May
05
2018

The Benefits Of Drinking Green Tea

Chances are you heard about the benefits of drinking green tea to reduce heart disease. But the polyphenols of green tea also prevent cancer, depression and cognitive decline.

Green tea lowers cardiovascular mortality

A study in the Chianti region of Tuscany, Italy consisted of 807 men and women aged 65 years and older. They had urine tests for metabolites of green tea in the beginning of the study. The study went on for 12 years. 274 participants died, which was 34% of the total study group. Tests measured the total urinary polyphenol (TUP) concentration in both groups, the survivors and the participants who died. Those participants whose TUP was in the highest tertile of the TUP values had the lowest all-cause mortality. And those participants whose TUP was in the lowest tertile had the highest all-cause mortality. 

High blood pressure and stroke

A Taiwanese study from 2004 examined the blood pressure of 1507 subjects. There were 711 men and 796 women with a recent diagnosis of  high blood pressure. The investigators looked at tea consumption (green tea and oolong tea) and blood pressure reduction. They found that those who drank 120 to 599 mL/day of green tea or oolong tea decreased their blood pressure by 46%. Those who drank more than 600 mL/day of green tea or oolong tea lowered their blood pressure by 65%.

Another meta-study involving 194,965 people and 4378 strokes found that there was a reduction of strokes with increasing tea consumption. Those who drank 3 or 4 cups of green tea or black tea per day were the experimental group. Researchers compared them  to the control group that drank less than one cup of tea per day. The experimental group had a 21% lower risk of getting a stroke than the control group.

Cancer prevention more with black tea than with green tea

A meta-analysis of 18 studies from China showed that green tea and black tea consumption was beneficial for prevention of cardiovascular disease and for cancer prevention. The highest consumption of green tea reduced cardiovascular mortality by 33%. The highest black tea consumption lowered mortality by 12%. Cancer mortality turned out to be different. Green tea did not produce a reduction in mortality, but black tea lowered it by 21%.

Another study, this one from Shanghai, China, points out that there are 15 polyphenols in green tea that likely work on different target areas of the body. They target 200 different genes in humans affecting diabetes, cancer, cardiovascular disease, neurodegenerative disease, muscular disease and inflammation.

Other cancers like prostate and breast cancer benefit from green tea

This study shows evidence that habitual green tea drinkers do prevent prostate cancer and breast cancer to a certain extent.

Another study investigates the effect of tea on health. One of the studies from the same authors have shown that the oxidative damage to cells from cigarette smoking can come out in a urine test. Those smokers who drank 4 cups of tea per day had a 31% decrease in their urinary biomarkers to indicate DNA damage. As DNA damage is often the first step in cancer development, these findings are important to note.

Cognitive effects of green tea consumption in dementia patients

A 2017 review of dietary supplements to improve cognitive impairment pointed out several supplements that will improve cognition. Green tea is one of them, but omega-3 fatty acids (EPA), and docosahexaenoic acid (DHA) are also useful supplements to restore neuronal functioning.

A 2017 study from Basel, Switzerland found that green tea improved memory, reduced anxiety and activated the working memory, which could be made visible on functional MRI scans. These researchers also pointed out that green tea has this effect as a whole, you cannot attribute it to a single constituent. Separate tests of  caffeine or L-Theanine  showed that the beneficial effect was smaller than when green tea as a whole was tested.

2016 study on severe Alzheimer’s patients

This 2016 Iranian study looked at 30 patients with severe Alzheimer’s disease. A baseline assessment was first, and 2 months after taking 4 green tea pills daily another assessment followed. A blood test measured the oxidative stress before and after, so was the antioxidant level from the green tea. The oxidative stress test showed an improvement during the study. The antioxidant level in the blood was higher than before the start of the study. The cognitive function test improved only slightly.

A 2018 study from Singapore looked at the effect of drinking tea (black tea or green tea) regarding symptoms of anxiety or depression. In a group of 614 subjects who were elderly individuals, aged 60 years and above; 59% consumed tea for longer than 15 years. These tea-drinking people were significantly less depressed and significantly less anxious when they underwent psychological tests, compared to non-tea drinkers.

Depression and green tea consumption

There is a 2018 study from South Korea that looked at the link of beverages from 15 studies with depression. 347,691 participants were part  of  these 15 studies, and 20,572 cases of depression developed. Comparing a high consumption of tea or coffee to low consumption, the following statistics were the result: coffee consumption reduced depression by 27%, green tea consumption by 29%.

The Benefits Of Drinking Green Tea

The Benefits Of Drinking Green Tea

Conclusion

Bioflavonoids are powerful antioxidants. But there are many more substances in green tea and coffee that are all beneficial for our health. One of the studies mentioned identified 15 polyphenols in green tea. But another study said that trying to identify one of the components as more active than the others would be a waste of time. They measured some of the factors by themselves and found that the overall effect was much smaller than green tea as a whole.

Other research has shown that the components of green tea activate several genes. This includes anti-inflammatory effects, prevention of heart attacks and strokes, lowering of blood pressure, anti-cancer effects, improvements of cognitive function, as well as improvement of depression and anxiety. As you can see the effect of green tea is diversified. Don’t hesitate to consume another cup of tea!

Mar
31
2018

Self-Love Is Important

You need to appreciate that self-love is important, if you want stable mental health and well-being. Before you can take care of people around you, you need to practice self-love first. You cannot give love, if you don’t love yourself first. We get so busy in working hard, wanting to achieve goals and then surpass ourselves. We want to be perfect. But this is not possible without first looking after our own needs: again, self-love is important to be able to reach the goals you want to achieve.

Perfectionism can be harmful

Most of us were grew up  in the Western society thinking that perfectionism would be good for us. After all, we achieve things; we criticize ourselves and improve it even more; so finally we end up with our dream goal. What is the downside of perfectionism?

Perfectionism often comes with chronic stress, which can shorten our life span. Perfectionism leads to diseases like irritable bowel syndrome, fibromyalgia, depression and eating disorders. Depression can have a serious complication, namely suicide attempts and actual suicide. Perfectionists also often suffer from anxiety disorders that can make life miserable. Chronic stress together with perfectionism can weaken the immune system, which in turn can cause infections and even autoimmune diseases.

Moving away from perfectionism

The United Nations passed a resolution in 2012 saying, “pursuit of happiness is a fundamental human goal.”

Psychologists also tell us that happiness is something we deserve to have; it is our right. A clinical psychologist in Vancouver, Canada, compares the inner critic of perfectionists to a “nasty adult beating the crap out of a tiny child”. We don’t have to beat ourselves up internally; it is not healthy for us. Don’t let the inner bully put yourself down for a minor thing that went wrong.

Start cultivating self-compassion. Self-compassion is not something that you have or do not have. According to psychologists self-compassion is something that you can learn.

The more you learn self-compassion, the less important perfectionism will be for you. You will still be productive and successful, but you will stop injuring yourself in the process.

Learning about self-compassion

Psychologists have researched how self-compassion can be developed. They even have invented an 8-week program that helps the client to build up self-compassion. These psychologists could measure a significant improvement of the level of self-compassion before taking the course and after completing it. According to Prof. Neff and associates there are three parts to self-compassion.

  • Self-kindness, which means treating yourself with understanding and forgiveness.
  • Recognition of one’s place in the shared humanity. This acknowledges that people are not perfect. It also means that personal experiences are part of the larger human experience.
  • Mindfulness, which means emotional balance and avoiding over identifying with painful emotions.

