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 pain seemed to be localized 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 exercise is overdone or lack of judgment leads 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 is not corrected, 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. He was offered

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 Trilipotropic (from Trophic), which contains 300 mg of choline bitartrate, 300mg of inositol and 300 mg of methionine in one tablet. He learnt at a medical conference that two of these tablets were as effective in relieving the pain as one tablet of Motrin, an anti-inflammatory drug. He took two of these pain relievers from the health food store a couple of times per day alternating with the heating pad to control his pain.

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

Prolotherapy

When the chiropractor mentioned after 5 treatments that he could not treat the pain successfully, the patient decided to try prolotherapy, because 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. 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

When the chiropractor had admitted that he could not help removing the pain, 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.

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.

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. But occasionally the pain came back with a vengeance and felt like a charley horse that suddenly could occur in his left shoulder making it difficult to move his left arm, particularly when he needed an outstretched arm for ballroom dancing, lifting of heavy objects or for working out in the gym. 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

The patient remembered having heard of low-dose laser therapy that might be useful in treating chronic pain. This method, called interstitial low-laser therapy was used to treat his trigger point in his left shoulder. A physician who is the president of ISLA –the international society for laser applications- specializing in laser treatment treated him by 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, all given interstitially after which the cannula was removed.

He was surprised to feel relief almost instantly. There was still a bit of pain from the interstitial needle for about two days, but he noticed that the trigger point in the trapezius muscle had completely vanished. Finally after 6 months of intermittent pain there was relief of about 50% of the original pain. This time the pain in that particular trigger point stayed away, which was encouraging.

But there were two other trigger points that were bothering him. After one month he got a second interstitial low dose laser treatment by the naturopath who had previously given him the prolotherapy into another trigger point, and finally 2 weeks after this, the third laser treatment was given 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 latest trigger point that was still palpable was treated with the same low-dose laser treatment method. 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, it is referred to as “chronic pain” and is often termed neuropathic pain that is difficult to treat. You may have guessed by now that I was the patient in this blog, and so I had a vested interest in getting rid 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.

I was lucky that this treatment responded similar to the one in my lower back. The difference was that my left shoulder required a total of nine low-dose laser treatments to be resolved and my pain had lasted a total of 14 months!

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 and told me when he had reached his limits.

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

The naturopath who did the prolotherapy said that he had strengthened the ligaments along the spine on the left side, but that the trigger point from the gym injury likely was not responding 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 where many physicians and naturopathic physicians use it as part of their pain management methods. The equipment has been FDA approved; Health Canada approved and is approved by the Medical Devices Directive in Europe. Please note that this type of laser (low-dose laser) has nothing to do with laser treatment for cosmetic purposes.

It has to be stressed that chronic pain treatment requires attention to detail, feedback from the patient to the healthcare provider and persistence on behalf of the patient to follow through until the chronic pain is resolved. It also shows that giving up is not an option!

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 the pain is regulated 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

Adult patients above the age of 18 who started 27 different types of NSAIDs between 2000 and 2010 were followed. 92,163 hospital admissions for heart failure were noted; 8,246,403 patients who were not taking NSAIDS served as controls. There were 4 countries involved 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 were found to be associated with hospital admission 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.

  1. 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.
  2. 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, this is the time when the NSAIDs are usually taken at a higher dose and tend to also be taken 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.
  3. 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 and involved almost 10 million subjects that were compared 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, like celecoxib (brand names Celebrex and Celebra) and 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, in case your health provider has not heard about it yet.

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Sep
17
2016

Seven Steps To Live Over 100 Years

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Explanation:

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

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

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

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

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. Since 1910 about 1.6 million tons have been used for agricultural/industrial purposes. Half of this was only used since the mid-1960s. Although arsenic use has been banned as an insecticide in the 1980’s, residues from the decades of use still linger on in agricultural soil today. The south-central region of the US was where cotton was produced 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 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.

Many people are addicted 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.

In this context it is interesting to note that even organic rice cannot be trusted with regard to arsenic toxicity. The last link notes that the rice grains accumulate arsenic from the soil. If the soil or the water are contaminated all of the other organic culturing methods are not enough to protect the crop from arsenic accumulation.

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 gets slowly accumulated from foods we eat that are contaminated such as regular chicken that was fed arsenic compounds for growth, rice, non-organic grape juice and apple juice. Studies in Argentina and Chile where in some areas drinking water has naturally high arsenic levels, showed that chronic exposure to arsenic is a cause for lung and bladder cancer.

