Jan
21
2017

Effects Of Metformin On The Gut Microbiome

Matthew Andry, MD talked about the effects of metformin on the gut microbiome. This talk was delivered at the 24th Annual World Congress on Anti-Aging Medicine. The congress took place from Dec. 9 to Dec. 11, 2016 in Las Vegas. A lot of the sessions that I attended dealt with the gut flora and how it affects our health. This talk belongs to the theme of what a healthy gut microbiome can do for us.

History of metformin

Dr. Andry is a clinical associate professor of the Indiana School Of Medicine.

He pointed out that metformin has been used for a long time for type 2 diabetes, particularly, if fasting insulin levels are high. Metformin is a biguanide, which was isolated from French lilac (also known as Goats Rue). In the middle ages this herb was used to treat “thirst and urination”. In retrospect we recognize these as symptoms of diabetes. Chemists were able to synthesize the active ingredient in this herb in the 1920’s. Since then it is known as metformin. Dr. Jean Stern was able to show in the 1950’s in clinical studies that Glucophage, the brand name of metformin was able to reduce blood sugar without raising insulin levels. Between 1977 and 1997 metformin enjoyed wide spread acceptance for treating diabetics. Several clinical investigators demonstrated that diabetic patients on metformin lived longer and had less heart attacks than patients who were treated otherwise.

Metformin is the first-line drug in the treatment of type 2 diabetes in children and adults. It is one of the most widely prescribed drugs throughout the world with 120 million prescriptions per year.

Off-label use of metformin

There are many other clinical conditions for which metformin have been found to be beneficial. Polycystic ovary syndrome (PCOS), obesity, prediabetes, metabolic syndrome and nonalcoholic steatohepatitis are a few examples of off-label use of metformin. Metformin is also used as an anti-aging agent as it was found to elongate telomeres, which helps people to live longer. Metformin has been identified as a possible cancer prevention agent. In prostate cancer it was found to have an effect against prostate cancer stem cells. Without these cells prostate cancer does not recur after surgical removal.

Action of metformin

Metformin increases the action of an enzyme, AMPK, which leads to lipid oxidation and breakdown of fatty tissue (catabolism). In the liver the metabolic pathway of making sugar from fatty acids, called gluconeogenesis is inhibited. Metformin causes increased uptake of sugar into skeletal muscle tissue. This is the reason for the previously mentioned stabilization of blood sugar. Metformin has two beneficial effects on the liver. First it stabilizes insulin sensitivity. This means that a given amount of insulin has a larger effect on the liver. Secondly metformin decreases the toxic effect of fatty acids on the liver tissue. In other words metformin has a healing effect on non-alcoholic steatohepatitis, a precursor to fatty liver and liver cirrhosis. Metformin also has an effect on the appetite center in the brain. It helps many obese and overweight people, but not all to lose weight. The mechanism for that effect is in the hypothalamus, where the appetite center is located. The neuropeptide Y gene expression in the hypothalamus is inhibited by metformin leading to reduced appetite.

Finally, metformin also normalizes the gut flora. This last point was the main focus of Dr. Andry’s talk.

Metformin and the gut

An animal experiment on mice showed in a study published in 2014 that metformin was stimulating the growth of a beneficial gut bacterium, Akkermansia. This is a mucin-degrading bacterium. But it also affects the metabolism of the host. The authors found that metformin increased the mucin-producing goblet cells.

Akkermansia muciniphila bacteria were fed to one group of mice. This group was on a high fat diet, but not on metformin. The mice showed control of their blood sugars, as did the metformin group. In other words manipulation of the gut flora composition could achieve control of the diabetic metabolism. The authors concluded that pharmacological manipulation of the gut microbiota using metformin in favor of Akkermansia might be a potential treatment for type 2 diabetes.

Effect of metformin on the gut flora

Akkermansia muciniphila bacteria comprise 3%-5% of the gut flora. It does not form spores and is strictly anaerobe, in other words oxygen destroys it. This is the reason why it is difficult to take it as a supplement. It is mostly growing in the mucous of the epithelium layer of the gut. The highest number of Akkermansia bacteria is found in the colon, lesser amounts in the small intestine of all mammalian species including the human race.

Here are the effects of metformin on Akkermansia:

  • Metformin increases the Akkermansia bacteria count both in a Petri dish as well as in the gut of experimental mice. This suggests that metformin acts like a growth factor for Akkermansia.
  • Metformin increased the count of Akkermansia bacteria by 18-fold up to a maximum of 12.44% (up from the normal 3-5%) of all of the gut bacteria.
  • Researchers observed that the mucin layer of the lining of the gut in metformin treated mice was thicker. This suggests that the thickness of the mucin layer plays a role in increasing the Akkermansia count.

Effect of the gut on the body’s metabolism

Other researchers have investigated how a high fat diet can change the composition of the gut bacteria, which in turn are altering the body’s metabolism. Essentially a shift in the bowel flora can increase the gut’s permeability. This is called leaky gut syndrome. It leads to absorption of lipopolysaccharides (LPS) from bad bacteria in the gut. The end result is endotoxemia in the blood. This causes systemic inflammation in the body. Insulin resistance and obesity develop and this can be followed by type 2 diabetes. It is interesting to note that the effects of a high fat diet that led to these changes can be reversed by increasing Akkermansia bacteria in the gut or by treating with metformin.

An interesting mouse experiment showed that the changes that take place in the gut bacteria with cold exposure could be transferred to germ-free mice with no gut flora. This changed their metabolism proving that gut bacteria have profound influences on the metabolism. The fact that the gut bacteria have a profound influence on the metabolism is not only true for animals, but also for humans.

Akkermansia Facts

Here are a few facts about the Akkermansia bacteria.

  • The amounts of Akkermansia bacteria in the gut are inversely related to how fat we are. This is measured by the body mass index (BMI). Fat people have less Akkermansia in their guts.
  • A high fat diet lowers the amount of Akkermansia in the gut
  • Systemic inflammation is present with low Akkermansia counts
  • A high fat diet causes gut permeability (leaky gut syndrome).
  • Low levels of Akkermansia causes worsened severity of appendicitis and inflammatory bowel disease.
  • Low levels of Akkermansia causes fat storage (both in subcutaneous fat and visceral fat).
  • Low levels of Akkermansia cause insulin resistance (associated with diabetes) and high blood sugars.
  • Increased Akkermansia counts increase brown fat’s ability to burn calories, which leads to weight loss. Decreased Akkermansia counts lead to fat storage (weight gain).
  • Increased Akkermansia improves gut-barrier integrity
  • Increased Akkermansia reduces visceral and total body fat
  • Increased Akkermansia reduces synthesis of sugar in the liver (gluconeogenesis)

We have 10 times more bacteria in the gut than we have cells in our body. The Akkermansia percentage of the gut flora can be decreased from antibiotics or food that contains traces of antibiotics. If there is a lack of Akkermansia species, there is more gut permeability, causing LPS increase and causing increase of inflammation in the body. This translates into high blood pressure, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS. But it can also cause inflammatory bowel disease and autoimmune diseases.

What increases Akkermansia?

We can increase Akkermansia bacteria in the gut by eating Oligofructose-enriched prebiotics. Oligofructose belongs into the inulin type soluble fibers. It is found in a variety of vegetables and plants. This includes onions, garlic, chicory, bananas, Jerusalem artichokes, navy beans and wheat. But wheat can be problematic. Clearfield wheat is the modern wheat variety which is now grown worldwide. It is much richer in gluten and can cause problems with gut permeability.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria.

Metformin as pointed out earlier can be used as pharmacotherapy. But it must be stressed that the use of metformin for dysmetabolic syndrome is off-label. There are real side effects of metformin. Lactic acidosis with an unusual tiredness, dizziness and severe drowsiness can develop. Also chills, muscle pain, blue/cold skin and fast/difficult breathing has been described. Slow/irregular heartbeat, vomiting, or diarrhea, stomach pains with nausea are also listed under side effects.