Listening to yourself

Dr. Kristin Neff has written a book that describes how to change your inner voice from a harsh voice to a softer, kinder internal voice. By becoming aware what your internal thoughts are, you can gradually change your internal talk. Profs. Neff and Germer have developed an 8-week course called “mindful self-compassion training”. In their own words “Self-compassion says, ‘Be kind to yourself in the midst of suffering and it will change.’ Mindfulness says, ‘Open to suffering with spacious awareness and it will change.'”

Part of the course is to learn how to deal with suffering when things go badly. In this case they recommend to their clients to repeat the following 3 phrases: “This is a moment of suffering,” “Suffering is a part of life,” and “May I be kind to myself.” This will take the sting away from the suffering and reduce the emotional pain.

Doubts about mindful self-compassion training?

You may have some doubts whether or not self-compassion training would work. But psychological tests regarding self-compassion ratings before and after the course have found a significant 43% difference. Similar compassion training can be found under this link.

These mindful exercises in self-compassion have been proven to down regulate the stress response. The hormones ACTH and cortisol in the blood were found to be much less in persons who had undergone self-compassion training. The training also was shown to increase heart rate variability, which is the body’s natural way to react to stress.

Not everybody is a good meditator. But apart from meditating there are other methods to recognize that self-love is important, as is self-compassion. You can write a letter to yourself, but pretend it comes from a close, loving friend. You could also write a letter that you pretend comes from you addressed to a person that you show compassion to.

Yoga to help you realize that self-love is important

Yoga is a great way to re-acquaint you with pleasures you experienced in childhood. Part of a yoga exercise can be “Mindful Eating”. You are simply refocusing your attention to the tastes that you may have taken for granted. Such a technique helps you to listen to yourself, become aware of your needs and train yourself in self-love and self-compassion. One of the top recommended Internet accessible yoga classes was this.

Self-love Is Important

Self-love Is Important

Conclusion

Perfectionism is widespread and is often taught in schools to be desirable. However, we become so good at this that it often turns into self-injurious behavior. We become harsh on ourselves and nothing is good enough to please us. And we expect perfection from people around us. We may even become abusive when they do not measure up to our expectations.

Dr. Kristin Neff has written a book that describes how to change your inner voice from a harsh voice to a softer, kinder internal voice. She also teaches an 8-week course at Harvard University how to develop self-compassion and self-love.

Mindful exercises in self-compassion

Mindful exercises in self-compassion have been proven to down regulate the stress response. It teaches you to deal with suffering when things go badly.

The bottom-line is to find your path away from perfectionism to a feeling of wholeness. And by achieving this we will free the negative energy of harsh and often unjustified criticism to give our best and succeed.

Nov
12
2016

Stress Drives Our Lives

Every year the American Psychological Association (APA) monitors the American public how stress drives our lives. This yearly report has been compiled since 2007. About 75% of the people questioned reported that they have experienced moderate to high stress over the past month.

Symptoms when stress drives our lives

What kind of symptoms can stress cause? It can cause sleep deprivation, anxiety, headaches and depression. But there can be more symptoms from any disease that stress may cause. The “Stress in America” report from February 2016 shows on page 5 that unhealthy life habits are used by low-income Americans to cope with stress. A bar graph shows that watching television or movies for more than 2 hours per day is common. Another way of coping is to surf the Internet more often, take more naps or sleep longer. Eating more, drinking alcoholic beverages and smoking more are other unhealthy ways to cope with stress.

As the stressed person gains extra weight and eventually becomes obese, there is a higher rate of diabetes that can develop with all of its complications.

Causes of stress in our lives

The “Stress in America” survey was based on 3,068 adults in the US who completed the survey during August 2015. 72% were stressed out about financial issues. 22% of these said that they were extremely stressed in the past month as a result of money concerns. Other common concerns were work, the economy, family responsibilities and concerns about personal health. Average stress levels among Americans decreased when compared to 2007. On a 10-point stress score respondents rated their stress at 4.9 in 2016 compared to 6.2 in 2007. But according to the American Psychological Association this is much higher than a stress rating of 3.7 considered to be a healthy level.

Stress affects people from all walks of life, workers, women, young adults, students and those with lower incomes.

“Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us” Stevan Hobfoll, PhD, a clinical psychologist from Rush University Medical Center said. “So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health…” is what causes stress.

Stress drives our lives causing disease

When stress is too much for our system, we are starting to see pathology develop. “Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease” professor Hobfoll says. The following are common diseases that can result from chronic stress.

Heart attacks and strokes

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for a mean of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There were a total of 13% more heart attacks in those who worked extra hours compared to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. A dose-response association was calculated for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives our lives and causes substance abuse

In order to cope with stress many of us treat daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next many people still smoke, which has been proven long time ago to be bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. As comfort food relieves stress, extra pounds are put on. As you know it is easier to put weight on than get it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This deteriorates your health outlook.

Diabetes

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition unhealthy eating habits associated with stress can cause weight gain and high blood sugars leading to diabetes.

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. Their waist/hip ratio was elevated.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless.

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

Diabetes was significantly associated with a 30-day episode of any anxiety disorder with a 1.53-fold risk. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Stress has been identified as being at least a contributing factor. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychological stress was rated in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was reported higher in those women who had frequent/constant stress in the past and was more severe the more stress they were exposed to in the past. Women who were exposed to stress on one, two or three examinations were observed to have higher dementia rates later in life, when compared to women who were not exposed to any significant stress. Specifically, dementia rates were 10% higher when exposed to one stressful episode, 73% higher after two stressful episodes and 151% higher when exposed to three stressful episodes.

Remedies for stress

Before you can attempt to remedy stress, you must first detect that you are under stress. You can recognize this when you have problems sleeping, you suffer from fatigue, when overeating or undereating is a problem, and if you feel depressed. Others may feel angry or are irritable. Some bad lifestyle habits may also make you aware that you are under stress. You may smoke or drink more in an attempt to manage stress. Some people abuse drugs.

Here are some suggestions how to remedy stress:

  1. Seek support from family, friends or religious organizations. If you engage in drugs or alcohol overuse or you feel suicidal, it is best to seek the advice from a psychiatrist or psychologist.
  2. Engage in regular exercise. This produces endorphins, the natural “feel-good” brain hormone. This reduces symptoms of depression and improves sleep quality.
  3. Do something that increases pleasure, such as having a meal with friends, starting a hobby or watching a good movie.
  4. Positive self-talk: avoid negative thoughts like “I can’t do this”. Instead say to yourself “I will do the best I can”. Psychologists have developed a technique where they teach patients how to turn negatives into positives. It is called “cognitive therapy”. You may want to seek the advice of a psychologist to have a few cognitive therapy sessions.
  5. Daily relaxation: you may want to use self-hypnosis, tai-chi exercises or meditation to reduce your stress levels.
Stress Drives Our Lives

Stress Drives Our Lives

Conclusion

Stress is very common. Diverse diseases like heart attacks, strokes, diabetes and Alzheimer’s disease can all be caused by stress. It is important to minimize the impact of stress by seeking family support and support from friends. Engaging in regular exercise will release endorphins and make you feel better. Relaxation exercises and seeking counselling can all help you to manage stress. It is not a force in your life that can be ignored or simply tolerated. Stress is indeed there, but we can make a difference by managing it to avoid that stress manages us.

Sep
03
2016

Hidden Cause Of Depression

About 15.7 million Americans suffer from depression every year, but there remains a hidden cause of depression.

Not everybody responds well to antidepressant medicine. Only 30 to 50% of depressed people respond to antidepressants. There are two blood tests many physicians do not know and therefore fail to order: homocysteine blood levels and 5-methylfolate levels (5-MTHF).

