Feb
18
2017

Weight Gain In Menopause

Dr. Tasneem Bhatia, also known as Dr. Taz gave a lecture about weight gain in menopause. This was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The full title of the talk was “Hormone Balance and Weight Control in Menopausal Women”. Dr. Taz practices integrative medicine at CentreSpring MD, Atlanta. GA.

A few statistics about menopause

Weight gain in menopause is common. There are 50 million women who suffer from this in the US. Globally 300 million women have this problem. The average weight gain is between 5 and 50 pounds. There may be a small percentage of women where a genetic component comes in, and where all the females in the ancestry had a weight problem after menopause. But we do not know for certain what is genetic and what is due to hormone deficiency. It is only in the last few decades that doctors have determined how important hormone deficiencies are in menopause.

About 10 million women who are over 40-years-old need treatment in long-term care facilities.

We will see below that when physicians incorporate this knowledge into a treatment schedule, the weight problem can normalize. It is possible to reduce the costs of taking care for postmenopausal women with obesity and diabetes by 2/3 of these cases.

Pathophysiological changes in menopause

There are three intertwining aspects that drive weight gain in menopause. There is an altered metabolic rate, and less calories are burning, which makes you gain weight when you eat the same amount of calories. Secondly there is a significant decline of three key hormones, estrogens, progesterone and thyroid hormones in menopause. Third, as the weight rises and the other mentioned hormones are missing, it is harder for the pancreas to keep up with insulin production and insulin resistance develops. I will explain this further below.

1. Decreased energy expenditure

With the lack of the ovarian hormones there is a slowing of the resting metabolic rate. There is also is a decrease of energy expenditure from reducing fat oxidation. Overall there is less need to consume the same amount of calories as before. But the hormonal changes trigger hunger and cravings.

2. Ovarian aging

With ovarian aging there is less estrogen production in the ovaries. This leads to less ovulation in the premenopausal period. A lack of ovulations creates a lack of progesterone production. When there are anovulatory cycles, there is no progesterone producing corpus luteum reducing progesterone production further. When estrogen and progesterone are missing, this is a stress on the thyroid gland that is trying to partially compensate for the lack of the ovarian hormones. Eventually though there is permanent thyroid hormone production and hypothyroidism sets in. This is very hard on the adrenal glands that produce cortisol. For some time the adrenal glands can compensate for missing thyroid hormones with cortisol overproduction. But in time adrenal gland fatigue develops.

3. Insulin resistance

Insulin resistance can lead to diabetes, which becomes a real menace together with the metabolic changes of obesity.

Health risks of weight gain

Dr. Taz pointed out that around the time of menopause there are very specific risks that have to do with the metabolic changes. There is a definite risk for heart attacks and strokes as LDL cholesterol and triglycerides show an increase and arteries calcify from circulating calcium leaking out from the bones into the blood stream.

Osteoporosis is common in menopause; the brittle bones lead to an increased risk of fractures in the hips, wrists and vertebral bodies.

Postmenopausal women also risk increase of cancer, particularly breast cancer and colon cancer. The higher the weight, the more risky it is for these women to get one of these cancers.

Alzheimer’s disease and cognitive decline is also very common in menopause. This may be directly related to a lack of estrogen and progesterone, but may also have to do with overconsumption of sugar and starchy foods.

Hormone changes in menopause

Hormone changes in menopause can be complex. It is not only about a lack of estrogens and progesterone. All hormones work together. When there is weakness in one area (in the ovaries with menopause), this condition will affect the hormones that are acting in the same way or in opposition to ovarian hormones. In this way it is understandable that the thyroid gland can develop a weakness (hypothyroidism) or why the adrenal glands are over stimulated first, but later suffer from adrenal fatigue. In a similar way the pancreas produces too much insulin, partially because weight gain stimulates this. Typically the physician finds the fasting insulin level elevated with menopausal obesity. But as insulin levels are too high, the body’s insulin receptors get lazy and do not respond fully to insulin anymore. The name for this condition is insulin resistance. In time insulin resistance can lead to diabetes.

1. Lack of estrogen

A lack of estrogen in menopause is likely the single most important reason for weight gain in menopause.  As estrogen secretion declines, visceral obesity increases. In addition there is an impairment of insulin regulation. With obesity there is an additional risk of developing diabetes.

2. Progesterone

Progesterone is the other female hormone that is reduced with menopause. Bioidentical progesterone cream can prevent osteoporosis and hot flashes in menopause. Bioidentical progesterone replacement can also help a menopausal woman to sleep better. In menopause the production of progesterone goes down by 75% while estrogen production drops down by 35%.

3. Hypothyroidism

Menopausal women often suffer from hypothyroidism (with elevated TSH blood tests). Weight gain is often part of this. As a result it is important to check for hypothyroidism in menopausal women. It is important to check for micronutrients like iodine, selenium and iron and if they are low, supplementation may be necessary. Some women develop an inflammatory thyroiditis, called Hashimoto’s disease. A thyroid nuclear scan can confirm this. The reason this is important to recognize is that after several years when it burns itself out, hypothyroidism develops often, which requires thyroid hormone replacement.

4. Cortisol response

The cortisol response to stress is suboptimal due to the decreased progesterone levels in menopause. Progesterone is a precursor of cortisol, so in menopause not enough of it is around to synthesize cortisol. But in a group of menopausal women following a significant stressful event cortisol production was much higher than in non-stressed women.

5. Other hormones

Other hormones like leptins and melatonin are also contributing to weight gain in menopause. In rat experiments performed ovariectomies (mimicking menopause) and there was a clear relationship between low estrogen levels and weight gain. Higher estradiol doses inhibited leptin expression resulting in weight normalization.

Leptin and melatonin are influencing insulin regulation. This can in time lead to diabetes in connection with weight gain. It is at this point when a woman’s body shape can turn from a healthier pear shape to an unhealthy apple shape. The extra visceral (abdominal) fat is very active metabolically and causes inflammation in the body. These changes can lead to high blood pressure, heart attacks, strokes and digestive dysfunction.

Treatment of weight gain in menopause: food, hormones and lifestyle

How do you treat a complex problem like weight gain in menopause? It is no surprise that this will require a number of treatment modalities in combination.

1. Diet

It is important to start on an anti-inflammatory diet like the Mediterranean diet. Any extra sugar should be cut out as surplus carbohydrates lead to fat deposits and higher blood lipids. Dr. Taz suggested a 1200-calorie diet. Reduce salt intake. Eat more food during the day until 4 PM, nothing to eat after 8 PM. Increase plant-based foods, lower or eliminate trans fats. Increase foods rich in probiotics (bifidobacteria) like kefir, yogurt and kombucha.

2. Exercise 

Do some exercise in a gym where you combine a treadmill for 30 minutes with 25 minutes of weight machines for strength training. Aim for doing this 5 times per week. But it would be more beneficial doing it every day. Have additional activity bursts on and off during the day. Exercise has been shown to increase HDL cholesterol, which protects from heart attacks and strokes.

3. Stress management

Supplements like adaptogens help the adrenal gland to better cope with stress. These are available through your health food store. Meditation, yoga, self-hypnosis will all help to refocus and protect you from stress. B-complex vitamins and vitamin C strengthen your immune system and give you more energy. Building and maintaining community is another factor in reducing stress.