Effects Of Metformin On The Gut Microbiome

Effects Of Metformin On The Gut Microbiome

Conclusion

Our gut bacteria are important for us, more so than you may be aware of. An anaerobe bacterium, Akkermansia makes up 3%-5% of the gut flora. This bacterium lives in the mucous layer of the lining of the gut and ensures that the gut wall is tight. When these bacteria are lacking (due to consumption of junk foods) the gut wall becomes leaky, which is why this condition is called “leaky gut syndrome”. Irritating toxic substances can now leak into the blood stream and lipopolysaccharides are among them. This causes inflammation in the gut wall, but can go over into the blood vessels and the rest of the body including the brain. High blood pressure, obesity, diabetes, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS can develop from the inflammation. But it may also cause inflammatory bowel disease and autoimmune diseases.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria. In particular, onions, garlic, chicory, bananas, Jerusalem artichokes and navy beans provide lots of oligofructose to support Akkermansia in your gut bacteria.

As pointed out earlier metformin can be used as pharmacotherapy of dysmetabolic syndrome. But it must be stressed that the use of metformin is off-label. It is also important to remember, that with effects there are side effects of metformin.

It may be news to you, how close the health of the gut is connected to our overall health. With the knowledge that food can be your medicine, choose your foods wisely. Add some or all of the above named foods that help you support beneficial gut bacteria, and take care of your health!

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Jan
02
2017

Gut Bacteria Can Protect Your Brain

The neurologist, Dr. David Perlmutter gave a keynote address where he pointed out that gut bacteria can protect your brain. The topic of his actual talk was “Rewrite your brain’s destiny” and the venue was the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. Many of the talks centered around the gut microbiome. In this talk Dr. Perlmutter stressed the fact that the right mix of gut bacteria will protect your brain, while the wrong mix can make you sick. There were many slides, but too much information to mention all of details of the talk here. I will summarize the broad outline of Dr. Perlmutter’s presentation and emphasize the practical implications this has for everyday life to prevent degenerative brain diseases.

A few facts

  1. Did you know that the brain uses 25% of the body’s energy, but has only a 3% of the body’s weight?
  2. The gut flora has trillions of gut bacteria with its own DNA material. 99% of the DNA material in our body comes from the gut bacteria and the bacteria on our skin surface; only 1% of the entire DNA in the body is your own DNA. We are eating for 100 trillion bacteria, but if they are good bacteria they provide us with important vitamins and they produce molecules that stimulate our immune system.
  3. This means we better have bacteria in our guts that are friendly, not the bad bacteria that can cause us problems. An Italian study determined the gut flora of children in central Africa (Burkina Faso) and compared the gut flora to children from developed countries in Europe. There was a significant difference with the African children having a healthy microbiome in the gut and the children from developed Europe having unhealthy gut bacteria. This is important new information. Many other research papers have established that leaky gut syndrome and autoimmune diseases are linked to dysbiosis, which is the name for the unhealthy microbiome in the gut.

Chronic inflammation

Dr. Perlmutter showed several slides where literature was cited showing that chronic inflammation in the civilized world is increasing. He also showed that dysbiosis (unhealthy gut bacteria taking over) is also increasing. On several slides Dr. Perlmutter showed that in civilized countries like Iceland, Denmark, Germany, the US, Japan and others the bacterial diversity of the gut bacteria in people was vastly reduced compared to the diversity of gut bacteria of people in Kenya, Ethiopia, Nigeria or rural India. The same countries that have diminished gut bacterial diversity (dysbiosis) also have the highest prevalence of Alzheimer’s disease. On the other hand the same countries with diverse gut bacteria have a low incidence of Alzheimer’s disease. When infestation with parasites was examined there was also a parallel between increased parasitic stress and low Alzheimer’s disease rates, again in countries like Kenya, Ethiopia, Nigeria or rural India. The same countries where gut dysbiosis was present the parasitic infestation was low.

Further research has established that gut dysbiosis leads to an inflammatory condition of the gut where lipopolysaccharides (LPS) from gut bacteria are absorbed causing inflammatory reactions within the body.

At the same time this leaky gut syndrome can cause obesity and leakage in the gut/brain barrier as indicated in this link. The result is neuroinflammation, cognitive impairment and vulnerability to develop Alzheimer’s disease. Our most dreaded brain diseases come from inflammation: Alzheimer’s, Parkinson’s disease, autism, multiple sclerosis etc. These are degenerative brain disorders due to chronic inflammation. If you eat a lot of red meat, sausages and processed foods your gut microbiome will undergo negative changes. If you eat healthy food with lots of vegetables, fruit and you cut out sugar and too many starches, you have a healthy microbiome, which develops a robust immune system. We have to rethink the gut/brain connection and learn how to prevent these chronic illnesses.

Obesity and gut dysbiosis

In the link above it was shown that obesity is associated with inflammation. It was also shown with MRI scans that the part in the brain, called hippocampus was shriveled up (atrophied). This is a typical sign of dementia and Alzheimer’s disease. The investigators also confirmed with mental health functional tests that these patients had cognitive decline.

Another study also noticed that in a group of obese patients the hippocampus part of the brain was shriveled up the more obese people were. Obesity is associated with dysbiosis of the gut flora.

Practical application: the DASH diet and the Mediterranean diet are both healthy, balanced diets, strikingly different from the Standard American diet. In a study the hypothesis was tested whether the DASH diet and the Mediterranean diet would postpone dementia in a group of elderly patients. The answer was: yes, the hypothesis is true.

What does gut dysbiosis do?

It was shown in mice that chronic inflammation of the gut through ingestion of an irritant (dextran sodium sulfate) led to reduced new nerve growth in the hippocampus compared to control animals. It only took 29 days to show a marked difference between experimental and control animals in terms of reduced growth in the nerve cells of the hippocampus, the center of cognitive control.

The negative mediators were inflammatory kinins released from the gut wall and affecting the brain.

Antibiotic treatments and antibiotic residues in milk, milk products, meat, but also in all GMO foods are the irritants of the gut wall in humans. The antibiotics change the gut flora and lead to dysbiosis, which then causes gut wall inflammation and the cascade of events described above. The new finding is that GMO food contains RoundUp (they are “Roundup ready” crops). The herbicide Roundup was originally patented as an antibiotic and still leads to significant dysbiosis. Dr. Perlmutter urged the audience to buy organic food as the only method to reduce our exposure to Roundup. Roundup contributes to causing celiac disease and gluten intolerance in addition to exposure to the modern wheat (Clearfield wheat). The FDA is starting to do testing on foods for Roundup (glyphosate).

If things are sounding bad for Roundup, it only gets worse: Roundup has now been linked to causing cancer. In medicine it usually takes some time before definite action is taken. The agriculture industry is so deeply entrenched in the use of Roundup; I suspect that denial will be the first line of defense. My first line of defense in turn is to stick to organic food.

To sum up: Roundup and the Standard American diet lead to dysbiosis in the gut, which causes leaky gut syndrome. This causes inflammation with the release of cytokines and LPS from the gut wall to the blood. These substances cross the blood/brain barrier and lead to inflammation in the brain. This affects the hippocampus with the classical sign of shrinkage. But Parkinson’s disease, multiple sclerosis, autism in children and Alzheimer’s disease in older people are all caused by chronic inflammation. There are three more brain-related diseases that are related to gut inflammation: stroke, depression and attention deficit hyperactivity disorder (ADHD). Dr. Perlmutter spent some time explaining that antibiotic overuse even leads to an increase of breast cancer as a Danish study has shown. Antibiotic use showed a linear increase of breast cancer as a result of increased antibiotic amounts used. The highest group had a twofold risk compared to a control group with no antibiotic use. Dr. Perlmutter interpreted this to indicate that chronic gut inflammation can even cause a disease like breast cancer.

What can we do to diversify our gut bacteria?

