Nov
03
2018

When you are sleepless

You are not alone when you are sleepless. Insomnia is a widespread problem in society.

Previous review of the topic of insomnia

I have reviewed the topic of insomnia before in a blog.

Briefly I pointed out that in some people there is a mutation of the gene that controls the circadian sleep rhythm. It is called the CRY1mutation. Some people have sleep disturbances from working night shifts. I mentioned the blue light of electronics that is produced by the TV screens or computer screens. The more you are exposed to it, the more it stimulates the brain to produce serotonin. This undermines the melatonin production, and as a result the person finds it extremely difficult to fall asleep. Children playing with i-phones, tablets or watching children’s programs on television can have sleep disturbances from the blue light. Blue has the frequency that over stimulates the brain and interferes with melatonin production. Drug and alcohol abuse can also interfere with the normal circadian sleep rhythm and cause insomnia.

Hormone factors of insomnia

For natural sleep to occur, we need melatonin which the pineal gland releases in the evening. It initiates and maintains sleep during the night. The natural opponent of melatonin is cortisol, the stress hormone, from the adrenal glands. Both hormones need to be in balance to allow you to sleep normally. Shortly before we wake up in the morning melatonin production goes down and cortisol production is up. Cortisol levels are low at night and high during the day. So it is cortisol that keeps us going throughout the day. But an excess of cortisol from chronic stress can also interfere with falling asleep and sleeping through the night.

Stress and insomnia

When we feel stressed, cortisol production goes way up. This has consequences regarding our sleep pattern. It can interfere with falling asleep, causes us to wake up from a deep sleep in the middle of the night and can give us problems falling asleep again. Chronic stress exposure leads to high cortisol production by the adrenal glands, which in turn will lower melatonin and cause sleep disturbances. Older people (above the age of 50) have very little melatonin production left, as there is an age-related decline of melatonin production. The melatonin production is highest in younger years and lowest in older age.

What to do when you are sleepless

There are several over-the-counter remedies, which in combination can be quite effective.

Melatonin for when you are sleepless

Melatonin (3 mg at bedtime) is a good start to see what it does for your sleeplessness. Taking a small amount of melatonin at bedtime we can re-establish the balance between cortisol and melatonin, which helps the circadian hormone rhythm and sleep pattern to come back. Some people wake up in the middle of the night and find it difficult to fall asleep again. If this happens at 3 AM, a good remedy at this time is to take another 3 mg of melatonin. Melatonin stays in the system for about 4 hours. Light during the day de-activates the effect, when light hits the retinas upon opening your eyes. You should not exceed 6 mg of total melatonin overnight. Otherwise it will interfere with the balance of cortisol and melatonin, lowering cortisol levels, which would rob you of energy during the day.

Phosphorylated serine (Seriphos)

A supplement that is freely available in the US (but not in Canada) consists of a simple amino acid. As this link shows (second item in the link) phosphorylated serine Seriphos) helps to down-regulate cortisol levels (lowering them). This means that melatonin gets the upper hand and you can sleep again.

The dosage for phosphorylated serine (Seriphos) varies from person to person, but will be in the range of 1000 mg to 3000 mg in the evening. After about 30 days the circadian rhythm may have recovered and you can stop the Seriphos. A one-day pause is required once a month for resetting the hormone receptors. Should you still have problems sleeping, you can continue with it for another month and pause again for a day. Seriphos has very few side effects.

Valerian root capsules

Another useful sleep aid is valerian root (as capsules). 500 mg to 1000 mg will help you to relax. It does not have the side effect of feeling groggy the next morning.

Other considerations when you are sleepless

Hormone problems like thyroid abnormalities (too much or too little thyroid hormones) are issues that your doctor has to investigate. Women in menopause often have sleep disturbances due to a lack of estrogen and progesterone. A knowledgeable healthcare professional is able to take care of that by prescribing bioidentical hormone creams.

When men approach andropause (the equivalent of menopause in women), they lose testosterone production. This can cause insomnia. The doctor can verify the hormone loss by a blood test. Replacement with either bioidentical testosterone cream or injections will rebalance testosterone levels. Insomnia may disappear. It is essential not to overdose testosterone, as this can also cause insomnia.

Sleep lab for when you are sleepless

When home remedies do not help, it may be time to check into one of the sleep labs to diagnose the kind of sleep disorder you are suffering from. Here is an overview what is happening there.

Essentially you get hooked up to monitors and are encouraged to just sleep as you would normally do. The physician in charge of the lab will later explain to you what the monitors showed, and tell you what type of sleep. According to the findings your doctor will recommend what measures are appropriate to remedy the situation.

Treatment for insomnia when over-the-counter remedies fail

Short acting benzodiazepams

When anxiety is not a problem, but only insomnia is (falling asleep or staying asleep) lorazepam 1 mg (Ativan) or temazepam 10 mg (Restoril) are shorter acting benzodiazepams that will help. It is not a permanent but a short “emergency break” for intermittent use, so that the GABA benzodiazepine receptors have time to recover. Otherwise, with continuous use tolerance would set in. This means higher and higher doses of the sleep medication would be necessary to achieve the same effect. Another non-benzodiazepine is Zolpidem 5 mg (Ambien). Even though this medication is not a benzodiazepine, it works on stimulating the same GABA benzodiazepine receptors.

Longer acting benzodiazepams combined with antidepressant Trazodone

For several years the combination of a small amount of the longer acting benzodiazepams, clonazepam (Rivotril) at 0.5 mg combined with a small amount of the anti-depressant trazodone (Oleptro or Desyrel) at 50 mg at bedtime has been has been in use quite successfully.

But there is a concern of drowsiness caused by Rivotril as this link shows.

Trazodone, which is an antidepressant has a sleep cycle restoring effect at low doses and has less side effects, because it is used at ¼ the dose for a full-blown depression. Males are often complaining that it reduces their sex drive, and it may cause erectile dysfunction.

Clonazepam side effects

Rivotril was originally in use to control epileptic seizures and anxiety. The combination therapy for sleep disorders uses Rivotril at ¼ of the regular dose. Although it is good as a sleep aid, it has a long half-life and stays in the system well into the next day. This may present as sleepiness and cause falls in elderly patients because of clouded attention. Replacement by one of the medium long acting benzodiazepams could be the solution. A drug pause for 1 day will help to reset the GABA benzodiazepine receptors and prevent tolerance from happening. Knowing all those effects and side effects it is wiser to reserve the use of these medication strictly when everything else has failed!

When you are sleepless

When you are sleepless

Conclusion

As I mentioned before, you are not alone when you are sleepless. Insomnia can present as having problems to fall asleep, but it may present in others as a problem in the middle of the night waking up and having problems going back to sleep again.

I described non-conventional methods to help you to sleep using melatonin, Seriphos and valerian root capsules. If this fails, a sleep lab investigation may be necessary to get to the bottom of your insomnia problem. Physicians often prescribe short acting benzodiazepams like lorazepam (Ativan) and temazepam 10 mg (Restoril).

Other possibilities to treat insomnia

There are other possibilities to treat insomnia, with a combination of a low-dose antidepressant (trazodone, brand name Oleptro in the US) and low-dose anti-seizure and anti-anxiety drug clonazepam (Klonopin or Rivotril). Anxiety can often be a big component in insomnia and this treats both. On the other hand, anxiety is a separate problem, which needs professional treatment. There can be side effects of sleepiness from clonazepam and men complain of a lack of sex drive and erectile dysfunction from trazodone. Help is available when you are sleepless. But you need professional help to work on the problem and find the solution.

