). It is now known that you require at least a level of more than 40 to 60 ng/ml of 25(OH)D as measured in the US, which translates to more than 100 to 150 nmol/L measured in metric units in other countries, to prevent cancer.

The Super Powers Of Vitamin D

The Super Powers Of Vitamin D

Metabolism of vitamin D3

90% of the vitamin D3 that we need comes from exposure to sunlight, which transforms a cholesterol metabolite (7-dehydrocholesterol) into the vitamin D precursor (vitamin D3 or cholecalciferol). This is what we absorb from naturally occurring fish oil and oily fish, but otherwise this does not naturally occur in foodstuffs (Ref. 1). Dr. Eisenstein pointed out that it is well known that people living north of the 37th degree latitude lack vitamin D3 because of a lack of sun exposure, particularly in the winter season. People south of the 37th degree latitude have enough sun exposure, but wherever you live, it is advisable to have your vitamin D3 level measured (as 25(OH)D level). If you do not eat enough fish or fish oil, the levels likely are too low as is the case for 2/3 of the US population. Vitamin D3 supplements will have to be taken by those whose levels are too low. Vitamin D3 is further metabolized by the liver and then by the kidneys into the active vitamin D compound, called 1,25(OH)2D3 (which is called “calcitriol”). The main effect of calcitriol is to absorb calcium and phosphate from the intestine into the blood stream. Together with vitamin K2 as explained in a prior blog these minerals are then taken up by the bone to prevent osteoporosis or rickets in the growing child. What has not been known for a long time is that vitamin D3 is also necessary for normal cell metabolism by most of your body cells, but particularly by the vital organs like the brain, the heart, the kidneys, the liver, the immune system and the bone. However, doses of 5000 IU to 10,000 IU of vitamin D3 capsules per day are required for optimal vitamin D3 health. This will lead to levels of below 200 ng/ml of 25(OH)D levels, which have been proven to be safe. According to Dr. Eisenstein no toxicity has been found below 30,000 IU of vitamin D3 per day, but based on other authors a dose of 10,000IU should be adequate for most people. Strangely enough colored people also have to take vitamin D3 supplements as their the higher melanin pigment in the skin filters out UV light so effectively that their 25(OH)D level can be low. Always err on the cautious side and have your vitamin D3 blood level taken.

Vitamin D3 has a characteristic stereotactic configuration (cis-triene structure), which allows it to bind free radicals and function as an antioxidant (Ref.2).

What are some of the clinical effects of vitamin D3?

1. Vitamin D3 has diverse effects on organs systems as Dr. Eisenstein summarized: vitamin D3 lifts depression and has been found to be of particular value for drug resistant depression. Take 5000 to 10,000 IU of vitamin D3 per day.

2. Muscle power increases with vitamin D3, particularly in those who work out regularly.

3. Many fertility clinics pay attention to vitamin D3 levels, as the higher the blood levels of vitamin D3 in a man, the faster this sperms move! And the more vitamin D3 she has on board, the better she ovulates. The end result is a higher pregnancy success rate when both partners take 5000 to 10,000 IU of vitamin D3 per day

4. Also, if a woman takes vitamin D3 during her pregnancy, the first set of teeth in the offspring will have fewer cavities.

5. Brain development in autistic children is much improved with vitamin D3 in higher doses. This needs to be combined with detoxification methods and supervised by one of the DAN physicians.

6.Chronic pain typically improves when vitamin D3 deficiency, which almost always is present in patients with chronic pain, is treated with vitamin D3 supplementation.

7. To prevent flus and colds and other infectious diseases, take higher doses of vitamin D3. When you come down with a flu, it is safe to increase your daily vitamin D3 intake to 30,000 IU of vitamin D3 for a few days until your symptoms improve, then resume your maintenance dose of 5000 IU to 10,000 IU per day.  This year’s dominant flu is the type A, subtype H1N1 – also known as the swine flu. Children should get 50% of the dose regimen detailed for adults when they develop a flu (for children: 15,000IU for three to five days , with tapering to a maintenance dose of 2500 to 5000 IU until blood levels of 25(OH)D are available). Here is a website of Dr. Cannell where he discusses dosages as well.

