Aug
23
2014

Ebola Virus An Emerging Killer Infection

By | Abdominal Pain, Infectious Disease, Prevention

Ebola virus has now infected about 2600 and killed more than 1400 people in its short history. That’s a mortality of about 54% overall.

Two Americans who had been treating patients with Ebola virus disease (formerly called Ebola hemorrhagic fever) in Liberia, West Africa had been treated back in the US at a hospital in Atlanta. They have just been released as cured. They have been treated with an experimental drug called ZMapp. This is a monoclonal antibody from mice against surface components of the Ebola virus.

At this point no safety studies on humans have been performed with ZMapp, but a recent ethics committee meeting of the WHO has determined that the emergency use of ZMapp would be ethically acceptable due to the high death rate of the disease otherwise without treatment.

Other scenarios of killer infections

Several decades back some of the diseases mentioned in this article were basically unknown to the general population, but in the meantime some new infectious diseases have received a lot of media attention.

You will remember that there was an outbreak of anthrax spores by inhalation in 2001 in the US. A recent New England Journal of Medicine report points out that prior to 2001 the death rate of patients who had inhaled anthrax spores was 80% to 90% even with the use of antibiotics. However due to earlier detection and diagnosis, and due to aggressive supportive measures this epidemic of anthrax by inhalation had a mortality of only 45% toward the end or that epidemic. Had there been a new substance used that was ineffective, but harmless otherwise the reduced death rate would have been attributed to the erroneous conclusion that this new drug was effective in reducing mortality rates. This article cautions that rigid safety and effectiveness studies have to be done on ZMapp to ensure that it is a safe and effective drug to treat Ebola virus and that the reduction in death rates is truly from the drug, not just from improved supportive measures.

Other newer infections have been Marburg hemorrhagic fever caused by the Marburg virus. This also belongs to the Filoviridae family of viruses to which Ebola virus belongs as well. Then there is the SARS virus, the cause of severe acute respiratory syndrome. Not too long ago the BSE prion, which is the virus causing bovine spongiform encephalopathy made history.

What do we know about the Ebola virus?

There are 5 strains of the Ebola virus, one of which (the Zaire strain) is responsible for the present outbreak of Ebola virus disease in Africa. Dr. Jon Lai who is associate professor of biochemistry at the Albert Einstein College of Medicine in New York City has developed antibodies in mice that will slow down and attack the aggressive Ebola virus when it enters the human body.

Ebola virus disease occurs in remote villages of the rainforest in Central and West Africa where fruit bats are the natural hosts of Ebola virus. It is transmitted from local fruit bats to animals (monkeys among others), to humans and can then be transmitted to other humans. The virus is not as easily transmitted as colds or the flu. For instance, the Ebola virus does not transmit through the air, food or water. But you can get Ebola virus through skin contact, fluid contact and through needles with blood from an infected person. Also, when surfaces are contaminated with infectious body fluids and you touch this contaminated surface with your skin, the virus will penetrate through the skin and get you infected.

There have been several outbreaks in Africa since 1976 as you can see from this WHO link.

This link also suggests that proper hygiene measure like cleaning of pig and monkey farms with sodium hypochlorite should be effective in inactivating the virus, which makes virus transmission to humans more difficult.

Ebola Virus An Emerging Killer Infection

Ebola Virus An Emerging Killer Infection

Symptoms of Ebola virus disease

Ebola virus disease has an incubation time of 8 to 10 days where the person may complain of some tiredness, but is not sick yet. This is the time when the Ebola virus multiplies. It  paralyzes the immune system and distributes itself through the organ system.

After these initial days of incubation there is a sudden onset of a sore throat, high fever and headaches, lack of appetite, a stomachache and weakness.

Now the Ebola virus disease takes off and becomes life threatening as the major organs are infected with the virus, and as a result, vital organs shut down their functions. As the production of coagulation factors from the liver stops, there is major bleeding from body orifices (nose, ears, eyes, mouth, and bloody diarrhea). A skin rash develops all over the body from bleeding into the skin.

At this point the disease gets out of control as the blood circulation collapses and the affected person dies in shock. Otherwise, if fluid loss can be corrected in time with intravenous fluids, there is the danger to die from multi-organ failure. A few persons manage to survive, if the immune system produces enough antibodies in a timely manner to inactivate the Ebola virus.

Treatment options

At this time there is no effective treatment against the Ebola virus disease. As mentioned earlier, ZMapp is an experimental drug that may have some merit treating Ebola virus disease in the future, but at this point it is considered experimental as human safety studies and effectiveness studies of the drug have not been completed. Any experimental treatment with ZMapp will be part of these studies for the next few years, but production issues will have to be sorted out as well as presently there is not enough ZMapp around to treat all of the Ebola virus infected people in Africa.

This leaves us with the only preventative approach of interrupting the infectious pathway. We do know that there is a geographic zone in Africa where fruit bats, the natural hosts of Ebola virus live. It is in the same geographic zone that all of the known Ebola virus disease cases have originated from. It follows from this that it is safer for humans to live outside that zone. So do not plan sightseeing or other trips into those areas, if you value your life; I should qualify this by saying “until an effective treatment against the Ebola virus has been established”.

Those who bury dead ones who came down with this disease must wear safety suits, which look like space suits. As already indicated, surfaces need to be disinfected with sodium hypochlorite. All of these hygienic measures interrupt the Ebola virus transmission. Quarantine measures need to be strictly enforced for those who are suspected of harboring Ebola virus disease to prevent spreading this disease into the rest of society.

Conclusions

Although the medical puzzle of the Ebola virus disease has not yet been completely solved, there are encouraging facts that have been learnt. The Ebola virus has been around Africa since 1976 and several outbreaks have occurred on this continent since. But spread beyond these borders has been avoided due to strict isolation practices. Even within Africa the worst cases of Ebola outbreaks have occurred mostly in villages where hygienic measures are not adhered to as thoroughly when compared to larger African cities where isolation around Ebola virus disease patients is strictly enforced by the local authorities.

Hopefully with the emergence of an effective treatment this disease will get out of the lime light as did other killer diseases in the recent past.

More information on Ebola virus: http://nethealthbook.com/infectious-disease/infectious-disease-infections/ebola-virus/

Last edited Nov. 8, 2014

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Aug
13
2014

Pure Water A Necessity

By | Infectious Disease, Nutrition, Prevention

Water has been in the news a lot: there has been the Toledo, Ohio incident affecting 400,000 residents because toxins of algae from Lake Erie entered into the public water system. At about the same time in northern British Columbia, Canada there was a broken dam from a mining company’s toxic wastewater reservoir spilling toxic wastewater into the Fraser River drinking water system.

Between 60 and 70% of our bodies are made up of water. We need water for a multitude of biochemical reactions that constantly take place within us. We need water to “run the engine”. This includes detoxification of our bodies as water is a large part of our kidney excretions (urine) and still is a significantly percentage of our stools. Water is the basis for our blood circulation.

Having said all this it is important that we insist only drinking pure water. In the following I will describe why this can be a problem and how to solve this problem.

Brief history of water purification

The first sand filter for water purification was developed in Scotland by a private company in 1804.

Based on this success, the Chelsea Waterworks Company in London in 1829 was founded, which was the first public water supply in the world. When a  choleraepidemic hit London in 1854, physician Dr. Snow discovered that cholera was confined to those districts in London where water was not purified and he provided the authorities with a dot map depicting the cholera cases in London, which correlated with the water system that used no filtration methods. When the pumps were switched off in this district of London, the cholera epidemic subsided.

Europe adopted the English model in the late 1800’s and added sewage treatment plants in order to separate wastewater from drinking water. The first sewage treatment plant was built in Frankfurt in 1887. This was necessary because of huge epidemics of cholera and typhoid fever that swept through Europe. When separation of sewage and drinking water was achieved, these epidemics stopped.

It is interesting that minimal water standards were introduced in the US only in 1914 and it took until 1940 before water purity was legislated federally.

Pure Water A Necessity

Pure Water A Necessity

Toxins in water

Townships have to get the drinking water they pipe into your house from somewhere. Often this is a lake, an artesian well or several artesian wells combined; in the past it was from rivers, but they are now mostly contaminated with sewage and chemicals.

There is the added problem that natural soil compositions vary tremendously throughout a country, so that arsenic is found very high in some parts of the world and the drinking water can be high in arsenic in those places.

Arsenic is contained naturally in soils of some areas, so-called “hot spots“.

It follows from here that some springs can also be contaminated with arsenic and other heavy metals. Heavy metals poison our internal enzyme systems and interfere with the body’s metabolism.

A well is more likely to contain arsenic than a river or lake as a water source. But we do not only concern ourselves with toxins; viruses and bacteria are also a problem.

Bacterial and viral contamination

In Europe, before cities built sewage systems it was not uncommon that excrements from humans and animals found their way into the well that was used for drinking water. We like to think that we are safe now with all of the laws and measures in place, but the various news stories teach us otherwise. Common bacterial contaminants are Salmonella, E.coli (strain O157:H7), Giardia lamblia, Legionella, the parasite Cryptosporidium and others.

In Canada there was a tragic incident in 2000 where thousands of residents of Walkerton, a small town in Ontario were exposed to E.coli (strain O157:H7). This was due to a chlorination unit that was not working, but those who were responsible for water quality maintenance were denying it and were not even properly trained to run the chlorination equipment.

