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.

Dec
02
2017

Vitamin K For Bones And Arteries

Vitamin K for bones and arteries is gaining a lot of attention as a valuable supplement. Most of all in the blood vessels, but in addition in the heart, lungs and kidneys the matrix GLA protein is a key substance. Vitamin K2 is crucial for removing calcium from these organs, as matrix GLA protein is carboxylated. Carboxylation of the GLA protein functions much as a broom. This removes all superfluous calcium from blood vessels and organ tissues. If there is a lack of vitamin K2 intake, matrix GLA protein is uncarboxylated, which as a result invites vascular calcification. Essentially vitamin K2 has emerged as an important player in the regulation of bone conditions like osteoporosis, but also in the prevention of hardening of arteries. Vitamin K2 removes calcium from blood vessels and deposits calcium in bone preventing osteoporosis. I will review some key publications, which support this.

Arterial stiffness study in postmenopausal women

Aging blood vessels become stiff from calcification. By removing calcium it seems like the arterial wall becomes more flexible again. Dr. Knapen and colleagues from Maastricht University, The Netherlands followed 244 healthy, postmenopausal women for 3 years in this double blind, placebo-controlled 2015 study.

120 women received 180 micrograms of vitamin K2 (as MK-7) once daily. 124 women received placebo pills. Next researchers checked arterial stiffness through two types of tests. First of all, carotid intima-media thickness was evaluated by echo tracking. In addition aortic stiffness was tested by carotid-femoral and carotid-radial pulse wave velocity. After 3 years there was a significant reduction of uncarboxylated matrix GLA by 50%. This was missing in the placebo group. All of the markers for arterial stiffness showed a reversal improving flexibility above the median. This shows that hardening of arteries in postmenopausal women is reversible with the help of vitamin K2.

Bone metabolism study in Japanese men and women

This 2015 Japanese study investigated what the minimum amount of necessary vitamin K2 would be to improve osteocalcin carboxylation.

First of all, study 1 examined the effect of 0, 50, 100, or 200 micrograms of vitamin K2 (=menaquinone-7) daily. A group of 60 postmenopausal women received vitamin K2 for 4 weeks. Only the 200 microgram per day dosage showed an effect of carboxylating osteocalcin.

Second part of study

Furthermore, study 2 consisted of 120 men and women. Measurements involved the ratio between carboxylated and uncarboxylated osteocalcin to demonstrate the effect of vitamin K2. As a result of study 1 only a placebo group, a 100-microgram and a 200-microgram daily vitamin K2 group was part of the investigation. Both, the 100 microgram and the 200 microgram doses, reduced the circulating uncarboxylated osteocalcin fraction. Hence they concluded that vitamin K-2 effectively keeps the calcium in the bones and prevents osteoporosis. The investigators recommended taking more than 100 micrograms of vitamin K-2 per day to improve osteocalcin carboxylation.

You can find more detail regarding the interaction of calcium, vitamin D3 and vitamin K2 in this link.

Trabecular bone structure preserved in postmenopausal women

148 postmenopausal women were participating for 12 months in a randomized, placebo-controlled, double-blinded clinical trial. All these women had osteopenia. All of them received supplements with calcium and vitamin D3. In addition they received 375 micrograms of vitamin K2 or placebo pills. Examination involved tests for bone mineral density with dual X-ray absorptiometry (DXA). Furthermore a high-resolution CAT scanner determined the microarchitecture of the tibia bone.

After 3 months the uncarboxylated osteocalcin decreased by 65.6% rather than the placebo group of only 6.4% decrease. The trabecular number, spacing and thickness in the tibial bone were unchanged in the vitamin K2 group. In contrast to that there was a clear deterioration of the bone structure in the placebo group.

Summary of trabecular bone study

The bone density studies showed no detectable difference between the groups. The deterioration of the trabecular microstructure in the placebo group was consistent with expected age-related changes. On the other hand, the vitamin K2 group clearly demonstrated preservation of the trabecular bone structure in the tibial bone.

Vitamin K2 helps to eliminate toxic effects of calcium

This 2015 publication from Krakow, Poland explains rather well how vitamin K2 is important to reduce calcium from blood vessels.

At the same time the article points out that vitamin K2 is important for depositing calcium into bones to prevent osteoporosis. The removal of calcium from blood vessels occurs by carboxylation of matrix GLA protein. This functions like a shield to protect blood vessels from calcium entering into the arterial wall. This way the arteries are probably safe from calcification, and hardening of the arteries cannot take place. On the other hand calcium is binding to the bone. As explained above the hormone osteocalcin is responsible for this.Vitamin K2 is the main player in the process of carboxylization. As a result vitamin K2 makes it happen that calcium travels into the bone, where it belongs.

Rotterdam Study: reduced heart attack rates from vitamin K2

4807 subjects from the Rotterdam Study in the Netherlands were part of a study for considerable time (about 10 years) with no sign of any heart attack in the beginning.

The investigators were interested to correlate the effects of various doses of vitamin K1 and K2. How would this impact the frequency of heart disease, hardening of the aorta and all-cause mortality? Researchers adjusted the data for smoking, age, gender, body mass index, diabetes, education, and dietary factors. Next they compared the middle and upper tertile groups of vitamin K1 and K2 to the lower tertile of vitamin K1 and K2.

Results of Rotterdam Study

Most noteworthy, the relative risk for coronary heart disease was lower for the middle and upper tertile of the vitamin K2 group. They found that the middle tertile vitamin K2 intake lowered heart attacks by 27%. It was especially relevant that the upper tertile of vitamin K2 intake lowered heart attack rates by 57%.

In addition, all-cause mortality also showed a reduction for the middle tertile of vitamin K2 by 9% and for the upper tertile by 26%. Finally, severe aortic calcification was 29% less for the middle tertile of vitamin K2 and even 52% less for the upper tertile. Intake of vitamin K1 (=phylloquinone had no impact on any of the outcomes. The investigators concluded that adequate intake of vitamin K2 (=menaquinone) was crucial for anybody’s health. First of all, vitamin K2 lowers heart attack rates, in addition it reduces hardening of the arteries including the aorta and finally, it lowers all-cause mortality.

Vitamin K For Bones And Arteries

Vitamin K For Bones And Arteries

Conclusion

This review shows evidence that vitamin K2 supplementation is important for the prevention of osteoporosis and heart disease. It prevents heart attacks and hardening of arteries, including the aorta. The dosage necessary to achieve this is only 200 micrograms of vitamin K2 per day. However, in Japan higher doses like 375 micrograms per day are the common protocol for prevention of osteoporosis.

Effect of vitamin K2 for bones and arteries

How does vitamin K2 work? In the blood vessels vitamin K2 carboxylates the matrix GLA protein. Essentially this keeps calcium out of the arterial wall and prevents hardening of the arteries. This reduces heart attacks and significantly lowers mortality from heart attacks as well. The second effect of vitamin K2 is on bones. Vitamin K2 prevents osteoporosis to a large extent. It does so by binding calcium to the bone. The hormone osteocalcin, which is carboxylated by vitamin K2 effectively moves calcium from the bloodstream into the bone and keeps it in the bone. If you take vitamin K for bones and arteries, you double the benefit from this simple vitamin. Remember to take 200 micrograms of vitamin K2 daily. The benefits are certainly remarkable!

 

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Oct
21
2017

Bioidentical Hormone Replacement

Recently Medical News Today published an article on bioidentical hormone replacement in the Sept. 19, 2017 edition.

Although it was partially informative, I felt that there was an underlying bias against the use of bioidentical hormone replacement. The article made it sound as if hormone replacement therapy would not be safe. But the opposite is true with bioidentical hormone replacement.

Why are many women afraid of bioidentical hormone replacement?

At the time when there was a lot of confusion about hormone replacement therapy (HRT) the results of the Women’s Health Initiative (WHI) made it even more confusing. After all there was one trial to show once and for all that HRT would be beneficial. The expectation was that HRT prevents osteoporosis, heart attacks and breast cancer. But the results were quite different. Instead the study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease and a doubling in the risk for blood clots.

Missing information about synthetic hormones

What the authors of the study did not explain was the fact that it was the properties of the synthetic hormones, progestin and Premarin were responsible for the negative effects. Had research insisted to perform the study with bioidentical hormones, the results would have been quite the opposite! With bioidentical hormone replacement we see the prevention of heart attacks and clots; cancer rates are lower than controls, and the prevention of osteoporosis is another benefit. The end result is a reduction in mortality rates. But the horrifying results that are due to the use of synthetic hormones and that the WHI warned about linger on in the minds of many women.

The use of bioidentical hormone replacement

Dr. John Lee pointed out in several of his books that the physician should only replace hormone loss with bioidentical hormones. He also pointed out that physicians should only replace those hormones that are at low levels or missing. This means that the woman should have confirmatory blood tests like FSH, LH, blood estrogen and salivary progesterone. If estrogen and progesterone are missing, the physician usually starts the woman on progesterone cream first. After two months, when laboratory tests show a saturation with progesterone , the addition of estrogen can follow, typically as the Bi-Est cream. This is a mix of estriol and estradiol.

