Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Apr

2020

Side Effects of the Birth Control Pill

By Ray Schilling | autoimmune disease, birth control pill, breast cancer, Cancer, Cardiovascular disease, cervical cancer, depression, headache, heart attack, Hormones, Menopause, Osteoporosis, Stroke

Dr. Jolene Brighten gave a lecture about side effects of the birth control pill. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Her exact title was “Your Body on Birth Control- What Prescribers Should Know About the Effects of Birth Control on the Female Body”.

Most commonly the oral contraceptive pill is prescribed to prevent pregnancy. But the long-acting reversible contraceptives like the IUD and progestin implants are also popular. Depot Provera, the ring and the patch are the least popular ones.

Why women use the birth control pill

Women age 15 to 49 are often on some form of birth control method. 58% of women who use the birth control pill use it for reasons other than to prevent pregnancy. They use it to control symptoms of various conditions.

31% use it for menstrual cramps
28% want to regulate their periods
14% hope to improve their acne
4% use the pill for menstrual pains associated with endometriosis
11% for other reasons

What the birth control pill does

The birth control pill exerts a negative influence on the hypothalamus and the pituitary gland. This is called “functional hypothalamic amenorrhea”. The birth control pill is not suitable to treat polycystic ovarian syndrome. Symptoms of bleeding may improve for 3 months, but after that the original symptoms return. Thyroid disease that may be present needs separate investigations.

The hormones that are part of the birth control pill are synthetic hormones. They do not quite fit the body’s hormone receptors. For instance, the progestins, artificial analogues of progesterone behave like estrogens, not progesterone. This causes clotting problems cancers of the uterus, breasts and cervix. It can also cause heart attacks and strokes.

List of side effects of the birth control pill

From depression to liver health

The list of side effects of the birth control pill (BCP) is long. The BCP can worsen symptoms of depression and anxiety. The deeper the depression is, the higher is the risk for suicide. There is increased risk of hair loss. The BCP depletes nutrients in the body that the thyroid gland needs to produce thyroid hormones. This can result in hypothyroidism.

It also increases thyroid binding globulin, a protein in the blood that binds thyroid hormones. As a result, there are fewer thyroid hormones available to the body cells. Breasts may become tender and enlarged after the start of the BCP. In some women with fibrocystic disease of the breasts the BCP may improve her cyclical breast changes. The BCP changes the liver both structurally and genetically. As a result, there is a higher risk of developing benign liver tumors and liver cancer.

From gallstones to blood clots

Women with a history of gallstones may experience faster gallstone formation on the BCP. The pill also can elevate your blood pressure. You should have blood pressure checks from time to time to prevent a stroke. Weight gain is common on the BCP. However, some women experience weight loss. Usually the BCP is 99% effective for the prevention of pregnancy. Pain from heavy periods or menstrual cramps are often relieved by the BCP. There is an increased risk to develop diabetes, because insulin resistance is gets worse in patients on the BCP. In postmenopausal women on HRT there is an even higher risk of developing diabetes. Blot clots are a common side effect of the BCP. Being a smoker, having a heart or liver condition, a history of genetic risk of blood clots, having migraines with an aura or being overweight are all additional risk factors for developing blood clots.

From effects on the brain to cancer risks

The BCP can change brain function and structure. This may lead to a different mate selection and production of neurotoxins. Some women get relief from hormonal headaches; but others experience exacerbations of migraines and headaches. In some women acne improves on the BCP; in others acne gets worse. When it comes to stress, some women experience an altered hypothalamic-pituitary-adrenal gland response from the BCP. The BCP reduces some cancer risks, like the risk of ovarian, uterine and colorectal cancer. But the risk for breast cancer, brain cancer and liver cancer are higher. The BCP increases gut permeability, leads to leaky gut syndrome and the disruption of the microbiome. There is often overgrowth of yeast in the gut. In addition, people with a genetic predisposition for autoimmune disease of the gut can develop immune diseases. Multiple studies have shown malabsorption of vitamins, minerals and antioxidants when on the BCP.

From vaginal yeast infections to osteoporosis and autoimmune diseases

Many women develop vaginal yeast infections. Women on the BCP often complain about low or a lack of libido. There can be vaginal dryness and pain with sex.

Teenage women on the BCP often develop decreased bone density. Synthetic hormones lack the specificity to the natural hormone receptors, which leads to decreased bone density. On the other hand, bioidentical estrogen and bioidentical progesterone will indeed build up bone mass. In the past it was thought that hormones would be good for the bones and this is still true with the use of bioidentical hormones.

A number of autoimmune diseases have been identified to be directly related to the use of the BCP. These are Crohn’s disease, multiple sclerosis, lupus, interstitial cystitis and ulcerative colitis.

Synthetic hormones will always have side effects

The body is a complex organism with various hormone receptors built into its cells. In order to be able to cash in on patented modified hormones Big Pharma introduced progestins to replace natural progesterone and various synthetic estrogen products to replace natural estradiol. However, the Women’s Health Initiative has shown in 2002 that these artificial hormones produced heart attacks, strokes, blood clots, colorectal and endometrial cancer and hip fractures. There was an increase of mortality of 15% over 5.2 years compared to controls who did not take artificial hormones within the same timeframe.

Bioidentical hormones have a perfect fit to the natural hormone receptors

In contrast, when bioidentical hormones are given in menopause, there is a 10 to 15 year extension of life expectancy and researchers did not see any of the above mentioned side effects that were noted with synthetic hormones. Many people in Europe have elected to stick to bioidentical hormones for decades; they did not use the synthetic hormones. As a result, there are good data going back to the 1960’s about the safety of bioidentical hormones. In this study several thousand postmenopausal women were followed for 9 years or more and showed no increase in the rate of heart attacks or any cancer. Their postmenopausal symptoms were optimally controlled. I conclude from this that bioidentical hormone replacement in menopause will protect the women from missing hormones safely. There are no side effects and for this reason the bioidentical hormone replacement should become the standard of care.

Side Effects of the Birth Control Pill

Conclusion

Synthetic hormones have a long list of devastating side effects. Yet, Big Pharma managed to influence general practitioners and gynecologist to prescribe them to postmenopausal women. The Women’s Health Initiative has changed everything. The promise was that synthetic hormones would show heart-protective effects, cancer protective effects and healing effects for osteoporosis. These have been empty promises! None of this occurred with synthetic hormones- to the contrary! Many physicians are now prescribing bioidentical hormone replacement for women in menopause.

No good alternative for teenage girls

However, for teenage girls there is no good alternative for the traditional birth control pill, even though the catalogue of side effects is of serious concern. One compromise is to limit prescribing the birth control pill for up to 5 years only and then switch to several years of a copper T or other intrauterine device (IUD). Suicide in teenage girls on the BCP is of real concern. Despite the list of side effects many doctors continue to prescribe synthetic hormones for decades to the same patients, who trust that it will benefit them. In time patients will know about the side effects, and unfortunately many will experience them. As a result, it is only a matter of time, till this will be exposed as malpractice!

Mar

2020

Fasting Can Prevent Cardiovascular Diseases

By Ray Schilling | Anti-aging medicine, Cardiovascular disease, Diabetes, diet, fasting mimicking diet, heart attack, Heart Disease, Inflammation, Obesity, Prevention, stem cells, Stroke

Dr. Joel Kahn gave a lecture in Las Vegas in which he explained that fasting can prevent cardiovascular diseases. Dr. Kahn is a Clinical Professor of Medicine at Wayne State University School of Medicine. He spoke at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas. The conference took place from Dec. 13 to 15th, 2019.

According to the CDC cardiovascular diseases like heart attacks and strokes are hitting the middle age adults in large numbers. Part of the problem is obesity and diabetes, both of which cause an increase of cardiovascular diseases. Heart attacks, strokes, heart failure and other related cardiovascular conditions caused 2.2 million hospitalizations in the US in 2016. This resulted in 415,000 deaths and a health care cost of $32.7 billion.

Fasting can improve the risk for cardiovascular disease

Dr. Kahn asked whether fasting can reduce the aging pathways, build up resilience and protect the heart from aging and heart disease. In a few words: eat less, live more! He showed with slides that fasting can indeed do that. One heart catheterization study showed that a fasting group had only 64% coronary artery disease compared to a non-fasting control group with 76%.

Another study showed that fasting patients had only 10.3% diabetes compared to controls with 22.0%. With heart catheterization 63.2% of fasting patients had cardiovascular disease while 75.0% of non-fasting control patients did have lesions in their coronary arteries.

Animal experiments confirmed that fasting had beneficial effects on heart health as well. In rats, researchers showed that fasting reduced infarct size and inflammation. It also preserved left ventricular function. With mice fasting produced less inflammatory response and less tissue damage.