Water testing

Water testing is at the beginning of any water purification system and intermittent ongoing testing is at the center of monitoring water quality on a permanent basis. Water inspectors need to constantly monitor the water source, the water purification process and the delivery system.

Many people in rural Canadian or US towns depend on well water. The same logic is true for water quality with regard to well water as it is for municipal water; just it is on a smaller scale.

You want to know what your water is like. It is not difficult to find out: take a water sample and have it analyzed at a water company. Depending on the result the water company will advise you what kind of filter you will need.

The first purification stage typically is an activated carbon filter that removes organic compounds, radon and other impurities. Every three or four days the filter automatically backwashes and cleans itself for about 45 minutes. Once a year the activated carbon has to be removed and replaced by a new filter. This type of filter is also useful for people who are on municipal water, but want to remove the halogens (fluoride, bromide, chloride) used to disinfect municipal water.

The second stage is an ultraviolet irradiation device. This disinfects the water just prior to coming to your water tap from any bacteria, viruses or parasites.

It is recommended that you also install a reverse osmosis system under your main kitchen sink. It will provide you with purified drinking water. Water produced by this filter goes through additional activated carbon filters and finally must pass through a porous membrane where only water can pass through, but heavy metals and other impurities will not. During an outbreak of Cryptosporidium in 1996 in Kelowna, BC those who had a reverse osmosis system were safe from this pathogen.

You can brush your teeth with confidence with reverse osmosis water, even if your drinking water is contaminated.

Proper water purification

If you are on municipal water, find out what system the municipality is using to ensure water safety. Usually there is a first step of a slow sand filter, where the raw water is first purified, then it undergoes a water chlorination, bromination or fluoridation process, which is done to remove bacteria and viruses. We know, however from a series of outbreaks of Cryptosporidium gastroenteritis cases in municipalities that only used this two stage purification process, that a third step, namely ultraviolet germicidal irradiation, is also necessary to eradicate this microscopic parasite.

Cryptosporidium was the problem behind a drinking water problem in the summer of 1996 in Kelowna, BC, the town of the interior of BC, Canada where I live. 50,000 residents had to get their drinking water from water trucks that were parked at certain locations of the town (about 40% of the population was affected by this water problem). Kelowna now has a modern ultraviolet irradiation system in place.

Immune system compromised people

People whose immune system is compromised such as AIDS patients or patients who had chemotherapy for cancer are very susceptible to Cryptosporidium and other parasites, bacteria and viruses. For them it is particularly important that the third stage, the ultraviolet irradiation step be part of the municipal water treatment process. If this is missing, have a home unit installed by a water company.

Conclusion

It is interesting to see how in Europe the history of water purification has been tightly linked to the history of cholera and typhoid fever epidemics; the quest for learning from these mistakes of the past has brought new solutions. The mistake in the past had been that in water sources wastewater contaminated the drinking water sources. To our modern thinking this seems unimaginable. But recent events that we read about in the news remind us that we cannot be lax on water purification. It is a reality that the same mistakes from the past are still sporadically made now! Know your water source; know the water quality of the water you brush your teeth with (for instance use only bottled water for this in Mexico). Remember that in many development countries to which you may travel there is no clear separation of drinking water and wastewater and there may not be a three-phase filtration system in place that I described above.

Enjoy drinking your clean, refreshing clean water until I meet you again in another blog.

More information on gastroenteritis (from unclean water): http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/gastroenteritis-food-poisoning/

Last edited Nov. 8, 2014

Jan
18
2014

The Superpowers Of Vitamin D

By | Alzheimer’s disease, Arthritis, Asthma, Autism, Cancer, fractures, heart attack, Heart Disease, High Blood Pressure, Infectious Disease, Infertility, Medical Condition, Multiple sclerosis, Nutrition, Osteoporosis, Other neurological conditions, Prevention, Vitamins and supplements

Introduction

This article deals with the superpowers of vitamin D. Originally, researchers found that vitamin D was the missing ingredient in preventing rickets in growing children. They established that 400 IU of vitamin D daily prevented rickets. Medical investigators determined that the active metabolite was vitamin D. The body has receptors on all vital organs for vitamin D. This includes the heart, brain, bones, kidneys and liver. In recent years new findings showed that the RDA of 400 IU of vitamin D3 daily was too low for many diseases. In other words, many diseases can develop when vitamin D intake is too low, particularly in the aging population. Researchers showed that higher doses of vitamin D3 in the range of 800 to 1000 IU per day prevent osteoporosis, falls and fractures in older adults and in nursing home populations.

The immune system requires higher doses of vitamin D3

But the immune system of everybody is dependent on higher doses of vitamin D3. Recently (Dec. 12 to 15, 2013) I attended a lecture at the A4M conference in Las Vegas where Dr. Eisenstein reviewed the latest on vitamin D3. It is now known that 2/3 of the US population is deficient for vitamin D as measured by blood tests (less than 25 ng/ml).  The standard test is the 25-hydroxy-vitamin D level (abbreviated as 25(OH)D level). It is now known that you require at least a level of more than 40 to 60 ng/ml of 25(OH)D as measured in the US, which translates to more than 100 to 150 nmol/L measured in metric units in other countries, to prevent cancer.

The Super Powers Of Vitamin D

The Super Powers Of Vitamin D

Metabolism of vitamin D3

90% of the vitamin D3 that we need comes from exposure to sunlight. This transforms a cholesterol metabolite (7-dehydrocholesterol) into the vitamin D precursor (vitamin D3 or cholecalciferol). We absorb this from naturally occurring fish oil and oily fish. Otherwise this does not naturally occur in foodstuffs (Ref. 1). Dr. Eisenstein pointed out that it is well known that people living north of the 37th degree latitude lack vitamin D3 because of a lack of sun exposure, particularly in the winter season. People south of the 37th degree latitude have enough sun exposure. But wherever you live, it is advisable to have your vitamin D3 level measured (as 25(OH)D level). If you do not eat enough fish or fish oil, the levels likely are too low as is the case for 2/3 of the US population.

Oral vitamin D3 supplements

Patients whose vitamin D levels are too low have to take vitamin D3 supplements. Vitamin D3 is further metabolized by the liver and then by the kidneys into the active vitamin D compound, called 1,25(OH)2D3 (which is called “calcitriol”). The main effect of calcitriol is to absorb calcium and phosphate from the intestine into the blood stream. Together with vitamin K2 as explained in a prior blog these minerals are then taken up by the bone to prevent osteoporosis or rickets in the growing child. What has not been known for a long time is that vitamin D3 is also necessary for normal cell metabolism by most of your body cells, but particularly by the vital organs like the brain, the heart, the kidneys, the liver, the immune system and the bone.

Some people require higher doses of vitamin D3

However, doses of 5000 IU to 10,000 IU of vitamin D3 capsules per day are necessary for optimal vitamin D3 health. This leads to levels of below 150 ng/ml of 25(OH)D levels, which were shown by researchers to be safe. According to Dr. Eisenstein no toxicity has been found below 30,000 IU of vitamin D3 per day, but based on other authors a dose of 10,000IU should be adequate for most people. Strangely enough colored people also have to take vitamin D3 supplements as the higher melanin pigment in the skin filters out UV light so effectively that their 25(OH)D level can be low. Always err on the cautious side and have your vitamin D3 blood level taken. Vitamin D3 has a characteristic stereotactic configuration (cis-triene structure), which allows it to bind free radicals and function as an antioxidant (Ref.2).

What are some of the clinical effects of vitamin D3?

  1. Vitamin D3 has diverse effects on organs systems as Dr. Eisenstein summarized: vitamin D3 lifts depression and is of particular value for drug resistant depression. Take 5000 to 10,000 IU of vitamin D3 per day.
  2. Muscle power increases with vitamin D3, particularly in those who work out regularly.
  3. Many fertility clinics pay attention to vitamin D3 levels, as the higher the blood levels of vitamin D3 in a man, the faster this sperms move! And the more vitamin D3 she has on board, the better she ovulates. The end result is a higher pregnancy success rate when both partners take 5000 to 10,000 IU of vitamin D3 per day

Vitamin D improves teeth in offspring, helps with chronic pain

  1. Also, if a woman takes vitamin D3 during her pregnancy, the first set of teeth in the offspring will have fewer cavities.
  2. Brain development in autistic children is much improved with vitamin D3 in higher doses. This needs to be combined with detoxification methods and supervised by one of the DAN physicians.

6.Chronic pain typically improves when physicians treat vitamin D3 deficiency, which almost always is present in patients with chronic pain.

Prevention of flus and Covid-19, asthmatics improve

  1. To prevent flus and colds and other infectious diseases, take higher doses of vitamin D3. When you come down with a flu, it is safe to increase your daily vitamin D3 intake to 30,000 IU of vitamin D3 for a few days until your symptoms improve, then resume your maintenance dose of 5000 IU to 10,000 IU per day.  This year’s dominant flu is the type A, subtype H1N1 – also known as the swine flu. Children should get 50% of the dose regimen detailed for adults when they develop a flu (for children: 15,000IU for three to five days , with tapering to a maintenance dose of 2500 to 5000 IU until blood levels of 25(OH)D are available). Here is a website about the pros and cons of vitamin D where dosages are also discussed.
  2. Asthmatic patients do better with vitamin D3 supplements requiring less maintenance anti-asthmatic medicine to keep them balanced with regard to their airways.