Aug
25
2018

The Downside Of Living To 100

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

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Jul
07
2018

Asthma In Adults

On April 6, 2018 CNN published an article about asthma in adults. It was called “Developing Severe Asthma in Adulthood”.

Asthma in adults occurs with a frequency of about 2.3 per 1000 people per year. This publication also noted that women suffer from this condition more often than men. For both sexes the occurrence of asthma in adults peaks at 35 years of age.

Symptoms of asthma

The triggering factors for asthma can be infections, allergies, or the condition can come on spontaneously. Coughing is one of the main symptoms. You may be breathless when walking stairs. You may feel weak or tired when exercising. After exercise you may be wheezing or coughing. If you measure your breathing capacity with a peak flow meter, the values are lower than normal. Cold air or irritants like cigarette smoke may trigger coughing or wheezing. In industrial workers the trigger for asthma can be noxious fumes.

Diagnosis of asthma

Spirometry

Your doctor likely will order a test, called spirometry. You are breathing into a tube with a connection to a spirometer. A technician will instruct you to breathe out to the max (maximal exhalation). Next you will have to breathe in as quickly as you can. These breathing activities translate into a breathing curve on the read-out of the spirometer. With asthma there is a certain degree of restriction of airflow due to spasms in the smaller bronchial tubes, called bronchioles. This will be obvious from the breathing pattern of the spirometry read-out.

Methacholine challenge test

When the spirometry test is normal or near normal, a Methacholine challenge test can be another diagnostic tool. If this produces an asthma attack, it is clear that the person does indeed have asthma.

Measuring nitric oxide in your breath

Our bodies normally produce nitric oxide, and a small amount of it appears in your breath. But if there is a large amount of it present in your breath, it indicates chronic inflammation in your airways, which can be one of the causes of asthma.

Other tests to rule out other related diseases

Your doctor may want to order sinus x-rays to rule out sinusitis or a chest X-ray to rule out pneumonia. If he suspects allergies a referral to an allergist sill be next. The specialist will do skin prick tests to see what you are reacting to.

Differential diagnosis of asthma and other diseases

When the physician is thinking about an asthma diagnosis, it will be necessary to exclude other diseases first. It is important to exclude a bronchial or lung infection as well as the presence of emphysema or chronic obstructive pulmonary disease (COPD). Clots in the pulmonary vasculature (pulmonary emboli) have to be ruled out. When there is a history of gastroesophageal reflux, tests should exclude that there is aspirated gastric contents into the lung. Another condition that could bring on wheezing is chronic congestive heart failure, where the heart fails to pump enough blood, and shortness of breath is a consequence. Tests are available to exclude all of these conditions.

Treatment of asthma in adults

Anti-inflammatory medication

As all patients with asthma have inflammation in the airways, it is important to use corticosteroid inhalers that will control this. These inhalers will control the swelling and mucous production in the lining of the bronchial tubes. With the daily use of these inhalers the airflow improves, the airways become less sensitive and the patient experiences fewer asthma episodes.

Bronchodilators

Bronchodilators are inhalers that will relax the muscle bands around the bronchial tubes. This allows the patient to breather easier. The mucous flows more freely and can be coughed up easier. There are short-acting and long-acting forms of bronchodilators. Your physician will instruct you which one to use.

Asthma In Adults

Asthma In Adults

Conclusion

Adult onset asthma is separate from asthma of childhood. Often the triggers are allergies or irritants, including industrial irritants. With a proper diagnosis and treatment adult asthmatics have a normal life expectancy. It is important to control the inflammation of the airways with anti-inflammatory corticosteroid inhalers. For acute asthma attacks a bronchodilator must be used right away to ensure normal airflow is restored. The patient learns how to modify the asthma therapy. As a result there are very few occasions where the patient would need treatment in a hospital. Most patients can treat an asthma attack quickly and they respond very well to the treatment. As a result adult asthmatics can lead active lives and have no physical limitations.

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Jun
09
2018

What Makes Chips Addictive?

When you emptied an entire bag of potato chips, you may ask yourself: what makes chips addictive? Scientists talk about hedonic hyperphagia or hedonic hunger. In plain English, it is the pleasure of eating, even when you are not hungry. There are certain foods that seduce you to overeat, and one of these are chips. Chocolate or candy can be other high-hedonic rating foods.

Erlangen experiments

A group of researchers from the Erlangen University in Germany set out to get to the bottom of this addiction eating. 17 healthy subjects with a body mass index of between 19 and 27 were recruited for eating experiments. They got either high calorie chips or low calorie zucchini. The chips created a marked stimulation on a functional MRI scan where the nucleus accumbens was lighting up. When they consumed zucchini no such stimulation could be documented. The researchers had done similar experiments with the same foods on rats. They too had functional MRI scans and the tests showed similar stimulation after the test animals consumed chips, but not after zucchini.

Nucleus accumbens, the addiction center for food

Professor Andreas Hess and his team in Erlangen say that the nucleus accumbens is the addiction center for food. They also did experiments with fat to carbohydrate composition to find the most addictive mixture. There is a certain fat to carbohydrate ratio that triggers food addiction. What surprised the Erlangen researchers was that both in rats and humans the optimal addiction potential was identical.

  • They found that rats preferred 35% of fat and 45% of carbohydrates in their chips. With humans there is the other factor: on top of the fat/carb mixture we like to taste some salt and spices, because this also will stimulate our appetite. The food industry has figured this out long time ago. This knowledge from tasting experiments is built into processed food.
  • The Erlangen researchers  also found that in obese people the nucleus accumbens was lighting up more intensely the higher the BMI was. That means that obese people are more food-addicted!

Triggering the nucleus accumbens

  • Professor Hess postulates that the 35% fat to 45% carb mix in potato chips is ideal for the body. It can mobilize quick energy from carbs, but also have storable energy from fat at the same time. It is this mix, which stimulates the addiction center in the nucleus accumbens.
  • In a study from Bethesda, Maryland researchers found an overlap between food addiction and drug addiction.  The common pathways in both is the release of dopamine in the nucleus accumbens. This dopamine release makes us feel good, and as a result, we want to experience it again.
  • In this study patients with bulimia nervosa were examined. They found that   overconsumption of sugar-laden foods had very similar effects as drugs in drug-addicted patients. It is the release of dopamine, glutamate and the opioid system that are involved in both. The nucleus accumbens is also receiving stimulation in both situations.

What can be done about food addiction?

This publication noted that people who are food addicted eat higher amounts of fat and carbohydrates. With this mix the feel-good nucleus accumbens produces most dopamine, which is the driving force behind the addiction.

  • If you cut out sugar, you find it easier to control your eating portions. But you also must cut out processed food, as this is where a lot of hidden sugar is coming from.
  • Cut down on your fat consumption. Even if you reduce it from 35% to 10% or 15%, this is a huge step forward. It reduces your calorie intake significantly, but also reduces the stimulation of your appetite center.
  • Eat lots of vegetables, salads and some fruit. Be careful with some fruit like grapes, bananas, mangos, papayas and dates. They are all higher in sugars. If you cannot entirely avoid those, use portion control, so you are not overeating on them.

Portion control

Besides changing the food quality, you can reduce the portions of food you are eating. Instead of mindlessly emptying a whole bag of chips, you could get a small bowl and fill part of the bag of chips into it. Remove the bag into a cupboard that is difficult to reach. If you are sitting and watching TV, you could eat one chip at a time, but only during commercial breaks. This way your chip eating becomes more conscious and more controlled, and you set a limit. In time you may find that you can replace the chips with a lower calorie food like slices of apples, celery sticks or carrot sticks.