Alternate day fasting shows benefit in clinical human trial

A 2019 publication reported about a 4-week randomized clinical trial on 60 healthy non-obese human subjects. The effect of alternate day fasting was compared to controls. On average there was a 37% calorie reduction in the alternate fasting group. The fasting group had improved fat mass, improved fat-to-lean ratio and cardiovascular markers. There was a reduction of age-associated inflammatory markers and low-density lipoprotein.

Fasting mimicking diet

A newer form of fasting is the fasting mimicking diet (FMD), which was invented and researched in depth by Dr. Valter Longo. Both animal experiments as well as human trials have shown that the FMD is safe and effective. It can be followed 5 days out of every month and will lead to some weight loss, an increase of telomeres, stem cells and lowered inflammatory markers.

My own experience with the fasting mimicking diet

My wife and I heard about the FMD from Dr. Longo when he spoke about it at the 2017 Anti-Aging Conference in Las Vegas. We immediately started the FMD in December of 2017 and have done it every month for 5 days since. But we never ordered the expensive meal kit. Instead, we calculated calories and use regular food to do the calorie-restricted diet. We eat 600 to 700 calories every day during the FMD days. In between we have unrestricted calories, but we noticed that we are more careful about our meal choices. I find that the result of the FMD is more energy, an improved sleep pattern and an easier way to keep my body-mass index in the 21.0 to 22.0 range. Here is a description of the effects of the FMD.

Use of FMD in high-risk patients

Dr. Khan said that the FMD is an ideal diet that the high-risk population of the US should use. 34% of the US population has a compromised metabolic condition. They are obese and at a high risk to develop diabetes. But on the FMD they gradually lose abdominal obesity, lower their cholesterol and triglycerides levels, which otherwise causes a high risk for heart attacks and strokes. The fasting blood sugar is lowering reducing the risk to get diabetes. The systolic and diastolic blood pressure comes down. And the C-reactive protein, which is a general inflammatory marker, becomes lower.

In non-obese patients the main effect of the FMD is a stimulation of stem cell release and telomere elongation. This postpones the aging process and with it delays the onset of cardiovascular diseases.

Fasting Can Prevent Cardiovascular Diseases

Conclusion

Dr. Joel Kahn gave a lecture at a Las Vegas conference that fasting can prevent cardiovascular diseases. He compared alternate day fasting with the fasting mimicking diet (FMD). The FMD was more effective in reducing danger markers, abdominal girth measurements and blood markers of cardiovascular diseases. Ultimately, he said, it was easier to follow an FMD where you only reduce your calorie intake to 600 to 700 calories per day for 5 days in one month. In those who are wanting to do this just for good health, the FMD increases stem cells and elongates telomeres. This postpones the aging process and keeps a person younger for longer. At the same time, it delays the onset of cardiovascular diseases.

Mar

2020

Telomeres are Important

By Ray Schilling | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, Diabetes, exercise, fasting mimicking diet, fish oil, Fitness, food, heart attack, High Blood Pressure, Hormones, Menopause, Nutrition, Obesity, omega-3 fatty acids, Smoking, Stress management, telomeres

In the first place, Dr. Joseph Raphaele reviewed why telomeres are important at a Conference in Las Vegas in December 2019. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15, 2019. The actual title of his lecture was: “Telomeres in 2019; clinical developments and cutting-edge applications”.

Notably, Dr. Raphaele reviewed how various animals have quite different life expectancies. First, the Aldabra giant tortoises, for instance can live up to 152 years. Second, the house mouse can at the most live up to 6 years, but its predator, the cat lives up to 38 years. Finally, humans can live up to 122.5 years.That is to say, the average mortality rate doubling curve of man is 8 years. Dr. Raphaele introduced the terms “lifespan” and “health-span”.

Lifespan versus health-span

The first thing to remember is that our lifespan is defined by the number of years we live. On the contrary, the health-span is defined by the number of years you do not have any disease and your physical and mental health are good. Dr. Raphaele explained that for the most part the body’s organs have a limit of functioning after 80. For this reason the kidneys, the maximum heart rate, the maximum breathing capacity and the maximum work rate (oxygen uptake) all decline after the age of 80. It is important to realize that in 1961 Dr. Leonard Hayflick showed that there is a limit of how often cells can divide. After 60 doublings cells in tissue culture either die or just stop dividing. The built-in molecular clock resides in the telomeres. The telomeres are the caps at the end of the chromosomes in the cell’s nucleus.

Telomeres and their function in aging

In a word, what is the function of telomeres? In essence, the telomeres protect the integrity of our genes. For the most part, they protect the chromosomes from deteriorating, prevent DNA fusion and massive instability of the genes. In addition, the telomeres allow the cells to divide in an orderly fashion, but only up to the Hayflick limits. In short, the bottom line is that telomeres prevent cells from mutations of the DNA, from senescence and from death.

Shortening of telomere length with age

Dr. Raphaele said that one of the important findings was that telomere length is shortening with age. Notably, he showed a slide similar to this. To clarify, this graph shows telomere length as a function of the lifespan in years. The telomere length is obtained by a blood test. This determines the length of the telomeres in white blood cells. At a young age it has a length of between 8 and 10 kb. kb stands for kilobase. A kilobase consists of 1,000 pairs of nucleic acid sequences. So, 10 kb means 10,000 pairs of nucleic acid sequences. Around the age of 80 people have much shorter telomeres, only 4 to 6 kb. There is an enzyme, called telomerase that can elongate telomeres by approximately 10%. But this may not be desirable as too much telomerase activation can also stimulate cancer growth.

Age changes telomere length

Dr. Raphaele explained further that a telomere loses about 100 base pairs per cell division. But there are other factors that shorten telomeres. Smoking, sedentary lifestyle, high blood pressure, stress and a low antioxidant status all can shorten telomeres. Certain congenital conditions can shorten telomeres by 28%. Dyskeratosis congenita is such a condition where 80% patients die by the age of 30 due to aplastic anemia. This is associated with bone marrow failure. 10% of these patients die from cancer. Apart from age, which shortens telomeres slowly, lifestyle factors are very important. A good lifestyle where you exercise regularly, you don’t smoke and you eat a healthy diet will slow down the shortening of your telomeres. Controlling your stress, sleeping enough hours per night and taking supplements also delays telomere shortening. Certain medications that control diabetes, high blood pressure or thyroid medication that treats hypothyroidism also delay telomere shortening.

Telomeres and shortened lifespan

Researchers could show that good lifestyle practices work by increasing telomerase to a certain degree. This results in lengthening of telomeres and translates into up to 10 years of increased life span. Jerry Shay, PhD said in 2011: “While the aging process is complex and certainly cannot be explained solely on the basis of telomere biology, there is a growing consensus that in some situations telomere biology and telomere tests may have important utility similar to cholesterol assays or blood pressure monitoring measurements.”

Telomeres are not just a biological clock inside our cells. They have a great influence on the function of mitochondria and on how many mitochondria multiply inside cells. This latter process is called mitochondrial biogenesis. In addition, telomeres regulate gene expression.

Chronic diseases associated with shortened telomeres

Here is a list of chronic diseases where all the patients have shortened telomeres.

High blood pressure
Hardening of the arteries (atherosclerosis)
Cancer
Chronic obstructive pulmonary disease (COPD)
Alzheimer’s disease
Diabetes and obesity
Chronic stress
Metabolic syndrome

Telomeres in cardiovascular disease

Telomere length was found to be shortened in those who developed a heart attack. Researchers compared the telomere length in coronary artery disease (CAD) patients to people with no history of heart attacks. In comparison to this normal group the heart attack victims had telomeres typical for people who are chronologically 11.3 years older than the healthy controls. The researchers calculated that people with telomere shortening had a 3-fold higher risk of coming down with a heart attack.

Telomere length enhancers

Lifestyle changes can have positive effects on telomere length. Examples are smoking cessation, weight loss and stress reduction.
Dietary changes: we know that fish oil (omega-3 fatty acids) supplements elongate telomeres as does a low-fat diet.
Supplements like vitamin D3, antioxidants (vitamin C and E) and astragalus (TA-65) elongate telomeres as well. The astragalus supplement, TA-65 showed a significant elongation of telomeres after 12 months while controls lost telomere length.
Exercise: in a 24-week experiment of care workers regular aerobic exercise increased the telomeres by 67.3 base pairs.
Bioidentical hormone replacement in aging people: when hormones are missing after andropause and menopause, the natural hormones need replacing, or the telomeres are shortening.
High cortisol levels cause telomere shortening.
Human growth hormone elongates telomeres via telomerase activation.
The fasting mimicking diet (FMD) was shown to extend life and telomeres as well.

