Mar
15
2014

Mold Allergies Often Overlooked

In a recent news story extensive mold infestation was found in a house that had oriented strand boards (OSB) instead of plywood walls. The house also was tightly sealed trapping moisture, which contributed to the extensive mold problem.

Mold problems have been around for centuries, but only in the past few decades allergists  have pointed out to their patients how important it is to prevent this from happening.

In the following I will review a few typical scenarios that can lead to mold accumulation.

1. Mold from airtight house construction

The homeowner described in the link above is not the only case in the world that has a mold problem. Energy efficient homes are popular because they save energy costs; homeowners often also respond to gas companies, electric utility companies and government incentives to convert to airtight home construction.

In the 1980’s the construction industry introduced the cheaper OSB products to replace the more expensive plywood for wall construction. This is often the problem with newer house construction. However, older homes are not immune to mold development.

2. Roof leaks in older homes

Older homes that were built in the 1970’s may have plywood walls and have a bit of airflow from poorer wall construction, which would prevent mold formation. But roofs are older and do not always get replaced right away when a leak is detected. It may even take some time in areas where there is less precipitation before it is picked up during a particularly heavy rainstorm. Water that enters from a leaky roof can form a puddle on top of the ceiling where mold softens the drywall material until a leak in the ceiling causes water to drip down onto the floor. The mold spores multiply particularly well in wall-to-wall carpeting, but OSB material is also a good growth opportunity for molds due to the mini air spaces between the glued wood pieces. Plywood with its several tight layers is much more resistant to water penetration and mold growth.

Mold Allergies Often Overlooked

Mold Allergies Often Overlooked

3. Mold growth after hurricanes

After hurricane Sandy images of “black mold” were frequently shown in the media. The problem is that after 48 hours anything that was in contact with water produces mold. However, often with disasters like hurricanes there are evacuation orders and you cannot return to your home for several days. There may be further delay because there is a waiting period for insurers to assess the amount of damage, before you can clean all surfaces affected by mold.

The end is result often that expensive mold sanitation is needed or the person ends up moving away and the house is levelled before a new house can be built.

4. Effects of molds

People with preexisting allergies and asthma are more susceptible to the effects of molds. It leads to itchy eyes, wheezing, coughing, and exacerbation of asthma.

Here is a brief overview what the CDC is stating about mold. This site also explains that you can recognize a mold problem because of a musty smell or foul stench in the air and because of the appearance (discoloration of ceilings or walls, water damage).

You can clean hard surfaces with bleach water. Bleach kills molds, but it may have to be cleaned several times within a few days to get rid of the last spores. Whatever cannot be sanitized in this way must be removed or replaced.

5. Health concerns regarding molds

Ref. 1 reviewed the public concern about the toxic effects of molds. It noted that with the Internet and the popular press having exaggerated some of the connections of symptoms with mold allergies, the term “mold madness” has been coined (Ref.2). Despite the paranoia in the general public about toxins from molds, there is only a small percentage of the population that is sensitive to molds where IgE antibodies and IgG antibodies against molds can be determined through blood tests. These individuals often are also allergic to other environmental allergens like grass pollen and dust mites. The asthmatic reactions in sensitive people are not as severe as what peanut traces would do to peanut sensitive patients, but skin testing and blood test screening for specific IgE and IgG antibodies do often confirm that sensitive people indeed can have specific mold allergies. In the vast majority of people these tests are negative and correlations between mold infestations and allergic reactions could not be verified (Ref.1).

6. Fixing mold damage and dealing with allergies

It follows from this that you should remove any visible molds and fix whatever the cause was for its appearance. Carefully disinfect the areas with diluted bleach water (the CDC recommends 1 cup of bleach per 1 gallon of water) several times. Make sure the areas are dry and not musty otherwise you  have  work on improving ventilation. If you are not one of these hypersensitive persons, there is nothing to worry further. However, if you are hypersensitive an allergist should examine you. Common indoor molds that cause the so-called “immediate type hyper reactivity” are due to the mold species Aspergillum and Penicillium. Most outdoor molds that can cause problems for sensitive people are due to Alternaria and Cladosporium species. The latter would be the ones found in carpets after a leaky roof has caused problems. When the allergist has found specific allergies to one or several of the mold species, allergy shots may be prescribed that would have to be given weekly to the sensitive person who was found to have environmentally induced asthma. Often it takes several years for these desensitization shots to stop the affected person from reacting  to molds. In some cases patients need to stay on these shots life-long.

Conclusion

The key with regard to mold allergies is to prevent mold growth by being vigilant about detecting early problems with leaky roofs, walls and cleaning up water damage right away. When there is a musty tell- tale smell, investigate right away and remedy the problem. For most people this is the end of the story. However, a small percentage of very sensitive people need to consult with an allergist who should investigate whether or not these people would benefit from allergy injections.

In some rare cases the affected person may have to relocate to another house that is free from molds.

More information about asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

References

1.Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. Copyright 2007 Saunders

2. Zacharisen MC, Fink JN: “Is indoor “mold madness” upon us?” Ann. Allergy Asthma Immun. 2005; 94:12-13.

Last edited Nov. 7, 2014

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Mar
01
2014

Smoking Remains A Health Hazard

Recently new statistics came out that show that 48.8 million people in the US (19% of the population) still smoke. 22 % of the population are male, 17% female. Smoking is responsible for 20% of all deaths in the US (1 in 5 deaths). It is interesting to note that in the older age group (above the age of 65) only 8% are smoking, but 22 % of the 25 to 44 year old group is smoking. Among the American population Native Americans have the highest percentage of smokers (32% are smokers). 10% of Americans of Asian descend smoke. Blacks, Whites and Hispanics are placed in between them and the American Indians. Finally, people who can least afford it (who are below the poverty level) have the highest percentage of smokers (29% smoke) while 18% of people above the poverty level smoke. Education seems to have a protective effects when it comes to smoking: of the least educated group of people 45% are smokers while only 5% with postgraduate education smoke.

Effects of cigarette smoke on the body

As this link shows the concoction of various ingredients in the smoke of cigarettes causes various parts of the body to react differently to these chemicals. Here is a rundown of diseases caused by smoking cigarettes.

1. Lung cancer: This is the most common cause of death in women who smoke, more common now than breast cancer. 90% of lung cancers in women are due to smoking. The same was true in males, but as a group they now smoke less than in the past.

2. Other cancers:  cervical cancer, kidney cancer, pancreatic cancer, bladder, esophageal, stomach, laryngeal, oral, and throat cancers are all caused by smoking. Recently acute myeloid leukemia, a cancer of the bone marrow has been added to the list of smoking related cancers.

3. Abdominal aortic aneurysm: As cigarette smoke destroys elastic tissue, it is no wonder that the loss of support of the wall of the aortic artery leads to the development of large pouches, which eventually rupture with a high mortality rate due to massive blood loss.

4. Infections of lungs and gums: Smokers are prone to infections of the lungs (pneumonia) and of the gums (periodontitis).

5. Chronic lung diseases: emphysema, chronic bronchitis, asthma.

6. Cataracts: lack of perfusion of the lens leads to premature cataract formation.

7. Coronary heart disease: hardening of the coronary arteries, which leads to heart attacks, is very common in smokers.

8. Reproduction: reduced fertility in mothers, premature rupture of membranes with prematurely born babies; low birth weight; all this leads to higher infant mortality. Sudden infant death syndrome is found more frequently in children of smoking moms (Ref. 1).