What Makes Chips Addictive?

What Makes Chips Addictive?

Conclusion

Researchers found that chips were addictive in rats and in humans. Functional MRI scans of brains in rats and humans showed that potato chip eating stimulated the nucleus accumbens. It was lighting up in both species when the test subjects consumed potato chips. Surprisingly, it did not matter, whether these were test animals or humans! A review of several research papers showed a similarity between food addiction and drug addiction. It is dopamine and other brain transmitters that stimulate the nucleus accumbens, which is the addiction center. One of the keys, professor Hess from Erlangen University in Germany found, is the fat/carb mix. When the potato chips contained 35% fat and 45% carbs, this stimulated the nucleus accumbens.

Changing your eating habits

Knowing all of this helps us to be able to change our eating habits. To avoid the pitfalls of food addiction, cut out sugar and starchy foods, and remove processed foods from your diet. Also reduce some of the fat to 10% or 15% fat in your total diet. Eat lots of vegetables and fruit low in sugar. In addition you should also consider with portion control to avoid mindless munching. Before you know it you can shed the pounds that you may have accumulated before. You will be able to reduce your BMI to 21 to 23. Many people have done it before you.

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Feb
24
2018

What Causes Premature Aging?

Some people look 10 years older than their stated age, and we often wonder: what causes premature aging? Accelerated or premature aging can have a multitude of underlying causes. I will list a few here:

1. Weakening hormones

Men go through andropause at around the age of 60 to 65 and women go through menopause around the age of 55 to 65. In both males and females it is the sex hormones that are missing around that age. If hormones replacement follows fairly quickly with bioidentical hormones, this will not affect the visual appearance that much. In contrast, if bioidentical hormones are not the therapeutic choice for  hormone replacement, but synthetic ones, the hormones are not in balance, as synthetic hormones do not restore the hormonal balance. Nothing is gained, as the person will still age prematurely.

Synthetic versus bioidentical hormone replacement

In addition the synthetic hormones will cause heart attacks, strokes, clots, and cancer. Prescriptions for synthetic hormones are often the cause that the aging patient population gets these serious complications. Frequently physicians insist on using synthetic hormones from a “reputable” drug company to replace missing hormones. The reason this does not work is that a male has testosterone receptors. They need to be stimulated by bioidentical testosterone to restore all of his missing functions. Also, the same is true in menopausal females who need stimulation of their estrogen receptors and progesterone receptors. Consequently, only bioidentical hormones will return a postmenopausal woman back to normal. There is a perfect fit between the bioidentical replacement hormones and her hormone receptors. Using synthetic hormones is like trying to unlock a door with a key that does not have a perfect fit: you damage the lock!

2. Missing human growth hormone (HGH) and thyroid hormones

These hormones have a special place in aging.

Human growth hormone deficiency

First, HGH production is running out in many people at age 60. A person with HGH deficiency will have lower muscle mass and strength. Other symptoms are dry and thin skin, particularly at the back of the hands. Men are balding, and they loose interest in sex. There are difficulties concentrating and they may have “senior moments”, which are memory lapses. Often they are prone to depression and anxiety. A blood test will frequently show elevated triglycerides. A blood test (IGF-1) and a urine test exist which make it possible to look for HGH metabolites to assess whether a 40, 50 or 60 year-old person is producing enough HGH. Many may need replacement of HGH. This is administered by injection through a tiny needle into the skin, similar to a diabetic injecting insulin. This will bring back what was missing due to HGH deficiency.

Thyroid hormone deficiency

Thyroid hormones (T3 and T4) are other important factors that could make you look older prematurely. Your hair is getting thinner; your skin turns dry and pale. The nails may be getting brittle. When the outside half of the eyebrows is very thin or missing, this can be a sign of hypothyroidism. In a similar vein the skin in the face may be puffed up due to swelling of the layers under the skin (myxedema). It is important to diagnose hypothyroidism, which is common in the aging population. The physician needs to order a blood tests (TSH, T3 and T4). If TSH is above the upper limit, your physician needs to replace both T3 and T4 by tablets (I prefer Armour as the T3 and T4 is balanced).

3. Smoking

The lining of the airways absorb cigarette smoke. The chemicals circulate around in the blood and lead to aging of the skin. Chronic cigarette smoke exposure also melts away the subcutaneous tissue. The end result is a haggard look. The natural glow disappears from the skin and because of carbon monoxide binding to hemoglobin the skin color looks more greyish. In addition the blood vessels are narrowing or clogging. This means that the body cannot absorb nutrients as well, and cells are starving. There is only one remedy for this: quit smoking!

4. Overexposure to ultraviolet light

The radiation of UV light can penetrate deep into and under the skin. This makes the subcutaneous fat melt away. The largest UV exposure is in the facial area. As a result we see aging there. The end result is a sagging appearance of the face. This link has an image of a woman before and after a non-surgical facelift with stem cells and fatty tissue: Stem Cell Treatments That Are Currently Available – Medical Articles by Dr. Ray

In a surgical procedure the physician harvests mesenchymal stem cells from fatty tissue by liposuction. A cell separator separates the mesenchymal stem cells, the connective tissue and the fat cells. The connective tissue is discarded. Mesenchymal stem cells and fat cells are mixed and injected into the thinned subcutaneous fatty tissue until the person’s younger facial contour is back to normal. Typically this will last for 10 years or more.

5. Drugs and alcohol abuse

Both can lead to malnutrition with weight loss and loss of subcutaneous fatty tissue, which causes sagging breasts in women. In men “beer tits” are common. The reason for this is estrogen accumulation, as alcohol interferes with the elimination of estrogen in the liver. Alcohol is a general cell poison. It causes all of the cells to age prematurely. The more alcohol you drink, the faster you age. The skin develops wrinkles, loss of elasticity and collagen, redness and puffiness. In other words chronic alcohol abuse ages you prematurely. The only remedy for this is to quit drinking. Some of your skin vitality may come back. Our body has an amazing capability to heal itself!

6. Medical illnesses

Many medical illnesses like diabetes, mental illness (depression and schizophrenia), multiple sclerosis, inflammatory bowel disease; cancer and others make you look a lot older very fast.

I will briefly explain the reasons for this.

  • Diabetes

With diabetes type 2 the pancreas releases too much insulin after a meal with starches and sugar; think about a sweet muffin or a toast with jam. The extra insulin causes inflammation. This stimulates enzymes that break down elastin and collagen, leading to wrinkles and sagging skin.

  • Mental illness like depression and schizophrenia

We know from studies that depression leads to shortening of telomeres. This in turn causes cell death in the most rapidly dividing cells like in the skin and hair follicles. The end result is prematurely aged hair and skin. Schizophrenia also leads to premature shortening of the telomeres, which causes premature aging, mitochondrial dysfunction, inflammation and oxidative stress. The end result is that the person looks older than what their chronological age is.

  • Multiple sclerosis

It is sometimes difficult to discern in patients with MS what is normal aging and what is aging from the disease. This link gives some background on this. Many MS patients are anxious, and anxiety and stress by itself also leads to premature aging.

  • Inflammatory bowel disease

The chronic inflammation of either ulcerative colitis or Crohn’s disease can lead to premature aging. High doses of vitamin D3 and molecularly distilled fish oil can be useful to help treat the inflammation. Probiotics are also important to restore the bowel flora.