Therapeutic rationale for telomere lengthening in CAD and AD

Patients with coronary artery disease (CAD) are at risk for developing heart attacks and other cardiovascular diseases. Here is an overview of many clinical trials that have been done in humans with CAD. It shows shortening of telomeres in these high-risk patients. But the review also shows that telomeres can lengthen by changing the risk factors of cardiovascular disease. Researchers were increasing the enzyme telomerase that indirectly lengthens telomeres. Both approaches prevent serious cardiovascular disease and increase life expectancy significantly. In severe cases of telomere shortening the physician can consider TERT gene therapy.

Alzheimer’s disease (AD) also is a condition where telomeres are shortened compared to normal controls. Time will tell whether TERT gene therapy is possible to prevent Alzheimer’s disease.

Telomeres are Important

Conclusion

Telomeres are the caps of the chromosomes in our cells. In the past the word “telomere” appeared obscure and only scientists discussed this among themselves. Now we know that telomere shortening is often the reason for chronic illnesses like high blood pressure, hardening of the arteries (atherosclerosis), cancer, chronic obstructive pulmonary disease (COPD), Alzheimer’s disease, diabetes and obesity. Patients who have these conditions often have shortened telomeres in their white blood cells. Over the years we have learnt that lifestyle changes can have positive effects on telomere length. Smoking cessation, exercise, weight loss and stress reduction are elongating telomeres.

Additional factors elongating telomeres

In addition, supplements like antioxidants (vitamin C and E), vitamin D3 and astragalus root (TA-65) elongate telomeres as well. By elongating telomeres, a person can add 10 to 11 years of disease-free life to the normal life expectancy. Researchers showed that telomerase activation by human growth hormone increased telomere length without causing cancer. Dr. Thierry Hertoghe, an endocrinologist from Belgium spoke about HGH replacement in aging people on other occasions. He said that cautiously treating patients with low doses of HGH when blood tests showed deficiency, adds about two decades of life-expectancy to these patients’ lives.

Mar

2020

Eat Right for a Long Life

By Ray Schilling | alcohol, Alzheimer’s disease, antibiotics, autoimmune disease, Cancer, Cardiovascular disease, fiber, fish oil, food, heart attack, Inflammation, lifestyle, Nutrition, olive oil, omega-3 fatty acids, organic food, polyunsaturated oil, Processed food, Stroke, sugar, toxins

Dr. Felice Gersh gave a talk at a conference in Las Vegas stressing the importance to eat right for a long life. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. The actual title of her presentation was “Nutrition for Longevity”.
Dr. Gersh has a fellowship in Integrative Medicine at the University of Arizona School of Medicine.

In the first place she pointed out that an anti-inflammatory diet consists of vegetables, fruits, nuts, whole grains, healthy oils like olive oil and fish. This is a modified Mediterranean diet. On the other hand, with a pro-inflammatory diet or Western diet, you eat high fat, cholesterol, lots of protein from red beef, high sugar, excessive salt and a lot of processed and fast-food.

Prevention of diseases

It is important to realize that for prevention of cardiovascular disease, cancer and degenerative diseases you need to eat fruits and vegetables, which contain important phytochemicals. They contain a wide variety of molecules, like carotenoids, vitamins and polyphenols. Another key point is that cruciferous vegetables (broccoli, Brussels sprouts, and kale) contain glucosinolates, which are sulfur-containing compounds. They protect you from cancer.

Vitamins and magnesium

It must be remembered that in order to strengthen the immune system and prevent hardening of the arteries (atherosclerosis) we need the following: omega-3 and omega-6 fatty acids, the enzyme Co-Q10, vitamin A, B complex, C, D, E, carotenoids, phytosterols, stilbenes and flavonoids. Another key point is that magnesium is extremely important. Many of our dietary habits have reduced magnesium intake to a minimum. Our soils are depleted of magnesium, it is no longer in drinking water, and it is absent in processed foods. However, magnesium is involved as a co-factor in more than 700 enzymatic reactions in our bodies. Magnesium is involved in heart contractions, is important to maintain our blood pressure and is important for glycemic control. It is also important for bone development and for DNA and RNA synthesis. Magnesium binds serotonin and dopamine to their receptors and plays a role in many more body functions.

Brassica vegetables

This group of vegetables consists of broccoli, cauliflower, green cabbage and Brussels sprouts. Notably, they have long been recognized to lower the risk of many cancers. The first thing to remember is that the active ingredients in them are glucosinolates and isothiocyanates. Certainly, food preparation has a lot of influence on maintaining beneficial substances in the brassica vegetables. To emphasize, finely shredded vegetables had a marked decline of their glucosinolate levels by 75% within only 6 hours. On the negative side, microwave cooking destroys 74% of glucosinolates, but on the positive side, storage in room air preserves almost all of the glucosinolates for 1 week. In addition, stir frying brassica also preserves the glucosinolates. This reference points out how fruit and vegetables can contribute to cancer prevention.

The gut microbiome

The Western diet leads to a change in the gut flora with Gram-negative bacteria taking over the healthy gut flora and disrupting the intestinal barrier. To emphasize, this result is called endotoxemia. Part of this is increased serum endotoxin, which mainly consists of lipopolysaccharides. Indeed, it causes gut inflammation and a breakdown of the gut barrier. When this happens, autoimmune antibodies are produced. To put it another way, the Western diet undermines your health. In a word, high fat foods and added sugars (refined carbohydrates) lead to increased Gram-negative bacteria and the disruption of the intestinal barrier.

An unhealthy diet causes disease

In the long run this causes autoimmune diseases, leads to higher heart attack rates and to diabetes. Healthy gut bacteria in fact help to digest fibre, which leads to three short-chain fatty acids: butyrate, acetate and propionate. For the most part, they are important as energy source, affect cardiometabolic health and appetite. On balance, butyrate also helps to maintain the blood brain barrier.

Importance of fiber

Higher fiber content in food leads to less cardiovascular disease, has positive effects on obesity and the metabolic syndrome. Fiber changes the microbiome in the gut, leads to less gut permeability and more short-chain fatty acids production.

The best diet

60% to 70% complex carbohydrates are the foundation of a healthy diet. It consists of vegetables, green leafy and root vegetables, beans, legumes, whole grains and fruit.
Eat healthy fats from nuts, olives, seeds, krill or fish oil. Limit fat intake to 18 to 28% of your daily calorie intake. Avoid hydrogenated fats. Limit your saturated fatty acid intake. 85% chocolate is OK. Otherwise consume olive oil and omega-3 fatty acid containing foods (from seafood and fish).
Add about 12% of the daily calorie consumption as protein per day. Choose fish, seafood, lean cuts of chicken, only the occasional red meat (organic or grass-fed meat)
Eat lots of fiber, eat organic and minimally processed food. Limit sugar, fat and salt. Avoid antibiotics from the agricultural industry, sweeteners, gluten and excessive alcohol intake. Take a daily probiotic and eat probiotic food. Eat three meals a day, a big breakfast, a moderately-sized lunch and a small dinner. A fasting mimicking diet once per month for 5 days activates your longevity genes.

Eat Right for a Long Life

Conclusion

Dr. Felice Gersh gave a talk at a conference in Las Vegas. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. She said that we need to eat right for a long life. She gave a thorough outline of what to eat and what not to eat. It is important to note that she suggested to cut out additional refined sugar and processed food. The bacteria in the gut must be normal, or the gut barrier breaks down. This failure can cause autoimmune diseases. Eating lots of vegetables and fruit as well as fiber will help to keep your gut bacteria normal.

What foods to eat

A Mediterranean type diet gives you the right foods that you need for your health. Avoid the Standard American diet as it is unhealthy and kills the good gut bacteria. Brassica vegetables like broccoli, cauliflower, green cabbage and Brussels sprouts prevent the development of many cancers. Eat three meals a day, a big breakfast, a moderately-sized lunch and a small dinner. This fits best into the diurnal rhythm of your gut bacteria. Eat right for a long life!

Feb

2020

Celiac Disease in Various Disguises

By Ray Schilling | Allergies, Alzheimer’s disease, Autism, autoimmune disease, blood brain barrier, Dementia, depression, diet, food, Inflammation, Nutrition, Pregnancy, schizophrenia

Dr. Tom O’Bryan gave a lecture in Las Vegas on Dec. 13, 2019 about celiac disease in various disguises. This was at the 27th Annual World Congress on Anti-Aging Medicine. The title of his talk: “An Ounce of Prevention Is Worth a Pound of Protocols: Halting Our Brains Slow Deterioration”.