Homocysteine as a hidden cause of depression

In 2004 a research group studied 924 middle-aged men. They noted that those men who fell into the highest third of homocysteine levels had a two-fold higher risk of being depressed than those who fell into the lower third of homocysteine levels. Other studies showed that SAMe, a nutrient that is required to build up mood enhancing neurotransmitters was sadly lacking in depressed people. In addition, folate levels were also found to be low in depressed people.

Having found this association between lack of nutrients and depression offered new opportunities to treat depression. Two studies examined the effect of taking 5-methylfolate on the effect of antidepressants. The result was astounding: in one study 7% of patients taking an antidepressant experienced improvement of their depression when assessed with a standard depression score. However, the same group improved their depression by 19% when 5-methylfolate was given in addition to the antidepressant.

Patients with the most severe depression on antidepressants had a 16% improvement of their depression. Adding 5-methylfolate to the antidepressant caused a 40% overall improvement in these severely depressed people, 24% more than without this simple vitamin supplement.

There is other evidence that patients with depression recover faster in the presence of 5-methylfolate. Moderately depressed patients recovered within 231 days on antidepressants alone, but in only 177 days when 5-methylfolate was present as well. The most severely depressed patients recovered within 150 days with antidepressants alone, but recovered within only 85 days on 5-methylfolate and the antidepressant.

Hidden cause of depression and Alzheimer’s disease

The story is getting more involved. Depression is related to proper balance of neurotransmitters that can be influenced by antidepressants and 5-methylfolate. But new research showed that Alzheimer’s disease (dementia) patients with cognitive decline have elevated homocysteine blood levels. A study in the New England Journal of medicine in 2002 found that after 8 years of observation more than 75% of them were diagnosed with Alzheimer’s disease. When blood homocysteine levels exceeded 14 micromole per liter the risk of Alzheimer’s had doubled compared to those with normal homocysteine levels. The researchers concluded that homocysteine is an important risk factor for the development of Alzheimer’s diseases and dementia, although it is not the only one.

Methylation pathway defects as a hidden cause of depression

40% of the population is defective in one or more genes that control the so-called methylation pathway in each of our cells (Ref. 1). This can slow down the metabolism of brain cells including the synthesis of certain neurotransmitters. At the same time it can cause the rising of homocysteine, which is then a useful marker for methylation defects. Another marker is the 5-methyl folate level, which, when low, indicates a deficiency in methyl donors including 5-methylfolate (5-MTHF).

Mental illness is an area where epigenetic factors play an important role. Depression that responds only partially or not at all to SSRI’s (antidepressants) often responds to L-methylfolate, a simple supplement from the health food store as a supplement. Similar epigenetic approaches can be used to treat psychosis, schizophrenia, bipolar disorder and Alzheimer’s disease.

Other illnesses due to methylation defects

Dr. Rozakis mentioned that 92% of migraine sufferers have a defective methylation pathway involving histamine overproduction and they can be helped with a histamine-restricted diet (Ref.2).

Autism, ADHD (hyperactivity) and learning disabilities are other diseases where methylation pathway defects are present. Every patient with autism should be checked for methylation pathway defects, and appropriate supplements and diet restrictions can help in normalizing the child’s metabolic defects. DAN physicians (“defeat autism now”) are well versed in this and should be consulted.

S-adenosylmethionine (SAMe) defects are another type of methylation defect, which is associated with certain liver, colon and gastric cancers.

Dr. Rozakis went on to say that methylation defects lead to disbalances between T and B cells of the immune system and are important in autoimmune diseases like lupus or rheumatoid arthritis.

Methylation defects can also cause autoimmune thyroiditis and type 1 diabetes. They can also cause cardiac disease by raising homocysteine levels, which causes dysfunction of the lining of arteries and premature heart attacks.

Epigenetic factors through global methylation defects from vitamin B2, B6 and B12 deficiency can cause many different cancers. Hypomethylation is the most common DNA defect of cancer cells.

With skin diseases it has come to light that atopic dermatitis, eczema, psoriasis, scleroderma and vitiligo are related to methylation.

When we age, certain hormones are gradually missing, which leads to menopause and andropause. This leads to impaired cell function, elevated cholesterol, arthritis, constipation, depression, low sex drive, elevated blood pressure, insomnia, irritable bowel syndrome and fatigue. Replace the missing hormones with bioidentical ones, and symptoms will normalize.

Tests and treatment for hidden cause of depression

It is important for a physician to test patients for homocysteine levels once per year. As we age, we tend to lose some of the methylation pathway enzymes, which can result in an increase of homocysteine in the blood. A normal homocysteine level is less than 7 to 8 micromoles per liter. This is lower than the commonly recommended 15 micromoles per liter.

If the homocysteine level is too high, the treatment consists of methionine containing foods like dairy products and meat. Methionine, an essential amino acid, functions as a donor of methyl groups, which will normalize the methylation pathway defect and allow the homocysteine level in the blood to decrease. Research studies have been using 1000 to 5000 micrograms of 5-methyl folate daily to reduce homocysteine. Other B vitamins are necessary to reduce homocysteine, like vitamin B2, B6 and B12 in addition to 5-MTHF.

Hidden Cause Of Depression

Hidden Cause Of Depression

Conclusion

Depression and several other illnesses that are related to methylation pathway defects can be caused by a lack of 5-MTHF resulting in high homocysteine blood levels. It is important for elderly patients to be checked for homocysteine blood levels once per year to prevent depression, Alzheimer’s disease, migraines and a number of other illnesses mentioned above.

Once a methylation pathway defect has been identified, it is relatively easy to treat the patient with a proper methionine rich diet and 5-MTHF supplements as well as other B vitamins as discussed. It can prevent a lot of disability and human suffering.

References

Ref.1: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Ref. 2: http://www.askdrray.com/life-expectancy-is-influenced-by-lifestyle/

Oct
17
2015

Depression Needs Treatment

Depression is common: 10% of all men and 20% of all women have a period of depression in their lives. In people with medical illnesses depression is more common: 20% to 40% (Ref.1).

The peak age for depression is usually the age of 25 to 44. There are special groups where depression is also common. In adolescents 5% are affected with depression and 13% of women tend to get depressed after delivery, a condition called postpartum depression.

In any age group with depression there is a risk of suicide, but with adolescents this is particularly true.

About 10% to 15% of people with general medical illness are developing depression, such as patients with Parkinson’s disease, stroke, Alzheimer’s disease, cardiac disease, HIV infection, end-stage renal failure and cancer.

Causes of depression

Officially it is not known what causes depression. That is what medical textbooks say. However, other books like Datis Kharrazian’s book “Why isn’t my brain working?” offers several scenarios that can cause depression and he has examples of cases that were cured of depression (Ref.2). He points out that deficiencies in two major brain transmitters can cause depression: serotonin and dopamine.

  1. Serotonin is produced in the midbrain from the amino acid tryptophan in two biochemical steps. These biochemical conversions require iron, vitamin B6, vitamin B12, niacin, folic acid and magnesium as co-factors. But you also need the “large neutral amino acid transporter” (LNAA) to transport tryptophan through the blood/brain barrier into the brain.
  2. Dopamine is a neurotransmitter that is produced in the frontal lobes of the brain. It is also necessary for learning. Dopamine is synthetized by the brain from tyrosine, which has to be manufactured in the liver from the amino acid phenylalanine. You need to have a healthy liver to produce tyrosine, which needs to be transported through the blood/brain barrier into the brain; similar to tryptophan this requires the “large neutral amino acid transporter” (LNAA). People with hepatitis, fatty liver, insulin resistance or diabetes may have problems with the LNAA transporter, which can cause dopamine deficiency (Ref.2). But as mentioned earlier they may also have low serotonin because tryptophan was not transported into the brain. This will happen with sugar overconsumption, as insulin resistance develops and affects the LNAA transporter resulting in both low serotonin and dopamine (Ref.2).
  3. Since the 1990’s it is known that inflammation is also a possible factor in the causation of neurological disease including depression. Ref. 2 points out that gut issues can become brain issues as inflammatory substances can leak trough a leaky gut into the blood stream and trough a leaky blood/brain barrier into the brain. Hypothyroidism can activate brain inflammation and lead to an imbalance of the neurotransmitters. Gluten sensitivity is also an important cause of depression through the inflammatory connection, but few physicians recognize the full impact of this.