8. Asthmatic patients do better with vitamin D3 supplements requiring less maintenance anti-asthmatic medicine to keep them balanced with regard to their airways.

9. Chronic low vitamin D3 levels cause brain damage including Alzheimer’s disease. In this context it is important to know that the enzymatic conversion in the liver and kidneys slow down as we age requiring higher doses in older patients. This may have been the reason for the confusion about relatively low doses of 400 IU of vitamin D3 preventing rickets in children versus the need of vitamin D3 in middle aged and older patients where much higher doses are required as already explained.

10. High blood pressure is linked to vitamin D3 deficiency and it is better manageable with medication when vitamin D3 levels are normalized.

11. Live longer with vitamin D3. How is this possible, you might ask: the answer has been found in the telomeres, the shoelace like structures at the end of the DNA strand of each cell. Vitamin D3 lengthens the telomeres and promotes telomere repair; this is associated with a longer life span. Centenarians have longer telomeres. You can measure telomere length, but it is a pricey test, which is not for everyone, contrary to supplementation with vitamin D3 that should be taken by everyone!

12. As already indicated, vitamin D3 strengthens the immune system, but it also modulates the inflammatory response from muscle damage, so athletes can perform better. Patients with multiple sclerosis will improve as it slows down the inflammatory process. But other inflammatory diseases like arthritis, inflammatory bowel disease and even cancer will respond favorably to higher doses of vitamin D3 (20,000 to 30,000 IU of vitamin D3 in these cases). This is information that has not yet percolated into mainstream medicine, but will do so in the next few years (or decades?).

13. Higher percentages of cardiovascular disease are found in patients who have lower than 15 ng/ml  25-Hydroxy- vitamin D3 levels in their blood meaning that vitamin D3 supplementation prevents heart disease (Ref.3).

What are toxic vitamin D levels?

What is known about the safety of vitamin D3, particularly the higher vitamin D3 doses? First, it is wise to have your 25(OH)D blood levels taken from time to time. If any of these levels exceed 200 ng/ml it would be prudent to reduce the vitamin D dose or stop supplementation for a while. Otherwise it has been difficult to establish a toxic range.

This website claims that 40,000 IU of vitamin D3 or more would lead to toxic levels where the blood calcium levels would be increased, which can be measured as hypercalcemia. However, another study done in 2007 showed in MS patients that took 40,000 IU per day and that led to a blood level of 400 ng/ml of 25(OH)D did not lead to increased calcium levels and did not lead to hypercalciuria (too much calcium in the urine). So, all of the papers that either indicated to the public that it would be unsafe or unnecessary to take vitamin D3 seem to have other agendas than communicating the truth. Had it been true that calcium would be released from the bones or calcium were absorbed too much from the gut, this would have caused calcification of the bones, soft tissues, heart and kidneys. Also, kidney stones would have developed. However, a low calcium diet combined with corticosteroid drugs usually leads to a full recovery within a month. Interesting that all of the dire predictions regarding toxic vitamin D3 levels did not materialize. Here is another website discussing vitamin D3 dosing.

I talked to a participant of the conference (who has a fellowship degree of the A4M) about what is really known about vitamin D3 toxicity. He told me that there has been an unintentional overdose where a compounding pharmacy made a mistake, so that a patient accidentally received a dosage of 500,000 Units of vitamin D3 per day for a full three months, before the mistake was uncovered. The patient felt sluggish, but did not have any other symptoms. He was told to stop the vitamin D3 compound. He had an uneventful recovery with no detrimental effects. At this point no overdose of vitamin D3 has been established.