9. Intermittent claudication: after decades of smoking the larger arteries in the legs are hardening and not enough oxygen reaches the muscles to walk causing intermittent pausing to recover from the muscle aches. If it is feasible a cardiovascular surgeon may be able to do a bypass surgery to rescue the legs, often though this is not feasible and the patients lower legs or an entire lower limb may have to be amputated.

10. Others: osteoporosis is more common in smokers; poor eye sight develops due to age-related macular degeneration that sets in earlier and due to tobacco amblyopia, a toxic effect from tobacco on the optic nerve; hypothyroidism is aggravated by smoking and menopause occurs earlier.

Smoking Remains A Health Hazard

Smoking Remains A Health Hazard

What happens in the lung tissue in smokers?

Ref. 1 gives a detailed rundown of the changes in the lung tissue as a result of exposure to cigarette smoke. The various components of cigarette smoke lead to an activation of special white blood cells, called monocytes that after stimulation turn into tissue macrophages. In addition neutrophils (regular white blood cells) also get stimulated. Between them they produce cytokines and chemokines and the neutrophils secrete elastase that digests elastic tissue in the lungs. Breakdown products of the elastic tissue serve as a powerful stimulus to the immune system to mount an autoimmune response. After some time of being exposed to cigarette smoke the immune system considers part of the lining of the lungs as foreign and cytotoxic lymphocytes attack the lining of the air sacs (alveoli). Lung specialists consider chronic obstructive pulmonary disease (COPD or emphysema) to be an autoimmune disease (Ref.1).

The sad part is that when this condition has progressed far enough, even quitting smoking may be too late to stop the autoimmune disease by itself as the body has been sensitized and the immune system is convinced that the altered lung tissue should be attacked. Add to this that carcinogenic substances and toxins in cigarette smoke damage the DNA of all cells and the energy producing mitochondria, and the stage is set for the combination of chronic inflammation and the release of free radicals to cause all of the diseases mentioned above.

Quit smoking still important

It is extremely important to quit as soon as possible to avoid the full-fledged sensitization of the immune system against ones own lung tissue. Studies have shown that 36% of survivors of heart attacks will successfully quit, 21% of healthy men with a known risk of cardiovascular disease will quit when asked to do so and 8% of pregnant women will quit. When a physician examines a patient in the office and asks a smoker to quit smoking 2% of these smokers will respond and still not smoke 1 year after this doctor’s visit. This may not sound like much, but it is an encouraging effect. Perhaps the most important fact is what I mentioned in the beginning of this blog: the least educated group of people smoked the most (45%) while the most educated people smoked the least (5% of people with a postgraduate education). My hope is that the Internet and other educational media will contribute to education to convince people how important prevention is.

Pharmacological assistance to quit smoking

Nicotine replacement therapy can involve any of 2- and 4-mg nicotine polacrilex gum, transdermal nicotine patches, nicotine nasal spray, the nicotine inhaler or nicotine lozenges. Discuss with your doctor what may be best in your case. Typically one of these products is used for 3 to 6 months.

Bupropion is an antidepressant with a nicotinic acetylcholine receptor affinity. Bupropion is useful to help with the withdrawal from nicotine addiction, which occurs in depressed or non-depressed people. It strictly has to do with the stimulation of the nicotinic acetylcholine receptor.  Typically the dose is 150 mg of a sustained released bupropion tablet per day for 7 days prior to stopping smoking, then at 300 mg (two 150-mg sustained-release doses) per day for the next 6 to 12 weeks. 44% quit at 7 weeks versus 19% of controls. A newer nicotine partial receptor stimulator, varenicline, has been compared to bupropion. It was slightly more effective in helping people to get off cigarettes. Varenicline is started at a dose of 0.5 mg per day for 3 days, then 0.5 mg twice daily for 4 days, followed by a maintenance dose of 1 mg twice daily. If nausea is a problem, lower doses can be used. Varenicline has been approved for a 3-month period with an option of a second 3-month period, if relapse occurs. Discuss with your doctor what is best for you.

According to Ref. 1 a combination therapy of bupropion and nicotine patch was more effective than either one alone.

Will power, hypnotherapy

Hypnotherapy to quit smoking has been popular, but is not as effective as it is often claimed. Will power, measured by the “placebo” response is quite effective given the fact that nicotine is very addictive and yet 19% in the placebo group were able to quit on their own. According to Ref. 1 varenicline treatment for 12 weeks produced abstinence for 9 to 52 weeks and was compared to bupropion and placebo. The abstinence rates were 23%, 15%, and 10% for varenicline, bupropion, and placebo. This means that will power was still 2/3 as effective as bupropion and 43% as effective as varenicline. Don’t underestimate will power!

Conclusion

The best scenario is to never start smoking. The second best is to quit as soon as possible. Unfortunately, the third scenario of continuing to smoke is still very prevalent worldwide. I have seen the damage done first hand in practicing medicine, which motivated me to never smoke. But I am aware of the difficulties of quitting because of the highly addictive nature of cigarette smoking. Where is the support from governments on this? The problem is that the government benefits from taxation of cigarettes. Nevertheless it is laudable that there are government sites through the CDC to help you quit smoking.

At the end we are all responsible for our own health. If you are presently smoking, psych yourself up for the day that you will quit. Quitting means that you are deciding actively to live longer. Studies have shown that it takes often several attempts before you eventually quit successfully.More information on some of the topics mentioned:

1. Lung cancer and other cancers: http://nethealthbook.com/cancer-overview/overview/epidemiology-cancer-origin-reason-cancer/

2. Heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

3. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

Reference

1. Mason: Murray and Nadel’s Textbook of Respiratory Medicine, 5th ed.© 2010 Saunders

Last edited Nov. 7, 2014

Dec
21
2013

Buying Into High Carb, Low Fat Myth Makes You Sick

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

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

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

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

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

Buying into High Carb, Low Fat Myth Makes You Sick

Buying Into High Carb, Low Fat Myth Makes You Sick

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

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

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

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

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

Inflammation as the alternative explanation of arteriosclerosis

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

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

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

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

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

Reassessment of what a heart healthy, brain friendly diet is

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

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

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

This causes inflammation, heart attacks, strokes and cancer.

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

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

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

Conclusion

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

More information on:

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

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

References

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

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

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

Last edited Nov. 7, 2014

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Nov
23
2013

Stop Obesity

Introduction

Being obese is not just a problem that is known as “middle age spread’. It has become an alarming condition that affects all age groups, children, adolescents and adults; it has escalated into a health problem that affects a large percentage of the US population. Statistics are hard to ignore: in 2012 one third of adults in the US were overweight. Another third was obese. That means that  two thirds of the population exceeded the upper limit of a normal body weight (a body mass index of less than 25.0). Other countries in the Western world share in the record of being the fattest nations: they are Mexico, New Zealand, Chile, Australia, Canada, The United Kingdom, Ireland and Finland. Not every country with high living standards has high obesity rates. Japan and Korea by comparison have obesity rates of 3 to 4%.