A fast heart beat, low blood pressure and shock can be symptoms of arsenic poisoning. The mental status may be changed, 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 and that have been tested 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 is the gold standard that is used to get rid of heavy metals including arsenic and lead. Dr. Cranton noted in his book on chelation therapy that arsenic was excreted 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.

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 deliberately done. 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 a person was brought 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 are thickened 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 X-rays can be made that show the condition of each of the coronary arteries. If a blockage is identified, this can be overcome through angioplasty, where an instrument is used to pierce through the atheromatous deposits and reopen 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 previously closed off coronary artery is fully functioning again and the stent keeps the previously narrowed 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. This part of the heart is supplied by the left anterior descending coronary artery. 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. 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, called ventricular fibrillation 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.

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, 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, so the heart muscle has a hard time keeping up the blood flow against an abnormally high pressure gradient.

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.

A patient in danger of getting into trouble can be referred to a cardiologist and 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Once every 2 years it would be good to measure your heart function as is outlined in this blog.
  8. 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. 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 of the heart as a pump has become. When we reach the point of less than 50% of ejection fraction, we enter disability country with 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/

Mar
19
2016

Book Review: “Healing Gone Wrong – Healing Done Right”, By Ray Schilling, MD

This book entitled “Healing Gone Wrong – Healing Done Right” (Amazon, March 18, 2016) is dealing with the practice of medicine then and now. Medical errors, false diagnoses and wrong treatments are nothing new in the history of medicine. It happened in the past, and it is happening now. My first book dealt with anti-aging and was entitled “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1 describes that famous people like President Kennedy, Elvis Presley, Churchill, Beethoven or more recently Michael Jackson have something in common: all of them suffered the consequences of blatant medical mistakes. In Beethoven’s time lead containing salves to plug the drainage holes from removing fluid from his abdomen caused lead poisoning. In this chapter I review also how the illnesses of the above-mentioned celebrities were treated, but then ask the question: “What could have been done better to prevent some of the disastrous treatment outcomes?”

Chapter 2 deals with how modern drugs seem to come and go. We learn that twenty-first century medications that are touted as the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation of “improved” arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3 deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but nothing is done about the causes of their illnesses. This is a scary thought.

Chapter 4 asks the question whether we could learn something from these poor health outcomes in the past, so that we will be able to prevent any disastrous outcomes pertaining to our own health care in the present and future. As we will see, the problem today is still the same as it was in the past, namely that many physicians still like to treat symptoms instead of the underlying cause of an illness. Even though Big Pharma has the seducing concept of a pill for every ill, it is not always in your best interest, when these medications have a slew of side effects. “Gastric reflux” means a mouthful of stomach acid. This is a fact the suffering patient knows already! Big Pharma simply offers the patient with the symptom of gastric reflux a multitude of medications to suppress this symptom. But it is more important to dig deeper to find the reason for the illness and treat the underlying cause.

Chapter 5 concentrates on the brain and how we can keep our brains functioning optimally until a ripe old age. This review spans from prevention of head concussions to avoiding type 3 diabetes (insulin sensitivity from overconsumption of sugar). It manifests itself in Alzheimer’s disease. It is a form of diabetes of the brain that leads to deposits of a gooey substance. Prevention of this condition is also reviewed .

Chapter 6 reviews what we now know about how to keep a healthy heart. Certain ingredients are necessary such as regular exercise, a healthy Mediterranean diet, supplements etc. The good part is that what is good for the heart is also good for the brain. You are preventing two problems (brain and heart disease) at the same time.

Chapter 7 delves into the question why healthy food intake matters. Without the right ingredients of our body fuel, the body machinery will not work properly. The Mediterranean diet is an anti-inflammatory diet that is particularly useful.

Chapter 8 talks about healthy limbs, bones and joints. We are meant to stay active in our eighties and nineties and beyond. No osteoporosis, no joint replacements, no balance problems that result in falls! Learn about how to deal with problems like these in this chapter.

Chapter 9 deals with detoxification. What do we do as we are confronted with pollution, with radiation in the environment and poisons in our daily food? A combination of organic foods, intravenous chelation treatments and taking supplements can help us in that regard.

Chapter 10 deals with reducing the impact of cancer in our lives. A lot of facts have come out in the past 10 years telling us that reduction of sugar and starchy food intake reduces cancer. Curcumin, resveratrol and vitamin D3 supplements also reduce cancer rates as does exercise and stress management. All of this is reviewed here.