Tests for depression

There are no laboratory tests that would define depression. However, every patient should be checked for hypothyroidism, a common cause of depression. If hypothyroidism is found, this can easily be treated by thyroid hormone replacement.

Otherwise the diagnosis of depression is made based on mental status examination, history and review of symptoms. A good start is to ask: “In the past 2 weeks how little interest or pleasure in doing things have you had?” and “Have you been feeling down, depressed, or hopeless in the past 2 weeks?” (Ref.3).

There are detailed psychometric questionnaires available such as the Beck Depression Inventory that can assist the physician to establish the diagnosis.

Myths of depression

One of the myths regarding depression is that it would be contagious. A study on 2000 high school students showed that depression was not infective. The contrary was true: human interaction with friends who had a “healthy mood” improved depression. By the same token, when you constantly compare yourself with your Facebook friends, and you are not in the best mood, your mood may worsen and you could become depressed.

Treatment of depression

Despite advances in the treatment of depression the response rate with antidepressant therapy is limited to 60% to 70%. According to Ref.4 inadequate dosing and misdiagnoses account for the fact that 30% to 40% of treated people with depression have treatment failures. Typically the first antidepressant involves a selective serotonin reuptake inhibitor (SSRI), but newer trials have shown that the older monoamine oxidase inhibitors (MAOIs) have a higher success rate when treating depression initially (Ref.4).

A good antidepressant for mild to moderate depression is St. John’s wort, which is recommended by Ref. 5 as having less side-effects as other antidepressants.

In treatment resistant depression the psychiatrist often employs other combinations of antidepressants. In addition cognitive/behavioral therapy is added, which makes the overall treatment more successful. It goes without saying that complicated cases of depression belong into the hands of an experienced psychiatrist.

Suicides

Unfortunately there is still a stigma attached to have a mental disease like depression and people are in deep denial. Friends who do not understand depression may inadvertently say things that make the symptoms of the depressed person more severe and distance themselves at a time when they would need support from friends. The end result is loneliness, feelings of being misunderstood and having suicidal thoughts. Often it is men who will resist seeking treatment for depression, women are better in getting treatment started.

This is where a psychiatrist needs to intervene. If this does not happen, people start attempting suicide and finally commit suicide. In the US committed suicides have a gender ratio of male to female of 3:1 to 10:1. These situations become very difficult. The family needs to step in and talk to the patient. It is best to accompany the patient to the hospital for an assessment. Going to the hospital may be done privately or by ambulance. Don’t be shy to call 911 for an ambulance. Better to be cautious than have a major crisis that ends in completed suicide.

Alternative depression treatments

There are alternative treatments for depression.

1. Magnetic therapy for depression: This therapy is also called transcranial magnetic stimulation (TMS) and was approved for Canada and in 2008 by the FDA.

But it is not as powerful according to Ref. 3 as unitemporal electroconvulsive therapy.

2. Bifrontal electroconvulsive therapy (ECT): Electroconvulsive therapy with two pedals applied to the front of the skull appears to have the best results in terms of treating depression.

3. Omega-3 fatty acids (EPA and DHA) are powerful anti-inflammatory agents, which will take care of the inflammatory component of depression. Both fish oil and krill oil in combination give the optimal response as outlined here.

4. Vitamin D3 is also anti-inflammatory and will contribute to an improvement with existing depression, but it also helps prevent the development of depression when taken in regularly as a supplement.

5. Light box therapy: The observation of seasonal affective disorder (SADS) can develop as a result of lack of light. This has led to the discovery that light boxes are helpful for treating depression and also for prevention of depression due to seasonal affective disorder.

A light box should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often it takes up to 4 weeks to reach its full benefit.

6. It is known for a long time that alcohol is a depressant; it can actually cause depression and in persons with bipolar disease it can trigger a flare-up of that disorder as well.

7. Finally it matters what you eat: sugar and too much starchy foods (high glycemic index carbs) lead to insulin overproduction and insulin resistance. This causes inflammation, and this will cause depression. As mentioned earlier it also lowers the two key brain transmitters, dopamine and serotonin.

The solution is an anti-inflammatory diet, the Mediterranean diet without sugar and high glycemic index carbs; only low glycemic index carbs are allowed. This will normalize insulin production and eliminates inflammation.

8. Vitamin supplements: Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.5). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

9. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.6).

10. Exercise on a regular basis helps to equalize the mood and seems to exert a slight anti-depressant effect on the person who engages in regular physical activity.

Depression Needs Treatment

Depression Needs Treatment

Conclusion

I have attempted to show the complexity of depression and what is known about its causes and treatment. Very likely there are several causes for depression and further research will hopefully bring more clarity to this. Treatment modalities, both conventional and unconventional have been developed over the years by trial and error. The physician and patient need to use common sense: if a treatment is working, stick to it and use it. If it does not work, move on and try something else. More difficult cases should be referred to a psychiatrist who has the most experience with difficult to treat cases. Do not neglect life-style factors and alternative depression treatments as they can often help to stabilize depression significantly. We all must be vigilant about suicide risks in depressed patients and act by calling 911, if necessary to intervene.

More info on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

1. Depression, Major: Fred F. Ferri M.D., F.A.C.P., Ferri’s Clinical Advisor 2016, by Elsevier, Inc.

2. Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

3. Goldman-Cecil Medicine “Major depressive disorder” 2016, by Saunders, an imprint of Elsevier Inc.

4. Massachusetts General Hospital Comprehensive Clinical Psychiatry, Second Edition: Theodore A. Stern MD, Maurizio Fava MD, Timothy E. Wilens MD and Jerrold F. Rosenbaum MD © 2016, Elsevier Inc.

5. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders.

6. George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Oct
03
2015

What Stress Does

We all are stressed out at times. Some people are stressed all the time and this is called chronic stress.

Acute stress

Let’s say you were involved in a minor rear-ender accident. It is annoying, but at least you were not injured. But you have to deal with the insurance company, get the repair done and maybe get a car rental during the time of repair. Yes, you may have a few days where you feel that your hands are shaky and your heart pounds, or your sleep may not be restful. But when everything is done things are back to normal. This is an example of acute stress with a shorter running time. It has a limited severity, is an inconvenience, but it does not really affect your body on the long-term.

Chronic stress

Let’s assume the car accident was more severe and you received a personal injury with a broken leg. You end up in hospital and the orthopedic surgeon fixes the fracture with a surgical plate. The leg has to be in a cast for several weeks, and you have to use crutches. Every day you feel reminded of the car accident, because it is awkward to walk with crutches. After weeks you notice that you have gained weight. Your doctor is also worried about you because your blood pressure showed higher readings. You do not sleep as well, waking up frequently and having nightmares about another fictitious accident. On top of that you came down with the flu. What happened here? The stress reaction released cortisol, which weakened your immune system and may be responsible for you catching the flu. On the long-term cortisol can also contribute to high blood pressure, but so can alcohol consumption. You may have increased your alcohol intake in the evening to relax more, but with the chronic stress and the cortisol increase this can cause high blood pressure. The weight gain that you noticed has to do with the fact that you cannot work out any more because of your healing leg fracture and you having to use crutches. Inadvertently you may also eat a bit more rich food; a lot of people do that as food can be used as comfort food. And why do you sleep less well? Chronic cortisol elevation leads to lower melatonin levels, as these two hormones are natural opponents. A high melatonin level leads to a low cortisol level and vice versa. With relaxation methods you can lower cortisol and the melatonin level increases normalizing your sleep. Chronically elevated cortisol can also lead to weight gain as sugar is converted into fatty acids that are stored as subcutaneous fat. Muscles can melt down when cortisol is high giving the appearance of spindly arms and legs.