Partial prevention of Alzheimer’s disease with vitamin D

  1. Chronic low vitamin D3 levels cause brain damage including Alzheimer’s disease. In this context it is important to know that the enzymatic conversion in the liver and kidneys slow down as we age.  Older patients require higher doses of vitamin D3. This may have been the reason for the confusion about relatively low doses of 400 IU of vitamin D3 preventing rickets in children versus the need for much higher doses of vitamin D3 in middle aged and older patients.
  2. There is a link of high blood pressure to vitamin D3 deficiency and it is better manageable with medication when vitamin D3 levels are normal.

Vitamin D lengthens telomeres and increases longevity

  1. Live longer with vitamin D3. How is this possible, you might ask: the answer has been found in the telomeres, the shoelace like structures at the end of the DNA strand of each cell. Vitamin D3 lengthens the telomeres and promotes telomere repair; there is an association of vitamin D3 and a longer life span. Centenarians have longer telomeres. You can measure telomere length, but it is a pricey test, which is not for everyone, contrary to supplementation with vitamin D3 that should be taken by everyone!

Vitamin D fights inflammation

  1. As already indicated, vitamin D3 strengthens the immune system. But it also modulates the inflammatory response from muscle damage, so athletes can perform better. Patients with multiple sclerosis will improve as it slows down the inflammatory process. But other inflammatory diseases like arthritis, inflammatory bowel disease and even cancer respond favorably to higher doses of vitamin D3. In these cases physicians use 20,000 to 30,000 IU of vitamin D3 daily. This information has not yet percolated into mainstream medicine.
  2. Higher percentages of cardiovascular disease occur in patients who have lower than 15 ng/ml  25-Hydroxy-vitamin D levels in their blood meaning that vitamin D3 supplementation prevents heart disease (Ref.3).

What are toxic vitamin D levels?

What is known about the safety of vitamin D3, particularly the higher vitamin D3 doses? First, it is wise to have your 25(OH)D blood levels taken from time to time. If vitamin D blood levels exceed 150 ng/mL reducing the vitamin D dose or stopping supplementation is prudent. Otherwise it has been difficult to establish a toxic range. Most publications about toxic levels of  vitamin D point out that anything above 150 ng/mL would be in the toxic range.

This website claims that 40,000 IU of vitamin D3 or more would lead to toxic levels where the blood calcium levels would be increased, which can be measured as hypercalcemia. However, another study done in 2007 showed in MS patients that took 40,000 IU per day and that led to a blood level of 400 ng/ml of 25(OH)D did not lead to increased calcium levels and did not lead to hypercalciuria (too much calcium in the urine).

Toxic vitamin D levels difficult to find

The papers that indicated that it would be unsafe or unnecessary to take vitamin D3 were untrue. It seems that they had other agendas than communicating the truth. There was no release of calcium from the bones and calcium absorption from the gut was not too high. This would have caused calcification of the bones, soft tissues, heart and kidneys. Also, kidney stones would have developed. However, a low calcium diet combined with corticosteroid drugs usually leads to a full recovery within a month. Interesting that all of the dire predictions regarding toxic vitamin D3 levels did not materialize. Here is another website discussing vitamin D3 dosing.

Patient taking unintentional high doses of vitamin D3 survived

I talked to a participant of the conference with a fellowship degree in anti-aging medicine what knowledge we have about vitamin D3 toxicity. He told me that there has been an unintentional overdose. In this case a compounding pharmacy made a mistake. A patient accidentally received a dosage of 500,000 Units of vitamin D3 per day for a full three months. The patient felt sluggish, but did not have any other symptoms. His physician told him to stop the vitamin D3 compound. He had an uneventful recovery with no detrimental effects. At this point no documented overdose of vitamin D3 exists.

Conclusion

Vitamin D3 is a vital supplement. Initially researchers showed that it prevents rickets in children. Subsequently physicians found that it also prevents depression, MS, infections and many cancers (Ref. 4). As usual there will be many critiques that doubt the validity of the above statements. But I have found that all of these effects described above were confirmed in several sources of various medical information. Keep in mind that negative rumours have a tendency to linger on for years.

More information on vitamin D3 for prevention of osteoporosis and hardening of arteries: https://www.askdrray.com/calcium-vitamin-d3-and-vitamin-k2-needed-for-bone-health/

Vitamin D3 deficiency can cause pancreatic cancer: http://nethealthbook.com/news/insufficient-vitamin-d3-linked-to-pancreatic-cancer/

References

1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed.,  © 2011 Saunders

2. Rheumatic Diseases Clinics of North America – Volume 38, Issue 1 (February 2012) , © 2012 W. B. Saunders Company

3. Wang TJ, Pencina MJ, Booth SL, et al:  Vitamin D deficiency and risk of  cardiovascular disease.   Circulation 117. (4): 503-511.2008.

4. “Recognition and Management of Vitamin D Deficiency”: American Family Physician – Volume 80, Issue 8 (October 2009),  © 2009 American Academy of Family Physicians

Oct
19
2013

Healthy Choices Start In Your Brain

By | Alzheimer’s disease, Anti-aging medicine, Diabetes, Fitness, High Blood Pressure, Infectious Disease, Mental Health, Other neurological conditions, Prevention, Stroke, Substance abuse, Vitamins and supplements

This article deals with healthy choices start in your brain. You may have seen the CNN heading “Where is self-control in the brain?”  If we want to make any healthy choices in life including sound financial choices, we need a balanced brain that makes the right decisions for us.

Two ways of making food choices

Researchers at the Caltech in Pasadena, CA have examined this question in detail using functional MRI scans and found out that there are two loci on the frontal lobe of the brain that control your impulses: the “ventral medial prefrontal cortex” (red in this link) that processes your initial image (like seeing a delicious ice cream cone”) and the “dorsolateral prefrontal cortex”(green in this link), where you decide that this is not healthy for you because it has too much sugar in it.

Two groups of volunteers

The Caltech researchers found a group of volunteers who were impulsive and made the wrong choice simply based on their taste buds without consideration for their health in general. An equally large group of volunteers was also found who had functional activity in the ventral medial prefrontal cortex and the dorsolateral prefrontal cortex, the latter of which modified the final decision into the healthy choice. The impulsive group made their decision to buy simply with the activation of only the ventral medial prefrontal cortex.

Balanced thinking required to make the right choices

The researchers think that it is this kind of lack of balanced thinking that decides whether we are going to make the right or wrong health choices for ourselves. The sad part is that ultimately, the summation of bad health decisions during life can become the cause of developing dementia, such as Alzheimer’s disease. The good news is that many of the causes of dementia can be avoided, which means that the average person could prevent dementia. I will discuss this in detail here.

Causes of dementia

It is interesting to study patients with various forms of dementia as it is often in the frontal and temporal portions of the brain where brain cells are dying off resulting in impulsive buying, impulsive behavior and lack of recent memory. It is also important to recognize that a number of conditions or factors can cause dementia:

1. Genetic causes

There are two types of frontotemporal lobe dementias, a tau-protein positive FTD and a ubiquitin-positive FTD, which has been shown to be due to a deficiency in progranulin. Both of these genetic defects are located on chromosome 17. In Alzheimer’s dementia, which occurs later in life there can be genetic defects at chromosomes 21, 14 or 19. Epigenetic factors like exercise, avoidance of alcohol, and taking omega-3 supplements can even partially prevent or postpone the onset of dementia from genetic causes.

Healthy Choices Start In Your Brain

Healthy Choices Start In Your Brain

2. Toxins like alcohol

Another example of how people can get dementia is through the effect that regular alcohol consumption has on our brains and bodies. This image of an MRI scan shows a normal brain for comparison on the right and  the MRI scans of the brain of a chronic alcoholic on the left.  When a chronic alcoholic has severe atrophy of the brain a psychiatric condition, called Korsakoff’s syndrome can occur. This psychotic condition as a result of the brain having been poisoned by regular alcohol intoxication. Essentially the toxic effect of high daily doses of alcohol have shrunk not only the surface of the brain, but also the deeper substance of the brain. The patient is psychotic, has loss of memory and is unable to care for him/herself.

3. Vascular damage to the brain

Strokes can cause vascular dementia that leads to Alzheimer’s disease-like memory loss. This link points out that diseases like hypertension, obesity, diabetes, atrial fibrillation, ischemic heart disease and dyslipidemia all predispose you to possibly get a stroke with subsequent dementia.

4. Traumatic head injuries

In boxers, football players and combat soldiers brain cells can get lost from repetitive head trauma leading to dementia (in this case it is called “dementia pugilistica”).

5. Infectious dementia

HIV in AIDS patients can affect the brain and cause an HIV-associated dementia. Bacterial meningitis and viral meningitis can kill brain cells and cause a form of dementia as well.