Chapter 11 checks out your hormone status. Women need to avoid estrogen dominance; both sexes need to replace the hormones that are missing. By paying attention to your hormonal status and replacing the missing natural hormones with bioidentical ones, most people can add 10 to 15 years of useful, active life!

Chapter 12 is refining some of the thoughts about anti-aging. You will learn about the importance to keep your mitochondrial DNA healthy. Apart from that there are ways how to keep your telomeres longer; certain supplements that are reviewed will help. Also your lifestyle does make a big difference in how old you can turn.

Chapter 13 investigates the limits of supplements. Many supplements are useful, but you do not want to overdo it and get into toxic levels. More is not necessarily better!

Chapter 14 reviews an alternative approach to treating ADHD. Attention deficit and hyperactivity disorder has been over diagnosed, has been neglected and has been over treated with dangerous drugs. An alternative treatment plan is discussed, which includes a combination of therapeutic steps.

Chapter 15 gives you a brief summary of the book.

Kirkus Review

Kirkus Reviews reviewed the book on March 17, 2016: “A retired physician details how various preventative measures can fend off disease and disability in this consumer health guide. Schilling (A Survivor’s Guide to Successful Aging, 2014) had a family medicine practice in Canada for many years before retiring. Although Schilling ventures into some controversial territory in his latest book, it’s generally an engaging, helpful synthesis of ideas that draws on reputable research from the Mayo Clinic and other sources. Overall, it serves as an intensely detailed wake-up call to the importance of preventative health. He largely brings an accessible and even-tempered tone to his narrative, warning readers, for example, that preventative health measures can only aid in “a delay of aging, not ‘eternal living.’ ” A thought-provoking, impassioned plea to be proactive about one’s health.”

Healing Gone Wrong – Healing Done Right

Healing Gone Wrong – Healing Done Right

Conclusion

In this book it becomes evident that it is better to prevent an illness whenever possible rather than to wait for illness to set in and cause disabilities or death. You heard this before: “Prevention is better than a cure” or “an ounce of prevention is better than a pound of cure”. I will give an explanation, based on scientific data that there is indeed evidence to support these notions on a cellular level. The mitochondria, the energy packages within our cells, are the driving force that keep people vibrantly healthy well into their nineties. All this can only happen when the mitochondria function properly. If the mitochondria are poisoned and as a result of toxins malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may be confined to a wheelchair. If you want a life without disabilities, a life without major illnesses and enjoy good health to a ripe old age, you are reading the right book.

The book is written in American English.

Available in the US: http://www.amazon.com/gp/product/1523700904

In Canada: https://www.amazon.ca/Healing-Gone-Wrong-Done-Right/dp/1523700904/  

In other countries the book is available through the local Amazon websites.

Mar
05
2016

Catch Cancer Early

Cancer of the cervix was the first cancer where early diagnosis was practiced and this changed reduced the mortality due to this cancer significantly.

Pap test

When the Pap test was invented and used on a large scale, cervical cancer could be diagnosed at the earliest stage, which is “stage 0” or “cancer in situ” (the earliest local cancer). In 1943 Dr. Papanicolaou published the book “Diagnosis of Uterine Cancer by the Vaginal Smear” where he described in detail how to do the Pap test. This became the norm very quickly and the use of the Pap test spread all around the world following WWII.

This was important, because later it was detected that cure rates of close to 100% could be achieved by removing the tiny accumulation of local cancer cells, which are present with cancer in situ. This could be achieved by surgical removal (cone biopsy), radiation therapy, and cryotherapy or later also with laser treatment. The key to success in cancer treatment is early detection and early treatment.

Other cancer prevention and early detection

  • With melanoma, a darkly pigmented skin cancer, the earliest stage, namely stage 0 or carcinoma in situ is treated by surgical excision leaving a wide margin of healthy skin around it. This is the cure, because it was detected early and had not yet invaded the surrounding tissues.
  • The most common breast cancer type is ductal carcinoma in situ (DCIS), of which 80% are diagnosed by mammography. Treatment for this is usually by local surgical excision, called lumpectomy followed by radiation.
  • Colon cancer typically arises out of colonic polyps. Colonoscopy in high-risk patients with a history of colon cancer in a first degree relative is typically done every three years. Any polyps that are found are removed during the procedure. My mother died at the age 59 of colon cancer. I had colonoscopies every three years since the age of 40 and on several occasions polyps were removed. Had I not had the colonoscopies, an unnoticed carcinoma in situ would have developed within one of the polyps and subsequently invasive colon cancer would have developed. Colonoscopies are a means of true colorectal cancer prevention.