Conclusion

Vitamin D3 is a vital supplement that has been shown to prevent not only rickets in children, but also depression, MS, infections and even many cancers (Ref. 4). As usual there will be many critiques that doubt the validity of the above statements. But I have found that all of these effects described above were confirmed in several sources of various medical information. Keep in mind that negative rumours have a tendency to linger on for years.

More information on vitamin D3 for prevention of osteoporosis and hardening of arteries: http://www.askdrray.com/calcium-vitamin-d3-and-vitamin-k2-needed-for-bone-health/

Vitamin D3 deficiency can cause pancreatic cancer: http://nethealthbook.com/news/insufficient-vitamin-d3-linked-to-pancreatic-cancer/

References

1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed.,  © 2011 Saunders

2. Rheumatic Diseases Clinics of North America – Volume 38, Issue 1 (February 2012) , © 2012 W. B. Saunders Company

3. Wang TJ, Pencina MJ, Booth SL, et al:  Vitamin D deficiency and risk of  cardiovascular disease.   Circulation 117. (4): 503-511.2008.

4. “Recognition and Management of Vitamin D Deficiency”: American Family Physician – Volume 80, Issue 8 (October 2009),  © 2009 American Academy of Family Physicians

Last edited Nov. 7, 2014

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Jan
11
2014

From Inflammation To Heart Attacks, Strokes And Arthritis

Have you ever wondered why people who limp from arthritis in their hip also often get heart attacks? And have you ever wondered why people with high blood pressure get strokes and/or heart attacks?

It is not that difficult to understand, although many people do not like to hear the truth.

After the holidays with lots of sweet presents and rich food it is a good time to reflect about the internal connections between our organs.

Let’s follow what foods can do to our system, then you will understand what to do to get out of a trap, where food is not friendly but damaging to your body.

1.    Sugar, omega-6 fatty acids and trans fats enter your system

When you opened the cheap chocolate bars, ate the pastas, the turkey gravy and the ice cream for dessert, your stomach faithfully digested all that food and broke it down into glucose (a simple sugar), omega-6 fatty acids and highly reactive trans fat with free radicals (from deep fried foods, margarine, shortening, pie crusts, cake mixes, frostings and non dairy coffee creamers just to mention a few).  Within ½ hour the sugar molecules from the digested meal will enter your blood stream.

2.    The metabolism sets in

We know from years and years of research that the glucose in the blood triggers the release of insulin from the pancreas, which facilitates absorption of sugar into your liver and muscles where it is stored as glycogen. This is meant to be a storage form of sugar, just in case you do not eat for a few hours, but need energy to burn for your physical activity. When you have saturated the glycogen storage in liver and muscles, your liver metabolizes sugar into fatty acids and triglycerides. There is the transport LDL cholesterol that is supposed to supply the brain and heart with healthy cholesterol for these organs to replace cell membranes. Instead, the LDL cholesterol that is supposed to be balanced by the protective HDL cholesterol gets oxidized from the extra sugar and from the free radicals of the TRANS fats that are now being outlawed by the FDA for exactly that reason. So, the oxidized LDL cholesterol turns into the vicious VDLDL particles, which can be measured as a special blood test by your doctor. The overabundance of omega-6 fatty acids start an internal fire by stimulating the arachidonic acid pathway, which causes inflammation in your arteries, your joints and your immune system.

From Inflammation To Heart Attacks, Strokes And Arthritis

From Inflammation To Heart Attacks, Strokes And Arthritis

3.    The consequences of eating foods which spike your blood sugar levels

The end result is hardening of your arteries and the beginning of arthritis in your joints. Mind you, this does not happen overnight, but when you eat this way decade after decade it takes its toll. Typically in your forties or fifties you will notice some swollen knuckles. Don’t just let this happen. Think that this is a sign that something is festering in you! If you don’t interfere, there could be one wrong move, when you play sports and a meniscal tear in your knee could put an end to the fun. Sure, you will find a reason that the angle of your jump was unfortunate and this was simply enough for your meniscus to tear. But could it be that there were inflammatory changes in your meniscus long before this incident, the meniscal material softened up, dried up because of a lack of proper nourishing synovial fluid? I found when I was in primary care practice that this was what caused the majority of meniscal tears. A normal meniscus does not tear easily, but decades of malnutrition will lead to these hidden changes, where a meniscus can be softened and is prone to damage without a warning.