  1. Exercise: A recent study has shown that regular exercise is associated with a diversified gut flora. The reason seems to be the production of butyrate with exercise, which leads to a diversified gut flora. There are reduced LPS levels (lipopolysaccharides from gut bacteria) in people with a higher fitness score.
  2. Eat a DASH diet or the Mediterranean diet as indicated above.
  3. Avoid GMO foods because of the presence of Roundup, which functions like an antibiotic and leads to gut bacteria dysbiosis.
  4. Remember “Antibiotics are weapons of mass microbial destruction”. If you need to take them be careful that you rebuild your gut flora with probiotics. Use of antibiotics increases the risk of type-2 diabetes by 1.53-fold. It also causes a quadrupling of Alzheimer’s disease.
  5. A woman should consider natural childbirth whenever possible, as with a vaginal birth the child is “anointed with gut bacteria”. Vaginally delivered children remain healthier than children delivered by Cesarean section for several years.
  6. Acid-suppressing medications and NSAIDs (anti-inflammatory medication for arthritis) can also lead to dysbiosis. Proton pump inhibitors increase the risk of Alzheimer’s disease by 44%.
  7. Prebiotic fiber can prevent Alzheimer’s. Probiotics do the same.
  8. Avoid sugar: even the Oompa Loompa knew that “If you eat sugar, you get fat” as this YouTube video shows. And obesity is associated with gut dysbiosis with the associated higher risk of degenerative brain diseases.
  9. Take magnesium supplements (250 mg twice per day) and DHA from fish oil capsules. It stabilizes your brain metabolism.
  10. In severe, persistent cases of gut dysbiosis a fecal transplant can be considered by your gastroenterologist. This procedure is done in more than 500 hospitals in the US.
Gut Bacteria Can Protect Your Brain

Gut Bacteria Can Protect Your Brain

Conclusion

The diversity of gut bacteria is immensely important. As discussed, in rural areas of the world there is gut bacteria diversity. In civilized parts of the world dysbiosis of the gut flora frequently occurs. This can lead to gut inflammation and the inflammation eventually gets internalized and can even reach the brain. These are the points to remember: exercise; avoid GMO foods, use prebiotics and probiotics. Avoid antibiotics; also avoid meat from animals that were fed antibiotics for faster growth. Don’t eat processed foods and avoid sugar. A healthy gut creates a healthy body, and this includes a healthy brain as well.

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Oct
08
2016

Vitamin D3 Protects Your Brain

More and more studies are showing that vitamin D3 protects your brain. It protects against MS, but also against Parkinson’s disease and Alzheimer’s disease. In the following I will review what evidence there is to support each of these topics.

Vitamin D3 protects your brain from multiple sclerosis (MS)

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn produces less vitamin D3 in the skin.

MS is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that immune cells are calmed down by vitamin D3 and remission of an MS relapse is more likely.

There are two forms of MS, the relapsing-remitting MS and the progressive MS. The first one (relapsing-remitting) is more common. After a bout of active MS, the illness calms down and the condition of the patient is stable for some time until the next relapse occurs.

With progressive MS there are two forms, primary progressive MS and secondary progressive MS. The primary form is a case of MS where symptoms steadily worsen, without any remission. The secondary form of progressive MS occurs at the end of fairly stable relapsing-remitting MS. Symptoms become more pronounced and the condition deteriorates steadily from there.

Progression and disability in MS patients with various vitamin D3 levels

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015.

They took 1482 men and women who were on interferon beta-1b treatment. This treatment utilizes the immunomodulator interferon beta-1b and reduces the number of relapses in patients with MS. The study took place between November 2003 and June 2005. Results were analyzed between June 2013 and December 2014. The researchers measured vitamin D levels (as 25-hydroxy vitamin D). The vitamin D levels were obtained at baseline, at 6 months and 12 months.

The number of brain lesions were measured by MRI scans. All of the patients also underwent a functional test, called expanded disability status scale. This measured impairment of ambulation, ability to communicate and activity levels.

Results of this study showed marked differences between patients with high and low vitamin D levels. Those patients who had the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies had found that a low blood level of vitamin D (less than 25 ng/mL) in patients was associated with a much higher risk of developing MS. Dr. Fitzgerald’s study showed that a 50.0-nmol/L increase in serum vitamin D levels associated with a 31% lower rate of new MS lesions. Patients with the highest vitamin D level of more than 100 nmol/L had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Another study showed that a low-dose vitamin D level accelerated MS. There was a 5.9-fold risk converting the initial relapsing-remitting form of MS into the secondary progressive form of MS.

All these studies show that vitamin D3 can decrease the risk of getting MS. In addition vitamin D3 also delays progression in those who have MS.

Vitamin D3 protects your brain from Parkinson’s disease

Vitamin D3 plays a role in preventing Parkinson’s disease.

Parkinson’s disease is a neurodegenerative disease that causes tremor in muscles, causes balancing problems and eventually can lead to dementia. A metaanalysis was done in 2014 and 7 studies where identified to be relevant. The authors were looking for correlation of vitamin D levels with Parkinson’s disease. 1008 patients were included in the metaanalysis with 4,536 controls.

  • Patients with a vitamin D level of less than 75 nmol/L had a 1.5-fold higher risk of developing Parkinson’s disease than the controls.
  • Patients with a vitamin D level of less than 50 nmol/L were at a 2.2-fold higher risk of developing Parkinson’s disease.

Another metaanalysis utilized 5,690 Parkinson’s disease patients and 21251 matched controls.

It found that vitamin D levels of less than 20 ng/ml were associated with a risk of 2.08-fold to develop Parkinson’s disease. Interestingly, vitamin D3 supplementation reduced the risk of Parkinson’s disease by 38%. Outdoor work reduced the risk of developing Parkinson’s disease by 28%.

Vitamin D3 protects your brain from Alzheimer’s disease

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

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

What does vitamin D3 have to do with this?

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

Specifically the following observations were made.

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

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

Vitamin D3 combined with metformin suppresses cancer

The newest development with respect to vitamin D3 is the finding that it also has anti-cancer effects. Dr. Li demonstrated that vitamin D reduced prostate cancer cell line growth by 45% while metformin alone reduced it by 28%.

But when both vitamin D and metformin were present in the cell cultures there was growth inhibition of 86%. Dr. Li explained that vitamin D potentiated the growth inhibitory effect of metformin.

Vitamin D3 protects your brain: guidelines to proper vitamin D3 dosing

For years the medical profession stated that 400 IU of vitamin D3 would be enough supplementation. It may be enough to prevent rickets in children. But these low doses will be insufficient in many patients who are deficient for vitamin D to prevent MS, Parkinson’s disease, Alzheimer’s disease or cancer.

A study on medical staff in Northern India showed that 85% of the staff had very low vitamin D levels of less than 10 ng/ml.

It took high doses of vitamin D3 to increase the vitamin D level in the blood.

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

Vitamin D3 Protects Your Brain

Vitamin D3 Protects Your Brain

Conclusion

Many people are deficient with regard to vitamin D, and they do not know it. The most important thing is to do a vitamin D blood test to assess your vitamin D status.

We know for a long time that vitamin D plays a role in bone metabolism and this is why women approaching menopause often need vitamin D3 supplementation. But it may come to you as news that vitamin D3 also protects from MS, Parkinson’s disease and Alzheimer’s disease. In addition, as indicated above, we know that many cancers are suppressed by taking vitamin D3 regularly.

When you realize that all body cells have vitamin D receptors on their surface, it is no surprise that vitamin D3 is so important to take. The vitamin D3 receptors must be there for a reason. If your body is deprived of this valuable vitamin, the high risk of degenerative diseases will be the consequence.

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Feb
12
2016

Our Toxic Environment

Dr. Jill Carnahan gave a talk about environmental toxins at the 23rd Annual World Congress on Anti-Aging Medicine (Dec. 11-13, 2015) in Las Vegas. Her talk was entitled: “Diagnosis and Treatment of Environmental Toxicity”. It was very interesting, but it cannot be summarized here in depth with all of the details. It would take 10 pages or more to do this. Here I am summarizing the key points that she made, as they are not likely general knowledge. Dr. Jill is a functional medicine expert consultant and treats environmental and mold-related illnesses as well.

Toxins around us

The world we live in is full of toxins like industrial toxic chemicals, car exhausts, and housing materials (carpet, drywall, lumber, flooring). The list goes on with clothing bedding and furniture. More chemicals lurk in the bathroom: they can be found in toothpaste, hair shampoo, conditioners, and personal beauty products that we apply to our face and bodies. Cleaning products and laundry chemicals are also on the list.

