Sep
10
2016

Crazy Food Trends

CNN wrote about strange, crazy food trends that seem to receive a following. I thought it would be interesting to analyze them medically and point out to the reader what’s right and what’s wrong.

Crazy food trend one: Ashwagandha

In India this herb, also known as Indian ginseng has been used as part of the Ayurvedic medicine for centuries.

At the 22nd Annual Anti-Aging (A4M) Las Vegas Conference in mid December 2014 Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She gave a comprehensive overview of what you can do to prevent Alzheimer’s disease.

Dr. Smith recommended many other supplements, which I will not explain in detail here: B vitamins, vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q-10 (or CoQ-10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwagandha, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE and others. She specifically pointed out that she felt Ashwagandha was very powerful. It helps people preserve their memory, more so than regular drugs that doctors prescribe.

When the benefits of taking CoQ-10 were discussed, Dr. Smith reminded the audience “whatever is good for the heart, is good for the brain”. She recommended reading Dr. Perlmutter’s book from which this phrase was borrowed (Ref. 1).

Ashwagandha is an herb with multifaceted effects. Here is a review by a doctor about the various effects of Ashwagandha.

It does not belong into foods; it should be used as a supplement, if your doctor agrees with it.

Crazy food trend two: astrologically farmed eggs

Picture biodynamic farming of eggs with the guidance of the moon. Now you are producing astrologically farmed eggs. The Hemsley sisters insist you should eat these astrologically farmed eggs for breakfast. I don’t buy into this. This is hokey! It smells like somebody is trying to lure money out of your pocket by trying to convince you that there is health benefit to “astrologically farmed eggs”. There isn’t.

What does make sense is to buy eggs that do not have antibiotic residue in them and that came from free-range hens. Yes, I buy organic eggs that are somewhat more expensive. If you like to buy organic omega-3 eggs, this would also be scientifically superior to ordinary hen eggs. There is also the difference of “free run” and “free range” hens. “Free run” does not give you any guarantee for a healthy product, as the birds live in crowded barns and are likely receiving medications to combat diseases. “Free range” birds are hens that have access to the outdoors, and there is less of the overcrowding that is common in a barn.

Crazy food trend three: Cordyceps

There are about 400 subspecies to these sac fungi. Cordyceps has been used in Chinese medicines to help as an aphrodisiac, help improve kidney function in the elderly and also with regard to some anticancer activity. There are very few clinical review papers to substantiate any of these claims; yet traditional medicine insists on using Cordyceps for these purposes. If you want to see a traditional Chinese doctor, do so on your own. But don’t consume food that is prepared with Cordyceps.

Gwyneth Paltrow’s morning smoothie cost more than 200$, so if anything, I would be more concerned about bankruptcy than real nutrition with this type of breakfast drink.

I have my doubts that Cordyceps that kill ants to sprout their spores in their corpses (see Wiki link above) could be of any objective benefit to humans.

Crazy food trend four: blue majik

Blue Majik is just another name for a common antioxidant, phycocyanin. It is derived from algae, Arthrospira platensis.It has some similarity with the green spirulina. But just because it seems fashionable right now, does not mean that it is superior to vitamin C as a cheap antioxidant or vitamin E. The creators of blue majik are cashing in on color effects and selling false hopes of better health. You can live very well without it.

Crazy food trend five: cannabis

When I heard that people are starting to mix cannabis into foods, I was reminded about a story I heard from one of my patients in the mid 1980’s who worked in the shipyards of North Vancouver. One day he saw some cookies on a tray in the lunchroom. A co-worker offered some to him and he ate it. After 5 minutes his head started pounding with an excruciating headache and he became nauseous. Shortly after he vomited and started getting a rapid heartbeat. His co-workers laughed and told him that they were special cookies laced with marijuana.

I suspect that whoever baked these cookies used a higher dose of marijuana and my patient experienced a marijuana overdose.

This example illustrates that cannabis has special properties that affect the body.