  • Cancer

Cancer leads to cachexia (excessive weight loss). There is also excessive inflammation, which leads to accelerated aging. The inflammation causes increased oxidative stress. This leads to tissue damage and DNA damage, which makes all cells more vulnerable to develop other cancers. Oxidative stress can substantially accelerate telomere shortening. As a result skin can become saggy, wrinkles develop and the person looks prematurely aged.

7. A chronic lack of physical activity

People who never exercise tend to get overweight and eventually obese. This leads to premature aging. Exercise would elongate telomeres, but inactivity shortens them. Obesity leads to increased oxidative stress and to DNA damage. Obesity also shortens telomeres. All of this leads to premature aging.

What Causes Premature Aging?

What Causes Premature Aging?

Conclusion

These are only a few examples of causes of accelerated aging. The key is to stick to a healthy, balanced diet (like the Mediterranean diet) and exercise regularly. Stop smoking (if you do), don’t take street drugs, and make sure you get enough sleep. Getting enough sleep helps your hormones regenerate overnight. The sympathetic overdrive from your daily activities is counterbalanced by the parasympathetic activities during sleep that causes relaxation. For hormone replacement you may have to see an anti-aging physician, a naturopath or integrative medicine physician. This may be your only chance to address any hormonal deficiencies. Conventional medicine does a very poor job of HRT (hormone replacement therapy) with synthetic hormones. Conventional practitioners want to treat you with synthetic hormones that will make you sick. Hormones for replacement have to be bioidentical! This way you will live 10 to 15 years longer, look younger and stay healthy.

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Feb
03
2018

Drugs Are Not An Escape

We have a drug epidemic, but drugs are not an escape. Along with this epidemic there have been thousands of lethal overdoses. I like to review why so many people use street drugs or prescription pain pills. It started years ago with heroin injections had become more popular. But then heroin was getting a bad name, it became illegal, and prescription pain pills replaced heroin. Percocet, OxyContin and morphine prescriptions took off. Together with it the number of people with addiction increased drastically. The latest fashion craze is Fentanyl.  Fentanyl works faster than morphine, but also wears off faster. One of the deadly side effects is respiratory depression. This  means that a person cannot breathe and as a result will die. This is what is happening right now and what creates the news headlines.

Pain receptors

There are pain receptors all over the body, in muscles, organs and the skin. They are called nociceptors. Many medical conditions lead to pain in various parts of the body. For instance, with end stage degenerative arthritis bone rubs on bone. This causes a lot of pain in joints like the knees or the hips. Physicians often prescribe narcotics like OxyContin to control the pain. It may help for some time. But after a few weeks patients complain that the strength of OxyContin has worn off. The same dosage that gave them relief from the pain initially just does not give them relief any more. This observation is crucial. It is exactly what people who use OxyContin as illicit street drug found as well. The drug wears off, because the opioid receptors are getting weaker.

Pain receptor resistance

Nociceptors or opioid receptors are pain receptors. These receptors report pain to the body, and they have connections through the spinal cord to the brain. When an opioid is interacting with the pain receptor it inhibits acute pain to a large extent. But when the pain becomes chronic, the pain receptor is not working as well. More and more of the pain medication is necessary to achieve pain relief.  Eventually the opioid medication is not working to relieve pain any more. The name for this phenomenon is “pain receptor resistance”. Scientific work behind why pain receptors get lazy in responding to opioids is still ongoing. In the meantime it simply is an observation. This is the reason why drug addicts are tending to increase the dosage of OxyContin or of Fentanyl. The toxic threshold of Fentanyl that is exceeded in the process is the reason for the deaths.

Insulin resistance

You may have heard of insulin resistance in diabetics. This is a very similar problem. With insulin resistance the diabetic no longer has a 100% response to insulin. This means that blood sugar is not going through cell membranes effectively as it should when the insulin receptor is working. The blood sugar values stay high and make the diabetes worse.

With pain receptor resistance the opioid is not giving the relief from pain it used to give. No wonder that the patient is feeling frustrated that the pain medication is no longer working properly.

Therapeutic index

The layperson does not normally know that there is a dosage for any drug where it becomes toxic. There is also a lower dosage where the drug is becoming effective. The difference between the two dosages is the “therapeutic window” or the “therapeutic index”.

Morphine has a therapeutic index of 70:1. Compare that to alcohol with a therapeutic index of only 10:1. Fentanyl has a therapeutic index of 300:1.

The danger of Fentanyl

One would think that Fentanyl should be safer than morphine, because the therapeutic index is larger. But the onset of Fentanyl is much faster than that of morphine and by the time drug users take Fentanyl they often are desperate for the drug to take their pain away and they overdose, which causes respiratory depression. If they are not intubated by an anesthetist and connected to artificial respiration, they die very quickly. Janssen Pharmaceutica first developed Fentanyl in 1959. Fentanyl was strictly part of the pre-anesthetic medicine for patients before going into surgery requiring a general anesthetic. The anesthetist was right there and would intubate the patient. That’s why we never heard of deaths from Fentanyl in the past.

If a person gets no pain relief from any opioid because of receptor resistance, the tendency is to increase the dosage. But this is what pushes the person into toxic ranges and this is what causes death from inadvertently suppressing the ability to breathe. People can get into trouble with alcohol overdoses, but the ordinary person usually knows how to handle alcohol. Fentanyl is a lot different due to the fact that respiratory depression (not being able to breathe) is one of the early symptoms that hits you suddenly.

What drugs do to your brain

Dr. Daniel Amen, a psychiatrist and brain researcher has used SPECT brain scans to produce images of different clinical conditions. This link shows the effect of a stroke, of Alzheimer’s disease and of drug abuse on the brain. Dr. Amen says that a brain can be rehabilitated. He has other SPECT images showing the images of an addicted brain and that of a rehabilitated brain. Spect scans are expensive.  But they may be worth it, to impress a drug addict to stop the drugs and get rehabilitated.

Big Pharma and opioid drugs

In 1995 the FDA approved the use of OxyContin for chronic pain. Perdue Pharma, the drug company that had developed this opioid convinced the FDA that OxyContin stayed in the blood for 12 hours and they claimed that by being active longer than other opioids this would lead to better pain control and less addiction. It turns out that this was a slick sales pitch, however it was not true. Pain receptor resistance is as much a problem with OxyContin as with any other opioid. And the drug is as addictive as all the others. But the problem is that the FDA had approved OxyContin. What’s more, Purdue Pharma sent aggressive drug representatives to all the practicing physicians misleading them as well as the FDA that OxyContin would not be as addictive as other opioids.

Penalty for misrepresentation of OxyContin

In 2007 Purdue Pharma had to pay a fine of 634 million $ for misrepresenting the addiction potential of OxyContin. But the drug company was allowed to continue to market OxyContin. Since 2015 Purdue Pharma has been cashing in 2.4 billion $ annually from the sales of opioids including OxyContin. In the meantime Fentanyl, despite its danger of suppressing the ability to breathe, has taken off with regard to sales. Fentanyl also has taken over in terms of causing deaths across the US and other countries.

Alternative treatment of pain

According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). in the meantime the more effective electro-acupuncture has replaced acupuncture needles with the use of electrical skin pads.”

Other applications for electroacupuncture

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. It is effective to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy.