Causes of chronic stress

Holmes and Rahe tested a stress scale in 1970, which has become the standard ever since. You get a certain amount of points for a stressful event, e.g. 100 for the death of a spouse; 45 point for retirement; 23 for trouble with the boss etc. Add up all of the points that are affect you right now; if the total score is less than 150 points there is only a minor risk of getting medical problems from the chronic stress; for 150 to 299 points the risk of illness is moderate and for 300 and more points you are at a significant risk for illness.

There is physical illness and mental illness that chronic stress can cause. Physical illness can be high blood pressure, hardening of the arteries. The long-term risks from this are possible heart attacks and strokes. But chronic adrenalin and noradrenalin elevation associated with chronic stress can burn part of your brain cells in the hippocampus and medial prefrontal cortex. This can lead to memory loss, spatial memory loss and aggression. Mental illness caused by chronic stress can be anxiety, depression, social isolation, panic attacks and panic disorder. Psychosomatic symptoms can include headaches, back pain, abdominal pain and difficulties concentrating.

Job stress and cancer

Perhaps one of the best examples of job stress and cancer is a study where the amount of breast cancer was correlated to the amount of stress. I discussed this in another blog. Briefly, women with a less responsibility had the lowest rate of breast cancer, but they too had some stress as there was a higher breast cancer risk after 15 years on the job versus only 5 years on the job. The same study showed that women with high responsibility had the highest breast cancer rates. A hormone disbalance can explain this based on high cortisol levels associated with chronic stress. If cortisol is high, the cortisol binding globulin (CBG) increases; this in turn also binds more circulating progesterone, as progesterone attaches to CBG. CBG is a transport protein for both cortisol and progesterone. The end result is that estrogenic compounds get the upper hand, a condition called estrogen dominance. I have explained under the above link that this was the real reason for the increase in breast cancer in the stressed women. Similar mechanisms are causing other cancers to occur more frequently with chronic stress.

Chronic stress and cardiovascular disease

High stress jobs were found to cause a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease when compared to low stress jobs. This was based on a British Medical Journal study in October 2002. As I discussed above under a brief description of chronic stress cardiovascular disease is often what develops as part of chronic stress. People who are under chronic stress feel that they do not have enough time to prepare good, healthy food at home. They tend to eat out more often. Even well educated people just swallow a quick hamburger and other processed foods. This increases the bad fats like trans fats and omega-6 fatty acids in their system causing inflammation of the blood vessels as explained in this blog. The LDL cholesterol and triglycerides get elevated, sugar from sugary snacks oxidizes the LDL cholesterol and your coronary arteries and brain arteries get clogged up. This sets anybody on the downward pathway, and it is now only a matter of time when the chronically stressed person will develop a heart attack or stroke.

Chronic stress extremes: PTSD and burnout in soldiers

Dr. Thierry Hertoghe gave a lecture during the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014). The title was: “Burnout: A multiple hormone deficiency syndrome”. Burnout is the extreme of chronic stress. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers (teacher’s burnout scale) to monitor them whether they are heading this way. Soldiers who return from combative situations often suffer from burnout or from PTSD. Their burnout severity can be monitored using the teacher’s burnout scale already mentioned. In suspected cases laboratory tests that measure hormone levels give concrete answers about hormone deficiencies. Treatment protocols were discussed in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not life long. In addition supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? It is important, because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body. Also, by recognizing what is going on and helping the affected individuals, a lot of pain and suffering can be prevented.

Accelerated aging from telomere shortening

Chronic stress has been shown to cause telomere shortening. So does a lack of sleep (insomnia), smoking and alcohol overconsumption, all conditions that can be associated with chronic stress. What can we do about this? Learn what shortens telomeres and ultimately your life. Cut out what you can and take supplements that lengthen your telomeres.

Positive thinking combats stress

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or by getting caught up in needless anxiety. Worrying does not get us anywhere, but it depletes our energy.

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. Prayer is know to help people in sickness and in health. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Building social ties and mutually supportive relationships will also build you up. It makes you feel that you belong, you have your place in society, you help others, and they support you.

We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. He had developed end stage arthritis in his hips requiring total hip replacements on both sides. He wanted to illustrate that stress leads to physical consequences; it may be a heart attack in one person, a stroke in another, arthritis in a third. Constant overdrive has physical consequences.

What Stress Does

What Stress Does

Conclusion

Stress can be deadly, particularly if it lingers on and becomes chronic. But we can reorganize our lives to minimize stress. Some people may decide to seek a less stressful occupation. Others may elect to stay at that job, but develop hobbies and get involved in relaxation methods to combat job stress. The key is to start thinking about what stress you may be under and then develop a plan to counter it so you can allow yourself to rebalance your life.

Jun
13
2015

Preserving Our Energy

We are all aging, and as we do we are gradually losing energy until we reach our last breath. Here I like to review where our energy comes from and what we can do to preserve our energy. When we preserve our energy we are in fact also slowing down the aging process and this in essence is the approach to anti-aging.

Mitochondria are power packs of energy

Each of our body cells has many mitochondria to give us energy. Some organs are more demanding. They are the main players in our body like the brain, the heart, the liver or the kidneys. Their cells have thousands of these energy packages. Without the mitochondria there would be no energy available to these key organs to perform all the work they do. They allow us to think and produce brain hormones, to contract our heart muscle and pump the blood through our arteries. They are organs like the liver that are in charge of all of the major metabolic reactions or the kidneys that filter our blood for impurities and eliminate them in urine. Mitochondria can be likened to our power bundles that give our organs and us energy to get through life.

Get enough sleep

Sleep is an energy rebuilder. But it has to be deep enough and long enough, and there has to be enough REM sleep to give us the feeling that we had a refreshing sleep. As we age some of our hormone production slows down. One of those substances is melatonin. It is crucial for good and restful sleep. If our body is not producing enough, we can supplement with small dosages like 3 mg orally to help our body to initiate sleep. It is not an addictive substance. It is the body’s own hormone. Should you wake up later in the night, you could take another 3 mg of melatonin. There is no risk either to feel tired or “hung over” after taking melatonin.

Exercise regularly

The cheapest energy you can get is by exercising regularly. When you exercise on a treadmill, go jogging or go for a brisk walk you condition your heart, improve your lungs; in short you develop cardiovascular fitness. At the same time your muscles are strengthened with isometric exercises. You are optimizing your energy flow. In the process of exercising you create a stimulus for your mitochondria to multiply in the affected tissues. This applies as much to your muscles as it does to your heart and to your lungs. You will find that your muscle strength increases. With exercise you spend energy, but you feel more energetic from it because your body is being tuned up.

Manage stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Lifestyle

You need a lifestyle that is conducive to keeping your energies. Listed here are several factors that interfere with energy production.