4. Establishing healthy sleep

Many postmenopausal women have poor sleep habits, partially from hot flashes (due to estrogen deficiency), partially from melatonin deficiency and also from progesterone deficiency. In the next section I will describe how to normalize these hormones. But in addition you need to educate yourself to go to bed between 10 PM and 11 PM every night and to sleep 7 to 8 hours. If you go to bed later, you will disturb your diurnal hormone rhythm and this will interfere with a normal sleep pattern. There is an age-related reduction of melatonin production in the pineal gland. This is why many postmenopausal women are deficient in melatonin. You may need 3 mg of melatonin at bedtime. If you wake up in the middle of the night you could take another 3 mg of melatonin. You may experience a few nightmares as a side effect; otherwise melatonin is very well tolerated.

5. Bioidentical hormone replacement

The complex hormone deficiencies described above are responsible for the many symptoms of menopausal women including weight gain. It is important to work with a knowledgeable health care provider who knows how to prescribe bioidentical hormones. Typically blood tests and possible saliva hormone tests are done before replacement. This establishes which hormones have to be replaced. Typically bioidentical progesterone is replaced first. Secondly, estrogen is added as Bi-Est cream, if blood levels indicate that it is low. If thyroid is required because of a high TSH level (meaning hypothyroidism) supplementation with Armour or a similar balanced T3/T4 combination is started. If fasting insulin levels are high, the doctor may want to start metformin as this is known to normalize insulin resistance. Blood tests have to be repeated from time to time to ensure adequate hormone levels.

6. Supplements

Every woman treated will likely require different supplements. But magnesium is one mineral that is often missing in the diet. 250 mg of magnesium twice a day will be enough for most women and men to balance internal metabolic reactions. Magnesium is a co-factor to many enzyme systems. Vitamin K2 (200 micrograms daily) and vitamin D3 (around 4000 to 5000 IU per day) in combination are important to prevent osteoporosis. Apart from these there are many options to take other supplements. Ask your healthcare provider what you should take.

Weight Gain In Menopause

Weight Gain In Menopause

Conclusion

This was a fast review of what Dr. Taz explained in a talk about weight gain in menopause. There are complex hormone changes that need to be addressed. Patients with menopause need to follow a well-balanced diet like the Mediterranean diet. Stress management skills need to be learnt. A regular exercise routine needs to be followed. Healthy sleep patterns have to be reestablished. And missing hormones need to be replaced not in synthetic forms, which are toxic to the body, but in the bioidentical forms. Postmenopausal women will feel better when this comprehensive treatment program is in place; and in time they will feel normal again.

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Feb
04
2017

Benefits Of The Ketogenic Diet

Dr. Jeff Volek, PhD, RD gave a talk that clarified the benefits of the ketogenic diet. He is a professor at the Department of Human Sciences at The Ohio State University, Columbus, OH, and teaches in the Kinesiology Program. His lecture was part of the 24th Annual World Conference on Anti-Aging Medicine in Las Vegas, Dec. 9 to 11, 2016.

There were 58 slides, some of them very detailed. I will summarize as best as I can what the presentation was all about.

History of diets

Dr. Volek stated that there were unintended consequences when the low fat/ high carb diet was introduced in the 1970’s and 1980’s. Ancel Keys, a physiologist had proposed in his diet heart hypothesis that saturated fat was the culprit that caused heart attacks.

As a result all major health agencies recommended the low fat/high carb diet. Obesity, diabetes, heart attacks, and strokes were the consequences. Another offshoot later from this was the statin craze where everybody was put on statins as high cholesterol was symptomatically treated. Nothing changed the diabetes and obesity wave and heart attacks and strokes continued to kill the affected persons. Among performance athletes the hypothesis was formed that carb loading would increase muscle performance. Researchers showed evidence that carb loading would improve performance. But athletes were dissatisfied with prediabetes and metabolic problems. Both the average consumer as well as the performance athlete noted that they felt better on a low carb/high fat diet. This is what the ketogenic diet is all about.

Diet heart hypothesis

With the diet heart hypothesis the saturated fat was removed from the diet and replaced by vegetable oils rich in linoleic acid. Dr. Volek explained that blood tests and other investigations were done on people who ingested the low saturated fat/high carb diet. The question was whether this would reduce heart attack rates and deaths by lowering serum cholesterol.

The Minnesota Coronary Experiment was a double blind study, which answered this question.

Cholesterol was reduced in the experimental group. But there was no reduction of heart attacks or strokes compared to a control group. Of concern was the large amount of refined carbohydrate content with the low fat diet. This essentially was responsible for the obesity and diabetes wave. The excess sugar turned into fat deposits and to insulin resistance, which caused diabetes. The low saturated fat/high carb diet of the 1960’s to 1990’s did not reduce heart attacks and strokes. To the contrary: the obesity/type 2 diabetes wave it had caused increased mortality from strokes and heart attacks further.

Laboratory tests on low fat/high carb diet versus the ketogenic diet

Forget hypotheses for a moment. Let us review what the different diets do in terms of lab tests. In a study where physicians put 40 overweight people with metabolic syndrome on a low fat diet or a low carb/ketogenic diet, they received the following blood test results. There were 20 patients in each group.

  1. Low fat/high carb diet

Triglycerides in the blood went down by 20%, saturated fatty acids by 22%. LDL (the bad cholesterol) rose by 4%. Insulin levels went down by 17% and leptin levels also down by 17%. Glucose levels were down by 1%.

  1. Low carb/ketogenic diet

Triglycerides went down by 52%, saturated fatty acids by 57%. LDL (the bad cholesterol) went down by 18%. Insulin levels went down by 49% and leptin levels by 42%. Glucose levels were down by 11%.

In this group of 20 subjects for each group the body mass index went down by 5% for the low fat diet and by 10% for the ketogenic diet after 3 months. The abdominal fat went down in that time by 12% for the low fat diet and by 20% for the ketogenic diet. The conclusion from these laboratory results and from the body measurements is that the low fat diet is showing some results of weight loss, but the ketogenic diet has superior results. The same is true for the blood tests. Only the ketogenic diet showed reduction of 7 key anti-inflammatory markers. In contrast, the low fat diet did not trigger the production of a single anti-inflammatory marker.

Anti-inflammatory benefits of the ketogenic diet

A 2008 study showed that several anti-inflammatory markers were greatly reduced from the ketogenic diet while a low fat diet did not show such a reduction.

As this 2009 study showed the LDL particles were getting bigger under the influence of a ketogenic diet, but they were getting smaller with a low fat diet.

Large LDL particles are also called pattern A particles, while small LDL particles are also called pattern B particles.

As this link shows there is good evidence that small LDL particles oxidize easier and are more atherogenic (causing hardening of the arteries). This means they lead to hardening of the arteries easier translating into heart attacks and strokes down the road. It is one thing that a ketogenic diet leads to larger LDL particles, which are more resistant to oxygenation. But it is another good thing that this diet is also anti-inflammatory. Overall this means that a ketogenic diet is counteracting the development of heart attacks and strokes.

Are saturated fatty acids in the diet causing heart attacks or strokes?

Dr. Volek discussed several large studies that have investigated this question. One of these studies discussed was a metaanalysis from 2010. Like all the other studies it showed that saturated fatty acids do not cause heart attacks and strokes. This is the secret behind the Inuit and the Eskimo diet. It is a high fat and meat diet. There is lots of seafood on the menu as well, which provides omega-3 fatty acids.

Dr. Volek pointed out that if you replace a certain percentage, let’s say 5% of saturated fatty acids with carbohydrates, this would cause 7% more heart attacks. He showed literature evidence to back this up. What causes increased heart attacks and strokes is more refined carbs in your diet (sugar and starchy foods!).

Do saturated fatty acids in your blood increase the risk for disease?