The newest development: Oncoblot test to detect in situ cancers

At the 23rd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec. 11-13) Dr. Mark Rosenberg spoke about the universal cancer marker ENOX-2 that is only expressed during embryogenesis (the development of the fetus) and in adulthood only again when cancer develops. A test has been developed to check for the ENOX-2 gene, which becomes positive 5 to 7 years before cancer can be detected clinically. This is called Oncoblot test. Sensitivity of ENOX-2 is high and false positives are negligible, which makes the ENOX-2 marker ideal for cancer screening.

There are various isoelectric points for various cancer tissues, so the lab physician can tell the treating physician from which tissue a positive cancer test originates. The interesting aspect is that a combination of green tea and capsicum has been able to suppress the expression of the gene, and the cancer gene can be turned off. Corresponding biopsy samples showed that the cancer cells had disappeared. This is an entirely new concept and will have to be further investigated by clinicians for the various cancer types.

Here are the 25 cancers that are screened with the Oncoblot test: Bladder, Breast, Cervical, Colorectal, Endometrial, Esophageal, Gastric, Hepatocellular (liver), Kidney, Leukemia, Non-Small cell (lung), Lung Small cell, Lymphoma, Melanoma, Mesothelioma, Myeloma, Ovarian, Pancreatic, Prostate, Sarcoma, Squamous Cell, Follicular Thyroid, Papillary Thyroid, Testicular Germ Cell, Uterine. Considering that testing for all of these cancers is 1000 USD, this means that each specific cancer test is only 40 USD per test. I suspect that in future the price will come down as mass screening will be done. But the key is that this test is available right now; it is highly specific and highly sensitive.

But the important finding right now is that we have a very sensitive and very specific cancer screening test for over 25 various cancer types that can detect these cancers in the in situ stage (very early).

This has not been the case in the past except with the introduction of the Pap test for cervical cancer.

Change of treatment protocols may be required

The company producing the Oncoblot test states that the results need to be discussed between patient and treating physician. Although the treatment protocol does not change, there will be a lot more early diagnoses of cancer than in the past. In the past stage 1 and 2 stage cancers were considered to be early cancers and protocols to have these treated have been worked out. But with this very sensitive blood test (Oncoblot test) in situ cancers (stage 0) can be found. Mind you, it sets you back about 1000 USD, the cost for processing your blood and the test. But despite the monetary barrier I believe, that enough people will want this test done, because with the knowledge that cancer is diagnosed, it can be treated effectively with high cure rates.

The down site may be that those who have the test done and are found to be positive may have to undergo additional tests to locate and treat the tumor.

Suggested future approach to cancer detection and treatment

I envisage four steps to the future of cancer diagnosis and treatment.

  1. Screening for cancer using the Oncoblot test and other similar tests that likely will be developed in the future. This will give a tissue specific cancer diagnosis at the earliest possible point in time when clinically in most cases no tumor can be found for another 5 to 7 years.
  2. Staging of the cancer found: this requires confirmation of the cancer by doing imaging studies and possibly biopsies. An MRI scan of the affected area will likely be very useful, also to rule out early lymph gland metastases. Without being certain about the stage of the cancer the treating physician can not be certain what treatment schedule to follow as treatments differ for various stages of a cancer.
  3. Minimal invasive therapy like low-dose laser phototherapy using three different photosensitizers as shown in the example of end stage prostate cancer in this link under the heading “Photodynamic therapy of a group of inoperable prostate cancer patients”. The tragedy in this pilot study was that all of the men presented with end stage prostate cancer, which is difficult to cure. But early prostate cancer is easy to cure with the same method, simply because the cancer cells are local (in situ). Every cancer expert knows that cure rates are very high in the early stages of cancer, with the highest cure rates for cancer in situ (stage 0) and somewhat lower success rates for stages 1 and 2. Stages 3 and 4 have very poor cancer cure rates, as the cancer is already spread into the surrounding area in stage 3 and presents with distant metastases in stage 4. To make an impact in these latter cases requires toxic therapies like chemotherapy, radiotherapy and/or extensive surgery. Having said this, 20% of these end stage prostate cancers still experienced a cure with the triple photosensitizers and low-dose laser therapy (see link above), which conventional therapies would not have achieved.
  4. Retesting for residual cancer using Oncoblot test. Two months after the cancer treatment has been completed, the Oncoblot test should be repeated, which will reassure the patient and physician as well that all of the cancer cells have disappeared. As this test is so sensitive, any remaining cancer cells would shed tumor protein into the blood, which the Oncoblot test would immediately pick up. In the few cases that would remain positive this would enable the physician to do further tests, modify treatment and hopefully get rid of the last cancer cell that way.