Health consequences

The diseases resulting from obesity as a direct consequence include high blood pressure, cardio-vascular problems (heart attacks and strokes), and type II diabetes. This results in health expenses spiraling upwards. The excessive weight creates additional problems. Not only the heart and blood vessels face an overload, but the joints are also bearing the brunt in the form of joint diseases like arthritis or back pain. These conditions are not fatal, but they account for less productivity at the work place and they create disabilities. In the public sector obesity presents more problems: how can an obese individual be accommodated in a standard airline seat? How can nursing personnel in a hospital manage to lift or transfer a very heavy patient without a mechanical lift?

Obesity can be compared to a snowball that is on a downhill run and if it is not stopped in time, will turn into a deadly avalanche.

Stop Obesity

Stop Obesity

Causes of obesity

In the last few years it has become clearer how obesity was created. It originated from the perfect storm that a number of practices of the food industry brought about:

1. Processed food has become more prominent in the super market, laden with salt (creating high blood pressure) and sugar (causing diabetes).

2. Wheat and wheat products are contained in a lot of processed foods, and if they are not in it directly, food manufacturers add MSG (mono sodium glutamate) to stimulate your taste buds. This leads to food addictions encouraging you to eat bigger portions and to eat more sweet, calorie-laden foods.

3. Wheat has undergone forced hybridization in the 1970’s changing the genetic make-up of wheat significantly. The result is much more gliadin, the gooey substance that stimulates your opiate receptors and makes you addicted to food and sweets (Ref. 1).

4. Sugar and high fructose corn syrup are a huge problem for our bodies: sugar consumption in any form leads to overproduction of insulin, insulin resistance and diabetes. 10 to 15 years of life can be lost from premature death due to sugar overconsumption. The causes are accelerated hardening of the arteries with premature heart attacks, strokes and kidney damage. Alcohol in its many disguises is also a problem. The body metabolizes it similar to sugar, excess calories from alcoholic drinks are stored as fat.

5. The oils that are now used to produce baked goods are the cheaper omega-6-fatty acid containing oils derived from safflower, sunflower, soybean, cottonseed and canola. The result is a disbalance of the omega-3/omega-6 ratio in our diet, which causes inflammation in our bodies. This in turn causes heart attacks, strokes, arthritis, asthma, inflammatory bowel disease and Alzheimer’s disease (Ref. 2).

6. In the US there are problems with bovine growth hormone in milk and milk products unless you buy organic milk and milk products. This too causes your fat to accumulate as it blocks your own growth hormone receptors. Antibiotic residuals in beef from feedlots also contribute to obesity in humans.

7. Add to this the fact that we have become more sessile, driving cars, watching games rather than playing games, watching TV and sitting in front of the computer for hours on end. All this burns up less calories than if you work out in a gym.

Knowing the enemy helps us to fight the causes of obesity. Here is my recipe to counter what the agro industry has been doing to us.

What can be done to stop obesity?

1. The biggest factor is to cut out genetically modified wheat that is now the only source of wheat around the world. When you cut out all wheat and wheat products from your diet, you will lose 400 calories every day. Ref. 1 describes this in detail and provides 150 recipes of tasty foods. Dr. Davis allows you a fair amount of monounsaturated fatty acids, which makes dieting a lot easier and you will find that once you have lost the necessary pounds, you will keep your weight down easily. How come I know? Because I have done this myself since 2001. Why does it work? Because gliadin from wheat is an addictive protein that stimulates your opiate receptors in the brain and makes you want to eat more wheat and wheat products, which means taking in more and more calories (Ref.1). It also stimulates your taste buds to eat more sugar and starchy foods. So you need to cut out wheat.

2. Next you need to look at the glycemic index of your foods. Low and medium glycemic foods are OK to eat, but not the high glycemic index foods. It is clear from this link that white bread, pasta, rice, low-fiber cereals and baked goods are not desirable, because they are high glycemic on the index. On the other hand fruit, vegetables and legumes are desirable food choices, as they are low glycemic index foods. Legumes are higher in their carbohydrate content, and a helping of ca. ½ a cup should not be exceeded. Fruit that are high in fruit sugar (grapes, pineapple, mangoes, papayas, bananas) should be consumed in moderation. Fruit juices present an overload of sugar; just remember that it takes several apples to make one serving of apple juice! The same goes for alcoholic drinks. It likely is responsible for much of the obesity wave.

3. Perhaps the most important step is to look at the food that goes into your mouth, eliminate all MSG (monosodium glutamate) and then switch to organic food. I remember that 1/3 of the items on the kitchen shelf and in the fridge had to be thrown out when my wife and I first learnt about this in 2001. We studied the food labels of every food item that was in our kitchen. We added the switch to organic food in the last three years, after hearing about it from Suzanne Somers’ books and at several A4M anti-aging conferences in Las Vegas. Take the time to prepare most of your food that you eat yourself at home from natural, organic  ingredients. This way you can avoid sugar and extra salt, which would be present in processed foods.

4. Watch oils and fat when you cook: extra virgin, cold pressed organic olive oil is your best friend when it comes to cooking Mediterranean type food. Lately there is a trend of cooking with coconut oil, but I think this is a marketing hype (if you decide on coconut oil, make sure it is virgin and fresh pressed, not processed).  Ref. 2 explains that it is important to avoid all polyunsaturated oils as they turn rancid and lead to free radicals in your blood and in your fatty organs like the brain. In order to reintroduce the balance between omega-3 and omega-6 fats, it is useful to take 3 capsules or more (up to 6 or 7 per day in persons with arthritis) of a strong, molecularly distilled EPA/DHA  supplement daily that will restore your prostaglandins. This ensures that no inflammatory reactions take place in your tissues preventing heart attacks, strokes, arthritis, asthma, inflammatory bowel disease and Alzheimer’s disease.

Fish has been and still is highly recommended as a good source of omega-3 fatty acids, which is also anti-inflammatory. But, unfortunately it is contaminated with various amounts of mercury wherever you are in the world, so I find it difficult to recommend it as healthy unless you are willing to undergo chelation therapy on an ongoing intermittent basis to remove heavy metals and this method may not be perfect either. Fish like sardines or wild salmon are the better choices. Tuna, swordfish or shark should never be consumed as their toxic load is dangerously high.

5. Finally, a word about reintroducing exercise. As kids we were more active. You may have played games as a youth. What our bodies need at all times is movement, walking, dancing, in short some form of activity every day. The easiest is to work out in a gym for 1 hour every day (30 minutes of aerobics like a treadmill or elliptical for 30 minutes and isometric exercises like working with machines or weights). Add on top of this whatever you can. This stimulates your metabolism, your blood circulation and rebalances your hormones.

Conclusion

Obesity is a national concern and a concern that affects nations internationally. Bear in mind that the food processors and the associated industry is not on a mission to increase the well being of the consumer, but is driven by the motivation to increase profits. In the past bad dietary advice added more injury to this situation, when the science behind diets was not yet developed. But now we know that a low fat high carb diet does not work; instead a balanced fat, low glycemic index diet as in a Mediterranean diet is what is beneficial. The large amounts of sugar that are currently added and consumed in many processed foods have no place in sensible human nutrition. The senseless overfeeding with grain has also presented its results: it has fattened up North America and other nations. We need quality fats (olive oil, omega-3-fatty acids and nuts). Organic food whenever possible is important in order to avoid poisoning ourselves with pesticides, antibiotic residues or bovine growth hormone. Add regular exercise to this and your recipe for treating and preventing obesity is complete.