Why is it important to be aware of that? Because toxic chemicals that enter our bodies through the skin, the gut and the lungs will accumulate over the years in fatty tissue, in breast tissue and breast milk. Over the long term they contribute to the development of cancer, autoimmune disease like Crohn’s disease or thyroiditis and many other chronic diseases, particularly neurodegenerative diseases like Alzheimer’s and Parkinson’s disease.

Environmental history and tests

Dr. Jill (as Dr. Carnahan calls herself) explained in great detail how important it is to take a thorough environmental history, which includes exposure to occupational poisons, home environmental and nutritional exposures, not only for the present time, but also back several decades. One tool Dr. Jill uses consists of several websites that list environmental toxins by zip code. When the physician is informed of of the places where the patient has lived and worked, based on the zip codes a complete exposure picture emerges.

Symptoms are the indicator whether or not toxins may play a role: fatigue, sleep disturbances, memory problems, headaches and the presence of more serious conditions like autoimmune diseases, neurodegenerative diseases and cancer.

In addition refined blood and urine tests are performed that check out toxic levels of common toxins.

There are exotoxins, coming from the outside: phthalates, parabens, heavy metals, solvents, organophosphates and pesticides to just name the more common ones. Toxic molds and heterocyclic amines are also exotoxins. These latter carcinogens (heterocyclic amines) are produced by overheating meat.

Then there are endotoxins, toxins that are produced inside the body: endotoxins in the form of toxic lipopolysaccharides from gram negative bacteria (causing toxic shock syndrome), yeast, chemical additives from food, stress and constant negative emotions leading to an overdose of glucocorticosteroids. All of this leads to the total toxic body burden.

Total toxic body burden

Here what leads to the total toxic body burden: Eating a Standard American Diet is one of the main reasons why people accumulate toxins. Add to that petrochemicals, residues, pesticides, and fertilizers, and exposure to heavy metals, like mercury and lead. Some medications like antifungals can also be toxins. Food allergies, environmental allergies and allergies to molds indicate that the body has accumulated toxins. There are also internal toxins from bacteria, fungi, viruses, and yeast that contribute to the total toxic burden. Hormonal and metabolic toxins that aren’t eliminated properly add to the problem, as do isolation, loneliness, anger, jealousy, and hostility. These negative emotions function like toxins on the immune system. Mental illness can contribute similarly in a negative manner, as the mind and the body work together.

When to expect environmental toxicity

A functional medicine expert like Dr. Jill will suspect environmental toxicity when one or more of the following symptoms are present:

Headaches, joint pain, muscle aches, fatigue, difficulty concentrating, food cravings, gas/bloating, constipation, foul-smelling stools, diarrhea, postnasal drip, sinus congestion, canker sores, heartburn, insomnia, trouble losing weight, water retention, rashes, acne, skin problems, psoriasis, eczema, dark circles under the eyes, bad breath or premenstrual syndrome.

Diseases that are related to environmental toxicity

As already mentioned before Parkinson’s disease and Alzheimer’s disease are among the neurological diseases that have been identified to be linked to environmental toxicity. Some forms of dementia and MS also belong to these. In the very young child autism has been identified as filtering out those who are particularly sensitive to environmental toxicity. Attention deficit disorder also belongs here.

Among adult patients heart disease, chronic fatigue syndrome, fibromyalgia, Crohn’s disease and ulcerative colitis are red flags for possible underlying environmental toxicity. Food allergies, depression, anxiety and insomnia can also be indicators of environmental toxicity. Arthritis, menstrual disorders, autoimmune disease and any form of cancer are also flags for environmental toxicity.

Dr. Jill explained that the doctor who specializes in environmental issues would take a detailed history paying attention to chemicals the patient may have ingested or be in contact with. It also includes a dental history, including whether or not the patient has silver amalgam fillings or had them removed without subsequent chelation therapy.

She even showed several slides of known associations with specific toxins for the diseases just indicated. These are subsequently identified as closely as possible by doing toxicity tests.

Markers of reserves

There are several marker substances that get used up when the body starts detoxifying some of the environmental toxins.

  1. Glutathione levels in the blood can be measured and can serve as an indicator as to whether or not the body has been challenged by toxins. Glutathione is synthesized by the liver and is a powerful antioxidant and toxin remover. A low glutathione levels is associated with many chronic illnesses.
  2. A low total antioxidant capacity is an indicator that toxic metal exposure, infection, inflammation, xenobiotic exposures or environmental toxicity in general may be present. There are two metabolic pathways that are important for detoxification to occur: the methylation pathway and the trans-sulfuration pathway. It would be too technical to go into this further, but treatment concentrates on re-establishing these metabolic pathways.
  1. Co-Q-10 (=ubiquinone) can be measured in the plasma and is also a marker of reserve. It can also be given as a supplement at 400 mg per day, which will strengthen mitochondrial function. The mitochondria are the energy packages of each cell.

Organic acids

There are organic acids that are toxic. One of them is methyl-tert-butyl ether (MTBE), which is an additive used to increase octane ratings in gasoline. It has been found in ground water from leaks of gas from tanks in filling stations. Inhalation at the gas station can cause dizziness, headaches and mental confusion. In animals it has caused gastrointestinal irritation, liver and kidney damage. Another organic acid, styrene, is widely distributed in rubber, insulation, plastic, fiberglass, food containers and carpet backing. The US-EPA has labeled it as “potential human carcinogen”. Special tests, which the environmental doctor can order can measure the levels of these organic acids in the body.

Epigenetics

Autistic children have taught doctors a lot about epigenetics. After initial 2 or 3 years of normal functioning autistic children suddenly have a variety of severe symptoms like balancing problems, lack of social skills, problems concentrating, tiptoeing etc. What happened is that one or more of the enzymes involved in the methylation pathway are no longer working properly because of epigenetic effects, events that cause their DNA to have a different gene expression. However, with detoxification and nutritional rehabilitation it is possible to turn this around, as the underlying cause is not a fixed genetic defect, but rather an epigenetic malfunctioning. You fix the methylation pathway, and full function returns.

Other research has shown that a similar methylation defect occurs in PTSD and in schizophrenia. Orthomolecular physicians have developed treatment programs for schizophrenics that often work (but not in all cases).

Dr. Jill stated that with genetic disease there is a multitude of characteristic symptoms, which is due to abnormal methylation pathways that is often combined with a severe oxidative overload, caused by environmental insults. Most cancer and chronic diseases are epigenetic in nature, not caused by genetic causes. Dr. Jill explained that the molecular switches of the epigenetic switch that turns a gene on or off have been unmasked: Acetyl groups promote gene expression, while methyl groups inhibit gene expression. As long as there is a balance in the methyl/acetyl ratio, the patient is healthy; the moment environmental toxins disturb the balance and an epigenetic switch occurs, the patient is heading towards disease. What genes are switched on or off determines what disease will develop.

More toxins: alkylphenols, organochlorines and volatile solvents

Alkylphenols: Bisphenol (BPA) is contained in food and beverage containers, water bottles and plastic dinnerware. Many countries have outlawed BPA in baby bottles.

Triclosan is contained in deodorants, toothpaste and shaving creams.

Organochlorines: Many of these substances have been banned because they are persistent poisons. Because of this they are still in the environment today, particularly in non-organic produce. DDT was used agriculturally as an insecticide until 1972, but is still found now in meat, poultry, dairy products and fish. Hexachlorobenzene was used as a pesticide until 1965 and as fungicide in cereal grains. Mirex was used as a pesticide for fire ants until 1978.

When you buy non-organic butter, farmed Atlantic salmon, non-organic cheese and non-organic fatty meats (lamb, ground beef) they contain various pesticides.

Dr. Jill’s advice: don’t buy that, but buy organic food!

Sauna therapy and colonic irrigations will remove much of the chlorinated pesticides. Chlorophyll and all chlorophyll containing foods will also help in eliminating persistent organic pollutants. This could be a good reason to consume the occasional homemade green smoothie with leafy organic ingredients like spinach or kale!