Dr. Volek showed several slides with references to various publications. Elevated saturated fatty acids in the blood cause a higher risk of getting a heart attack, heart failure, metabolic syndrome and diabetes. But this does not happen with a ketogenic diet. The values of the saturated fatty acids in the blood are 4% lower with the start of a ketogenic diet. With a low carb diet the calories derived from carbs are 12%. In comparison a low fat diet has 56% of carbs. Protein content in the low fat diet is 20%, in the ketogenic diet 28%. Saturated fat content in the low fat diet is 24%, in the ketogenic diet it is 59%.

Comparison of saturated fatty acid diet with the ketogenic diet

Let’s assume that both diets remain at 1500 Cal. per day. Then the saturated fat content for the low fat diet is 12 grams and the carbohydrate content is 208 grams. For the ketogenic diet these values are as follows: 36 grams of saturated fat and 45 grams of carbohydrates. Although there was a threefold higher saturated fatty acid intake, measurements of the circulating level of saturated fatty acids were 4% lower.

You are what you eat, but go easy on carbs

Dr. Volek pointed out that what makes you healthy or sick is how many carbs you include in your diet. If you follow a ketogenic diet with only 12% carbs you are much better off than when you follow a diet like the low fat diet with 56% of carbs. The higher the carb percentage in your food, the higher the production of saturated fatty acids in your system and the higher the storage of saturated fatty acids in your body fat. Conversely, the lower the carb percentage in your food is the higher the oxidation of saturated fatty acids will be.

Low fat diet compared to ketogenic diet

In other words the saturated fatty acids disappear from your blood. Also, with a ketogenic diet the storage of saturated fatty acids is lower in your body fat. With a low fat diet your insulin resistance increases, while with a ketogenic diet insulin resistance decreases. The difference in calories in these two diets (56% derived from carbs in a low fat diet versus 12% derived from carbs in a ketogenic diet) explains why the obesity/type 2 diabetes wave has developed and why heart attacks and strokes still top the mortality figures today.

Endurance athletes win medals on a ketogenic diet

Dr. Volek shared a few cases of world-class athletes that are on a ketogenic diet. They did well for themselves winning medals. Tim Olsen won the Western States 100-mile endurance run from Squaw Valley to Auburn, CA in 2012. Zach Bitter was the 100-mile track record holder in 2015. Mike Morton won the American 24-hour distance running record for 172 miles. Two Tour De France bicyclists made first and second place, Chris Froome (first place) and Romain Bardet (second place).

Sports teams also have been successful on a ketogenic diet: the Columbus Crew soccer team; New Zealand national rugby union team, commonly called the All Blacks; the Los Angeles Lakers basketball team are all on ketogenic diets.

Dr. Volek also pointed out that the military has tested the ketogenic diet. A ketogenic diet restores metabolic health, gives the soldiers more endurance, more stress resistance and decreased fatigue.

Benefits Of The Ketogenic Diet

Benefits Of The Ketogenic Diet

Conclusion

A ketogenic diet is on the one end of the carb spectrum with only 10 to 12% of calories derived from carbs. At the other end is the low fat/high carb diet that caused the obesity/diabetes wave. The Mediterranean diet is in the center. The more you are able to cut down the carb percentage in your diet by cutting out sugar and starchy foods, the more your metabolism stabilizes and blood tests can be measure this. The ketogenic diet makes you lose weight down to your ideal weight and makes you gain more muscle strength and physical endurance. Sophisticated blood tests have shown that inflammatory markers go down on a ketogenic diet and factors that lead to hardening of arteries also go down.

The end result of being on a ketogenic diet

The end result on the ketogenic diet is that the rate of heart attacks and strokes goes down, something which was the original goal of Ancel Keys. It did not work, but it promoted a wave of diabetes and heart disease! Ironically adding saturated fat and other healthy fats while cutting down carbs will achieve disease prevention. This is the opposite of what Ancel Keys had recommended to do and what the processed food industry has mimicked. The ketogenic diet lowers mortality by cutting down heart attacks and strokes. With this knowledge it will finally be possible to get people on a path to better health.

More information about ketogenic diet: https://www.dietdoctor.com/low-carb/keto

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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. Specifically, 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. With this in mind, I will summarize the broad outline of Dr. Perlmutter’s presentation and certainly emphasize the practical implications this has for everyday life to prevent degenerative brain diseases.

A few facts

Did you know that the brain uses 25% of the body’s energy, but has only a 3% of the body’s weight?

There are trillions of gut bacteria

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 it is important to remember that if they are good bacteria they provide us with important vitamins and they produce molecules that stimulate our immune system.

We need healthy gut bacteria

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.

Diminished gut bacterial diversity causes more Alzheimer’s disease

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.

Leaky gut syndrome causes neurological diseases

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

The link above showed that obesity has a connection to inflammation. It was also shown with MRI scans that the part in the brain, called hippocampus was shrivelled 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 and dysbiosis of the gut flora are part of the same problem.

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 gut wall released inflammatory kinins, which were the negative mediators affecting the brain.

Antibiotic residue and Roundup in food causes gut dysbiosis

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).

Roundup linked to cancer

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 the effect becomes obvious is. The agriculture industry has embraced 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.

Chronic inflammation and neurological disease

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. LPS levels (lipopolysaccharides from gut bacteria) are lower 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 gets into contact 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”. Obesity and gut dysbiosis cause a 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 takes place 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 becomes internal 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.

Dec
17
2016

Magnesium Is Essential To Life

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

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

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

A lack of magnesium can cause heart disease

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

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

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

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

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

Low magnesium increases your stroke risk

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

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

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

Those with the highest magnesium supplement had a 26% lower stroke risk. Those with the lowest magnesium intake served as a control.

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

This study included 32,826 participants in the Nurses’ Health Study. Examiners followed them for 11 years.

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

Magnesium protects kidney function

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

Magnesium helps blood sugar control

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

An important factor in helping control blood sugar is magnesium. Here is an article as an example.

Magnesium good for bones and teeth

Magnesium is important for calcium metabolism and this is helping your bones and teeth to stay strong. The bones store half of the body’s magnesium. Another location for magnesium are in our teeth.

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

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

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

Those who took magnesium supplements had healthier teeth.

Migraine sufferers improve with magnesium

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

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

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

Intravenous magnesium showed effects on improving migraines within 15 – 45 minutes. The authors concluded that one could supplement other migraine treatments with both oral and intravenous magnesium.

Too little magnesium can cause cancer

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

Pancreatic cancer

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

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

Colorectal cancer

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

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

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

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

Live longer with magnesium

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

Because of the distribution of the enzymes to which magnesium is a co-factor, virtually every cell in the body depends on our regular intake of magnesium.

Magnesium deficiency develops in older age

Since the 1950’s soils have lost magnesium where farmers grow vegetables and raise fruit trees. We simply do not get enough magnesium from food.

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

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

Proton pump inhibitors lowering magnesium levels

At this age many people are on multiple drugs. For many proton pump inhibitors (PPI) are used to suppress acid production in the stomach. PPI’s have been associated with low magnesium blood levels. This link explains that when a patient takes PPI’s the total time of taking the medication should not exceed 1 year.

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

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

Here is why we live longer with magnesium supplementation

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

The bottom line is we live longer and healthier; that is the meaning of longevity.

Magnesium Is Essential To Life

Magnesium Is Essential To Life

Conclusion

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

Dec
11
2016

Cancer Rates Increased In Women

A recent review of cancer rates worldwide shows that cancer rates increased in women. This by itself is alarming, but based on that data the rates likely will go up by 60% in the year 2030. The main reason is the smoking discrepancy among women and men. Men as a group have been smoking more than women. But women as a group are more and more embracing smoking. All of the negative health consequences of the last 3 decades for men are just starting to show now for women as well.