In the brain it binds to cannabinoid receptors. These are not only present in brain tissue, but also in lungs, liver and kidneys. Even the immune cells have cannabinoid receptors.

There may be a place for chronic pain patients under the guidance of a physician to get medical marijuana. But keep cannabis away from your food. Don’t consume it! You have no idea what you are doing to your body that is full of receptors for cannabis. If cannabis is used like a drug, it should be prescribed by a doctor and taken according to doctor’s orders. Like with any drug there will be effects and also side effects.

Crazy Food Trends

Crazy Food Trends

Conclusion

Out of five crazy foods reviewed there are only 2 that merit consideration, but not mixed into food. These are Ashwagandha as a supplement (part of memory loss prevention and others) and cannabis for chronic pain. A physician should supervise both. The remainders are fashion crazes. Unfortunately many people will fall for these fashion trends and lose a lot of money. This will make someone who peddles these items very rich. Is this what you want to do: throw your money out and toss it right into the pocket a huckster? Rethink what you want to do. You may just want to buy organic eggs from chickens that happily scratch away in a farmyard. This is very much down to earth, and nothing “astronomically farmed” is needed.

References

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

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Apr
09
2016

Treating Lack Of Sexual Arousal

A few years back lack of sexual arousal was not discussed that much. But since Viagra has been such a success in males, the search was on for a similar drug for females who have a lack of sexual arousal. The new drug, the “Viagra equivalent for women” is flibanserin under the trade name Addyi.

The news about this new drug has been noted in the media.

How flibanserin works

How does flibanserin work? It stimulates 5-HT1A receptors in the frontal brain to produce more serotonin and dopamine. Due to these substances a premenopausal woman with a lack of desire for sex becomes more arousable. It may sound reasonable at first, but when you look at the many other effects that a stimulation of 5-HT1A receptors can produce, I find it surprising that the FDA gave approval to this drug.

Flibanserin can cause opening up of skin veins leading to hypothermia and fainting due to a lowering of blood pressure. It has some pain relieving properties. Flibanserin can also interfere with learning and inhibit some aspects of memory. Some positives are decrease in aggression, increase in sociability and decreased impulsivity.

Here are a few points that need to be discussed regarding this new drug.

Treating a symptom rather than the cause

Premenopausal women have a lack of progesterone, as their ovaries do not ovulate as regularly as they did in the past. When the last ovulation has occurred, the woman’s periods stop for good. She is said to have entered menopause. There is a profound lowering of estrogen and progesterone levels, which also leads to a lowering of the testosterone blood level. In women the percentage of testosterone is minute compared to men, but testosterone is essential for normal libido. About 5 years before a woman gets into menopause testosterone levels and progesterone levels may already be getting reduced. It is this low testosterone level, which is the cause of the lack of sexual arousal. So, why are we suddenly treating these symptoms with a poorly understood drug? Why are we not treating the cause? The causes for a lack of sexual arousal are premenopausal hormone changes: mostly lowered progesterone and including lowered testosterone levels as well.

Alternative treatment of lack of sexual arousal

Dr. Lee has written several books that became famous. He treated hormone deficiencies in people with replacement of bioidentical hormones, which resulted in feeling renewed energy and losing the symptoms for which the patients were seen. With regard to premenopausal symptoms Dr. Lee wrote the following in one of his books.

It is interesting that these premenopausal women were all helped with progesterone cream, and their sexual arousal returned as well as a tiny amount of bioidentical progesterone is metabolized into testosterone, which is known to increase libido in women.

It is clear that Dr. Lee would have done what any anti-aging physician today would do: measure hormone levels and add back the hormones that are missing. In the case of premenopausal women it is mostly progesterone that is missing.

What is better: using a chemical or using a natural hormone?

We need to come to terms with the question: is a chemical like Viagra better for a male to get an erection or natural testosterone?