6. Immune disorders

We know that MS can go on to develop dementia as a late complication. In MS there are autoantibodies against myelin, the insulation material that surrounds nerve fibers. An important category of immune disorders is autoimmune disease that can cause dementia. The cardiologist, Dr. William Davis, has presented compelling evidence that wheat allergies can cause dementia, but if detected early and treated by a gluten free diet, this clears up the mind and stops further development of dementia (Ref.1 describes wheat allergies causing dementia; a wheat free diet is described in Ref.2).

7. Hormone deficiencies

A classical example is hypothyroidism, which in the past before thyroid medicine was available, often led to dementia. A simple blood test, TSH (thyroid stimulating hormone) can detect whether or not you are hypothyroid. The A4M recommendation for a normal level is below 2 (not below 5 as often reported by official lab value reports).

8. Lack of vitamins

Thiamine (=vitamin B-1) is often missing in alcoholics. If you are missing vitamin B-6 and vitamin B-12 in your diet, this can predispose you to develop dementia as well. Aging people lose a factor from the gastric mucosa (the intrinsic factor) that is essential to absorb vitamin B-12 in the mall bowel, which predisposes them to develop pernicious anemia and dementia. A simple vitamin B-12 injection can prevent this from happening.

9. Too much sugar consumption

Sugar consumption has skyrocketed in the 1900’s and keeps on going up in the new millennium as well. Here is a review that discusses the possibility that Alzheimer’s can be triggered by overconsumption of sugar. The higher the blood sugar levels in diabetics, the higher the risk for developing Alzheimer’s disease. A study in Seattle has confirmed this. High insulin levels are found in type 2 diabetes; they are responsible for making brain cells stimulate the production of the gooey substance amyloid that causes Alzheimer’s disease. The authors of this study showed this to be true both in humans and in animal models.

10. Lifestyle issues

These include lack of exercise, excessive weight (obesity, being overweight) and poor diet (fast foods). They play an enormous role in terms of causation of dementia in addition to the other factors mentioned. On the other hand organic foods Lack of toxins) and a Mediterranean type diet will preserve your brain cells.

Treatment of dementia

At present treatment of dementia is very limited, as we do not have a complete understanding of dementia at this point. The traditional treatment of dementia outlined here will only marginally delay further deterioration of dementia, but ultimately fail. In my opinion this is because the medical profession has been concentrating on fighting the symptoms of dementia rather than the cause.

Given the known causes mentioned above, I like to give you a list of 6 recommendations. These will help you to prevent Alzheimer’s disease and dementia in general.

Cut out sugar

I would suggest that you cut sugar out of your diet and replace it with stevia. This also includes dates, grapes, bananas; also wheat and wheat products and starchy foods like pasta, potatoes, rice and bread (see Ref. 1 and 2 for details). The manufacturers of soda drinks, pies and cakes will not be happy about this recommendation, but it will please your brain cells. You will also be surprised how easy it is now to lose weight, which will please you (this also lowers your risk for heart attacks and strokes).

Limit your alcohol consumption

Severely limit your alcohol consumption to less than 1 drink for women and 2 drinks for men per day (better still would be to stay sober) unless you want to become part of the hospital population mentioned in one of the links at the beginning of this blog.

Have your hormones checked

Have your hormones checked, particularly your thyroid hormones, but also estrogen and progesterone levels in women and testosterone in men. Our brain cells have hormone receptors for a reason. They need stimulation from our hormones, even in menopause or andropause. Replace the missing sex hormones with bioidentical hormone creams and missing thyroid hormones with thyroid tablets (Armour is the best mix of T3 and T4 thyroid hormones, not Synthroid).

Prevent repetitive brain injuries

Prevent repetitive brain injuries before it is too late. Rethink whether you really need to box, street fight, play football, rugby or hockey. An Accumulation of head concussions can cause Alzheimer’s later in life!

Use vitamins for prevention of dementia

Use vitamins for prevention of dementia: The B complex vitamins like B-2, B-6, B-12 (by injection); vitamin D3 has recently been shown to be effective in slowing down Alzheimer’s disease. Vitamin D3 is low in Alzheimer’s patients and vitamin D3 supplements will slow down this disease. Although vitamin C showed equivocal results, it does have some neuroprotective qualities and decreases β-amyloid production and acetyl cholinesterase activity. A Mediterranean-type diet (Ref.2) is also helpful in preventing dementia

Do regular exercise

Exercise daily. It will discipline you to stick to the other points mentioned above. It gives you some extra endorphins and will make you feel good about yourself.

Conclusion

Although we do not yet have a complete picture regarding Alzheimer’s disease and dementias, we do know enough to reduce our risk of getting them. When you cut out wheat and wheat products, your immune system stops production of autoimmune antibodies against your brain cells. Your opiate receptors in the brain will no longer  seduce you to eat more and more sugar, starchy foods or high fructose corn syrup. You no longer have a problem cutting out high glycemic index foods (Ref.1). This will reduce insulin and reduce IGF-1 growth factors. These can lead to the production of the gooey amyloid substance that makes you lose your memory. The orbitofrontal part of your brain (particularly the dorsolateral prefrontal cortex) will be reminding you what you read here: healthy lifestyle choices start in your brain.

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

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

Last edited Oct. 19, 2013

Oct
05
2013

Fighting Back Against The Flu

By | Fitness, Infectious Disease, Lung Disease, Nutrition, Prevention, Stress management, Vitamins and supplements

Every year there is concern about the upcoming flu season. Mostly the discussion centers on the composition of the latest flu bugs and what type of strains would be included in the latest vaccine recommended. The first flu case of the season has just been reported in a child. Here I am going to review what you can do to minimize your probability of getting the flu, or if you get it, how to minimize the severity of the illness.

The immune system

We know for some time that the antibody-mediated immune system is what helps overcome flus. The body’s immune system produces antibodies against the flu via T-helper cells that recognize the glycoprotein (hemagglutinin) of the flu virus and pass a signal on to B cells (bone marrow derived lymphocytes), which in turn are turned on to produce a lot of antibodies (Ref.1). These protect you from future flus of this type. If you have pre-existing antibodies that fit the bug in circulation you are OK ,and you will usually not get the disease.

The factors that protect you from the flu

However, there are many other factors that support your immune system. I will discuss the most important factors in more detail here.

1. We do know that vitamin D3 strengthens the immune system. I would recommend 1000 to 2000 IU per day in the wintertime, but up to 4000 IU or 5000 IU per day during an active epidemic would be reasonable. There is less flu when people are taking Vitamin D3 supplements.

Influenza A was reduced in school children supplemented with 1200IU of vitamin D3. This study recommended higher doses of 2000 to 7000 IU of vitamin D3 per day; but it also stated that as a precaution serum vitamin D levels should be monitored (technically it is serum 25-hydroxy-vitamin D levels that are measured) to avoid vitamin D toxicity. Normal levels are between 40-70 nanograms per ml. Toxic levels are above 100 nanograms per ml. Your family doctor can order a serum 25-hydroxy-vitamin D level for you.

2. Eating fruit and vegetables is important for maintaining a healthy immune system. In a randomized study from Belfast, UK elderly volunteers (82 of them, aged 65 to 85) were assigned to either eat 2 portions or 5 portions of fruit and vegetables per day over 16 weeks. At 12 weeks into the trial both groups received a Pneumovax II vaccination, and the antibody response was measured at the end of the 16th week of the study.  There was a significant increase in antibody binding capacity to pneumococcal capsular polysaccharide in the 5 portion fruit and vegetable group compared to the 2 portion group that had no such increase. The authors concluded that there is a measurable improvement of the immune system when an older population increases their fruit and vegetable intake.

3. Avoid stress, because stress has been shown to weaken the immune system. This review shows that the immune system is weakened by the stress response via the elevated corticosteroid hormones (the stress hormone ACTH stimulates cortisol release from the adrenal glands). The stress of social isolation is also contributing to the weakening of the immune system in older people.

Fighting Back Against The Flu

Fighting Back Against The Flu

4. Exercise moderately and your immune system will get strengthened. Over exercising should be avoided as too much cortisol is released from your adrenal glands, which is toxic to lymphocytes thus weakening your immune system.

5.  Socializing is good for you as studies have shown that you live 2 ½ years longer. This study here is from Connecticut, but other studies confirmed this as well.

6. Make love. The endorphins that are released in the process stimulate the immune system.

7. Take probiotics, because they help your gut flora to stay normal. A normal gut flora promotes a stronger immune system as the Peyer’s patches (clumps of immune cells) in the gut wall are intimately linked to the immune system. In this way probiotics indirectly support your immune system.

8. Avoid smoking.  Smokers have more upper and lower respiratory tract infections than non-smokers. Here is information that explains this as well.

9. Get enough sleep. The circadian rhythm of your hormones ensures that your hormones function at their optimal level. Melatonin from the pineal gland is important in triggering the circadian rhythm, but melatonin itself supports the immune system as well. Your adrenal glands need resetting overnight so that cortisol is secreted according to your stress level, not too much and not too little. Overstimulation from performance sports, grief reactions, car accidents, injuries etc. lead to a surplus of cortisol and weakening of the immune system.

10. Take your flu shot (but without thimerosal) every year, but take it as a single shot (without thimerosal as a preservative). This CDC link explains that single shot flu vaccines are available without thimerosal. I recommend this type of flu vaccine. The central nervous system is extremely sensitive to nanograms of mercury, and it is for this reason that I would not buy into the argument of the CDC that one should not be concerned about safety of thimerosal. The newest for this flu season is the quadrivalent (or four-strain) flu vaccine, which is now available in pharmacies throughout the US.