Arthritis in your joints is similar to the process of what I described regarding meniscal degeneration. An imbalance of the omega-6/omega-3 ratio where people take in 12 to 16 times as much omega-6 fatty acids from processed food compared to omega-3 fatty acids from fish oil or fish consumed, causes inflammation of the joints via the arachidonic acid metabolism.

What about the arteries? It is no secret that many people in their 60’s have suddenly an episode of chest pain that leads to a referral to a cardiologist who will do a heart catheterization. A stent or two may have to be placed because of hardening and narrowing of the coronary arteries. In many trials where people with coronary artery disease were followed laboratory tests showed that these individuals had low 25-hydroxy-vitamin D levels in their blood and the calcium that was meant to make their bones strong, ended up in the arteries. Vitamin K2 is often also missing because of malnutrition.

People with high blood pressure often do not have enough nitric oxide production from their arteries, because they do not eat enough vegetables, they are too sessile and they eat too many sweets and starchy foods. As a result  the liver overproduces triglycerides and fat, and oxidized LDL cholesterol damages the lining of the arteries. Just treating high blood pressure with blood pressure lowering medications will not correct the underlying metabolic disbalance. This is why people who had 2 or three stents for coronary artery hardening will come back 5 or 10 years later and need more stents until they die of a full-blown heart attack. You must stop the underlying metabolic derangement, if you want to prevent further deterioration.

4.    Inflammation takes its toll

But what do the lining of the arteries, the inflamed joints, a degenerative meniscus and heart attacks and strokes have in common? It is the INFLAMMATION that changes the body chemistry. It gets even more complicated, because the extra calories that we consume get stored as visceral fat. This is done automatically when you eat too much sugar and starchy foods as you may have done over the holidays. Remember, our ancestors were hunters and gatherers, and our genetic make-up is still the same. So, when the glycogen stores are full, any surplus sugar gets metabolized by the liver into triglycerides, fatty acids and LDL cholesterol and gets stored as body fat. The most active fat is the visceral fat between our guts and around our body organs. This produces interleukins and other inflammatory cytokines that circulate in the blood causing inflammation in all our arteries.

This is the link between the various manifestations of inflammatory conditions in our bodies. We rarely think of all of these various conditions as being linked. We concentrate on each disaster as it strikes, but think that it is only a one-point-in-time event. We do not see the years of abuse of our bodies that have preceded any of these events.

5.    Disaster strikes in different ways

We usually hear about a person who just got a heart attack. Now it is an emergency!  Nobody thinks about the years of inappropriate food intake and the lack of exercise that led up to this heart attack event.

The same is true for a sudden stroke. The patient arrives at the hospital in an ambulance and cannot move one arm and one leg. Initially the patient may be unconscious. There is too much action required by the emergency personnel to ask the question why it had to come to this. The truth though is that the blood vessel deterioration in the brain vessels that led to the stroke have quietly happened years before the acute event.

And then there is the aging 75-year-old man with a stiffening hip and arthritis in the hands. The inflammation has been quietly developing in the synovial membranes of the joints for more than a decade. The patient probably swallowed anti-inflammatory medications for years for arthritis symptoms, which as you guessed has not changed the underlying biochemistry. But now it has come to the point where a total hip replacement is required, just to be able to continue to walk. I have experienced that scenario in the hospital setting many times. Many patients went through the total hip replacement surgery with no problems. But other patients had their total hip replacement done and they developed a heart attack under the general anesthetic, because unbeknown to the orthopedic surgeon the patient also had severe hardening of the arteries that had not shown up on the pre-surgical electrocardiogram. A stress test or a Thallium heart scan when the patient still could exercise would have shown this hidden cardiac condition before the surgery, so that a cardiologist could have addressed this condition before the surgery. After that the total hip replacement would most likely have been uneventful.