Prolotherapy

Prolotherapy has been successful for the treatment of back and neck pain, for arthritic pain and pain from chronic muscle spasm. When prolotherapy is done by itself 12.5% Dextrose is injected into the area of injury. Dr. Fields said that the reason it works is that there is activation of local stem cells in the injured area in the area of the Dextrose injection site. These stem cells will do the healing (details explained in an interview with Dr. Reeves). Further improvement of this technique and better results are possible by injecting a small amount of platelet rich plasma (PRP) very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are not necessary, but the platelet fraction and some of the plasma are part of the the PRP preparation.

It is often striking how much pain control occurs after only one or two prolotherapy treatments.

Stem cell therapy with PRP and low-dose laser therapy

This is a more direct way to get stem cells where the doctor wants them to do their work. Stem cell therapy with PRP and low-dose laser activation is the latest in terms of controlling pain. At the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014) Dr. Purita gave an overview of this method of pain control. He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They are visible through the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental in stem cell injections with PRP in the past. There was a poor survival rate of stem cells.

Low dose laser activation of stem cells and PRP

Photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections.

Soft laser stimulation with red, green and blue soft lasers have also been effective to improve tissue healing significantly when stem cells and PRP are used together with light activation. The main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). The stem cells mesenchymal stem cells (from fatty tissue) and bone marrow stem cells. The mix of all of this can mend osteoarthritic joints, degenerative disc of the spine, in short all musculoskeletal injuries that may be painful. The hallmark of healing with stem cells is that chronic pain disappears.

Curative treatment versus symptomatic treatment

It is one thing to treat a patient for pain symptomatically by prescribing OxyContin or other opioids. It is a completely other thing when the physician cures the pain by one of these alternative methods. Let us assume that a patient has a fall of a few step from a ladder and sustains a contusion of the lower back. This can be painful and may require a few pain pills. But if it does not improve within one week and diagnostic tests show that there is no fracture, electroacupuncture may be the solution to treat the pain rather than the use of an opioid. If this does not help, consider the combination stem cell/PRP/low-dose laser therapy. Chances are better than 80% that this will help. The patient will no longer suffer of pain. With healing life can go on: no pain pills. No addiction. No death.

Drugs Are Not An Escape

Drugs Are Not An Escape

Conclusion

Conventional medicine treats pain symptomatically instead of treating the cause. It gets the physician to prescribe opioids, which can be the beginning of a series of tragic events. It can lead to drug addiction, dose acceleration, toxic effects of opioids including possible death through asphyxiation from no longer being able to breathe.

Stem cell therapy

The physician who concentrates on treating causes will use alternative methods to treat pain. The most effective of these methods is stem cell therapy. It is a mixture of adipose mesenchymal stem cells with bone marrow stem cells that are part of the therapy. The addition of platelet rich plasma is another part of the mix, and the final step is activation of stem cells with low-dose laser therapy. The cell mix is injected in the critical area. The end result is that the patient’s pain disappears, and it leads to a cure. The only situation where short-term opioids are justifiable is following surgical procedures. But even in these cases the narcotics should only be necessary for a few days to avoid serious side effects.

Reference 1: 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

More info about electroacupuncture: https://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

More about prolotherapy stem cell therapy: https://www.askdrray.com/prolotherapy-and-stem-cell-therapy/

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Sep
30
2017

Parkinson’s Disease May Be Stopped

Parkinson’s disease is common in the US; new research shows that the use of an old anti-depression medication can stopParkinson’s disease The use of nortriptyline, a 50-year old antidepressant has shown to normalize a nerve cell protein. In rats nortriptyline dissolved toxic alpha-synuclein clusters in brain cells. These toxic protein clusters seem to be happening in the brain of Parkinson’s disease patients also. It is the protein by the name of alpha-synuclein that research first found in rats to cause the toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem.

But nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.

Placebo controlled trial with nortriptyline

Now a research team from Michigan State University in Grand Rapids conducted a larger clinical placebo-controlled trial. The lead researcher Collier of the study group found that Parkinson’s patients who received treatment for depression with the tricyclic agent nortriptyline needed less dopamine, the main drug used to treat Parkinson’s disease. This indicated to the researchers that nortriptyline was preserving brain cells that were still making their own dopamine. In rat experiments they could show that it was the dissolving of toxic alpha-synuclein proteins by nortriptyline that was the key to therapeutic success.

Lisa Lapidus, a co-worker on the Michigan State University research team summed up their research: “What we’ve essentially shown is that we are dealing with a drug that the FDA approved already 50 years ago. Patients tolerate the medication relatively well. This could be a much simpler approach to treating the disease itself, not just the symptoms.”

Parkinson’s disease may be stopped also by old diabetes drug

Thomas Foltynie found that the diabetes drug exenatide helps patients with Parkinson’s disease. Dr. Foltynie is a professor of neurology at the University College London and co-author of the study.

Exenatide is an injection drug. When preliminary studies showed that this drug was effective in helping Parkinson’s disease patients lose their problems with walking and balance, a formal study followed.

Professor Foltynie designed a study where 60 people with Parkinson’s disease either got injections of exenatide or placebo injections. Patient exams followed regarding their musculoskeletal system and balance at baseline and every 12 weeks. A score system of 132 points assessed their Parkinson’s disease. After 48 weeks those who had been taking exenatide had a gain of 1 point on that scale while the placebo group dropped 3 points. After 48 weeks the drug administration (exenatide) finished. But after another 12 weeks another scoring and assessment of the Parkinson’s disease symptoms took place. The experimental group on exenatide scored 3.5 points higher than the placebo group. This suggests that exenatide is helping to treat the cause of Parkinson’s disease, not just the symptoms.

Parkinson’s disease may also stop through the use of caffeine

Parkinson’s disease was in the news again because of another study that involved breaking up misfolded alpha-synuclein through caffeine.

Misfolded alpha synuclein forms clumps inside dopamine producing cells in the substantia nigra of the brain stem. Misfolded alpha synuclein acts like a toxin to the dopamine producing cells and eventually these cells die off. This is the brain region that is responsible for making muscle movements smooth and stabilizes balance. The cells that have misfolded alpha synuclein clumps in them also go under the name of “Lewy bodies”.

Dr. Jeremy Lee from the University of Saskatchewan (Saskatoon, Saskatchewan, Canada) has isolated two compounds from coffee. They are called C8-6-I and C8-6-N. They can bind to alpha-synuclein and prevent clumping, which stops the toxic effects on dopamine producing nerve cells. Like with nortriptyline the caffeine effect is a curative approach to Parkinson’s disease.

 

Parkinson’s Disease May Be Stopped

Parkinson’s Disease May Be Stopped

Conclusion

There is a new therapeutic approach to Parkinson’s disease. Researchers have detected a protein called alpha-synuclein to cause toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem. When these cells die from the accumulation of these misfolded proteins, patients come down with Parkinson’s disease. But three different methods of treatment can improve Parkinson’s disease by dissolving the protein alpha-synuclein.

  1. Nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.
  2. Exenatide, an injection drug for diabetes, has been described to help Parkinson’s patients get better.
  3. Caffeine can also dissolve misfolded alpha synuclein (two compounds from coffee called C8-6-I and C8-6-N). This helps patients with Parkinson’s disease to stabilize.

This is only the beginning of a new approach to Parkinson’s disease and an attempt to cure the disease by dissolving the underlying mechanism. So far the drugs that are in use for Parkinson’s disease are only attempting to stimulate dopamine producing nerve cells to produce more dopamine. But the underlying pathology of accumulating misfolded alpha-synuclein clumps is not yet in the treatment protocol. The new research is different, as it takes this into account in an attempt to prevent the condition.