11. Vitamins and supplements support your immune system, particularly vitamin D3. DHEA, which is available over the counter in the US stimulates antibody production when the flu vaccine is given, particularly in the elderly, in other words DHEA strengthens the immune system Vitamin C is known to support the immune system and is rapidly depleted in those who suffer from any viral infection. There are other nutrients that are useful to stimulate your immune system.

12. Consider herbs: Echinacea, Siberian ginseng, Asian and American ginseng, astragalus, garlic, and shiitake, reishi (also called “lingzhi mushroom”) and maitake mushrooms have all been shown to stimulate the immune system with negligible side effects.

13. Wash your hands, particularly when there is a flu going around. Door knobs for instance are known to keep live viruses for 2 to 8 hours, so washing your hands will reduce the amount of virus you are exposed to.

Conclusion

There is no single solution to prevent the flu, but we can all minimize our exposure to the virus and strengthen our immune system. Although it is wise to get a yearly flu shot to boost your immune system (without thimerosal as a preservative) just before the epidemics come around, this alone is not as good as combining the non-specific factors mentioned here with it. Particularly vitamin D3 (2000 IU to 4000 IU per day) and the old stand-by vitamin C (1000 mg to 2000 mg daily) will stimulate your immune system. Spice up your dinners with mushrooms that stimulate your immune system (maitake, shiitake, reishi mushrooms). Go to bed early enough to allow your circadian hormone rhythms to be reset overnight as you sleep. This will stimulate your immune system (from melatonin and DHEA of your adrenal glands).

More info on the Flu: http://nethealthbook.com/infectious-disease/respiratory-infections/flu/

References:

1. Long: Principles and Practice of Pediatric Infectious Diseases, 4th ed. Prevention. Vaccine. © 2012 Saunders

Last edited Nov. 7, 2014

Sep
14
2013

Food Processing Can Be A Danger To Your Health

By | Alzheimer’s disease, Cancer, Diabetes, Gastrointestinal Disease, Health, heart attack, Heart Disease, High Blood Pressure, Infectious Disease, Nutrition, Obesity, Prevention, Stroke

This article is entitled: food processing can be a danger to your health. Food processing is found everywhere: in pizzas, hamburgers, ready to eat deep frozen dinners, and in the myriad of packages that you see in the center of the grocery store. There are aisles and aisles of ready-made food packages including potato and corn chips, power bars, low fat yoghurt, and on and on it goes. So, what are the problems with these foods? Here are the major players that you will find (sometimes not) on the food ingredient lists.

Hidden sugar

With the recommendation for the past few decades that we should use low fat yoghurt a whole industry has sprung up surrounding low fat products. If you study the labels you will see that this has been done at the expenses of adding hidden sugar content. Don’t go for the berry or other fruit yoghurt, because it is over processed, sweetened with sugar or high fructose corn syrup. This is a fast track to becoming a diabetic. Stick to plain yoghurt with 2 to 3 % fat, which has only the original milk sugar in it, but no additives. Also, in the US you ought to avoid any milk and milk products containing bovine growth hormone, which is solely there for increasing the milk farmer’s profit, but will seriously undermine your health (it blocks your growth hormone receptors).

Added sugar changes your metabolism

Ref. 1 and 3 explain in detail how the metabolism is being changed through added sugar and an overdose of starchy foods, which is the reason for the pancreas over producing insulin. This in turn causes such varied diseases like heart attacks, diabetes, inflammatory conditions like arthritis, MS, Alzheimer’s disease and cancer.

Cut out cookies, excessively starchy foods like potatoes, bread, pasta and rice. Within half an hour of ingesting these your system will be overrun with sugar, the breakdown product of starchy food.

Added salt

The chef adds salt often to preserve foods, to lengthen their shelf life and to stimulate your appetite. Restaurants add salt to stimulate your appetite for more liquids. As a result more beverages (alcoholic and nonalcoholic) will be ordered, which is where the profit margin is highest. High amounts of salt will not be beneficial to you, as it will raise your blood pressure and on the long-term will cause high blood pressure, heart attacks and strokes. When you buy organic food, there is no additional salt in it, although you get sodium chloride, which is naturally present in the vegetables and fruit. Add very little salt, if any; instead add  herbs and spices, which contain valuable trace minerals.

Food Processing Can Be A Danger To Your Health

Food Processing Can Be A Danger To Your Health

Hidden fat

Whenever you have a food that was deep fried such as potato chips, corn chips or French fries, there is the danger of exposing yourself to trans fats from polyunsaturated fatty acids. This is also true for deep fried chicken or any other ready to eat foods that have been prepared in the deep fryer. This type of oil is often reused after it is filtered and advanced glycosylation end products (AGE’s) are accumulated in it. This ages your cells including your skin much faster. AGE’s also worsen diabetes by causing more complications like heart attacks and kidney failure. For the same reason you should avoid burning meats on the BBQ or food that you cook on a stove.

Beware of hidden fat in hamburgers

Hamburgers also have a lot of hidden fat, sometimes as much as 50%. This fat enters your bloodstream and finds its way as fat deposits in your arteries. After decades of eating too many hamburgers and sausages your coronary arteries clog and you require a stent or a bypass surgery. If you do not want to become a statistic prematurely, cut out sausages, hamburgers and other processed meats replacing them with lean turkey breast, organic chicken and lean pork, venison or grass-fed lean cuts of beef or bison.

MSG and other food additives

Many foods have artificial sweeteners in them, which includes excitotoxins like MSG and aspartame. Food manufacturers add MSG to stimulate your appetite, but it has devastating effects on your brain cells on the long term. Food manufacturers disguise the name by using synonyms like yeast extract, sodium caseinate, broth stock, malt extract, natural flavors and others. Soda drinks either have added sugar, in which case your insulin response makes you want to eat more calories in a day leading to obesity and to dementia. Diet conscious people use aspartame in low-calorie drinks, but it causes insulin resistance making you gain weight. It also damages your brain.

I recommend stevia extract

I recommend the plant extract stevia, which is a sweetener that does not have the deleterious effects of aspartame. Sucralose (Splenda) was developed through research on insecticides when a student found out that it tasted sweet. Although Big Pharma has succeeded to introduce sucralose into the diet of diabetics, it is a sweetener that in my opinion is not safe. First it kills ants: a few years ago, I did an experiment where I took a package of Splenda from Starbucks and sprinkled it on Hawaiian ants.

Experiment with Splenda powder and ants in Hawaii

In the beginning they were reluctant to eat it, but after a few hours they came and took it in. One day later there were only dead ants left in the area where I sprinkled Splenda before. I refuse to eat insecticide-laced soda! Second, when you read the link about the “sweet deception about Splenda” above you find that it has reduced the growth rate of rats, caused anemia in mice, enlarged the liver and the brain of rats, shrunk ovaries of rats and caused kidney damage with calcifications in rats. We have no official human data, although millions of Splenda doses have been consumed.  Nobody has done clinical safety studies in man.

Gluten and gliadin

One of the food additives you may not think much about is gliadin, which bakers user to bind the ingredients together. Its origin is wheat, which is usually the Clearfield variety of wheat (a dwarf variety). Dr. William Davis (Ref.1) has examined the effects of wheat and wheat products on humans in detail. Suffice it to say that it is safest to avoid wheat and wheat products entirely; otherwise, you could develop bowel disease like celiac disease, ulcerative colitis, Crohn’s disease; heart disease, obesity, autoimmune diseases, but also CNS disease like Parkinson’s disease, ataxia, and dementia (including Alzheimer’s disease).

Other health problems associated with marketing and so-called “best practices” of agroindustry

Milk and milk products are not as innocent as in the past when no marketing boards were around. Animals are no longer freely roaming on green pastures. The farmer keeps them in high-density facilities and they put them on antibiotics to prevent infectious illnesses. So the rumor goes. In reality farmers have found out that antibiotics and bovine growth hormone will both increase milk production. The profit principle has been applied and as a result the consumers of milk and milk products have a change of their bowel flora from the antibiotics, which can cause heart attacks. The bovine growth hormone from milk and milk products causes breast cancer and prostate cancer.

Superbugs

Superbugs have emerged as a danger from treating beef animals with antibiotics in feeding lots leading to resistant bacterial strains that can cause human disease like flesh eating disease etc. These superbugs imported from the grocery store and meat market are what can make us sick! Eating only organic meat and organic foods are one way that we can use to protect ourselves. Organic milk or goat milk are alternatives to regular (unhealthy) milk.

Toxins in our foods

Roundup is rampantly present in agroindustry to protect crops from weeds. Traces of it are present in most regular crops. Despite claims that Roundup would be safe for the consumer, newer research has shown that it is not. Genetically modified crops are routinely sprayed with Roundup, as they are resistant to this herbicide, so I recommend to stay away from these crops as well.

Your best protection is to buy organic foods, as inspectors test these crops for Roundup contamination.

Heavy metals

Heavy metals can be another source of food toxicity. Red wine was found to contain heavy metals, which could undermine that heart healthy effect of a glass of red wine per day.