Caution to balance against estrogen dominance

Progesterone is started first to balance against the potential cancer-inducing effect of estradiol. With the addition of progesterone a balance is the result, and estrogen will not cause breast cancer. This is also why Bi-Est is used: it is a mix of estriol and estradiol. Estriol is neutral with regard to causing breast cancer. Estradiol is the main natural estrogen in a woman, so some of it is necessary to make the woman feel normal. This is how the body receptors are functioning. But estradiol alone, when not in balance with progesterone, can cause breast cancer and uterine cancer.

The key is that only women who need bioidentical hormones should receive it. There are some women whose blood tests do not show a lack of estrogen, but only a lack of progesterone. These women should receive replacement with bioidentical progesterone to re-establish the hormone balance between estradiol and progesterone.

Safety of bioidentical hormone replacement products

As I have mentioned before, the Women’s Health Initiative in 2002 showed that on Premarin and progestin, two synthetic hormone products women came down with breast cancer, heart attacks, stroke, and thromboembolic events. They were using the synthetic drugs, namely conjugated equine estrogen and medroxyprogesterone acetate. The reason these women had to suffer these side effects was because their physicians insisted in using “pure hormones that a drug company had manufactured”. But these synthetic hormones were not pure hormones; they were adulterated with side chains so that pharmaceutical companies could patent them. These side chains made the synthetic hormones not fit the body’s hormone receptors. And this is the reason why the synthetic hormones created chaos in form of breast cancer, strokes and heart attacks.

Women’s Health Initiative authors whitewashed study results

Instead of admitting their mistakes, the full truth never became public. Instead the authors of the WHI study stated that it would be necessary to limit hormone replacement in menopause to the minimum amount of synthetic hormones to control symptoms, and their use should not exceed more than 5 years. These authors never distinguished between bioidentical hormones that fit the body’s hormone receptors and the synthetic hormones that irritated or blocked the body’s hormone receptors. There are thousands of women in Europe who have been on bioidentical hormones for decades, and they are doing just fine!

Bioidentical hormones in balance have no side effects

The truth is that bioidentical hormones –as long as they are kept in balance-do not have any side effects. Bioidentical hormones are the same that a woman produces in her ovaries before menopause sets in. The production of her bioidentical hormones kept her healthy. But the treating physician needs to carefully watch the balance of the hormones in the woman who is replaced with bioidentical estrogen and progesterone. This means that she needs to get enough progesterone to counterbalance estrogen stimulation. Hormones are constantly changing and if you don’t measure them, you don’t know what you are dealing with.

Dr. Lee said to measure hormone levels

John Lee showed a long time ago that you should measure hormones and identify those women who are truly hormone deficient. These are the ones who need hormone replacement. However, physicians should use only bioidentical hormones to replace what is missing. And they should also replace only as much as necessary to normalize the levels. This is also the level where postmenopausal symptoms disappear. Dr. Lee noted: “A 10-year French study of HRT using a low-dose estradiol patch plus oral progesterone shows no increased risk of breast cancer, strokes or heart attacks”.

How is bioidentical hormone replacement done?

The best method is usually a bioidentical hormone cream applied to the forearms or to the chest wall once per day. This avoids the first-pass metabolism where the hormones, if absorbed from a pill in the gut have to pass through the liver. Part of the hormones can get metabolized and some of the hormone effect may disappear. By applying bioidentical Bi-Est cream and progesterone cream to the skin, the hormones get directly absorbed into the blood stream and can do their job without interference. The treating physician can prescribe different amounts of the bioidentical hormones depending on saliva tests or blood tests. 1 or 2 months later repeat blood or saliva tests can follow to verify that the amounts of the replacement hormones and their absorption are adequate for the patient’s need.

What are the side effects of bioidentical hormone replacement?

Normally, when estrogen and progesterone are in balance, there should be no side effect. However, in the beginning of replacement therapy sometimes one of the hormones gets too high. If this happens with estrogen replacement, the woman becomes estrogen-dominant. She would experience symptoms of bloating, fatigue, weight gain, depression, headaches, loss of sex drive. She can also develop uterine fibroids, endometriosis and hypothyroidism. It was Dr. John Lee who first described this (Ref.1). There can also be mood swings, craving for sweets, irritability, and sluggishness in the morning. The key is to cut back on the estrogen dosage; alternatively, if progesterone is low in saliva tests, this hormone may need an increase, which would rebalance estrogen. At the end of fine-tuning of bioidentical hormone replacement the woman will feel normal and have no negative side effects, but the process of fine-tuning may take several months.

Difficulties to measure progesterone levels

Dr. David Zava, PhD gave a talk on breast cancer risks. This was a presentation at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. Dr. Zava, who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way.

Blood (serum) progesterone levels do not adequately reflect what the hormone tissue level is like in a woman’s breasts. On the other hand saliva hormone levels are giving an accurate account of what breast tissue levels are like.

Progesterone blood levels versus progesterone tissues levels

Dr. Zava gave an example of a woman who received an application of 30 mg of topical progesterone. Next, laboratory tests observed hourly progesterone levels in the serum and in the saliva. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream based on a misleading blood test. This leads to overdosing progesterone. With salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava emphasized that testing blood or urine as progesterone hormone tests will underestimate bio-potency and lead to overdosing the patient.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Conclusion

Bioidentical hormone replacement, properly done, does not cause cancer, does not cause blood clots and prevents heart attacks and strokes. It also prevents osteoporosis and the associated fractures in older women. The key is that the natural hormones fit the body’s own hormone receptors. The reason why menopausal symptoms appear is that natural hormones (estrogen and progesterone) are missing. With the replacement of the missing hormones in a menopausal woman through bioidentical hormone replacement, the menopausal symptoms disappear. Contrary to the Women’s Health Initiative in 2002 when patients received synthetic hormones, there are no breast cancers, no heart attacks and no strokes with bioidentical hormone replacement. What is even better is that these women will live without all the postmenopausal problems, and their life expectancy will be about 10 years longer than without bioidentical hormone replacement.

References

Ref. 1. Dr. John R. Lee: “What your doctor may not tell you about menopause: the breakthrough book on natural hormone balance”. Sept. 2004.

Sep
02
2017

Resveratrol Effective In Humans

Resveratrol is a powerful antioxidant; but is resveratrol effective in humans?

  1. Quack watch says: don’t buy into the hype that resveratrol is effective in humans.
  2. WebMD claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive benefits.

Despite these recommendations the following evidence supports that resveratrol is indeed effective in humans.

Resveratrol effective in humans: high blood pressure patients

First of all, a 2017 study of high blood pressure patients examined resveratrol supplementation with two groups, 46 stage 1 hypertension patients and 51 stage 2 hypertension patients. Stage 1 hypertension had a systolic blood pressure of 140–159 mmHg and a diastolic blood pressure of 90–99 mmHg. Stage 2 hypertension had a systolic blood pressure of 160–179 mmHg and a diastolic blood pressure of 100–109 mmHg. Analysts divided both stage 1 and 2 subgroups into two groups, one receiving regular antihypertensive medication, and the other group receiving regular antihypertensive medication plus Evelor. Evelor is a micronized formulation of resveratrol. The trial lasted two years.

Blood pressure lowering effect of resveratrol

The purpose of the trial was to determine the effect of resveratrol.  added to the regular antihypertensive medication (or not) to see whether it had blood pressure lowering effects. The interesting result showed that the resveratrol addition was sufficient to bring the blood pressure down to normal levels with only one antihypertensive drug. The control group without resveratrol needed two or three drugs to get the blood pressure under control. In addition, liver function tests showed that resveratrol normalized negative side effects of the antihypertensive drug on the liver. Both liver enzymes, glutamate-pyruvate transaminase (SGPT) and gammaglutamyl transferase (Gamma-GT) were normal in the resveratrol group.

Resveratrol effective in humans: diabetes patients

Diabetes patients can get help with resveratrol. Resveratrol, the bioflavonoid from red  wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. Another group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol was 1000 to 5000 mg.

Resveratrol effective in humans: improves bone density

Furthermore, resveratrol improves bone density in men: 66 middle-aged obese men with an average age of 49.3 years and a mean body mass index of 33.7 were recruited for this randomized, double blind, placebo-controlled trial. The purpose was to study whether there would be changes in bone turnover markers (LDH, an enzyme involved in bone turnover), but also whether bone mineral density (BMD) would increase. The researchers gave resveratrol to a high group (1000 mg per day), a low group (150 mg) and the third group received a placebo (fake pills). The end point was an elevation of the bone alkaline phosphatase (BAP). The investigators measured this in the beginning of the study and at 4, 8 and 16 weeks.

Difference between high and low dose resveratrol

The high group of resveratrol had a 16% increase of the BAP throughout the study and a 2.6% in lumbar spine bone density (measured by a trabecular volumetric method). The low resveratrol group showed no bone restoring effect. MJ Ornstrup, MD, the lead investigator said that this was the first time that a clinical team has proven that resveratrol can serve as an anti-osteoporosis drug in humans. She added that resveratrol appears to stimulate bone-forming cells within the body.