More about metabolic syndrome (the metabolic changes associated with obesity): http://nethealthbook.com/hormones/metabolic-syndrome/

 

References

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

2. 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.

 

Last edited March 4, 2015

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Sep
28
2013

Sleepless Nights

Sleeping problems (insomnia) are very common. About 10% of the population suffers from chronic insomnia; 30% of the population suffers from occasional sleep problems. In a large outpatient population of a clinic consisting of 3500 patients who had at least one major clinical condition, 50% complained of insomnia, 16% had severe symptoms, 34% had mild symptoms (Ref.1). Insomnia is more common among women, and older people as well as in people with medical or psychiatric illnesses. Long-term studies have shown that the same insomnia problems persist throughout many years. It is not possible to offer a simple remedy for insomnia, because insomnia is a complex problem. Here I will discuss some of the causes of insomnia and also discuss some of the treatment options.

Symptoms of insomnia

The person who suffers from insomnia will usually state that they have problems falling asleep. Worries of the day suddenly circulate through their thoughts and they toss and turn nervously looking at the clock from time to time and getting more and more anxious that they cannot sleep. Others fall asleep OK, but in the middle of the night they wake up perhaps to visit the restroom, but then they cannot go back to sleep. Others wake up 2 hours before their normal alarm clock time and they feel their stomach rumbling making it impossible to fall back to sleep. Older people with chronic diseases and general poor health suffer more from insomnia. In this setting insomnia may be more related to the underlying disease rather than old age. Psychiatric disorders also are associated with more insomnia. Treat the underlying psychiatric illness, and the insomnia disappears.

Although insomnia is a sleep disturbance during the nighttime, people who are affected with this complain of daytime fatigue, of overstimulation, yet they catch themselves making frequent mistakes, and their inability to pay attention gets them involved in accidents and falls. Longitudinal studies have shown (Ref. 1) that people with chronic insomnia are more likely to develop psychiatric disease, such as major depression,  anxiety disorder and alcohol and substance abuse. Unfortunately these disorders can by themselves again cause insomnia, which reinforces chronic insomnia. Insomnia leads to poorer social and physical functioning, affects emotions, leads to a lack of vitality and physical endurance, contributes to worsening of pain and can affect general and mental health.

Research about insomnia

Much has been learnt from sleep studies using polysomnography monitoring during a full night’s sleep. These studies have been used mainly as a research tool. In such studies eye movements, brain wave activity, muscle activity, chest movements, airflow, heart beats, oxygen saturation and snoring (with a microphone) are all simultaneously recorded. This way restless leg syndrome, sleep apnea, snoring, seizure disorders, deep depression etc. that can all lead to insomnia can be diagnosed and separated from insomnia. The stages of sleep (wakefulness, stage 1 to 3 sleep and the REM sleep stage) can also be readily measured using polysomnography (Ref.2). According to this reference the majority of insomnia cases do not need this complex procedure done.

Sleepless Nights

Sleepless Nights

Causes of insomnia

Traditionally insomnia cases are classified into primary insomnia and secondary insomnia. Secondary insomnia is caused by all of the factors discussed below. When they are dealt with, we are left with cases of primary insomnia.

The following medical conditions can cause insomnia: heart disease, pulmonary diseases like asthma and chronic obstructive pulmonary disease (COPD); gastrointestinal disease like liver cirrhosis, pancreatitis, irritable bowel syndrome, ulcers, colitis, Crohn’s disease; chronic kidney disease; musculoskeletal disease like arthritis, fractures, osteoporosis; neurodegenerative disease like MS, Parkinson’s disease, Alzheimer’s disease; endocrine disease like diabetes, hyper- or hypothyroidism, adrenal gland fatigue and insufficiency; and chronic pain conditions. Also, psychiatric conditions like major depression, schizophrenia and anxiety disorders can cause insomnia.

This list in not complete, but it gives you an idea of how complex the topic of insomnia is.
The physician who is seeing a patient with insomnia needs to rule out any of these other causes of insomnia to be certain that the only condition that is left to treat in the patient is insomnia itself. The other diagnoses have to be dealt with separately or else treatment of insomnia will fail.

Ref. 1 points to a useful model of how to think about causation of insomnia: there are three points to consider, namely predisposing, precipitating, and perpetuating factors. Let’s briefly discuss some of these.

Predisposing factors

We are all different in our personal make-up. If you are well grounded, chances are you are not susceptible to insomnia. Anxious persons or persons who have been through a lot of negative experiences in life will have personality traits that make them more prone to insomnia. Lifestyle choices such as late nights out, drinking with the buddies in a bar (extreme circadian phase tendencies) will have an impact on whether or not you develop insomnia.

Precipitating factors

A situational crisis like a job change or the death of a loved one can initiate insomnia.  However, there could be a medical illness such as a heart attack, a stroke or the new diagnosis of a psychiatric illness that has become a precipitating factor. Sleep apnea and restless leg syndrome belong into this group as well as would the stimulating effect of coffee and caffeine containing drinks. Jet lag and nighttime shift work can also be precipitating factors.

Perpetuating factors

Daytime napping to make up for lost sleep the night before can undermine sleep initiation the following night, which can lead to a vicious cycle. Similarly, the use of bedtime alcoholic drinks leads to sleep disruption later that night and can become a perpetuating factor, if this habit is maintained. Even the psychological conditioning of being anxious about whether or not you will fall asleep easily or not the next night can become a perpetuating factor.

I will return to this classification and the factor model of causation of insomnia when we address treatment options.

Drugs that can cause insomnia

One major possible cause for insomnia  can be side effects from medications that patients are on (would belong to the ‘perpetuating factors’ among causes). Physicians call this “iatrogenic insomnia”. The antidepressants, called selective serotonin reuptake inhibitors (SSRI’s) like Prozac are particularly troublesome with regard to causing insomnia as a side effect. Other antidepressants like trazodone (Desyrel) are used in small doses to help patients with insomnia to fall asleep. Some asthmatics and people with autoimmune diseases may be on prednisone, a corticosteroid drug. This can cause insomnia, particularly in higher doses; so can decongestants you may use for allergies; beta-blockers used for heart disease and hypertension treatment; theophylline, an asthma medication and diuretics. Central nervous stimulants like caffeine or illicit drugs can also cause insomnia. Hormone disbalance in general and hyperthyroidism specifically as well as Cushing’s disease, where cortisol levels are high will cause insomnia.

Treatment of insomnia

So, how should the physician approach a patient with insomnia? First it has to be established whether there is secondary insomnia present due to one of the predisposing, precipitating or perpetuating factors. In other words, is there secondary insomnia due to other underlying illnesses? If so, these are being addressed first. Lifestyle choices (staying up late every night) would have to be changed; alcohol and drug abuse and overindulging in coffee or caffeine containing drinks needs to be dealt with. Cognitive therapy may be beneficial when mild depression or anxiety is a contributing factor to insomnia.

The remaining insomnia (also medically termed “primary insomnia”) is now being treated.

The following general points are useful to get into the sleeping mode (modified from Ref. 3):

  1. Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average fill of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  2. Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  3. Get into a regular exercise program, either at home or at a gym.
  4. Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  5. Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  6. If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  7. A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.