  1. Smoking: If you smoke, you burn up energy with every cigarette you consume. You interfere with the oxygen transport through your lungs, but the chemicals that poison your system also poison the mitochondria of the cells. By smoking you are destroying your power packs. Pollution damages your lungs in a similar fashion as smoking does, but it is a slower process. There are a number of big cities with severe air pollution and they may not be worthwhile visiting.
  2. Sugar and starchy foods: Back in the 1970’s based on the Framingham Heart Study it was thought that hardening of arteries would be due to an accumulation of cholesterol from fat in the diet. Saturated fatty acids were accused to be the culprit. A low fat diet was supposed to be the solution. But the end result was the obesity and diabetes wave that we still see now. There had to be another explanation of where hardening of the arteries came from. Banning fats did not lead to better statistics. The new observation was that a low carb/medium fat diet was associated with low heart attack rates, low stroke rates, and even low cancer rates. Researchers also found the real culprit: They are sugar, starchy foods and processed foods. Sugar and starchy foods are metabolized in the liver into LDL cholesterol, triglycerides and they also oxidize LDL cholesterol. This starts a vicious process of inflammation of the lining of the arteries with fat deposits into the wall of the arteries. By eating the wrong foods we interfere with our body chemistry to the point where free radicals are produced that attack everything in us including our mitochondria. I have blogged about this many times before. You can read about it here.
  3. Alcohol: the famous one glass of red wine for women and two glasses of red wine for men is supposedly keeping us younger for longer. This is true for the resveratrol in the red wine, which is a powerful antioxidant. But to say that alcohol itself would prolong your life is a white lie. Alcohol is a nerve and cell poison; it robs you of energy. I take the resveratrol as a supplement from the health food store to protect my system. I stay away from alcohol.

Keep the arteries open

We need healthy arteries to pump blood through all of the branches and deliver oxygen and nutrients to the body cells. Unfortunately, as we age our arteries tend to get deposits that make them more narrow, and this could also raise our blood pressure. The end result is that less nutrients and oxygen will reach our body cells. We perceive that something is wrong by not feeling as energetic as usual. Simple lifestyle changes as mentioned below can improve our circulation and lower our blood pressure. Chelation therapy has also been shown as helpful in the TACT study.

Get rid of inflammation

Dr. Paul Ridker found that approximately 50% of patients with heart attacks had a normal cholesterol level. He was looking for a more meaningful screening test and found it in the C-reactive protein. If the test result was higher than 3 there was a high probability that there was inflammation somewhere in the body, but a test result of less than 1 was normal. In the meantime scientists have learnt that the C-reactive protein is a very sensitive tool to measure inflammation in the body, but it is not specific for heart attacks. It is also positive in people with arthritis, cancer, and autoimmune diseases. Chronic inflammation is also destroying immune cells: this explains the development of cancer as the end stage of chronic inflammation.

Chronic inflammation robs you of energy. We can do a lot with natural anti-inflammatory supplements to quench inflammation.

Preserve your immune system

We can strengthen our immune system by exercise, taking vitamin C regularly and by taking vitamin D3 supplements to just name a few. DHEA, the precursor hormone from the adrenal gland also helps stimulate the immune system.

Balance your hormones

As we age we loose hormones one by one. With melatonin this starts happening after the age of 20, with DHEA and growth hormone after you are in your mid thirties. Women start to get into menopause at the age of 45 to 55, but this can occur earlier or later. Men are going through their hormone change (andropause) at the age of 55 to 60. Both, women and men know when they are entering their hormone change because of a lack of energy and a few other unpleasant symptoms. Women get hot flashes. Men get grumpy, have erectile dysfunction, a lack of sex drive, week muscles and slower thinking. If you feel those symptoms, seek the help of a naturopath who is knowledgeable on bioidentical hormone replacement. Chances are that your regular doctor will want to prescribe synthetic hormones unless you can find an anti-aging physician. If your blood tests show deficiencies in the sex hormones, you will need to get a bioidentical hormone prescription. They are usually dispensed as creams, which you apply to your chest wall or non-hairy forearms in the morning. After 4 weeks your energy will be back, and your body will function normally again. All the body functions that you thought were gone forever just needed that extra stimulus from the missing bioidentical hormones.

Organic, GMO free food

I was tempted to just write “good food”. But this may be confusing to people. It is difficult anywhere in the world to get good food. Often insecticides and pesticides contaminate fruit and vegetables, which function as xenoestrogens blocking hormonal receptors. These residues are toxic for your body, and they are destructive to your energy. Organic food with the USDA certification or any independent certification is the best way to ensure that you get a good food product. I take this seriously and pay the extra dollar. We do not need plates heaped with foods. Small helpings of good quality foods are more important for our well-being.

Treat depression and mental disease

People who are depressed will complain of a lack of energy. Their brain circuits are constantly in overdrive being busy with negative thinking. Cognitive therapy can help depressed patients to face their negative emotions. It is a learning process of thinking step by step to distinguish what is real and what is magic thinking. It is important to seek qualified help. Depressed patients distort the way they think, but cognitive therapy sets their thinking straight (Ref.1). When the thinking is normalizing, the drained energy returns, people sleep better again and they can use the energy to move forward.

Positive thinking

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or by getting caught up in needless anxiety. Worrying does not get us anywhere, but it depletes our energy.

Preserving Our Energy

Preserving Our Energy

What can we do to prevent aging?

It follows from all that I said that anything that preserves energy would also prevent premature aging.

As mentioned, it is important to exercise regularly (gym, swimming, dancing, fast walking, jogging etc.). Have good, balanced nutrition, preferably organic food. Some supplements are also helpful: resveratrol, Co-Q-10; pages 100 to 103 of my book contain more vitamins and supplements (Ref.2). Here is a link to my website NetHealthBook, which also addresses vitamins and supplements (scroll down to table). Avoid sugar and starchy foods to avoid oxidizing LDL cholesterol. Use bioidentical hormones to replace what is missing. Get your 7 to 8 hours of sleep and don’t forget relaxation. Detoxify to get rid of toxins that would slow you down. Infrared saunas are one way to detoxify. It is helpful to consider chelation treatments. Last but not least have a positive outlook on life.

Conclusion

Our energy that we feel tells us whether we are staying healthy or whether we are at the verge of getting sick. It is best to maintain your energy at all times by doing a combination of things outlined above. You will retain youthful energy; you prevent cardiovascular disease, Alzheimer’s and even cancer. Most of all you have the energy to do the things you want and love to do.

I prefer to work on staying well and in the process I have the energy to do the things I want to do. Part of it is blogging, part of it is writing books, and part of it is dancing. The key is that I like what I am doing. I invite you to do what will keep you energized. Listen to your body.

 

References:

1. David D. Burns, MD: “feeling good – the new mood therapy” 1999, Harper Collins.

2. Dr. Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling

May
16
2015

Facebook Use And Depression

There has been a recent study that showed that too much time spent on Facebook could have negative effects on your mood. In the most extreme case it could cause depression.

A person who is lonely and spends a lot of time on Facebook will learn about how much fun others have who report about what they have done or achieved. They may also brag about parties they have gone to. But they rarely talk about the times when they are down. When people read about others on Facebook, those who are sensitive or are in a dull mood could get discouraged. As they compare their own lives with those who portray themselves as upbeat people it leaves some with feelings of low self worth, of depression, of isolation and worsening loneliness and isolation. On the other hand, some people do share negative experiences on Facebook. There is the chance that friends can offer encouragement and support, but this is far removed from the personal, close interaction. Even a phone call is more tangible!

We all are subject to feeling blue at times, but a normal blues can turn into depression, which is part of a mental disease.

What is depression?

Depression belongs into the mood disorders. Psychiatrists have found out in the 1970’s and 1980’s that a lack of serotonin, an important brain hormone is associated with depression.