Case # 1: 44-year old male with an assumed diagnosis of ALS

In the first place a 44-year old male had a history of a right leg weakness that developed over the last 6 months. He had intermittent spasms in his right quadriceps muscle. In addition, over the last few months he noticed a weakness develop in his right arm with difficulties writing. Significantly, his family history revealed that a maternal aunt had celiac disease. Moreover, a sister had Crohn’s disease and his maternal grandmother had multiple sclerosis. Electromyographic studies showed widespread acute denervation. An MRI scan of the spine showed hyperintensity in the corticospinal tracts. A diagnosis of amyotrophic lateral sclerosis (ALS) followed as a result based on the MRI scan findings.

Further tests

At the same time blood tests revealed that his anti-endomysial antibodies were elevated. Duodenal biopsy demonstrated villous atrophy, crypt-hyperplasia and increased intraepithelial lymphocytes consistent with gluten-sensitive enteropathy (celiac disease). An MRI scan of the brain also showed some hyperintense lesion in the left-brain hemisphere.

Gluten free diet instituted

It was clear with these test results that the initial diagnosis was a misdiagnosis. The real diagnosis was celiac disease. 7 months after the onset of his symptoms he started on a gluten free diet. He received no medications. Notably, his right arm function returned to normal after 9 month of the gluten free diet. Although there was some improvement in his right leg function, he still had some muscle wasting and spasticity in his right leg. However, he could now walk without any aid. His hand-writing was back to normal, and he could button his shirts again. Repeat MRI scans followed 2 months and 9 months after the start of the gluten free diet. At two months after initiation of the gluten free diet the brain lesion in the left brain was somewhat larger than before, but at 9 months it was half the original size.

Case #2: Autism in children, youth depression and Alzheimer’s patients

The autism spectrum disorder (ASD) has significantly increased from 1 in 166 in 2004 to 1 in 40 in 2018. In addition, Dr. O’Bryan also mentioned that in 2017 statistics showed that 13.3% among youth aged 12 to 17 in the US suffered major depressive episodes. 1 in every 12 youth suffer from severe behavioral and emotional problems. According to the CDC since 1994 the number of children on psycho-stimulants increased 5-fold. In the same time children under 18 with bipolar disorder have increased 40-fold. There has been a 6-fold increase of prescriptions for antipsychotic medications for children in the same time frame.

Other effects on adolescents

However, I like to point out that there are other powerful factors that can explain increased depression and emotional problems in adolescence. The Canadian Medical Association published an article about social media and smart phones and the effects they have on adolescence.

On the other end of the life cycle 1 in 3 seniors die with Alzheimer’s disease or dementia. Between 2000 and 2015 death from Alzheimer’s disease has increased by 213%.

Breakdown of the blood brain barrier

According to Dr. O’Bryan autism in children, behavioral and emotional problems in teenagers and dementia from Alzheimer’s disease are all related to the same process, namely a breakdown of the gut barrier, often called leaky gut syndrome. It is important to realize that this leads to a secondary breakdown of the blood brain barrier. The end result is a compromise of the brain, where antibodies attack the brain protein. In young children this causes lower adaptive and cognitive function and behaviors typical for autism. Teenagers are more likely to present with depression or schizophrenia. In older people the breakdown of the blood brain barrier can result in Alzheimer’s disease and other forms of dementia.

25 to 30% of protein in wheat are non-gluten. Antibodies can be directed against gluten, but also against non-gluten protein.

IgG antibodies against gluten cross placenta

In the later stages of pregnancy IgG antibodies cross the placenta easily. They provide passive immunity from various viral infections. Unfortunately, antibodies against gluten also cross through the placenta, which can lead to a breakdown of the fetal gut lining, in the sense of leaky gut syndrome. In this study 211 children were found to have a risk of 1.7-fold to develop psychosis later in life. The mothers were positive for anti-gliadin IgG antibodies in the last 4 weeks of pregnancy. Anti-casein antibodies did not have this psychosis effect (risk only 0.8-fold). The investigators felt that an allergy to wheat in the mother set up general inflammation. Psychosis in the offspring only develops when inflammatory mediators reached the brain of the fetus. It was the brain inflammation, which caused the subsequent psychosis later in the child.

Blood brain barrier and healthy gut barrier

Another key point is that the barrier both in the gut and in the blood brain barrier consists of a single epithelial layer. The cells are held together by zonulin and occludin proteins. Autistic children were exposed already in the uterus to mother’s wheat induced anti-gliadin antibodies. This led to a break-down of the children’s blood brain barrier and the symptoms of the autism spectrum disorder. These children have a lot of brain inflammation and in addition often have impaired gut barrier integrity. It must be remembered that they require a comprehensive program to improve the gut flora, build up the gut barrier integrity and re-establish the blood brain barrier.

Effects of phthalates on young children

A 2014 study measured urinary metabolites of phthalates and related this to the children when they were 7 years old.

The investigators did several cognitive tests and measured the IQ (Wechsler Intelligence Scale). Children of mothers with the highest quartile of phthalates had an IQ, which was on average 7.0 points lower than the control group of the lowest quartile of phthalates. Dr. O’Bryan showed a slide taken from this study.

With this in mind, it points out that a pregnant woman has an intact blood brain barrier, which prevents antibodies from entering. However, the immature brain of the fetus has not developed an efficient blood brain barrier yet. This allows maternal gliadin antibodies from wheat intolerance to enter the fetal brain and cause autism spectrum disorder (ASD).

PCB’s disrupt the blood brain barrier

In mouse experiments the effects of PCB’s were investigated. By the same token, researchers found that the blood brain barrier was broken down by PCB’s that are known to have carcinogenic and neurotoxic properties on the brain. The researchers injected melanoma cells into the animals and found that the PCB pretreated mice sustained brain metastases. However, the control animals that did not have PCB pre-treatment did not develop brain metastases. They concluded from this that PCB’s are breaking down the blood brain barrier.

Maternal brain antibodies causing autism in children

This publication examined antibodies to two different brain proteins. The researchers found that 86% of the children from mothers with two different fetal brain antibodies were diagnosed with autistic regression. According to this publication there are at least 50 different epitopes of gluten peptides that exert cytotoxic, gut permeating and immunomodulatory activities.

DNA microarray technology can now detect many subtypes of food disorders and gluten sensitivities. The tests for celiac disease have a sensitivity of 97% for IgG and 99% for IgA. With regard to specificity the test is now 98% accurate for IgG and 100% for IgA.

Case #3: 34-year old female vegan patient with depression and mild cognitive decline

A 34-year old woman has followed a Vegan lifestyle for 10 years. She has been working long hours and had a lot of stress. In addition, her thyroid was borderline low with high TPO antibodies. A blood test for vitamin D showed vitamin D deficiency. For the past year her energy level was low and she had developed chronic depression. Her physician did a genetic test that found she carried the gene that converts GABA into glutamate. She thinks that she has small intestinal bacterial overgrowth (SIBO). A review of her dietary habits revealed that she ate more cooked foods and less raw food. Her memory is slightly off, her speech not as fluid and she has some cognitive decline.

Her blood tests showed anti-immunity to RAGE peptides. To put it another way, RAGE stands for “receptor for advanced glycation end products”. When you eat too much overcooked foods you ingest advanced glycation end products. This can have adverse effects on your body, particularly the brain.

More tests regarding this woman

Another specific test revealed a blood brain barrier disruption with the presence of anti-brain antibodies. A stool sample was obtained. It showed low Akkermansia, low Faecali bacterium, low Bifido longum and low Bifido adolescentis bacteria. A chemical analysis revealed low butyrate, propionate and acetate. The treating physician concluded that she had a gut dysbiosis and a dysfunctional gut barrier. This has also affected her blood brain barrier. The constellation of symptoms and blood tests explain her clinical condition. She has developed autoantibodies that affect her thyroid gland and her brain because of the antibodies against her RAGE peptides. People can develop Alzheimer’s disease given enough time with exposure to these antibodies. The leaky gut has led to a break-down of her blood brain barrier and exposed her brain to autoimmune antibodies directed against brain cells.

Treatment of gut dysbiosis

This patient started a gluten free diet (GFD). But one of the problems of the GFD is that wheat is removed that normally provides 69% inulin and 71% oligofructose, both important prebiotics that are necessary for probiotics to work with. Inulin is contained in beets, leeks, asparagus, onions, garlic and bananas. Oligofructose is contained in chicory root, bananas, onion, and garlic.

When people consume a typical Western diet, they get between 1 and 4 grams of inulin daily. But others who eat balanced diets get up to 25 to 100 grams of inulin per day. Dr. O’Bryan explained that going on a GFD leads to an altered microbiome.

Experiment with volunteers to measure the effects of a gluten free diet

He discussed an experiment on 10 healthy volunteers who were fed a GFD for 1 month.