Resveratrol effective in humans: anti-aging effects

Finally, the Nurses’ Health Study showed that both a Mediterranean diet and resveratrol can elongate telomeres.

The fact that you can have a longer life with a Mediterranean diet is common knowledge for some time. But now a study has shown that the reason for a longer life is the fact that telomeres get elongated from the Mediterranean diet. Telomeres are the caps at the end of chromosomes, and they get shorter with each cell division. This is the normal aging process.

Important information from the Nurses’ Health Study 

The finding of elongated telomeres comes from the ongoing Nurses’ Health Study that started enrolling subjects in 1976. At that time 121 700 nurses from 11 states enrolled in the study. In 1980 participants filled in diet sheets to determine who was adhering to a Mediterranean diet. The researchers accepted 4676 middle-aged participants in this study. This diet consists of a combination of vegetables, legumes, fruits, nuts, grains and olive oil. They also consumed fish and lean meats. The control group followed a regular diet. Between 1989 and 1990 blood tests were obtained to measure telomere length in white blood cells. It is known that smoking, stress and inflammation shortens telomeres.

Slowed telomere shortening

The lead author Marta Crous-Bou stated that overall healthy eating was responsible for longer telomeres in comparison to the control group. But the strongest association was in women eating a Mediterranean diet in comparison to the controls. For the best diet adherence score there was a 4.5 year longer life expectancy due to slowed telomere shortening.

Resveratrol lengthens telomeres

Longer telomeres associated with the lowest risk to develop chronic diseases and the highest probability of an increase of the life span. I have reviewed the importance of lifestyle factors in this blog where I pointed out that Dr. Chang found a whole host of factors that can elongate telomeres by stimulating telomerase. Research in humans supports the notion that an increase in physical activity elongates telomeres. So did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet and marine omega-3 fatty acid supplementation. In addition higher fiber intake, bioidentical estrogen and progesterone replacement in aging women and testosterone in aging men, as well as relaxation techniques like yoga and meditation are also elongating telomeres.

Aging is due to shortening of telomeres. Elongation of telomeres by resveratrol leads to prolonged life (or anti-aging).

Resveratrol effective in humans: resveratrol and cancer

In addition, this overview shows, it seems that several mechanisms of action give resveratrol the power to be an anticancer agent. Resveratrol is anti-proliferative and has anti-angiogenesis mechanisms. In addition resveratrol stimulates apoptosis, which is programmed cell death. All these actions together help resveratrol to have anticancer properties. Resveratrol is also useful in combination with other cancer treatments, which improves survival figures. As the link above explains, there is a need for more cancer clinical trials with a variety of cancers and larger patient numbers. Many smaller clinical trials have already been very successful showing efficacy of resveratrol as a chemotherapeutic agent.

Resveratrol is anti-inflammatory

Also, in this 2015 publication about malignancies and resveratrol an overview is given about the use of resveratrol and cancer treatment. It summarizes that the development of cancer is a multifactorial process that involves the 3 stages of initiation, promotion and progression. One of the cancer promoting factors is chronic inflammation. Resveratrol has anti-inflammatory qualities. At this point it is not clear how the animal experiments will translate into the human situation. More clinical observations are necessary.

Resveratrol effective in humans: cardiovascular disease

Resveratrol has beneficial effects on preventing hardening of the arteries, diabetes, various cancers and inflammatory conditions like Crohn’s disease and arthritis. Furthermore,  as this link explains resveratrol also stimulates the antiaging gene SIRT1 by 13-fold. This confirms the anti-aging effect of resveratrol. This 2012 study confirmed that it is resveratrol from red wine that is responsible for the “French paradox” (longer life expectancy despite high saturated fat intake).

Resveratrol effective in humans: polycystic ovarian syndrome 

Similarly, polycystic ovarian syndrome could be significantly healed with resveratrol in a randomized, double blind, placebo-controlled trial. It involved 30 subjects who completed the trial. Each of the subjects received 1500 mg of resveratrol or placebo daily for 3 months. Measurements showed a decrease of serum total testosterone by 23.1% at the end of 3 months in the experimental group versus the placebo group. There was also a decrease of dehydroepiandrosterone sulfate of 22.2%.There was a reduction of the fasting insulin level by 31.8%. At the same time there was an increase of the insulin sensitivity by 66.3%. The authors concluded that resveratrol had significantly reduced ovarian and adrenal gland male hormones (androgens). This may be in part from the drop in insulin levels and the increase of insulin sensitivity.

Resveratrol effective in humans: anti-arteriosclerotic effects in diabetics

Most noteworthy, a double blind, randomized, placebo-controlled study was done on 50 diabetics. Arterial stiffness was determined by the cardio-ankle vascular index (CAVI). The purpose of this study was to determine the effect of resveratrol on the stiffness of arteries in a group of diabetics and compare this to a placebo. Diabetics have premature hardening of the arteries (arteriosclerotic changes). After 12 weeks of taking 100 mg of resveratrol per day there was a significant reduction in arterial stiffness in the experimental group, but not in the placebo group. Blood pressure also decreased by 5 mm mercury (systolic) in the experimental group.

Resveratrol effective in humans: ulcerative colitis patients

Finally, 56 patients with mild to moderate ulcerative colitis received 500 mg of resveratrol or placebo and were observed for 6 weeks. This was a randomized, double blind, placebo-controlled pilot study. The researchers used bowel disease questionnaires to assess the bowel disease activity before and after the treatment. The resveratrol group decreased the disease activity significantly, but it also increased their quality of life. Blood tests showed that this improvement occurred as a result of reducing oxidative stress by resveratrol.

Resveratrol effective in humans: Alzheimer’s disease prevention

Here is a study where 52 Alzheimer’s patients were divided into two groups; one group received 200 mg of resveratrol for a number of weeks, the other group placebo pills. There was a significant improvement in memory tests in the resveratrol group and functional MRI scans showed better functional connectivity in the hippocampi of the subjects. The hippocampus is the seat for short-term memory, which is not functioning normally in Alzheimer’s patients.

Resveratrol Effective In Humans

Resveratrol Effective In Humans

Conclusion

Resveratrol has a long history of showing evidence of improving health. It does so by countering oxidation of LDL cholesterol, which lessens hardening of arteries. This prevents heart attacks and strokes. Resveratrol is also a powerful anti-inflammatory, which helps patients with diabetes, with Crohn’s disease and arthritis. There is even a cancer preventing effect of resveratrol because of anti-proliferative and anti-angiogenesis effects as well as stimulating apoptosis. These combined anticancer properties make resveratrol a chemotherapeutic agent. It is also effective in combination with conventional anticancer drugs.

Resveratrol helps prevent hardening of arteries and cancer

There are enough randomized, double blind, placebo-controlled trials in humans to show that resveratrol is effective in preventing and treating several disease conditions. The medical establishment claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive health benefits. After my review outlined above I come to the opposite conclusion. It is quite clear that resveratrol has several important healing properties. It can improve diabetes; prevent hardening of arteries, lower blood pressure, attack osteoporosis and prevent Alzheimer’s disease. I have been taking 500 mg of resveratrol daily for years. It has not harmed me.

Feb
18
2017

Weight Gain In Menopause

Dr. Tasneem Bhatia, also known as Dr. Taz gave a lecture about weight gain in menopause. This was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The full title of the talk was “Hormone Balance and Weight Control in Menopausal Women”. Dr. Taz practices integrative medicine at CentreSpring MD, Atlanta. GA.

A few statistics about menopause

Weight gain in menopause is common. There are 50 million women who suffer from this in the US. Globally 300 million women have this problem. The average weight gain is between 5 and 50 pounds. There may be a small percentage of women where a genetic component comes in, and where all the females in the ancestry had a weight problem after menopause. But we do not know for certain what is genetic and what is due to hormone deficiency. It is only in the last few decades that doctors have determined how important hormone deficiencies are in menopause.

About 10 million women who are over 40-years-old need treatment in long-term care facilities.

We will see below that when physicians incorporate this knowledge into a treatment schedule, the weight problem can normalize. It is possible to reduce the costs of taking care for postmenopausal women with obesity and diabetes by 2/3 of these cases.

Pathophysiological changes in menopause

There are three intertwining aspects that drive weight gain in menopause. There is an altered metabolic rate, and less calories are burning, which makes you gain weight when you eat the same amount of calories. Secondly there is a significant decline of three key hormones, estrogens, progesterone and thyroid hormones in menopause. Third, as the weight rises and the other mentioned hormones are missing, it is harder for the pancreas to keep up with insulin production and insulin resistance develops. I will explain this further below.

1. Decreased energy expenditure

With the lack of the ovarian hormones there is a slowing of the resting metabolic rate. There is also is a decrease of energy expenditure from reducing fat oxidation. Overall there is less need to consume the same amount of calories as before. But the hormonal changes trigger hunger and cravings.