Drugs and supplements for insomnia

1. In the past benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), fluorazepam (Dalmane), temazepam (Restoril), triazolam (Halcion) and others were and still are used as sleeping pills. However, it was noted that there are significant side effects with this group of drugs. Notably, there is amnesia (memory loss), which can be quite distressing to people such as not remembering that someone phoned while under the influence of the drug, you promised certain things, but you cannot remember the following morning what it was. Another problem is the development of addiction to the drugs with worse insomnia when the drugs are discontinued. Many physicians have stopped prescribing benzodiazepines.

2. There are non-benzodiazepines drugs that are used as sleeping pills (hypnotics), such as Zaleplon (Sonata), Zolpidem (Ambien) and Eszopiclone (Lunesta).  They seem to be better tolerated.

3. Ramelteon, a melatonin agonist, is available by prescription in the US. It probably is the best-tolerated mild sleeping pill and works similar to melatonin, but is more expensive. Chances are that your physician likely would prescribe one of the non-benzodiazepines drugs or Ramelteon for you as they do not seem to be addicting.

4. However, there is an alternative: Many patients with insomnia tolerate a low dose of trazodone (Desyrel), which is an antidepressant with sleep restoring properties. A low dose of 25 to 50 mg at bedtime is usually enough for insomnia. This allows the patient to fall asleep within about 30 minutes of taking it, and sleep lasts through most of the night without a hangover in the morning. Many specialists who run sleep laboratories recommend trazodone when primary insomnia is diagnosed. However, this is still a drug with potential side effects as mentioned in the trazodone link, but 50 mg is only ¼ of the full dose, so the side effects will also be less or negligible.

5. I prefer the use of melatonin, which is the natural brain hormone designed to put us to sleep. Between 1 mg and 6 mg are sufficient for most people. We know from other literature that up to 20 mg of melatonin has been used in humans as an immune stimulant in patients with metastatic melanoma with no untoward side effects other than nightmares and some tiredness in the morning. A review from the Vanderbilt University, Holland found melatonin to be very safe as a sleeping aid. There are several melatonin receptors in the body of vertebrates (including humans), which are stimulated by melatonin.

6. Other natural methods are the use of L-Tryptophan at a dose of 500 mg at bedtime, which can be combined with melatonin. It is the amino acid contained in turkey meat, which makes you tired after a Thanksgiving meal. GABA is another supplement, which is the relaxing hormone of your brain, but with this supplement tolerance develops after about 4 to 5 days, so it is only suitable for very short term use. Herbal sleep aids are hops, valerian extract and passionflower extract. They are available in health food stores.

Conclusion

A lack of sleep (insomnia) is almost a given in our fast paced lives.

When it comes to treatment, all of the other causes of secondary insomnia need to be treated or else treatment attempts would fail. What is left is primary insomnia. This is treated as follows:

We need to review our sleeping habits, lifestyles and substance abuse. Remove what is detrimental to your sleep. Start with the least invasive treatment modalities such as self-hypnosis tapes, melatonin, L-Tryptophan or herbal extracts. Should this not quite do the trick, asks your doctor for advice. The non-benzodiazepines drugs or Ramelteon would be the next level up. It may be that an alternative such as low dose trazodone would be of help. Only, if all this fails would I recommend to go to the more potent sleeping pills (keep in mind the potential for addiction to them).

References

1. David N. Neubauer, MD (John Hopkins University, Baltimore, MD): Insomnia. Primary Care: Clinics in Office Practice – Volume 32, Issue 2 (June 2005)  © 2005, W. B. Saunders Company

2: Behrouz Jafari, MD and Vahid Mohsenin, MD (Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA): Polysomnography. Clinics in Chest Medicine – Volume 31, Issue 2 (June 2010), © 2010 W. B. Saunders Company

3. Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Last edited Sept. 28, 2014

Aug
03
2013

Treating Symptoms Not Effective, Find And Eradicate Causes

When you see a physician about a health problem, he or she general listens to your symptoms, examines you, comes to a diagnosis and then treats the symptoms. Medicine has been evolving since, anti-aging medicine has become more prominent and comprehensive medical practitioners have started to treat differently. The changing approach is best explained with some examples below. This is important as many general practitioners continue to treat symptoms and neglect to search for causes. Big Pharma is trying to keep the medical system in the “status quo” (the way it is), because they make big money by having general practitioners try out different ineffective medications (this way the profits keep on coming in.) One example is the cholesterol story. Only 50% of heart attacks are caused by high cholesterol, but physicians keep on prescribing statins whenever high cholesterol is found to prevent a heart attack. But the finding of high cholesterol could be caused by hypothyroidism (when the thyroid gland does not produce enough thyroid hormone). Diet can also play  a role, if the patient eats too many helpings of fatty meats and drinks alcohol regularly. Just prescribing statins to lower cholesterol is not the answer, treating the cause is!

I am going to describe 5 examples where usually symptoms are being treated instead of the causes. If you are in a hurry, just read example 3 below (gastritis and duodenal ulcer). After that you can skip forward and read the conclusion, where I will summarize what I think we should learn from this.

Treating Symptoms Not Effective, Find And Eradicate Causes

Treating Symptoms Not Effective, Find And Eradicate Causes

1)  Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease where autoantibodies attack the joint surfaces. It is a multifaceted disease and typically requires a rheumatologist to get involved in the treatment. The standard treatment for RA is summarized in this link. Before engaging in these toxic treatments, it is very worthwhile to study this link and see, if any of your food components may have triggered your arthritis. Various agents in the food can contribute to the development of autoantibodies, such as wheat, soy, MSG, even salicylates. An elimination diet approach could pinpoint if there is any food component that may be the cause of your RA.

Dr.Lichten, in treating many RA cases has found (Ref.1, p. 85 and 86) that many patients had hormonal deficiencies, particularly a lack of DHEA when blood tests were done for this. DHEA is known to treat immune deficiencies and T cell responses were observed to raise 10-fold after DHEA supplementation; IGF-1 levels (an indirect measure of human growth hormone) increased and muscle mass improved when exercised as well along with DHEA replacement. RA patients responded well to relatively low doses of DHEA (25 mg daily for women and 50 mg daily for males). When other hormone tests are done to look for deficiencies, Dr. Lichten found sometimes thyroid deficiencies requiring hormone supplementation. Similarly when saliva tests are done to look for sex hormone deficiencies, there may be progesterone and/or estrogen deficiency in women and testosterone deficiency in males that needs to be replaced with bioidentical hormones. In RA patients there may be adrenal gland deficiency setting in, which can be diagnosed by a four-point saliva cortisol hormone test. Only these cases of true hormone deficiency will benefit from small doses of cortisol (the original bioidentical human hormone) given four times per day.

Here is a summary of the usual recommendations for home remedies for treating rheumatoid arthritis. Using electro acupuncture can be very useful for controlling chronic pain, but you still need to work out the cause for your particular case of RA.

2) High Blood Pressure

Most cases of high blood pressure (hypertension) are simply there without a particular cause. It used to be called “essential hypertension”, a fancy name meaning “essentially, we do not know the cause”. The doctor will start treatment with drugs to bring high blood pressure down. Before that the doctor is supposed to ask you to make a good effort to change your life style (cutting out additional salt, exercising, weight loss), but this is often glossed over and drugs are used right away. Drugs for hypertension are not harmless; here are some of the side effects.