The World Health Organization explains it this way: in high-income countries like Australia, Canada, the US and Western Europe women smoke at nearly the same rate as men.

But in low and middle income countries women do not smoke as much as men do. For instance in China 61% of men are smokers, but only 4.2% of women are smoking. In Argentina 34% of men are currently smokers, which compares to 23% of women who smoke in this country.

When this gap will close, likely by the year 2030 women will have a whole host of diverse cancers, heart attacks and strokes caused by the smoking habit.

Some statistics and facts

High-income countries like Australia, Brazil, Canada, Israel and many northern and western European countries have a 5-year survival rate for breast cancer of 85%. In contrast the 5-year survival rates are 60% or less in low- and middle-income countries like South Africa, Mongolia, Algeria and India.

Cancer prevention measures can make a big difference later in life. Examples are hepatitis B vaccination, which will prevent liver cancer; vaccinating boys and girls against HPV, which will prevent cervical cancer in women; also having regular mammograms will detect breast cancer earlier and improve breast cancer survival rates.

Dr. Nestor Esnaola, surgical oncologist at Fox Chase Cancer Center at Temple University Hospital, Philadelphia, PA said that the cancer prevention methods just mentioned might not be available in developing countries. Instead of mammographies repeat breast self-examinations are more important there. Campaigns against smoking can be utilized in order to prevent cancer of the lungs, the throat and neck. And if colonoscopies are not available, stool samples can be tested for blood and hemoglobin to check for colon cancer.

Different cancer rates increased in women in different countries

There are different cancer types that make the top chart for different countries. For instance in 2012 breast cancer was on top of most countries worldwide as the number 2 killer behind heart attacks and strokes. But other cancers ranked fairly high as well as causes of death: colorectal, lung and cervical cancers.

Despite this trend there were other countries like China and North Korea that had a higher incidence of lung cancer rather than breast cancer. The cancer researchers stated that the reason for this is that the smoking rates are higher in these countries. As already pointed out in China more than ½ of the men smoke, but only a small minority of the women smoke. But women in China are exposed to high amounts of secondhand smoke in addition to environmental pollution, which still causes a lot of lung cancer in women who live in this environment.

In many African countries cervical cancer is very common. Women, who are HIV positive, have a 5-times higher rate of cervical cancer. Southern and eastern Africa where there are higher rates of HIV, have higher rates of cervical cancer.

More data about women’s cancer rates

An overview article entitled “Global Cancer Incidence and Mortality Rates and Trends—An Update” points out some interesting statistics. The greatest numbers of cancer cases and deaths occur among women in Eastern Asia. The estimate for 2012 worldwide was for 1.7 million cancer cases and 1 million deaths in women. China dominated its region with 75% of all female cancer cases and deaths in the region. In North America cancer cases and deaths within the US comprise 90% of the region. The cancer cases and deaths in India make up about 65% of the region of South-Central Asia.

The top mortality rates are found in low to medium income countries, namely in Zimbabwe, Malawi, Kenya, Mongolia and Papua New Guinea.

The most frequently diagnosed cancers in women are breast, lung, and colorectal cancers in economically more developed countries. However, the statistics are different for less developed countries where the top three most diagnosed cancers are breast, cervix, and lung. Similarly the leading causes of cancer deaths for women in developed countries are lung, breast, and colorectal cancers. In developing countries the leading causes of cancer deaths for women is cancer of the breast, lung, and cervix.

Cancer frequencies for women in different countries

The American Cancer Society reports that breast cancer is the most common diagnosed cancer among women in 140 countries. Cervical cancer is most common in 39 countries, all of which are low to medium income countries. There are some countries where other cancer types are more common. For instance in China and North Korea lung cancer is more common among women, in Mongolia and Laos liver cancer, and in South Korea it is thyroid cancer.

The most common cause of death from cancer in women is breast cancer in 103 countries, cancer of the cervix in 43 countries and lung cancer in 27 countries. Other most common cancer deaths in women are in the following countries:

  • Stomach cancer: in Bhutan, Peru, El Salvador, Guatemala, and Tajikistan
  • Liver cancer: in Laos, Mongolia and The Gambia
  • Colorectal cancer: in Japan and Slovakia
  • Esophagus cancer: in Turkmenistan.

Prevention and early detection

Changing the risk factors could modify 20% of breast cancer mortality worldwide. Avoiding excess body weight, physical inactivity and reducing alcohol consumption could all significantly reduce breast cancer mortality. For instance, women with a body mass index of greater than 35.0 have a 1.6-fold higher risk of breast cancer and a 2.1-fold higher mortality rate from breast cancer than women with a body mass index of less than 25.0.

Regular breast cancer screening with mammography is another tool that will reduce breast cancer mortality as the cancer is diagnosed earlier and treated at an early stage where it can often be cured. The WHO recommends for those countries where mammography programs are established that screening should be done only every two years and only between the ages of 50-69 to avoid X-ray over exposure.

Early detection, like for any cancer is the key for successfully treating breast cancer. When there is an early diagnosis of breast cancer, surgical removal in healthy tissue (lumpectomy) often cures breast cancer. Unfortunately in low to medium income countries the cancer is often found too late, requires more invasive mastectomies and radiotherapy and has a lower survival rate than in developed countries.

Cervical cancer

Cervical cancer accounts for the 4th most frequently diagnosed cancer in the world. In 2012 there were 527,600 cases of cervical cancer worldwide and 265,700 deaths from cervical cancer occurred in the same year. 90% of cervical cancers occur in developing countries with India accounting for 25% of the total cases. The key in detecting cervical cancer is a regular screening program. In developed countries where this has been in place cervical cancer incidence has decreased by 80% in 4 decades. At the other end of the spectrum are countries like Uganda, Zimbabwe, and some countries of Central and Eastern Europe where cervical cancer rates have been climbing.

Human papilloma virus

The reason for the spread is that the human papillomavirus (HPV) is now more common and screening methods for cervical cancer are not in place. HPV 16 and 18 are the most common carcinogenic subtypes of the human papilloma viruses; they are responsible for 70% of cervical cancers worldwide. Vaccinating teenagers before they engage in sex is a powerful tool to interrupt the infectious spread of an important risk factor for cervical cancer.

Cervical swab for HPV-DNA test

Instead of the traditional Pap test from the past the new test that is in use now is an HPV-DNA test, a cervical swab that will detect DNA from HPV directly. It is more sensitive than the traditional Pap test. If the HPV-DNA test is positive, the patient sees a gynecologist who performs a colposcopy test. This is a microscopic exam of the cervix. The gynecologist can use several effective treatment methods like a loop electrosurgical excision procedure, laser ablation therapy, cryotherapy or conization for deeper cervical cancer lesions.

As with any cancer early detection and treatment is paramount with cervical cancer. In developed countries the 5-year survival rate is 60 to 70%. In India the 5-year survival rate is 46%.

Cancer of the lung

In 2012 there were 583,100 cases of lung cancer in women worldwide and 491,200 died from it. Lung cancer is the second leading cause of cancer death in women and the third most common cancer. The statistics of lung cancer reflect the tobacco epidemic. It takes about 20 to 30 years after widespread smoking begins in a country before the deadly statistics set in. The peak of the cancer epidemic and the heart attack rates occurs about 30 to 40 years following the peak of smoking in that population.

Lung cancer rates globally

Lung cancer rates in women have lagged behind men, because women as a group have started smoking later. In places like Hong Kong, the United Kingdom, Australia, and the United States women started smoking earlier, and they are in the process of declining their smoking habit or quitting. The new lung cancer cases and also the lung cancer mortality rates are reflecting this. Sadly, in many countries of Europe and Latin America women started smoking much later and they are still increasing their lung cancer statistics and mortality rates. Lung cancer killed 1.1 million men and 0.5 million women worldwide in 2012. Cancer epidemiologists estimate that in addition there are 21,400 lung cancer deaths annually from second-hand smoke in non-smokers worldwide.