Examples of two clinical scenarios

Two common cancers are prostate cancer in men and breast cancer in women.

1. Prostate cancer is very common in older men. From the age of 50 onwards the risk of getting prostate cancer is higher with every decade.

Another problem is that not every prostate cancer is invasive, some cancers are low grade and sit around for a long time and may never metastasize. A cancer expert discusses this here.

To attempt to distinguish between the aggressive form of prostate cancer and the slower “wait and see type”, a score has been developed, called the 4K score. This score combines the PSA test and a prostate specific kallikrein marker within one blood sample. Patients with a high 4K score are the ones who have an aggressive prostate cancer that needs urgent treatment. Patients with a low 4K score are the ones where many urologists recommend to wait and observe.

If I were the patient I would lean towards treating any kind of prostate cancer. Any cancer can do whatever it wants to, and you do not really know how these cancer cells will behave in the future. The only difference in prostate cancer is that the prostate has a tough capsule where the tumor stays localized for a long time, sometimes for decades, but it grows until it breaks out of this shell and metastasizes to the rest of the body. At that point it is often too late to rescue the patient, because it suddenly is a late stage. As stated earlier, late cancer stages are associated with poor treatment successes. Knowing this, I would suggest to use either a radical prostatectomy in a stage I cancer or low-dose laser phototherapy with three photosensitizers and three matching laser frequencies as indicated in the link to my blog mentioned above.

 2. Breast cancer is common in women. Often early cancer is found on a routine mammography or else with the Oncoblot test. An MRI scan can localize the tumor when it has a certain size, but it may take 5 to 7 years following an Oncoblot test to be visualized. This may be a diagnostic dilemma, which has to be worked out in the future. But as most breast cancers develops from the epithelium of the breast ducts, low-dose laser phototherapy with photosensitizers could be given to treat this early cancer stage. If a repeat Oncoblot test 2 months later is negative, the treatment was successful. If not, the clinician will have to closely follow the patient with repeat MRI scans of the breasts. Compared to the present diagnostic system without utilizing the Oncoblot test, this method is still superior, until perhaps in the future another way to localize early cancer becomes available. The fundamental difference between breast cancer and prostate cancer is that breast tissue is very vascular and any cancer of the breast tends to metastasize very early. For this reason it is crucial to treat breast cancer very early to have optimal treatment successes.

Catch Cancer Early

Catch Cancer Early

Conclusion

The introduction of the Oncoblot cancer-screening test may revolutionize diagnosis and treatment of 26 or more cancers that can be screened with this test. I have only highlighted the possibilities with the example of two cancers and explained what this might mean in practical terms. The exciting news is that cancer can now be detected earlier. The confusing part is that it can be diagnosed 5 to 7 years before the cancer is clinical detectable, and many physicians will feel uncomfortable treating cancer that early. Having seen many cancer patients in their end stages in clinical practice, I can only state that you cannot be too early diagnosing cancer. Only stage O (cancer in situ) and stage 1 (and sometimes stage 2) can be treated successfully and guarantee a cure. Experience will teach us what the best way is in the future. In the meantime this is an approach to an early diagnosis without taking any risks.

Feb
12
2016

Our Toxic Environment

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

Toxins around us

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

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

Environmental history and tests

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

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

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

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

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

Total toxic body burden

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

When to expect environmental toxicity

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

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

Diseases that are related to environmental toxicity

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

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

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

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

Markers of reserves

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

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

Organic acids

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

Epigenetics

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

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

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

More toxins: alkylphenols, organochlorines and volatile solvents

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

Triclosan is contained in deodorants, toothpaste and shaving creams.

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

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

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

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

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

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

Clean diet 101”:

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

Our Toxic Environment

Conclusion

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

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Feb
06
2016

Effects Of Hormones On The Heart

Since February is heart month, I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group was given testosterone replacement therapy, another was not given replacement therapy and one group was given replacement with testosterone, but normalization of testosterone levels was not achieved.