6.Prevention is the key

The lesson to be learned from all of this is: prevent these disasters from happening in the first place. Do the following:

1) Good, balanced nutrition

2) Regular exercise.

3) Take vitamins and mineral supplements for bone health.

4) As you age, have your hormones measured and replace what is missing.

5) Avoid toxins. Use detoxification.

6) Avoid junk foods.

I have covered these topics in many blogs before as indicated in the above links.

Conclusion

Health disasters are mostly not accidental, but are rather caused by not paying attention to the silent metabolic changes based on improper nutrition and a lack of exercise, which could also be termed as a lack of prevention. It takes some time, often even some suffering to understand the deeper meaning of what I discussed above (that prevention is much more powerful on the long-term than curative medicine). I speak from experience having worked in the medical field for more than 30 years. Curative medicine will take care of an emergency, but the underlying inflammation and metabolic derangement will persist, if this is not changed through the steps mentioned above. Treat inflammation and LDL oxidation by modifying your lifestyle. Think prevention!

More information on inflammation medicine: http://www.askdrray.com/chronic-inflammation-causes-cancer-heart-attacks-and-more/

Last edited Nov. 7, 2014

Jan
04
2014

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

Here are 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). It took place 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. There was also 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. This is the focus of my interest since my retirement in 2010.

Here are some highlights from the conference. 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.  The FDA agreed to allow it to be freely available in health food stores. In 1996 DHEA followed this trend. The A4M exerted pressure on the FDA to allow the sale of Co-Q10 in health food stores. Co-Q10 is an important cardio protective supplement and it became available in health food stores in 1998.

Insulin an aging substance

In 1999 the A4M stated in a public statement that insulin levels matter in obesity and diabetes. Newer research had confirmed this, and insulin 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. This means that heart attacks and strokes are due to the end stage of chronic inflammation in blood vessels.  Reduce or eliminate fasting insulin, reduce inflammation in arteries and you eliminate the risk for heart attacks and strokes.

Stem cells

In 2004 the A4M announced that stem cells could be an important treatment tool. It would allow to treat various end stage diseases so people could 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.

Adequate vitamin D3 intake

Originally the recommendation was to use 400IU per day  to fight rickets in infants. Now the guidelines have changed that 4000 or 5000 IU of vitamin D3 are necessary every day. This will take care of the 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 Asian American women in New Jersey with 91.8 years have the longest life expectancy in the US. It just so happens that in New Jersey most of the 26,000 A4M physicians are practicing. This 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.

Early detection of deficiencies from blood tests

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 treatment is only possible with early blood tests. They will detect any hormone or chemical abnormalities. It is possible to detect the beginning stages of any disease 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. Unfortunately this is what is 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.

Current treatment of hypertension

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 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.

False data about 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.

Testosterone replacement cuts heart attack rates

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”.

Mesenchymal stem cell/fat transplant

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.

Neuroplasticity in the brain

He also stated 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.

Zinc and hormone disbalance

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. In order to age gracefully it helps to know the length of your body’s telomeres.

Measuring telomere length

Dr. Andrews 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

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.

Western diet

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

Dr. Mark Rosenberg gave a talk about this topic. He has been involved with drug research in an attempt to elongate telomeres 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.

Low LDL cholesterol

But he also found in the literature and in his own clinical experience that patients with low LDL cholesterol have increased cancer susceptibility. Dr. Rosenberg 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.

Effect of lifestyle

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!”

Infiniti award for Governor Arnold Schwarzenegger

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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Aug
24
2013

Pimples And Acne Can Be Caused By Food

For a long time nobody knew why teenagers get acne. But many assumed that it would come from hormonal changes as teenagers grow up. But why then are there some ethnic regions in the world where teenagers do not get acne? In this blog I will present the background that shows that wheat, sugar and dairy products are the culprits. They are not eaten in those regions of our planet where acne does not exist.