Mercury is toxic to the central nervous system. It comes from the effluent of gold mines, the smog from coal burning and volcanic activity, which finds its way into the ocean. Fish is the main source of exposure to humans as explained in this link.

Conclusion

We need to be vigilant about the food we eat. The more food processors create new items, the more ingredients they mix in. We need to ask questions about food preparation. Did the food processors mix in food additives? Are they harmless or bad for our health? Beware of sugar as this causes insulin levels to raise causing obesity, diabetes, heart attacks, strokes and cancer. Watch the addition of salt, which causes high blood pressure, heart attacks and strokes. Avoid polyunsaturated fats, cook with olive oil instead. It’s the Mediterranean way of preventing heart attacks. No butter, no margarine, because this fat ends up in your arteries. Avoid wheat and wheat products that food manufacturers often mix into foods. Cook your own food whenever possible. Eat lots of vegetables and salads.

Keep the glycemic index of your food low

Watch the glycemic index and avoid high glycemic index foods. Sweeten with stevia, but avoid all other sweeteners. This way you avoid the insulin response discussed above.

The dietitians of the US have summarized the problems the American public faces in Ref. 2. Essentially, we need to take back the responsibility for our own food preparation and become less dependent on manufactured foods. Ref. 3 lists a good collection of wheat-free recipes.

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. The Profession of Dietetics at a Critical Juncture: A Report on the 2006 Environmental Scan for the American Dietetic Association; Journal of the American Dietetic Association – Volume 107, Issue 7 (July 2007)

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

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Jul
27
2013

Flossing and Brushing Saves Your Heart

By | Dentistry, Health, heart attack, Heart Disease, Infectious Disease, Nutrition, Prevention

It was not until about the mid 1990’s when it became apparent that gum infections and severe tooth decay could cause inflammation in the blood measurable by using the CRP marker (C-reactive protein). As this link shows Dr. Joseph Muhlestein at the University of Utah demonstrated in 1996 that chronic gum infection could cause a heart attack. He isolated the bacterium Chlamydia pneumoniae in 79% of patients undergoing coronary bypass surgery, while samples from heart transplant patients isolated this bacterium in only about 5%. The new thinking was that bugs that multiply in diseased gums could migrate into the blood and cause platelets from the blood to clump together and block coronary arteries causing heart attacks. Harvard University researchers have confirmed this. In the past it was known that a bad tonsillitis with an aggressive bacterium, Streptococcus viridans, could cause subacute endocarditis, a dangerous infectious disease of the heart valves, which can be responsible for sudden death in younger persons. Neglected cavities in teeth can also harbor this bacterium. Another study in 2009 showed that two particular strains of bacteria in infected gums, Tannerella forsynthesis and Preventella intermedia, were associated with an increased risk for heart attacks; but it was more the overall burden of bacteria in the infected gums than the specific bacteria strains that mattered most.

Flossing and Brushing Saves Your Heart

Flossing and Brushing Saves Your Heart

 

Preventing heart disease by brushing and flossing

With this background it is easier to understand that we need to take good care of our teeth and gums, if we want to maintain good health. As a start most people should see their dental hygienist (who usually works in a dentist’s office) twice a year. The dental hygienist will probe the depth of gingival pockets with a periodontal probe. A normal depth measures up to and including 3 mm. Deeper pockets than that usually indicate that the patient did not floss regularly. One needs to floss at least once per day, better twice per day and it should not bleed after flossing (initially when a person flosses for the first time the gums tend to bleed a bit).

The hygienist will do scaling of plaques on the tooth enamel. Any cavity that is detected will be brought to the attention of the dentist. At the end of the scaling procedure fluoride is applied, which puts a coating on the tooth surfaces to prevent tooth decay.

When deeper pockets (6 mm or more) are detected a trial of subgingival root brushings has shown to have a very beneficial result within only 14 days.

Periodontal pockets were improved and bacterial counts of periodontal infections were shown to have improved as well.

Oral care and cavity prevention in the population

It has been accepted for quite some time that a combination of brushing and flossing are the best methods to control dental plaque, which is the precursor for cavities.

In order to test the knowledge of adults in families with small children these authors from the School of Public Health of the Maryland University investigated Maryland’s adult population knowledge regarding caries prevention. It turns out that there were deficiencies in knowledge about the prevention of dental caries and the importance of fluoride to create strong, decay resistant enamel.

A randomized, prospective study is planned in Hong Kong which will start teaching oral hygiene to kindergarten children aged 3 and will be reinforced several times later to instill good dental hygiene behaviors into these children’s health routine as outlined in this link. Not only is it important to teach brushing and flossing, but also food habits with cutting down on sugary and starchy snacks as these foods make the saliva acidy promoting caries producing bacteria in the plaque.

This English study shows that a primary school based caries prevention program reduced caries by 35% when sugar intake was limited in the interventional group and brushing of teeth was done twice per day along with flossing.

An addition to flossing for those with narrow tooth intervals or those with braces is a waterpik system. This can be used to clean food residues from the spaces between your teeth and from gum pockets. Flossing once or twice per day is still needed to remove plaque to avoid tartar build-up. Before bedtime it is advisable to floss first, then use a waterpik, then use your electric toothbrush with a fluoridated toothpaste. During the day use the waterpik after meals followed by brushing with an electric toothbrush with non-fluoridated toothpaste.  Water Picks are also called “water flossers”; they are easier on your gums.

Other measures helpful in preventing tooth decay

Xylitol is a natural sweetener originally derived from birch. Sugarless gum often is sweetened with Xylitol. This study has shown that chewing Xylitol containing gum can effectively reduce caries. This paper describes that the increased saliva production from chewing gum provides a slightly alkaline environment for teeth. This helps to clear out sugar faster from the oral cavity after a meal, inhibits bacterial growth, neutralizes the pH in plaque that is on the acidy side after sugar consumption. The authors concluded that chewing Xylitol gum is a useful addition to the other known preventative measures of dental decay prevention, such as brushing and flossing teeth.

The techniques the dentist is using to treat plaque and dental decay have been refined by a new technique describe in this Australian publication as a minimum intervention caries prevention program.

The four methods used in minimum intervention dentistry are described here.

1. Recognition: to recognize potential caries factors early through lifestyle factor analysis and saliva testing.

2. Reduction: alter the diet and lifestyles to increase the pH of the saliva, which will reduce the risk factors for caries.

3. Regeneration: to arrest and reverse minimum lesions at the earliest stage. Use agents such as fluorides and casein phosphopeptides-amorphous calcium phosphates to achieve this.

4. Repair: when a cavity is present, a technique of “conservative caries removal” involves using bioactive materials to allow healing of the dentine layer of the tooth.

Reduction of cariogenic bacteria

I already mentioned above that alkalization of saliva by chewing Xylitol gum could significantly help prevent tooth decay. It does so by raising the pH, while chewing on sugary foods or starchy foods lowers the pH (making it more acidy). Growth of caries producing bacteria, which are called “cariogenic bacteria” is stimulated by acidy saliva and inhibited by alkaline saliva. For this reason people whose diet consists of a lot of vegetables and greens will have more alkaline saliva and are less prone to develop cavities. The worst foods to get cavities are sugar in its many disguises and starchy products (candies, bread, rice, potatoes, pasta, bagels, cookies, cakes).

What can cause bacteria from the mouth to appear in the blood? One common condition is periodontitis, which is a chronic inflammatory condition of pockets of the gums around the teeth. This originates from neglecting your teeth and not flossing. Smokers are more afflicted by this as well. Dental procedures called scaling and root planing are often done for chronic periodontitis. This study from January 2013 shows that there is about the same amount of bacteria that leak into the blood following these procedures when compared to flossing.

Sometimes a dentist will recommend using a short-term antibiotic to reduce the leakage of bacteria into the blood, particularly with people who have heart valve problems or had porcine heart valve replacement in the past. This publication from 2009 also describes that dental flossing causes bacteria to be shed into the blood (bacteremia).

Conclusion

Dental self-care should be taught to children at an early age to educate them to brush their teeth twice a day and floss them at least once per day. At the same time they need education what causes cavities in terms of food intake and that fluoride can help make teeth more cavity resistant. They should avoid sugar in pop, candies and cookies etc. Parents best teach by example! Regular visits to the dentist’s office will safe money on the long term. Regular scaling by a dental hygienist every 6-month will remove plaque from which cavities develop when bacteria thrive in them and produce acids that affects the enamel. Minimum intervention dentistry discussed above (4 methods used) can prevent your teeth from decaying. Regular flossing will keep your gums healthy and reduce the colonization of the mouth with bad, cariogenic bacteria. With all this in place you likely will keep your teeth for a long time and not need dentures or tooth implants because of lost teeth. At the same time you will prevent your immune system being overwhelmed by mouth bacteria, which could have lead to a heart attack had you neglected your teeth. As mentioned in the beginning, a CRP blood test is a useful tool to rule out chronic infection.

More information on:

1. Tooth decay: http://www.nethealthbook.com/articles/dentistry.php#Tooth_Decay

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

Reference: http://www.webmd.com/heart-disease/features/your-guide-gum-disease

Last edited Nov. 7, 2014

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Jul
13
2013

Low Cost Cervical Cancer Screening

By | Cancer, Infectious Disease, Prevention, Women’s Diseases

Introduction

Recently a low cost cervical cancer screening method was developed in India. About 25% of all invasive cancers of the cervix in the world are contributed from India as screening for cervical cancer is not practiced there on a large scale. Many screening methods for cervical cancer became more elaborate over the years as I describe here.