The researchers ordere stool samples in the beginning and at the end of the experiment. There was less of the good bacteria and more of the the bad bacteria. This led to a less protective and more inflammatory environment. The remedy for that is to eat 1 root vegetable and 2 other prebiotics per day. The patient on a GFD must supplement with prebiotic-rich foods to prevent this from happening.

Non-digestible oligosaccharide supplement

Inulin and oligosaccharides support the intestinal microbiota. Dr. O’Brien suggested to add a supplement, called Precision Prebiotic™, non-digestible oligosaccharides that can increase microbial diversity. This supplement supports the growth of the healthy bacteria. These are keystone bacteria like Akkermansia muciniphila, Faecal bacterium prausnitzii, and Bifidobacteria.

Other supportive measures for the gut

1 tablespoon of fermented vegetables like sauerkraut once per day
The ingestion of fermented foods increases the beneficial gut bacteria by a factor of 10,000-fold!
A 100% spore-based probiotic supplement increases diversity of the gut flora and helps to maintain the gut barrier
Sodium butyrate, which comes from fermented food is an important modulator of the central nervous system
In addition, sodium butyrate also inhibits pathological gut bacteria and maintains the gastrointestinal balance
In neurodegenerative disorders sodium butyrate provides anti-inflammatory and neuroprotective effects
Sodium butyrate restores the blood brain barrier
Following heart attacks or strokes sodium butyrate promotes tissue repair and recovery through cell survival

Celiac Disease in Various Disguises

Conclusion

Dr. Tom O’Bryan delivered a lecture at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas on Dec.13, 2019. Wheat allergies have increased in the last decades. Researchers have found that in many people there is a deterioration of the gut flora and a breakdown of the gut barrier. This leads to antibody formation against gluten or gliadin (wheat proteins). This exposes the body to many proteins from the gut. The body reacts by producing antibodies to them. These are also affecting cells in the body as they cross react with body proteins. The inflammation from the autoantibodies cause the blood brain barrier to break down. Now the immune system can produce antibodies against brain tissue. In the past with an intact blood brain barrier this was not possible.

Autoantibodies in various life epochs

At a young age autism can develop because of antibodies against gliadin from wheat. In our youth schizophrenia and depression can occur from gut dysbiosis and a subsequent break down of our blood brain barrier. In old age Alzheimer’s disease develops in 1 out of 3 people due to gut dysbiosis and a breakdown of the blood brain barrier with anti-brain antibodies. Dr. O’Bryan explained how a person can turn this negative spiral around and start a new life without these problems. You can avoid a lot of these diseases by eliminating wheat and processed food from your diet.

Feb

2020

Clinical Applications of the Fasting Mimicking Diet

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, autoimmune disease, Cardiovascular disease, Diabetes, diet, fasting mimicking diet, food, Health, Hormones, Inflammation, lifestyle, mitochondria, Multiple sclerosis, Prevention, regenerative medicine, stem cells, telomeres, Weight loss

Dr. Kurt Hong, professor of clinical medicine spoke about clinical applications of the fasting mimicking diet in Las Vegas. This was at the 27th Annual World Congress on Anti-Aging Medicine on Dec. 14, 2019. Although he spoke on various forms of fasting, he concluded that the fasting mimicking diet had the best results and was most consumer-friendly.

How we age

Dr. Hong reviewed the processes of aging. We age, because our cells experience oxidative damage and our telomeres (the end caps of our chromosomes) get shorter in time. We also age, because there are genetic mutations in our cells’ DNA and our mitochondria are aging as well. The mitochondria are the small energy packages inside the cells that give us energy. When people age, they have lost mitochondria, there is less energy that the body makes out of food and we feel chronically tired.

Above the age of 65 we are also likely to develop diseases of various organs:

Heart disease: 31%
Cancer: 24%
Chronic lung disease (lower respiratory disease): 21%
Alzheimer’s disease: 13%
Diabetes: 11%

Women are generally healthier than men and their life expectation is 4 to 5 years longer than that of men.

Cellular and molecular aging

Longevity researchers have done mouse experiments and human clinical trials for decades. Dr. Hong asked the question: how much longer could humans live, if we could cure cancer, heart disease, stroke and diabetes? The answer is: 13 years. But if we transfer the animal data to humans it should be 30 years of longer life. Why is there such a discrepancy? The answer is that it is easy to force good lifestyles onto animals, but humans are resistant to changes. Humans have their habits; they like to continue to smoke and eat fast food instead of switching to a healthier Mediterranean diet. Humans also resist a regular exercise program. And they do not want to hear that they should replace missing hormones with bioidentical ones. The result is that we humans will prolong our lives only by less than 50% of what we could achieve.

The concept of intermittent fasting

Dr. Hong stated, that ten thousand years ago, people did not always have enough food to eat. They were forced to intermittently fast. That did not mean that they had long life expectancies, as there was no cure for any disease. But one fact was true: the body learnt to rejuvenate itself during periods of fasting. And these longevity genes are still present in our genes. But they will only help us when we actually fast for some periods of time.

Dr. Hong reviewed what kind of fasting methods are available.

Prolonged fasting and juice fasting are not among the options. With prolonged fasting electrolyte disturbances become an issue. Juice fasting does not remove enough calories and nutrients. This, however is needed to allow the body to stimulate the longevity genes.

How fasting diets work

Dr. Hong explained that there are essentially 5 fasting diets that are effective in regulating the key nutrient sensitive pathways of IGF-1, TOR and PKA. This increases cellular protection and maintenance. It also increases activation of stress resistance pathways and removes and replaces damaged and dysfunctional cells. Finally, a fasting diet also reduces inflammation, which is often the start of disease.

A review of the 5 fasting diets

Time-restricted eating (TRE)

With TRE the person fasts for 12 to 16 hours every day. The person restricts the daily food consumption to a 4- to 12-hour window. The disadvantage is that this fast is done every day. The period of fasting may not be long enough to change the metabolism, where the above-mentioned effects take place.

Alternate-day fasting

This is a 24-hour fast every other day with a 1:1 day eating-fasting cycle. This does not appear to be physiological and is disruptive with regard to social activities.

5:2 intermittent fasting

With this fast you fast for 2 days every week. With this 2:5 eating-fasting cycle the person fasts for 2 days every week; the other 5 days you eat as much as you desire.

Although this is effective, it can be quite disruptive to your lifestyle.

Periodic fasting

You fast for 48 to 72 hours every couple of months. This fast is socially more acceptable. It is not that often, just a couple of times in a year. The question remains whether it is effective in changing the metabolism to trigger the effects mentioned above.

Fasting-mimicking diet (FMD)

The original suggestion by Dr. Longo, the inventor of the FMD was that you should fast for 5 days once every month. Since then he has modified it and said that you can achieve similar metabolic changes, if you only fast for 3 days and do this a couple of times per year. I have done the FMD since December 2017 and I adhere to the original schedule of doing the FMD monthly for 5 days. This has provided me with more energy. It is easier to keep my body mass index in the 21.0 to 22.0 range. Dr. Hong explained that the FMD allows you to eat, but it tricks the body into acting like you are fasting. Because you are eating 500 to 600 calories per day, you are getting some fluid and nutrients, so the hunger pangs are tolerable.

More details about the FMD

Here is Dr. Hong’s summary about the FMD: “The stomach sees food, while the cells see fasting”. Dr. Hong said that the FMD is the most user-friendly method of fasting. It also has had the most scientific studies to validate that it is indeed working. Poorly functioning mitochondria and misfolded proteins are removed by a process of phagocytosis. The FMD reduces heart disease, cancer, and neurodegenerative disorders. Stem cell production also gets a boost. This promotes cell regeneration and reduces risk factors of premature aging.

Publication on the effectiveness of the FMD

A publication came out in 2017 reporting about the findings of a clinical trial regarding the FMD.

Researchers followed markers of aging, diabetes, cancer and cardiovascular disease in 100 volunteers. They underwent a FMD for 5 days on 3 consecutive months. The results were astounding. The body mass index, the fasting blood sugar level, triglycerides, total and LDL cholesterol and the CRP were all lower. CRP stands for C-reactive protein, which measures the degree of inflammation in the body. The blood pressure was also lower. Overall the 5-day FMD was a safe method with no side effects. The FMD reduced markers and risk factors of aging and age-related diseases. In doing so it prolongs life by reducing the likelihood of coming down with disease.

Who should abstain from fasting?

Dr. Hong mentioned that the FMD is not for everybody. Pregnant women should refrain from going on it, also type 1 and type 2 insulin dependent diabetics. Anybody who has a sign of an active infection (coughing, having a fever or diarrhea) should be excluded. Other exclusions are people who are underweight (BMI less than 18.5) or are malnourished (protein deficiency). Patients with heart failure and advanced kidney or liver disease should not take part in a fasting program.