It is a mental condition where the person sees everything negative feels hollowed out and may have a lack of energy. A depressed person sees no way out of their bleak situation; they ruminate about any problems in their lives, but do not have the strength to reason things out and solve their problems. They start having problems falling asleep and sleeping through; their sex live fades due to a lack of sex drive. They are tearful and anxious. There may be a tendency of committing suicide, which is one of the things the psychiatrist will monitor for. In severe cases of depression the suicide potential may be the main reason to commit a person to a psychiatric ward for intensive treatments, either involving antidepressants or using electro convulsive therapy (ECT).

Facebook/depression research

In the Houston University study mentioned at the beginning of this blog it was found that the more hours people spent on Facebook the more depressed they were, at least for men, not so much for women. A second study showed that the more time they spent on Facebook, the more depressive symptoms they had in both sexes. This study found that the depressive symptoms were initiated because of social comparisons between what the Facebook friends did in their lives and how the lives of the subjects of the study were perceived to be. But Mai-Ly Steers, the author, said that “most of our Facebook friends tend to post about the good things that occur in their lives, while leaving out the bad”. The author went on to say: “the act of socially comparing oneself to others is related to long-term destructive emotions“. In plain English: the chronic braggers on Facebook sites are not really doing anything constructive for their friends; they are just on an annoying ego-trip!

If blues turns into depression, it is important to know more about the how depression is treated.

Treatment of depression

Here are the most common treatment modalities.

1. Drug therapy

In mild to moderate depression the caregiver may want to use an anti-depressant drug. It is important to study the side effect of drugs before treatment is even begun. The reason this is important is that the severity of side effects will decide how compliant the patient will be in continuing to take the antidepressant for a period of time. The anti-depressants amitriptyline (Elavil) and imipramine (Tofranil) tend to produce a dry mouth as a side effect. Some people can put up with this, others find it simply too much and they will discontinue treatment, which often can lead to suicide, because the negative thoughts come back when the treatment is stopped. There are newer anti-depressants like fluoxetine (Prozac), but there is a disclaimer that it could bring on suicide in teenagers who are put on this. Discuss the side effects with your physician before you are put on anything. One of the safest mild to moderate anti-depressants is St. John’s wort. This is an ancient herb and a lot is known about it. Side effects are minimal and for this reason it is well tolerated.

2. Cognitive therapy and behavioral therapy

These two forms of psychological intervention strategies have been found to be very useful to help depressed patients to normalize their thinking.

It is in the area of “self-talk” that patients learn how to reprogram their internal thoughts. They learn to use their cognitive thoughts to intervene when they get caught in negative, stereotype thought patterns or negative generalizations (“I always do everything wrong” etc.). You learn how to use rational questioning to expose generalizations: “are you really always wrong? Tell me the last time you were successful in something!” This way the generalization of “always” being wrong is put into the right context.

3. Electroconvulsive therapy

For more severe depression admission to a psychiatric ward in a hospital equipped for psychiatric patients may be required. The psychiatrist who is involved in these cases needs to observe the patient closely and determine the suicide risk. Some patients are put on special psychiatric monitoring involving psychiatric nurses that frequently talk to the patient and monitor the suicide risk. Some patients will respond fairly well to anti-depressant therapy combined with cognitive therapy, behavioral therapy or both. If the patient does not respond adequately to this treatment approach, the psychiatrist may recommend a brief course of unilateral ECT treatments.

They are more gentle than the bilateral ECT treatments. Memory loss that was a big issue with bilateral ECT treatments is not so much an issue any more with unilateral ECT treatments. One of the advantages with ECT treatments is that after 6 to 9 such treatments there is often an impressive response of depression where the suicidal risk gets overcome. Other treatment modalities like anti-depressant therapy and cognitive/behavioral therapy will then guide the patient to a full recovery from depression.

Bipolar disorder, a special form of depression

In the past bipolar disorder was termed “manic/depressive illness”. This can be inherited, and certain triggering factors can suddenly bring on a manic phase where the person is hyperactive, has racing thoughts and behaves in weird ways. But on other occasions the same person may present with strong depressive symptoms including suicidal thoughts and behaviors. These patients need to be brought to the attention of a psychiatrist right away, because untreated they may do harm to themselves (suicide) or they may do harm to others. Sadly it is often not recognized by police or firefighters if a person presents with psychiatric symptoms. Some of these cases make news headlines when police responds by firing shots, but the underlying mental disease is often not detected and treated. As fast as patients with bipolar disorder can flare up with their symptoms, they can also calm down and regain their normal controlled condition very rapidly as well. Often a person in a manic state is sleep deprived and when relaxed with a major tranquilizer drug, they fall into a deep prolonged sleep from which they wake up with much of their manic symptoms having resolved. If the psychiatrist now decides to put them on a simple mineral, called lithium carbonate, as a maintenance therapy, the mood fluctuations may never come back. The person stays equal tempered and you would not think that they could ever have needed psychiatric intervention.

Facebook and mental disease

I like to come back to the topic of this blog, namely what influence the social media and in particular Facebook has on mental illness.

We all have certain needs that we may or may not be aware of and that need to be met. Abraham Maslow, an American psychologist has taught about this many years ago. I like to simplify these needs and point out four of these basic needs as follows: we have a need for self worth, a need for autonomy, a need to belong and a need for love. If any of those needs is not met, we will feel hurt inside and our thinking may get disbalanced. Once we are on a negative internal spin and there are no friends that help us see things in perspective, this could grow into depression as found in the study discussed in the beginning of this blog. When a semi-depressed person reads some of the upbeat communications on Facebook, comparing oneself to others, it can lead to a feeling that they do not belong to this upbeat group, but they are left out. They may feel that they are not loved and the need of self worth is undermined. It is easy to see how one’s self-talk could get into a negative spin and the mood would be spiraling downwards toward depression. It depends on how emotionally stable the person is who reads these Facebook entries. An emotionally robust person will be able to reason within oneself that people tend to show the rosy part of them on Facebook. They may also limit Facebook time and contact some of their friends and meet them in person rather than only by computer or texting. The electronic world can be a lonely experience. There is no substitute for personal touch, talking, listening and interacting with real people, and this is still one of the valuable tools of preventing mental illness. But if depression or other mental illness sets in, contact your family doctor to get a referral to a psychologist or psychiatrist.

Facebook Use And Depression

Facebook Use And Depression

Conclusion

Mental illness still has a stigma from the past. However, now we know that the symptoms of mental disease are just due to a disbalance of brain hormones that can be rebalanced through the treatment protocols mentioned above. Facebook can have a negative influence on the development of mental illness, because the basic needs mentioned above are unmet or even are being undermined, which in turn tends to make mental symptoms worse. The solution to this is to limit Facebook time, to meet real people and share all of the feelings with them and listen to their feelings as well. This human interaction tends to stabilize our mental well-being. It is also important to realize when professional help is needed and to seek it.

May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014

Feb
19
2014

Every Patient Is Unique

Modern Western Medicine tends to see the disease of a patient as a unique entity. Conventional medicine behaves as if a disease is associated with characteristic symptoms, findings and lab test results, which are then treated in a standard fashion by treating the symptoms of the disease.

The reality though is different: The same disease can present in various patients with different symptoms.

Naturopathic physicians, integrative physicians and anti-aging physicians see patients as unique individuals with characteristic personality traits and slightly varied presentations, which may be shared in a disease entity, but differ substantially from person to person.

It is important to be aware of this uniqueness, if the caregiver wants to achieve the optimal treatment result.

Big Pharma does not like this approach as they would like you to think that the conventional medicine system is superior. A certain disease is treated a certain way, preferably with the most expensive drugs.