Other causes of lung cancer

Beside smoking there are other risks causing lung cancer. The estimated risk for women to die in millions is: exposure to household air pollution, 1.6; outdoor air pollution, 1.4; second-hand smoke, 0.35; occupational risk factors, 0.10; and residential radon, 0.03.

Cancer Rates Increased In Women

Cancer Rates Increased In Women

Conclusion

Women are still in the midst of a global increase of cigarette smoking, which starts often with female teenagers. As long as the smoking rate goes up there will be more breast cancer, lung cancer and cervical cancer. The American Cancer Society provided a detailed review of various cancers and how they are still increasing worldwide, because nobody pays attention to preventative measures. A simple step to prevent cancer is to quit smoking. Another step is to engage in regular physical activity. Finally keeping your body mass index under 25.0 is a third step that can be done by adopting a Mediterranean diet.

There are several pockets within the developed countries where cancer rates are coming down, which is encouraging. I illustrated this complex topic by giving an initial overview and then three examples of breast cancer, cervical cancer and lung cancer.

Nov
26
2016

Chronic Shoulder Pain Treatment

This overview is about chronic shoulder pain treatment. A 71- year old health conscious patient was exercising in a gym. When he used the shoulder machine, he suddenly experienced a stinging pain in his left shoulder. The location of the pain seemed to be in the upper (superior) portion of the trapezius muscle. With this he also felt pain in his left neck.

This was fitness gone wrong! It can happen, that overdoing exercise or lack of judgment can lead to injury. Trainers caution us, when we embark on exercise programs, and yet, it happens! Often the road to recovery is a bumpy stretch, and if the problem persists, it can lead to chronic pain. With this knowledge the patient sought help. The first approach was visiting a

Chiropractor

He sought the help of a chiropractor and had 6 manipulations in the neck and thoracic spine. The spine had good range of motion, but the left shoulder pain in the trapezius muscle stayed.

He found that heat application to the trapezius muscle helped. So he bought an electric heating pad that he applied once or twice a day for pain relief. He also sought the input of his G.P. The doctor offered him a prescription for pain pills.

Pain pills

This was the predictable regimen, but the patient was concerned about the side effects of pain pills, and he declined. He had heard of a supplement, called Lipo (from Trophic). It contains 300 mg of choline bitartrate, 300mg of inositol and 300 mg of methionine in one tablet. At a medical conference he learnt that two Lipos were as effective in relieving the pain as one Motrin. He took two of these pain relievers from the health food store a couple of times per day. He alternated this with the heating pad to control his pain.

Since the condition improved only marginally, he looked at the option of

Prolotherapy

After 5 treatments the chiropractor mentioned  that he likely could not help the patient. The patient decided to try prolotherapy. He had heard that this would be good for chronic musculoskeletal pain. The naturopath whom he saw examined thoroughly and determined that the patient would be a good candidate for 2 to 4 prolotherapy treatments. After one treatment on the left side along the cervical spine and the left trapezius area the pain was reduced by 30% of what it was before. The second prolotherapy treatment was given again to the left side and also to the right side to keep it symmetrical. The naturopathic physician told the patient that he would see him for follow-up in 4 weeks.

Treatment of left should did not improve things

The treatment of the right asymptomatic side did not cause any pain, but the left side started flaring up after the second treatment, causing pain that was almost as bad as the original pain. When the patient returned to the naturopath and told him about the flare-up of pain in his left shoulder, he was told that this is what sometimes happens when treatments are not spaced far enough apart. He felt that this should be observed now and reassessed in 6 months in case there was no progress. It was time to look at other options.

IMS treatments

The chiropractor indicated that he could likely could not remove the pain. Instead he suggested that maybe a physiotherapist trained in intramuscular stimulation treatment (IMS), also known as dry needling could be of help. The patient was waiting for the appointment with the naturopath for prolotherapy when he saw the physiotherapist for IMS treatments. He examined the patient and noticed a persistent trigger point in the upper trapezius muscle, which he thought was causing the chronic pain.

Partial success of intramuscular stimulation treatment (IMS)

Two IMS treatments relieved the pain by about 50%. But about two or three days later the pain came back to about 75% of the original pain after the gym injury. The appointment for the prolotherapy by the naturopath had taken two months to wait for, so he had already had 3 IMS treatments just before the prolotherapy to get some pain relief. The IMS trained physiotherapist thought that perhaps a few more treatments, up to five or six might be able to take the pain away. So the patient continued treatments on a weekly basis.

Ultimate failure of IMS

Unfortunately the hope for pain relief did not materialize. The pain improved to about 30 to 40% of the original pain, but it always came back just 2 or 3 days later. Fortunately for him he could apply the heating pad and the pain would stay away for 3 to 5 hours. It also responded to taking two tablets of the choline bitartrate/inositol/methionine combination that took the residual pain away for several hours. Self-massaging the trigger point also gave some relief.

Recurrence of pain

But occasionally the pain came back with a vengeance and felt like a charley horse. This could suddenly occur in his left shoulder making it difficult to move his left arm. It as particularly bad when he needed an outstretched arm for ballroom dancing. Also, lifting of heavy objects or working out in the gym were difficult to do. Even just holding on to the rails of the treadmill when doing a fast walk on the treadmill for half an hour could lead to a flare up of the left shoulder pain. It is frustrating, when there is only temporary relief, but no real cure, but giving up is no option. Often we find more information on the Internet. What came up was low-dose laser therapy.

Low-dose laser therapy

The patient remembered having heard of low-dose laser therapy that might be useful in treating chronic pain. The physician treated the trigger point in his left shoulder with interstitial low-dose laser therapy. Dr. Weber who is the president of ISLA, the international society for laser applications, specializing in laser treatment, treated him with low-dose laser therapy.  This involved inserting a cannula into his left trapezius muscle close to the trigger point. He injected a small amount of procaine (local anesthetic), then 5 ml of normal saline. This was followed by three low-laser beam treatments for 10 minutes each, first blue, then green and finally yellow color. They were all given interstitially after which the cannula was removed.

Relief of pain with low-dose laser therapy

The surprise was that he felt relief almost instantly. There was still a bit of pain from the interstitial needle for about two days, but the trigger point in the trapezius muscle was no longer there. Finally after 6 months of intermittent pain there was relief of about 50% of the original pain. It was encouraging that this time the pain in that particular trigger point stayed away.

More laser treatment for other trigger points

But there were two other trigger points that were bothering him. After one month he received a second interstitial low dose laser treatment by the naturopath. He was the one who previously treated him with prolotherapy. 2 weeks later the naturopath administered the third laser treatment for yet another trigger point. This continued on for another few months. The pain disappeared, then it crept in slowly again, but at a lower level. It became a quest to eradicate the trigger points! Each time the same low-dose laser treatment targeted the remaining trigger points still palpable. It took a total of 9 interstitial treatments to finally reach the point where all of the pain was gone.

It felt strange: the chronic left shoulder pain had disappeared!

Chronic Shoulder Pain Treatment

Chronic Shoulder Pain Treatment

Conclusion

When pain lasts for more than 3 months, physicians refer to it as “chronic pain”. Often another name, neuropathic pain, is a substitute term that describes difficult to treat pain. By now you may have guessed that I was the patient in this blog.  It was in my interest to rid myself of this pain. I had previously described a similar pain in my lower back that was relieved with just one interstitial low-dose laser treatment at that time and my back has remained pain free since. Shortly after that successful treatment I developed the left shoulder pain from a soft tissue injury in the gym as mentioned. I was fortunate that Dr. Weber could treat me again, this time at his clinic in Lauenförde, Germany on occasion of a Germany trip that I had booked for holiday purposes.