2. Ovarian aging

With ovarian aging there is less estrogen production in the ovaries. This leads to less ovulation in the premenopausal period. A lack of ovulations creates a lack of progesterone production. When there are anovulatory cycles, there is no progesterone producing corpus luteum reducing progesterone production further. When estrogen and progesterone are missing, this is a stress on the thyroid gland that is trying to partially compensate for the lack of the ovarian hormones. Eventually though there is permanent thyroid hormone production and hypothyroidism sets in. This is very hard on the adrenal glands that produce cortisol. For some time the adrenal glands can compensate for missing thyroid hormones with cortisol overproduction. But in time adrenal gland fatigue develops.

3. Insulin resistance

Insulin resistance can lead to diabetes, which becomes a real menace together with the metabolic changes of obesity.

Health risks of weight gain

Dr. Taz pointed out that around the time of menopause there are very specific risks that have to do with the metabolic changes. There is a definite risk for heart attacks and strokes as LDL cholesterol and triglycerides show an increase and arteries calcify from circulating calcium leaking out from the bones into the blood stream.

Osteoporosis is common in menopause; the brittle bones lead to an increased risk of fractures in the hips, wrists and vertebral bodies.

Postmenopausal women also risk increase of cancer, particularly breast cancer and colon cancer. The higher the weight, the more risky it is for these women to get one of these cancers.

Alzheimer’s disease and cognitive decline is also very common in menopause. This may be directly related to a lack of estrogen and progesterone, but may also have to do with overconsumption of sugar and starchy foods.

Hormone changes in menopause

Hormone changes in menopause can be complex. It is not only about a lack of estrogens and progesterone. All hormones work together. When there is weakness in one area (in the ovaries with menopause), this condition will affect the hormones that are acting in the same way or in opposition to ovarian hormones. In this way it is understandable that the thyroid gland can develop a weakness (hypothyroidism) or why the adrenal glands are over stimulated first, but later suffer from adrenal fatigue. In a similar way the pancreas produces too much insulin, partially because weight gain stimulates this. Typically the physician finds the fasting insulin level elevated with menopausal obesity. But as insulin levels are too high, the body’s insulin receptors get lazy and do not respond fully to insulin anymore. The name for this condition is insulin resistance. In time insulin resistance can lead to diabetes.

1. Lack of estrogen

A lack of estrogen in menopause is likely the single most important reason for weight gain in menopause.  As estrogen secretion declines, visceral obesity increases. In addition there is an impairment of insulin regulation. With obesity there is an additional risk of developing diabetes.

2. Progesterone

Progesterone is the other female hormone that is reduced with menopause. Bioidentical progesterone cream can prevent osteoporosis and hot flashes in menopause. Bioidentical progesterone replacement can also help a menopausal woman to sleep better. In menopause the production of progesterone goes down by 75% while estrogen production drops down by 35%.

3. Hypothyroidism

Menopausal women often suffer from hypothyroidism (with elevated TSH blood tests). Weight gain is often part of this. As a result it is important to check for hypothyroidism in menopausal women. It is important to check for micronutrients like iodine, selenium and iron and if they are low, supplementation may be necessary. Some women develop an inflammatory thyroiditis, called Hashimoto’s disease. A thyroid nuclear scan can confirm this. The reason this is important to recognize is that after several years when it burns itself out, hypothyroidism develops often, which requires thyroid hormone replacement.

4. Cortisol response

The cortisol response to stress is suboptimal due to the decreased progesterone levels in menopause. Progesterone is a precursor of cortisol, so in menopause not enough of it is around to synthesize cortisol. But in a group of menopausal women following a significant stressful event cortisol production was much higher than in non-stressed women.

5. Other hormones

Other hormones like leptins and melatonin are also contributing to weight gain in menopause. In rat experiments performed ovariectomies (mimicking menopause) and there was a clear relationship between low estrogen levels and weight gain. Higher estradiol doses inhibited leptin expression resulting in weight normalization.

Leptin and melatonin are influencing insulin regulation. This can in time lead to diabetes in connection with weight gain. It is at this point when a woman’s body shape can turn from a healthier pear shape to an unhealthy apple shape. The extra visceral (abdominal) fat is very active metabolically and causes inflammation in the body. These changes can lead to high blood pressure, heart attacks, strokes and digestive dysfunction.

Treatment of weight gain in menopause: food, hormones and lifestyle

How do you treat a complex problem like weight gain in menopause? It is no surprise that this will require a number of treatment modalities in combination.

1. Diet

It is important to start on an anti-inflammatory diet like the Mediterranean diet. Any extra sugar should be cut out as surplus carbohydrates lead to fat deposits and higher blood lipids. Dr. Taz suggested a 1200-calorie diet. Reduce salt intake. Eat more food during the day until 4 PM, nothing to eat after 8 PM. Increase plant-based foods, lower or eliminate trans fats. Increase foods rich in probiotics (bifidobacteria) like kefir, yogurt and kombucha.

2. Exercise 

Do some exercise in a gym where you combine a treadmill for 30 minutes with 25 minutes of weight machines for strength training. Aim for doing this 5 times per week. But it would be more beneficial doing it every day. Have additional activity bursts on and off during the day. Exercise has been shown to increase HDL cholesterol, which protects from heart attacks and strokes.

3. Stress management

Supplements like adaptogens help the adrenal gland to better cope with stress. These are available through your health food store. Meditation, yoga, self-hypnosis will all help to refocus and protect you from stress. B-complex vitamins and vitamin C strengthen your immune system and give you more energy. Building and maintaining community is another factor in reducing stress.

4. Establishing healthy sleep

Many postmenopausal women have poor sleep habits, partially from hot flashes (due to estrogen deficiency), partially from melatonin deficiency and also from progesterone deficiency. In the next section I will describe how to normalize these hormones. But in addition you need to educate yourself to go to bed between 10 PM and 11 PM every night and to sleep 7 to 8 hours. If you go to bed later, you will disturb your diurnal hormone rhythm and this will interfere with a normal sleep pattern. There is an age-related reduction of melatonin production in the pineal gland. This is why many postmenopausal women are deficient in melatonin. You may need 3 mg of melatonin at bedtime. If you wake up in the middle of the night you could take another 3 mg of melatonin. You may experience a few nightmares as a side effect; otherwise melatonin is very well tolerated.

5. Bioidentical hormone replacement

The complex hormone deficiencies described above are responsible for the many symptoms of menopausal women including weight gain. It is important to work with a knowledgeable health care provider who knows how to prescribe bioidentical hormones. Typically blood tests and possible saliva hormone tests are done before replacement. This establishes which hormones have to be replaced. Typically bioidentical progesterone is replaced first. Secondly, estrogen is added as Bi-Est cream, if blood levels indicate that it is low. If thyroid is required because of a high TSH level (meaning hypothyroidism) supplementation with Armour or a similar balanced T3/T4 combination is started. If fasting insulin levels are high, the doctor may want to start metformin as this is known to normalize insulin resistance. Blood tests have to be repeated from time to time to ensure adequate hormone levels.

6. Supplements

Every woman treated will likely require different supplements. But magnesium is one mineral that is often missing in the diet. 250 mg of magnesium twice a day will be enough for most women and men to balance internal metabolic reactions. Magnesium is a co-factor to many enzyme systems. Vitamin K2 (200 micrograms daily) and vitamin D3 (around 4000 to 5000 IU per day) in combination are important to prevent osteoporosis. Apart from these there are many options to take other supplements. Ask your healthcare provider what you should take.

Weight Gain In Menopause

Weight Gain In Menopause

Conclusion

This was a fast review of what Dr. Taz explained in a talk about weight gain in menopause. There are complex hormone changes that need to be addressed. Patients with menopause need to follow a well-balanced diet like the Mediterranean diet. Stress management skills need to be learnt. A regular exercise routine needs to be followed. Healthy sleep patterns have to be reestablished. And missing hormones need to be replaced not in synthetic forms, which are toxic to the body, but in the bioidentical forms. Postmenopausal women will feel better when this comprehensive treatment program is in place; and in time they will feel normal again.

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Dec
17
2016

Magnesium Is Essential To Life

Magnesium is an important co-factor in many biochemical reactions, so magnesium is essential to life.

Many diverse diseases and cancers can develop from magnesium deficiency. The key is to supplement with magnesium regularly to get more than the government recommended daily allowance (RDA). The RDA for magnesium is 420 mg a day for males and 320 mg a day for females.

In the following I will review the diseases that occur without enough magnesium on board.

A lack of magnesium can cause heart disease

In this 2014 study 7216 men and women aged 55-80 with at high risk for heart attacks were followed for 4.8 years. The risk of death from a heart attack was found to be 34% lower in the high tertile magnesium group when compared to the lower magnesium tertile group.

The protective mechanism of magnesium was found to be as follows. Magnesium counteracts calcium and stabilizes heart rhythms. Magnesium helps to maintain regular heart beats and prevents irregular heart beats (arrhythmias). It also prevents the accumulation of calcium in the coronary artery walls. This in turn is known to lower the risk of heart attacks and strokes.

Another study, which was part of the Framingham Heart Study, examined calcification of the heart vessels and the aorta as a function of magnesium intake.

There were 2,695 participants in this study. For each increase of 50 mg of magnesium per day there was a 22% decrease in calcification of the coronary arteries. For the same increase of magnesium the calcification of the body’s main artery, the aorta, fell by 12%. Those with the highest magnesium intake were 58% less likely to have calcifications in their coronary arteries. At the same time they were 34% less likely to have calcifications of the aorta.