However, these screening methods are expensive.  They require a doctor who does the Pap test (or takes a swab for DNA testing) and a cytological laboratory. In addition, this service requires a gynecology service back up for positive cancer cases. In the Western world these services are in place and are responsible for improved cervical cancer survival rates.

The American Cancer Society (ACS) guidelines

The ACS guidelines state that cervical cancer screening should begin 3 years after the initiation of sexual intercourse. Women benefit from  screening every year for the first 3 years. If 3 consecutive screening results were normal, then a Pap test once every 2 or 3 years would suffice. Because of the Pap test the incidence of cervical cancer has continually dropped in the Western world as seen in this image. Compare this to the next link, which shows India as the main part of the undeveloped countries as a graph on top of the graph for cervical cancer incidence of developed countries.

Cervical cancer is due to a chronic HPV infection

With the new insight that cervical cancer is due to a chronic HPV infection, mostly due to strains 16 and 18 there are shifts in screening methods even in the Western world as DNA tests for HPV can identify a high percentage of cases that would otherwise go on to develop cancer of the cervix. However, due to cost issues with regard to DNA testing for HPV the Pap test is still the method of choice in many Western countries including the US.

Low Cost Cervical Cancer Screening

HPV16 and HPV18 were very prevalent in the cervical cancers found, not only in premalignant lesions, but also in advanced cervical cancer as this study showed. The authors concluded that vaccination with the HPV vaccine (e.g. Gardasil) would have a significant impact on the prevention of cervical cancer, particularly in a country like India where a regular screening program is not yet in place.

An inexpensive test for cervical cancer screening

In 2009 there was a publication in the New England Journal of Medicine that investigated three screening methods for cervical cancer, the familiar Pap test (cytology testing), human papilloma virus (HPV) testing and visual inspection after staining with 3-5% acetic acid. In Western medicine the Pap test is done first and if suspicious cancer cells are detected, this is followed up with colposcopy where acetic acid staining is done and a biopsy is taken from the suspicious area. After this one-time test in 1999 the patients of this study received follow-up again (10 year follow-up).

The direct DNA test for HPV

The direct DNA test for HPV caused a 52% reduction of deaths from cervical cancer in comparison to the control group. The other two test methods, done as a single test (cytology testing and acetic acid visualization) did not result in reduced mortality when compared to the untreated control group after 10 years. However, a 15-year follow-up of a one-time screening with the acetic acid test showed a reduction of 31% in the cervical cancer death rate (reduction from 16.2 women per 100,000 to 11.1 women per 100,000) as reported recently at the annual meeting of the American Society for Clinical Oncology. Shastri and co-workers, the authors of this study, estimate that this would translate into prevention of 22,000 cervical cancer deaths annually in India and if instituted across the developing world it would save 73,000 lives annually.

Is cervical cancer screening effective?

A meta-analysis of several randomized studies regarding the effectiveness of cervical cancer screening in reducing mortality from invasive cervical cancer was published in May 2013 and found that cancer screening is indeed very effective.

In most studies Pap tests (cytology testing) or DNA tests for HPV led to a 62% to 65% reduction of mortality from invasive cervical cancer 10 to 15 years later. The protective effect from screening lasted about 5 years. However, the practice of doing Pap tests or DNA/HPV testing every 1, 2 or 3 years is safer than waiting 5 years between tests as there is a cumulative protection to the point of preventing almost 100% of cervical cancer over the years with regular testing.

Staining with 3-5% acetic acid and visual inspection

For India and other development countries the inexpensive visual inspection method to screen for cervical cancer after staining with 3-5% acetic acid is better than not doing any screening at all. A nurse can readily learn this type of screening. Only patients with positive or questionable screening results receive a referral to a treatment center.  The best results were possible through a combination of this screening method and vaccinating girls with an HPV vaccine. This leads to a more complete prevention program for cervical cancer in these countries that could otherwise not afford screening. The Bill & Melinda Gates Foundation is helping to reduce the cost of the HPV vaccine to about $4.50  from about $170 in the US, which will allow mass vaccination in development countries in the near future.

What other cervical cancer prevention is available?

As pointed out earlier it is now evident that most cases of cancer of the cervix are due to chronic HPV16 and HPV18 infections. Teens can acquire these and the HPV viruses linger on unnoticed within the affected cervical cells. However, 10 to 15 years later they can manifest themselves as cancer of the cervix . This long latency period allows the physician to screen for this before it becomes invasive and is more difficult to treat. What has become more evident only in the past few years is that other human tissues can get infected with papilloma virus as well and turn cancerous over the years.

Cancers that can occur from sexual contact

Oropharyngeal cancer, anal cancer, penile cancer, vulvar and vaginal cancer and even some forms of throat cancer and lung cancer can develop from intimate contact with a person who is HPV positive. Researchers confirmed that oral cancer is now more than 70% related to HPV infection rather than to cigarette smoking or alcohol as in the past. Sexual practices have changed over the past decades with oral sex being more common. This likely is the reason why HPV caused more oral cancers in recent years.

Finger pointing is not constructive

Finger pointing is not uncommon when it comes to a rational discussion of HPV transmission, but it has become apparent that males are often the ones who may be spreading HPV unknowingly through promiscuous sexual activities. Both heterosexual and homosexual activities will spread HPV. But the more promiscuous a woman is, the more she will also contribute to HPV infections in the population.

HPV vaccines Gardasil and Cervarix

When the pharmaceutical industry developed the HPV vaccines Gardasil and Cervarix many religious groups have spoken out against vaccination, as this would “encourage promiscuous behavior”.  I look at this question from the point of view that lives can be saved down the road by preventing several cancers as indicated, and that is what counts on the long-term. In this context it makes a lot of sense that not only females get a vaccination, but also males to interrupt the infectious chain and this trend can now be seen as it is adopted by several jurisdictions.

Conclusion

Cervical cancer screening is still very necessary doing a Pap test or a DNA/HPV test. Screening is necessary more often than every 5 years as pointed out. Most women need a Pap test every 2 to 3 years. HPV vaccination with Gardasil and Cervarix for boys and girls prior to sexual relations is very preventative, but still does not mean that screening should be stopped. Cervical cancer is the cancer that has the longest medical history of moving from a very prominent deadly disease (back in the 1960’s) to a cancer that can now be cured and prevented.

References

  1. Causes of cervical cancer: http://nethealthbook.com/cancer-overview/cervical-cancer/causes-cervical-cancer/
  2. HPV vaccine: http://www.mayoclinic.com/health/cervical-cancer-vaccine/WO00120
  3. Review of cervical cancer: http://www.nethealthbook.com/articles/cancer_cervicalcancer.php#topoftable

Last edited Nov. 7, 2014

May
25
2013

What We Can Do About Superbugs

By | Gastrointestinal Disease, Health, Infectious Disease, Nutrition, Prevention, Vitamins and supplements

Introduction

This article is about what we can do about superbugs. Several decades ago nobody talked about superbugs. Then came stories of “flesh-eating disease” or necrotizing fasciitis. Since 2001 it became obvious that these cases have become more common. Methicillin-resistant Staphylococcus aureus (MRSA) was often the underlying cause.

Antibiotics for weight gain in cattle

Government bodies accuse physicians of overprescribing unnecessary antibiotics for viral colds and flus. All physicians had to attend educational programs as part of the continuing education programs to use antibiotics only sparingly.  But the frequency of these serious infections often requiring amputations and mutilating surgeries continued to escalate. Research into the phenomenon of increasing superbugs took place already in the 1970’s. In 1977 the FDA came to the conclusion that antibiotics were used widely in the US by the agroindustry for weight gain in livestock (pigs, cattle, chicken, turkeys). Although masked as protecting animals from infections, the real motivation of the farmer was to increase profits. The FDA recommendation in 1977 to change the practice of feeding livestock antibiotics did nothing to change that.

Farmers continued to use the old antibiotic feeding practice

After a court review in 2012 a New York court ordered the FDA to do something about the same problem. The answer was a lame recommendation of a voluntary program to downsize the use of antibiotics in livestock, requiring a vet and a prescription for antibiotics. The problem with this is that farms had no mandatory checks of livestock by trained inspectors. The ruling about antibiotic reduction contained no penalties for farmers who continued the old antibiotic feeding practice. Fast-forward to an American citizen who visited India recently as told in this story.

Superbugs are all over the world

It is clear that superbugs are all over the world. It is also clear from this article (and other literature I have reviewed) that 80% of today’s antibiotics are fed to livestock, not to treat infections, but because of their effect on weight gain in livestock and the associated larger profits. The result is that we are looking at farming practices that produce deadly superbugs. Next we are reading headlines about a recall of meat meat and meat products.

Here is an interesting list from the Environmental Working Group, which shows what percentage of meats in your neighborhood grocery store is contaminated, and these are the numbers for superbug contaminations: The worst is ground turkey with 81%, pork chops with 69%, ground beef with 55% and chicken breasts, wings or thighs with 39%.