The medical textbooks are not very clear on what causes high blood pressure. With renal causes (narrowing of a renal artery) a stent can be placed, the cause is treated and the blood pressure normalizes. As indicated, essential hypertension is the name for the majority of other cases of high blood pressure where officially no cause is known. Patients are usually put on life-long antihypertensive medications, often several drugs in combination, to bring the blood pressure down to 120 over 80.

Despite the notion that we do no know the cause of high blood pressure, we do know that a number of factors can contribute to developing high blood pressure: too much salt in the diet, too much nicotine from smoking and too much alcohol consumption.

A lack of nitrates from green vegetables can cause high blood pressure as well. Nitrates are necessary for the body to produce nitric oxide, a powerful messenger that dilates blood vessels lowering blood pressure. It is produced every second by the lining inside the walls of your arteries. Greens and vegetables, particularly beets, provide nitrates for nitric oxide production.

Nitric oxide, along with omega-3-fatty acid and prostaglandins are important in relaxing the arterial walls, thus lowering high blood pressure.

We also know that in diabetes and obesity high blood pressure is very common, because inflammatory substances circulate in the blood, which interfere with the normal production of the blood pressure lowering nitric oxide.

Treating high blood pressure with the conventional drugs will mask the real underlying causes.

The DASH diet has helped a lot of people to get their blood pressure under control. However, the limiting point in that diet is the amount of grains that are allowed. In my opinion, wheat and grains, starches and sugar are all empty calories and only stimulate your appetite because of the high leptin and gliadin content from wheat and wheat products. According to the cardiologist, Dr. William Davis, cutting these out will cure not only many cases of hypertension, but also diabetes and obesity. Many physicians have criticized him, but in my opinion his work is on solid researched ground. If a patient honestly gives lifestyle changes a try, many side effects and deaths from antihypertensive drugs could be avoided.

3) Gastritis and duodenal ulcer

You see your doctor, because lately you regurgitate acidy stomach contents. You may be diagnosed with gastritis and get a prescription for an acid suppressive drug. But before you take proton pump inhibitors (PPI) study the side effects here.

The interesting part is that many chronic gastritis cases are associated with a bacterium called H. pylori. Unfortunately it is now known that cimetidine, ranitidine and particularly PPI’s are treating the acid problem (the symptomatic treatment of acid suppression seems to work), but on the longer term they encourage H. pylori to grow more, particularly in the stomach. The bacterium undermines the lining of the stomach and the duodenum and interferes with the production of the protective mucous production, which is meant to protect you from gastritis and ulcers. Dr. Murray explains that the cause of gastritis, gastric ulcer and duodenal ulcer is the breakdown of the mucosal barrier (Ref. 3, p.73-75). So the symptomatic treatment of the H. pylori infection with triple therapy (2 antibiotics and a PPI) may be the medical treatment commonly accepted as the norm, but it does not cure H. pylori in many cases. Some patients develop diarrhea from a Clostridium difficile super infection as a result of the antibiotics from the triple therapy requiring even more expensive antibiotics for that condition. This only happened, because the patients’ symptoms were treated instead of the cause. The cause of gastritis and duodenal ulcers is a weakening of the lining in the stomach and the duodenum resulting in a breakdown of the mucous barrier. In some people dietary habits play a role, like too much cereal and wheat consumption with too little alkaline vegetables in the meals to neutralize the acid formation (see Ref. 2 for more details). However, when a simple licorice compound (DGL, which stands for deglycyrrhizinated licorice) is given, the symptoms from gastritis, acid reflux, and ulcers in the stomach or duodenum disappear. DGL supports the lining of the stomach and duodenum and reestablishes the defense against the acidy milieu. Not only that, but after a few weeks of DGL treatment all of the findings on endoscopy such as inflammation and ulcerations disappeared. Dr. Murray states that he has not encountered a case of gastritis or ulcer that would not have responded. It appears that the cause of gastritis and ulcers in the stomach and duodenum is not from too much acid, not from H. pylori infection, which appears to just be a concomitant infection, but actually is due to a breakdown of the barrier in the lining of the stomach and duodenum, which responds to DGL. The other interesting thing is that you can buy DGL in the health food store; the dosage is two to three chewable tablets on an empty stomach three times per day. According to Ref. 3 it needs to be taken 8 to 16 weeks, after which there is a full therapeutic response. Pepto-Bismol is another coating substance that is available over the counter and works well for minor stomach upsets.

4) Chronic back pains and insomnia

Many people see their chiropractor for chronic recurrent back pains and their physician for insomnia to get sleeping pills. It all depends what the underlying causes are of back pains and insomnia.

If there is a misalignment in the spine, a chiropractor doing manipulation would be a reasonable approach and the back pain symptoms often disappear. However, thyroid deficiency or adrenal gland insufficiency or adrenal gland fatigue may be the cause of back pains and muscle cramps. Unless the underlying cause is treated (in the case of hypothyroidism treatment with thyroid hormones), the back pains will stay. In fibromyalgia where muscle pains are all over the body, the standard treatment with antidepressants and pain pills just will not do it on the long-term. These patients require a detailed work-up with analysis of the hormonal status. Often they are suffering from a lack of thyroid hormones, a lack of sex hormones (in women a lack of estrogen and progesterone, in men a lack of DHEA and/or testosterone). But they may also have weak adrenal glands and a lack of growth hormone. An anti-aging physician (A4M) can order the appropriate tests and treat the underlying causes.

Fibromyalgia patients often have insomnia (sleep disorders). Dr. Lichten (Ref.4) recommends GABA in small doses (125mg to 250 mg) at bedtime along with 500 mg of L-tryptophan. He also recommends 4000 IU – 5000 IU of vitamin D3 (as often insomnia patients are deficient in vitamin D3) as well as 500 mg to 1000 mg of magnesium. If this alone is not sufficient, melatonin, 1 mg to 3 mg at bedtime will be beneficial. Dr. Lichten cautions that GABA leads to tolerance quickly, so it should only be taken 5 days out of 7 to allow the body’s receptors to recover. This alternative approach to treating insomnia will prevent many patients from getting addicted to sleeping pills (hypnotics).

5) Asthma symptoms

Not every case of asthma needs steroid inhalers and salbutamol or other bronchodilator inhalers as treatment. This link shows that low thyroid can also cause asthmatic symptoms of wheezing and shortness of breath. It is important to listen to the patient’s symptoms, but the treatment will only be successful when the cause is treated. Dr. David Derry described in this link how many of his severe asthma patients had iodine deficiency and low thyroid hormones and no longer had to see him when iodine treatment and desiccated thyroid hormone replacement was given as treatment. This goes against what the standard recommendation for asthma treatment is, but it seems to get patients unhooked from dependence on steroid inhalers.

Steroid dependency from anti-asthmatic inhalers can suppress the adrenal glands and lead to adrenal gland insufficiency.

The adrenal glands are vital for coping with stress as the more stress you are under, the more your pituitary gland produces ACTH hormone, which in turn stimulates the adrenal glands to produce cortisol. However, a significant percentage of patients with asthma that been on corticosteroid inhalers for a long time, experience a suppression of the pituitary gland and the adrenal glands cannot produce the required stress hormones; in other words, adrenal fatigue or adrenal insufficiency can set in.

This is an example where during the treatment of asthma symptoms were controlled with corticosteroid inhalers, but the stress hormone circuit was undermined to the point where the patient experienced another disease (called a “iatrogenic disease”, a disease from the side-effects of drugs). Treatment of adrenal fatigue is described in this link.