The various groups were followed for between 4.6 years and 6.2 years. The results were astounding: When results between testosterone treated men were compared to non-treated men there was a 56% reduction of all cause mortality, a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the non-treated control group and the partially treated testosterone group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where testosterone levels are monitored and corrected, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic has been clouded for many years because of the insistence of the medical profession to use horse derived estrogen (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When progesterone is missing, replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally is needed.

Estrogen

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

This study was done on 700 women in early menopause. They were treated with 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following:

  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that is often overlooked. It balances the effects of estrogens, but it can also be metabolized into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. Progesterone production from the ovaries is already reduced when the woman is premenopausal and should be replaced by transdermal bioidentical progesterone cream.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments it was found that GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. This can be done using a similar pen that is used for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day, given before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Melatonin is a hormone that is mostly thought of as the “sleeping hormone”. It is released by the pineal gland and rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease are usually found to have very low blood melatonin levels. Melatonin can be used intravenously in patients who have heart attacks to reduce the amount of damage to the tissue and stabilize the heart rhythm.

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. Another 3 mg can be taken, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middfle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome, enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked as thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.
  4. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  5. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, levels of both hormones can be measured and if low, they can be replaced.
  6. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.
Jan
23
2016

Life Extended By Several Decades

Have you ever thought about the possibility to prolong your “Freshness Date”? At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. Dr. Hertoghe explained that it is possible to extend life by paying attention to the factors that prolong life and combining them as an anti-aging type lifestyle. He made a distinction between

  1. normal aging: up to age 82
  2. healthy aging: up to age 100
  3. anti-aging medicine: up to age 122
  4. reversing aging medicine: much more than 122, perhaps to age 150 or more.

Normal aging (up to age 82)

When you live without any interventions your life expectancy on average is about 82 years. From the age of 50 to 60 onwards you may encounter problems with increased cholesterol, high blood pressure leading to heart attacks and strokes. Coronary artery by-pass surgery may extend an individual’s life by 10 to 15 years. But hardening of the arteries in the general circulation will eventually cut down the blood supply to vital organs leading to premature death that could have been avoided.

Around the mid 60’s to mid 70’s 12.4% of African Americans or 2.9% Caucasians get Alzheimer’s disease. These figures worsen rapidly with further aging: in their mid 70’s to mid 80’s 32.5 % of African Americans and 9.8% of Caucasians suffer from Alzheimer’s disease. At the age of 85+ years 54% of African Americans and 27% of Caucasians have Alzheimer’s disease. Particularly with normal aging Alzheimer’s has already increased, and this trend is likely going to continue.

Memory loss also leads to a shortened survival curve; people with memory loss live two years less on average than compared to a group with no memory loss.

Add to this loss of life because of depression, which is common in older age. Compared to a non-depressed group of older people the depressed group lived 30% shorter over a period of two years.

Musculoskeletal pain is reported in younger age (18-44) to be 38%; the next demographic group aged 45-64 reported 61% of musculoskeletal pains; seniors between 65 and 74 had 68% of musculoskeletal pain, and in the demographic group of 75 and up 71% of persons suffered of musculoskeletal pain. As we will learn later there may be hormone deficiencies behind these neck and back pains that, if left alone. lead to falls, fractured hips and premature loss of life. Those who survive accidents will often become wheel chair bound and get admitted to nursing homes.

One specific subgroup of patients with musculoskeletal pain are rheumatoid arthritis sufferers. After 10 years of having rheumatoid arthritis patients will have a survival of only about 50%; if more than 30 joints are involved (more severe form of the disease) only about 40% will survive. In other words, rheumatoid arthritis is an important factor for lowering people’s life expectancy.

At an age of 65 to 74 men have 23% of disabilities, while woman have 27.5% disabilities. This increases between the ages of 75 or older to 40% for men and 44.5% for women. At the age of 65 disabled men have a 3.5% higher death rate than the average population; disabled women’s death rate is 2.5% higher than the normal population. In other words, disability kills.

Urinary urgency and incontinence leads to a 3.13-fold higher mortality rate than a control group of men who do not have these symptoms.

65% of men and 85% of women above the age of 50 have abdominal obesity. This is not just a harmless condition. It is associated with increased triglyceride levels and increased mortality due to cardiovascular disease and diabetes.