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Sep
23
2017

Close Diabetes Control Prolongs Life

 

A 20-year study showed that close diabetes control prolongs life. A study divided 160 people with diabetes into two groups. The one group continued to get standard care. Yet the other group received a multi targeted, aggressive treatment protocol. As a result after 20 years the group with the intensive treatment protocol lived 7.9 years longer than the group with the standard treatment.

Dr. Oluf Pederson was the senior investigator of the physician team that followed the diabetes group. He said that they concentrated on a number of known adverse factors and treated them aggressively. These factors were first of all high blood glucose values and clotting risks, also high blood pressure and high triglycerides and in addition cholesterol values. Behavior modification was the therapeutic method to get people with risk factors to exercise more, adopt a healthy diet and stop smoking. Medication in select cases also played a role.

More details about the study

The intervention of intensive treatment lasted 8 years. After that the patients were still in a follow-up study for 13 years. At the beginning of the study patients were on average 55 years old and were borderline obese.

The investigation team screened for complications of diabetes. This included screening for kidney disease, heart disease and blindness. Dr. Joel Zonszein, the director of the New York Clinical Diabetes Center at Montefiore Medical Center said: ”These results are impressive and most patients do not receive the correct treatment, according to national surveys.”

Other studies about diabetes  

Foreign studies

Study from Croatia
  • Another study from Croatia involved 200 patients. It concentrated on patients who did not respond to metformin. Physicians used alternative treatment modalities, and they observed and measured blood sugars and hemoglobin A1C in the following 6 months. The study concluded that those patients who received aggressive treatment of their condition did better than those who did not receive the same vigorous approach.
Study from Japan
  • This Japanese study documented that female patients with type-2 diabetes developed kidney damage earlier than their male counterparts.  Consequently, the investigators pointed out how important it is to treat diabetes aggressively to avoid kidney damage.
Study from Singapore
  • This 2016 study from Singapore analyzed retroactively the impact of diabetes on the long-term survival after coronary bypass grafting (CABG).  5720 consecutive patients had their isolated first CABG surgery between 1982 and 1999. The mean follow-up was 13 years. 34.6% of the patients had diabetes, 51% had high blood pressure and 46.6% had elevated blood lipids. The initial mortality after the CABG surgery was 2.4% in the diabetic group and 1.8% in the non-diabetic group. 20-year survival rates following CABG surgery were 30.9% in diabetics and 49.2% in the non-diabetics, an 18.3% difference. The 20-year freedom from cardiac mortality rates was 56% in diabetics and 68.4% in non-diabetics. Other risk factors that led to cardiac mortality were the following: female gender (1.43-fold risk), diabetes (1.51-fold risk), previous heart attack (1.54-fold risk) and a low left ventricular ejection fraction of less than 35% (2.6-fold risk). The conclusion from this study was that long-term survival in diabetics following CABG surgery was much lower than that of non-diabetic controls. Hence the key to improving long-term survival for diabetics is to treat comorbidities like high blood pressure and elevated lipids aggressively as well as getting blood sugars and hemoglobin A1C values under control.

US studies

  • In this US study 558 youth (age less than 21) between February 2012 to July 2015 received follow-up. Between 40% and 50% of these diabetics needed insulin to improve their diabetes. Unfortunately their diabetes showed poor control, as their high hemoglobin A1C values indicated. Median HbA1C was 6.7%, 8.5%, 9.6%, and 9.7% in those with disease duration less than 1 year, 1-2 years, 2-3 years and less than 4  In other words, the longer the young patients had diabetes, the less seriously they took their treatment. Only 33% treated their high blood pressure and only 11% their elevated blood lipids. Microalbuminuria, an indicator of diabetic kidney disease, and non-alcoholic fatty liver disease were present in 5% to 6% of these young diabetic patients. The authors came to the conclusion that there were serious gaps in treating these young diabetics. Further follow-up data of the same group of patients in the coming years will provide further data. In conclusion, the new hemoglobin A1C ranges of 3.8% to 4.9% as the new normal range explains why these youths who do not treat their diabetes properly are at high risk to develop complications from their poorly controlled diabetes.
Heart attacks and erectile dysfunction
  • Heart attacks are more common among patients with uncontrolled diabetes. This US study classified diabetics according to the tightness of their diabetes control. Researchers found examining 606 men and 606 women with diabetes that they could reduce their risk of a heart attack, if they controlled smoking, glycated hemoglobin (hemoglobin A1C), systolic blood pressure, and total and high-density lipoprotein cholesterol. The control of all these risk factors could contribute to the prevention of heart attacks. 35% of men and 45% of women could prevent having a heart attack. A laxer control still would prevent 36% of heart attacks in men and 38% in women. A very aggressive diabetes control could prevent 51% of heart attacks in men and 61% in women. Most noteworthy: close diabetes control prolongs life.
  • Erectile dysfunction (ED) is a big problem among diabetic men. This study from Seattle shows the investigation of 136, 306 men with erectile dysfunction. 19, 236 of these men had diabetes prior to their ED problem. Over a two-year observation period diabetic men had much worse ED problems. As a result they needed to receive secondary line treatments  like penile suppositories or injectables. Others needed tertiary treatments like penile prostheses. In those whose diabetes control was good, oral agents as first-line therapies were usually sufficient.
More studies about risks and benefits of lifestyle
  • Middle-aged women with diabetes have a 4- to 5-fold higher risk for developing heart attacks while men do not show such a higher risk. It is probably particularly important for women to control diabetes when they are diagnosed with it to reduce the risk of coming down with a heart attack.
  • In 2011 Taylor from Newcastle University showed in a group of diabetes patients that he could cure diabetes permanently with an extremely low calorie diet. The trial was simple: he took overweight or obese patients with diabetes and put them on a starvation diet of 600-700 calories per day for 8 weeks. Consequently 43% of diabetic patients received a permanent cure of their diabetes. More info: http://nethealthbook.com/news/cure-diabetes-permanently/

 

Close Diabetes Control Prolongs Life

Close Diabetes Control Prolongs Life

Conclusion

The new hemoglobin A1C ranges that are desirable are between 3.8% to 4.9%. When diabetics bring their hemoglobin A1C level into this range, they do not get complications from their previously poorly controlled diabetes. Close diabetes control prolongs life. But as can be seen from a brief review of the literature physicians tend to be lax, patients are lax, and diabetes is often not well controlled. This leads to erectile dysfunction in males, to heart attacks and kidney failure in both sexes. Blindness and painful diabetic neuropathy are also common complications of poorly controlled diabetes. Amputations from clogged arteries are also among the complications. “Close diabetes control prolongs life” is the new mantra that everybody with diabetes needs to follow.

Lifestyle changes control diabetes and prolong life

As stated above Dr. Taylor from Great Britain has shown that a brief 600 to 700 calorie diet can cure 43% of diabetic patients permanently. Quit smoking, bring the glycated hemoglobin (hemoglobin A1C) into the normal range, control your systolic blood pressure as well as your total and high-density lipoprotein cholesterol. Do all these things, exercise regularly, and your diabetes will be well controlled. Remember: close diabetes control prolongs life!

Aug
26
2017

Decreased Sperm Counts In Men

What do decreased sperm counts in men tell us about our world? A recent study has shown that over the past 40 years males in many centers that tested for sperm counts have lost 50% of the sperm count that was normal in the 1970’s. The question is, what could have caused this? Nobody has definite answers. But here are the factors that the Mayo Clinic lists for low sperm counts.