Volatile solvents: Benzene (gasoline), styrene, toluene, xylenes are all solvents contained in car exhaust fumes and styrene in Styrofoam. Don’t microwave food contained in Styrofoam, as it releases the toxic styrene into the food. Avoid breathing the fumes of gasoline, glues and solvents; use non-toxic cleaners. Vitamin C, selenium and glycine help to detoxify volatile toxins.

After discussing mold and mold toxicity as well as glyphosate toxicity from GMO crops in detail, which would be too long to discuss here, Dr. Jill presented a quick

Clean diet 101”:

  1. Buy organic food. It should be sugar-free, gluten-free, dairy-free, non-GMO food.
  2. Buy only whole and un-processed foods, a variety of leafy greens and other chlorophyll-rich foods. Add to this a variety of colorful fruits and veggies, but avoid the dirty dozens; buy them organic.
  3. Limit processing of your food.
  4. Get local or homegrown food; avoid refined oils and trans fats.
  5. Limit alcohol and caffeine.
  6. Avoid food allergens; avoid the most toxic foods.
  7. Avoid farmed Atlantic salmon, high mercury fish like tuna, orange roughy, Chilean sea bass, shark and swordfish. Here is a detailed guide to low mercury fish. Stick to “very low” and “low mercury fish”.
  8. Avoid non-organic eggs & dairy. Avoid the dirty dozen fruits/veggies mentioned under point above.
Our Toxic Environment

Our Toxic Environment

Conclusion

Here is a quick whirlwind tour through toxins in our environment. The most important step I suggest you take is to review the toxins in your bathroom and around the house. The next important step is to buy and eat the right foods that are toxin free. If you follow Dr. Jill’s “clean diet 101” as described above, you will avoid exposure to toxic substances. Your healthy food intake becomes your maintenance treatment to detoxify at the same time. Only more seriously affected people need to see an expert like Dr. Jill. People with mercury or other heavy metal poisoning may need a series of intravenous chelation treatments as mentioned in this link. The entire process requires a lot of attention and vigilance. Ask questions about products and read labels. It is worth the effort, as this means preventing health problems in the future.

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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

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Apr
25
2015

Rejuvenate With Stem Cells

We all age; but can we rejuvenate with stem cells? There is a limit to detoxification, to eating organic food, to exercising, to the effects of vitamins and supplements and even to the effect of bioidentical hormone replacements. The limit comes from our telomeres and from stem cells that get depleted in our body as we age. Some researchers report that in regions where we suffer from a disease stem cells are even more depleted than in the rest of the body.

We do not have all the answers yet. We would like to know why our stem cells in the fatty tissue or in the bone marrow do not migrate on their own into an aching back or a sore shoulder. There are all the aches and pains associated with old age. So, why do our own stem cells not help us? They seem to be locked away in fatty tissue and in bone marrow.

At the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec. 10-14, 2014) I learnt that there is a group of stem cell experts in California with affiliates all over the US. They simply take stem cells from the fatty tissue and sometimes also from the bone marrow, isolate the stem cells through a stem cell separator and infuse the stem cell rich fraction (minus fatty and connective tissue) in a bit of saline solution back into the vein of the patient. When the stem cells are in the blood stream, they get activated by the growth factors that are present in blood and can now find where they are needed and start the healing process.

Studies have shown that when stem cells are in circulation in the blood, they are very sensitive to signals from tissues that indicate that there is an inflammatory process. This is why stem cells will repair arthritic changes. The can repair a torn meniscus, a rotator cuff tear in the shoulder or repair a weak immune system. The interesting observation is that stem cells from fatty tissue, also termed mesenchymal stem cells, are pluripotent. This means they can develop into cartilage building cells (chondrocytes) and build up cartilage; this is badly needed in a person with severe osteoarthritis. But stem cells are flexible: they can turn into meniscus cells in a knee with a torn meniscus. They also can repair the damage and relief the patient of the chronic pain. In a shoulder with a rotator cuff tear they can turn into a tough ligamentous material mending the tear.

Some data even indicates that circulating stem cells can repair vital organs like the brain, heart, liver, kidneys and bone marrow; these latter observations were mostly done in animal experiments, but human data is starting to be published in the medical literature.

So, let’s examine what has been found useful with regard to stem cells that are taken from your fatty tissue or your bone marrow and injected into one of your veins.

Here is a website from Arizona that I am only showing as a typical example (I have no conflict of interest and no commercial connections to this group) of what I described above.

With websites like this it is also important to read the disclaimer: “Even though our treatments are done using autologous cells, our Stem Cell Therapies are not approved by the FDA. Stem Cell Treatments are not a cure for any condition, disease or injury, nor a substitute for proper medical diagnosis and care…” Another website from La Quinta, CA describes the use of mesenchymal stem cells for regenerative therapies.

Stem cell treatments are in flux. There is a large body of knowledge that has accumulated showing that with proper technique and aseptic conditions it is a safe procedure. The FBA has been watching this. There are publications regarding the safety of procedures with adipose mesenchymal stem cells; here is one example.

The next step is to show in clinical trials that a certain procedure with stem cells is effective in treating a certain condition.

Below I did a literature review, which are only a few examples, but does not claim to be complete; it highlights some of the problems with stem cell treatments.

Stroke treatment with intravenous administration of bone marrow mononuclear stem cells

This study from India showed no statistical difference of stroke patients treated intravenously with bone marrow derived mononuclear stem cells (the experimental group) and the control group that did not receive such treatment. The investigators examined both groups with functional brain tests and performed PET scans to look at the healing of the brain lesions. Unfortunately the tests showed no statistical difference, but did show that the stem cell procedures were safe. It may be that the wrong stem cells were used (mononuclear bone marrow stem cells) when adipose derived mesenchymal stem cells may have done better. In stark contrast to the study from India is the stem cell treatment for a severe stroke in the former hockey player, Gordie Howe that has gone through the media recently. His procedure was done in Mexico. The stem cells were administered via a lumbar puncture approach as well as intravenously. As you can see from this case, stem cell treatment is even possible in patients who are in their mid 80’s with impressive results.

Parkinson’s disease

Here is a feasibility study from March 2014. A 71-year-old Asian man with progressive supranuclear palsy, an aggressive form of Parkinson’s disease was treated with adipose tissue-derived mesenchymal stem cells that were administered intravenously and intrathecally (to get stem cells into the cerebrospinal fluid that bathes the brain). A remarkable functional recovery took place.

Possible side-effects

This is a report of pulmonary embolism after administering intravenous adipose tissue-derived stem cell therapy. The blood clots in the lungs were treated with anticoagulant therapy. Repeat CT scans of his lungs showed later that the emboli were dissolved spontaneously. It is not clear whether this was a case where familial clotting problems pre-existed as a relative of this patient experienced a similar occurrence after stem cell therapy as well.

A case of chronic autoimmune thrombocytopenic purpura

A rare form of autoimmune disease exists where the body forms antibodies against platelets that help your blood to clot. Here is a paper from June 2009 that describes how a man with this disease was cured using adipose tissue-derived mesenchymal stem cells that were injected intravenously.

Renal transplant survival in type 1 diabetes patient

This case report from India shows that adipose tissue derived mesenchymal stem cells that were given at the time of a kidney transplant to treat end stage kidney disease. The treatment stabilized the condition of this patient after a kidney transplant. At the same time some of the mesenchymal stem cells differentiated into insulin producing cells, which made it much easier to control this patient’s diabetes. In this case stem cells were providing stability following an organ transplant (kidney) and some stem cells turned into insulin producing pancreatic cells.

Osteonecrosis of hip treated with adipose tissue derived MSC

In this study from South Korea dated January 2012 two cases of osteonecrosis of the hip, where the hipbone died (osteonecrosis) are described. The following stem cell protocol helped: The fraction that contained the stem cells (called stromal vascular fraction) was mixed with platelet rich plasma and hyaluronic acid. Using a long needle this mixture was injected into the affected hip joint. Conventional medicine has nothing to offer except a total hip replacement. But here are two cases that showed complete resolution of their pain, regained hip function completely, and healing could be documented with the help of MRI scans.