Nine low-dose laser treatments for chronic shoulder pain

I was lucky that my lower back responded to this treatment in the past. The difference was that it took a total of nine low-dose laser treatments for my left shoulder to respond. Before the chronic pain came to a resolution I needed a total of 14 months of treatments!

It occurred to me that a successful outcome of treating pain requires collaboration between patient and therapist. Call it trial and error. In my case it was only the fourth treatment modality, the low-dose laser therapy that worked permanently.

I feel that the chiropractor did his best to ensure there was no nerve root irritation. He told me that his treatment had reached its limits.

IMS treatment and prolotherapy gave only limited relief

The IMS trained physiotherapist treated me before and after the prolotherapy. He told me after a total of 12 visits that he likely could not help me any more.

The naturopath who did the prolotherapy said that he had strengthened the ligaments along the spine on the left side. But he also stated that the trigger point from the gym injury showed no response to prolotherapy.

The final answer came from the treatment by Dr. Weber in Germany and the naturopath in Kelowna using the same Weber system machine with low-dose lasers. I think that this is an under-recognized treatment modality of musculoskeletal injuries, including sports injuries. You can find treatment providers for low-dose laser therapy throughout the US, Canada and Europe.

Persistence required on behalf of the patient, but also regarding the physician

Many physicians and naturopathic physicians use it as part of their pain management methods. The equipment has the FDA approval; Health Canada approved it also and the Medical Devices Directive in Europe approved it as well. Please note that this type of laser (low-dose laser) has nothing to do with laser treatment for cosmetic purposes.

It cannot emphasize enough that chronic pain treatment requires attention to detail. Feedback from the patient to the healthcare provider is necessary. Also, persistence on behalf of the patient is essential to follow through until the chronic pain recedes. It also shows that giving up is not an option!

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Oct
22
2016

Arthritis Drugs Can Cause Heart Failure

The British Medical Journal has published a research articles in Sept. 2016 showing that arthritis drugs can cause heart failure. This occurs particularly in elderly patients around the age of 77 years and older. This is an age where arthritis is often causing pain, and people regulate the pain with over-the-counter pills. These anti-arthritis drugs belong into the group of anti-inflammatory drugs, called NSAIDs. This stands for “non-steroidal anti-inflammatory drugs”. The study was entitled “Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries…”

Arthritis drugs can cause heart failure shows study

The researchers followed adult patients above the age of 18 who started 27 different types of NSAIDs between 2000 and 2010. There were 92,163 hospital admissions for heart failure; the controls consisted of 8,246,403 patients not taking NSAIDs. 4 countries shared in this study providing 2.2 million patients from the Netherlands, 7.5 million from Italy, 13.7 million from Germany and 11.1 million from the United Kingdom.

Results of study

NSAID use of up to 2 weeks prior to assessment had a risk of 19% of resulting in a hospital admission for heart failure. A control group of patients who had not taken NSAIDs for at least 6 months or more had no hospital admission risk.

Seven traditional NSAIDs led to hospital admissions for heart failure. They were: diclofenac (brand name Voltaren), ibuprofen (brand name Motrin), indomethacin (brand name Indocin), ketorolac (brand name Toradol), naproxen (brand name Naprosyn or Aleve), nimesulide (brand name Mesulid and many others), and piroxicam (brand name Feldene). In addition two COX 2 inhibitors, etoricoxib (brand name Arcoxia) and rofecoxib (brand name VIOXX) were also having the same side effects.

Different risks of causing heart failure for different NSAID’s

The risk for heart failure was not the same for every NSAID. The risks ranged from 1.16-fold to 1.83-fold. Specifically ketorolac had a risk of 1.83-fold, indomethacin 1.51-fold, piroxicam 1.27-fold, diclofenac 1.19-fold, ibuprofen 1.18-fold, and naproxen 1.16-fold. Translated into common language it means that ketorolac had a risk of 83% of causing a hospital admission due to heart failure. In the case of ibuprofen it was only an 18% risk.

Some NMSAID’s doubled risk for heart failure

The risk for heart failure doubled for diclofenac, etoricoxib, indomethacin, piroxicam, and rofecoxib when used at very high doses. Doubling the risk means a 200% risk. Typically, when an arthritis patient has a flare-up of pain, the patient increases the NSAIDs dose. The patients usually take the higher dose for a longer time. Some NSAIDs had a significant risk for heart failure even at a medium dose. This was the case for indomethacin and etoricoxib. The good news was that celecoxib (brand names Celebrex and Celebra) at usual doses did not lead to an increased risk of heart failure.

Dose-response curves for toxicity of NSAID’s (exception: celecoxib, brand names Celebrex and Celebra)

Dose-response curves were obtained where possible. Here the researchers looked at the effect of low, medium, high and very high doses of NSAIDs in patients. Again heart failure occurrence was studied among those patients. The result clearly showed that low and medium doses of NSAIDs were fairly safe, but high and very high doses of NSAIDs caused heart failure. Etoricoxib, Piroxicam and Rofecoxib were particularly toxic in higher doses. Indomethacin was toxic at medium and high doses. An important exception to the rule was celecoxib (brand names Celebrex and Celebra), which did not cause heart failure, either at low doses or high doses. This is one of the most used NSAIDs, so it is fortunate that it does not cause heart failure.

Discussion of study

The authors of this study discussed why they believe heart failure is developing in patients who take NSAIDs. They argued that NSAIDs inhibit prostaglandin synthesis and the enzymes COX1 and COX2. This is how inflammation and pain gets inhibited, which is a good thing. But at the same time blood supply to the kidneys is reduced, kidney function is impaired, and sodium is retained. This is a bad thing as it leads to fluid retention and fluid overload of the heart resulting in heart failure. As the prostaglandin inhibition is dose-dependent, the authors said this is the reason that the heart failure rate is also dose-dependent when measured in large populations, as was done in this study. A noted exception, as already mentioned, is the popular celecoxib, which does not cause heart failure, even at high and very high doses.

Arthritis Drugs Can Cause Heart Failure

Arthritis Drugs Can Cause Heart Failure

Conclusion

This publication has a lot of statistical power as it was based on research in 4 European countries. It also involved almost 10 million subjects. The researchers compared them to an equally large control population. Because of the size of the study population it was possible to calculate risk ratios for NSAIDs causing heart failure for 27 different types of NSAIDs. Furthermore, the authors succeeded in quite a few cases to calculate risk factors for different concentrations of NSAIDs used. This statistical method is called a dose-response curve. It is a powerful pointer to toxicity when high doses cause heart failure, but low doses don’t.

The physician can use the information from this publication to select one of the NSAIDs that is least harmful. This would be a drug like celecoxib (brand names Celebrex and Celebra). The physician would tell the patient to use the least amount possible to minimize side-effects. Many aging arthritis sufferers will benefit from this. Hopefully the FDA will review this material and shut down the use of some of the more dangerous NSAIDs or force the manufacturer to attach a black box warning about the drugs that belong into this category. You should review what your favorite NSAID is and discuss this with your physician. Perhaps print a copy of this review and take it with you to your health provider. He may not have heard yet about the study.