Regions where acne does not exist

1. The Kitivan Islanders of Papua New Guinea have no cases of acne in teenagers. They adhere to the old hunter/gatherer diet of no sugar, no alcohol, no wheat and no grains. Instead they eat root vegetables such as sweet potato, yam, taro, tapioca; fruit like papaya, pineapple, banana, mango, watermelon, guava and pumpkin; and also vegetables, coconuts and fish.

2. African Bantus and Zulus: These original African warriors eat a low glycemic diet with no wheat, no milk and no refined sugar or starches. Their teenagers and young adult do not have acne, if they stick to the original tribal diet.

3. Aché hunter/gatherers of Paraguay: a study by researchers from the Colorado State University in 2002 showed that sugar, wheat and other high-glycemic foods were missing in the diet of these native tribes. As a result they have no acne when they consume this type of diet, which is very similar to the Kitivan Islanders of Papua New Guinea.

4. Japan’s Okinawans when sticking to their original diet before 1970 had clear complexion and no pimples (acne). But as this link shows the McDonald’s and other fast foods with too much salt, too much sugar, wheat, deep fried and convenience foods entered the scene after 1970 and the acne rate went up to the American level.

5. The natives of the Purus Valley in Brazil: A dermatological examination of 9955 school children age 6 to 16 showed an acne incidence of only 2.7%. In contrast in Westernized countries the rate of acne is 60 to 80%. The diet in this region is again similar to the other groups already mentioned above.

6. Canadian Inuit before 1950 did not consume dairy products and were acne free. Since then there has been a steady increase of dairy products, soda, beef, and processed foods.

How acne develops

The medical term for pimples or acne is “acne vulgaris”. For years it has been postulated that hormones and medication can cause acne. According to Ref.1 there are several steps that work together in causing acne. The hair follicle and sebaceous gland work as one unit. Male hormones, called androgens play an important role in the development of acne, both in males and females. Testosterone in males is not only produced in testicles, but also in the skin itself. It gets converted by an enzyme, 5-alpha-reductase, into the much more active metabolite dihydrotestosterone. In individuals with hypersensitive receptors in the sebaceous gland this will cause blockage in the sebaceous gland duct and at the same time stimulate the sebaceous gland oil production leading to the formation of a keratotic plug. White heads and black heads are formed this way. Contributing factors are inflammatory substances that are caused by insulin release stimulated by sugar, wheat and starch intake. This stimulates IGF-1 receptors in the skin, which causes growth of the subcutaneous skin layers, which is pushing up from the layer below the skin, kinking the sebaceous gland duct and causing acne pustules (pimples) to form. A skin bacterium, called Propionibacterium acnes (P. acnes), is getting trapped in the pimple causing a local skin infection, which in turn can cause acne cysts and furuncles, particularly in males where there is a family history of acne. High cortisol levels from stress can also be a contributing factor in causing acne. Today’s teenagers are exposed to a lot of stresses from exams, competitive sports and peer pressures.

Females with PCOS (polycystic ovary syndrome) have higher androgen production from ovarian cysts, which results in acne as well.

Both male and female teenagers experience an androgen surge when puberty sets in. If the teenager avoids the additional insulin response, which comes from eating sugar, starch, grain and particularly from consuming wheat and wheat products, the plugging up of skin pores will not occur, meaning these teenagers will be acne free. Some teenagers are also sensitive to milk protein from milk and milk products. In sensitive people whey protein allergy causes the same insulin/skin IGF-1 response described above, which leads to blocking of skin pores. If there is no blockage in the hair follicle, the P. acnes bacteria will stay on the surface of the skin (these bacteria are part of the normal skin flora) and the sebaceous gland secretions flow unimpededly to the surface of the skin keeping  it naturally lubricated. These observations are further confirmed by a study from Malaysia in 2012 showing that a high glycemic load diet with milk and ice cream caused worsening of acne in teenagers of both sexes.