Treating heart attack patients with stem cells

Here is a paper from The Netherlands, published in June 2014 that describes the problems with stem cell treatment in humans. It points out that much has been learnt from animal experiments. The problem following a heart attack is that there is a massive inflammatory response in the infarcted heart muscle, which makes it difficult for stem cells to establish themselves in the injured heart muscle. However, stem cells have been shown to prevent the development of cardiomyopathy that follows a massive heart attack and often is the cause of death. More refinements are needed for successful treatments, such as the ideal timing of stem cell injections in relationship to the time of the heart attack, the best treatment approach and what number of stem cells to inject are all questions that still need to be answered.

MS model in mice shows promise with adipose mesenchymal stem cells

Experimental encephalitis in mice is used as a model for MS in humans. It helps to preselect potentially effective treatments for MS in humans. In this 2013 paper from Australia researchers used mesenchymal stem cells from adipose tissue and injected them intravenously. To their surprise the mesenchymal stem cells were able to penetrate the blood/brain barrier and end up in the myelin lesions inside the brain. In contrast, bone marrow derived stem cells were unable to do that. The researchers stated that adipose mesenchymal stem cells should be considered “as a cell therapeutic that may be used to treat MS patients”.

A group from Iran published this paper in February 2015 further emphasizes that mesenchymal stem cells would be a logical way to treat MS in humans.

Immunosenescence

As we get older the immune systems weakens because of a process called immunosenescence.

A research group from Austria published a paper in December 2011 that is typical for the thinking that mesenchymal stem cells from fatty tissue have properties that help the immune system to get stimulated. Based on this human data it should be possible to stimulate the immune system by giving stem cells from the fatty tissue to the same person intravenously. This publication shows that this process, which would benefit people above the age of 50 or 60 when the immune system gets weaker, will indeed stimulate the immune system. However, at this point we do not have the data of large clinical trials where this would have been done with measurements of the immune function before and on several occasions after stem cell injection to get a feeling for how long the effect would last. We also do not know whether this procedure is associated with longevity.

Rejuvenate With Stem Cells

Rejuvenate With Stem Cells

Conclusion

Stem cell therapy is definitely coming and many applications are already established as I discussed in a prior blog. It is only recently that physicians are no longer worried about creating tumors with stem cell transfer. Now we are in a phase where various stem cell transfer methods (intravenous, intrathecal, interstitial) are being tested as a treatment for various illnesses. It looks like stem cells from fatty tissue may soon be used intravenously, but I have not seen any such trials when checked on PubMed. The activation of stem cells by laser light has only been mentioned sparingly in the literature. This combination (laser activated, intravenous mesenchymal injection) has the potential for being useful for a multitude of chronic illnesses like fibromyalgia, MS, generalized arthritis, just to mention a few. Mesenchymal stem cells are anti-inflammatory, and they can mend defects without leaving scars.

Apr
15
2015

Avoid Brain Atrophy

When a 24-year old football player (Chris Borland) suddenly decides to quit his active sports career, because he wants to plan for a disability-free long life without brain atrophy, the world listens. Chris did his research about traumatic brain injuries, which can lead to degenerative brain disease or chronic traumatic encephalopathy (CTE). Trauma to the brain is just one cause of brain shrinkage (medically termed “brain atrophy”).

I like to take a broader overview of the topic of brain atrophy, which looks at all of the factors that can lead to brain shrinkage including physical injuries to the brain from blows to the head.

The vast majority of cases of brain shrinkage do not come from physical injuries, but rather from medical illnesses. Many of them including many sports injuries are preventable. This is the topic of my blog today.

Brain atrophy means a loss of brain cells, which causes a smaller brain. An MRI scan (around 800 to 1000$) will give information about the brain.The most sophisticated tool to depict the functioning of the brain may be the SPECT scan (ranging from 2000 to 2500$).

What causes brain atrophy?

It is important to realize that a multitude of different factors can cause the same end result – brain atrophy. All of these factors work together causing brain atrophy and the more factors are at play the worse the outcome. So, let’s review the various known causes of brain atrophy.

Diabetes

It has been known for a long time that diabetics can develop brain atrophy and dementia when their blood sugars are not well controlled. This leads to the formation of advanced glycation end-products (AGEs).

Insulin and IGF-1, a factor produced by the liver in response to human growth hormone have been found to counter the development of brain atrophy in diabetics.

The key in patients with diabetes is a close control of blood sugars, best measured as the hemoglobin A1C blood test. At the 22nd Annual World Congress on Anti-Aging Medicine In Las Vegas (Dec. 10-14, 2014) Dr. Theodore Piliszek stated that the new normal range for hemoglobin A1C is 3.8 to 4.9%, quite a bit lower than the normally recommended values. Accepting the old values that proclaim levels of 5.5. as normal automatically puts you in a higher risk of developing brain atrophy and dementia.

Cardiovascular disease

What is good for the heart is good for the brain. That is what Dr. Perlmutter stated in his book (Ref.1). But the reverse is also true: if your cardiovascular system is sick, your brain gets sick!

Here is a full-text article that describes how intimately connected heart function and brain function is.

Cardiovascular disease is a broad term and includes atrial fibrillation, blood clots in the coronary arteries or brain vessels (medically called “thrombotic events”), high and low blood pressure, heart failure, heart valve defects, low cardiac output, inflammation in the blood and a genetic marker, called Apo E, which is commonly associated with Alzheimer’s disease.

The end result of any of these conditions will cause brain atrophy. Once a problem is identified, it is important that the patient is seeing the appropriate specialist who will take care of the risk factor in order to prevent brain atrophy.

Vitamin B deficiency

Some people are born with a certain degree of a methylation defect, a deficiency of certain enzymes, which prevents methylation of brain hormones and other metabolic products. This can lead to depression, schizophrenia, memory loss and you guessed right: brain atrophy, which manifests itself as Alzheimer’s disease or dementia.

By using the proper nutrients with high enough supplements of vitamin B2, B6 and B12 this biochemical process can be restored and brain atrophy can be prevented. SAMe is also a useful supplement that supports methylation and a normal brain metabolism. Ref.2 explains methylation defects in more detail.

Obesity

The question is whether the “brain shrinks as the waist expands”. The answer is a clear “yes”. Researchers have found that the grey matter (with which we think) in the frontal lobes of the brain shrink in obese people of all ages. The researchers found further that the grey matter shrunk in the temporal and parietal parts of the brain of people in middle and old age.

The key here is to cut out refined carbs (sweetened sodas, pasta, bread, sugar in any form), as they are the ones that cause obesity. This occurs by the liver metabolizing sugar and turning it into fat that is stored. Just by cutting out sugar and starchy foods both my wife and I lost 50 pounds each in 2001. It can be done, but it takes a bit of will power.

The terminology may be confusing here: it is really sugar that causes brain atrophy via causing obesity and damage to the blood vessels.

Smoking and alcoholic beverages

Smoking leads to brain atrophy by damaging the blood vessels that are supposed to supply the brain with nutrients. If blood vessels close off or hardening of the arteries reduces the blood flow to the brain, brain cells die and brain atrophy develops.

Smoking also robs the body of vitamins, which slows down the brain cell function.

Alcohol is a nerve cell poison; it causes brain atrophy by directly damaging the brain cells (grey matter).

The results are memory loss, poor judgment, problems planning one’s future, loss of control with regard to emotions. This can lead to violent behavior and problems with regard to inter-personal relationships.

Genetic factors

ApoE4 gene variant, which causes inherited Alzheimer’s disease, causes a change of brain metabolism with deposits of a glue-like substance in the brain that damages nerve connections resulting in memory loss.

Researchers believe that ApoE4 is implicated in 20 to 25% of all Alzheimer’s cases.

Despite this apparent negative story, there is hope by radically changing one’s diet and taking supplements. Not every patient with one or two doses (alleles) of ApoE4 comes down with Alzheimer’s.

Avoid Brain Atrophy

Avoid Brain Atrophy

What can you do to prevent brain atrophy?

Supplements: Take regular B complex vitamins (particularly B2, B3, B6, folic acid, B12), vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q-10 (or CoQ-10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwaganda, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE. All of these have been found to support brain function and often restore memory function. Unfortunately regular anti-Alzheimer’s medications are not keeping their promise and on average just delay Alzheimer’s by 3 to 6 months. For details how these supplements work see this link.