In a Korean study a group with low magnesium levels was at a 2.1-fold higher risk of developing coronary artery calcifications compared to a group with normal magnesium levels.

Low magnesium increases your stroke risk

In a 2015 study 4443 subjects, men and women aged 40-75 were followed along.

928 stroke cases developed. The researchers compared the group with the highest 30% of magnesium intake with the lowest 10% of magnesium intake. They had significantly lower blood pressure (7 mm mercury) and lower total cholesterol levels. They also had 41% less strokes than those with low magnesium intake.

In a 2015 study that lasted 24 years the authors investigated 43,000 men.

Those with the highest magnesium supplement had a 26% lower stroke risk. Those with the lowest magnesium intake served as a control.

Among women low magnesium levels were shown to cause 34% more ischemic strokes than in controls.

This study included 32,826 participants in the Nurses’ Health Study. Examiners followed them for 11 years.

It is clear from all these studies that supplementation with magnesium can prevent strokes.

Magnesium protects kidney function

This study examined 13,000 adults for 20 years to see how kidney function was dependent on magnesium levels. Those with the lowest magnesium levels had a 58% higher risk of developing chronic kidney disease. It makes sense when you consider that magnesium is necessary to keep arteries healthy, blood pressure low, and blood sugars stable. When diabetics do not control their blood sugars optimally their kidneys develop kidney disease. The term for this is diabetic nephropathy. In the presence of magnesium supplementation and a low sugar diet people are less likely to develop diabetes or kidney disease.

Magnesium helps blood sugar control

A metaanalysis showed that magnesium supplementation was able to improve blood sugar control. This occurred in both diabetics and borderline non-diabetics within 4 months of supplementing with magnesium.

An important factor in helping control blood sugar is magnesium. Here is an article as an example.

Magnesium good for bones and teeth

Magnesium is important for calcium metabolism and this is helping your bones and teeth to stay strong. The bones store half of the body’s magnesium. Another location for magnesium are in our teeth.

Low levels of magnesium lead to osteoporosis, because one of the two structural components of bone (calcium and magnesium) is missing. In addition low magnesium causes inflammatory cytokines to increase. These break down bones. The Women’s Health Initiative showed that when daily magnesium intake exceeded 422.5 mg their hip and whole-body bone mineral density was significantly greater than in those who consumed less than 206.6 mg daily.

With regard to healthy teeth magnesium is important as it prevents periodontal disease.

This study found that there was less tooth loss and there were healthier periodontal tissues in 4290 subjects between 20 and 80.

Those who took magnesium supplements had healthier teeth.

Migraine sufferers improve with magnesium

A double blind randomized study showed that magnesium supplementation can reduce migraines. The researchers in this trial used 600 mg of magnesium supplementation for 4 weeks.

This reduced migraines by 41.6% in the magnesium group compared to the non-supplemented control group.

Another study showed that both intravenous and oral magnesium are effective in reducing migraine headaches.

Intravenous magnesium showed effects on improving migraines within 15 – 45 minutes. The authors concluded that one could supplement other migraine treatments with both oral and intravenous magnesium.

Too little magnesium can cause cancer

It may surprise you to hear that magnesium can even prevent some cancers. Two cancers have been studied in detail. I will limit my discussion to these two.

Pancreatic cancer

One study found that pancreatic cancer was reduced. Researchers recruited 142,203 men and 334,999 women between 1992 and 2000 and included them in the study. After 11.3 years on average 396 men and 469 women came down with pancreatic cancer. On the male side they found that when the body mass index (BMI) was greater than 25.0 there was a 21% reduction of pancreatic cancer for every 100 mg of added magnesium per day. There were a lot of smokers on the female side, which interfered with the study as confounding factors undermined statistical validity.

In another study, the US male Health Professionals Follow-up Study was examined after 20 years of follow-up. Those with a BMI of above 25.0 on magnesium supplementation had a reduced risk of pancreatic cancer. The pancreatic cancer rate in the higher magnesium group was 33% lower than in the lower magnesium group. The higher group consumed 423 mg of magnesium daily, the lower group 281 mg per day. It is significant that in both studies it was the heavier patients who came down with pancreatic cancer. It is common knowledge that obesity is a pancreatic risk factor.

Colorectal cancer

A study done on Japanese men showed that magnesium could protect them significantly from colon cancer.

Men who consumed the highest amount of magnesium developed 52% less colon cancer over 7.9 years. Researchers compared them to the group with the lowest 20% intake of magnesium. The women in this study did not reach statistical significance.

A study from the Netherlands examined colon cancer in patients. They found that only in patients with a BMI of greater than 25.0 magnesium did have protective effects. For every 100 mg of magnesium per day increase there was a 19% reduction of colon polyps. And there was also a 12% reduction of colorectal cancer for every 100 mg increase of magnesium per day.

Magnesium plays an important role in genome stability, DNA maintenance and repair. It also prevents chronic inflammation and reduces insulin resistance, all factors contributing to cancer reduction.

Live longer with magnesium

Consider that magnesium is the fourth most common mineral in the body. Add to this that magnesium is a co-factor of more than 300 enzymes in the body. Magnesium is an important co-factor in the conversion of chemical energy from food that we ingest. Magnesium is regulating blood sugar, blood vessel health and our brain electrical activity. 50% of our stored magnesium is located in our bones, which helps the strength and integrity of them.

Because of the distribution of the enzymes to which magnesium is a co-factor, virtually every cell in the body depends on our regular intake of magnesium.

Magnesium deficiency develops in older age

Since the 1950’s soils have lost magnesium where farmers grow vegetables and raise fruit trees. We simply do not get enough magnesium from food.

But chelated magnesium is freely available in health food stores. Take 250 mg twice per day, and you will have enough.

Because our metabolism slows down, there is a critical age where magnesium deficiency becomes more obvious than when we are younger. By the age of 70 there are 80% of men and 70% of women who do not get the minimum of magnesium-required amount they should get (350 mg for men and 265 mg for women).

Proton pump inhibitors lowering magnesium levels

At this age many people are on multiple drugs. For many proton pump inhibitors (PPI) are used to suppress acid production in the stomach. PPI’s have been associated with low magnesium blood levels. This link explains that when a patient takes PPI’s the total time of taking the medication should not exceed 1 year.

Low magnesium levels accelerate the aging process on a cellular level. Low magnesium levels increase senescent cells that can no longer multiply. Some of them could cause the development of cancer. These senescent cells also can no longer contribute to the immune system. This causes more infections with an adverse outcome.

Remember to take chelated magnesium capsules or tablets 250 mg twice per day and you will be protected from low magnesium levels in your body.

Here is why we live longer with magnesium supplementation

Our blood vessels will not calcify as early; they keep elastic for longer, preventing high blood pressure. Our kidneys will function longer with magnesium, preventing end-stage kidney disease. We need our kidneys to detoxify our system! More than 300 enzymatic reactions all over our body help that we have more energy and also help to prevent cancer. When there are fewer strokes and less heart attacks this helps reduce mortality. Magnesium supplementation helps to lessen the risk for Alzheimer’s disease and also reduces insulin resistance. Researchers have shown that this prevents Alzheimer’s disease.

The bottom line is we live longer and healthier; that is the meaning of longevity.

Magnesium Is Essential To Life

Magnesium Is Essential To Life

Conclusion

Magnesium is a key essential mineral. It balances calcium in the body and participates in many enzymatic reactions in the body as a cofactor. As long as we have enough of this mineral we won’t notice anything. It is with magnesium deficiency that things go haywire. Heart disease or a stroke could affect you . You could get kidney disease. And you could even get pancreatic cancer or colorectal cancer. If this is not enough, magnesium deficiency can cause diabetes, osteoporosis and bad teeth. You may suddenly die with no obvious cause. But, if balance your your magnesium blood level by taking regular supplements, you will carry on living and eliminate a lot of health problems.

Jun
18
2016

High Vitamin D3 Prevents Cancer

In the last few years we learnt a lot about vitamin D3, but the newest thing is that high vitamin D3 prevents cancer.

Researchers at the University of California, San Diego School of Medicine reported that with respect to several cancer types higher doses of vitamin D3 led to less cancer over a period of time.

The cancers investigated were colon cancer, breast cancer, and lung and bladder cancer. People absorb vitamin D3 differently.  The researchers found that the best way to measure vitamin D3 concentration in the body is to use serum 25-hydroxyvitamin D (25(OH)D). In the past people did not pay much attention to this matter. However, several studies including the present study showed that in patients who had a lower level of 20 ng/ml cancer rates were higher.

Comparison of two cohort studies

The researchers used data from two prior studies, a randomized clinical trial of 1,169 women and a prospective cohort study of 1,135 women. The researchers found that the age-adjusted cancer incidence was 1,020 cases per 100,000 person-years in the randomized clinical trial, called “Lappe cohort”. The other prospective cohort study was called the “GrassrootsHealth cohort” where cancer incidence was 722 per 100,000 person-years. The interesting fact was that the Lappe cohort median blood serum level of 25(OH)D was 30 nanograms per milliliter, while the GrassrootsHealth cohort had a higher level of 25(OH)D of 48 ng/ml.