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Sep
17
2016

Seven Steps To Live Over 100 Years

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Explanation:

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

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

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

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

May
21
2016

Arsenic In Rice

Recently news stories reported that there is arsenic in rice. This is important to know because in large parts of the world rice is one of the main food staples. But rice has also become an important side step from wheat for those who are gluten sensitive. Rice is one of the main ingredients in gluten free diets.

Source of arsenic in rice

Naturally high levels of arsenic in soil can be a source of high levels of arsenic in rice, although these cases are the minority. By and large high arsenic in rice comes from inadvertent, but deliberate human poisoning. As explained in the Consumers Report high arsenic values were found in rice grown in these states: Arkansas, Louisiana, Missouri, and Texas. These are the same states, where cotton was grown in the past. The U.S. has been the world’s leading user of arsenic.

Arsenic in soil cotton was grown

Since 1910 about 1.6 million tons have been in use for agricultural/industrial purposes. Half of this occurred since the mid-1960s. Although arsenic is banned as an insecticide since the 1980’s, residues from the decades of use still linger on in agricultural soil today. Cotton production occurred in the south-central region of the US for a long time. This is a crop where heavy treatment with arsenical pesticides was used for decades in an attempt to combat the boll weevil beetle.

Arsenic in grape juice, apple juice and chicken meat

Arsenic containing insecticides are also used in the fruit growing industry. This explains the presence of arsenic in grape juice and apple juice.

Another source are arsenic compounds in chicken feed that is used to promote growth. As a result arsenic can then be found in chicken meat. For this reason alone it is recommendable to eat organic chicken that is free of arsenic.

Keep in mind that brown rice has persistently tested higher in arsenic than white rice.

Alternatives to rice

As drastic as it may sound, your safest approach is to avoid all cereals. This keeps you away from the various forms of gluten proteins that are present in all cereals, even in corn and oats. You can fill your plate safely with organic vegetables like broccoli, bell peppers, asparagus, cauliflower and many others. You also can eat all lettuce varieties including spinach, arugula, Romaine lettuce, head lettuce, super greens and more.

Wheat has the highest gluten concentration

Many people have an addiction to grains and grain products, but they can do more harm than good. Wheat has the highest concentration of gliadin, but rye has its own gliadin protein, so does barley. It is much safer on the long term to stay away from them all. Not everybody will agree with me on that, but as far as I am concerned I can live this way quite well. High endurance athletes who seem to need more carbs for fuel, could have sweet potatoes for example instead of grains and do well on that.

Eliminating exposure from arsenic in rice

Now that we know that brown rice has more arsenic in it than white rice, and that Arkansas, Louisiana, Missouri, and Texas have high arsenic because of residual arsenic in their soils, it is relatively easy to choose the right rice, if you decide to consume it. This report explains what are safe rice alternatives and what rice is the safest.

Basmati rice from California is the lowest in arsenic. Quinoa and millet are rice alternatives that are low in arsenic. Low-arsenic buckwheat is not related to wheat and is gluten free.

Watch the origin of organic rice

In this context it is interesting to note that you cannot trust even organic rice with regard to arsenic toxicity. The last link notes that the rice grains accumulate arsenic from the soil. All of the other organic culturing methods are not enough to protect the crop from arsenic accumulation, if there is contamination of the soil or the water.

If you are serious about eliminating arsenic from your food, you may want to consider avoiding grains altogether.

What are signs of toxicity from arsenic in rice?

Arsenic toxicity can be acute or chronic. Most of today’s arsenic toxicity is chronic. Arsenic accumulates slowly from foods we consume. Arsenic contaminated occurs in regular chicken that was fed arsenic compounds for growth. Another source for arsenic are rice, non-organic grape juice and apple juice. Chronic exposure to arsenic can cause lung and bladder cancer. This is what studies in Argentina and Chile found where in some areas drinking water has naturally high arsenic levels.

A fast heart beat, low blood pressure and shock can be symptoms of arsenic poisoning. The person with arsenic poisoning may have a changed mental status and seizures can occur. A person may present with delirium with irrational thoughts and behaviors. The patient may present with a cholera-like clinical picture with vomiting and severe diarrhea leading to marked dehydration. Liver and kidney damage can occur. The finger nails show white lines across, called Mees lines.

Treating toxicity from arsenic in rice

A study of 3633 individuals showed that those who ate 1 helping of rice per day had a urinary arsenic level that was 44 percent greater than those who did not consume rice. People eating two or more rice products had 70% higher arsenic urine levels that those who ate no rice. It is clear from that study that avoidance of rice is a powerful tool treating chronic arsenic poisoning. With respect to drinking apple or grape juice the total urinary arsenic levels were nearly 20 percent higher than those who did not consume apple or grape juice.

There are natural substances that are good chelators. Researchers tested them found them and found them good to eliminate arsenic from the body.

Here are natural chelators: milk thistle seed extract, dandelion leaf extract, garlic bulb (allium sativum), cilantro leaf extract, L-glutathione, N-Acetyl-L-Cysteine.

Intravenous chelation using EDTA

Intravenous chelation using EDTA is the gold standard that is in use to get rid of heavy metals including arsenic and lead. Dr. Cranton noted in his book on chelation therapy that arsenic occurs in the urine within 5 hours of intravenous EDTA chelation (Ref. 1).

Other supportive steps are to check your drinking water for high arsenic and lead levels, particularly if you are on a well. Change the way you cook rice, if you want to continue to eat rice. Rinse the rice with 6 times the amount of water and discard the water. This will lower the arsenic content of the rice by about 30% while you deplete the rice only marginally of vitamin and mineral contents.

Eliminate arsenic from food and drinks

Avoid drinking non-organic grape juice and apple juice. This eliminates a significant amount of arsenic from your diet.

If you eat more than two or three helpings of rice per week, consider replacing some rice portions by arsenic-free grains. For those on a gluten-free diet quinoa, millet, and amaranth are good replacement options.

Arsenic In Rice

Arsenic In Rice

Conclusion regarding arsenic in rice

It is sad to notice that the food industry is inadvertently trying to poison us with arsenic. I am sure this is not happen deliberately. But it is necessary for us to defend ourselves and think about the food we are eating. Is it safe? Are we taking the right steps to minimize exposure to arsenic? I have covered this from various angles, avoidance of high arsenic food items, chelating out accumulated arsenic, and preventing further exposure to arsenic. I hope this has been helpful and has shown you what you can do in your particular case.

References:

Ref.1: Special Issue of Advancement in Medicine “A Textbook on EDTA Chelation Therapy”, edited by Elmer M. Cranton, Spring/Summer 1989. Human Sciences Press Inc. NY, USA.

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Mar
26
2016

Heart Attacks Can Kill

We rarely hear that heart attacks can kill; we are more likely to hear that an ambulance transported a person to the hospital with a heart attack. The doctors placed a stent or two and the person left the hospital two or three days later, fully recovered.

What silent changes occur before a heart attack?

A heart attack does not happen out of nowhere. There can be one or several risk factors present before, like smoking, a lack of exercise, being overweight or obese from eating too much sugar, consuming sugary drinks and eating lots of starchy foods. This will have changed the cholesterol fractions with the bad LDL cholesterol being high and the good HDL cholesterol being low. Triglycerides in this setting are also usually high. The end result is that the lining of the body’s arteries, including the coronary arteries close off to the point where blood has a harder time flowing through the opening of the coronary arteries. One day the heart muscle reports severe pain from a lack of oxygen and nutrients. There are essentially three coronary arteries that supply oxygen and nutrients to the heart muscle. For details follow this link.

Often people have 50% to 60% of coronary artery narrowing, but do not know about this. There are tests available that a person could do to check the amount of hardening of the arteries (for instance the IMT test, see below).

What happens after stent placement?