Omega-3 fatty acids including DHA: These essential fatty acids from fish oil are very useful as they are anti-inflammatory and help support the normal brain metabolism, particularly DHA. In a Feb. 2015 US study from the Rhode Island Hospital 193 Alzheimer’s patients, 397 individuals with mild cognitive impairment and 229 normal individuals were followed for 5 years with MRI scans and cognitive tests every 6 months. 117 subjects were taking fish oil on a regular basis. The study showed a decline in gray matter in those who did not take fish oil and in carriers of the apolipoprotein E4 gene (a gene liked with Alzheimer’s disease). The gray matter on the MRI scans and brain function measure with cognitive function tests were much better preserved in those who took fish oil supplements.

Resveratrol: This powerful antioxidant is an anti-aging supplement. It is preventing heart disease, hardening of the arteries and helps preserve brain function by keeping the brain vessels from getting clogged up. DHA and omega-3-fatty acids are helping in that regard as well.

Eat nuts: Nuts are healthy (provided you are not allergic to them); but just because you are allergic to one kind does not mean you are allergic too all of them. Often a person allergic to hazelnuts will not be allergic to Macadamia nuts, cashew nuts or walnuts. Nuts contain a mixture of essential fatty acids, blood vessel friendly, saturated fatty acids and minerals that are all brain supportive.

Exercise regularly: Whoever moves and exercises keeps the heart healthy and whatever keeps the heart healthy keeps the brain healthy as stated before.

Stress management and sleep (avoid chronic overstimulation of your brain): In our hectic society everything has to be instant, the expectations of managers are high, the labor force is stressed. The fastest runner, the best player etc. is celebrated. The rest of us often feel like “underdogs”, if we allow this type of thinking to rule ourselves. Use yoga, self-hypnosis, meditation, religious mediation and prayer to counter some of the stress from everyday life. We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. He had developed end stage arthritis in his hips and required total hip replacements on both sides. He wanted to illustrate that stress leads to physical consequences; it may be a heart attack in one person, a stroke in another, arthritis in a third. Constant overdrive has physical consequences.

Avoid sugar and starchy foods: I left this point as the last as it may be more difficult to understand. I started touching this topic under “obesity” above. An overload of refined carbs leads to an overstimulation of the pancreas pouring out insulin. Too much insulin (hyperinsulinemia) causes hormonal disbalance and leads to diabetes type 3, the more modern name for Alzheimer’s. All starch is broken down by amylase into sugar, so essentially you get a sugar rush from any starchy food as well. Too much sugar in the blood oxidizes LDL cholesterol, which leads to inflammation in the body. The consequence of this are the following conditions: hardening of the arteries, strokes, heart attacks, Alzheimer’s due to brain atrophy, arthritis, Parkinson’s disease and cancer. I have blogged about these topics in many separate blogs.

Conclusion

In this blog I have reviewed how brain atrophy develops. There are a multitude of factors that over a lifetime can lead to brain atrophy. Repetitive head trauma from contact sports is only one reason; poor nutrition with too much sugar and starch and missing essential fatty acids (omega-3/DHA) is another potential cause. Add to this a lack of exercise, too much stress, alcohol and smoking and you covered most of the causes. Studies have shown that even when you carry the ApoE4 gene trait, only 30% will express it as supplements can suppress the expression of it. The key is prevention. Preserve your brain cells, prevent brain atrophy!

References:

Ref. 1: David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

Ref.2: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Mar
07
2015

Drink Your Coffee, But…

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

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

1. Calcification of coronary arteries and osteoporosis

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

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

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

2. Whether or not you put sugar into your coffee

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

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

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

4. Micronutrient components of coffee

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

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

This link explains more details about the micronutrients in coffee.

5. Clinical conditions that are partially prevented by coffee consumption

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

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

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

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

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

6. What are the risks of drinking coffee?

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

7. What is the process of decaffeinating coffee?

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

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

Drink Your Coffee, But…

Drink Your Coffee, But…

Conclusion

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

References:

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

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

Dec
21
2013

Buying Into High Carb, Low Fat Myth Makes You Sick

If you are like most people, you probably still think that “healthy grains” like wheat are good for you and are “essential for a well balanced diet”. Ever since Kellogg’s introduced cereal for breakfast and the bagel was invented as a mid morning snack, which has captured the tastes of millions, the Agro Industry and the food industry have lobbied to have “healthy grains” in the food pyramid or on your plate. The very thought of “the daily bread” is deeply ingrained in our culture.

Other agencies like the Heart Foundation, the Academy of Nutrition and Dietetics (formerly “American Dietetic Association“) and the American Medical Association have reiterated this statement over and over until both the public and physicians accepted this as the truth. However, the scientific data does not support this point of view!  It has been a myth!

We are gradually learning that there has been a big misinformation campaign going on as far back as 1984 (and before) when a consensus panel came up with revised normal values for cholesterol and we as the medical profession were told (myself included) to treat high cholesterol levels much earlier and more aggressively than in the past with statins.

Big Pharma is still pushing for this. Now that I am retired for more than three years I can freely write about what is really going on. The truth has already leaked out, but it is not yet common knowledge.

I like to review the switch from the old school of thought that a high carb/low fat diet would be healthy to the new school of thought that a low carb/high healthy fat diet is healthy. Before you panic, sit back, relax and read what I am saying.

Buying into High Carb, Low Fat Myth Makes You Sick

Buying Into High Carb, Low Fat Myth Makes You Sick

A brief history of the high carb/low fat diet recommendation

It was the Framingham Study, which is an ongoing study since 1948 where a large group of people was followed for decades to sort out what causes heart attacks and strokes and how one could develop a program of prevention. This objective at the beginning of the study was very noble and promising. However, as time went on the results from the Framingham Study that were published intermittently appeared to be more and more confusing.

First there was the lipid theory that was based on the observation that high lipids (called triglycerides) and high cholesterol in the blood would cause heart attacks and strokes. It was assumed that it must have been the fats in the diet that would have caused this. Based on this thinking the lipid theory of arteriosclerosis was formulated, a theory trying to explain how heart attacks were caused.

If this theory were true, a lowering of the blood lipids and cholesterol should have lowered the rates of heart attacks and strokes. Many large trials were done and the statins were developed to lower cholesterol. In a recent blog I have explained that this has not lowered the mortality rates from heart attacks and strokes, but instead of admitting that the researchers made a mistake, many are still doggedly holding on to the dogma of the lipid theory. The truth is that the lipid theory has not been proven to be true; the recommendation of a high carb/low fat diet has also not worked out to save lives by preventing heart attacks and strokes. In fact the opposite is true: older people with high cholesterol live longer and have less Alzheimer’s disease than those with lower cholesterol levels in the blood as Ref. 1 has explained in detail. Dr. Perlmutter mentioned a study from the Netherlands (Ref. 1, page78) involving 724 individuals who on average were 89-year old that were followed for 10 years. Those with high cholesterol lived longer than those with low cholesterol, exactly the opposite of what the lipid theory predicted! Specifically, for each 39% increase in cholesterol there was a 15% decrease in risk of mortality. Think about it: the brain and the heart have LDL receptors on their cell surfaces for a reason. The reason is that both vital organs burn fat and need cholesterol to build up the membranes of the brain and heart cells.

Despite this compelling evidence Big Pharma is in denial and you will still find the lipid theory of arteriosclerosis heavily mentioned on the Internet as the only “valid” explanation for how heart attacks and strokes would be caused.

Inflammation as the alternative explanation of arteriosclerosis

Since the mid 1990’s the first reports surfaced to explain that about 50% of patients with normal cholesterol levels still develop heart attacks. In these patients the C-reactive protein, an inflammatory marker, was very high indicating that an inflammatory process likely caused their illness.

Subsequently further research was able to show that the LDL cholesterol, when oxidized by sugar was responsible for clogged arteries in these patients. It also became apparent that diabetics have a much higher risk to develop heart attacks than patients with normal blood sugars. This led to the conclusion by several different research teams that the lipid theory was wrong and needed to be abandoned.