I thought that in this blog it would be good to shed some light on this important topic.

Menopausal women with symptoms

Let us consider an example of a 55-year old woman who has hot flashes, dry skin, a loss of hair from the outer aspect of her eyebrows, does not sleep well and has lost her sex drive. She also has put on 20 pounds in the last year despite no change in her diet.

This is how conventional medicine would handle this patient

The doctor examines the woman and does a Pap test as well. A conventional doctor would likely order standard blood tests consisting of a complete blood count, thyroid tests (T4, TSH) and FSH and LH levels. The conventional physician would find that the thyroid hormones are low with a high TSH (thyroid stimulating hormone) and would treat the woman with Synthroid (a synthetic thyroid hormone drug). The LH and FSH were found to be high indicating to the conventional physician that the woman is in menopause. He would offer the standard PREMPRO (a synthetic hormone preparation containing a mare estrogen combination with a progestin) with the warning that he will give her the lowest estrogen combination and only up to 5 years because of the negative findings of the Women’s Health Initiative.

Every Patient Is Unique

Every Patient Is Unique

Here is an example how a naturopathic or anti-aging physician’s would investigate and treat the patient

A naturopathic physician or an anti-aging physician would likely add a female saliva hormone panel to the other blood tests mentioned above and also do a T3 hormone level as part of the thyroid blood tests. The doctor will explain to the patient that she was found to be menopausal and also hypothyroid. With respect to the hypothyroidism the physician will explain that apart from thyroxin (T4) there is a second hormone, triiodothyronine (T3) that is also necessary in order to replace all of the thyroid hormones that humans have. Drug companies assume that T4 (Synthroid) will reverse automatically into whatever amount of T3 the body needs, so they have convinced most conventional doctors to prescribe T4 drugs only (like Synthroid). The problem is that as the body ages, the enzymes necessary to convert T4 into T3 do not work as well as in a younger age.This can be verified by testing T3 and T4 levels simultaneously.

The end result is that the patient who only gets T4 replaced may still have some of the symptoms like lack of energy and depression even when T4 has been replaced. Not so with the patient treated by the naturopath or the anti-aging physician who put our patient on Armour (porcine-derived thyroid hormone replacement containing both T4 and T3).

With regard to the blood tests and the saliva hormone tests the second patient was told that the blood tests confirmed menopause (high LH and FSH) and that the saliva female hormone panel showed what was going on. In this particular patient the female saliva hormone tests showed that the progesterone level was low, the testosterone level was low and estrogen was normal. Another hormone, DHEA-S (which is DHEA sulfate, the storage form of DHEA) was also on the low side. Cortisol that had also been tested was normal. The physician explained that the woman’s adrenal glands showed a slight weakness not producing enough DHEA, which is a precursor to testosterone. The low testosterone level was responsible for her lack of sex drive. Progesterone, which needs to be high enough to counterbalance estrogen, was missing, which was likely the cause of her hot flashes and the lack of energy together with the missing thyroid hormones. The physician explained that the woman needed a small amount of DHEA tablets by mouth, a full replacement of progesterone (through the use of a bioidentical hormone cream) and also a small amount of bioidentical testosterone cream to normalize her hormones.

A reassessment of the patients 2 months later showed that the first woman still had some depression and lack of energy, while the second woman felt her normal self again. Both women had regrown their eyebrows from replacing the missing thyroid hormones and have lost several pounds since the beginning of their treatments, but obviously there were quite different clinical results. The first woman was treated in a “standard conventional medicine” fashion, which will lead to breast cancer as unnecessary estrogen was given. She also will be at risk of getting cardiovascular disease as she was replaced with Progestin, a synthetic drug thought by conventional physicians to represent “progesterone”. The Women’s Health Initiative has proven that this was the outcome with PREMPRO and yet this drug is still on the market!

The second woman received an individualized and personalized holistic treatment protocol. The low progesterone from missing her ovulations after menopause was being replaced and her body very quickly responded favorably by making her feel normal again. The missing adrenal gland hormones and testosterone were replaced and this normalized her sex drive. Both, progesterone and thyroid hormones (T3 and T4) are anabolic hormones and they gave her back her energy and restored her sleep pattern. With normal hormone levels she also lost her depression symptoms.

Two men with depression

If you thought that the difference of these two clinical approaches were just coincidental, think again. The next examples are two men in their early 50’s who see their physicians because they felt depressed and had a lack of energy. Both were normal weight.

Here is the conventional medicine approach

The physician took a history, during which a lack of sex drive was also noted. He examined the patient and came to the conclusion that physically nothing was wrong with the man, but a diagnosis of depression was made. This would account for the tearfulness, sleep problems and loss of sex drive. The doctor prescribed one of the standard antidepressants (in this case sertraline, brand name Zoloft). Three weeks later the patient returned and as he was better, a repeat prescription for the antidepressant was given. After a further two months the patient was reassessed. When the symptoms were reviewed, it became apparent that a lack of sex drive was still present, if anything the patient felt the antidepressant had made this worse. Some of the depressive symptoms have improved on the conventional antidepressant. The doctor discussed that the antidepressant could be increased by one tablet per day. The doctor also discussed the option of using Viagra for the decreased sex drive and difficulty having an orgasm.

This would be the  naturopathic or anti-aging physician’s approach. Again similar to before a history was taken and a physical examination was done. The physician noted that the patient was in the age where a lack of sex drive could indicate an early andropause (the male equivalent of menopause, often difficult to spot with the first presentation). A depression questionnaire indicated that the man was moderately depressed. The patient was sent for blood tests and for saliva hormone tests (a male hormone panel). The physician stated that he would like to arrange for cognitive therapy treatment to sort out the various factors of his depression, but also help his mood by trying to start him on St. John’s wort, an herb that has been proven to be effective for mild to moderate depression. The blood work came back as normal. However, the hormone tests showed that testosterone was in the lower third of the normal range. DHEA-S, cortisol and estrogen were normal. So a few weeks later when the tests had come back the patient was called in.  The doctor explained to him that the low testosterone level would explain why his sex drive had deteriorated along with his symptoms of depression. Bioidentical testosterone cream was added to the antidepressant herbal treatment. The result was that within one month this patient’s sex drive was back to normal. Together with the cognitive therapy treatments and the herbal antidepressant the depression was also resolved. After a further three months of counseling he was able to stop the St. John’s wort. Due to the counseling sessions he felt stronger than ever before and his mood remained stable even when the counseling sessions were terminated. He continued to use the bioidentical testosterone cream regularly.

These are examples of two different approaches in two identical men in their early 50’s. It appears to me that the conventional approach did a disservice to the sick person, only treated symptoms, but did nothing to solve this patient’s real problems. The second case’s depression was treated properly and the physician luckily also did not miss the underlying early andropause with low testosterone levels. Repeat testosterone levels showed a high normal testosterone level, which was now in the upper 1/3 of the normal range.

The conventional approach missed the early testosterone deficiency, which  would cause heart disease, should the testosterone levels become even lower. Viagra certainly would not be the answer as this has a number of potentially serious side effects. The antidepressants at even higher doses would cause more erectile dysfunction, which was what he hoped to have treated.

Conclusion

People often have several conditions at the same time. It takes intuition, readiness to do testing, repeat close observation and repeat examination on the part of the physician. This needs to be coupled with good listening skills to sort out a patient. On behalf of the patient it is important to tell the physician all of your symptoms and observations. Be patient and never give up. A good patient/physician relationship will go a long way in sorting out complex medical problems. Every patient is unique. Not every symptom means the same thing in two different patients.

More information on:

1. Menopause: http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/menopause/

2. Depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

Last edited Nov. 7, 2014