By the age of 65-74 heart disease has a frequency of 32% in men and 23% in women. At the age of 75 years and older this jumps to 44% in men and 32% in women. Once heart disease is established, it causes a lot of premature deaths: on average persons with heart disease live 10 years shorter than those who do not have heart disease!

Healthy aging (up to age 100)

If we look at normal aging, we realize that all these diseases and disabilities we discussed are eventually killing us. In order to live longer we have to take steps that are known to interfere with some of these factors. For instance, quitting smoking will prevent heart disease, several cancers and chronic obstructive lung disease (emphysema). Positive thinking, social support and transcendental meditation will increase survival by preventing mental illness and depression, which in turn will prevent suicides. A healthy diet such as the Mediterranean diet or the Pegan diet will avoid cardiovascular disease and cut down cancer rates. One dietary change called the “polymeal” would contain fish, fruit, vegetables, garlic, almonds, a moderate amount of wine and dark chocolate. Compared to the Standard American diet this type of diet would add 9 years for men and 8.1 years for women regarding their life expectancy. For instance, prostate cancer showed a 7-fold increase in a group of men who ate a lot of pickled vegetables, fermented soy products, salted fish and preserved meats, when compared to a control group who did not include these foods. In a group of women who had their meat well done and ate three servings of beef per week, breast cancer risk was 4.62-fold higher that the risk of women who had their meat done rare or medium rare.

Overall cancer and cardiovascular mortality dropped by 35% in a study where 5 or more servings of fruit and vegetables were eaten per day.

A regular exercise program will strengthen the heart and lungs, keep your weight stable, reduce heart attacks and strokes and reduce the probability to develop cancer. A group of men between 61 and 81 were observed over 12 years and divided into those who did not exercise versus those who walked more than 2 miles per day. The exercising men had 19% less mortality compared to the sessile men. Vitamin C from fruit and vegetables or from taking supplements reduces global mortality from all causes by 46% compared to controls that did not. Similarly taking omega-3 fatty acid supplements (fish oil) daily reduced all cause mortality by 20%.

Dr. Hertoghe calls this “healthy aging” and this would allow you to be able to reach an age of about 100 years.

Anti-aging medicine (up to age 122)

Dr. Hertoghe told the audience that further attention to anti-aging factors could reduce mortality even further. In particular, he found over the years that paying attention to correcting hormonal weaknesses would have profound effects on how old a person becomes. Thyroid hormone replacement has been one of the steps that have helped people to experience more energy and less musculoskeletal problems (less muscle pain, less falls, less fractures and complications). This translates into more energy and longer lives.

One slide showed that a low free T3 level (low thyroid) was associated with a 3.6-fold higher death rate. A low free T3 level predicts of cumulative death rate in cardiac patients most accurately.

T3 is also important for the maintenance of the immune system, which shows in patients with tuberculosis: the one-year mortality rate in thyroid deficient patients with low T3 levels was 75%, while patients with a normal thyroid had a mortality from tuberculosis of only 7%.

Secondly, replacing missing sex hormones can add more life because cardiovascular disease is postponed (less heart attacks, less strokes), there is less cancer and better cancer survival, if a person comes down with cancer. Many statistics were quoted.

One interesting slide showed the longitudinal survival follow-up of congenital dwarfs in comparison with their normal brothers or sisters. Untreated male dwarfs turned only 56 years on average, while their unaffected normal brothers turned 75 years on average (19 years longer). With female dwarfs the difference is even more striking: untreated females dwarfs turned 46 years on average, while their normal sisters turned 80 years on average (a difference of 34 years).

Another publication showed that the heart attack risk was 3.8-fold higher in a group of patients with hypopituitarism (under function of the pituitary gland), but the treatment group (treated with GH) had a normal rate of heart attacks.

11606 men aged 40 to 79 years were followed for between 6 and 10 years. The group who had the top 25% range of testosterone had a 19% lower mortality rated from heart attacks or cancer.

Older women, particularly aged 100 in Okinawa had 2.3-fold higher testosterone levels than women in the US at age 70. On the other hand 70-year old Okinawan women had 2.7-fold higher estrogen levels than US women.

Bioidentical hormone replacement therapy (BHRT) prior to developing breast cancer showed a 27% longer survival among 984 breast cancer patients in Sweden compared to those without prior hormone treatment.