Instead a new theory has developed that explains that heart attacks and strokes develop in patients where free radicals have damaged LDL cholesterol. This oxidizes LDL cholesterol and leads to hardening of the arteries (arteriosclerosis). Sugar from increased carbohydrate intake has a lot to do with this: it leads to glycation of protein causing glycation end products (abbreviated as AGE’s).

This is an appropriate name as it really is the cause of premature aging, of developing wrinkles, of getting premature hardening of arteries and having a 50-fold risk of free radical formation. This in turn will lead to more tissue aging. LDL used to be thought of as the “bad cholesterol” (I myself have used that term in the past). LDL is now known to be the friendly and important transport form of cholesterol, which is sent from the liver to the brain and heart cells that need it for their metabolism. If LDL is oxidized, however, it becomes useless and the heart and brain cannot absorb cholesterol for membrane synthesis via the LDL receptors. The end result is that vital organs like the heart and the brain do not get enough oxygen and nutrients, which leads to heart attacks and strokes. The free radicals that are released from oxidized LDL cholesterol and that circulate in the blood cause an inflammatory response in the lining of the arteries all over the body, which you know as hardening of the arteries (arteriosclerosis).

This may sound complicated, but all you need to remember is that sugar and starch consumption lead to accelerated hardening of arteries in your body, which causes heart attacks and strokes.

Reassessment of what a heart healthy, brain friendly diet is

The above-mentioned research findings require a complete re-thinking of what a healthy diet would be. The villain turned out to NOT be saturated fat (meat, eggs, butter and avocado), but rather TRANS fat (margarine, hydrogenated polyunsaturated fatty acids) and I agree with the FDA that this should be abolished.  Trans fat is full of free radicals oxidizing LDL cholesterol, which we just learnt is causing hardening of arteries. It is sugar and starches that turned out to be the main villain. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you also as they lead to inflammation through the arachidonic acid system in the body. Conversely flaxseed oil, omega-3 fatty acids (EPA and DHA) derived from fish oil are very protective (anti-inflammatory) oils, as is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well.

The new “heart and brain healthy diet” consists of no refined carbohydrates (sugar and starch), but about 45% complex carbohydrates (organic vegetables like broccoli, spinach, cauliflower, Brussels sprouts, peppers, onions, garlic, peppers, Swiss chard, zucchini, asparagus etc.), 20 % protein and 35% saturated and other fats like omega-3 (1:3 mix with omega-6) fatty acids and monounsaturated fats (like olive oil or coconut oil).

According to Ref.1 you can even eat butter, lard and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Dr. Perlmutter (Ref.1) points out that even extreme diets like the Inuit diet with 80% saturated fat and 20% protein leads to longevity with healthy arteries. The patients who died in the many trials including the Framingham Study did so, because of free radicals from sugar, starch and wheat. Wheat contains the addictive gliadin molecule (part of gluten), which makes people eat more sweets and starchy foods. The liver turns the extra calories into visceral fat deposits that in turn cause the release of cytokines like tumor necrosis factor alpha (TNF alpha) and COX-2 enzymes.

This causes inflammation, heart attacks, strokes and cancer.

Contrary to what Big Pharma wants you to know cholesterol is an anti-inflammatory, LDL is a cholesterol transporter (provided it is not oxidized) and HDL is protective of hardening of the arteries as long as the “ratio of total cholesterol to HDL cholesterol” is less than 3.4 for males and 3.3 for females. This is the cholesterol risk ratio used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2).

Paradigm shift in causation of heart attacks and strokes, but also of cancer, and neurological diseases

As pointed out in Ref. 1 there has been a paradigm shift in our thinking about what causes inflammation and what causes all of the major diseases including premature aging. Many physicians are not up to date in this new thinking although it has been in the medical literature since about 1995. In my colleagues’ defense I like to say that they are busy people and they do not always have the time to do their continuing education. However, it is imperative that the public learns about this paradigm shift as it affects literally everyone. In my YouTube video on the home page of www.nethealthbook.com I have talked about this new thinking in the summer of 2012. Now we are learning that there is an anti-inflammatory, cholesterol containing, fat rich diet without refined carbs, but containing ample complex carbs, which is a modified zone diet or a modified Mediterranean diet that will prevent all these diseases. At the same time it is a weight loss diet as cholesterol and fat in your diet stops the liver from producing lipids and triglycerides and helps you to lose weight. Critics will say that it sounds too good to be true, but I agree with Dr. Perlmutter and Dr. Davis, both of whom have provided ample evidence that it is true. Try some of their recipes. Just read Ref. 1 and 2, where recipes are listed in the back part of their books. Or try the recipes I listed for one day in this blog. I am publishing a book entitled “A Survivor’s Guide To Successful Aging” through Amazon.com, which will come out later in early 2014 where you can find recipes for 1 week in the last chapter.

Conclusion

There has been a paradigm shift in the thinking of how hardening of the arteries is caused. Now it is known that an inflammatory process causes it. It is an overindulgence in sugar, starch and wheat products that causes the liver to produce lipids, cholesterol and leads to the “wheat belly” and the “grain brain”. All of this causes cytokines to bring about an inflammatory reaction that affects the lining of arteries causing heart attacks, strokes, but also Parkinson’s disease, MS, autism, asthma, arthritis, epilepsy, Lou Gehrig disease and Alzheimer’s disease (Ref.1). The inflammation does not stop there. If you keep up the high carb/low fat diet, it will lead to various cancers (Ref. 1 and 3). The solution is a diet high in healthy fats (I would call it a low carb/medium high healthy fat diet) as outlined above consisting of 30 to 35% healthy fat, 20% of protein and 45 to 50% of complex carbs, but none of the refined carbs. I have followed such a diet since 2001. I am enjoying that I can now eat  a reasonable amount of healthy fats, which I was not aware of being allowed before I read Ref. 1 and 3, but I continue with the antioxidant vitamins and anti-inflammatory supplements to prevent LDL oxidization. I hope that many of you can benefit from prevention so you can enjoy a healthy life without being a victim of illness or disability.

More information on:

1. arteriosclerosis: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

2. paradigm shift regarding hardening of the arteries: My book “A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling” explains the content of this blog in much more detail.

References

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

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

3. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Nov. 7, 2014

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Dec
01
2006

Rotigotine Patch For Parkinson’s Also Helps Restless Leg Syndrome

One of the difficulties in curative medicine is compliance. There are various aspects: patients dislike the feeling of dependency on medications. In some cases there is a dislike for swallowing that pill, and if medications have to be taken several times per day, it can present even more of a challenge. People are busy with their daily routines, they may forget the one or the other dose, and it may very well compromise the effectiveness of a medication.

Various medications can now be administered through a transdermal patch. For sufferers of Parkinson’s disease a new transdermal treatment with the dopamine agonist rotigotine (brand name Neupro®) has been tested. It can become the first line of defense and ease the symptoms. The transdermal patch was generally safe, and as it was well tolerated, patients did not discontinue the treatment. The treatment with rotigotine can help postpone the commonly used medication levodopa, which tends to lose effectiveness over the years.
Another study with the rogitotine patch showed effectiveness for individuals suffering from restless leg syndrome. This disorder makes sleep difficult, and as a result the patient turns sleepy during wakeful hours. Dr. Karin Stiasny-Kolster, a neurologist at Phillips University in Marburg, Germany reported on favorable results with 340 patients suffering of restless leg syndrome.

Rotigotine Patch For Parkinson's Also Helps Restless Leg Syndrome

Rotigotine Patch For Parkinson’s Also Helps Restless Leg Syndrome

In a controlled study, those patients who were wearing the rotigotine patch were showing improvement. Again, the transdermal system was well tolerated and safe and there was no problem with fluctuating dopamine levels. Placebo-treated patients did not respond. The product has been released in European countries and the FDA is investigating for release in the US soon.

More information about restless leg syndrome: http://nethealthbook.com/neurology-neurological-disease/restless-leg-syndrome/

Reference: The Medical Post, November 3, 2006, page 57-58

Comment: The FDA approved the patch under the name “Neupro-P”. Here is a meta analysis. It shows that the drug improved symptoms of Parkinson’s disease. but it also was associated with more side effects.

Last edited November 2, 2014