Autoimmune diseases and FMD

The myelin sheath around the axon of nerve cells in the central nervous system are supported by oligodendrocytes. In multiple sclerosis (MS) patients T lymphocytes activate macrophages and B cells to produce autoantibodies. They destroy oligodendrocytes breaking down the insulating barrier of the myelin sheath. In MS patients the broken-down myelin sheath suppresses the electrical impulses transmitted through the nerve fibers. The FMD led to clinical improvements.

In a pilot study intermittent fasting changed the gut flora into a healthier flora.

This triggered the immune system in the gut to make less inflammatory T cells producing the IL-17 cytokines. There was also an increase in regulatory T helper cells.

Inflammatory bowel disease (IBM) can be improved with several courses of FMD. As the authors showed, intestinal inflammation improved with FMD. The intestinal gut flora improved with the FMD and it promoted intestinal regeneration.

Reversal of physical and functional decline

The fasting mimicking diet (FMD) has a variety of effects on the human body. Dr. Hong showed a slide where we could see that ketone bodies, cortisol and ghrelin levels are increased in the blood. At the same time glucose, insulin, leptin and IGF-1 levels are reduced. In addition, triglycerides and LDL levels are getting lower. Inflammatory markers including the C-reactive protein (CRP) are reduced as well.

Effects of the FMD on various organs in the body

A look at all of the organs shows that in the liver the ketone body production and insulin sensitivity are up. Glycogen production in the liver as well as the liver size are down.

The intestines produce ketone bodies. In the skeletal muscles the insulin sensitivity is increased, while the muscle structure and function are improved. In the brain the hunger feeling increases the release of neurotropic factors including the neuropeptide Y. Cognitive function and stress resistance increase with the FMD. The FMD reduces inflammation and oxidative stress in the brain. With respect to the cardiovascular system the heart rate drops down and blood pressure gets lower. The insulin production in the pancreas is reduced.

Fatty tissue

In fatty tissue lipolysis is up and also the production of adiponectin. This is a protein hormone involved in glucose and fatty acid metabolism. Insulin sensitivity with the FMD is also increased. On the other hand, the FMD reduces fat mass, leptin production and inflammation.

The FMD is the solution to preventing disease and prolonging your life

All of these effects lead to a reversal of physiologic and functional declines. Age-related metabolic diseases like type 2 diabetes are postponed or eliminated. The FMD prevents neuro-cognitive decline like Alzheimer’s disease. In addition, the risk of developing cancer is getting lower. In summary, the FMD improves the health-span, quality of life and can prepare you for a long life.

Clinical Applications of the Fasting Mimicking Diet

Conclusion

Dr. Kurt Hong is a professor of clinical medicine at UCLA. He gave a talk at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas on Dec. 14, 2019. He discussed what we could do to help patients with various autoimmune diseases like multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease. It turns out that the fasting mimicking diet (FMD) is the best solution to reduce inflammation and modify the autoimmune response from aggressive T lymphocytes. With the FMD you consume only 500 to 600 calories per day for 5 days every month. The rest of the days of the month you eat a healthy Mediterranean-type diet.

Fasting mimicking diet, the best way to treat autoimmune diseases

Dr. Hong explained in detail what cellular mechanisms are at work to achieve the modification of the immune system in autoimmune diseases. The FMD is also the solution to slow down aging in healthy people. Dr. Hong discussed clinical applications of the fasting mimicking diet fort autoimmune diseases. It is easier to prevent disease than it is to cure an illness. The FMD is an easier way, because you don’t fast completely, you only reduce your food intake to the bare minimum, but your body “thinks” that you are fasting.

Ultimately, this approach does take some effort, and it does take time to familiarize yourself with it. If patients do it for the first time, they will experience some hunger, the first and second day tend to be a hurdle! Once you make it part of a health routine on a regular basis, it is a lot easier.

Feb

2020

Rheumatoid Arthritis Treatment by Regenerative Medicine

By Ray Schilling | Arthritis, autoimmune disease, fasting mimicking diet, Nutrition, stem cells

Dr. David Lans gave a talk at a conference in Las Vegas about rheumatoid arthritis treatment by regenerative medicine. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. The full title of his presentation was “Rheumatoid Arthritis, A Regenerative Medicine Approach”.

Dr. Lans is a rheumatologist and Assistant Clinical Professor of Medicine at the New York Presbyterian Lawrence Hospital, Bronxville, NY.

Introduction

Rheumatoid arthritis is a worldwide immune disorder. About 1% of the general population suffer of this illness with a female to male ratio of 3:1. Typically it can affect the synovial membranes of all joints. To clarify, the presentation is usually symmetrical, but in 40% of all cases this systemic inflammatory disease can also involve other tissues and organs. 70% of cases have a positive rheumatoid factor (RF) in blood tests. However, a newer, more specific blood test for rheumatoid arthritis is anti-cyclic citrullinated peptide (anti-CCP). Symptoms of rheumatoid arthritis are anemia, fatigue, malaise, joint pain and joint stiffness. Inflammatory blood markers are positive.

Causes of rheumatoid arthritis

Genetic causes play an important role in the causation of rheumatoid arthritis. Over 100 genes can increase due to genetics. Twin studies showed that the concordance rate to develop RA is only 15-20%. Certainly, this means that in order to develop RA you need a double hit: the genetic vulnerability for RA and also an environmental triggering factor. Meanwhile, here is a list of environmental risk factors:

Smoking
Gum disease (chronic gingivitis)
Any chronic infection
Dysbiosis in the gut
Environmental toxins
Heavy metal toxicity
Poor diet and nutrition

In other words, the common denominator to all of these environmental risk factors is the disruption of the mucosal integrity. In fact, this starts the process of chronic inflammation and autoantibodies (like RF and anti-CCP) resulting in chronic synovitis.

How inflammation travels from mucosal surfaces to the synovium of joints

Inflammation in gums, lungs or gut can travel via the blood and the lymphatic system into periarticular bone. This leads to bone and cartilage damage. Consequently, the bone destruction leads to chronic synovitis. To emphasize, Dr. Lans said that no patient with rheumatoid arthritis will develop symptoms of RA unless the autoantibodies have developed. In the same vein, there is a distinct preclinical period of RA with positive blood tests for RA, but absent clinical symptoms.

Prevention of synovitis through a preventative program

It is important to realize that because of this time relationship there is room for a preventative program where patients are taught the importance of dental hygiene. Another key point is that good health habits and nutrition are also important for prevention. When patients develop early-onset RA, the following measures often help to alleviate the development of symptoms: anti-inflammatory diet, stress management, intermittent fasting, a gut healing program, nutraceuticals like vitamin D3 and fish oil. Herbal therapies are also important like curcumin, Boswellia serrata, devil’s claw, ginger, Ashwagandha and others.

Conventional medicine approach versus the regenerative medical approach

To explain, the conventional treatment approach of rheumatoid arthritis is to induce a disease remission with drugs. To this effect doctors use anti-inflammatory drugs like ANSAIDs, disease modifying anti-rheumatic drugs (DMARDs). For example, drugs like methotrexate and sulfosalazine belong into this category. Unfortunately, the conventional drugs have many serious side effects that often make the rheumatoid arthritis patient’s condition worse.

In contrast, the integrative medicine approach to rheumatoid arthritis is to use dietary measures to reduce the inflammation. The fasting mimicking diet is able to reduce the severity of the inflammation in RA patients.

Other authors described the use of the Mediterranean diet to reduce inflammation. In addition, there are a number of regenerative methods that help improve the condition of RA patients.

Regenerative medical treatments for RA patients

Significantly, platelet rich plasma (PRP), peptides, stem cell therapy and exosomes are some of the modalities that show promise. (I’ll explain the meaning of exosomes later.) In addition, red light therapy and low-level laser therapy can help joint synovitis.

PRP provides growth factors to repair damaged tissues and is anti-inflammatory. Peptides consist of short chains of amino acids that have anti-inflammatory effects and promote healing of damaged tissues. Thymosin-alpha 1, Thymosin-beta 4, BPC-157, Melanotan II and FOXO4-DRI are examples of peptides used in patients. Special blood tests are used to monitor whether the treatment of RA is successful. These tests are: C-reactive protein, sedimentation rate (ESR) and Vectra. Vectra measures 12 protein markers that are important in RA.

More info about peptide therapy

Researchers noticed that peptides are very safe, but they are also very effective. HAP-1 seems to bind to synovial surfaces. RDG peptides work closely together with integrin-binding proteins. Together they have an anti-inflammatory effect in rheumatoid arthritis. They are capable of blocking both the inflammatory and autoimmune components of rheumatoid arthritis. Thymosin-alpha 1 is a peptide with powerful effects as an immune and inflammation modulator. Thymosin-beta 4 is promoting tissue healing. BPC-157 is a peptide with 15 amino acids. It helps with the regeneration of tissue after damage.