Viagra and others of that type are drugs that are a foreign substance to the body. There are a significant number of side effects with this medication such as headaches and clotting problems that limit the use for certain patients. Bioidentical testosterone replacement therapy, which can stimulate libido significantly, can often eliminate the need for Viagra type drugs. In the past, with the use of synthetic testosterone, hepatic toxicity and with long-term use the risk of liver cancer existed. Dr. Morgentaler has shown that prostate cancer is not a risk with long-term use of bioidentical testosterone. Also, with synthetic testosterone blood could get thickened (secondary polycythemia), which could cause a stroke. Patients on synthetic testosterone need to be monitored for these side effects accordingly, but not on bioidentical testosterone.

If a male with erectile dysfunction is found to have a low testosterone blood level, this is the cause of erectile dysfunction and therefore treatment consists of bioidentical testosterone replacement therapy, NOT a drug like Viagra. Testosterone is well tolerated with no side effects. Instead the man experiences a profound feeling of wellbeing.

The same reasoning is true for a premenopausal woman with a lack of sexual arousal. If she is deficient in progesterone hormone, she needs bioidentical progesterone cream, not a new drug called flibanserin with a myriad of side effects.

Evidence of efficiency of flibanserin in treating sexual arousal

Evidence based medicine scrutinizes research papers to calculate the numbers of patients to be treated before there is one positive therapeutic effect. A good medical treatment is one where there are only 50 or less patients needed to treat before one therapeutic success occurs.

The observation from the studies on flibanserin was that satisfying sexual events rose from 2.8 to 4.5 times a month. However, women receiving placebo reported also an increase of satisfying sexual events from 2.7 to 3.7 times a month. There was only a difference of 0.8 times per month that a satisfying sexual event occurred compared to the placebo! If the average American couple has sex 2 to 3 times per week (2.5 times per week), this translates to 10 times per month. We just heard that 0.8 times of these 10 times per months a satisfying sexual event occurred on flibanserin. Flibanserin is taken as one tablet at bedtime.

Compared to the placebo group, it would take 12.5 episodes of sex to generate one event of success (satisfying sexual event), which can be attributed to taking flibanserin daily. The NNT (number needed to treat) is 12.5. However, if the number of days of taking tablets is used, it would take 37.5 days of taking flibanserin to create one satisfying sexual event, so the NNT=37.5. Nevertheless, both numbers would still be acceptable as a moderately effective medicine, as they are below 50.

But I think that we have to be much more cautious in this case as the side effects are considerable and an alternative with no side effects and much more effect exists (bioidentical progesterone replacement).

Consumer education needed

Should the patient trust a physician’s prescription? Should the patient put up with side effects like nausea, tiredness, and difficulty falling asleep or staying asleep, a dry mouth, constipation or excessive sleepiness? Should the patient insist to be educated about bioidentical hormone replacement therapy?

From an evidence-based medicine view bioidentical hormone replacement with a number needed to treat (NNT) of 2 to 5 has a much higher efficiency than flibanserin. In other words, many women would experience the satisfying sexual event a lot more commonly, namely after having had sex 2 to 5 times instead of 12.5 times. This is what you expect when a similar hormone environment is provided like in the time when the woman was younger. It is the responsibility of the physician to explain to the premenopausal woman that bioidentical progesterone replacement is a much safer treatment option with no side-effects as progesterone as a hormone from the ovaries has been part of the woman’s  menstrual cycle all along. It is also important for the woman to educate herself about bioidentical hormone replacement and ask questions. Some physicians are of the old conservative school and may refuse this type of approach. In this case it is time to seek out a naturopathic physician.

Treating Lack Of Sexual Arousal

Treating Lack Of Sexual Arousal

Conclusion

Nobody would suggest to treat depression associated with hypothyroidism with antidepressants. Instead the physician treats hypothyroidism with thyroid hormones and the depression disappears.

Similarly, lack of arousal, a symptom associated with premenopausal syndrome is due to progesterone deficiency and should be treated with bioidentical progesterone cream. It does not make sense to treat symptomatically with flibanserin and risk all of the side effects mentioned. It makes more sense to treat the cause (low progesterone) rather than the symptoms. See a naturopath or a physician who understands natural hormone therapy to get the best results.