What We Can Do About Superbugs

What We Can Do About Superbugs

Wash meat thoroughly

This shows how important it is to wash meat thoroughly and to cook it long enough to kill the superbugs. It is also extremely important to frequently wash your hands when you prepare meat. This avoids  colonizing your skin surface with superbugs. The first step is for a person to have skin surface flora with superbugs. The second step is to get a small abrasion or a skin sore where a superbug can enter. The final step is that this bug multiplies under the surface of the skin and starts a serious infection. If the immune system is not in top shape to eradicate these bugs right away, the next step may be flesh-eating disease or toxic shock syndrome.

Solutions to stay on top of Superbugs

In northern Saskatchewan, one the provinces of Canada, an 8 year community based study was done to see whether it would be possible to reduce community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) by a combination of hand washing and education regarding appropriate antibiotic use. Using this program it was shown that in the time period of 2006 to 2008 the infection rates went down from 242.8 to 129.3 infections/10,000 population, which is almost half of the infection rate from before.

Hospital associated methicillin-resistant Staphylococcus aureus

What can physicians and nurses do about hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) and other superbugs in the hospital? In a hospital it is extremely important that HA-MRSA free patients do not get exposure to this superbug . Their immune system is already weak from the underlying disease. This is how they got into the hospital. At Stanford University a robot was developed that emits pulsating ultra violet light to kill any leftover superbug after the initial cleanup with scrubbing using bleach and germicidal solutions. Support staff treat the isolation rooms with the double treatment and robots disinfect the operating rooms overnight. So far tests have shown a complete eradication of the superbugs with these methods.

Breaking the chain of infection

Since about 2005 the major food production animals have been shown to be colonized with superbugs (MRSA) as this publication shows.

With 80% of the world’s production of antibiotics still going into the agroindustry for weight gaining purposes, it is high time that international “laws with teeth” apply. The WHO needs to get action in this and the public needs to put pressure on politicians to achieve this. Medical history has shown that infectious epidemics can be cured by breaking the chain of infection. In the example regarding superbugs the story of interrupting the chain of infection is exactly the same here: As shown in this study from Stanford University MRSA bugs are not contained in organic foods. So, by attempting to eat 100% organic, which can be challenging at times, you can intercept the infectious cycle involving MRSA and other Superbugs.

Attempt to eat mostly organic foods

You do not get exposed to the meat from food production animals treated with antibiotics for growth purposes. In the meantime, you are protecting yourself by keeping fit, taking vitamins and supplements all with the hope that the immune system stays strong from this. By eating organic meats and meat products you also keep your body free of toxins that would weaken your immune system and set you up for getting autoimmune diseases down the road.

The end result is that people who follow this example avoid colonization from exposure to superbug-infected meat products.  At the same time this prevents exposure to other toxins that a manufacturer of organic food can not use. Here is a story of a company that produces meat products without antibiotics (organic meats).

Conclusion

You can interrupt the infectious cycle of superbugs by eating organic foods. Make sure your immune system is strong by exercising, supplementing with vitamins and minerals. Wash your hands with soap and clean water, particularly after handling meat or meat products. Do not take antibiotics for a long time unless there is a specific reason of  bacterial infection that requires it. Do not consume meats from animals that were fed antibiotics. Read food labels!

References

1. Stick to organically grown meats:  http://www.helpguide.org/life/organic_foods_pesticides_gmo.htm

2. Super bugs in hospitals:  http://patients.about.com/od/atthehospital/a/hais.htm

3. Useful 2008 article : hand washing, reducing antibiotic use in humans and in animal feed are the solution to combat superbugs. http://evolution.berkeley.edu/evolibrary/news/080401_mrsa

Last edited May 25, 2013

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Jan
31
2013

Staying Healthy During Exotic Travel

By | Health, Infectious Disease, Prevention, vaccinations

A study of 82,825 ill travelers from Europe, North America, Israel, Japan, Australia and New Zealand was published who were interested in staying healthy during exotic travel. They had traveled the world between June 1996 and August 2011. The data was based on the GeoSentinel surveillance network database. There were 3,655 patients (4.4%) who were seriously sick with one of 13 tropical diseases. There were 13 deaths (=0.4%), 10 of which were from malaria. Two died from melioidosis. This is an infectious disease caused by a bacterium found in soil in Southeast Asia (including Thailand, Laos, southern China, Singapore, Malaysia, Burma and Vietnam), Taiwan and northern Australia. One person died from severe dengue. The interesting fact is that there was not a single case of Ebola virus, although this is a highly publicized and lethal illness in Africa. The majority of travelers sustained malaria and typhoid.

The tropical diseases were either due to viral illnesses, bacterial infections or protozoan infections.

Frequent viral illnesses encountered by visitors to Asia were dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS); avian influenza, Lassa fever as well as other tropical hemorrhagic fevers, Japanese encephalitis including other tropical encephalitis cases, Rift Valley fever and yellow fever.

This is a list of the bacterial infections that were reported: Anthrax, Carrion’s disease (=Bartonella bacilliformis), epidemic typhus, leptospirosis, melioidosis, murine typhus, paratyphoid fever, plague, relapsing fever, scrub typhus, spotted fever group rickettsioses and typhoid fever.

An interesting side-note is that even in familiar places like Hawaii leptospirosis is re-emerging as this link shows. So, it is important for visitors to Kauai and the Big Island of Hawaii (Waipio valley) to refrain from swimming in streams or natural ponds and to not expose your face to cascading waterfalls as leptospirosis can enter through the eyes, the nose, the mouth and scratches on the skin.

Finally, the following protozoan infections were found frequently: East African sleeping sickness, falciparum malaria and Plasmodium knowlesi malaria.

Staying Healthy During Exotic Travel

Staying Healthy During Exotic Travel

Each travel region has its special infection characteristics. With travel to Central America infectious diseases ranked in decreasing frequency like this: typhoid fever, leptospirosis, falciparum malaria and paratyphoid fever. In the Caribbean falciparum malaria was followed by typhoid fever, leptospirosis and paratyphoid fever. In South America the highest on the list was again falciparum malaria, followed by typhoid fever, paratyphoid fever and leptospirosis. In Sub Saharan Africa the highest number of falciparum malaria cases were registered (2633 of them), followed by 42 cases of typhoid fever, paratyphoid fever and leptospirosis. In the Middle East only one case of falciparum malaria, one case of typhoid fever and 2 cases of paratyphoid fever were reported. In contrast there were many more infections reported in South Central Asia (India): 286 cases of typhoid fever, followed by parathyroid fever, falciparum malaria and leptospirosis. All of the cases of typhoid fever and parathyroid fever in India were adequately treated with antibiotics and no deaths resulted from that. This is an example where no vaccine is available for prevention, but swift medical treatment could help immediately when an infection had occurred.

In South East Asia (Malaysia, Philippines, Indonesia) leptospirosis was on top, followed by typhoid fever, falciparum malaria and parathyroid fever. North East Asia (Korea, Mongolia), had only 3 cases of typhoid fever and 1 case of paratyphoid fever. Oceania (Polynesia) reported 26 cases of falciparum malaria, followed by paratyphoid fever and typhoid fever.

Several interesting observations were made with regard to this study.

  1. Most patients with travel acquired tropical illnesses presented within less than 17 days at the doctor’s office at home and 91% of them had developed a fever.
  2. The spectrum of the tropical disease that was diagnosed and treated varied according to the geographic destination where the traveler had been, which is consistent with the observations mentioned above (different distribution of tropical diseases depending on which area was traveled). Visitors to West Africa had a high rate of falciparum malaria, visitors to India sustained largely enteric fevers; and leptospirosis,  scrub typhus and murine typhus were the dominant tropical diseases for visitors to South East Asia.
  3. Males were found to be less diligent in using chemoprophylaxis for malaria prior to their travel than females. Overall only a minority had attended a travel clinic prior to their travel for immunizations and chemoprophylaxis for preventable tropical disease such as malaria.
  4. Other global life-threatening diseases like meningitis, other forms of septicemia, severe bacterial pneumonia and legionnaires also have to be considered as they occurred in roughly 30% of returning travelers.
  5. Malaria was the largest percentage of the tropical diseases that travelers brought home and 67% of all cases were male patients. They were mostly visiting West Africa where they acquired malaria (typically from Nigeria,  Ghana and the Ivory Coast). As mentioned they accounted for 10 of the 13 deaths.

The authors recommend that travelers should prepare themselves for trips to the tropics and subtropics, preferable visiting one of the travelers’ clinics. The recommended procedures should be followed meticulously. Not all of the diseases can be prevented, but if the traveler turns sick, they should seek medical advice as soon as possible in the country where they travel as these physicians often have special expertise in these tropical diseases.

One of the comments of the study was that often people visit relatives and friends in an area where tropical disease exists without any chemoprophylaxis or vaccinations beforehand. The visitors were under the impression that prior living in the area as a child would still protect them now during the travel as an adult, which is not the case. This can be prevented by visiting a travel clinic well before the planned trip, so there is enough time for vaccinations and possible blood tests.  

More information on:

1. Traveler’s diarrhea:  http://nethealthbook.com/infectious-disease/parasites/travelers-diarrhea/

2. Parasites: http://nethealthbook.com/infectious-disease/parasites/