Melanotan II is a synthetic peptide derived from melanocortin, a pituitary hormone. It helps to suppress cytokine-meditated inflammation.

FOXO4-DRI is a peptide that stimulates the removal of senescent cells. Because of this it is called a senolytic. Researchers are still investigating FOXO4-DRI in humans and for the tissue repair effect in rheumatoid arthritis patients.

The use of stem cells in RA therapy

Another biological remedy for treating RA patients is the use of mesenchymal stem cells. In 2013 rheumatoid patients received umbilical cord stem cells to study the effect of stem cells. The clinical trial consisted of 172 patients. In the trial disease modifying anti-rheumatic drugs plus placebo were compared to disease modifying anti-rheumatic drugs plus umbilical cord stem cells (treatment group). In the treatment group inflammatory cytokines were reduced and regulatory T cells were increased. Improvement was assessed with objective clinical measures and blood tests. The improvement lasted between 3 and 6 months.

Exosome therapy from mesenchymal stem cells

Many of the effects of stem cells are explainable by so-called exosomes. They are cell particles shed by stem cells. They contain signalling proteins (integrins), messenger RNA and many other healing substances. The bioactive effects are very diverse. Exosomes are bactericidal, antifungal, stimulate angiogenesis and stimulate tissue regeneration. They are also anti-apoptosis, anti-tumoral, anti-fibrosis, stimulate immunomodulation and cause chemoattraction.

What does that mean clinically? Exosomes suppress the release of inflammatory cytokines. Anti-inflammatory cytokines (like transforming growth factor beta or TGF-beta) are increased. Exosomes reduce the Th17 cells (T helper cells that produce the inflammatory cytokine IL-17). They also promote osteochondral regeneration, which is important for joint healing in the treatment of RA patients.

Treatment of RA using the integrative and regenerative medicine approach

The physician assesses all affected joints and orders blood tests to check the inflammatory status.
Identify the triggers that perpetuate the RA disease. Typically there are gut dysbiosis issues that need treatment. Sleep hygiene and stress issues require modification.
Assess the need for disease modifying anti-rheumatic drugs (DMARDs); these are drugs like methotrexate, sulfosalazine and others.
Peptide protocol: BPC-157: 300 micrograms once or twice daily IV; Thymosin alpha: 300 micrograms once or twice daily IV; Thymosin beta: 100 to 300 micrograms once daily IV, limit to 3-month cycle.
Mesenchymal stem cell therapy and exosomes.

Rheumatoid Arthritis Treatment by Regenerative Medicine

Conclusion

Rheumatoid arthritis is a common autoimmune disease, which leaves the patient disabled, if she receives no treatment for it. Conventional rheumatologist protocols treat the inflammation with various drugs, but they cause a lot of side effects.

There is an emergence of regenerative therapies that may be able to help treat the inflammation of the rheumatoid arthritis patient with less side effects. At the same time these treatments can also help to repair the damaged tissues. There is a great need for more clinical studies. Current human data are limited. Safe options to treat RA patients are mesenchymal stem cell therapy, exosome treatment and peptide therapies. The approach of the physician depends on the clinical stage the patient is in. It is common sense that early diagnosis and treatment will have better results. Also, an integrative approach has the best chance to help the patient with the least side-effects.

Jan

2020

Nitric Oxide (NO) Can Provide You With Energy

By Ray Schilling | depression, diet, Inflammation, Nutrition

Dr. Nathan S. Bryan explained that nitric oxide (NO) can provide you with energy. His presentation was given at the 27^th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15, 2019 that I attended. Dr. Bryan worked at the Department of Human Genetics at the Baylor College of Medicine in Houston, Texas. In his 20 years of research he asked the following questions:

How does the human body produce NO?
There are people who cannot make NO; what went wrong in these people?
What are the clinical consequences when NO is missing?
How do you fix or restore your inborn NO production?

Mental disease is also closely related to heart disease and to strokes. Over 44 million patients in the US have a mental illness. Mental disease and heart disease are linked by the fact that both have higher rates of heart attacks and strokes. Marc de Hert et al. published a paper entitled: “The intriguing relationship between coronary heart disease and mental disorders”.

Mental health and heart disease related

Mental health and heart disease are related. Both show increased heart attack rates and strokes. But there is another important finding: sexual dysfunction is common among psychiatric patients. The sexual dysfunction among schizophrenic patients was related to both the psychobiology and the pharmacotherapy. Emotional and sex-related problems were more common in a patients group who experienced poor physical and emotional health.

Another finding that shows the importance of normal circulation is peripheral artery disease (PAD). A group of people with depression had an increase in PAD.

SPECT scans of brains as a tool to investigate circulation

SPECT stands for Single Photon Emission Computed Tomography. It is a tool that Dr. Amen has used for years to study the brain. He found, for instance that with chronic marijuana use the brain circulation develops deficiencies where certain parts of the brain are not properly perfused. This is associated with certain brain malfunctions. When the patient is rehabilitated the blood circulation to the brain gradually recovers. Dr. Bryan noted that there is a decrease in blood flow with every chronic disease. If we can restore blood flow to the region in the brain where where there is a blood flow disturbance, we can cure many neurological diseases.

Restoration of circulation with nitric oxide (NO)

Dr. Bryan showed vignettes of improved body circulation with systemic nitric oxide therapy. One example was that nitric oxide supports a healthy blood pressure. At the same time nitric oxide also improves endothelial function. A 13% increase in blood vessel diameter increases blood flow by 34%!

Thermographic images show a 49-year-old smoker with Raynaud disease in the hands. Within 10 minutes after nitric oxide application the poorly circulated fingers showed a sudden opening up and normal perfusion to the fingers.

Nitric oxide can repair skin damage

Before and after pictures showed the effect of anti-aging skin care serum with nitric oxide. The anti-aging skin care serum improved skin texture, increased elasticity, evened skin tone, restored moisture, reduced fine lines and wrinkles and created tighter and smoother skin. A chronic skin ulcer on a woman’s right chin disappeared in a matter of a few weeks and healed with hardly any scar formation.

Here are some final remarks on nitric oxide replacement

Dr. Bryan concluded with these remarks: Nitric oxide governs vascular structure and function. NO production undergoes an age-related decline. This leads to cardiovascular risks and neurological disorders. Restoring NO production improves tissue perfusion and vascular function. Strategies of nitric oxide production will positively affect general health and the aging process. Any anti-aging strategy should include nitric oxide as a tool.

Nitric Oxide (NO) Can Provide You With Energy

Conclusion

Dr. Bryan gave a good overview of how nitric oxide (NO) can help people to improve their complexion, their perfusion, and how cardiac and neurological disorder can be prevented. Before and after pictures showed the effect of anti-aging skin care serum with nitric oxide. The anti-aging skin care serum improved skin texture, increased elasticity, evened skin tone, restored moisture, reduced fine lines and wrinkles and created tighter and smoother skin. A chronic skin ulcer on a woman’s right chin disappeared in a matter of a few weeks and healed with hardly any scar formation.

But these are only examples about skin appearance. Perhaps the more important aspect of nitric oxide is the repair of the lining of the arteries and the improvement of circulation to various organs. Nitric oxide can even prevent neurological disease with regular consumption.

Jan

2020

Antibiotics In Children Can Trigger Allergies And Asthma Later In Life

By Ray Schilling | Allergies, antibiotics, Asthma, immune system, Infectious Disease

Whoever treats a child’s cold must know that antibiotics in children can trigger allergies and asthma later in life. This is what a study released on Dec. 20, 2019 has shown. The researchers examined records of 798,426 children seen at the Department of Defense TRICARE health care program. They were born between 2001 and 2013. The physicians examined the children later again for allergies. The more antibiotics the children received in childhood, the more severe the youngster’s allergies were later in life.

More details about the study

The researchers found that different antibiotic types had different risks to cause allergic reactions later in life.

Penicillin: 1.3-fold risk
Penicillin with a β-lactamase inhibitor: 1.21-fold risk
Macrolides: 1.28-fold risk)
Cephalosporins: 1.19-fold risk
Sulfonamides: 1.06-fold risk

The type of allergies that the children developed later in life were food allergies, anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis or contact dermatitis. The researchers stressed that their finding indicated an association between taking antibiotics and developing allergies later. It was not a causal relationship.

Food allergies in more detail

Anaphylaxis

This allergic condition is an emergency and requires immediate medical attention. It can occur when the body overreacts to peanuts or penicillin. It can occur with foods, and the reaction is sudden and severe. The symptoms may include wheezing, shortness of breath, a cough or tightness in the throat. The blood pressure may drop leading to light-headedness and passing out. The skin may show hives, swelling and a rash. The digestive symptoms may be nausea, vomiting and diarrhea. Other symptoms may involve itching eyes, headaches, anxiety and a feeling of impending doom.