Conclusion

Medicine can become quite complex as these examples show. Many times physicians tell their patients that the cause of their symptoms is not known. However, this is not always true, but conventional medicine continues to hold onto the old dogmas. With the third example above (gastritis and duodenal ulcer), until the mid 1980’s the original theory in medicine was that too much acid production would be the cause of these conditions and treatment concentrated on suppressing acid production. Then the new theory came up that H. pylori, a bacterium would be the cause of chronic inflammation, which together with too much acid would cause the condition. That is why physicians now treat it with the triple therapy, a good deal for Big Pharma, but a bad deal for many patients. They still do not get cured, but develop a worsening of their conditions as H. pylori growth proliferates, particularly from the PPI’s, which undermines the lining of the whole stomach. As pointed out above DGL, a simple licorice compound, which is available in health food stores, can strengthen the lining of the stomach and duodenum, which at the same time gets rid of the H. pylori problem without any other drugs.

The problem with conventional medicine is that in many cases physicians still treat symptoms instead of treating known causes. Big Pharma supports this, as it is expedient for them to protect their multi billion-dollar industry. Patients need to demand that the causes of their diseases are being treated rather than the symptoms.

References

1. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

2. William Davis, MD: “Wheat belly. Lose the wheat, lose the weight, and find your path back to health.” HarperCollins Publishers Ltd., 2011.

3. Michael T. Murray, ND: “What the drug companies won’t tell you and your doctor doesn’t know”. Atria Books, New York, 2009.

4. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

Last edited Aug. 3, 2013

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Apr
14
2013

Allergies Not Only In Spring

Springtime is the time of spring allergies: those affected develop a runny nose, itchy eyes and in more severe cases they may experience a flare-up of asthma. Allergies can be triggered by the increase of pollen counts in the air that occurs every spring. In those who are sensitive, this leads to antibody formation in the blood. But often people have not only sensitivities to the pollens of spring bloomers; they may also be allergic to spores from molds, to dust mites and may have underlying allergies to foods. The immune system has memory cells that memorize that a person has had an allergic encounter to one of these items in the past, and allergic reactions can become more significant with a future encounter. Allergies can also be made worse when a person has food sensitivities and there are cross reactions between pollens of trees or grasses that can share surface protein regions with similar protein regions in foods.

It is known that cross allergies are possible between birch pollen and apple, carrots or hazelnut. In its extreme form allergies due to antibodies, called IgE antibodies, can cause anaphylaxis. A person presensitized by inhaling birch pollen, after eating an apple, hazelnuts or a carrot can develop itching of the throat, swelling of the lips and very quickly deteriorate getting into an anaphylactic shock.

Other cross allergies exist between ragweed pollen, which is a powerful inhalant allergen and melons or bananas. Again there are specific IgE antibodies that are responsible for this immune reaction. In this case the ragweed allergy primes the immune system to produce IgE antibodies, which are potentiated by certain foods that share similar protein components as the ragweed pollen.

In the following I will deal with inhalant allergies separately from food allergies.

Allergies Not Only In Spring

Allergies Not Only In Spring

Inhalant allergies

Inhalant allergies are easier to diagnose and to treat than food allergies. Your doctor will likely refer you to an allergist when you have allergies that do not respond to treatment with intermittent over the counter antihistamines. Your symptoms may come on in the spring with itchy eyes and a runny nose. From year to year you find that you become more and more dependent on antihistamines and nose drops to unplug your nose. The allergist likely will do sensitivity tests, which consist of skin prick or scratch tests on the back or the forearms.

In more serious allergies, where the patient has coughing and wheezing attacks following allergic reactions, the allergist may suggest to start intermittent allergy injections alongside the standard inhalation therapy for asthma. An allergy serum is prescribed where the lab mixes ingredients based on all of the positive tests that led to a strongly positive skin reactions when allergy testing was done. Typically the family doctor or his nurse will start the allergy injections initially in weekly intervals, later when the maintenance dose is reached, it may be modified to injections every 10 to 14 days.

The allergy injections stimulate the immune system to produce harmless competing antibodies, which counteract the disease producing allergic antibodies. In the process of desensitization shots the immune system will normalize, which means that the inflammatory response of the immune system settles down to normal.

This is not the end of the story with inhalant allergies. The patient needs to be retested on a yearly basis by the allergist. The immune system changes all the time as new allergies can develop and old ones may go away.

Retesting is necessary to keep track of what is going on and to change the composition of the allergy serum. Those patients who are working together with the allergist can do very well, and often they gradually outgrow their allergies. Others may not be so lucky. They may have reactions to the allergy injections. In these cases avoidance of what causes the allergy may be the only solution to treat the allergies.

There is an alternative to allergy injections, which has been used in Europe, namely a sublingual immunotherapy. Recently there has been a review of the literature for FDA approval that is needed for oral desensitization for ragweed, dust mites, grass pollen and cat dander. It will take some time before the FDA approval process will become a reality for sublingual desensitization in the US.

A special form of inhalant allergies are allergies to pets (mainly dogs and cats, but also allergies to petting zoo animals). The dander that the human comes in contact with is a protein contained in the animal hair. It causes hives when it touches the skin. This occurs as the dander is absorbed through the skin and meets the local mast cells that release histamine. This in turn is responsible for the hive formation. Sneezing and even asthma can develop from inhaled protein particles that reach the lungs. Allergy injections for the treatment of animal dander allergies are very limited as they often do not help or make the allergies worse. Avoidance of animal contact is usually what the allergist recommends as the solution, a recommendation, which often is not appreciated by the affected animal lover.

Food allergies

Often we eat  some foods more frequently, because they are our favorites. This means that our gut lymphocytes that get in contact with these foods can start to react to one or more of the foods we ingest. At this time we may experience abdominal cramps, diarrhea, vomiting and a host of other possible symptoms.

The physician will tell the patient that testing for food allergies is a problem as most of the usual skin tests employed for inhalant allergies do not reliably work in determining food allergies. The doctor will ask the patient or the mother of the child with food allergies to keep a food diary and keep track of the allergic symptoms in the diary as well. An elimination diet will have to be devised based on the information gathered in the diary as it becomes clear from that record which foods cause which symptoms. The foods causing allergic symptoms are subsequently eliminated. This is a cumbersome process, but it is the most reliable method of testing and treating food allergies.

In the past there was a blood tests, called RAST test, which tested for common food allergies that can cause severe allergic reactions like egg, milk, peanut, tree nuts, wheat, crustacean shellfish and soy. Since about 2010 this has been replaced by the more sensitive ImmunoCAP Specific IgE test.

Children often develop food allergies to egg, milk, wheat, nuts, peanuts and soy, which are food allergies with positive IgE tests. When they age, their immune system develops tolerance to many of these foods and they often outgrow these allergies.

There are other popular lab tests where a blood drop is analyzed with IgG, IgM and IgE antibodies against a panel of foods. A number of suppliers offer these tests.  However, the specificity, sensitivity and reliability can pose problems with regard to the interpretation of the results: allergists often point out that a test may be a false positive when a person likes certain foods and IgG antibodies against this food show up despite the patient having no symptoms. Another specialist may interpret this to indicate that the body shows early sensitization to a certain food, but clinically it is not yet obvious. In other words the sensitivity of the test is so high that it undermines the validity of the test. Recently a panel of international scientists reviewed the validity of these IgG based food intolerance tests and they found the tests not reliable.