Medical causes of decreased sperm counts in men

  • A varicocele: A varicocele is dilatation of veins close to the testicles. It is presumed that this leads to a higher temperature inside the testicles and this causes a lowered sperm count and poor sperm quality.
  • Antisperm antibodies can cause infertility. Due to low sperm counts.
  • Infections in the testicles reduce sperm production. Gonorrhea and HIV infection are some of the common infections.
  • Some men develop retrograde ejaculation. With this the sperm enter the bladder on ejaculation instead of coming out from the tip of the penis. Alpha-blockers, a type of blood pressure medication can do this as a side effect. But there are also various health problems that can cause retrograde ejaculation like diabetes, surgery to the prostate, urethra and bladder. Spinal injuries can be also a cause of retrograde ejaculations. In many cases the sperm production in the testicles is still present and sperm could be sampled from there for artificial insemination.
  • Tumors of the pituitary gland can interfere with hormone production of testosterone and sperm counts will fall or stop. But other pituitary hormones, thyroid hormone and adrenal gland hormones are needed for fertility.
  • Chromosome defects like Klinefelter syndrome and others can be a cause of abnormal development of the male genitals with low or missing sperm production.
  • Celiac disease is a bowel disease that is due to gluten sensitivity. It causes low sperm counts and infertility, which responds to a gluten free diet. Sperm counts normalize with this diet.
  • There are medications that can decrease sperm production like chemotherapy, anabolic steroid use, antifungals and certain antibiotic medications and some ulcer medications.

Lifestyle causes leading to decreased sperm counts in men

Certain lifestyles and occupations can cause a man to have a decreased sperm count.

  • Drinking alcohol excessively can reduce testosterone production, which decreases sperm count.
  • Recreational drug use: steroids to increase muscle mass cause testicular atrophy and decreased sperm count. Cocaine and marihuana also decreases the sperm count.
  • Certain occupations like welding from exposure to heat and truck driving from prolonged sitting have been associated in some studies with infertility. But there are other studies that could not confirm this correlation.
  • Smoking: Men who smoke have lower sperm counts than men who don’t smoke.
  • Excessive weight: Obese men transform some of their testosterone into estrogen through the action of the enzyme aromatase, which is amply present in fat cells. This leads to low testosterone levels and low sperm counts.

Environmental causes of decreased sperm counts in men

The environment in terms of heat production around the scrotum or exposure to chemicals or ionizing radiation can lower sperm counts in men.

  • Heat around the testicles: studies do not all agree, but there is a tendency for low sperm counts when using saunas and hot tubs frequently. Sitting for longer times or using a laptop computer for longer periods can also increase the temperature of a man’s scrotum and lead to a low sperm count.
  • Exposure to heavy metals like lead, mercury and others can be the cause of infertility.
  • Exposure to radiation can reduce sperm production. With high doses of radiation sperm production may cease entirely. With lower radiation exposures sperm counts may be down for several years before they recover to normal.
  • Industrial chemicals: exposure to fumes from certain chemicals can lead to low sperm counts; benzenes, herbicides, pesticides, xylene, toluene, painting materials and organic solvents are on this list.

Recent study about decreased sperm counts in men as an indicator

We have now reviewed the major causes of low sperm counts in men. I like to revisit the recent sperm study I mentioned in the beginning of this blog. It is unlikely that men in North America, Europe and Australia would spontaneously produce less than 50% of the sperm than men 40 years earlier had produced. The next puzzling fact is that the study found normal sperm production in men in Africa, South America and Asia.

This points to epidemiological differences that reduce the sperm count in men in North America, Europe and Australia. In view of the multitude of possible causes it will require a task force that does a comparative study worldwide looking at exposure history, diets, social habits and other factors.

Fertility clinics are thriving because couples want children. With low sperm counts of males there is more infertility than there was in the past. Density gradient centrifugation is a reliable method of enriching sperm counts.

In the past a couple had no problem getting a successful pregnancy when they wanted it. Now couples often have to be assessed in a fertility clinic because of problems with regard to decreased sperm counts in men, which can cause infertility.

Decreased Sperm Counts In Men

Decreased Sperm Counts In Men

Conclusion

A new study has noticed that over the past 40 years many men have developed low sperm counts. This has caused significant problems with fertility among couples. Fertility clinics are busy trying to help these couples. Density gradient centrifugation has become a common technique to enrich sperm samples prior to artificial insemination. It is a puzzle why the recent study has found normal sperm counts in samples of men living in Africa, South America and Asia. In contrast men living in Europe, North America and Australia have 50% lower sperm counts. The reason may be multifactorial. It will require a team of experts to sort out this discrepancy and hopefully find an answer for men in Europe, North America and Australia to bring their sperm counts back to normal.

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Dec
31
2016

What Works Against Alzheimer’s?

.Eli Lilly’s promising drug solanezumab failed; so, what works against Alzheimer’s? This drug was supposed to dissolve the amyloid deposits that function like glue and make the patients lose their memory. This phase 3 trial was to test the drug on patients to assess efficacy, effectiveness and safety. But instead it showed that the new drug did not stop the loss of memory.

Brain bleeding as a side effect of potential Alzheimer’s drug

Now all those who were hoping for solanezumab to be effective, will jump on another drug, aducanumab. Biogen from Cambridge, Massachusetts, has developed this drug. Out of 165 subjects only 125 completed preliminary studies. 40 patients who discontinued it, had negative side effects. These included fluid building up in the brain, which was thought to be due to removal of the plaques. But others, had brain bleeding.

Although the drug manufacturer is still hoping that aducanumab will work out as an anti-Alzheimer’s drug, I have my doubts. A drug that can have potential brain bleeding as a side effect does in my opinion not qualify as an anti-Alzheimer’s drug.

Factors that help prevent Alzheimer’s

1. Diet can be as effective as a drug in treating Alzheimer’s

In September 2015 researchers from Rush University published results of putting Alzheimer’s patients on the MIND diet. The MIND diet was a prospective study where 923 people aged 58 to 98 years participated. Researchers followed these people for 4.5 years. Three groups of diets were tested: Mediterranean diet, DASH diet and MIND diet.

The MIND diet study result

The adherence to the diet was measured: those who followed the diet very closely, other participants who were less diligent, and finally those who were not compliant with the diet. With regard to the MIND diet the group with the highest adherence to the diet reduced the rate of Alzheimer’s by 53% compared to the lowest third. This is like a highly effective Alzheimer’s drug! The second group still was able to reduce the rate of Alzheimer’s by 35%, which would be like a regular strength drug. The control diets were the DASH diet and the Mediterranean diet. The group that was strictly adhering to the DASH diet reduced Alzheimer’s by 39%, the group that was very conscientious in adhering to the Mediterranean diet reduced Alzheimer’s by 54%. The middle thirds of both control diets did not show any difference versus the lower thirds.

Findings of Alzheimer prevention by diet

The conclusion was that a strict Mediterranean diet had a very good Alzheimer prevention effect, as did a strict MIND diet. However, when patients did not adhere too well to a diet, the MIND diet was superior still yielding 35% of Alzheimer’s prevention after 4.5 years. The other diets, when not adhered to that well, showed no difference from being on a regular North American diet. Here is more info about the MIND diet.

Conclusion

Avoid the Standard American Diet. Adopt a Mediterranean diet and stick to it in a strict fashion or adopt the MIND diet. The other benefit is that there are no side effects!