Pimples And Acne Can Be Caused By Food

Pimples And Acne Can Be Caused By Food

Treating acne correctly

A)   Conventional acne treatment

This is a thorny issue, because Big Pharma has a firm hand in the treatment of acne and they are supporting symptomatic treatment of acne rather than treating the cause. There are surface treatment modalities that are supposed to open the skin pores: peeling agents such as benzoyl peroxide. General practitioners often treat the infection with antibiotic pills (tetracycline or erythromycin), but this is not treating the cause, only the super infection that comes from the plugged up skin pores (stasis of sebaceous gland secretions). Another approach is topical application of antibiotic and peeling agent in combination (1% clindamycin and 5% benzoyl peroxide gel), which is applied twice daily (Ref.2). Resistant cases, usually the ones who have a family history of severe acne, have been treated by a skin specialist who has a special license to treat with isotretinoin (Accutane), a vitamin A derivative, which works in many cases, but which can have serious side effects. These include skin dryness, eye dryness, muscle and bone pains, headaches, liver enzyme abnormalities, and instability of mood including depression and causing birth defects in the fetus of a pregnant woman (Ref. 3). In 2009 the manufacturer stopped distributing the drug in the US, because of too many lawsuits regarding damages from the drug.

I am not saying you should ever take this toxic medication. What I am saying is that treating symptoms, but not the cause has led to peculiar drug manufacturing. This drug is now used to treat brain cancer and pancreatic cancer.

B)   Dietary approach to treat acne

There has been a renewed interest in the last 40 years to sort out the connection between dietary factors and acne.

The most straightforward treatment in my opinion is to modify what you eat.

A clinical trial from the University of Melbourne in 2007 showed that a low-glycemic diet reduced the acne lesions by 22% compared to a control group.

Two factors are clear: a low-glycemic diet produces fewer pimples, the stricter the low-glycemic diet is applied, the more effective the treatment will be. Up to 50% reduction in acne lesions were observed among patients with acne who adhered to a strict low-glycemic index diet in just 12 weeks. There is also evidence that milk and other dairy products can contribute to acne, which works through the same mechanism of IGF-1 stimulation mentioned above.

A US study from Boston showed a 22% increase in acne lesions with total milk consumption and increase of 44% after skim milk consumption.

Omega-3-fatty acid supplementation is useful for inflammatory acne in about 2/3 of the cases as this study showed. Here is a patient from this study who benefitted from omega-3 supplementation. The baseline image is seen with inflammatory acne lesions on his cheek. Only 12 weeks after taking 3 Grams of omega-3 supplementation daily his face looked much improved.

Conclusion

There is a lesson to be learnt from the analysis of the regions in the world where acne does not exist and from all these observational studies mentioned. Cutting out wheat, wheat products, grains, sugar, milk and milk products will lead to amazing results regarding acne prevention and improvement of patients who suffer from acne. We have been lulled into believing that medical science will give us a magic pill or magic potion that would solve our complexion problems. As mentioned above one of the “magic pills” (isotretinoin) is so toxic that it is now used for cancer treatments. All along we allowed the food industry to destroy our complexion by inducing an insulin and IGF-1 response that plugged up our skin pores. We can open them up by eliminating wheat and wheat products, sugar, high-glycemic foods as well as dairy products.

More information on acne: http://nethealthbook.com/dermatology-skin-disease/acne-vulgaris/

References

  1. Rakel: Integrative Medicine, 3rd ed., Saunders 2012. Chapter 73 : Acne Vulgaris and Acne Rosacea, by Sean H. Zager, MD
  2. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., © 2009 Churchill Livingstone.
  3. Cleveland Clinic: Current Clinical Medicine, 2nd ed., © 2010 Saunders.

Last edited Nov. 7, 2014

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