Higher vitamin D levels correlate with lower cancer incidence

This likely explains the lower cancer rate in the GrassrootsHealth cohort. Researchers combined the two trials in order to increase the statistical significance . The striking finding was that above 40 ng/ml the overall cancer risk was more than 71% lower than for the group of people whose level of 25(OH)D was 20 ng/ml or lower. The above ScienceDaily article was based on this scientific study.

Other studies showing high vitamin D3 prevents cancer

AfroAmerican men had less prostate cancer, if vitamin D level was higher

In a 2015 study Afro American men were found to have 71% less prostate cancer, if their serum 25-hydroxyvitamin D level was at least 30 ng/ml or higher.

Prospective study showing high vitamin D levels cancer protective

This 2006 study reported a 14-year prospective follow-up in men where all cancers were counted and blood serum 25-hydroxyvitamin D levels were correlated to cancer incidence. An increase of 25 nmol/L (=10 ng/ml) in predicted serum 25(OH)D level showed an association of a 17% reduction in total cancer incidence, with a 29% reduction in total cancer mortality and a 45% reduction in digestive-system cancer mortality. These investigators stated that it takes about 1500 IU of vitamin D3 increase per day to achieve an increment of serum 25(OH)D increment of 25 nmol/L (=10 ng/ml).

University of Arizona Cancer Center study

A publication from the University of Arizona Cancer Center in Jan. 2016 is more critical of the evidence regarding vitamin D3 and the claim that it lowers cancer rates. The researchers reviewed the cancer literature and found that for colorectal cancer there is a clear inverse relationship between serum 25(OH)D levels on the one hand and rates and mortality of colorectal cancer on the other hand. However, with breast cancer the literature was more divided. Only higher vitamin D levels were related to a lower risk for progression of breast cancer and a lower mortality rate. Randomized, double-blind clinical trials with regard to breast cancer failed to show effectiveness on cancer prevention or reduction of mortality. For prostate cancer conditions were similar with the exception of a study using 4000 IU of vitamin D3 per day, which inhibited progression of prostate cancer.

Mouse model regarding ovarian cancer and vitamin D

In a mouse model using a carcinogen to induce ovarian cancer there was an inverse dose-relationship between vitamin D3 and ovarian tumor development both in tissue culture and in the animal.

How high vitamin D3 prevents cancer

Immune stimulating effect of vitamin D3

Several studies have attempted to speculate how vitamin D3 may prevent cancer. Chirumbolo summarized the literature and noted that vitamin D3 has been shown to function as an immune cytokine stimulating the immune system non-specifically.  Vitamin D3 is also anti-inflammatory and counters insulin resistance and inflammatory kinins in obesity. Flavonoids with their antioxidant activity are also cancer preventing. We know that low levels of vitamin D have an association with higher cancer frequency. This means,. it is important to use vitamin D3 as supplements in our diet.

Chinese study describing action of vitamin D3 in detail

This Chinese study examined the effects of vitamin D3 on cancer prevention. It found that vitamin D3 combines three specific actions in one. Vitamin D3 is anti-proliferative meaning that it stops uncontrolled cell division. Secondly, it has an apoptotic (cell death) effect, which means it supports the removal of cells that are dying. If they are dying, but not removed, cancer can occur from these cell remnants. The third effect of vitamin D3 is that it has differentiating effects in several malignant cell types. When cancer cells are non-differentiated (=more immature cells) cancer can multiply quickly. Mature cells find it more difficult to turn cancerous. This is an effect that controls the speed by which cancer cells divide and how quickly cancer metastasizes.

High Vitamin D3 Prevents Cancer

High Vitamin D3 Prevents Cancer

Conclusion

There still is some confusion about the effects of vitamin D3 regarding cancer prevention. In colorectal cancer the statistics are clear: vitamin D3 can significantly prevent colorectal cancer to a large extent. There are also preventative effects in breast cancer and prostate cancer. But individuals may have to take at least 4000 IU of vitamin D3 or more. This is particularly true in higher latitudes where sunlight exposure is lower in the wintertime. Also, people absorb vitamin D3 differently. For this reason it is important to at least check your serum 25-hydroxyvitamin D levels on a few occasions. This will tell you whether your vitamin D3 supplementation is sufficient. Aim for levels in the 50-80 ng/ml, which is health promoting.

Apart from cancer prevention vitamin D3 is also important for prevention of cardiovascular disease. This is particularly true for diabetes, osteoporosis and Alzheimer’s disease.

May
14
2016

Hormone Replacement Therapy In Menopause

Back in the 1980’s many physicians were hopeful that hormone replacement therapy in menopause (HRT) could extend the lives of postmenopausal women by approximately 10 years, if HRT would be started early enough. But the HERS study (Heart and Estrogen/progestin Replacement Study) in 1998 and the WHI study (Women’s Health Initiative) of 2002 changed things dramatically.

The HERS study did not show any benefit with regard to prevention of heart disease. Instead it showed more gallbladder disease (1.38-fold) and blood clots (2.89-fold) develop in the experimental group versus the placebo.

The WHI study was complex and had several arms. There also were some methodological errors in the study as pointed out here.

Instead of a decrease in heart attacks, there was an increase, when estrogen and progestin was combined. There were more cases of colon cancer, more blood clots and heart attacks in the placebo groups compared to the experimental groups. It seems that something went wrong with these trials.

Unknown facts about hormone replacement therapy in menopause

Premarin is not bioidentical to human estrogens

Both clinical trials used the wrong hormones to do the trials. If you use the wrong hormones in a trial, you would expect to get the wrong test results. Horse derived estrogen (equine estrogen) is hardly a match for bioidentical, human estrogen in women. But decades ago the drug manufacturer had decided that estrogen was easiest to manufacture on a large scale when urine from pregnant mares was used. The product contains conjugated horse estrogen and is known by the name Premarin. Premarin is not bioidentical to human estrogens.

Synthetic progesterone causes heart attacks

The other hormone, medroxy progesterone (MPA) is a progestin, a bad copy of the bioidentical progesterone that a woman’s corpus luteum of one of her ovaries produces. This is in the second half of her menstrual cycle. During pregnancy the placenta produces lots of progesterone to protect the pregnancy. As Dr. Masley, a cardiologist stated synthetic progestins cause heart attacks, while progesterone does not. Masley said: “Medroxy progesterone (MPA) increases the risk for heart disease and for breast cancer. I can’t understand why any physician would recommend medroxy progesterone during menopause, but it is still in use.”

Don’t use estrogen orally, but only by estrogen patch or estrogen cream

Next there is the question whether the liver changes the composition of an oral hormone tablet metabolically or not. The answer is: yes! Dr. Masley stated in the link above that oral estradiol, when compared to estrogen rubbed onto the skin, increases levels of inflammation by 192%. The C-reactive protein (CRP) can be measured with a blood test. The risk for a blood clot increases by 400%. A woman using estrogen should always use the estrogen patch or an estrogen cream with bioidentical estrogen to avoid these complications.

Measure hormones, don’t estimate

Measure hormones – don’t estimate: Hormones are constantly changing and if you don’t measure, you don’t know what you are dealing with. Dr. John Lee showed a long time ago that you should measure hormones and identify those women who are truly hormone deficient. These are the ones who need hormone replacement. However, you use only bioidentical hormones to replace and you replace only as much as is needed to normalize the levels. This is also the level where postmenopausal symptoms disappear. Lee noted: “A 10-year French study of HRT using a low-dose estradiol patch plus oral progesterone shows no increased risk of breast cancer, strokes or heart attacks.”

Measure progesterone hormone levels only in saliva

The elusive progesterone: when the physician measures progesterone as a blood test, it may come back as high while it can be low in a saliva hormone test in the same woman. Dr. Lee has pointed out that studies have shown that progesterone levels in tissue are usually higher by several factors when compared to blood levels and that blood levels are not reliable predictors of tissue levels (Ref.1). On the other hand he found that saliva levels have a good correlation with tissue levels in organs like the ovaries or the uterus. Dr. Lee preferred saliva hormone tests for this reason. When it comes to progesterone levels you can trust saliva test, but you cannot trust blood tests. Many physicians ignore that fact and strictly order blood progesterone levels coming to false conclusions.

Progesterone to estradiol ratio

We know that estrogen and progesterone must be balanced to avoid troubles of developing heart attacks or cancer. The link of Dr. Lee above stated that women without breast cancer have saliva progesterone hormone levels that are more than 200-fold higher than the saliva estradiol levels. On the other hand women with breast cancer have a ratio of less than 200 to 1 with respect to progesterone to estradiol saliva levels. There is a similar ratio in men. Here the ratio of testosterone to estradiol must be larger than 20 to 1. If this is not the case, he is at a higher risk of developing prostate cancer. Unfortunately many older men, when overweight or obese, have high estrogen levels and the ratio is less than 20 to 1.