2. Stress and Alzheimer’s

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

Psychological stress ratings went back to 1968,1974 and 1980. 161 females developed dementia (105 of them Alzheimer’s disease, 40 vascular dementia and 16 other forms of dementia). The risk of dementia was higher in those women who had frequent/constant stress in the past. The condition became more severe the more stress they had to face in the past. Women with exposure to stress on one, two or three examinations had higher dementia rates later in life in comparison to women who had no exposure to any significant stress. Specifically, dementia rates were 10% higher after exposure to one stressful episode, 73% higher after two stressful episodes and 151% higher after exposure to three stressful episodes.

Conclusion

Prevention of Alzheimer’s is possible by avoiding stress and seeking counselling when stress occurred .

3. Be creative, prevent Alzheimer’s and dementia

In an April 8, 2015 publication from the Mayo Clinic in Rochester, MN and Scottsdale, AZ 256 participants aged 85 years and older (median age 87.3 years, 62% women and 38% men) were followed for 4.1 years. Psychological tests measured mild cognitive impairment (MCI). At the time of recruitment into the study all of the tests for MCI were normal. As the study progressed it became apparent that there were various risk factors that caused the onset of MCI, which is the immediate precursor of dementia/Alzheimer’s disease.

The finding was that the presence of the genetic marker APOE ε4 allele carried a risk of 1.89-fold to develop MCI and later Alzheimer’s disease.

Further findings of the study

When patient showed signs of depression at the time of enrolment into the study, the risk of MCI development was 1.78-fold. Midlife onset of high blood pressure led to a 2.43-fold increase and a history of vascular disease showed a relationship of 1.13-fold higher MCI development. The good news was that four activities correlated with a lower risk of developing MCI with aging. When the person engaged in artistic activities in midlife or later in life the risk for MCI development 73% lower, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life reduced MCI development by 53%. These are very significant observations. This would be equivalent to highly effective anti-Alzheimer’s drugs.

Conclusion

If you stimulate your mind in older age, even browsing on the computer, this will help you to prevent Alzheimer’s disease.

4. Lifestyle factors contributing to Alzheimer’s

a) Sugar consumption: Sugar consumption and too much starchy food like pasta (which gets metabolized within 30 minutes into sugar) causes oxidization of LDL cholesterol and plaque formation of all the blood vessels including the ones going to the brain. On the long-term this causes memory loss due to a lack of nutrients and oxygen flowing into the brain.

b) Lack of exercise: Lack of exercise is an independent risk factor for the development of Alzheimer’s disease. Exercise increases the blood supply of the brain, strengthens neural connections and leads to growth of neurons, the basic building blocks of the brain. Exercise increases mood-regulating neurotransmitters like serotonin and endorphins.

c) Sleep deprivation leads to memory loss, but so does the use of aspartame, the artificial sweetener of diet sodas. Make your own homemade lemonade. Squeeze the juice of half a lemon. Add mineral water to fill an 8 oz. glass. Add a tiny bit of stevia extract for sweetening. Stir and enjoy. Stevia has been in use for thousands of years.

5. Hormone changes

A lack of testosterone in men and estrogen in women interferes with cognition and memory. For this reason it is important after menopause and andropause (=the male menopause) to replace what is missing with the help of a knowledgeable health professional.

Progesterone is manufactured inside the brain, spinal cord and nerves from its precursor, pregnenolone, but in women it also comes from the ovaries until the point of menopause. The myelin sheaths of nerves requires progesterone and progesterone also has a neuroprotective function. In menopausal women bioidentical progesterone is a part of Alzheimer’s prevention.

Melatonin is a hormone, a powerful antioxidant and a neurotransmitter at the same time. It helps in the initiation of sleep, stimulates the immune system and protects from the toxic effects of cobalt. Lab tests in Alzheimer’s patients found elevated values. In an aging person it is wise to use melatonin at bedtime as a sleep aid and to preserve your brain.

6. Genetic risk of Alzheimer’s

At the 22nd Annual A4M Las Vegas Conference in mid December 2014 Dr. Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She pointed out that there are about 5 genes that have been detected that are associated with Alzheimer’s disease and in addition the apolipoprotein E4 (APOE4). About 30% of people carry this gene, yet only about 10% get Alzheimer’s disease, which shows how important lifestyle factors are (in medical circles physicians call this the “epigenetic factors”) to suppress the effect of the APOE4 gene. She also stated that our genes contribute only about 20% to the overall risk of developing Alzheimer’s disease. This leaves us with 80% of Alzheimer’s cases where we can use the brain nutrients and hormones discussed above and exercise to improve brain function.

7. Vitamin D3 protects your brain from Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease of old age. We know that it is much more common in patients with type 2 diabetes where insulin levels are high. Studies have shown that Alzheimer’s disease can be termed type 3 diabetes.

The resulting neurofibrillary tangles and amyloid-beta deposits damage nerve cells, which are responsible for the memory loss and the profound personality changes in these patients.

What does vitamin D3 have to do with this?

A 2014 study showed that a low vitamin D level was associated with a high risk of dementia and Alzheimer’s disease.

Specifically, the findings were as follows.

  • Vitamin D level of less than 10 ng/ml: 122% increased risk of Alzheimer’s
  • Vitamin D level 10 to 20 ng/ml: 51% increased risk of Alzheimer’s

The same research group found in two trials that vitamin D deficiency leads to visual memory decline, but not to verbal memory decline.

Generally supplements of vitamin D3 of 5000 IU to 8000 IU are the norm now. But some patients are poor absorbers and they may require 15,000 IU per day. The physician can easily determine what the patient needs in the dosage of vitamin D3 by doing repeat vitamin D blood levels (as 25-hydroxy vitamin D levels). The goal is to reach a level of 50-80 ng/ml. The optimal level with regard to nmol/L is 80 to 200 (according to Rocky Mountain Analytical, Calgary, AB, Canada).

8. Avoid sugar overload

We already mentioned sugar consumption under point 4. But here I am mentioning it again because of the insulin reaction. An overload of refined carbs leads to an overstimulation of the pancreas pouring out insulin. Too much insulin (hyperinsulinemia) causes hormonal disbalance and leads to diabetes type 3, the more modern name for Alzheimer’s. All starch is broken down by amylase into sugar, which means that anybody who consumes starchy food gets a sugar rush as well. Too much sugar in the blood oxidizes LDL cholesterol, which leads to inflammation in the body. The consequence of chronic inflammation are the following conditions: hardening of the arteries, strokes, heart attacks, Alzheimer’s due to brain atrophy, arthritis, Parkinson’s disease and cancer.

What Works Against Alzheimer’s?

What Works Against Alzheimer’s?

Conclusion

In the beginning we learnt about a failed phase 3 trial regarding an anti-Alzheimer’s drug. Next we reviewed several factors that can all lead to Alzheimer’s and that have been researched for many years. It would be foolish to think that we could just swallow a pill and overlook the real causes of Alzheimer’s disease. I believe there will never be a successful pill that can solve the increasing Alzheimer’s problem. It is time that we face the causes of Alzheimer’s. This means cutting down sugar to normalize your insulin levels.

Lifestyle changes necessary to avoid Alzheimer’s

We need to supplement with vitamin D3 because we know that it helps. For women in menopause or men in andropause it is time to replace the missing hormones with bioidentical ones. We need to handle stress and avoid sleep deprivation. And, yes we need to exercise regularly. Following a sensible diet like the Mediterranean diet or the MIND diet makes sense. And let us keep our minds stimulated. Chances are, when we do all of this that we will not need any Alzheimer’s pill. This is not good news for the drug companies, but will be very good news for you. Last but not least, there are no side effects, only health benefits!

Additional resource on how to preserve your memory.