The interventional cardiologist inserts a catheter from a wrist artery or elbow artery backwards through the aorta and from there into each of the openings of the coronary arteries. By injecting a dye the radiologist can use X-rays to show the condition of each of the coronary arteries. If the physician identifies a blockage, angioplasty can overcome this. With an angioplasty an instrument pierces through the atheromatous deposits and reopens the coronary artery. To prevent re-stenosing, the cardiologist places a wire mesh stent that opens up upon withdrawal of the instrumentation. The end result is that the previous obstruction of the coronary artery is fully functioning again and the stent keeps the coronary artery open. The cardiologist may have to place two or more stents during the same procedure.

A 5-year follow-up study summarized the outcome after stent placements in 1095 patients with 3-vessel coronary artery disease. Percutaneous coronary intervention, a fancy name for saying “angioplasty combined with stent placement” had a 5-year mortality rate of 14.6%, 9.2% heart attack rates and 24.4% reoccurring blockages requiring repeat procedures to reopen the coronary arteries. There were 3% strokes over 5 years demonstrating that not only heart vessels, but also brain vessels were affected by the hardening of the arteries.

What is heart failure?

You may think that the heart would now be entirely back to normal. But this is a gross simplification. The heart functions like a pump, and we know that pumps can fail. In the past when the heart stopped functioning, the person would die. This was the case because there was a complete irreversible closure of one or more coronary arteries. As a result the muscle of one part of the heart, typically involving the left heart chamber would stop functioning. The left anterior descending coronary artery supplies this part of the heart. The left heart chamber is the main pump that pushes blood out into the aorta and from there through the whole body. We need the left anterior descending coronary artery to be open and supply nutrients and oxygen to this vital heart pump all the time.

Ventricular fibrillation and heart attack

When there is a 70% to 80% narrowing of this artery and the heart is not yet failing, there can be life threatening irregular heartbeats. They are called ventricular fibrillation and they come from a lack of oxygen. This makes the heart muscle contractions no longer effective.  as they are no longer synchronized making the heart muscle beat as one unit. This causes acute pump failure and the patients dies. The other possibility is that the patient has a massive heart attack that kills a large portion of the heart muscle off (called myocardial infarction or heart attack). If the patient is not lucky to have immediate access to a hospital with an interventional cardiologist waiting for him or her, even angioplasty and stent placement will not revive the dead portion of the heart muscle and the patient will not survive.

Measuring ejection fraction

Using a echocardiography the ejection fraction can be determined. This is a measure of how well your heart empties with each heartbeat. Normally it would be between 50 and 70. Below 50 indicates that heart failure is present.

Patients who had a mild heart attack may only have an ejection fraction of 40 and get short-winded with mild activity. Other reasons for mild heart failure can be atrial fibrillation. This is  a common chronic condition in older patients where the atrial chamber is not contracting properly, but fibrillating. Another cause can be inadequate treatment of high blood pressure. In this case the heart muscle has a hard time maintaining blood flow against an abnormally high pressure gradient.

Lowered ejection fracture indicating various degrees of heart failure

Many patients who had a heart attack and were quickly treated with angioplasty and stent insertion have had some minor persistent damage to the heart muscle resulting in abnormal echocardiograms with lowered ejection fractions. In the past without the acute intervention they would likely not have survived. Now due to modern medical technology these patients did survive, but they are left with a mild degree of heart failure, as a certain portion of their heart muscle has died off.

What kills the patient with a heart attack?

As explained above, when the heart muscle no longer is able to function as a pump, the patient dies. This can come from irregular heartbeats, particularly ventricular fibrillation that does not respond to emergency treatment with a defibrillator. This is an electrical device that resets  The reason can also be a heart attack that kills a significant part of the heart muscle. Ventricular fibrillation often occurs when not enough oxygen reaches the heart muscle and the special nerves that coordinate that heart muscle fibers to contract as one unit. Regular monitoring of the carotid intimal-medial thickness (IMT) by ultrasound will give a fairly accurate test for coronary artery hardening as the two are closely related.

Elective angioplasty or stent placement

The doctor who has a patient in danger of deterioration can refer the patient to a cardiologist. Angioplasty and stent placement can prevent further deterioration for the time being. It is much safer to do these procedures electively rather than during an emergency when the patient is in distress.

Prevention of heart attacks, any volunteers?

Following the overview above it becomes apparent that prevention to not get heart disease is the best approach with regard to hardening of the arteries. This can be achieved by doing the following:

Adopt a Mediterranean diet

You must abandon the Standard American diet. This means no processed food, no refined sugar intake, avoid as much starchy foods as possible. Adopting a Mediterranean diet or a DASH diet is a first step. The DASH diet was developed to help patients with high blood pressure to reduce their blood pressure through the use of this diet. Reducing blood pressure will also reduce the risk of heart disease.

Avoid excessive alcohol intake

Avoid excessive alcohol intake (more than two drinks per day for men and more than one drink per day for women) as the toxic effect of alcohol kills heart muscle cells. This in turn leads to heart failure.

Regular physical exercise

Regular physical exercise will condition your lungs and heart and improve your cardiac output. By having bigger reserves the person becomes more resilient to developing a heart attack.

Increase your fiber intake

Increasing your fiber intake to 30 to 35 grams per day using vegetables and fruit and additional fiber supplements. Common fiber supplements consist of psyllium husk and/or others from the health food store. Take it in the morning with breakfast and with lunch. By avoiding extra fiber at dinnertime you sleep better at night. It turns out that fiber intake is very important to lower LDL cholesterol and triglycerides by interfering with the enterohepatic pathway that leads to recirculation of bile salts rich in these fatty substances. The net results are lower LDL cholesterol and triglyceride levels and higher HDL cholesterol (the good cholesterol) levels.

Vitamins and supplements

Take some vitamins and supplements. Vitamin B2, B6, B12 and methyl folate will support methylation pathways. Vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2, 200 micrograms per day will remove calcium out of the arteries and transport it into the bones; this effectively prevents hardening of the arteries and prevents osteoporosis at the same time. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control and delay hardening of the arteries; it helps to lower LDL and increase HDL.

Bioidentical hormone replacement

Have your hormones checked. Some doctors do not feel comfortable doing this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles. The essential hormones involved in cardiovascular disease prevention are thyroid hormones, sex hormones and in some aging people also human growth hormone.

Measuring heart function

Once every 2 years it would be good to measure your heart function as is outlined in this blog.

17 causes of blood vessel disease

There are many more factors that have been identified by researchers to contribute to hardening of the arteries.  It is useful to read this and think about which of these factors may apply to your case.

Heart Attacks Can Kill

Heart Attacks Can Kill

Conclusion

I have explained that hardening of the arteries is the cause of heart attacks. This is caused by a multitude of factors including sugar and processed food overconsumption, smoking, excessive alcohol intake, obesity, undertreated high blood pressure and diabetes. Simply doing angioplasties and placing stents will not stop the process of what led to the heart attack in the first place. Almost 15% died within 5 years following those procedures and 9% got another heart attack. They did not change their diets and stayed inactive.

Congestive heart failure can kill

There is another sad aspect about clogging of coronary arteries. The more coronary artery flow we lose through hardening of the coronary arteries, the lower our ejection fraction. This means our heart as a pump is failing more and more. When we reach the point of less than 50% of ejection fraction, we enter disability country. This means clinical heart failure, forcing us to wear continuous oxygen masks and being unable to exercise or walk. Heart failure is as deadly as terminal cancer having a very high mortality rate.

Concentrate on prevention now, because heart disease remains the number one killer. Remember that we can largely prevent heart disease when we follow the steps mentioned above!

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