In another group of breast cancer patients (2755 patients) aged 35 to 74 who were treated with bioidentical hormone replacement after their breast cancer diagnosis, 50% had a lower recurrence rate (compared to no-BHRT treatment) and there was a reduction of 66% of mortality from breast cancer compared to controls without BHRT treatment. Another study showed that breast cancer patients would have a mortality rate of 33.3% without hormone treatment, 12.5% mortality rate after non-estrogen hormone use and 6% after estrogen/progesterone use.

This shows the healing results of the various natural hormones.

A group of 280 men and women around the age of 50 were treated with anti-aging hormone replacement for 2 or more years. In the beginning there were 34% of women and 15% of men with coronary artery disease. There were also 36.4% of women and 34.1% of men with high blood pressure. After replacing all of the missing hormones with bioidentical hormones for more than 2 years, coronary artery disease had dropped to 1.6% of the women and 1.08% of the men; high blood pressure had dropped to 2% of the women and 3% of the men. No drugs, just hormones! Of course, initially there were drugs used to stabilize their condition, but they could gradually be dropped safely, because the underlying hormone deficiency, which was the cause of cardiovascular disease, had been treated (treating the cause rather than the symptoms).

Dr. Hertoghe presented data of 6.38-year follow-up of 286 consecutive patients using anti-aging medicine (replacement of missing hormones with bioidentical hormones). These patients had an overall cancer rate of 2.1%, which compared very favorably to the 3.2% cancer rate among US women, 3.1% French women and 3.1% Belgium women on no hormones. This is the type of information that is needed following the Women’s Health Initiative (WHI) that scared women into the false belief that hormones would be “poisonous”. In the WHI synthetic hormones were used causing cancer and heart attacks; the reason for this was that synthetic hormones are not the identical shape as the natural hormones. But hormones and hormone receptors have to fit like a key into a lock; otherwise they are not effective or even block the natural life prolonging action of the natural hormone. This is why in the WHI study the outcomes were poor. Using bioidentical hormones heart attacks and strokes are prevented and they are also cancer-protective.

Reversing aging medicine (much more than 122, perhaps to age 150 or more)

General medicine has the goal to make patients as healthy as possible. With reversing aging medicine the goal is to make patients as young as possible so that they are at their healthiest and feel younger again.

With anti-aging medicine using a healthy diet, exercise and bioidentical hormone replacement therapy the patients can add 15 years of good life. Add to these organ transplants, if necessary, telomerase activators and stem cell therapy and you can add another 25 years of life expectancy to a total of 40 years.

Growth hormone deficiency is the one factor that has been underestimated. We have seen in the discussion of dwarfs in comparison to their healthy brothers and sisters that normal growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many are deficient with regard to GH production. These were patients who already had their thyroid hormones replaced, if abnormal and had their sex hormones replaced when they were found to be low. But they lost hair, developed old looking faces with wrinkles, loss of subcutaneous fatty tissue giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands. He replaced their missing GH using daily GH self-injection with a tiny needle (similar to diabetes injections) and within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of GH daily. This is not inexpensive, but some health care plans pay for this, as a lack of GH is a true hormone deficiency.

Often it is a single limiting organ that determines when we die, typically the heart, lungs, brain, liver, kidneys, small bowel, pancreas or bone marrow. Organ transplants can add years of life, but it can be cumbersome to find a suitable donor. Another limitation is, as one study showed, that only 40% to 60% of organ transplants are surviving 8 years after doing the transplant surgery.

Stem cell therapies are other ways to prolong life. More research is needed to perfect this, but essentially 220 different cell types could be derived from stem cells in the future to replace malfunctioning organs.

Life Extended By Several Decades

Life Extended By Several Decades

Conclusion

The dream of staying younger for longer can be a reality today, if you are willing to discipline yourself to watch what you are eating (Mediterranean type diet), exercise regularly and have a positive psychological attitude. If the outdoor air is poor where you live, you may want to consider moving to a place with good air quality. Sleep well for 7 ½ hours every night and retire not later than 10 to 11PM. You need to be asleep between midnight and 3AM as the growth hormone peak occurs at that time. Take supplements that contain longevity micronutrients (magnesium, vitamins A, C, D, E, B6, B12, Co-Q-10, selenium, zinc, iron in premenopausal women etc.). Replace all missing hormones with bioidentical ones, like thyroid hormones (T3 and T4), sex hormones, DHEA and GH. Stem cell therapy and telomerase activators for cell rejuvenation will also have more of a place in the future.

Even, if you do only part of this reversing aging program you will slow down aging.