Bioidentical hormones can prevent heart attacks and stokes

Masley has mentioned that in the first 6 years after menopause using a topical form of estrogen and micronized progesterone as tablets can minimize the risk of future heart attacks and strokes. But after 10 years it is less obvious what is the best solution. The question is what type of estrogen application is used. Is it estradiol or is it Bi-Est or Tri-Est, which are other topical estrogen applications. Tri-Est is 80% estriol, 10% estrone, and 10% estradiol while Bi-Est is 80% estriol and 20% estradiol. Tri-Est in particular would be very close to the natural composition of estrogens in a woman’s body.

What to do after 10 years of hormone replacement therapy in menopause

Given the insecurity what to do after 10 years of menopause, my suspicion is that there are other factors that play a role with respect to hormone replacement. A lot of women have extra pounds accumulated. Fatty tissue contains an enzyme called aromatase.

This makes estrogen from androgenic hormones including testosterone. The adrenal glands situated above the kidneys produce these hormones in menopause. The more overweight or obese a postmenopausal woman is, the higher the estrogen levels in her blood because of the action of the aromatase. Most physicians have not measured hormones in the past, but just replaced hormones monitoring only postmenopausal symptoms. This is changing. What I said under point 4 above is happening more.

Bioidentical hormone replacement practiced by naturopaths

Naturopaths tend to be more comfortable with bioidentical hormone replacement the way I have described it. If you did hormone tests (preferably saliva hormone tests) you would pick up higher estrogen levels and low progesterone levels with unfavorable progesterone to estrogen ratios as mentioned. These women do not need estrogen (they have it already in their systems). They need progesterone replacement only. A woman can take progesterone by mouth as micronized bioidentical progesterone capsules at night. It also  comes as bioidentical progesterone cream for application to the skin. Here is another take on the use of bioidentical hormones.

Hormone Replacement Therapy In Menopause

Hormone Replacement Therapy In Menopause

Conclusion

Bioidentical hormone replacement is complex. It requires some basic knowledge of the facts mentioned above. I find it surprising that two separate research groups could not free themselves of the Big Pharma grip. In not doing so they unwillingly produced studies showing all of the undesirable side effects of using artificial hormones. When manufacturers modify natural hormones with unnatural side-chains, the end products are synthetic hormones. These do not fit the appropriate natural hormone receptors. The anti-aging community as represented by the A4M group (American Academy Of Anti-Aging Medicine) with more than 25,000 physicians worldwide has been saying this all along. Now we know that it is really true. Use hormone replacement knowledgeably and use bioidentical hormones!

References

  1. Dr. John R. Lee: “Natural Progesterone – The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

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May
07
2016

Sun Exposure Helps Many Symptoms

For the past few years it has become evident that sun exposure helps many symptoms. Patients with psoriasis have skin plaques on their skin. With sun exposure some of them disappear and the skin appearance improves. Patients with seasonal affective disorder have worsening of their depression over winter. Depression lifts with more sun exposure in the spring. Even a complicated disease like MS, which is more common in the northern latitudes, improves with sun exposure or a move to the southern states.

Osteoporosis: sun exposure has a positive effect

Osteoporosis was the subject of an April 2016 study from Argentina.

The researchers counted the amount of actinic keratosis lesions on the skin of subjects. This correlated well with lifetime sun exposure. Next they measured the  occurrence of hip fractures from osteoporosis. There was a correlation of the two. This case control study had 51 patients with hip fractures. Controls were 59 patients from the same hospital without hip fractures. The mean age was 80 years of age. 23.5% of patients with a history of hip fractures were observed to have actinic keratoses. In contrast 40.7 % of actinic keratoses were found in controls.

Sun exposure prevents hip fractures

The authors conclude that higher sun exposure is protective of hip fractures, but led to more actinic keratoses. They also stated that higher actinic keratoses rates, which are precancerous skin lesions are a risk for developing skin cancer. It is important to balance risk of osteoporosis from a lack of sun exposure with the risk of skin cancer from overexposure to the sun.

We know that higher doses of vitamin D3 in combination with vitamin K2 and calcium supplementation prevent osteoporosis. Reasonable daily doses are 5,000 to 10,000 IU of vitamin D3 per day, 200 micrograms of vitamin K2 per day and 500mg of calcium daily.

Psoriasis: sun exposure helps many symptoms

Psoriasis is an inflammatory condition of the skin with plaques and a characteristic skin rash. This February 2016 study from Turkey showed significant differences between women with psoriasis versus controls. Bone density studies showed lower levels in psoriatic females than in female controls. Female psoriasis patients had lower vitamin D levels than female controls. Male psoriatic patients showed no difference from controls. Low levels of vitamin D3 may be triggers for osteoporosis to develop in female psoriasis patients. Inflammation may also be a contributory factor. There was an elevation of the C-reactive protein (CRP) in female psoriasis patients.

Clinical observations have shown for years that the rash of psoriasis patients tends to improve during the summer.

Seasonal affective disorder: sun exposure lifts the mood

Seasonal affective disorder (SAD) has been known to respond to light therapy. Typically it peaks in the winter months and presents in mostly females who live far away from the equator. They improve when they travel to a sunny spot such as the subtropics or the southern states of North America during the winter months. But light therapy, vitamin D3, antidepressant therapy and counseling the mood swings of seasonal affective disorder will lessen.

In this 2014 study it was shown that depression in older people was not related to the darker months (between October and March). The summer depression rates in older people were identical to the winter depression rates.

Clinical trials with seasonal affective disorder (SAD) patients

In a group of 38 patients with SAD 14 patients were treated with white light visors, 15 with infrared visors and 9 served as a control (visors, no light). Both white light and infrared treated groups showed prevention of SAD while the control group developed SAD.

A 6-week trial was published March 2015. It involved 78 patients (51 Afro-Americans and 27 Caucasians). They all had SAD and received a treatment with 10,000-lux bright light for 60 min daily in the morning. Caucasians had a response rate of 75%. African-Americans had a response rate of only 46.3%. The investigators found that the symptomatic improvement and the rate of treatment response were the same in both groups. The researchers found that the Afro-American subgroup of patients required more education resources. This can overcome the inconsistent application with the bright light.

Vitamin D trials regarding SAD patients

In a study involving 185 female undergraduates of the Pacific Northwest, vitamin D blood levels were measured and a correlation of low vitamin D with depressive symptoms was found in SAD patients.

In a small study the hypothesis was tested that vitamin D3 in higher doses would be beneficial for SAD patients. Eight subjects received a treatment with 100,000 I.U. of vitamin D3, while seven subjects received phototherapy. All subjects had their vitamin D blood levels checked. Interestingly the vitamin D3 group improved on all depression scales. The phototherapy did not show improvement on the depression scale. The vitamin D level increased 74% in the vitamin D3 group and 36% in the phototherapy group.

Light exposure and vitamin D supplementation for SAD

All of these studies seem to indicate that SAD is more common in a younger population while in older people depression seems to be year-round. SAD does respond very well to 1-hour exposure of 10,000 lux of light in the morning. On a sunny day a walk in the sun for 1 hour is equivalent to an exposure at home with a SAD light. High dose vitamin D3 supplementation makes sense as low vitamin D levels were a persistent finding among SAD depression patients.

Multiple sclerosis: sun exposure makes a difference

Multiple sclerosis (MS) is more common in northern latitudes of the northern hemisphere. It is thought that sun exposure leads to higher vitamin D3 production in the skin, which prevents MS. On the other hand, once the diagnosis of MS is certain sun exposure or high doses of vitamin D3 can make it better.

This 2015 Australian study showed the same findings with a large group of MS patients.

This 2015 study from Sweden indicates that there is a compelling connection of prevention of MS through sun exposure or the taking of supplements of vitamin D3. In view of this evidence the authors suggest that you should take vitamin D3 supplements for prevention of MS before trials confirm this further.

Sun protection needed to prevent skin cancer

We have been hearing the slogan “slip, slop and slap” for skin cancer prevention. Slip, slop and slap stands for: slip on a shirt; slop on the sunscreen and slap on a hat. This publication dated March 2016 questions whether the precautions have been too zealous.

On the other hand the statistics regarding higher precancerous actinic keratoses in patients without osteoporosis are alarming too. It seems better to use high doses of vitamin D3, which will prevent osteoporosis, depression (SAD), MS and also improve psoriasis. Sun protection has decreased skin cancer, but did not curtail melanoma rates because sunscreen lotion can be penetrated by infrared radiation.

Use common sense for skin cancer prevention

This means that you should listen to the advice to stay out of the intense sun between 11AM and 3PM. Use vitamin D3 supplements in higher doses as this protects your skin. Research from England indicates that melanoma patients are usually the ones that are susceptible to melanoma genetically. They also have low vitamin D levels in the blood to a certain degree from skin cancer formation. The researchers recommend strongly that those at risk for melanoma need to be on higher vitamin D3 supplementations. A patient with a diagnosis of melanoma should receive high doses of vitamin D3.