Asthma

Airborne grass and tree pollens, mold spores and dust, but also peanuts and other strong allergens can trigger an asthma attack. The symptoms can be shortness of breath, wheezing, tightness in the chest, trouble falling asleep because of coughing and being short of breath.

Atopic dermatitis (eczema)

Often atopic dermatitis starts below the age of 5 and can last until late adolescence or adulthood. The symptoms can be dry skin, itching red patches of skin and thickened scaly skin. Allergic contact dermatitis is common in patients with atopic dermatitis.

Allergic rhinitis

People who suffer from allergic rhinitis are sensitized to particles in the air like grass and tree pollen, molds or cigarette fumes. They develop a stuffy nose, itching and watery eyes, sneezing and swelling around the eye lids. An allergist can do skin scratch tests to find out what the patient is allergic to. Subsequently, if the allergies are strong, the allergist may decide to start desensitization with allergy shots.

Allergic conjunctivitis

A person who is allergic to pollen and mold spores will react to this when in contact with it and often develop allergic conjunctivitis. An eye inflammation will develop within a few minutes leading to swelling of the conjunctiva around the eye ball. The eyes end up looking red, itching, burning and being watery.

Contact dermatitis

Contact dermatitis develops when your body brushes against a substance that your body has been previously sensitized to. One example is poison ivy contact dermatitis. But many other substances can cause similar reactions: solvents, shampoos, permanent wave solutions and rubbing alcohol. In addition, plants, bleach and detergents, fertilizers, pesticides and airborne substances (sawdust, dust from woollen materials) can also do the same.

The gut biome

Dr. Purvi Parikh is an allergist and immunologist at NYU Langone Health in New York. She was not involved in the study, but commented to it as follows: “One reason why there might be an association is because our microbiome, specifically in our gut, plays a large role in our immune systems. Antibiotics are known to not only kill the bacteria that are causing an infection, but also ‘good’ bacteria our immune system needs to protect us from developing allergic or autoimmune diseases.”

Treat bacterial infections with antibiotics when needed

She went on to say: “Overall, parents should know that this study shows an association but not necessarily cause and effect. So, if a child truly needs an antibiotic for a bacterial infection, they should not withhold it due to fear of allergic disease. However, on that same note, one should not over use antibiotics if not needed – for a virus or a cold – as there may be long-term consequences from over use.”

Antibiotics In Children Can Trigger Allergies And Asthma Later In Life

Conclusion

A new study showed that antibiotics can cause allergies and asthma later in life. The reason seems to be that our gut bacteria react to the antibiotics and the gut dysbiosis (disbalance of the gut bacteria) persists, when the antibiotics have been discontinued. The immune system can then react in ways that are detrimental to the child and adolescent. Anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis or contact dermatitis are all different manifestations of allergies that can develop later in life. At this point we only know that there is an association between these allergic manifestations and the antibiotic use in childhood. More clinical trials will need to shed a light on what causes allergies in some children, but not in others.

Jan

2020

Centenarians Are Positive Thinkers

By Ray Schilling | Anti-aging medicine, Anxiety, Mortality, stress

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27^th Annual World Congress on Anti-Aging Medicine. The topic of his talk was “Positive Psychological Attitudes of Centenarians “.

Dr. Hertoghe is an endocrinologist in Belgium. Dr. Hertoghe took an interest in people above the age of 100. He felt that these people are special people with a very optimistic outlook on life. He went on to study the literature about this topic in detail and this is what this talk was about.

The oldest man, Gustav Gerneth died at 114 years 7 days in Germany (Oct. 22, 2019). The oldest female is Japan’s Kane Tanaka at 117 years (birthday Jan. 2,1903).

So, what is their secret to age that well? Here is what Dr. Hertoghe found out about centenarians.

Attributes of centenarians

Centenarians have a will to live. They adapt to changes; they have a sense of purpose, and they stay active. Other psychological features show that they have is a positive mood and they avoid stress and anxiety. Another important attribute is self-determination. They are very sociable, have close family ties, love their relationships and often have a strong religious faith. There is a connection between their basic values and beliefs and their spirituality. Centenarians insist on their freedom and they have a feeling of youth. Centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing the details that Dr. Hertoghe gave. He covered 13 subtopics regarding causes of longevity in centenarians.

The will to live

It takes courage to grow old and all centenarians have this. They say “Life is worth living”. They have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Their mortality was only 33.3%. Be careful what you wish for!

Adaptability

This describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. Only 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group was associated with 2%-4% lower mortality risk. They had a 36%-55% higher odds of not developing cognitive impairment and they rated themselves as being in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. Short-term health decline was not associated with these high resilient centenarians.

A sense of purpose

Centenarians can still contribute to society. Tao Porchon-Lynch turned 100 in 2014. She opened the Westchester Institute of Yoga in 1982 and is still practicing yoga. There are many ways how centenarians express a sense of purpose. Males often work in their old job, but only part-time. They may help with babysitting the great-grandchildren. Others do volunteer service. Still others may enrol in a university and study what they always wanted to do.

In a 2016 publication people older than 65 were followed between February 2011 and November 2014. Those who had neither hobbies or a purpose in life did not fare well. They had a risk of mortality of 2.08-fold compared to those with a sense of purpose. Dr. Hertoghe provided 9 more references regarding studies that showed the same finding.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

Better stress management

Centenarians avoid excessive stress and attempt to relax instead. It has been known since the ground-breaking work by Dr. Hans Selye that stress undermines longevity. By using relaxation methods intermittently one can reduce the stress response, which normalizes the excessive ACTH production in the pituitary gland and the concomitant cortisol production in the adrenal glands.

Self-determination

Long-living people have a strong willpower and are determined to succeed with what they want. They have a sense of self-worth and self-esteem. Centenarians have concerns for others, but they also have a healthy regard for themselves. Dr. Hertoghe provided 4 references to illustrate this, but for brevity reasons I will omit them here.

Social involvement

Centenarians have an active social life. They are involved with their family, with the community including often church communities. Sociability has a 2.3-fold higher probability of survival (mortality reduced by 57% due to sociability). Other studies confirmed this.

Practicing religion

Those who are centenarians were often raised in religious families. They developed a strong faith in God. A common theme among centenarians is that they trust in God and believe it is His will that they lived a long life. They also believe that eventually God will call them “home” when He is ready for them. Centenarians who practice religion have a strong belief in an afterlife, which sustains them to live and they accept death when it comes. In a 2017 study 18,370 participants aged 50 and older were interviewed in 2004 and followed for all-cause mortality to 2014. Regular church attendants had a mortality that was 40% less than those who did not attend. Dr. Hertoghe provided 20 more references that showed similar findings.

Spiritual involvement

Attributes of spiritual involvement are high ethical principles, resilience and hope that everything will turn out OK. Dr. Hertoghe cited from 7 different references that the average effect of spirituality leads to a 2- to 4-fold greater survival over 17 years.

A feeling of freedom

This makes centenarians less concerned what other people think of them. Dr. Helen Langner, a psychiatrist, still does a part-time psychiatric practice at age 100. She says about a feeling of freedom: “In old age, there’s often a sense of personal freedom because there is less pressure of a career or the responsibilities of work or raising a

family. It can and should be a time for people to do the things that are important to them and a time to enjoy. “

A feeling of youth

Many centenarians are young at heart. Even though they may look physically old, they don’t feel old in their heart.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48%. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%.

Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

Jeanne Louise Calment

As an illustration for humor Dr. Hertoghe introduced Jeanne Louise Calment to the audience. She was a French woman who broke the record for being the oldest centenarian in the world. Jeanne Calment died on August 4, 1997 at the age of 122 years and 164 days. She was asked by someone: “Why do you live so long?” She replied: “Because God has forgotten me…” Next question: “How do you consider your future life?” “Very, very short”. Last question:” What do you think of your wrinkles?” “The only wrinkle I have is the one I am sitting on”.

Centenarians Are Positive Thinkers

Conclusion

Centenarians have certain attributes that make them more resilient than others who die earlier. They have a will to live, an ability to adjust, a sense of purpose and they stay active. Their psychological make-up is such that they have a positive mood and they tend to avoid stress and anxiety. They have a sense of self-determination. They are very sociable, have close family ties, love relationships with people around them, and often have a strong religious faith. Their spirituality has a connection to their basic values and beliefs. Centenarians insist on their freedom and they have a feeling of youth. They have their own centenarian spirit where they can feel young or old. But they also have humor as documented above with the oldest woman that lived. She was 122 years and 164 days old when she died in 1997.