The immune responses to food allergies are complicated as there are immediate type immune reactions and delayed type immune reactions. The immediate immune responses are investigated with the above mentioned ImmunoCAP Specific IgE test. The delayed immune responses can be measured using the ELISA test.

Other considerations about allergies

You see from this discussion that a patient with allergies needs a properly trained allergist who will do a comprehensive analysis involving a thorough history, examination, blood tests and immune tests.  The test results have to be interpreted with the experience and the clinical judgment of the specialist.

Since the 1970’s when Clearfield wheat was introduced around the world on a large scale, which has a much higher gliadin (gluten) content than the old wheat varieties. As a result of exposure to this new type of wheat gluten intolerance and leaky gut syndrome have increased substantially in the world population. Genetically modified foods like soy, corn, sugar beets, canola and more have challenged the immune system of sensitive humans even more to an extent, which is not fully understood yet. We do know that some people can develop autoimmune diseases and this may be the reason that a host of diseases that belong into this disease category (MS, rheumatoid arthritis, Hashimoto’s thyroiditis, ankylosing spondylitis etc.) are much more common now than in the past.

After food elimination for 2 to 12 months depending on the severity of the food allergy, your body may have eliminated the allergy to the food you have avoided, in other words your body built up tolerance. Before you expose yourself to any food that you used to be allergic to and that you want to re-test, it is best to have an EpiPen ready in case your allergy has not resolved. Caution is necessary with regard to foods that cause more severe allergies, e.g. shellfish or peanuts, which may last life long. It is safer to avoid these foods that cause more severe allergies altogether.

Allergic reactions of the immune system belong into the category of chronic inflammatory diseases. These are known to be the root of chronic diseases like asthma, arthritis, heart disease, high blood pressure and cancer. When you are vigilant about allergies and get proper assessment and treatment by an allergist, you will prevent serious health problems including the above mentioned chronic diseases.

More on asthma, which is a chronic inflammatory lung condition, often associated with multiple environmental allergies:

http://nethealthbook.com/lung-disease/asthma-introduction/

Last edited Nov. 6, 2014

Jun
01
2008

Boost Babies’ Health with Mom’s Diet

Prenatal supplements and good advice on proper nutrition during pregnancy have long been included in proper prenatal care. Importance has been placed on folic acid to prevent neural tube defects in the fetal development. Calcium is recommended, often in the form of dairy products, but it does not end there: just swallowing the supplement and adding some more milk may be helpful but not quite enough. Certain dietary habits have been found more beneficial, such as the eating habits in the Mediterranean countries. A research team from the University of Crete in Heraclion, Greece included women who were involved in antenatal care at all general practices in Menorca, Spain. The study took place in the time frame of 12 month starting in 1997. After six and a half years 460 children were also included in the analysis.

Dietary habits were studied and assessed by food questionnaires and the children were assessed for the development of allergies and asthma.

Boost Babies’ Health with Mom’s Diet

Boost Babies’ Health with Mom’s Diet

The children of mothers who consumed the most vegetables, fish and legumes were almost 80% less likely to have persistent wheeze and more than 40 % less likely to have allergies. The results are consistent with the fact that a high level of adherence to the Mediterranean diet during pregnancy is protective not only to the mother but also to the child.

More information about prenatal visits (where nutritional habits are checked as well): http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/prenatal-visits/

Reference: The Medical Post, April 22, 2008, page 25

Last edited December 18, 2014

May
01
2008

Tree Pollen Connected With Mood Disorders

Seasonal affective disorder (SAD) does have its grip on people who react to a lack of sunlight in the winter month. As a result depression in the winter season is not uncommon. Some people just report it as feeling “down” and “tired” or report a lack of energy. Despite all the reports about SA, epidemiological studies have shown that the rate of depression is not the highest in dreary months like January or February but it spikes in the months of April and June. Dr.Teodor Postolache, a psychiatrist at the University of Maryland made a recent presentation at a meeting of the American Acadamy of Allergy, Asthma and Immunolgy delving into the reason for this finding. He compared the exposure of tree pollen which triggers a cytokine release to a tsunami.Virtually no outdoor allergens are present in the winter months, but with the release of tree pollen people who are vulnerable to allergies are exposed to massive amounts of allergens. The released cytokines may affect brain function and behaviour, resulting ultimately in changed cortisol levels and an altered serotonin metabolism. After breathing the cytokines are already released in the nose and they can continue their action in the prefrontal brain area where the centers for mood, anxiety and impulsivity are located. Dr. Postolache and his colleagues confirmed that individuals with a history of allergy and asthma had a 2.5 fold of suicide compared to controls and those with allergic rhinitis had a 1.7 fold higher risk.

Tree Pollen Connected With Mood Disorders

Tree Pollen Connected With Mood Disorders

For the first time it could also be demonstrated that cytokine levels in suicide victims were significantly elevated in the orbitofrontal cortex, the brain area that affects mood. Intranasal corticosteroids in the form of nosedrops can bring significant relief to allergy sufferers, and Dr. Postolache and his team will examine the benefits of intranasal corticosteroids closer  in a clinical study. Whereas systemic corticosteroids have shown a negative impact on mood disorders and depression, the local application of a nasal spray or drops is geared to abolish the pathways from the nose to the brain for the inflammatory cytokines.

More information on seasonal rhinitis: http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/nose-problems/allergic-rhinitis/

Reference: The Medical Post, April 1, 2008, page 1, 34

Last edited November 3, 2014

Jul
01
2007

Asthma And Bronchitis From Exposure To Chlorinated Water In Infancy

Every new parent has the wish to stimulate infants in healthy development. Children’s programs are plentiful, whether they involve gymnastics and dance or toddlers play. It is no surprise that swimming classes are also offered, and parents are not only looking at the water fun but also at water safety. They want the best for their baby and make use of swim groups that are offered for babies and infants.

It turns out that it may be better to hold off on putting baby into swim classes at the public indoor pool. The water is fine, but the chlorination is the problem. It is common to see a irritation of the eyes due to chlorination, but data reported in the June issue of Pediatrics described findings from a group of 341 school children age 10 to 13, 13% of whom had participates in infant swimming programs point to damaging effects on the respiratory organs. Among others the respiratory condition of these children was assessed. The infant swimming group had signs of so-called Clara cell damage and changed permeability of the lining of the lung. The group that had been enrolled in infant swim groups also had significantly elevated odds of having chest tightness, physician-diagnosed asthma and exercise-induced airway constriction. The problems were aggravated even more, if the children were exposed to parental smoking.

Asthma And Bronchitis From Exposure To Chlorinated Water In Infancy

Chlorinated water exposure during childhood leads to asthma later in life

The researchers conclude that infant swim practice in chlorinated indoor swimming pools is associated with airway changes, which along with other factors can predispose children to the development of asthma and recurrent bronchitis. More research is recommended to examine the effects of chlorination products on the infant respiratory tract.

More information on asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

Reference: http://www.ncbi.nlm.nih.gov/pubmed/20075053 : Voisin C, Sardella A, Marcucci F, Bernard A.: ” Infant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy.” Eur Respir J. 2010 Jul;36(1):41-7. Epub 2010 Jan 14.

Last edited November 2, 2014