Sun Exposure Helps Many Symptoms

Sun Exposure Helps Many Symptoms

Conclusion

It is not a myth: sun exposure helps many symptoms as explained above. Diverse body systems like osteoporotic bones, psoriatic skin and seasonal affective disorder respond to sun exposure. Sun exposure also prevents MS, a degenerative central nervous system disorder. The effects of vitamin D3 can explain some of this effect. It likely stems from sun exposure to the skin. But sunlight has hormonal effects. This occurs through the optic pathways and connections to the hypothalamus. We know that the sun helps combat many symptoms, but more research will be necessary, till we know exactly how it works.

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Mar
26
2016

Heart Attacks Can Kill

We rarely hear that heart attacks can kill; we are more likely to hear that an ambulance transported a person to the hospital with a heart attack. The doctors placed a stent or two and the person left the hospital two or three days later, fully recovered.

What silent changes occur before a heart attack?

A heart attack does not happen out of nowhere. There can be one or several risk factors present before, like smoking, a lack of exercise, being overweight or obese from eating too much sugar, consuming sugary drinks and eating lots of starchy foods. This will have changed the cholesterol fractions with the bad LDL cholesterol being high and the good HDL cholesterol being low. Triglycerides in this setting are also usually high. The end result is that the lining of the body’s arteries, including the coronary arteries close off to the point where blood has a harder time flowing through the opening of the coronary arteries. One day the heart muscle reports severe pain from a lack of oxygen and nutrients. There are essentially three coronary arteries that supply oxygen and nutrients to the heart muscle. For details follow this link.

Often people have 50% to 60% of coronary artery narrowing, but do not know about this. There are tests available that a person could do to check the amount of hardening of the arteries (for instance the IMT test, see below).

What happens after stent placement?

The interventional cardiologist inserts a catheter from a wrist artery or elbow artery backwards through the aorta and from there into each of the openings of the coronary arteries. By injecting a dye the radiologist can use X-rays to show the condition of each of the coronary arteries. If the physician identifies a blockage, angioplasty can overcome this. With an angioplasty an instrument pierces through the atheromatous deposits and reopens the coronary artery. To prevent re-stenosing, the cardiologist places a wire mesh stent that opens up upon withdrawal of the instrumentation. The end result is that the previous obstruction of the coronary artery is fully functioning again and the stent keeps the coronary artery open. The cardiologist may have to place two or more stents during the same procedure.

A 5-year follow-up study summarized the outcome after stent placements in 1095 patients with 3-vessel coronary artery disease. Percutaneous coronary intervention, a fancy name for saying “angioplasty combined with stent placement” had a 5-year mortality rate of 14.6%, 9.2% heart attack rates and 24.4% reoccurring blockages requiring repeat procedures to reopen the coronary arteries. There were 3% strokes over 5 years demonstrating that not only heart vessels, but also brain vessels were affected by the hardening of the arteries.

What is heart failure?

You may think that the heart would now be entirely back to normal. But this is a gross simplification. The heart functions like a pump, and we know that pumps can fail. In the past when the heart stopped functioning, the person would die. This was the case because there was a complete irreversible closure of one or more coronary arteries. As a result the muscle of one part of the heart, typically involving the left heart chamber would stop functioning. The left anterior descending coronary artery supplies this part of the heart. The left heart chamber is the main pump that pushes blood out into the aorta and from there through the whole body. We need the left anterior descending coronary artery to be open and supply nutrients and oxygen to this vital heart pump all the time.

Ventricular fibrillation and heart attack

When there is a 70% to 80% narrowing of this artery and the heart is not yet failing, there can be life threatening irregular heartbeats. They are called ventricular fibrillation and they come from a lack of oxygen. This makes the heart muscle contractions no longer effective.  as they are no longer synchronized making the heart muscle beat as one unit. This causes acute pump failure and the patients dies. The other possibility is that the patient has a massive heart attack that kills a large portion of the heart muscle off (called myocardial infarction or heart attack). If the patient is not lucky to have immediate access to a hospital with an interventional cardiologist waiting for him or her, even angioplasty and stent placement will not revive the dead portion of the heart muscle and the patient will not survive.

Measuring ejection fraction

Using a echocardiography the ejection fraction can be determined. This is a measure of how well your heart empties with each heartbeat. Normally it would be between 50 and 70. Below 50 indicates that heart failure is present.

Patients who had a mild heart attack may only have an ejection fraction of 40 and get short-winded with mild activity. Other reasons for mild heart failure can be atrial fibrillation. This is  a common chronic condition in older patients where the atrial chamber is not contracting properly, but fibrillating. Another cause can be inadequate treatment of high blood pressure. In this case the heart muscle has a hard time maintaining blood flow against an abnormally high pressure gradient.

Lowered ejection fracture indicating various degrees of heart failure

Many patients who had a heart attack and were quickly treated with angioplasty and stent insertion have had some minor persistent damage to the heart muscle resulting in abnormal echocardiograms with lowered ejection fractions. In the past without the acute intervention they would likely not have survived. Now due to modern medical technology these patients did survive, but they are left with a mild degree of heart failure, as a certain portion of their heart muscle has died off.

What kills the patient with a heart attack?

As explained above, when the heart muscle no longer is able to function as a pump, the patient dies. This can come from irregular heartbeats, particularly ventricular fibrillation that does not respond to emergency treatment with a defibrillator. This is an electrical device that resets  The reason can also be a heart attack that kills a significant part of the heart muscle. Ventricular fibrillation often occurs when not enough oxygen reaches the heart muscle and the special nerves that coordinate that heart muscle fibers to contract as one unit. Regular monitoring of the carotid intimal-medial thickness (IMT) by ultrasound will give a fairly accurate test for coronary artery hardening as the two are closely related.

Elective angioplasty or stent placement

The doctor who has a patient in danger of deterioration can refer the patient to a cardiologist. Angioplasty and stent placement can prevent further deterioration for the time being. It is much safer to do these procedures electively rather than during an emergency when the patient is in distress.

Prevention of heart attacks, any volunteers?

Following the overview above it becomes apparent that prevention to not get heart disease is the best approach with regard to hardening of the arteries. This can be achieved by doing the following:

Adopt a Mediterranean diet

You must abandon the Standard American diet. This means no processed food, no refined sugar intake, avoid as much starchy foods as possible. Adopting a Mediterranean diet or a DASH diet is a first step. The DASH diet was developed to help patients with high blood pressure to reduce their blood pressure through the use of this diet. Reducing blood pressure will also reduce the risk of heart disease.

Avoid excessive alcohol intake

Avoid excessive alcohol intake (more than two drinks per day for men and more than one drink per day for women) as the toxic effect of alcohol kills heart muscle cells. This in turn leads to heart failure.

Regular physical exercise

Regular physical exercise will condition your lungs and heart and improve your cardiac output. By having bigger reserves the person becomes more resilient to developing a heart attack.

Increase your fiber intake

Increasing your fiber intake to 30 to 35 grams per day using vegetables and fruit and additional fiber supplements. Common fiber supplements consist of psyllium husk and/or others from the health food store. Take it in the morning with breakfast and with lunch. By avoiding extra fiber at dinnertime you sleep better at night. It turns out that fiber intake is very important to lower LDL cholesterol and triglycerides by interfering with the enterohepatic pathway that leads to recirculation of bile salts rich in these fatty substances. The net results are lower LDL cholesterol and triglyceride levels and higher HDL cholesterol (the good cholesterol) levels.

Vitamins and supplements

Take some vitamins and supplements. Vitamin B2, B6, B12 and methyl folate will support methylation pathways. Vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2, 200 micrograms per day will remove calcium out of the arteries and transport it into the bones; this effectively prevents hardening of the arteries and prevents osteoporosis at the same time. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control and delay hardening of the arteries; it helps to lower LDL and increase HDL.

Bioidentical hormone replacement

Have your hormones checked. Some doctors do not feel comfortable doing this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles. The essential hormones involved in cardiovascular disease prevention are thyroid hormones, sex hormones and in some aging people also human growth hormone.

Measuring heart function

Once every 2 years it would be good to measure your heart function as is outlined in this blog.

17 causes of blood vessel disease

There are many more factors that have been identified by researchers to contribute to hardening of the arteries.  It is useful to read this and think about which of these factors may apply to your case.

Heart Attacks Can Kill

Heart Attacks Can Kill

Conclusion

I have explained that hardening of the arteries is the cause of heart attacks. This is caused by a multitude of factors including sugar and processed food overconsumption, smoking, excessive alcohol intake, obesity, undertreated high blood pressure and diabetes. Simply doing angioplasties and placing stents will not stop the process of what led to the heart attack in the first place. Almost 15% died within 5 years following those procedures and 9% got another heart attack. They did not change their diets and stayed inactive.

Congestive heart failure can kill

There is another sad aspect about clogging of coronary arteries. The more coronary artery flow we lose through hardening of the coronary arteries, the lower our ejection fraction. This means our heart as a pump is failing more and more. When we reach the point of less than 50% of ejection fraction, we enter disability country. This means clinical heart failure, forcing us to wear continuous oxygen masks and being unable to exercise or walk. Heart failure is as deadly as terminal cancer having a very high mortality rate.

Concentrate on prevention now, because heart disease remains the number one killer. Remember that we can largely prevent heart disease when we follow the steps mentioned above!

More info about heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/